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      Infection and immunoglobulin levels in Sudanese children with severe protein-energy malnutrition.

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          Abstract

          A hospital-based case control study was carried out to determine the pattern of infections and immunoblobulin levels in Sudanese children with severe protein energy malnutrition (PEM). The pre-dietary rehabilitation levels of the three major immunoglobulins (IgG, IgA and IgM) were compared with those of normal controls, and with the levels after dietary rehabilitation. Eighty one children were included in the study: 49 with severe PEM (23 with marasmus, 17 with marasmic - kwashiorkor and 9 with kwashiorkor), 13 with tuberculosis and 19 healthy children as controls. The study showed high incidence of infections, especially pneumonia and gastrointestinal infections in the malnourished children. Of special concern was the high incidence of urinary tract infection: 13 (26.5%) had significant pyuria and 9 of them had positive urine cultures, mainly Escherichia coli. Eight of the malnourished children also had pulmonary TB, and the ESR and Mantoux tests were not helpful in the diagnosis. The Mantoux test was negative in 88.8% of the malnourished group compared to 62.5% in those malnourished with TB. The malnourished groups had significantly higher plasma levels of the 3 immunoglobulins. While the maramic group attained significantly higher levels of IgG and IgA compared to the marasmic -kwashiorkor and kwashiorkor groups, the 3 groups of PEM showed a uniformly higher level of the IgM. After 2 weeks of rehabilitation, the levels of the 3 immunoglobulins showed no significant changes, except for the IgA which significantly decreased in all malnourished and the oedematous groups, and the IgM which increased significantly in the oedematous group.

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          Author and article information

          Journal
          Sudan J Paediatr
          Sudanese journal of paediatrics
          0256-4408
          0256-4408
          2011
          : 11
          : 2
          Affiliations
          [1 ] 1. Department of Paediatrics and Child Health , Faculty of Medicine, University of Khartoum , Sudan.
          [2 ] 2. Department of Biochemistry , Faculty of Medicine, University of Khartoum , Sudan.
          [3 ] 3. The Central Laboratory , Uppsalla University , Sweden.
          Article
          4949832
          27493317
          51bdc9d5-3639-4571-b931-0348b8f25be7
          History

          Sudanese children,Proteinenergy malnutrition,Escherichia coli,Urinary tract infection,Infections,Acute respiratory infection,Tuberculosis,Immunoglobulins,Diarrhoea

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