Zaman K, Baqui A H, Yunus M, Sack R B, Bateman O M, Chowdhury H R, Black R E
International Centre for Diarrhoeal Disease Research, Bangladesh.
Eur J Clin Nutr. 1996 May;50(5):309-14.
To investigate the association between nutritional status, cell-mediated immune status and the incidence of acute lower respiratory infections (ALRI).
Community-based longitudinal study.
Three villages in rural Bangladesh at Matlab.
696 children aged 0-59 months were followed up for a year.
Trained field workers visited all children every fourth day and collected morbidity data for the preceding three days by recall. To determine the type and severity of respiratory infections, the field workers physically examined each child reporting a cough. Anthropometric status was determined monthly and cell-mediated immune status by skin tests was assessed at the beginning of the study and thereafter every 3 months.
The incidence of ALRI was 23 episodes per 100 child-years. A total of 73-78% of the children were below -2 z score weight for age, 15-30% were below - 2 z score weight for height, and 68-76% were below -2 z score height for age. In logistic regression models, malnutrition as assessed by weight-for-height status [odds ratio (OR) 0.66, 95% confidence interval (CI) 0.45-0.96, P = 0.03] or weight-for-age status (OR 0.64, 95% CI 0.45-0.92, P = 0.02) was significant predictor of ALRI. Anergic children had a higher risk of ALRI which approached to be statistically significant (OR 1.81, 95% CI 0.92-3.55, P = 0.08).
Improvement of nutritional and cell-mediated immune status in rural Bangladeshi children should reduce the incidence of ALRI.
研究营养状况、细胞介导免疫状态与急性下呼吸道感染（ALRI）发病率之间的关联。
基于社区的纵向研究。
孟加拉国农村Matlab的三个村庄。
对696名年龄在0至59个月的儿童进行了为期一年的随访。
经过培训的现场工作人员每四天探访所有儿童一次，并通过回忆收集前三天的发病数据。为确定呼吸道感染的类型和严重程度，现场工作人员对每例报告咳嗽的儿童进行体格检查。每月测定人体测量状况，并在研究开始时及之后每3个月通过皮肤试验评估细胞介导免疫状态。
ALRI的发病率为每100儿童年23次发作。共有73 - 78%的儿童年龄别体重低于-2 z评分，15 - 30%的儿童身高别体重低于-2 z评分，68 - 76%的儿童年龄别身高低于-2 z评分。在逻辑回归模型中，根据身高别体重状况评估的营养不良（优势比[OR] 0.66，95%置信区间[CI] 0.45 - 0.96，P = 0.03）或年龄别体重状况（OR 0.64，95% CI 0.45 - 0.92，P = 0.02）是ALRI的显著预测因素。无反应性儿童发生ALRI的风险较高，接近具有统计学意义（OR 1.81，95% CI 0.92 - 3.55，P = 0.08）。
改善孟加拉国农村儿童的营养和细胞介导免疫状态应能降低ALRI的发病率。
