Motor and cognitive development is associated with anthropometry and severe zinc deficiency in infants, in rural...

Globally, more than 250 million children under five fail to reach their developmental potential, with malnutrition representing a major contributing factor. In Madagascar, as in many low- and middle-income countries, malnutrition remains a serious public health concern. Although the high prevalence of micronutrient deficiencies, stunting, and wasting is well documented, their consequences for early motor and cognitive development, which can be assessed reliably by six months, are less studied. In 2019, a baseline data collection prior to intervention as part of a randomized controlled trial conducted in the Amparafaravola district assessed 706 children aged 6-7 months. The findings revealed high prevalence of stunting (28.6%), wasting (3.3%), anemia (39.2%), and micronutrient deficiencies (48.7% for thiamine deficiency and 6.2% for severe zinc deficiency for example). Cognitive scores, assessed with the Mullen Scales of Early Learning, were comparable to other vulnerable populations. At six months, cognitive scores were strongly associated with stunting, wasting and severe zinc deficiency (p < 0.01). Associations with other micronutrient indicators, including anemia, low ferritin and vitamin A deficiency, were weaker and not statistically significant. Addressing these challenges requires multisectoral and well-targeted interventions. Therefore, further research is needed to improve our understanding of the longitudinal relationships between nutritional status, health and environmental factors, and cognitive and motor development.