Abstract
Micronutrients are essential minerals and vitamins needed for optimal health. There are however conflicting reports about the roles of micronutrients in severity and outcomes of childhood pneumonia. This study aims to determine the socio-demographic and serum micronutrients - Zinc (Zn), Selenium (Se), Vitamins (Vit) A, C and E status of Nigerian children with or without pneumonia and relate these to pneumonia severity and outcome. Children aged two months to 14 years with severe and non-severe pneumonia were recruited with age and sex-matched controls over 12 month period in a Nigerian tertiary health centre. Relevant history and serum micronutrients were compared in the two groups and related to pneumonia severity and length of hospitalisation (LOH). One hundred and forty-four children (72 for each group) were recruited with median (IQR) age 1.6 (0.6 - 4.0) years and fifty-six (38.8%) had severe pneumonia. Pneumonia incidence was associated with undernutrition, inappropriate immunisation and Zn deficiency (p < 0.05). Hypovitaminosis A [60.8(22.2)µg/dl vs. 89.5(34.7)µg/dl; p < 0.001], low serum Zn [71.6(32.5)µg/dl vs. 92.6(24.6)µg/dl; p=0.019] and indoor air pollution (IAP) were associated with pneumonia severity. However, only IAP (OR = 4.529; 95%CI 1.187-17.284; p=0.027) and Zn deficiency (OR=6.144; 95%CI 1.157-32.617; p=0.033) independently predicted severe pneumonia. No significant correlation between serum micronutrients and LOH. Exposure to IAP and low serum micronutrients particularly Zn and Vit A were associated with pneumonia incidence and severity in Nigerian children. Routine micronutrient supplementation may assist to reduce the burden of childhood pneumonia in developing countries.
Highlights
Micronutrients are essential minerals and vitamins needed for optimal health
Major risk factors associated with childhood pneumonia include exposure to indoor air pollution (IAP) – caused by cooking and lighting with biomass fuels like wood and dungs
No significant difference in the age, gender and socioeconomic class, breastfeeding status and exposure to IAP of the children with Community acquired pneumonia (CAP) compared to controls
Summary
Micronutrients are essential minerals and vitamins needed for optimal health. There are conflicting reports about the roles of micronutrients in severity and outcomes of childhood pneumonia. Conclusions: Exposure to IAP and low serum micronutrients Zn and Vit A were associated with pneumonia incidence and severity in Nigerian children. Recent reports by the World Health Organization (WHO) estimated that pneumonia is responsible for over 800,000 under-five deaths representing 15% of global childhood mortality [2]. The majority of these deaths occurred in Low and Middle Income Countries (LMICs) [2]. Others include inadequate breastfeeding and immunisation, overcrowding and childhood undernutrition including micronutrient deficiencies [13] These predisposing factors should be holistically addressed in LMICs to reduce the burden of childhood pneumonia
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