Epidemiologic evidence for a potentiating effect of malnutrition on child mortality

Objective. Despite broad agreement that severe malnutrition contributes to child mortality in developing countries and that malnutrition has a physiologically synergistic relationship with morbidity, evidence of an epidemiologic synergism has been lacking. Also, the literature provides conflicting e...

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Bibliographic Details
Published in:American journal of public health (1971) 1993-08, Vol.83 (8), p.1130-1133
Main Authors: Pelletier, D.L, Frongillo, E.A, Habicht, J.P
Format: Article
Language:English
Subjects:
AGE
ANALISIS DE DATOS
ANALYSE DE DONNEES
Anthropometry
Biological and medical sciences
Body Weight
Child mortality
Child, Preschool
Children & youth
Confounding Factors (Epidemiology)
Developing countries
EDAD
ENCUESTAS
ENFANT
ENQUETE
Environment. Living conditions
EPIDEMIOLOGIA
EPIDEMIOLOGIE
Epidemiology
Factors
Humans
Infant
Infant Mortality
LDCs
MALNUTRICION
MALNUTRITION
Medical sciences
MEDICION DEL CUERPO
MENSURATION CORPORELLE
MODELE
MODELOS
Models, Theoretical
Morbidity
MORTALIDAD
MORTALITE
Mortality
NINOS
Nutrition Disorders - mortality
PESO
POIDS
Public health
Public health. Hygiene
Public health. Hygiene-occupational medicine
RIESGO
RISQUE
SINERGISMO
SYNERGIE
Tropical medicine
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Summary:Objective. Despite broad agreement that severe malnutrition contributes to child mortality in developing countries and that malnutrition has a physiologically synergistic relationship with morbidity, evidence of an epidemiologic synergism has been lacking. Also, the literature provides conflicting evidence concerning the existence of elevated mortality among children with mild to moderate malnutrition. A review of published population-based studies of anthropometry-mortality relationships was undertaken to clarify these relationships. Methods. Six studies with the relevant data were reanalyzed to test for synergism and elevated mortality in mild to moderate malnutrition. Results. The results demonstrate that mortality increases exponentially with declining weight for age. This effect is consistent across studies and there is no apparent threshold effect on mortality. The primary difference across studies is in baseline levels of mortality, which determine the quantitative impact of malnutrition on mortality in a population. Conclusions. These results indicate that mild to moderate malnutrition in associated with elevated mortality and that there is an epidemiologic synergism between malnutrition and morbidity. This previously undemonstrated finding has significant implications for child survival policies and research
ISSN:0090-0036
1541-0048
DOI:10.2105/AJPH.83.8.1130