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Stephanie A. Richard, Robert E. Black, Robert H. Gilman, Richard L. Guerrant, Gagandeep Kang, Claudio F. Lanata, Kåre Mølbak, Zeba A. Rasmussen, R. Bradley Sack, Palle Valentiner-Branth, William Checkley, for the Childhood Malnutrition and Infection Network, Diarrhea in Early Childhood: Short-term Association With Weight and Long-term Association With Length, American Journal of Epidemiology, Volume 178, Issue 7, 1 October 2013, Pages 1129–1138, https://doi.org/10.1093/aje/kwt094
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Abstract
The short-term association between diarrhea and weight is well-accepted, but the long-term association between diarrhea and growth is less clear. Using data from 7 cohort studies (Peru, 1985–1987; Peru, 1989–1991; Peru, 1995–1998; Brazil, 1989–1998; Guinea-Bissau, 1987–1990; Guinea-Bissau, 1996–1997; and Bangladesh, 1993–1996), we evaluated the lagged relationship between diarrhea and growth in the first 2 years of life. Our analysis included 1,007 children with 597,638 child-days of diarrhea surveillance and 15,629 anthropometric measurements. We calculated the associations between varying diarrhea burdens during lagged 30-day periods and length at 24 months of age. The cumulative association between the average diarrhea burden and length at age 24 months was −0.38 cm (95% confidence interval: −0.59, −0.17). Diarrhea during the 30 days prior to anthropometric measurement was consistently associated with lower weight at most ages, but there was little indication of a short-term association with length. Diarrhea was associated with a small but measurable decrease in linear growth over the long term. These findings support a focus on prevention of diarrhea as part of an overall public health strategy for improving child health and nutrition; however, more research is needed to explore catch-up growth and potential confounders.
