Consequences of infections for three-month length increment in young children in rural Zambia


JJM Tolboom, Department of Paediatrics, University Hospital Nijmegen St Radboud, PO Box 9101, 6500 HB Nijmegen, The Netherlands (Tel. +31 24 3614412, fax. +31 24 3619123, e-mail, J.Tolboom@CKSKG.AZN.NL)


It was the aim of this study to describe the relationship of infections with subsequent 3-mo length increment in children below 2 y of age in rural Zambia. Children aged 6-9 mo (‘infants’; n= 84) and 14-20 mo (‘toddlers’; n= 81) attending Mother-and-Child Health clinics, were included and followed up after 3.0 mo (min-max; 2.1-3.7 mo). Anthropometric measurements were taken at each visit. At baseline, C-reactive protein (CRP), α1-acid glycoprotein (AGP), retinol and malaria parasitaemia were assessed. Length increment during the 3.0 ± 0.5 mo was 1.0 ± 0.5 cm/mo for infants and 0.6 ± 0.4 cm/mo for toddlers; 50-71% of the children showed increased acute phase proteins, 79-83% had malaria parasitaemia and 55-64% had low serum retinol concentrations. In the total group of children, serum AGP concentrations (r= -0.18; p= 0.03) and serum CRP concentrations (r= -0.15; p= 0.05) showed a negative relation with length increment. After correcting for micronutrient status, dietary intake and maternal height, results of multiple regression analyses showed that the relation between serum AGP concentration and subsequent length increment remained significant.

We conclude that, within the multifactorial model, presence of infections in these Zambian children contributes to the short-term retardation of linear growth.