1. INFECTION-MALNUTRITION INTERACTION CUHAS

2. Malnutrition is primarily due to: 1.An inadequate intake of food (food gap) both in quantity and quality. 2.Infections, particularly diarrhea, measles, intestinal worms and respiratory infections. In fact it is a vicious circle – Infections make malnutrition worse and poor nutrition increases the severity of infectious diseases. 2 INFECTION AND MALNUTRITION

3. Inadequate dietary intake Weight loss Growth flattering Decreased immunity Mucosal damage Appetite loss Nutrient loss Malabsorption Altered metabolism Disease[HIV,TB]: increase in incidence, duration, severity MALNUTRITION CYCLE 3

4. Infection can lead to malnutrition by affecting the food consumption ability, food uptake after digestion and affect the body metabolism. Malnutrition makes children prone to infectious diseases. Under nutrition causes decreased body immunity against infectious agents.

5. GENERAL EFFECTS OF UNDERNUTITION ON IMMUNITY Diminished T-cell help in immune responses dependent on mature CD4 cells„ Delayed Antibody responses to certain Antigen Depressed mucosal IgA and associated Antibody in response to mucosal infections Impaired complement activation„ Impaired Opsonization activity Affect cell mediated and antibody mediated production machinery [Thymic atrophy]

6. EFFECTS OF INFECTION ON NUTRITIONAL STATUS Protein catabolism and negative nitrogen balance and altered priorities for protein anabolism„ Depletion of CHO stores and Increased resting energy metabolism Increased gluconeogenesis„ Peripheral insulin resistance Altered lipid metabolism Trace element (Fe, Cu, Zn) redistribution Increased vitamin utilization and excretion

7. GLOBAL BURDEN OF MALNUTRION AND INFECTIOUS DISEASE AMONG UNDER FIVES