Growth and Immune Function in Aboriginal Children during Recovery from Malnutrition and Infection

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Abstract
The clinical, nutritional progress and immunological changes of 30 Aboriginal children admitted to the Alice Springs Hospital with malnutrition and infection, and 11 adequately nourished children admitted with acute infection were studied. The initial toxic phase of infection lasted from six to 21 days during which the mean weight velocity of malnourished children averaged 8·8 g/kg/day. The subsequent period of nutritional rehabilitation was accompanied by a slower weight velocity of 3·7 g/kg/day up to a body weight at discharge of approximately 80% standard weight for age. The principal clinical form of malnutrition was moderate protein calorie malnutrition of marasmic type. All children showed laboratory evidence of persistent immunological stimulation with leukocytosis, elevated numbers of T and B lymphoid cells, raised erythrocyte sedimentation rates and hyperimmunoglobulinaemia. These findings were not significantly changed by short-term antibiotic therapy and nutritional rehabilitation and may indicate an underlying defect resulting in the high rate of reinfection and readmission of these children.