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Timing of growth faltering in rural Malawi
1Paediatric Research Centre, Tampere University Hospital. kenneth.maleta@uta.fi
Insights
In rural Malawi, children under three experienced height faltering from birth and weight faltering mainly between 3-12 months. These distinct growth patterns suggest different causes requiring further investigation.
Area of Science:
- Pediatrics
- Global Health
- Child Development
Background:
- Growth faltering is a critical indicator of child health and development.
- Understanding the timing of growth faltering is essential for timely interventions.
Purpose of the Study:
- To determine the specific timing of growth faltering in children under three years old in a rural African setting.
Main Methods:
- Prospective population-based cohort study in rural Malawi.
- Regular measurements of weight, height, and mid-upper arm circumference from birth to three years.
- Comparison with international growth references (CDC 2000 and NCHS/WHO).
Main Results:
- Newborns were shorter and lighter than international references.
- Height faltering was evident from birth and persisted for three years.
- Weight faltering predominantly occurred between 3 and 12 months of age.
Conclusions:
- Height and weight faltering exhibit different temporal patterns, suggesting distinct underlying causes.
- Further research is needed to understand the etiology of height faltering.
- Tailored preventive interventions may be required for different types of growth faltering.
Aim:
To determine the timing of growth faltering among under 3 year old children.
Methods:
Prospective population based cohort study in Lungwena, rural Malawi, southeast Africa. A total of 767 live born babies were regularly visited from birth until 3 years of age. Weight, height, and mid upper arm circumference were measured at monthly intervals until 18 months and at three month intervals thereafter. Growth charts were constructed using the LMS method and comparisons made to two international databases: the traditional United States National Center for Health Statistics/World Health Organisation (NCHS/WHO) reference and the recently developed 2000 Centers for Disease Control (CDC) growth reference.
Results:
Compared to the 2000 CDC reference population, newborns in Lungwena were on average 2.5 cm shorter and 510 g lighter. On a population level, height faltering was present at birth and continued throughout the first three years. Weight faltering, on the other hand, occurred mainly between 3 and 12 months of age. At 36 months, the mean weight and height of the study children were 2.3 kg and 10.5 cm lower than those of the reference population, respectively. The results remained essentially similar when the comparisons were made to the NCHS/WHO reference.
Conclusions:
The fact that weight and height faltering do not follow identical time patterns suggests that they may have different origin and determinants. Further studies on the aetiology of height faltering and different approaches to preventive interventions are needed.