R. SAÇ, F DOĞAN, D. SARAÇOĞLU, M.A. TAŞAR, İ. BOSTANCI, Y. DALLAR

Sosyoekonomik düzeyi düşük çocuklardaki toplum kaynaklı pnömonilerde A vitamini ve çinko düzeyleri

Giriş: Çocukluk çağında pnömoniden korunma önlemleri içinde besinsel faktörler, çinko ve A vitamini desteğinin yapılması, pasif sigara içiminin engellenmesi, sosyoekonomik durumun iyileştirilmesi ve aşılanma bulunmaktadır. Bu çalışmada amaç, toplum kaynaklı pnömoni tanısıyla kliniğimize yatan çocukların besinsel ve sosyal faktörleri araştırmak, serum A vitamini ve çinko düzeylerini belirlemektir. Gereç ve Yöntem: Hastanemiz Çocuk Kliniğine Ocak 2006-Ocak 2007 tarihleri arasında toplum kaynaklı pnömoni teşhisiyle izlenen 60 çocuk, kesitsel olarak çalışmaya alındı. Bulgular: Olguların 30'u (%50) kız, ortalama yaş 3.7±3.6 yıl (min-max:1 ay-14 yıl) idi. Olguların %73.3'ünün sosyoekonomik seviyesi düşüktü. Evde pasif sigara içimi %38.3'ünde mevcuttu ve %33.3'si altı aydan daha kısa süre anne sütü almıştı. Ortalama serum A vitamini düzeyi 1.0±0.5 µmol/L (min-max: 0.2-2.4) ve çinko düzeyi 15.4±5.1 µmol/L (min-max:8.9-31.5) saptandı. Vitamin A 18 (%30) ve çinko 5 (%8.3) olguda düşük bulundu. Vitamin A düşüklüğü ile yeşil sebze ve meyve tüketiminin az olması arasında ilişkili saptandı (p=0.002). Çinko düşüklüğü 0-2 yaş grubundaki çocuklarda saptandı (p=0.01). Olgulardan hiçbirinde malnütrisyon saptanmadı, ancak hastanede yedi günden uzun yatanların ağırlık persentilleri daha düşüktü (p=0.09). Sonuç: Pnömonili çocuklara A vitamini desteği yapılmasını öneriyoruz. Sıfır-iki yaş grubundaki çocukların çinko eksikliği yönünden değerlendirilmesi gerekmektedir. Pasif sigara içimi önlenmeli, anne ve toplum eğitimi üzerinde durulmalıdır.

Vitamin A and zinc levels in socioeconomically disadvantaged children with community-acquired pneumonia

Introduction: Among preventive measures from childhood pneumonia nutritional factors, supplementation zinc and vitamin A, preventing passive smoking, improving socioeconomic conditions and immunization exist. We aimed to determine the nutritional status, investigate social conditions, frequency of vitamin A and zinc deficiencies in children which were hospitalized with the diagnose of community-acquired pneumonia. Materials and Methods: Sixty children, who were hospitalized during January 2006 to January 2007, were included in the study, by cross-sectional method. Results: Thirty (50%) were girls. Mean age was 3.7±3.6 years (min-max: 1 month-14 years). Socioeconomic levels were low in 73.3%, 38.3% were passive smokers and 33.3% were breast-fed less than six months. Mean levels of vitamin A were 1.0±0.5 µmol/L (min-max: 0.20-2.35), and zinc were 15.4±5.1 µmol/L (min-max: 8.9-31.5). Vitamin A levels were low in 18 (30%) and zinc in 5 (8.3%). Low vitamin A levels were associated with inadequate fruit and vegetable consumption (p=0.002). Low zinc levels were seen in 0-2 year group (p=0.01). Malnutrition was not determined in any case. Lower weight and height percentiles were associated with longer hospital stay (p=0.09). Conclusions: Vitamin A supplementation was offered to children with pneumonia. Also, zinc deficiency should be considered in infancy. Passive smoking should be prevented, education of mothers and population is crucial.

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