Anemia remains one of the most widespread nutritional disorders globally, particularly affecting children in developing countries. According to global estimates, nearly half of preschool-aged children suffer from anemia, primarily due to iron deficiency.

Respiratory infections, especially acute respiratory infections (ARI), are another leading cause of morbidity and mortality in children under five years of age. The interplay between anemia and infections is well established, as anemia can impair immune function, making children more susceptible to infections.

Despite the known association, limited data exist evaluating the correlation between anemia severity and respiratory infections in pediatric populations. This study aims to bridge this gap.

Study Design and Setting A cross-sectional study conducted in the Department of Pediatrics of a tertiary care hospital. Study Population Children aged 6 months to 12 years attending OPD/IPD. Sample Size A total of 200 children were included based on prevalence estimates from previous studies. Inclusion Criteria • Children aged 6 months–12 years • Consent obtained from parents/guardians Exclusion Criteria • Known hematological disorders • Chronic illnesses • Recent blood transfusion Data Collection • Demographic details • Clinical examination • Laboratory investigations (Hemoglobin estimation) Definition of Anemia (WHO Criteria) • Mild: 10–10.9 g/dL • Moderate: 7–9.9 g/dL • Severe: <7 g/dL Diagnosis of Respiratory Infection Based on: • Clinical symptoms (cough, fever, difficulty breathing) • Chest examination • Radiological findings (if required) Statistical Analysis Data analyzed using SPSS software. Chi-square test used for categorical variables. p-value <0.05 considered significant.

Demographic Profile
A total of 200 pediatric patients were included in the study. The mean age of the participants was 5.2 ± 3.1 years. Among them, 55% were males and 45% were females, indicating a slight male predominance in the study population.

Prevalence of Anemia
The overall prevalence of anemia among the study population was found to be 58%. Among these, 22% of children had mild anemia, 28% had moderate anemia, and 8% were classified as having severe anemia based on WHO criteria. Moderate anemia constituted the largest proportion among anemic children.

Respiratory Infections
Respiratory infections were observed in 32% of the study population, highlighting a substantial burden of respiratory morbidity among pediatric patients.

Association Between Anemia and Respiratory Infections
A significantly higher proportion of respiratory infections was noted among anemic children compared to non-anemic children. Specifically, 45% of anemic children had acute respiratory infections, whereas only 14% of non-anemic children were affected. This association was found to be statistically significant (p < 0.001), indicating a strong correlation between anemia and increased susceptibility to respiratory infections.

Severity-wise Association
The prevalence of respiratory infections increased with the severity of anemia. Among children with mild anemia, 28% had respiratory infections. This proportion increased to 48% in those with moderate anemia and further to 65% among children with severe anemia. These findings suggest a dose-response relationship between anemia severity and the risk of respiratory infections.

The present study demonstrates a high prevalence of anemia (58%) among pediatric patients, consistent with findings from previous studies in developing countries. Nutritional deficiencies, especially iron deficiency, remain the primary cause.

The prevalence of respiratory infections (32%) aligns with global pediatric morbidity trends. A significant association was found between anemia and respiratory infections, suggesting compromised immunity in anemic children.

Children with moderate and severe anemia were more prone to recurrent infections, supporting the hypothesis that hemoglobin plays a vital role in immune function and oxygen delivery to tissues.

These findings are comparable with earlier studies that reported increased susceptibility to infections among anemic children.

Anemia is highly prevalent among children and significantly increases the risk of respiratory infections. Strengthening nutritional programs, early screening, and timely management can help reduce pediatric morbidity. Limitations • Single-center study • Cross-sectional design (cannot establish causality) Limited microbiological confirmation

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