Growth faltering in childhood related to diarrhea: a longitudinal community based study

Objective: This study aimed to evaluate the association of diarrhea and acute lower respiratory tract infections (ALRI) with growth of preschool children. Design: A longitudinal community-based study over a 12-month period. Children were followed up with thrice-weekly household visits for collection of morbidity data. Every 4 months (round) clinical and anthropometric examinations were performed. At baseline a questionnaire was used to collect socioeconomic family data and environmental household variables. Generalized estimating equation was used in the statistical analysis. The variations in weight-for-age or height-for-age Z -scores in each round were the dependent variables, while the main independent variables were the number of days with diarrhea and ALRI. Setting: Serrinha, located in Northeast Brazil. Subjects: In total, 487 children, aged 6–48 months at baseline, with 1-y complete follow-up. Results: The number of sick days with diarrhea or ALRI was not associated with mean changes in weight-for-age Z -scores. However, the mean of height-for-age Z -scores was found to decrease in those children with 7 or more days of diarrhea ( β =−0.0472; P =0.016) but not with 1 or more days of ALRI ( β =0.0022; P =0.406) in all rounds of the follow-up period. Conclusion: Results of the study reinforce the concept of diarrhea burden as a major determinant of poor growth in children under 5 y of age. Actions targeted to decrease the risk factors for the occurrence of diarrhea may represent an important component of interventions aimed to ensure satisfactory child growth. Sponsorship: Financial support was provided by the World Health Organization (CDD), PRONEX/CNPq/MCT of the Brazilian Government (Agreement no. 661086/1998-4) and UNICEF (NY).