CHAIN Publications

The impact of malnutrition on childhood infections

By January 9, 2019 No Comments

Judd L. Walson and James A. Berkley

 

Purpose of review

Almost half of all childhood deaths worldwide occur in children with malnutrition, predominantly in sub- Saharan Africa and South Asia. This review summarizes the mechanisms by which malnutrition and serious infections interact with each other and with children’s environments.

Recent findings

It has become clear that whilst malnutrition results in increased incidence, severity and case fatality of
common infections, risks continue beyond acute episodes resulting in significant postdischarge mortality.
A well established concept of a ‘vicious-cycle’ between nutrition and infection has now evolving to
encompass dysbiosis and pathogen colonization as precursors to infection; enteric dysfunction constituting
malabsorption, dysregulation of nutrients and metabolism, inflammation and bacterial translocation. All of
these interact with a child’s diet and environment. Published trials aiming to break this cycle using
antimicrobial prophylaxis or water, sanitation and hygiene interventions have not demonstrated public
health benefit so far.

Summary
As further trials are planned, key gaps in knowledge can be filled by applying new tools to re-examine old questions relating to immune competence during and after infection events and changes in nutritional status; and how to characterize overt and subclinical infection, intestinal permeability to bacteria and the role of antimicrobial resistance using specific biomarkers.

Keywords
clinical trial, children, colonization, dysbiosis, environmental, growth, malnutrition, mortality, survival,
susceptibility, undernutrition

Full article on: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6037284/

 

 

 

 

 

 

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