Acute lower respiratory infections.pdf

356 Bulletin of the World Health Organization | May 2008, 86 (5) Acute lower respiratory infections in childhood: opportunities for reducing the global burden through nutritional interventions Daniel E Roth,a Laura E Caulfield,a Majid Ezzati b Robert E Black a Abstract Inadequate nutrition and acute lower respiratory infection (ALRI) are overlapping and interrelated health problems affecting children in developing countries. Based on a critical review of randomized trials of the effect of nutritional interventions on ALRI morbidity and mortality, we concluded that: (1) zinc supplementation in zinc-deficient populations prevents about one- quarter of episodes of ALRI, which may translate into a modest reduction in ALRI mortality; (2) breastfeeding promotion reduces ALRI morbidity; (3) iron supplementation alone does not reduce ALRI incidence; and (4) vitamin A supplementation beyond the neonatal period does not reduce ALRI incidence or mortality. There was insufficient evidence regarding other potentially beneficial nutritional interventions. For strategies with a strong theoretical rationale and probable operational feasibility, rigorous trials with active clinical case-finding and adequate sample sizes should be undertaken. At present, a reduction in the burden of ALRI can be expected from the continued promotion of breastfeeding and scale-up of zinc supplementation or fortification strategies in target populations. Bulletin of the World Health Organization 2008;86:356–364. Une traduction en fran?ais de ce résumé figure à la fin de l’article. Al final del artículo se facilita una traducción al espa?ol. ??????? ??????? ???? ??????? ?? ????? ???? ?????? ???? ???????. a Department of International Health, Johns Hopkins University, Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD, United States of America. b Department of Population and International Health and Department of Environmental Health, Harvard School of Public Health, Bost