The Interaction of Infection in Children - Coursework Example

The interaction of nutrition and infection in children Introduction: Nutrition determines the capability of immunity of the body and also its competence against illness. Various researches have proved that undernourished and malnourished individuals have impaired immune responses to a number of disease and infections. The malnutrition in young children significantly increases their mortality and morbidity, largely to infectious disease (Chandra, 1983). The risk of infections has been attributed to many inter-related factors and it is an understood fact that nutritional status of the individual is one of the significant factors. The relationship between the nutrition and infection is synergistic meaning malnutrition reduced the resistance to infection and infection negatively affects the nutritional status of the individual (Brown, 1977). Various qualitative and quantitative researches carried out on children of the developing countries prove that fact that severe malnutrition increases the risks of infectious diseases and consequently results in high mortality rate and debilitating chronic diseases (Brown, 1977). The high prevalence of the infectious diseases in the society affects the children indirectly too through reducing the ability of many of its members to produce or earn their food supply. The children and adults of the areas where the infections are common lack the stamina to be efficient in labor and agriculture. Even the farm animals which are a source of food and earnings are affected by these parasites and infections. It has been intricately observed in the underprivileged societies that the malnutrition along with many other handicapping factors is a significant contributor of infections which in turn produce physiological changes that adversely affects the nutritional status even more (Chandra, 1983). (Adopted from ‘Interaction between Nutrition and infection in the developing world’ by Keith P et al) The interaction of and infection and malnutrition is a two way street as both of the variables impacts each other. Deficiencies in nutrition greatly reduce the capacity of the host to sustain the physical health and resist the consequences of infection. All the infectious diseases, in return have direct adverse effects on the amount and kind of food consumed (Nevin, et all, 1968). The body is unable to defend itself as a result of malnutrition. It keeps the children’s bodies from producing antibodies after they are given vaccines of typhoid and other infectious diseases. The formation of white blood cells is reduced as a consequent of malnutrition and its ability to consume and engulf bacteria is also compromised (Ed Semba and Bloem 2001). The likelihood of infectious organisms entering the body becomes more because the inadequate amounts of vitamin C causes small vessels in the body which bring nutrients to the skin to become fragile; the skin then breaks down more easily, facilitating the entry of infectious organisms (Ed Semba and Bloem 2001). The malnutrition works to increase the body’s exposure to infection and simultaneously decreases the body’s capability to fight the infections. The synergistic relation of the nutrition and the infection results in a loss of appetite in the presence of infections. Additionally substantial amounts of nitrogen are lost in the urine as a result of the breakdown of protein in muscle tissue. The effect of the presence of infection and malnutrition at the same time is greater than the sum of the effects of malnutrition plus the effects of infection. It can be amply explained by the examples of diarrhea, measles and parasitic infestations. Discussion: The micronutrient deficiencies are widespread in the developing countries and are associated with and are causes of many infectious diseases. In children as young as 5 years of age, who live in developing countries, malnutrition has been the cause of more than the 50% of the 10.8 million deaths which are mainly caused by neonatal disorders, measles, pneumonia, malaria and HIV/AIDS and other infectious diseases (Hussey, 2005). Malnutrition and Infection at prenatal and post birth: There are many causes of childhood undernourishment and malnutrition. The first and the foremost is the mother’s under nutrition during pregnancy which leads to intrauterine growth retardation or the premature delivery. The many other reasons includes low energy and protein intake by the child after the birth, it might also include the intake on unclean or non-nutritious food which is low in energy and micronutrient density. The children also suffer undernourishment because of a early displacement of breast milk or dilution of formula. These reasons put the children more prone to the risks of infections including measles, diarrhea, HIV and many others (Keith 2007). The under nutrition and malnutrition badly effect the immune system by impairing its complement activation and diminishing T-cell which helps in immune responses. The nutritional status of the children is also consequently adversely affected due to infections. The many a effects of infection on the nutritional status of the children includes; protein catabolism and negative nitrogen balance, depletion of CHO stores, altered lipid metabolism, increased vitamin utilization and excretion (Keith 2007). The link of nutrition to various infectious diseases: Diarrhea: Diarrhea is one of the leading causes of mortality in children of the developing world. The infections start from eating contaminated foods and from lack of nutritious food. The infection itself does not result in death but the dehydration actually becomes the cause of death. It has been estimated that some 4.6 Million children die from diarrhea every year (Kosek et al 2003). Moreover it was revealed through a study in 1980’s that HIV/aids might have a potential impact on the global burden of diarrhea diseases. Measles: The alarming 180 times higher death rate of children as a result of measles in Mexico in comparison to United States is testament of the Measles being a dire problem of children in the developing countries. This disease further badly affects the immune system that has already been compromised due to malnutrition. The vaccination is of little help to malnourished children. A study was carried out to study the significance of nutritional status of children vaccinated against measles and HIV-1 infection. The sample size was 243 vaccinated children between the ages of 17-41 months from Kampala, Uganda. The