Urinary secretory immunoglobulin A and malnutrition in children admitted to nutritional rehabilitation wards in Basra

Abstract EN

Objective: A case-control study was carried out to determine urinary secretory IgA level in malnourished children and its relation to selected patients’ variables.

Methods: Eighty two malnourished children who have been admitted to nutritional rehabilitation ward in Basra General Hospital and Basra Maternity and Children Hospital, and ninety apparently healthy children who have visited Primary Health Care Center were recruited in the study, their ages ranged from 1-36 months; from the first of February 2014 till the end of November 2014.

Measurements of weight and length by standard procedure done for all infants and children recruited in the study.

Anthropometric data (weight and length) are applied to WHO growth charts.

All malnourished children were evaluated to exclude functional and anatomical renal abnormalities by estimating blood urea and serum creatinine and abdominal ultrasonography.

As well as urinary secretory IgA was done for all patients and controls after exclusion of urinary tract infection by dipstick test and urine culture.

Results: Regarding age and sex distribution, 54.9% of the malnourished children are females; mostly 6-12 months of age.

All admitted malnourished children are underweight, 97.6% are wasted, and 63.3% are stunted.

Severe wasting, underweight, and stunting are recorded in 87.8%, 92.7%, and 23.1% respectively.

Higher frequency of bottle feeding among malnourished patients, than control group (41.5%, 28.9%) respectively, as well as complementary feeding recorded less frequently in malnourished patients with statistically significant results (p-value=0.037).

The study reveals a statistically significantly low urinary secretory IgA in children with malnutrition than control group, (p-value<0.001).

But there is no significant difference in relation to the severity of nutritional indicators or the age and sex of malnourished children.

Diarrhea, poor weight gain and shortness of breathing are regarded as independent risk factors for low level of urinary secretory IgA.

Conclusions: Because urinary sIgA level reflect the state of mucosal immunity of urinary tract ; so can be used as a marker for assessment of local mucosal immunity of the urinary tract in children with malnutrition