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Pediatric Infectious Disease Journal:
doi: 10.1097/INF.0b013e31823eed8e
Original Studies

High Prevalence of Acute Respiratory Tract Infections Among Warao Amerindian Children in Venezuela in Relation to Low Immunization Coverage and Chronic Malnutrition

Verhagen, Lilly M. MD*,†; Warris, Adilia MD, PhD†,‡; Hermans, Peter W. M. PhD†,‡; del Nogal, Berenice MD§; de Groot, Ronald MD, PhD†,‡; de Waard, Jacobus H. PhD*

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Abstract

Background: Higher prevalence rates of acute respiratory tract infections (ARTIs) have been described in Australian and Canadian indigenous populations than in nonindigenous age-matched counterparts. Few studies on ARTIs in South American indigenous populations have been published. We performed a cross-sectional survey to describe the prevalence of upper respiratory tract infections and acute lower respiratory tract infections (ALRTIs) and associations with malnutrition and immunization status.

Methods: From December 1, 2009 to May 31, 2010, 487 Warao Amerindian children 0 to 59 months of age living in the Delta Amacuro in Venezuela were included in a cross-sectional survey. Data were obtained through parent questionnaires, vaccination cards, and physical examinations including anthropometric measurements.

Results: Of the 487 children, 47% presented with an ARTI. Of these, 60% had upper respiratory tract infections and 40% were ALRTI. Immunization coverage was low, with only 27% of all children presenting a vaccination card being fully immunized. The prevalence of malnutrition was high (52%), with stunting (height-for-age <−2 standard deviations) being the most frequent presentation affecting 45% of children. ARTI and ALRTI prevalence diminished with increasing age (odds ratio for ALRTI in children 25–59 months of age vs. children younger than 12 months, 0.49; 95% confidence interval, 0.26–0.93). Furthermore, significant differences in ARTI prevalence were seen between villages. No significant associations between immunization status or malnutrition and ARTI or ALRTI prevalence were identified.

Conclusions: A high prevalence of ARTIs and chronic malnutrition in combination with a low immunization status highlights the need for an integrated approach to improve the health status of indigenous Venezuelan children.

© 2012 by Lippincott Williams & Wilkins, Inc.

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