results of the study show that the HIV in Ugandan children immunized for measles may indirectly interfere with measles antibody levels by causing malnutrition (Waibale, 1999). Respiratory infections: A survey was carried out in the northeast of Brazil to examine and determine the association between Acute Respiratory Infection (ARI) and malnutrition in children less than 5 year of age. It was found that current and past malnutrition is in fact associated with acute lower respiratory infection does manifest more quickly in the face of malnutrition. It was suggested that through ample decrease in the malnutrition and timely diagnosis can help to improve the children’s health in the developing countries (Cunha, 2001). Another study was carried out in rural Bangladesh to investigate the link between nutritional status, cell-mediated immune status and acute upper respiratory infections (URI) of 696 children aged 0-59 months. The children were further observed for 1 year. The deep study found that Anergic children had 20% higher risk of developing URI than immune-competent children. The study demonstrated that wasting and depressed cell-mediated immunity (CMI), rather than stunting, were associated with the development of URI among rural Bangladeshi children (Zaman et al. 1997). HIV/AIDS infection: One of the many contributors of the children’s horrifying 5.6 Million death rate annually is malnutrition and Severe acute mal nutrition (SAM) is the direct cause of death in an estimated deaths of 2.7 million children (Heikens and Manary 2009). In poverty stricken societies, the food insufficiency, epidemics and infectious diseases go side by side. Severe Acute Mal Nutrition and HIV takes place as a result of food shortage, insecurity and extreme poverty. It indirectly affects the children who are not infected by the socio-economic conditions of their infected care-takers. The study carried out by WHO (Friis 2005) confirmed that micronutrients does in fact play an important role in HIV infections. Similar to other infections, HIV infections work to damage micronutrient status and the intake of nutrient (or lack of it) may also affect HIV transmission, progression and morbidity. Additionally the immunological dysfunctions which are observed in malnourished African children who are indeed negative for HIV infection are quite similar to those seen in HIV-infected children (Enwonwu 2006). The severely HIV infected children as a resultant of immunity due to malnutrition are a challenge for the Africans. In Zambia and Malawi more than half of the admissions to NRUs are HIV infected children with the pitiful 10% hospital mortality rate (Haikens and Manary, 2009). Infections and Oral Health: There are many health related problem prevailing in the African countries which can be associated with under-nutrition and malnutrition. Amongst many other factors, the most recent one is the urbanization of these countries which promote a lifestyle of physical activity, increased consumption of fats and refined carbohydrates as well as abuse of tobacco and alcohol. So it is serious health problem to the Africans who are becoming victims of infections as a result of this lifestyle including inflammatory oral diseases results from inappropriate interaction between microorganisms and the malnourished immune-compromised host (Enwonwu 2004). The less life threatening but alarming nevertheless is the ‘Stunting’ of the Africans children as a result of mal-nutrition. The measurement of the growth i.e. weight and the height is the determinant of the health and nutrition of the infants and the children. The growth assessment comes out to be alarming in most of the African countries where Stunting usually starts ar3-4 months postnatal and continues until about 18-20 months of age. Stunting is the linear growth retardation which is primarily associated with the feeding a locally prepared contaminated weaning foods to an immature infant. The stunting of the children population in African countries of Nigeria and Uganda is as high as 50% which is a very alarming figure (Enwonwu 2004). Conclusion: The Malnutrition and nutritional alterations plays a very vital role in morbidity and mortality of children. It makes them immune deficient to deadly viral infections like diarrhea, respiratory infections, measles and HIV/AIDS infection as it works to compromise their food intake, nutrient absorption, and intermediary metabolism (Feigin 2004). It has been proven through research that the Infection and malnutrition are very intricately linked. Malnutrition is the leading cause of immunodeficiency worldwide which puts the children and adults alike on a far more risk of infectious diseases. The alarming statistics is that, five most deadly infectious diseases are the cause of one-half of all children’s deaths under the age of 5 can be related to under or mal nutrition (Katona 2008). There is a dire need of future research regarding the interactions between infectious disease and nutritional status. It will help in extending the already available knowledge concerning these two major variables (Feigin, 1977). A consensus has yet to be reached regarding the best approach to need iron deficiencies other trace nutrients including the vitamins to amply tackle the infections. The primary health care should fulfill the five basic functions of promotion of food supply, proper nutrition, adequate supply of safe water, family planning, and the prevention of infectious diseases. The interesting fact is that all these five basic functions are either directly or indirectly related to dietary and to nutrition (Enwonwu 2004). It is a known fact that the worldwide magnitude of parasite infection is massive but its extent is still unknown. It has been understood and proved that the parasites lead to malnutrition but the conditions and many other underlying factors needs to be addressed (Berkman 2000). The under developed and many developing countries are enveloped in the devastating problems of hunger and malnutrition. The nutritious status and a competent immune system are perhaps the two most significant determinants of a sound health of the individuals. The turn of the 21st century has brought along with it many new challenges but with the strategic use of the new technologies and political changes, they can be tackled (Spink 1999). With the utilization of the new advanced medical approaches a healthier and more disease‐free, and better‐nourished population can be anticipated. 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