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Effects of acute diarrhea on linear growth in Peruvian children
William Checkley1, Leonardo D Epstein, Robert H Gilman
1Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. wcheckle@jhsph.edu
Insights
Diarrhea significantly stunts linear growth in Peruvian children, causing permanent height deficits, especially when occurring in the first six months of life. Controlling childhood diarrhea is crucial for improving child height and development.
Area of Science:
- Pediatrics
- Public Health
- Nutrition
Background:
- Linear growth retardation in childhood leads to short stature and reduced adult capacity in developing nations.
- Childhood diarrhea is a prevalent health issue with potential long-term consequences on physical development.
Purpose of the Study:
- To investigate the impact of diarrhea on linear growth in a Peruvian birth cohort.
- To determine the relationship between diarrheal prevalence, age of onset, and height deficits in children.
Main Methods:
- A birth cohort of 224 Peruvian children was followed for 35 months.
- Data on daily diarrhea incidence and monthly anthropometry were collected.
- Growth deficits were compared against the US National Center for Health Statistics/World Health Organization growth reference.
Main Results:
- Children at 24 months were 2.5 cm shorter than the reference standard, with 2.3% diarrheal prevalence explaining 2-27% of this deficit.
- Height deficits were proportional to diarrheal prevalence; 10% diarrhea led to a 1.5 cm deficit.
- Diarrhea in the first 6 months caused permanent height deficits, while later diarrhea had transient effects.
Conclusions:
- Diarrhea significantly impedes linear growth in Peruvian children, with early-life episodes having lasting impacts.
- Effective diarrhea control, particularly in the first six months of life, is essential for improving childhood linear growth.
- Addressing childhood diarrhea is a critical public health intervention for preventing short stature and associated long-term impairments.
Abstract:
Linear growth retardation during childhood is a determinant of short stature and impaired capacities in adults of developing countries. To study the effect of diarrhea on height during childhood, the authors followed a birth cohort of 224 Peruvian children for 35 months with records of daily diarrhea and monthly anthropometry. This study was conducted from April 1995 to December 1998. At 24 months of age, study children were 2.5 cm shorter than the US National Center for Health Statistics/World Health Organization growth reference. A diarrheal prevalence of 2.3% in the first 24 months of life explained 2-27% of this growth deficit. There was a 2-month delay before the effects of diarrhea on height became manifest. Height deficits were proportional to diarrheal prevalence. For example, children ill with diarrhea 10% of the time during the first 24 months were 1.5 cm shorter than children who never had diarrhea. In addition, the adverse effects of diarrhea on height varied by age. Diarrhea during the first 6 months of life resulted in long-term height deficits that were likely to be permanent. In contrast, diarrhea after 6 months of age showed transient effects. Study results indicate that diarrhea control, especially during the first 6 months of life, is likely to improve linear growth in Peruvian children.