Micronutriments et infections virales tropicales: un aspect du complexe
pathogene en medecine tropicale. [Micronutrients and tropical viral infections:
one aspect of pathogenic complexity in tropical medicine]
Med Trop (Mars) 1999;59(4 Pt 2):442-8
In tropical zones, uncertain
living conditions, inadequate food intake, and poor medical facilities
enhance unnecessary morbidity and mortality especially involving infants
and young children. In addition to protein-caloric malnutrition, deficiencies
in essential micronutrients have a specific health impact. Such deficiencies
can be the direct cause of disease such as vitamin A deficiency and blindness
or have a promoting effect by compromising immune status and increasing
susceptibility to and severity of infectious diseases especially of viral
origin. The promoting effect of micronutrient deficiency plays
a significant role in measles, rotavirus-related diarrhea, and, to a certain
extent, progression of HIV infection. Several examples are described to
illustrate the relationship between tropical viral infection and micronutrients
including vitamin A, selenium, and various other antioxidants.
These examples highlight the effect of infectious disease on micronutritional
status (vitamin A and measles) and the need to develop reliable, practical
tools to evaluate the relevance and effectiveness of dietary supplementation.
In any case, improving living conditions and health programs such as the
Expanded Vaccination Program are required and illustrate a transverse
approach for prevention of infectious and non-infectious tropical disease.
The relationship between micronutrients and infection is only one aspect
of the multifactorial reality that must be dealt with in tropical medicine.