Linear growth faltering and the role of weight attainment: Prospective analysis of young children recovering from severe wasting in Niger

Maternal and Child Nutrition - Tập 15 Số 4 - 2019
Sheila Isanaka1,2, Matt D.T. Hitchings3, Fatou Berthé4, André Briend5,6, Rebecca F. Grais1
1Department of Research, Epicentre, Paris, France
2Departments of Nutrition and Global Health and Population Harvard T.H. Chan School of Public Health Boston United States
3Department of Epidemiology Harvard T.H. Chan School of Public Health Boston United States
4Epicentre Niger
5Center for Child Health Research, University of Tampere School of Medicine, Tampere, Finland
6Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark

Tóm tắt

AbstractEfforts to reduce the impact of stunting have been largely independent of interventions to reduce the impact of wasting, despite the observation that the conditions can coexist in the same child and increase risk of death. To optimize the management of malnourished children—who can be wasted, stunted, or both—the relationship between stunting and wasting should be elaborated. We aimed to describe the relationship between concurrent weight and height gain during and after rehabilitation from severe wasting. We conducted a secondary analysis of a randomized trial for the outpatient treatment of severe wasting, including 1,542 children who recovered and were followed for 12 weeks. We described the overlap of stunting and severe wasting and the change in stunting over time. We showed the relationship between concurrent weight and height gain using adjusted generalized estimating equations and calculated the mean rate of change in weight‐for‐height z score (WHZ) and height‐for‐age z score (HAZ) during and after rehabilitation. At baseline, 79% (n = 1,223/1,542) and 49% (n = 757/1,542) of children were stunted and severely stunted, respectively. Prevalence increased over time among children <24 months. During rehabilitation when weight was not yet fully recovered, we found rapid WHZ gain but limited HAZ gain. Following successful rehabilitation, WHZ gain slowed. The rate of HAZ gain was negative after rehabilitation but increased relative to the period during treatment. The potential relationship between weight and height gain calls for increased coverage of wasting treatment to not only prevent child mortality but also reduce linear growth faltering.

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Maternal and Child Nutrition

Tập 15 Số 4

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