Burden of infection on growth failure

The high prevalence of infections among children living in poor areas of de veloping countries impairs linear growth in these populations. Acute, invas ive infections, which provoke a systemic response (e.g., dysentery and pneu monia), and chronic infections, which affect the host over a sustained peri od (e.g., gut helminth infections), have a substantial effect on linear gro wth. Such infections can diminish linear growth by affecting nutritional st atus. This occurs because infections may decrease food intake, impair nutri ent absorption, cause direct nutrient losses, increase metabolic requiremen ts or catabolic losses of nutrients and, possibly, impair transport of nutr ients to target tissues. In addition, induction of the acute phase response and production of proinflammatory cytokines may directly affect the proces s of bone remodeling that is required for long bone growth. Infection of ce lls directly involved in bone remodeling (osteoclasts or osteoblasts) by sp ecific viruses may also directly affect linear growth. Many interventions a re possible to diminish the effect of infection on growth. Prevention of di sease through sanitation, vector control, promotion of breast-feeding and v accination is crucial. Appropriate treatment of infections (e.g., antibioti cs for pneumonia) as well as supportive nutritional therapy (again includin g breast-feeding) during and after recovery, is also important. Targeted th erapeutic interventions to decrease the prevalence of gut helminth infectio ns may also be appropriate in areas in which such infections are widespread . Such interventions are of public health benefit not only because they red uce the incidence or severity of infections, but also because they decrease the long-term detrimental effect of malnutrition on populations.