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Potential interventions for the prevention of childhood pneumonia in developing countries: improving nutrition^1,2,3

¹ From the Departamento de Medicina Social, Universidade Federal de Pelotas, Pelotas, Brazil; the Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine; the Department of International Health, School of Hygiene and Public Health, The Johns Hopkins University, Baltimore; and Child Health and Development Division, World Health Organization, Geneva.

Acute respiratory infections are the leading cause of childhood death in developing countries. Current efforts at mortality control focus on case management and immunization, but other preventive strategies may have a broader and more sustainable effect. This review, commissioned by the World Health Organization, examines the relations between pneumonia and nutritional factors and estimates the potential effect of nutritional interventions. Low birth weight, malnutrition (as assessed through anthropometry), and lack of breast-feeding appear to be important risk factors for childhood pneumonia, and nutritional interventions may have a sizeable effect in reducing deaths from pneumonia. For all regions except Latin America, interventions to prevent malnutrition and low birth weight look more promising than does breast-feeding promotion. In Latin America, breast-feeding promotion would have an effect similar to that of improving birth weights, whereas interventions to prevent malnutrition are likely to have less of an effect. These findings emphasize the need for tailoring interventions to specific national and even local conditions.

Key Words: Protein-energy malnutrition • birth weight • breast-feeding • pneumonia • respiratory tract infections • children • review • developing countries

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