A comparative clinico-epidemiological study of acute respiratory infections and malnutrition in male and female children of central India

Pranav G. Jawade, Neelam D. Sukhsohale, Mohan B. Khamgaonkar, Gayatri G. Jawade, Saurabh P. Aklujkar, Rajkumar K. Dudhe, Aditya S. Bhagwat, Sudarshan S. Lamture, Nishtha P. Khatri, Binish ZA Khan


Background: In developing countries like India and many, some of the most commonly seen and prevalent conditions are the Acute Respiratory Infections (ARI) and Malnutrition in the pediatric age group. It is indeed a necessity of the time to understand the clinic-epidemiological aspects of it and develop an insight, which can help us to assess the ill effects on the child health and strengthen our policy.

Methods: A hospital based cross sectional study was carried out in children aged 0-14 years. Children were clinically assessed and diagnosis was made as URTI or LRTI Also anthropometry was performed and accordingly children were divided into categories of No Malnutrition (NM), Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM) in ‘under 5’ years age children according to WHO guidelines, whereas children aged ‘above 5’ years were categorized as per the IAP guidelines.

Results: On comparing the various socio-demographic aspects and environmental factors the incidence of Acute Respiratory Infections was found to be more or less equal in both male and female study subjects. The Anthropometric parameters were also similar and the difference was statistically insignificant. In Under 5 Age group study subjects incidence of SAM was 42.5% in male children as compared to 33.33% female children. In Above 5 age group study subjects 50% female study subjects were normal as compared to 42.10% male children. The incidence of overcrowding was 54.23% in male study subjects as compared to 70.73% female study subjects and the difference was found to be statistically significant as (P=0.04).

Conclusions: When comparing male and female study subjects the incidence and association of various socio-demographic and environmental factors is more or less similar without any statistically significant difference. However incidence of SAM is slightly higher in males whereas incidence of MAM is slightly higher in females. Also females having overcrowding in their houses are more prone to pneumonia (LRTI) than males.


Acute respiratory infections, Malnutrition, Male, Female, Socio-demographic, Environmental

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Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, et al. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet. 2012;379:2151-61.

Mulholland K. Childhood pneumonia mortality–a permanent global emergency. Lancet. 2007;370:285-9.

Million Death Study Collaborators; Bassani DG, Kumar R, Awasthi S, Morris SK, Paul VK, et al. Causes of neonatal and child mortality in India: a nationally representative mortality survey. Lancet. 2010; 376:1853-60.

World Health Organization: The global burden of disease: 2004 update. Geneva: World Health Organization 2008, Accessed 8 November 2009.

Schroeder DG, Brown KH. Nutritional status as a predictor of child survival: Summarizing the association and quantifying its global impact. Bull World Health Organ. 1994;72:569-79.

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

Broor S, Parveen S, Bharaj P, Prasad VS, Srinivasulu KN, Sumanth KM, et al. A prospective three-year cohort study of the epidemiology and virology of acute respiratory infections of children in rural India. PLoS One. 2007;2:e491.

Gladstone BP, Das AR, Rehman AM, Jaffar S, Estes MK, Muliyil J, et al. Burden of illness in the fi rst 3 years of life in an Indian slum. J Trop Pediatr. 2010;56:221-6.

Gladstone BP, Muliyil JP, Jaff ar S, Wheeler JG, Le Fevre A, Iturriza-Gomara M, et al. Infant morbidity in an Indian slum birth cohort. Arch Dis Child. 2008;93:479-84.

Sarkar R, Sivarathinaswamy P, Thangaraj B, Sindhu KN, Ajjampur SS, Muliyil J, et al. Burden of childhood diseases and malnutrition in a semi-urban slum in southern India. BMC Public Health. 2013;13:87.

Acharya D, Prasanna KS, Nair S, Rao RS. Acute respiratory infections in children: A community based longitudinal study in south India. Indian J Public Health. 2003;47:7-13.

Savitha MR, Nandeeshwara SB, Kumar MJ, ul-Haque F, Raju CK. Modifiable risk factors for acute lower respiratory tract infections. Indian J Pediatr. 2007;74:477-82.

Broor S, Pandey RM, Ghosh M, Maitreyi RS, Lodha R, Singhal T, et al. Risk factors for severe acute lower respiratory tract infection underfive children. Indian Pediatr. 2001;38:1361-9.

Krishnan A, Amarchand R, Gupta V, Lafond KE, Suliankatchi RA, Saha S, et al. Epidemiology of acute respiratory infections in children - preliminary results of a cohort in a rural north Indian community. BMC Infect Dis. 2015;15:462.

Duarte DM, Botelho C. Clinical profile in children under five year old with acute respiratory tract Infections. J Pediatr (Rio J). 2000;76(3):207-12.

Lodhi HS, Mahmood-ur-Rehman, Lodhi FS, Wazir S, Taimoor AR, Jadoon H. Assessment of nutritional status of 1-5 year old children in an urban union council of Abbottabad. J Ayub Med Coll Abbottabad. 2010;22(3):124-7.

Macedo SE, Menezes AM, Albernaz E, Post P, Knorst M. Risk factors for acute respiratory disease hospitalization in children under one year of age. Rev Saude Publica. 2007;41(3):351-8.

El-Gilany AH. Acute respiratory infections in primary health care centres in northern Saudi Arabia. East Mediterr Health J. 2000;6(5-6):955-60.

Birdi TJ, Joshi S, Kotian S, Shah S. Possible causes of malnutrition in Melghat, a tribal region of Maharashtra, India. Glob J Health Sci. 2014;6(5):164-73.

Acharya D, Prasanna KS, Nair S, Rao RS. Acute respiratory infections in children: a community based longitudinal study in south India. Indian J Public Health. 2003;47(1):7-13.

Ujunwa F, Ezeonu C. Risk Factors for Acute Respiratory Tract Infections in Under-five Children in Enugu Southeast Nigeria. Ann Med Health Sci Res. 2014;4(1):95-9.

Child mortality from solid-fuel use in India: A nationally-representative case-control study-Child- mortality-from-solid-fuel-use-in-India-2010. pdf. Available from: htt p:// Last accessed on 2013 Mar 11.

National Family Health Survey-3. Mumbai: International Institute of Population Science; 2005-06.

Kapur D, Sharma S, Agarwal KN. Dietary intake and growth pattern of children 9-36 months of age in an urban slum in Delhi. Indian Pediatr. 2005;42:351-6.

Rao VG, Yadav R, Dolla CK, Kumar S, Bhondeley MK, Ukey M. Undernutrition & childhood morbidities among tribal preschool children. Indian J Med Res. 2005;122:43-7.

Bisai S, Bose K, Ghosh A. Nutritional status of Lodha children in a village of Paschim Medinipur district, West Bengal. Indian J Public Health. 2008;52:203-6.

Espié E, Pujol CR, Masferrer M, Saint-Sauveur JF, Urrutia PP, Grais RF. Acute malnutrition and under-5 mortality, northeastern part of India. J Trop Pediatr. 2011;57:389-91.

Raj M, Sundaram KR, Paul M, Deepa AS, Kumar RK. Obesity in Indian children: Time trends and relationship with hypertension. Natl Med J India. 2007;20:288-93.

Van de Poel E, Hosseinpoor AR, Speybroeck N, Van Ourti T, Vega J. Socioeconomic inequality in malnutrition in developing countries. Bull World Health Organ. 2008;86:282-91.

National Family Health Survey-3. Mumbai: International Institute of Population Science; 2005-06.

WHO, UNICEF. Global action plan for prevention and control of pneumonia (GAPP). Geneva; 2008. Available at iles/GAPP3_web.pdf