ORIGINAL ARTICLE

Timing of growth faltering in rural Malawi

K Maleta¹, S Virtanen², M Espo¹, T Kulmala¹, P Ashorn¹

¹ Paediatric Research Centre, Tampere University Hospital
² Tampere School of Public Health

Correspondence to:
Correspondence to:
Dr K Maleta, Paediatric Research Centre, Tampere University Hospital, FM-3 Building, University of Tampere, FIN-33014, Finland;
kenneth.maleta{at}uta.fi

Aim: To determine the timing of growth faltering among under 3 year old children.

Methods: Prospective population based cohort study in Lungwena, rural Malawi, southeast Africa. A total of 767 live born babies were regularly visited from birth until 3 years of age. Weight, height, and mid upper arm circumference were measured at monthly intervals until 18 months and at three month intervals thereafter. Growth charts were constructed using the LMS method and comparisons made to two international databases: the traditional United States National Center for Health Statistics/World Health Organisation (NCHS/WHO) reference and the recently developed 2000 Centers for Disease Control (CDC) growth reference.

Results: Compared to the 2000 CDC reference population, newborns in Lungwena were on average 2.5 cm shorter and 510 g lighter. On a population level, height faltering was present at birth and continued throughout the first three years. Weight faltering, on the other hand, occurred mainly between 3 and 12 months of age. At 36 months, the mean weight and height of the study children were 2.3 kg and 10.5 cm lower than those of the reference population, respectively. The results remained essentially similar when the comparisons were made to the NCHS/WHO reference.

Conclusions: The fact that weight and height faltering do not follow identical time patterns suggests that they may have different origin and determinants. Further studies on the aetiology of height faltering and different approaches to preventive interventions are needed.

Keywords: growth faltering; longitudinal; sub-Saharan Africa; Malawi

Abbreviations: CDC, Centers for Disease Control; NCHS, United States National Center for Health Statistics; WHO, World Health Organisation

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Ashorn, P., Phuka, J. C., Maleta, K., Thakwalakwa, C., Cheung, Y. B., Briend, A., Manary, M. J. (2009). Undernutrition Malnutrition in Infants in Developing Countries. Arch Pediatr Adolesc Med 163: 186-186 [Full Text]  
• Phuka, J. C, Maleta, K., Thakwalakwa, C., Cheung, Y. B., Briend, A., Manary, M. J, Ashorn, P. (2009). Postintervention growth of Malawian children who received 12-mo dietary complementation with a lipid-based nutrient supplement or maize-soy flour. Am. J. Clin. Nutr. 89: 382-390 [Abstract] [Full Text]  
• Phuka, J. C., Maleta, K., Thakwalakwa, C., Cheung, Y. B., Briend, A., Manary, M. J., Ashorn, P. (2008). Complementary Feeding With Fortified Spread and Incidence of Severe Stunting in 6- to 18-Month-Old Rural Malawians. Arch Pediatr Adolesc Med 162: 619-626 [Abstract] [Full Text]  
• Lin, C. A., Manary, M. J., Maleta, K., Briend, A., Ashorn, P. (2008). An Energy-Dense Complementary Food Is Associated with a Modest Increase in Weight Gain When Compared with a Fortified Porridge in Malawian Children Aged 6-18 Months. J. Nutr. 138: 593-598 [Abstract] [Full Text]  
• Gladstone, M J, Lancaster, G A, Jones, A P, Maleta, K, Mtitimila, E, Ashorn, P, Smyth, R L (2008). Can Western developmental screening tools be modified for use in a rural Malawian setting?. Arch. Dis. Child. 93: 23-29 [Abstract] [Full Text]  
• Galpin, L., Thakwalakwa, C., Phuka, J., Ashorn, P., Maleta, K., Wong, W. W., Manary, M. J. (2007). Breast Milk Intake Is Not Reduced More by the Introduction of Energy Dense Complementary Food than by Typical Infant Porridge. J. Nutr. 137: 1828-1833 [Abstract] [Full Text]