Background: Anemia is a major nutritional universal problem of immense public health significance, affecting persons of all ages, sex and economic group. Acute lower respiratory tract infection (ALRTI) is a major cause of death in less than 5 years of age, and anemia is the commonest co-factor in pediatric patients seeking medical advice. There is little contemporary literature outlining the relationship between anemia and lower respiratory tract infection (LRTI) in children especially in our country Nepal. Hence, it was decided to conduct a study to determine the relationship between anemia and ALRTI. The study was to assess anemia as a risk factor for ALRTI in Nepalese children aged from 6 months to 5 years.

Methods: Two hundred children from 6 months to 5 years who attended the outpatient department and those admitted to the ward were included in the study. One hundred children with ALRTI were taken as the study group, and another 100 age- and sex-matched children without ALRTI were taken as the control. The study period was from July 2013 to June 2014. Complete blood count and peripheral blood smear were done in all children. A child with hemoglobin below 11 g% was considered anemic. Serum iron, serum ferritin level and total iron binding capacity were estimated for all anemic children. LRTI cases were diagnosed by WHO criteria. Chest radiographs were taken for all ALRTI cases.

Results: Anemia was found in 72% of cases and 34% of controls. Mean hemoglobin level was 9.2 g% and 11.4 g% in cases and controls respectively with a significant P value of < 0.05. Iron deficiency was found in 86% of total anemic children of study group and 63% children of control group.

Conclusions: Anemic children were found to be 4.99 times more susceptible to ALRTI compared to the non-ALRTI control group, and iron deficiency anemia was predominating. Early diagnosis and management might prevent the occurrence of ALRTI.