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Risk factors associated with the recall of a recent episode of acute respiratory infection (ARI) were evaluated in 1,553 Ecuadorian preschool children enrolled into a cross-sectional health and nutrition survey. In a univariate analysis, ARI recall was significantly higher in children living in low altitude regions (Relative Risk, RR = 2.4), in younger children (RR = 1.6), in children from larger families (RR = 1.3), in children with diarrhoea recall (RR = 1.9), in children served with poor quality drinking water (RR = 1.3) and in anaemic children (RR = 1.2) than that in the appropriate control groups. After taking into account the confounding effect of altitude, no association was found between ARI recall and low height-for-age values. Stepwise logistic regression analysis identified living in low altitude regions, diarrhoea recall, and younger age as independent factors associated with a higher recall of ARI. In contrast to the recall of acute diarrhoea, no association between ARI recall and nutritional status was found. The impact of nutritional interventions in children from developing countries may be greater on enteric than on respiratory diseases.

Serum samples from 1,221 Ecuadorian children 0 to 5 years of age and from 236 German subjects were tested by enzyme-linked immunosorbent assay for class-specific antibodies to the capsular polysaccharide of Haemophilus influenzae type b (PRP antigen). A gradual prevalence increase of and mean titer increase in immunoglobulin M (IgM) antibody was seen in Ecuadorian but not in German children older than 6 months. At the end of the first year of life, about 50% of the Ecuadorian children showed IgM and IgG antibody to PRP. Seroepidemiological analysis revealed that living at a low altitude and lower calorie intake (a proxy measure of breast-feeding) were factors associated with earlier acquisition of PRP antibody. Children from low-altitude areas of Ecuador also experienced significantly more episodes of significant respiratory infections. The acquisition of PRP-reactive antibodies in Ecuadorian children might thus reflect exposure to encapsulated H. influenzae type b in lower respiratory tract infections.