Effect of nutrition improvement project on morbidity from infectious diseases in preschool children in Vietnam: comparison with control commune

Objective: To evaluate the effect of a nutrition improvement project based on home garden production and nutrition education on morbidity from acute respiratory infection and diarrhoeal disease in preschool children. Design: The morbidity survey comprised five data collections undertaken by trained interviewers to ascertain the incidence and severity of respiratory infections and the incidence of diarrhoeal disease in children in two communes. Setting: A project commune and a control commune in Vietnam. Subjects: Preschool children to 6 years of age living in the project commune Khai Xuan (average 469 children) and the control commune Ching Cong (average 251 children). Main outcome measures: Differences between the two communes over time in the incidence and severity of respiratory infections and the incidence of diarrhoeal disease. Results: In Khai Xuan there was a significant reduction (P<0.0001) in the incidence of respiratory infections (from 49.5% to 11.2%) and diarrhoeal infections (18.3% to 5.1%); the incidence of pneumonia and severe pneumonia was also significantly reduced (P<0.0001). In Ching Cong there was no significant change in the incidence and severity of respiratory disease nor in the incidence of diarrhoeal disease. Conclusions: These findings emphasise the successful health outcome of a nutrition project based on household food production and nutrition education and the value of evaluating nutrition projects by reference to measurable health outcomes. Key messages Deficiencies of protein energy and a number of micronutrients compromise the immune system and, in many cases, the integrity of epithelial tissues, which lowers defences to pathogenic invasion The implementation of a nutrition project, focusing on household food production and nutrition education, significantly reduced the incidence and severity of acute respiratory infections and the incidence of diarrhoeal disease in preschool children in a rural commune in Vietnam Nutrition improvement should be widely adopted as a strategy for infectious disease control in international and national development programmes, especially in those countries where respiratory and diarrhoeal infections are the major cause of morbidity and mortality in young children