Effects of infection on growth in Sudanese children

A cohort of 439 infants from poor districts of Greater Khartoum were examined at intervals of 2 weeks from birth to 1 year. At each visit symptoms suggesting infection were recorded--diarrhoea, fever, vomiting and cough or cold. On average 30 per cent of children had episodes of diarrhoea and 40 per cent had episodes of cold or cough in each 4-week period, the incidence being somewhat lower in the first 2 months of life. The average duration of an episode was 5 d. The effect of illness on weight gain was calculated by regressing weight gain against number of days ill. Diarrhoea produced a deficit in weight gain of 32 g per day ill, and cough/cold a deficit of 16.4g per day ill. From these data the overall impact of illness on weight gain was calculated. In the average child between 12 and 24 weeks diarrhoea produced a reduction in growth of 160g, and cough/cold a reduction of 95g. In most periods the frequency of episodes of diarrhoea was not significantly greater in supplemented than in exclusively breast-fed children. In the first 3 months of life episodes of diarrhoea had little effect on weight gain, but thereafter an episode of diarrhoea in any 2-week period reduced the gain in that period to less than 50 per cent of that found in uninfected children. 'Faltering' was defined as a weight increment below -2 s.d. of the reference mean. Diarrhoea did not always lead to faltering, but it seems to have been an initiating factor in some 50 per cent of those children who did falter.(ABSTRACT TRUNCATED AT 250 WORDS)