Impact of infection on the growth of children from 0 to 2 years in an urban West African community

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Abstract
To determine the relationship between growth and morbidity in the first 2 y of life, we studied a cohort of 126 newborns in a Gambian township. Mean weight-for-age exceeded the National Center for Health Statistics (NCHS) standards in the first half of infancy but there was a mean deficit of 1.2 kg by age 1 y. Only two diseases contributed significantly to weight faltering: diarrheal diseases were estimated to cause one-half of the deficit and lower respiratory tract infections (LRTI) one-quarter. LRTI reduced weight gain in young children by 14.7 g/d of infection and diarrheal diseases in weaning infants by 14.4 g/d. Diarrhea had no significant impact on the growth of exclusively breast-fed infants. Growth velocity was normal in the second year of life, despite continuing infections. Previous studies have showed that diarrhea was the main nondietary cause of weight faltering in children aged 6 months to 3 years. To help determine the relevance of these findings in a wider context and to investigate whether some children were more affected than others, a group of young children from a Gambian township was studied longitudinally to determine the relationship between their growth, morbidity, and feeding patterns. This paper describes the quantitative impact of various categories of disease on the growth of these children. 126 newborns in the 1st 2 years of life were studied in Bakau. Mean weight-for-age exceeded the National Center for Health Statistics standards in the 1st 1/2 of infancy but there was a mean deficit of 1.2 kg by age 1 year. Only 2 diseases contributed significantly to weight faltering: diarrheal diseases were estimated to cause 1/2 of the deficit and lower respiratory tract infections (LRTI)1/4. LRTI reduced weight gain in young children by 14.7 grams per day of infection and diarrheal diseases in weaning infants by 14.4 grams per day. Diarrhea had no significant impact on the growth of exclusively breast-fed infants. Growth velocity was normal in the 2nd year of life, despite continuing infections.

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