Poster Topical Area: Global Nutrition

Location: Hall D

Poster Board Number: 599

P12-113 - Association between linear growth and repeated relapse to wasting in children during the year after recovery from moderate acute malnutrition

Monday, Jun 11
8:00 AM – 3:00 PM

Objective: The aim of this study was to identify associations between linear growth and relapse to acute malnutrition in children during the year following recovery from moderate acute malnutrition (MAM) in a longitudinal study. Nutrition programs frequently approach wasting and stunting as two separate conditions with distinct causes and effects; yet cross-sectional studies have identified an association between the two conditions. Longitudinal studies are useful to quantify the risk of relapse to acute malnutrition based on the trajectory of linear growth.


Methods: This was a secondary data analysis from a cluster randomized trial involving 1487 Malawian children 6-62 months old treated for MAM and enrolled upon recovery. Children were followed for one year, during which data were collected on anthropometric progress, symptoms of illness, and household food security. Multivariate fixed-effects logistic regression was used to identify associations between linear growth and relapse to acute malnutrition.


Results: Children who have recovered from MAM proved to be a high-risk population, with nearly half experiencing a decrease in height-for-age z-score (HAZ) for 12 months. Children whose HAZ was declining were more likely to relapse to MAM or SAM than those whose linear growth rate maintained or increased their HAZ (P


Conclusions: Our results add to the body of evidence suggesting that acute wasting is a harbinger of subsequent stunting. Children who experience poor linear growth following MAM are more likely to experience relapse. Given this bidirectional relationship between wasting and stunting, supplementary feeding programs should consider both when designing protocols, aiming to both optimize linear growth and achieve acute weight gain, as means to reduce relapse.



Funding Source:

This research was funded under a subaward funded by Family Health International under Cooperative Agreement/Grant No. AID-OAA-A-12-0005 funded by USAID. The content of this publication does not necessarily reflect the views, analysis, or policies of FHI 360 or USAID, nor does any mention of trade names, commercial products, or organizations imply endorsement by FHI 360 or USAID.


Change in HAZ from 0 to 12 months after MAM recovery according to type and number of relapses

CoAuthors: Beatrice Rogers – Tufts University; Patrick Webb – Tufts University; Irwin Rosenberg – Tufts University; Kenneth Maleta – University of Malawi; Indi Trehan – Washington University in St. Louis; Mark Manary – Washington University in St. Louis

Heather Stobaugh

International Nutrition Researcher
RTI International
Cary, North Carolina