Are diarrhoea control programmes likely to reduce childhood malnutrition? Observations from rural Bangladesh

Abstract

Growth of rural Bangladeshi children aged 6-35 months was examined in relation to the history of diarrhoea in 1772 3-month intervals. Weight gain and linear growth were lower in intervals with a history of diarrhoea than in intervals without diarrhoea. However, comparison of weight and height gains in intervals during which diarrhoea occurred at the beginning or at the end showed that after non-bloody diarrhoeas children catch up and that deficits in weight gain and linear growth were no longer apparent a few weeks later. These findings suggest that the effect of diarrhoea on growth is transient and that efforts to control diarrhoea are unlikely to improve children's nutritional status in the long term. PIP:

This study examines the relation between diarrhea and malnutrition in a rural community in Bangladesh giving special attention to the growth of children recovering from diarrhea to determine whether diarrhea is really a major cause of malnutrition. Baseline demographic information was collected in January 1984, and updated monthly until December 1987 in Mirzapur. Height and weight were measured quarterly from October 1984 to December 1987 by trained female community health workers. Anthropometric measurements were compared with the National Center for Health Statistics standards. The analysis was restricted to intervals of 60-120 days. Children aged 6-35 months were examined in relation to the history of diarrhea in 1772 3-month intervals. Weight gain and linear growth were lower in intervals with a history of diarrhea than without. However, comparison of weight and height gains in intervals during which diarrhea occurred at the beginning or at the end showed that after non-bloody diarrheas children catch up and that deficits in weight gain and linear growth were no longer apparent a few weeks later. However, if diarrheas occur very frequently, full recovery between 2 episodes might not be possible. Dysenteries and prolonged diarrheas are associated with a high risk of dying. Their prevention and treatment are high priorities. Improving feeding practices during diarrhea is important since there is strong evidence that a high proportion of deaths from diarrhea are related to hypoglycemia. These findings suggest that the effect of diarrhea on growth is transient and that efforts to control diarrhea are unlikely to improve children's nutritional status in the long run. Children are malnourished in poor communities because they do not get enough food and not because they suffer from diarrhea. Insuring that deprived children have enough to eat still seems the best approach to alleviate the problem of malnutrition