Acute lower respiratory infections in childhood: opportunities for reducing the global burden through nutritional interventions.
Inadequate nutrition and acute lower respiratory infection (ALRI) are overlapping and interrelated health problems affecting children in developing countries. Based on a critical review of randomized trials of the effect of nutritional interventions on ALRI morbidity and mortality, we concluded that: (1) zinc supplementation in zinc-deficient populations prevents about one-quarter of episodes of ALRI, which may translate into a modest reduction in ALRI mortality; (2) breastfeeding promotion reduces ALRI morbidity; (3) iron supplementation alone does not reduce ALRI incidence; and (4) vitamin A supplementation beyond the neonatal period does not reduce ALRI incidence or mortality. There was insufficient evidence regarding other potentially beneficial nutritional interventions. For strategies with a strong theoretical rationale and probable operational feasibility, rigorous trials with active clinical case-finding and adequate sample sizes should be undertaken. At present, a reduction in the burden of ALRI can be expected from the continued promotion of breastfeeding and scale-up of zinc supplementation or fortification strategies in target populations.
Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Daniel E
DE
Roth
Laura E
LE
Caulfield
Majid
M
Ezzati
Robert E
RE
Black
D000208:Acute Disease; D001942:Breast Feeding; D002648:Child; D015362:Child Nutrition Disorders / Q000150:complications* / Q000178:diet therapy / Q000401:mortality*; D019587:Dietary Supplements; D014943:Global Health; D006801:Humans; D018977:Micronutrients / Q000008:administration & dosage; D011014:Pneumonia / Q000150:complications; D016032:Randomized Controlled Trials as Topic; D012141:Respiratory Tract Infections / Q000150:complications* / Q000401:mortality / Q000517:prevention & control
D018977:Micronutrients