Childhood growth during recovery from acute illness in Africa and South Asia: a secondary analysis of the childhood acute illness and nutrition (CHAIN) prospective cohort.
Bourdon C., Diallo AH., Mohammad Sayeem Bin Shahid AS., Khan MA., Saleem AF., Singa BO., Gnoumou BS., Tigoi C., Otieno CA., Oduol CO., Lancioni CL., Manyasi C., McGrath CJ., Maronga C., Lwanga C., Brals D., Ahmed D., Mondal D., Denno DM., Mangale DI., Chimwezi E., Mbale E., Mupere E., Salauddin Mamun GM., Ouédraogo I., Berkley JA., Njunge JM., Njirammadzi J., Mukisa J., Thitiri J., Walson JL., Jemutai J., Tickell KD., Shahrin L., Mallewa M., Hossain MI., Chisti MJ., Timbwa M., Mburu M., Ngari MM., Ngao N., Aber P., Harawa PP., Sukhtankar P., Bandsma RHJ., Bamouni RM., Molyneux S., Mwaringa S., Shaima SN., Ali SA., Afsana SM., Banu S., Ahmed T., Voskuijl WP., Kazi Z.
BACKGROUND: Growth faltering is well-recognized during acute childhood illness and growth acceleration during convalescence, with or without nutritional therapy, may occur. However, there are limited recent data on growth after hospitalization in low- and middle-income countries. METHODS: We evaluated growth following hospitalization among children aged 2-23 months in sub-Saharan Africa and South Asia. Between November 2016 and January 2019, children were recruited at hospital admission and classified as: not-wasted (NW), moderately-wasted (MW), severely-wasted (SW), or having nutritional oedema (NO). We describe earlier (discharge to 45-days) and later (45- to 180-days) changes in length-for-age [LAZ], weight-for-age [WAZ], mid-upper arm circumference [MUACZ], weight-for-length [WLZ] z-scores, and clinical, nutritional, and socioeconomic correlates. FINDINGS: We included 2472 children who survived to 180-days post-discharge: NW, 960 (39%); MW, 572 (23%); SW, 682 (28%); and NO, 258 (10%). During 180-days, LAZ decreased in NW (-0.27 [-0.36, -0.19]) and MW (-0.23 [-0.34, -0.11]). However, all groups increased WAZ (NW, 0.21 [95% CI: 0.11, 0.32]; MW, 0.57 [0.44, 0.71]; SW, 1.0 [0.88, 1.1] and NO, 1.3 [1.1, 1.5]) with greatest gains in the first 45-days. Of children underweight (