Tupasi T E, Mangubat N V, Sunico M E, Magdangal D M, Navarro E E, Leonor Z A, Lupisan S, Medalla F, Lucero M G
Tropical Disease Foundation, Makati Medical Center, Manila, Philippines.
Rev Infect Dis. 1990 Nov-Dec;12 Suppl 8:S1047-54. doi: 10.1093/clinids/12.supplement_8.s1047.
The impact of malnutrition on morbidity and mortality associated with acute respiratory tract infection (ARI) was studied in Filipino children less than 5 years old. Malnutrition measured by weight-for-age Z-scores of less than -3 SD and less than -2 SD from the National Center for Health Statistics median reference population was associated with the following significant relative risks of morbidity: 1.24 (95% confidence interval [CI] = 1.14, 1.34) and 1.14 (95% CI = 1.08, 1.19), respectively, for ARI; and 1.9 (95% CI = 1.46, 2.39) and 1.2 (95% CI = 1.03, 1.47), respectively, for acute lower respiratory tract infection (ALRI). These risk ratios remained significant when adjusted for age, crowding, and parental smoking. Malnourished children with severe ALRI also had a mortality risk two to three times higher than that of healthy children. This risk remained significant even when adjusted for significant predictors of mortality, including clinical complications, concurrent measles, severe infections, and female gender; and for clinical factors, including extent of pneumonic infiltrates, dehydration, and hepatic enlargement. These findings underscore the importance of nutritional intervention in the control of morbidity and mortality among patients with ARI.
对菲律宾5岁以下儿童进行了研究，以探讨营养不良对急性呼吸道感染（ARI）相关发病率和死亡率的影响。根据美国国家卫生统计中心中位参考人群的年龄别体重Z评分低于-3标准差和低于-2标准差来衡量的营养不良，与以下显著的发病相对风险相关：ARI分别为1.24（95%置信区间[CI]=1.14, 1.34）和1.14（95%CI=1.08, 1.19）；急性下呼吸道感染（ALRI）分别为1.9（95%CI=1.46, 2.39）和1.2（95%CI=1.03, 1.47）。在对年龄、拥挤程度和父母吸烟情况进行调整后，这些风险比仍然显著。患有严重ALRI的营养不良儿童的死亡风险也比健康儿童高出两到三倍。即使在对包括临床并发症、并发麻疹、严重感染和女性性别等死亡率的显著预测因素，以及包括肺部浸润程度、脱水和肝脏肿大等临床因素进行调整后，这种风险仍然显著。这些发现强调了营养干预在控制ARI患者发病率和死亡率方面的重要性。
