Prevalence of malnutrition among under-five year old children with acute lower respiratory tract infection hospitalized at Udupi district hospital

Background: Increased incidence and severity of acute lower respiratory tract infection (ALRI) are variably associated with malnutrition. Objectives: We aimed to examine the prevalence of malnutrition in under-five year old hospitalized children with ALRI. Patients and Methods: Children aged from 6 to 60 months, mostly from a low socioeconomic population, admitted with ALRI, were enrolled prospectively. WHO case definition was used for ALRI. The data about the weight, length/height, mid-arm circumference (MAC) in 1-5 year old children and acute respiratory infections (ARI) episodes in the preceding 6 months were collected in addition to demographic characteristics. Nutritional status was assessed using an age independent criteria in the form of ratio of weight (in kilograms multiplied by 100) to the length or height (in centimeter) squared. Results: Among 206 children with ALRI, 21.9% had pneumonia, 55.8% had severe pneumonia and 22.3% had very severe disease. About 85% of the children were younger than 3 years old. Male to female ratio was 1.34:1. The prevalence of malnutrition was seen in 54.9% of the children. MAC was below 13.5 cm in 59.4 %. Severe malnutrition was observed in 68.7% of 3-5 years age group and 59.4% of 1-3 years age group. Severe malnutrition had shown higher percentages among children with pneumonia and severe pneumonia. Severely malnourished children had more ARI episodes in the preceding 6 months although it was not statistically significant (OR 1.22; 95% CI 0.71-2.12; P = 0.47). Conclusions: High prevalence of severe malnutrition and its significant association with increased ALRI in 1-5 year old children highlights the need for strengthened nutrition intervention programs.