The association of malaria morbidity with linear growth, hemoglobin, iron status, and development in young Malawian children: a prospective cohort study
Abstract Background Although poor complementary feeding is associated with poor child growth, nutrition interventions only have modest impact on child growth, due to high burden of infections. We aimed to assess the association of malaria with linear growth, hemoglobin, iron status, and development...
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| Format: | Article |
| Language: | English |
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BMC
2018-12-01
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| Series: | BMC Pediatrics |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12887-018-1378-2 |
| _version_ | 1818178500071260160 |
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| author | Jaden Bendabenda Noel Patson Lotta Hallamaa John Mbotwa Charles Mangani John Phuka Elizabeth L. Prado Yin Bun Cheung Ulla Ashorn Kathryn G. Dewey Per Ashorn Kenneth Maleta |
| author_facet | Jaden Bendabenda Noel Patson Lotta Hallamaa John Mbotwa Charles Mangani John Phuka Elizabeth L. Prado Yin Bun Cheung Ulla Ashorn Kathryn G. Dewey Per Ashorn Kenneth Maleta |
| author_sort | Jaden Bendabenda |
| collection | DOAJ |
| description | Abstract Background Although poor complementary feeding is associated with poor child growth, nutrition interventions only have modest impact on child growth, due to high burden of infections. We aimed to assess the association of malaria with linear growth, hemoglobin, iron status, and development in children aged 6–18 months in a setting of high malaria and undernutrition prevalence. Methods Prospective cohort study, conducted in Mangochi district, Malawi. We enrolled six-months-old infants and collected weekly data for ‘presumed’ malaria, diarrhea, and acute respiratory infections (ARI) until age 18 months. Change in length-for-age z-scores (LAZ), stunting, hemoglobin, iron status, and development were assessed at age 18 months. We used ordinary least squares regression for continuous outcomes and modified Poisson regression for categorical outcomes. Results Of the 2723 children enrolled, 2016 (74.0%) had complete measurements. The mean (standard deviation) incidences of ‘presumed’ malaria, diarrhea, and ARI, respectively were: 1.4 (2.0), 4.6 (10.1), and 8.3 (5.0) episodes/child year. Prevalence of stunting increased from 27.4 to 41.5% from 6 to 18 months. ‘Presumed’ malaria incidence was associated with higher risk of stunting (risk ratio [RR] = 1.04, 95% confidence interval [CI] = 1.01 to 1.07, p = 0.023), anemia (RR = 1.02, 95%CI = 1.00 to 1.04, p = 0.014) and better socio-emotional scores (B = − 0.21, 95%CI = − 0.39 to − 0.03, p = 0.041), but not with change in LAZ, haemoglobin, iron status or other developmental outcomes. Diarrhea incidence was associated with change in LAZ (B = − 0.02; 95% CI = − 0.03 to − 0.01; p = 0.009), stunting (RR = 1.02; 95% CI = 1.01 to 1.03; p = 0.005), and slower motor development. ARI incidence was not associated with any outcome except for poorer socio-emotional scores. Conclusion In this population of young children living in a malaria-endemic setting, with active surveillance and treatment, ‘presumed’ malaria is not associated with change in LAZ, hemoglobin, or iron status, but could be associated with stunting and anemia. Diarrhea was more consistently associated with growth than was malaria or ARI. The findings may be different in contexts where active malaria surveillance and treatment is not provided. Trial registration NCT00945698 (July 24, 2009) and NCT01239693 (November 11, 2010). |
| first_indexed | 2024-12-11T20:48:58Z |
| format | Article |
| id | doaj.art-5fb2123113a74cb1ac9f7c24a392cb24 |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-12-11T20:48:58Z |
| publishDate | 2018-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-5fb2123113a74cb1ac9f7c24a392cb242022-12-22T00:51:17ZengBMCBMC Pediatrics1471-24312018-12-0118111210.1186/s12887-018-1378-2The association of malaria morbidity with linear growth, hemoglobin, iron status, and development in young Malawian children: a prospective cohort studyJaden Bendabenda0Noel Patson1Lotta Hallamaa2John Mbotwa3Charles Mangani4John Phuka5Elizabeth L. Prado6Yin Bun Cheung7Ulla Ashorn8Kathryn G. Dewey9Per Ashorn10Kenneth Maleta11College of Medicine, Department of Public Health, School of Public Health, University of MalawiCollege of Medicine, Department of Public Health, School of Public Health, University of MalawiFaculty of Medicine and Life Sciences, Center for Child Health Research, University of TampereDepartment of Applied Studies, Malawi University of Science and TechnologyCollege of Medicine, Department of Public Health, School