|Undernutrition & risk of infections in preschool children|
||Prema Ramachandran & Hema S. Gopalan
||Indian Journal of Medical Research, November 2009, pp 579-583
Body Mass Index (BMI)
||Background & objectives: It is well documented that in preschool children undernutrition is associated with
immune depression and increased risk of infections; infections aggravate undernutrition. Underweight
is the most widely used indicator for assessment of undernutrition for investigating undernutrition and
infection interactions. In India, nearly half the children are stunted and underweight; but majority of
children have appropriate weight for their height and less than a fifth are wasted. The present study was
undertaken to explore which of the five anthropometric indices for assessment of undernutrition (weight
for age, height for age, wasting, BMI for age, and wasting and stunting with low BMI) is associated with
more consistent and higher risk of morbidity due to infection in preschool children.
Methods: The National Family Health Survey-3 (NFHS-3) database provided the following information
in 56,438 preschool children: age, sex, weight, height, infant and young child feeding practices and
morbidity due to infections in the last fortnight. Relative risk (RR) of morbidity due to infections was
computed in infants and children with stunting, underweight, low BMI for age, wasting and stunting
with low BMI (< mean-2SD of WHO 2006 standards).
Results: Comparison of the RR for infections in undernourished children showed that the relative risk of
morbidity due to infections was higher and more consistently seen in children with low BMI and wasting
as compared to stunting or underweight. The small group of children who had stunting with wasting had
the highest relative risk of morbidity due to infection.
Interpretation & conclusions: In Indian preschool children, RR for infection was more consistently
associated with BMI for age and wasting as compared to weight for age and height for age. Low BMI
for age and wasting indicate current energy deficit; early detection and correction of the current energy
deficit might reduce the risk of infection and also enable the child to continue in his/her growth trajectory
for weight and height.