TY - JOUR

T1 - Linear growth faltering and the role of weight attainment

T2 - Prospective analysis of young children recovering from severe wasting in Niger

AU - Isanaka, Sheila

AU - Hitchings, Matt D T

AU - Berthé, Fatou

AU - Briend, André

AU - Grais, Rebecca F

N1 - © 2019 The Authors Maternal & Child Nutrition Published by John Wiley & Sons Ltd.

PY - 2019

Y1 - 2019

N2 - Efforts to reduce the impact of stunting have been largely independent of interventions to reduce the impact of wasting, despite the observation that the conditions can coexist in the same child and increase risk of death. To optimize the management of malnourished children-who can be wasted, stunted, or both-the relationship between stunting and wasting should be elaborated. We aimed to describe the relationship between concurrent weight and height gain during and after rehabilitation from severe wasting. We conducted a secondary analysis of a randomized trial for the outpatient treatment of severe wasting, including 1,542 children who recovered and were followed for 12 weeks. We described the overlap of stunting and severe wasting and the change in stunting over time. We showed the relationship between concurrent weight and height gain using adjusted generalized estimating equations and calculated the mean rate of change in weight-for-height z score (WHZ) and height-for-age z score (HAZ) during and after rehabilitation. At baseline, 79% (n = 1,223/1,542) and 49% (n = 757/1,542) of children were stunted and severely stunted, respectively. Prevalence increased over time among children <24 months. During rehabilitation when weight was not yet fully recovered, we found rapid WHZ gain but limited HAZ gain. Following successful rehabilitation, WHZ gain slowed. The rate of HAZ gain was negative after rehabilitation but increased relative to the period during treatment. The potential relationship between weight and height gain calls for increased coverage of wasting treatment to not only prevent child mortality but also reduce linear growth faltering.

AB - Efforts to reduce the impact of stunting have been largely independent of interventions to reduce the impact of wasting, despite the observation that the conditions can coexist in the same child and increase risk of death. To optimize the management of malnourished children-who can be wasted, stunted, or both-the relationship between stunting and wasting should be elaborated. We aimed to describe the relationship between concurrent weight and height gain during and after rehabilitation from severe wasting. We conducted a secondary analysis of a randomized trial for the outpatient treatment of severe wasting, including 1,542 children who recovered and were followed for 12 weeks. We described the overlap of stunting and severe wasting and the change in stunting over time. We showed the relationship between concurrent weight and height gain using adjusted generalized estimating equations and calculated the mean rate of change in weight-for-height z score (WHZ) and height-for-age z score (HAZ) during and after rehabilitation. At baseline, 79% (n = 1,223/1,542) and 49% (n = 757/1,542) of children were stunted and severely stunted, respectively. Prevalence increased over time among children <24 months. During rehabilitation when weight was not yet fully recovered, we found rapid WHZ gain but limited HAZ gain. Following successful rehabilitation, WHZ gain slowed. The rate of HAZ gain was negative after rehabilitation but increased relative to the period during treatment. The potential relationship between weight and height gain calls for increased coverage of wasting treatment to not only prevent child mortality but also reduce linear growth faltering.

KW - Faculty of Science

KW - Child malnutrition

KW - Linear growth

KW - Niger

KW - Stunting

KW - Wasting

KW - Weight gain

U2 - 10.1111/mcn.12817

DO - 10.1111/mcn.12817

M3 - Journal article

C2 - 30903806

VL - 15

JO - Maternal and Child Nutrition

JF - Maternal and Child Nutrition

SN - 1740-8695

IS - 4

M1 - e12817

ER -