Prevalence and Predictors of Malnutrition among Guatemalan Children at 2 Years of Age.
OBJECTIVE
To identify the prevalence and predictors of malnutrition among 2-year old children in the Western Highlands of Guatemala.


METHODS
Prospective cohort of 852 Guatemalan children in San Lucas Toliman, Guatemala followed from birth to age 2 from May 2008 to December 2013. Socio-demographic, anthropometric, and health data of children was collected at 2 month intervals.


RESULTS
Among the 402 males and 450 females in the cohort, mean weight-for-age Z-score (WAZ) declined from -0.67 ± 1.01 at 1 year to -1.07 ± 0.87 at 2 years, while mean height-for-age Z-score (HAZ) declined from -1.88 ± 1.19 at 1 year to -2.37 ± 0.99 at 2 years. Using multiple linear regression modeling, number of children <5 years old, vomiting in the past week, fever in the past week, and WAZ at 1 year were significant predictors of WAZ at 2 years. Significant predictors of HAZ at 2 years included household size, number of children <5 years old, diarrhea in the past week, WAZ at 1 year, and HAZ at 1 year. Vomiting in the past week and WAZ at 1 year were significant predictors of weight-for-height z-score (WHZ) at 2 years.


CONCLUSIONS
Number of children <5 years old, symptoms such as vomiting or diarrhea in the previous week, and prior nutritional status were the most significant predictors of malnutrition in this cohort. Future research may focus on the application of models to develop predictive algorithms for mobile device technology, as well as the identification of other predictors of malnutrition that are not well characterized such as the interaction of environmental exposures with protein consumption and epigenetics.
Department of Pediatrics, Stanford University, Palo Alto, California, United States of America.
Jason M
http://orcid.org/0000-0002-6541-0604
JM
Nagata
Center for Health Policy and the Center for Primary Care and Outcomes Research, Stanford University, Palo Alto, California, United States of America.
James
J
Gippetti
Graduate School of Business, Stanford University, Palo Alto, California, United States of America.
Stefan
S
Wager
Center for Health Policy and the Center for Primary Care and Outcomes Research, Stanford University, Palo Alto, California, United States of America.
Alejandro
A
Chavez
Department of Pediatrics, Stanford University, Palo Alto, California, United States of America.|Center for Health Policy and the Center for Primary Care and Outcomes Research, Stanford University, Palo Alto, California, United States of America.
Paul H
PH
Wise
D015362:Child Nutrition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D002675:Child, Preschool; D005260:Female; D006166:Guatemala / Q000453:epidemiology; D015438:Health Behavior; D006801:Humans; D008297:Male; D015995:Prevalence; D011379:Prognosis; D062486:Public Health Surveillance; D012919:Social Behavior