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Clinical implications of growth monitoring: experiences from Sierra Leone
1Army Medical Services, Republic of Sierra Leone Military Forces, Freetown.
Insights
This study on child growth in Sierra Leone found 17% of children were underweight. Toddlers aged 12-23 months showed the highest rates of weight loss and malnutrition, often linked to dysentery and infections.
Area of Science:
- Pediatrics
- Public Health
- Global Health
Background:
- Child malnutrition remains a significant public health challenge in many low-income countries.
- Understanding growth patterns and associated factors is crucial for effective interventions.
Purpose of the Study:
- To assess the nutritional status of children under five in urban Sierra Leone.
- To identify factors associated with weight loss and poor growth in this population.
Main Methods:
- A 1-month survey of growth records from 877 children attending Under Fives' Clinics.
- Retrospective analysis of 299 episodes of significant weight loss (>2%).
- Correlation of weight status and loss with reported symptoms and age groups.
Main Results:
- Overall, 17% of children were below 80% of reference weight-for-age (RWA).
- Children aged 12-23 months had the highest incidence of being underweight (31%) and experiencing weight loss (32%).
- Respiratory and malarial symptoms were common; dysentery was a key factor in severe weight loss among toddlers. Helminthic infections increased with age.
Conclusions:
- Toddlers (12-23 months) are a vulnerable group requiring targeted nutritional support and management of infections like dysentery.
- Prompt treatment led to recovery, with 75% returning to their growth centile within 6 weeks.
- Integrated management of infections and nutritional monitoring is essential for improving child growth outcomes.
Abstract:
A 1-month survey of the growth records of children attending Under Fives' Clinics in urban Sierra Leone was performed. Current weight for age of all attendees (n = 877) revealed an overall 17 per cent to be less than 80 per cent reference weight for age (RWA). The 0-5-month-old groups had the lowest incidence (8 per cent) less than 80 per cent RWA and the 12-23-month-old had the highest incidence (31 per cent) less than 80 per cent RWA. Episodes of weight loss greater than 2 per cent of previous recorded weight (n = 299) were analysed retrospectively. The peak incidence (32 per cent) of an episode of weight loss was again in the 12-23-month-olds. Overall respiratory and malarial symptoms were associated with the greatest number of episodes. Dysentery was the most important symptom in the 12-23-month-old (other than multifactorial), was associated with severe degrees of weight loss and had the highest incidence of slow progress following treatment. Episodes of weight loss attributed to helminthic infection became increasingly evident with age. Following treatment, 75 per cent of children had returned to their pre-episodic centile within 6 weeks.