REVIEWS OF INFECTIOUS DISEASES. VOL. 12, SUPPLEMENT 8 • NOVEMBER-DECEMBER 1990 © 1990 by The University of Chicago. All rights reserved. 0162-0886/90/1206-0027$02.00
Malnutrition and Acute Respiratory li'act Infections in Filipino Children Thelma E. Tupasi, Nellie V. Mangubat, Ma. Elinor S. Sunico, Dianalyn M. Magdangal, Eileen E. Navarro, Zenaida A. l.eonor, Socorro Lupisan, Felicitas Medalla, and Marilla G. Lucero
From the 1ropical Disease Foundation, Makati Medical Center; and the Research Institute for Tropical Medicine, Department of Health, Manila, Philippines
The synergism between malnutrition and infection has long been recognized. Malnutrition is associated with impaired cellular immune response [1, 2], defects in granulocyte function , diminished complement level, and deficiency of minerals, trace elements, and vitamins , all factors that may predispose to infection and, in turn, may be aggravated by infection. This synergism between malnutrition and infection, in association with inadequate child care practices in the home and insufficient health services in the community, has been considered responsible for Guidelines of the Department of Health on clinical research involving human subjects were followed. Informed consent was obtained from each patient's parent or guardian. Financial support for this research was provided by the U.S. National Academy of Sciences/National Research Council by means of a grant from the office of the Science Advisor, Agency for International Development. Part of the work was undertaken at the Research Institute for lfopical Medicine, Department of Health, during the technical cooperation with the Japan International Cooperation Agency under the leadership of Yoshinori Kaneko. The authors acknowledge the contribution of Stella Gonzales in the anthropometric studies undertaken in the community- and hospital-based populations, the consultatory service of Florentino Solon, the anonymous reviewers whose suggestions assisted us in the preparation of the manuscript, and Nenita Landrito for typing the manuscript. Please address requests for reprints to Dr. Thelma E. Thpasi, lfopical Disease Foundation, Makati Medical Center, Makati, Metro Manila, Philippines.
the high mortality among children in developing countries of the world . While it is generally accepted that diarrhea is an important cause of malnutrition and, conversely, that malnutrition predisposes to diarrhea , the relationship between malnutrition and acute respiratory tract infection (ARI) is not well understood. In a report on a recent hospital-based study , we concluded that malnutrition is an important correlate of mortality among Filipino children with acute lower respiratory tract infection (ALRI). In the present report we have analyzed the impact of malnutrition on ARI-associated morbidity and have further assessed its impact on mortality in Filipino children from a depressed urban community who have ARI.
Subjects and Methods Community-Based Study
Study population. The impact of malnutrition on morbidity among patients with ARI was assessed in a longitudinal study of a cohort of 1,978 children