American Journal of Epidemiology Vol. 127, No. 2: 365-376
Copyright © 1988 by The Johns Hopkins University School of Hygiene and Public Health
research-article |
MALNUTRITION AND DIARRHEA
A LONGITUDINAL STUDY AMONG URBAN MEXICAN CHILDREN
1General Directorate of Epidemiology, Ministry of Health Mexico
2Department of Epidemiology, Harvard School of Public Health, and the Charming Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital Boston, MA
3Department of Epidemiology, The Johns Hopkins University School of Hygiene and Public Health Baltimore, MD
Reprint requests to Dr. Jaime Sepulveda, Aniceto Ortega 1321, Mexico D.F. 03100, Mexico
To address the hypothesis that malnutrition is associated with an increased risk of diarrhea, the authors identified a cohort of 284 Mexican children less than two years of age in order to equally represent different degrees of nutritional status. Nutritional status, defined anthropometrically, was measured at baseline and every three months for a total follow-up period of one year. The occurrence of diarrhea was assessed by weekly home visits. Among the combinations of weight and length examined, weight for age was the strongest predictor of subsequent diarrhea during a three-month interval. Among normally nourished children, the incidence of diarrhea was 3.3 episodes per year among those mildly malnourished, 3.7 episodes per year (relative risk (RR) = 1.1); and among the moderately malnourished, 6.0 episodes per year (RR = 1.8). Adjustment for demographic, seasonal, and socioeconomic variables only slightly reduced this association. Nutritional status was most strongly related to the occurrence of two or more episodes during a three-month follow-up interval, and this effect was most clearly seen among children with diarrhea in the preceding Interval. In a multiple logistic analysts that included potentially confounding variables as well as an autoregressIve term to account for the nonindependence of repeated observations, the relative risk of two or more episodes of diarrhea during an interval was 1.8 (95% confidence interval 1.1–2.9) for moderately malnourished children compared with those who were normally nourished or mildly malnourished. These data lend support to the hypothesis that malnutrition predisposes to the occurrence of diarrhea among young children.
child; diarrhea; gastroenteritis; nutrition; nutritional disorders
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  D. Mondal, R. Haque, R. B. Sack, B. D. Kirkpatrick, and W. A. Petri Jr Attribution of Malnutrition to Cause-Specific Diarrheal Illness: Evidence from a Prospective Study of Preschool Children in Mirpur, Dhaka, Bangladesh Am J Trop Med Hyg, May 1, 2009; 80(5): 824 - 826. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Checkley, G. Buckley, R. H Gilman, A. M. Assis, R. L Guerrant, S. S Morris, K. Molbak, P. Valentiner-Branth, C. F Lanata, R. E Black, et al. Multi-country analysis of the effects of diarrhoea on childhood stunting Int. J. Epidemiol., August 1, 2008; 37(4): 816 - 830. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. H. Brown Diarrhea and Malnutrition J. Nutr., January 1, 2003; 133(1): 328S - 332. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. C. King, R. E. Black, M. P. Doyle, K. L. Fritsche, B. H. Halbrook, O. A. Levander, S. N. Meydani, W. A. Walker, and C. E. Woteki Foodborne Illnesses and Nutritional Status: A Statement from an American Society for Nutritional Sciences Working Group J. Nutr., October 1, 2000; 130(10): 2613 - 2617. [Full Text]
|
|
|
|
 |
|
 D. M. Thea, M. E. St. Louis, U. Atido, K. Kanjinga, B. Kembo, M. Matondo, T. Tshiamala, C. Kamenga, F. Davachi, C. Brown, et al. A Prospective Study of Diarrhea and HIV-1 Infection among 429 Zairian Infants N. Engl. J. Med., December 2, 1993; 329(23): 1696 - 1702. [Abstract] [Full Text]
|
|