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The duration of diarrhea and fever is associated with growth faltering in rural Malawian children aged 6-18 months

Ariana Weisz1, Gus Meuli1, Chrissie Thakwalakwa2, Indi Trehan12, Kenneth Maleta2 and Mark Manary123*

Author Affiliations

1 Washington University in St. Louis, One Children's Place, Campus Box 8116, St. Louis, MO, 63110, USA

2 University of Malawi College of Medicine, Private Bag 360, Blantyre 3, Malawi

3 USDA Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates St., Houston, TX, 77030, USA

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Nutrition Journal 2011, 10:25  doi:10.1186/1475-2891-10-25

Published: 20 March 2011


Nutrition support programs that only focus upon better complementary feeding remain an insufficient means of limiting growth faltering in vulnerable populations of children. To determine if symptoms of acute infections correlate with the incidence of growth faltering in rural Malawian children, the associations between fever, diarrhea, and cough with anthropometric measures of stunting, wasting, and underweight were investigated. Data were analyzed from a trial where 209 children were provided with adequate complementary food and followed fortnightly from 6-18 months of age. Linear mixed model analysis was used to test for associations. Diarrheal disease was inversely associated with changes in height-for-age Z-score (HAZ), mid-upper arm circumference Z-score (MUACZ), and weight-for-age Z-score (WAZ). Fever was also inversely associated with changes in MUACZ and WAZ. These results suggest that initiatives to reduce febrile and diarrheal diseases are needed in conjunction with improved complementary feeding to limit growth faltering in rural Malawi.