DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20192029

Plasma zinc levels in normal and malnourished children with lower respiratory tract infection from 2 months to 5 years of age

Dinesk Kumar E., Thumjaa Annamalai, Shafath Ahmed M., Sundari S.

Abstract


Background: Acute Lower Respiratory Tract Infection (ALRI) is an important cause of morbidity and mortality in the developing world. Pneumonia is a severe form of ALRI that cause over 2 million deaths annually among children younger than 5 years of age. About 19% of all deaths, pneumonia is the leading cause of child mortality. Malnutrition is known to be associated with greater intensity of lower respiratory tract infections, higher the frequency of complications, longer episodes of infections. This study is to assess the plasma zinc levels in normal and malnourished children with LRI aged 2 months to 5 years.

Methods: This is a case control study, which was carried out in the Department of Paediatrics, Sree Balaji Medical College and Hospital, the study period is one year from July 2016 to July 2017. 100 children between 2 months to 5 years of age with LRI was included in the study and children less than 2 months and more than 5 years. 50 Children with normal nutrition were taken as controls and 50 children with moderate and severe malnutrition were taken as cases. Age and sex were matched among cases and controls. Blood samples were collected for zinc estimation in both the cases and controls. All children were investigated and treated as per the department protocol for the particular condition. All statistical procedures were performed using SPSS v 21.0.

Results: In present study, 66% of children had normal zinc levels, 34% of children had low zinc levels. The mean zinc level in our cases was 54.84±18.31 and in controls was 76.84±15.2, which was statistically significant (p = 0.000). Mean plasma zinc levels with respect to age and sex were not significant.

Conclusions: Total 34% of children with LRI had low plasma zinc levels. Plasma zinc level were significantly low in malnourished children than normally nourished children with LRI, which is one of the most important cause of high childhood mortality in developing countries.


Keywords


Lower respiratory tract infection, Malnutrition, Plasma zinc level

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References


Reddy MLN, Hedge S, Sadashiv. A study of nutritional risk factors and plasma zinc levels in children with acute lower respiratory infections. Int J Biol Sci. 2014;4(2):117-20.

Rudan I, Boschi-Pinto C, Biloglav Z, Mulholland K, Campbell H. Epidemiology and etiology of childhood pneumonia. Bull World Health Organization. 2008;86:408-16B.

Gordon JE, Chitkara ID, Wyon JB; Weanling Diarrhoea. Am J Med Sci. 1963;245:345-77.

Black RE. Zinc deficiency, infectious disease and mortality in the developing world. J Nutr. 2003;133(5):1485S-9S.

Abodium OA. Summary of workshop on clinical experience of micronutrient deficiency in children 0-5 years in Nigeria delivered at the 39th PANCONF, Lagos 2008:1-64.

Shankar AH, Prasad AS. Zinc and immune function: the biological basis of altered resistance to infection. Am J Clin Nutr. 1998;68(2 Suppl):447S-63S.

International Zinc Nutrition Consultative Group. Assessment of the risk of zinc deficiency in populations and options for its control. Food Nutr Bull. 2004;25:S99-204.

Cuevas LE, Koyanagi AI. Zinc and infection: a review. Ann Tropical Paediatr. 2005;25(3):149-60.

Lunn PG, Northrop-Clewes CA, Downes RM. Intestinal permeability, mucosal injury, and growth faltering in Gambian infants. Lancet. 1991;338(8772):907-10.

Black RE. Zinc deficiency, infectious disease and mortality in the developing world. J Nutr. 2003;133(5):1485S-9S.

Bhutta ZA. The Role of Zinc in Health and Disease-Relevance to Child Health in Developing Countries. J Pakistan Med Assoc. 1997;47:68-73.

Black RE. Therapeutic and preventive effects of zinc on serious childhood infectious diseases in developing countries. Am J Clin Nutr. 1998;68(2):476S-9S.

Roth DE. Caulfield LE, Ezzati M, Black RE. Acute lower respiratory infections in childhood: opportunities for reducing the global burden through nutritional interventions. Bull World Health Organ 2008; 86:356-64.

Hussain A, Saldanha P, Sharma D, Pandita A, Yachha M, Tariq M. Estimation of zinc levels in children with lower respiratory tract infections: a prospective observational study from India. Pediatr Neonatal Nurse Open J. 2016;2(3):91-8.

Rady HI, Rabie WA, Rasslan HA, El Ayadi AA. Blood zinc levels in children hospitalized with pneumonia: a cross sectional study. Egyptian J Chest Dis Tubercul. 2013;62(4):697-700.

Kumar S, Awasthi S, Jain A, Srivastava RC. Blood zinc levels in children hospitalized with severe pneumonia: a case control study. Ind Pediatr. 2004;41(5):486-92.

Arıca S, Arıca V, Dag H, Kaya A, Hatipoglu S, Fenercioglu A, Karatekin G. Serum zinc levels in children of 0–24 months diagnosed with pneumonia admitted to our clinic. Int J Clin Experiment Med. 2011;4(3):227.

Ibraheem RM, Johnson AB, Abdulkarim AA, Biliaminu SA. Serum zinc levels in hospitalized children with acute lower respiratory infections in the north-central region of Nigeria. African Health Sciences. 2014;14(1):136-42.

Panneerselvam R, Marimuthu B. Serum Zinc Level in Children Admitted with Pneumonia at Tertiary Care Children's Hospital. Int J Scientific Study. 2016;4(1):281-3.

Pushpa ML, Memon M. Association of serum zinc level with severe pneumonia in children. Pak J Nutr. 2009;8(12):1873-6.

Ansar Murtuza Hussain, Prakash RM saldanha, Estimation of Zinc levels in children with lower respiratory tract infections: A prosective observational study from India. Pediatr Neoatal Nurs J. 2016;2:91-8.

Singla PN, Chand P, Kumar A, Kachhawaha JS. Serum, zinc and copper levels in children with protein energy malnutrition. Indian J Pediatr. 1996;63(2):199-203.