{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T07:08:34Z","timestamp":1787987314480,"version":"build-2784847793"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T00:00:00Z","timestamp":1663891200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Infection is associated with impaired nutritional status, especially for infants younger than 5 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We assessed the impact of infection indicated by both acute phase proteins (APP), C-reactive protein (CRP), and \u03b1-1-acid-glycoprotein (AGP), and as reported by maternal recall on the nutritional status of infants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>A total of 505 pregnant women were enrolled in a nested longitudinal cohort study of vitamin A (VA). Data from 385 children are reported here. The incidence and severity of respiratory infection and diarrhea (previous 14 days) were assessed by maternal recall; infant\/child feeding practices were collected. Infant weight, recumbent length, and heel-prick capillary blood were taken at 9 months postpartum. Indicators of the VA status [retinol binding protein (RBP)], iron status (Hb, ferritin), and subclinical inflammation APP, CRP (&amp;gt;5 mg\/L), and AGP (&amp;gt;1 g\/L) were determined. Impacts of infection on the infant nutritional status were estimated using logistic regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Infection prevalence, based on elevated CRP and AGP levels, was 36.7%. For diarrhea reported symptoms, 42.4% of infants at 9 months had no indication of infection as indicated by CRP and AGP; for acute respiratory reported symptoms, 42.6% had no indication of infection. There was a significant positive association with infection among VA-deficient (RBP &amp;lt; 0.83 \u03bcmol\/L) infants based on maternal reported symptoms but not with iron deficiency (ferritin &amp;lt; 12 \u03bcg\/L). The odds of having infection, based on increased CRP and AGP, in underweight infants was 3.7 times higher (OR: 3.7; 95% CI: 2.3, 4.5;<jats:italic>P<\/jats:italic>= 0.019). Infants with iron deficiency were less likely (OR: 0.40; 95% CI: 0.1, 0.7;<jats:italic>P<\/jats:italic>= 0.001) to have infection based on CRP and AGP, while infants with VA deficiency were five times more likely (OR: 5.06; 95% CI: 3.2, 7.1;<jats:italic>P<\/jats:italic>= 0.0001) to have infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Acute phase proteins are more useful in defining infection in a population than reported symptoms of illness. Not controlling for inflammation in a population while assessing the nutritional status might result in inaccurate prevalence estimation.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnut.2022.921213","type":"journal-article","created":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T05:35:35Z","timestamp":1663911335000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Association between infection and nutritional status among infants in a cohort study of vitamin A in western Kenya"],"prefix":"10.3389","volume":"9","author":[{"given":"Frederick 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