title: Undernutrition in relation to childhood infections: a prospective study in the Sudan.
abstract: 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.
authors.affiliation: Harvard Institute for International Development, Cambridge, MA, USA.
authors.forename: J
authors.initials: J
authors.lastname: Kossmann
authors.forename: P
authors.initials: P
authors.lastname: Nestel
authors.forename: M G
authors.initials: MG
authors.lastname: Herrera
authors.forename: A
authors.initials: A
authors.lastname: El Amin
authors.forename: W W
authors.initials: WW
authors.lastname: Fawzi
mesh_terms: 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
chemical_list: D010919:Placebos