Childhood malnutrition and its predictors in rural Malawi

Abstract

We prospectively followed up a population-based cohort of 767 rural Malawian children from birth to 36 months to characterise the timing and predictors of malnutrition. Underweight and wasting incidence peaked between 6 and 18 months of age, whereas stunting incidence was highest during the first 6 months of age. After infancy about 40% of the children were underweight, 70% stunted, and about 4% wasted. Small size during the first 3 months of life predicted the incidence of severe underweight (relative risk [95% confidence interval], 1.8 [0.9, 3.4]), severe stunting ( 2.1 [1.3, 3.4]), and moderate wasting (2.0 [1.1, 3.5]). Children with many illness episodes in infancy had a twofold risk for the development of severe underweight and moderate wasting. Severe underweight was further predicted by residence far away from a health facility and moderate wasting by maternal HIV infection. Our conclusion is that the intrauterine period and first 6 months of life are critical for the development of stunting whereas the subsequent year is more critical for the development of underweight and wasting. Strategies combating intrauterine growth retardation, maternal HIV and infant morbidity are likely to reduce the burden of malnutrition in this population.

Micronutrient deficiencies in maternity and child health: a review of environmental and social context and implications for Malawi

“…A study of 767 rural Malawian children up to 36 months of age (Maleta et al 2003) found that one of the predictors of severe underweight was residence far away from a health facility, but did not observe a reason for this. However, it is suggested that malnutrition could be alleviated by increased accessibility to interventions relating to feeding patterns; people living in more remote areas may benefit the most from such interventions.…”

The impact of an integrated community-based micronutrient and health programme on stunting in Malawian preschool children

“…Stunting, which primarily affects children in their second year of life (2)(3)(4) , is a result of chronic inadequate intake of energy and nutrients, as well as frequent infections (1) .…”

Somatic growth from birth to 6 months in low birth weight, in Bukavu, South Kivu, Democratic Republic of the Congo

“…In Nigeria, Olusanya et al [37], in a cross-sectional survey to assess the impact of IUGR on growth at one week of life, showed an association between IUGR and nutritional disturbances, results confirmed later in this same cohort at the age of 3 months [38]. Comparable results on various anthropometric indices have been described in Kenya [39], Ethiopia [40] and Malawi [41].…”