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Title: The duration of diarrhea and fever is associated with growth faltering in rural Malawian children aged 6-18 months

Author
item WEISZ, ARIANA - Washington University
item MEULI, GUS - Washington University
item THAKWALAKWA, CHRISSIE - University Of Malawi
item TREHAN, INDI - Washington University
item MALETA, KENNETH - University Of Malawi
item MANARY, MARK - Children'S Nutrition Research Center (CNRC)

Submitted to: Nutrition Journal
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 3/20/2011
Publication Date: 3/20/2011
Citation: Weisz, A., Meuli, G., Thakwalakwa, C., Trehan, I., Maleta, K., Manary, M. 2011. The duration of diarrhea and fever is associated with growth faltering in rural Malawian children aged 6-18 months. Nutrition Journal. 10(25): 1-4.

Interpretive Summary: Malnutrition and growth faltering in children are major problems in the developing world; infection is known to contribute to both of these conditions. This study explores the interaction between growth faltering and infection by analyzing the relationship between signs of infection – diarrhea, fever, and cough – and growth in children enrolled in a complementary feeding trial in rural Malawi. The study found that greater duration of diarrhea is associated with short stature, and greater duration of fever, diarrhea, and cough are associated with greater reductions in weight. The occurrence of growth faltering in the study, even with complementary feeding, indicates the contribution of infection to poor growth and suggests the importance of treating infection during nutritional intervention.

Technical Abstract: Nutrition support programs that only focus upon better complementary feeding remain an insufficient means of limiting growth faltering in vulnerable populations of children. To determine if symptoms of acute infections correlate with the incidence of growth faltering in rural Malawian children, the associations between fever, diarrhea, and cough with anthropometric measures of stunting, wasting, and underweight were investigated. Data were analyzed from a trial where 209 children were provided with adequate complementary food and followed fortnightly from 6-18 months of age. Linear mixed model analysis was used to test for associations. Diarrheal disease was inversely associated with changes in height-for-age Z-score (HAZ), mid-upper arm circumference Zscore (MUACZ), and weight-for-age Z-score (WAZ). Fever was also inversely associated with changes in MUACZ and WAZ. These results suggest that initiatives to reduce febrile and diarrheal diseases are needed in conjunction with improved complementary feeding to limit growth faltering in rural Malawi.