In spite of projections and plans announced by both politicians and professionals in the last 25 years, protein-energy malnutrition (PEM) continues to be widely prevalent, particularly in Asia and Africa. This is associated with considerable morbidity due to infectious illness. Work during the last 30 years has demonstrated the important pathogenetic role of impaired immune responses in the two-way interaction between malnutrition and infection. Similarly, intrauterine growth retardation (IUGR) resulting from a variety of maternal and fetal factors is associated with impaired immune responses and enhanced susceptibility to infection. Unlike the reversibility of reduced immunity in post-natal PEM, decreased immunity in small-for-gestational-age (SGA) infants is prolonged and may last for months, even years.

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