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Review
. 2011 Apr;8(4):1174-205.
doi: 10.3390/ijerph8041174. Epub 2011 Apr 18.

Malnutrition and gastrointestinal and respiratory infections in children: a public health problem

Leonor Rodríguez  1 , Elsa Cervantes, Rocío Ortiz
Affiliations
Review

Malnutrition and gastrointestinal and respiratory infections in children: a public health problem

Leonor Rodríguez et al. Int J Environ Res Public Health. 2011 Apr.

Abstract

Infectious disease is the major cause of morbidity and mortality in developing countries, particularly in children. Increasing evidence suggests that protein-calorie malnutrition is the underlying reason for the increased susceptibility to infections observed in these areas. Moreover, certain infectious diseases also cause malnutrition, which can result in a vicious cycle. Malnutrition and bacterial gastrointestinal and respiratory infections represent a serious public health problem. The increased incidence and severity of infections in malnourished children is largely due to the deterioration of immune function; limited production and/or diminished functional capacity of all cellular components of the immune system have been reported in malnutrition. In this review, we analyze the cyclical relationship between malnutrition, immune response dysfunction, increased susceptibility to infectious disease, and metabolic responses that further alter nutritional status. The consequences of malnutrition are diverse and included: increased susceptibility to infection, impaired child development, increased mortality rate and individuals who come to function in suboptimal ways.

Keywords: gastrointestinal infections; immune response dysfunction; malnourished children; malnutrition; respiratory infections.

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Figures

Figure 1.
Figure 1.
Direct and indirect causes of malnutrition, showing that poverty is the main underlying cause of malnutrition and its determinants. Adapted from Müller and Krawinkel [14].
Figure 2.
Figure 2.
Distribution of 10.5 million deaths among children younger than 5 years of age in all developing countries. Adapted from Benguigui and Stein [28].
Figure 3.
Figure 3.
Relationship between nutrition and infection. Adapted from Brown [37].
Figure 4.
Figure 4.
Protein Energy Malnutrition Increases Prevalence of Infection, Leading to Energy loss for the Individual. Adapted from Schaible et al. [16].
Figure 5.
Figure 5.
Agents pathogens in children with pneumonia and severe malnutrition in developing countries. Adopted from Chisti et al. [130].
See this image and copyright information in PMC

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