Association of Nutritional Status with Severity of Pneumonia in Under-Five Children

Open Access

Abstract

Introduction: Pneumonia remains a major cause of morbidity and mortality among children under five years of age, particularly in low- and middle-income countries. Malnutrition may increase vulnerability to severe respiratory infection by impairing immune function and reducing physiological reserves. This study was conducted to assess the association between nutritional status and the severity of pneumonia among under-five children. Methods & Materials: This cross-sectional observational study was conducted at Department of Paediatrics, South Apollo Medical College & Hospital, Barishal, Bangladesh from January 2025 to December 2025 among 100 children aged 2-59 months diagnosed with pneumonia. Eligible children were enrolled consecutively, with a total sample size of 100. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 26.0. Result: Among 100 under-five children with pneumonia, 61.0% had severe pneumonia. Nutritional deficits were common, with 30.0% underweight, 35.0% stunted, 25.0% wasted, and 45.0% having at least one nutritional deficit. Severe pneumonia occurred in 77.8% of nutritionally deficient children compared with 47.3% of those with normal nutritional status (p=0.007). Severe stunting showed the strongest individual association with severe pneumonia, occurring in 83.3% of severely stunted children compared with 56.1% of those without severe stunting (p=0.032). Conclusion: The study demonstrated a significant association between poor nutritional status and increased pneumonia severity among children under five years of age. Nearly half of the participants had some form of nutritional deficiency, with severe pneumonia occurring more commonly among nutritionally compromised children than those with normal nutritional status. Among the individual nutritional indicators, severe stunting was most strongly associated with severe pneumonia.