of Public Health, University of MalawiCollege of Medicine, Department of Public Health, School of Public Health, University of MalawiDepartment of Nutrition, University of California, DavisProgram in Health Services and Systems Research and Centre for Quantitative Medicine, Duke-National University of Singapore Graduate Medical SchoolFaculty of Medicine and Life Sciences, Center for Child Health Research, University of TampereDepartment of Nutrition, University of California, DavisFaculty of Medicine and Life Sciences, Center for Child Health Research, University of TampereCollege of Medicine, Department of Public Health, School of Public Health, University of MalawiAbstract Background Although poor complementary feeding is associated with poor child growth, nutrition interventions only have modest impact on child growth, due to high burden of infections. We aimed to assess the association of malaria with linear growth, hemoglobin, iron status, and development in children aged 6–18 months in a setting of high malaria and undernutrition prevalence. Methods Prospective cohort study, conducted in Mangochi district, Malawi. We enrolled six-months-old infants and collected weekly data for ‘presumed’ malaria, diarrhea, and acute respiratory infections (ARI) until age 18 months. Change in length-for-age z-scores (LAZ), stunting, hemoglobin, iron status, and development were assessed at age 18 months. We used ordinary least squares regression for continuous outcomes and modified Poisson regression for categorical outcomes. Results Of the 2723 children enrolled, 2016 (74.0%) had complete measurements. The mean (standard deviation) incidences of ‘presumed’ malaria, diarrhea, and ARI, respectively were: 1.4 (2.0), 4.6 (10.1), and 8.3 (5.0) episodes/child year. Prevalence of stunting increased from 27.4 to 41.5% from 6 to 18 months. ‘Presumed’ malaria incidence was associated with higher risk of stunting (risk ratio [RR] = 1.04, 95% confidence interval [CI] = 1.01 to 1.07, p = 0.023), anemia (RR = 1.02, 95%CI = 1.00 to 1.04, p = 0.014) and better socio-emotional scores (B = − 0.21, 95%CI = − 0.39 to − 0.03, p = 0.041), but not with change in LAZ, haemoglobin, iron status or other developmental outcomes. Diarrhea incidence was associated with change in LAZ (B = − 0.02; 95% CI = − 0.03 to − 0.01; p = 0.009), stunting (RR = 1.02; 95% CI = 1.01 to 1.03; p = 0.005), and slower motor development. ARI incidence was not associated with any outcome except for poorer socio-emotional scores. Conclusion In this population of young children living in a malaria-endemic setting, with active surveillance and treatment, ‘presumed’ malaria is not associated with change in LAZ, hemoglobin, or iron status, but could be associated with stunting and anemia. Diarrhea was more consistently associated with growth than was malaria or ARI. The findings may be different in contexts where active malaria surveillance and treatment is not provided. Trial registration NCT00945698 (July 24, 2009) and NCT01239693 (November 11, 2010).http://link.springer.com/article/10.1186/s12887-018-1378-2ChildrenGrowth falteringMalariaMorbidityInfectionsStunting |
| spellingShingle | Jaden Bendabenda Noel Patson Lotta Hallamaa John Mbotwa Charles Mangani John Phuka Elizabeth L. Prado Yin Bun Cheung Ulla Ashorn Kathryn G. Dewey Per Ashorn Kenneth Maleta The association of malaria morbidity with linear growth, hemoglobin, iron status, and development in young Malawian children: a prospective cohort study BMC Pediatrics Children Growth faltering Malaria Morbidity Infections Stunting |
| title | The association of malaria morbidity with linear growth, hemoglobin, iron status, and development in young Malawian children: a prospective cohort study |
| title_full | The association of malaria morbidity with linear growth, hemoglobin, iron status, and development in young Malawian children: a prospective cohort study |
| title_fullStr | The association of malaria morbidity with linear growth, hemoglobin, iron status, and development in young Malawian children: a prospective cohort study |
| title_full_unstemmed | The association of malaria morbidity with linear growth, hemoglobin, iron status, and development in young Malawian children: a prospective cohort study |
| title_short | The association of malaria morbidity with linear growth, hemoglobin, iron status, and development in young Malawian children: a prospective cohort study |
| title_sort | association of malaria morbidity with linear growth hemoglobin iron status and development in young malawian children a prospective cohort study |
| topic | Children Growth faltering Malaria Morbidity Infections Stunting |
| url | http://link.springer.com/article/10.1186/s12887-018-1378-2 |
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