Interactions of diarrhea, pneumonia, and malnutrition in childhood: recent evidence from developing countries.
Interactions of diarrhea, pneumonia, and malnutrition in childhood: recent evidence from developing countries.
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DOI：
10.1097/qco.0b013e328349287d
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发表时间：
2011-10
影响因子：
3.9
通讯作者：
Moore SR
中科院分区：
文献类型：
--
作者：
Schlaudecker EP;Steinhoff MC;Moore SR
本综述强调了最近在了解低收入和中等收入国家儿童腹泻，肺炎和营养不良之间复杂相互作用方面取得的进展。新的研究与早期的报告相一致，即腹泻和肺炎会损害儿童的生长，而潜在的营养不良是这些疾病的主要危险因素。腹泻的发作可能使营养不良的儿童易患肺炎。其他研究支持母乳喂养和微量营养素补充，以预防和控制腹泻和肺炎。营养不良可能是低收入国家口服轮状病毒疫苗效力降低的部分原因。孕妇接种流感疫苗似乎也能减少胎儿宫内发育迟缓。对婴儿进行肺炎链球菌免疫接种可促进其生长。新的遗传学研究表明，载脂蛋白E或瘦素受体的多态性分别调节儿童腹泻和溶组织内阿米巴感染的风险，从而将两个对脂质代谢重要的基因与肠道感染联系起来。在了解发展中国家营养不良、腹泻和肺炎的恶性循环方面取得了重大进展。今后的挑战将是将这一进展转化为有效和可广泛利用的公共卫生措施。
This review highlights recent progress toward understanding complex interactions between diarrhea, pneumonia, and undernutrition among children in low-income and middle-income countries. New studies parallel earlier reports that diarrhea and pneumonia impair children’s growth and that underlying malnutrition is a major risk factor for these conditions. Episodes of diarrhea may predispose to pneumonia in undernourished children. Additional studies support breastfeeding and micronutrient supplementation for the prevention and control of diarrhea and pneumonia. Malnutrition may partially account for the reduced efficacy of oral rotavirus vaccines in low-income countries. Immunization of pregnant women against influenza also appears to reduce intrauterine growth retardation. Immunization of infants against Streptococcus pneumoniae may improve their growth. New genetic studies indicate that polymorphisms in apolipoprotein E or the leptin receptor modulate children’s risk for diarrhea and Entamoeba histolytica infection, respectively, thereby linking two genes important for lipid metabolism to enteric infections. Significant advances have been made in understanding the vicious cycle of malnutrition, diarrhea, and pneumonia in developing countries. Future challenges will be to translate this progress into effective and widely accessible public health measures.