Undernutrition in relation to childhood infections: a prospective study in the Sudan.
OBJECTIVE
The aim of the study was to examine the relationships between nutritional status and diarrhoea and respiratory infections.


METHODS
Prospective cohort study within the framework of a randomized double-blind placebo-controlled intervention trial.


METHODS
In rural communities in the Khartoum and Gezira regions, in Northern Sudan.


METHODS
28,753 Sudanese pre-school children between 6 months and 6 y old.


METHODS
Relative risks of subsequent diarrhoea and respiratory infections in relation to nutritional status measured by anthropometry (Z-scores of height-for-age (H/A), weight-for-height (W/H), and weight-for-age (W/A), which reflect stunting, wasting and underweight, respectively) were estimated using odds ratios from logistic regression adjusting for various covariates.


RESULTS
H/A, W/H and W/A were significantly and inversely associated with subsequent diarrhoea and febrile diarrhoea (P for trend <0.001) with risks being 2.00 times higher (95% confidence interval, CI (1.64, 2.43)) among children with W/A Z-scores below -4 Z, and 1.75 times higher (95% CI (1.56, 1.96)) among those with a W/A Z-score between -4 and -3 Z compared with children having a W/A Z-score > or =1. Age, gender, region of residence and seasonality modified these associations. Also, febrile cough was inversely associated with W/A and W/H (P<0.03), with risks ranging from 1.41 times higher (95% CI (1.02, 1.97)) to 1.21 times higher (95% CI (1.04, 1.41)) in the group of underweight children with W/A Z-scores below -4 and between -2 and -1 Z, all compared with normally nourished children (> or =-1 Z).


CONCLUSIONS
The reduction of severe but also mild and moderate undernutrition is necessary through nutrition, health and socio-economic improvement in order to prevent morbidity.
Kossmann
J
J
Harvard Institute for International Development, Cambridge, MA, USA.
Nestel
P
P
Herrera
M G
MG
El Amin
A
A
Fawzi
W W
WW
D001835:Body Weight; D001942:Breast Feeding; D002648:Child; D002675:Child, Preschool; D003371:Cough; D003967:Diarrhea / Q000150:complications; D005260:Female; D005334:Fever; D006801:Humans; D007223:Infant; D007239:Infections / Q000150:complications*; D008297:Male; D009748:Nutrition Disorders / Q000150:complications*; D010919:Placebos; D011446:Prospective Studies; D012307:Risk Factors; D012621:Seasons; D013397:Sudan
D010919:Placebos