title: Transition between stunted and nonstunted status: both occur from birth to 15 years of age in Malawi children.
abstract: OBJECTIVE
  The timing and frequency of stunting and possible catch-up growth are ambiguous in low-income settings. This study explored the timing and extent of becoming stunted and nonstunted between birth and 15 years of age in a resource-poor area of Malawi, south-east Africa.
  
  
  METHODS
  We followed 767 children from the foetal period until 15 years of age and examined the transition between stunted and nonstunted status and the pubertal stage at 15 years of age. We also plotted smoothed curves for the mean absolute deficits in centimetres and height-for-age standard deviation scores (HAZ) according to the World Health Organization's 2006 and 2007 references.
  
  
  RESULTS
  Most two-year olds (80%) were stunted (HAZ < -2 SD), but this had declined to 37% at 15 years of age. During the three five-year intervals, new stunting cases ranged from 3.9 to 21.3% and the percentage who became nonstunted was 9.1 to 15%. The majority (85%) of the children, who were moderately stunted at two years of age, became nonstunted during the follow-up period. Only, 9% of boys and 20% of girls had reached advanced puberty by the age of 15.
  
  
  CONCLUSIONS
  Becoming stunted and nonstunted status both occurred throughout the period from birth to 15 years of age in Malawi children. The small percentage who had reached advanced puberty by the age of 15 suggests significant further growth potential.
authors.affiliation: Department for International Health, School of Medicine, University of Tampere, Tampere, Finland.|Department of Paediatrics, Helsinki University Hospital, Helsinki, Finland.
authors.forename: Tiina
authors.initials: T
authors.lastname: Teivaanmäki
authors.affiliation: Department for International Health, School of Medicine, University of Tampere, Tampere, Finland.|Centre for Quantitative Medicine, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore.
authors.forename: Yin Bun
authors.initials: YB
authors.lastname: Cheung
authors.affiliation: Department for International Health, School of Medicine, University of Tampere, Tampere, Finland.
authors.forename: Emma
authors.initials: E
authors.lastname: Kortekangas
authors.affiliation: College of Medicine, University of Malawi, Blantyre, Malawi.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Maleta
authors.affiliation: Department for International Health, School of Medicine, University of Tampere, Tampere, Finland.|Department of Paediatrics, Tampere University Hospital, Tampere, Finland.
authors.forename: Per
authors.initials: P
authors.lastname: Ashorn
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D005260:Female; D006130:Growth Disorders / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008137:Longitudinal Studies; D008295:Malawi / Q000453:epidemiology; D008297:Male
keywords: Low-income countries; Malawi; Puberty; South-east Africa; Stunted growth