title: The MAL-ED cohort study: methods and lessons learned when assessing early child development and caregiving mediators in infants and young children in 8 low- and middle-income countries.
abstract: More epidemiological data are needed on risk and protective factors for child development. In The Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) cohort study, we assessed child development in a harmonious manner across 8 sites in Bangladesh, Brazil, India, Nepal, Pakistan, Peru, South Africa, and Tanzania. From birth to 24 months, development and language acquisition were assessed via the Bayley Scales of Infant and Toddler Development and a modified MacArthur Communicative Development Inventory. Other measures were infant temperament, the child's environment, maternal psychological adjustment, and maternal reasoning abilities. We developed standard operating procedures and used multiple techniques to ensure appropriate adaptation and quality assurance across the sites. Test adaptation required significant time and human resources but is essential for data quality; funders should support this step in future studies. At the end of this study, we will have a portfolio of culturally adapted instruments for child development studies with examination of psychometric properties of each tool used.
authors.affiliation: The Pennsylvania State University, University Park.
authors.forename: Laura E
authors.initials: LE
authors.lastname: Murray-Kolb
authors.affiliation: Fogarty International Center, National Institutes of Health, Bethesda, Maryland.
authors.forename: Zeba A
authors.initials: ZA
authors.lastname: Rasmussen
authors.affiliation: University of Virginia, Charlottesville.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Scharf
authors.affiliation: Aga Khan University, Karachi, Pakistan.
authors.forename: Muneera A
authors.initials: MA
authors.lastname: Rasheed
authors.affiliation: University of Bergen, Norway Haydom Lutheran Hospital, Haydom, Tanzania.
authors.forename: Erling
authors.initials: E
authors.lastname: Svensen
authors.affiliation: Fogarty International Center, National Institutes of Health, Bethesda, Maryland.
authors.forename: Jessica C
authors.initials: JC
authors.lastname: Seidman
authors.affiliation: icddr,b (formerly the International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh.
authors.forename: Fahmida
authors.initials: F
authors.lastname: Tofail
authors.affiliation: Christian Medical College, Vellore, India.
authors.forename: Beena
authors.initials: B
authors.lastname: Koshy
authors.affiliation: Institute of Medicine, Kathmandu, Nepal Royal Thai Army-Armed Forces Research Institute of Medical Sciences, Nepal and Thailand.
authors.forename: Rita
authors.initials: R
authors.lastname: Shrestha
authors.affiliation: University of Venda, Thohoyandou, South Africa.
authors.forename: Angelina
authors.initials: A
authors.lastname: Maphula
authors.affiliation: Asociacion Benefica PRISMA, Iquitos, Peru Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Angel Orbe
authors.initials: AO
authors.lastname: Vasquez
authors.affiliation: Federal University of Ceará, Fortaleza, Brazil.
authors.forename: Hilda P
authors.initials: HP
authors.lastname: da Costa
authors.affiliation: Aga Khan University, Karachi, Pakistan.
authors.forename: Aisha K
authors.initials: AK
authors.lastname: Yousafzai
authors.affiliation: Federal University of Ceará, Fortaleza, Brazil.
authors.forename: Reinaldo B
authors.initials: RB
authors.lastname: Oria
authors.affiliation: Christian Medical College, Vellore, India.
authors.forename: Reeba
authors.initials: R
authors.lastname: Roshan
authors.affiliation: Haydom Lutheran Hospital, Haydom, Tanzania.
authors.forename: Eliwasa B
authors.initials: EB
authors.lastname: Bayyo
authors.affiliation: Asociacion Benefica PRISMA, Iquitos, Peru Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Margaret
authors.initials: M
authors.lastname: Kosek
authors.affiliation: Institute of Medicine, Kathmandu, Nepal Royal Thai Army-Armed Forces Research Institute of Medical Sciences, Nepal and Thailand.
authors.forename: Sanjaya
authors.initials: S
authors.lastname: Shrestha
authors.affiliation: The Pennsylvania State University, University Park.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Schaefer
authors.affiliation: University of Venda, Thohoyandou, South Africa.
authors.forename: Pascal
authors.initials: P
authors.lastname: Bessong
authors.affiliation: Christian Medical College, Vellore, India.
authors.forename: Tahmeed
authors.initials: T
authors.lastname: Ahmed
authors.affiliation: Fogarty International Center, National Institutes of Health, Bethesda, Maryland The Foundation for the National Institutes of Health, Bethesda, Maryland.
authors.forename: Dennis
authors.initials: D
authors.lastname: Lang
mesh_terms: D002657:Child Development / Q000145:classification*; D003071:Cognition / Q000502:physiology*; D003906:Developing Countries / Q000706:statistics & numerical data; D015340:Epidemiologic Research Design; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D009035:Mothers / Q000523:psychology / Q000706:statistics & numerical data; D011594:Psychometrics; D013694:Temperament / Q000502:physiology
keywords: child; cognitive development; infant; low-and middle-income countries; methods