Malnutrition as an underlying cause of childhood deaths associated with infectious diseases in developing countries

Introduction Recent estimates suggest that malnutrition (measured as poor a nthropometric status) is associated with about 50% of all deaths among chil dren. Although the association between malnutrition and all-cause mortality is well documented, the malnutrition-related risk of death associated with specific diseases is less well described. We reviewed published literature to examine the evidence for a relation between malnutrition and child mort ality from diarrhoea, acute respiratory illness, malaria and measles, condi tions that account for over 50% of deaths in children worldwide. Methods MEDLINE was searched for suitable review articles and original repo rts of community-based and hospital-based studies. Findings from cohort stu dies and case-control studies were reviewed and summarized. Results The strongest and most consistent relation between malnutrition and an increased risk of death was observed for diarrhoea and acute respirator y infection. the evidence, although limited, also suggests a potentially in creased risk for death from malaria. A less consistent association was obse rved between nutritional status and death from measles. Although some hospi tal-based studies and case-control studies reported an increased risk of mo rtality from measles, few community-based studies reported any association. Discussion The risk of malnutrition-related mortality seems to vary for dif ferent diseases. These findings have important implications for the evaluat ion of nutritional intervention programmes and child survival programmes be ing implemented in settings with different disease profiles.