Neurodevelopment and Recovery From Wasting


Babikako, HM, Bourdon, C, Mbale, E ORCID: 0000-0001-7134-2858, Aber, P, Birabwa, A, Chimoyo, J, Voskuijl, W, Kazi, Z, Massara, P, Mukisa, J et al (show 10 more authors) (2022) Neurodevelopment and Recovery From Wasting Pediatrics, 150 (5). e2021055615-. ISSN 0031-4005, 1098-4275

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Abstract

BACKGROUND AND OBJECTIVES: 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. METHODS: Children aged 2 to 23 months were enrolled in a prospective observational cohort of the Childhood Acute Illness & 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. RESULTS: 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 < .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. CONCLUSIONS: 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 & Life Sciences
Faculty of Health & Life Sciences > Inst. Life Courses & Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 15 Dec 2022 11:31
Last Modified: 01 Mar 2026 09:29
DOI: 10.1542/peds.2021-055615
Open Access URL: https://doi.org/10.1542/peds.2021-055615
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URI: https://livrepository.liverpool.ac.uk/id/eprint/3166695
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