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Morbidity and growth performance of infants in Madura, Indonesia
P W Kolsteren1, J A Kusin, S Kardjati
1Institute of Tropical Medicine, Antwerp, Belgium.
Insights
Infant growth in Indonesia was not linked to illness in the first six months. After six months, acute respiratory infections (ARI) significantly impacted weight gain, but not linear growth.
Area of Science:
- Child Health
- Nutritional Science
- Epidemiology
Background:
- Infant growth and morbidity are critical indicators of child health.
- Understanding the relationship between illness and growth is essential for public health interventions.
Purpose of the Study:
- To analyze the relationship between infant morbidity and growth performance in Indonesian infants.
- To investigate the impact of specific diseases (ARI, diarrhea, fever) on infant growth parameters.
Main Methods:
- Longitudinal study of 1373 infants from birth to 12 months in Madura, Indonesia.
- Weekly interviews with mothers for disease symptoms (max 1-week recall).
- Monthly measurements of infant weight and height.
Main Results:
- No significant relationship between morbidity and linear growth at any age.
- No relationship between morbidity and weight or linear growth in the first 6 months.
- Acute respiratory infections (ARI) showed a significant negative impact on weight increment from 6 months onwards.
- No cumulative effect of disease on overall growth performance was observed.
Conclusions:
- Morbidity, particularly ARI, can affect infant weight gain after 6 months of age.
- Linear growth appears resilient to common childhood illnesses in this population.
- Early life interventions may need to focus on specific disease impacts rather than general morbidity.
Abstract:
Between January 1987 and July 1988, all children born in two villages on the island of Madura, Indonesia were visited weekly by a field worker trained to interview mothers on disease symptoms. The maximum recall period was 1 week. All infants were measured (weight and height) at monthly intervals. Information on growth and morbidity is analysed for infants from birth until the age of 11 months. Morbidity, defined as acute respiratory tract infection (ARI), diarrhoea, fever and other diseases, is analysed over 4-week periods and related to growth performance. In total, there are 1373 4-week reporting periods with morbidity information from birth to the age of 12 months. Of all the diseases recorded (1021), 47% were ARI, 13% diarrhoea, 14% fever and 26% other diseases. The average (SD) duration of diarrhoea was 7 (11) days, ARI 14 (9) days, fever 6 (4) days and 16 (10) days for other diseases. The most striking results in this analysis are: (i) the lack of a relationship between morbidity and growth (either linear or weight) during the 1st 6 months of life; (ii) the existence of a relationship between illness and weight increment for which only ARI showed significant influence for infants of 6 months and more; (iii) the lack of a relationship between morbidity and linear growth performance at all ages; and (iv) the fact that no cumulative effect of disease on growth performance was found to explain the observations.