Neurodevelopment and Recovery From Wasting

Babikako, Harriet M, Bourdon, Celine, Mbale, Emmie, Aber, Peace, Birabwa, Annet, Chimoyo, Josephine, Voskuijl, Wieger, Kazi, Zaubina, Massara, Paraskevi, Mukisa, John
et al (show 10 more authors) (2022) Neurodevelopment and Recovery From Wasting. PEDIATRICS, 150 (5). e2021055615-.

Access the full-text of this item by clicking on the Open Access link.


<h4>Background and objectives</h4>Acute illness with malnutrition is a common indication for hospitalization among children in low- and middle-income countries. We investigated the association between wasting recovery trajectories and neurodevelopmental outcomes in young children 6 months after hospitalization for an acute illness.<h4>Methods</h4>Children aged 2 to 23 months were enrolled in a prospective observational cohort of the Childhood Acute Illness &amp; Nutrition Network, in Uganda, Malawi, and Pakistan between January 2017 and January 2019. We grouped children on the basis of their wasting recovery trajectories using change in mid-upper arm circumference for age z-score. Neurodevelopment was assessed with the Malawi Developmental Assessment Tool (MDAT development-for-age z-score [DAZ]) at hospital discharge and after 6 months.<h4>Results</h4>We included 645 children at hospital discharge (mean age 12.3 months ± 5.5; 55% male); 262 (41%) with severe wasting, 134 (21%) with moderate wasting, and 249 (39%) without wasting. Four recovery trajectories were identified: high-stable, n = 112; wasted-improved, n = 404; severely wasted-greatly improved, n = 48; and severely wasted-not improved, n = 28. The children in the severely wasted-greatly improved group demonstrated a steep positive MDAT-DAZ recovery slope. This effect was most evident in children with both wasting and stunting (interaction wasted-improved × time × stunting: P &lt; .001). After 6 months, the MDAT DAZ in children with wasting recovery did not differ from community children. In children who never recovered from wasting, there remained a significant delay in MDAT DAZ scores.<h4>Conclusions</h4>Neurodevelopment recovery occurred in parallel with wasting recovery in children convalescing from acute illness and was influenced by stunting.

Item Type: Article
Uncontrolled Keywords: Humans, Wasting Syndrome, Malnutrition, Acute Disease, Growth Disorders, Child, Child, Preschool, Infant, Income, Female, Male
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 15 Dec 2022 11:31
Last Modified: 29 Apr 2023 21:49
DOI: 10.1542/peds.2021-055615
Open Access URL:
Related URLs: