Serum and hair zinc in severely malnourished Bangladeshi children associated with or without acute lower respiratory infection

Objective: To assess the zinc status in Bangladeshi children suffering from severe protein energy malnutrition (severe PEM), acute lower respiratory infection (ALRI), PEM presented with ALRI and to evaluate the relationship of zinc status with aforementioned clinical conditions. Methods: We assessed zinc status by simultaneous estimation of serum and hair zinc of Bangladeshi children less than 5 yr of age suffering from severe PEM, ALRI, severe PEM presented with ALRI and compared them with zinc status of well-nourished healthy children (control) in a hospital based cross sectional four cell study. Zinc concentration was estimated by Flame atomic absorption spectrophotometry. Results: Total one hundred and fifty two children were enrolled and number of children enrolled in severe PEM, ALRI, ALRI with PEM and control were 47, 35, 32 and 38 respectively. Both serum and hair zinc in univariate analysis were found significantly (p<0.05) low in severe PEM, ALRI and severe PEM associated with ALRI. However, in multivariate analysis, when serum and hair zinc were included in the same model, both serum and hair zinc were found to have significant negative association with PEM (p=0.002 & 0.013 respectively) and with ALRI only when ALRI was associated with PEM (p=0.043 and 0.034 respectively). Conclusion: Severe PEM and PEM with ALRI were significantly associated with low zinc status.