Association between Nutritional Status and Frequency of Respiratory Tract Infections in Children Under Five Years: A Prospective Cohort Study.
DOI:
https://doi.org/10.51168/wgaz2j03Keywords:
Nutritional status, Undernutrition, Respiratory tract infection, Under-five children, Wasting, Stunting, Prospective observational studyAbstract
Background:
Respiratory tract infections are a major cause of morbidity in children under five years, and undernutrition may increase susceptibility by impairing immune defence.
Objectives:
To assess the association between nutritional status and the frequency of respiratory tract infections among children under five years.
Methods:
This hospital-based prospective cohort study was conducted in the Department of Paediatrics at Dr. Pinnamaneni Siddhartha Institute of Medical Sciences & Research Foundation, Andhra Pradesh, from March to August 2025. One hundred consecutive eligible children were enrolled. Nutritional status was assessed using World Health Organization growth standards and categorized as normal, mild-to-moderate undernutrition, or severe undernutrition. Respiratory tract infection episodes were prospectively documented; frequent infection was defined as three or more episodes. Pearson's chi-square test and one-way analysis of variance were used.
Results:
The mean age was 31.6 ± 14.2 months, and 56.0% were male. Nutritional status was normal in 52.0%, mild-to-moderate undernutrition in 34.0%, and severe undernutrition in 14.0%. Frequent respiratory tract infections occurred in 39.0%. Their frequency increased from 15.4% in normally nourished children to 55.9% and 85.7% in the mild-to-moderate and severe undernutrition groups, respectively (χ²(2) = 29.11, p < 0.001). Mean infection episodes also increased across these groups (1.6 ± 0.9, 2.7 ± 1.1, and 4.1 ± 1.3; F(2, 97) = 35.82, p < 0.001). Underweight (χ²(1) = 15.04), wasting (χ²(1) = 15.30), and stunting (χ²(1) = 15.60) were each associated with frequent infection (all p < 0.001).
Conclusion:
Poorer nutritional status was strongly associated with more frequent respiratory tract infections.
Recommendations:
Nutritional screening, growth monitoring, breastfeeding support, immunization review, and early dietary counselling should be integrated into routine paediatric care.
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Copyright (c) 2026 Dr. Nishanth Madala, Dr. Shivananda Polisetty, Dr. Yedupati Lakshmi Prasanna (Author)
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