Growth faltering in childhood related to diarrhea: a longitudinal community based study.
OBJECTIVE
This study aimed to evaluate the association of diarrhea and acute lower respiratory tract infections (ALRI) with growth of preschool children.


METHODS
A longitudinal community-based study over a 12-month period. Children were followed up with thrice-weekly household visits for collection of morbidity data. Every 4 months (round) clinical and anthropometric examinations were performed. At baseline a questionnaire was used to collect socioeconomic family data and environmental household variables. Generalized estimating equation was used in the statistical analysis. The variations in weight-for-age or height-for-age Z-scores in each round were the dependent variables, while the main independent variables were the number of days with diarrhea and ALRI.


METHODS
Serrinha, located in Northeast Brazil.


METHODS
In total, 487 children, aged 6-48 months at baseline, with 1-y complete follow-up.


RESULTS
The number of sick days with diarrhea or ALRI was not associated with mean changes in weight-for-age Z-scores. However, the mean of height-for-age Z-scores was found to decrease in those children with 7 or more days of diarrhea (beta=-0.0472; P=0.016) but not with 1 or more days of ALRI (beta=0.0022; P=0.406) in all rounds of the follow-up period.


CONCLUSIONS
Results of the study reinforce the concept of diarrhea burden as a major determinant of poor growth in children under 5 y of age. Actions targeted to decrease the risk factors for the occurrence of diarrhea may represent an important component of interventions aimed to ensure satisfactory child growth.
Assis
A M O
AM
School of Nutrition, Federal University of Bahia, Salvador, Bahia, Brazil. amos@ufba.br
Barreto
M L
ML
Santos
L M P
LM
Fiaccone
R
R
da Silva Gomes
G S
GS
D000208:Acute Disease; D001827:Body Height / Q000502:physiology; D001835:Body Weight / Q000502:physiology; D001938:Brazil / Q000453:epidemiology; D002675:Child, Preschool; D015331:Cohort Studies; D015897:Comorbidity; D003967:Diarrhea / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006130:Growth Disorders / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012141:Respiratory Tract Infections / Q000453:epidemiology; D012307:Risk Factors; D012959:Socioeconomic Factors