Nutritional Status and Its Association with the Pattern and Risk of Acute Respiratory Infections among Infants in Rivers State, Nigeria: The Salient Factors and Way Out

Abstract

Nutritional status measures a child’s health, in view of normal growth and development, physical activity and response to serious illness. Acute respiratory infections present diverse risks of clinical conditions among infants of varying nutritional status. The aim was to determine the extent and pattern of relationship between risk of acute respiratory infections (ARI) among infants and nutritional status. The study design was population-based case-control study of 1,100 randomly selected infants from 12 communities in 6 Local Government Areas of the 3 senatorial districts of Rivers State. The subjects were selected using multistage random sampling technique down to the community level. The characteristics of the subjects were represented using descriptive method whereas bivariate logistics regression at 5% level of significance was used to test the differences in ARI between normal nutritional status and some types of malnutritional status. Measures of size effect of ARI on nutritional status disparities were interpreted using odds ratio (OR). Pattern of ARI occurrence among infants with undernutrition status indicated by weight-for-age (15.4%) is higher in rural communities, than in urban communities (13.3%). While the difference in pattern of ARI occurrence among infants with undernutrition status indicated by weight-for-height (11.6%) is higher in urban communities, than in rural communities (9.1%). Overall, infants with underweight (weight at -2SD and below) malnutrition status from weight-for-age and wasting malnutrition status from weight-for-height had higher frequencies of occurrence of ARI, 22.9% and 26.2% respectively than their control subjects of same nutritional status of ARI, 8.7% and 15.6% respectively. Among infants of weight-for-age (≤ - 2SD) undernutrition, the odds for ARI (unadjusted) was 3.09 times higher in significance compared to infants with normal weight-for-age, OR- Unadjusted=3.09 (p<0.0001,95%CI=0.227-0.478), whereas the odds for ARI (adjusted) was a significant risk lower among infants with normal weight-for-age by 70% (OR=0.31, p< 0.0001, 95%CI = 0.201 – 0.475) against infants having underweight malnutrition, while infants of weight-for-height (wasting) malnutrition, the odds for ARI (unadjusted) was 1.89 times higher in significance compared to infants with normal weight-for-height, OR-Unadjusted=1.89, (p<0.0001, 95% CI=0.406-0.786). These findings indicate trend of focus regarding rural and urban communities in the occurrence of ARI among infants based on under-nutritional status to effectively manage the condition, including renewed public health interventions from the prenatal period of life of the child.