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Growth faltering in childhood related to diarrhea: A longitudinal community based study

Abstract:

Objective: This study aimed to evaluate the association of diarrhea and acute lower respiratory tract infections (ALRI) with growth of preschool children. Design: A longitudinal community-based study over a 12-month period. Children were followed up with thrice-weekly household visits for collection of morbidity data. Every 4 months (round) clinical and anthropometric examinations were performed. At baseline a questionnaire was used to collect socioeconomic family data and environmental household variables. Generalized estimating equation was used in the statistical analysis. The variations in weight-for-age or height-for-age Z-scores in each round were the dependent variables, while the main independent variables were the number of days with diarrhea and ALRI. Setting: Serrinha, located in Northeast Brazil. Subjects: In total, 487 children, aged 6-48 months at baseline, with 1-y complete follow-up. Results: The number of sick days with diarrhea or ALRI was not associated with mean changes in weight-for-age Z-scores. However, the mean of height-for-age Z-scores was found to decrease in those children with 7 or more days of diarrhea (β =-0.0472; P =0.016) but not with 1 or more days of ALRI (β =0.0022; P =0.406) in all rounds of the follow-up period. Conclusion: Results of the study reinforce the concept of diarrhea burden as a major determinant of poor growth in children under 5y of age. Actions targeted to decrease the risk factors for the occurrence of diarrhea may represent an important component of interventions aimed to ensure satisfactory child growth. © 2005 Nature Publishing Group All rights reserved.