Measles
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]
Malvy D
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. |