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Modeling environmental influences on child growth in the MAL-ED cohort study: opportunities and challenges

Stephanie A Richard1, Benjamin J J McCormick1, Mark A Miller1

  • 1Fogarty International Center, National Institutes of Health, Bethesda.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|October 12, 2014
PubMed

Insights

Dietary insufficiency and infections are major causes of poor child growth. The MAL-ED study analyzes risk factors for linear growth faltering in early childhood using advanced methods.

Area of Science:

  • Child Health and Development
  • Nutritional Science
  • Infectious Diseases

Background:

  • Child growth faltering, particularly linear growth, is a significant global health issue in early childhood.
  • While genetics and birth weight are factors, dietary insufficiency and infectious diseases are primary contributors to growth faltering.
  • Understanding these risk factors is crucial for developing effective interventions.

Purpose of the Study:

  • To identify specific risk factors associated with linear growth faltering during the first two years of life.
  • To analyze the complex interplay between enteric infections, malnutrition, and child development.
  • To characterize growth trajectories and their determinants in resource-limited settings.

Main Methods:

  • Utilizing longitudinal growth data from the Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) study.
  • Applying novel statistical methods to analyze nonlinear growth patterns over the first two years of life.
  • Harmonizing protocols across eight diverse, resource-limited settings to ensure data comparability.

Main Results:

  • The study is designed to distinguish key pathways leading to linear growth faltering by examining variability in risk factors and growth outcomes across sites.
  • Expected variability within and between study sites will enable robust analysis of risk factor associations.
  • The methods described allow for the evaluation of both short- and long-term associations between risk factors and growth trajectories.

Conclusions:

  • Accurate characterization of early childhood growth is essential for understanding faltering.
  • Identifying specific risk factors and pathways is critical for targeted public health strategies.
  • The MAL-ED study provides a robust framework for investigating the multifactorial nature of child growth faltering.

Keywords:
MAL-EDdiarrheagrowthmalnutritionstunting

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