Diarrhea in early childhood: Short-Term association with weight and long-Term association with length

Stephanie A. Richard, Robert E. Black, Robert H. Gilman, Richard L. Guerrant, Gagandeep Kang, Claudio F. Lanata, Kåre Mølbak, Zeba A. Rasmussen, R. Bradley Sack, Palle Valentiner-Branth, William Checkley*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

108 Scopus citations

Abstract

The short-Term association between diarrhea and weight is well-accepted, but the long-Term association between diarrhea and growth is less clear. Using data from 7 cohort studies (Peru, 1985-1987; Peru, 1989-1991; Peru, 1995-1998; Brazil, 1989-1998; Guinea-Bissau, 1987-1990; Guinea-Bissau, 1996-1997; and Bangladesh, 1993-1996), we evaluated the lagged relationship between diarrhea and growth in the first 2 years of life. Our analysis included 1,007 children with 597,638 child-days of diarrhea surveillance and 15,629 anthropometric measurements. We calculated the associations between varying diarrhea burdens during lagged 30-day periods and length at 24 months of age. The cumulative association between the average diarrhea burden and length at age 24 months was -0.38 cm (95% confidence interval: -0.59, -0.17). Diarrhea during the 30 days prior to anthropometric measurement was consistently associated with lower weight at most ages, but there was little indication of a short-Term association with length. Diarrhea was associated with a small but measurable decrease in linear growth over the long term. These findings support a focus on prevention of diarrhea as part of an overall public health strategy for improving child health and nutrition; however, more research is needed to explore catch-up growth and potential confounders.

Original languageEnglish
Pages (from-to)1129-1138
Number of pages10
JournalAmerican Journal of Epidemiology
Volume178
Issue number7
DOIs
StatePublished - 1 Oct 2013
Externally publishedYes

Keywords

  • child health
  • diarrhea
  • malnutrition
  • stunting
  • wasting

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