Background
Methods
Study area and population
Field procedures
Data analyses
Results
n1
| Mean HAZ (SD)2
|
P
3
| % stunted4
|
P
5
| |
---|---|---|---|---|---|
Overall | 256 | −0.53 (1.15) | 10.2 | ||
Child’s sex | 0.376 | 0.866 | |||
Female | 132 | −0.59 (1.10) | 9.8 | ||
Male | 124 | −0.47 (1.21) | 10.5 | ||
Child’s age | <0.001 | 0.875 | |||
0-5 months | 21 | −0.24 (1.33) | 19.0 | ||
6-11 months | 27 | 0.30 (1.04) | 0.0 | ||
12-23 months | 47 | −0.41 (1.17) | 8.5 | ||
24-35 months | 56 | −0.83 (1.04) | 12.5 | ||
≥36 months | 105 | −0.70 (1.09) | 10.5 | ||
Socioeconomic characteristics
| |||||
Wealth index | 0.008 | 0.035 | |||
Below median | 136 | −0.70 (1.16) | 14.0 | ||
Above median | 118 | −0.32 (1.12) | 5.9 | ||
Land ownership | 0.035 | 0.136 | |||
No | 208 | −0.60 (1.16) | 11.5 | ||
Yes | 47 | −0.21 (1.09) | 4.3 | ||
Mother’s educational level | 0.003 | 0.074 | |||
0-4 years | 102 | −0.68 (1.12) | 11.8 | ||
≥5 years | 88 | −0.19 (1.12) | 4.5 | ||
Access to treated water | 0.866 | 0.242 | |||
No | 82 | −0.54 (1.34) | 13.4 | ||
Yes | 173 | −0.52 (1.06) | 8.7 | ||
Access to public garbage collection | 0.206 | 0.005 | |||
No | 53 | −0.70 (1.40) | 20.8 | ||
Yes | 199 | −0.47 (1.08) | 7.5 | ||
Maternal characteristics
| |||||
Mother’s age | 0.915 | 0.468 | |||
≤20 years | 27 | −0.45 (1.28) | 18.5 | ||
21-30 years | 143 | −0.51 (1.14) | 9.1 | ||
>30 years | 55 | −0.50 (1.28) | 10.9 | ||
Mother’s height | <0.001 | 0.008 | |||
1st tertile: ≤154.0 cm | 77 | −0.95 (1.16) | 18.2 | ||
2nd tertile: 154.1-159.4 cm | 77 | −0.55 (1.02) | 7.8 | ||
3rd tertile: ≥159.5 cm | 78 | −0.22 (1.10) | 5.1 | ||
Smoking during pregnancy | 0.016 | 0.193 | |||
No | 176 | −0.43 (1.18) | 8.5 | ||
Yes | 55 | −0.85 (1.00) | 14.5 | ||
Child characteristics
| |||||
Child’s birth weight | <0.001 | 0.013 | |||
≤2500 g | 18 | −1.45 (0.73) | 16.7 | ||
2501-3500 g | 156 | −0.66 (1.11) | 12.2 | ||
>3500 g | 76 | −0.01 (1.08) | 2.6 | ||
Child’s birth length | <0.001 | 0.003 | |||
1st tertile: ≤48 cm | 77 | −0.96 (1.06) | 14.3 | ||
2nd tertile: 49–50 cm | 73 | −0.17 (1.00) | 4.1 | ||
3rd tertile: ≥51 cm | 39 | 0.15 (1.25) | 0.0 | ||
Age at cow’s milk introduction | 0.689 | 0.867 | |||
<3 months | 77 | −0.60 (1.15) | 10.4 | ||
≥3 months | 165 | −0.53 (1.14) | 9.7 | ||
Morbidities 15 days before baseline visit: | |||||
Diarrhea | 0.892 | 0.985 | |||
No | 195 | −0.53 (1.19) | 10.3 | ||
Yes | 59 | −0.56 (1.04) | 10.2 | ||
Vomiting | 0.291 | 0.910 | |||
No | 233 | −0.51 (1.16) | 10.3 | ||
Yes | 21 | −0.79 (0.99) | 9.5 | ||
Cough with fever | 0.206 | 0.951 | |||
No | 222 | −0.50 (1.17) | 10.4 | ||
Yes | 30 | −0.79 (1.03) | 10.0 |
Mean HAZ (SE) according to age2,3
| |||||||
---|---|---|---|---|---|---|---|
n1
| 6 mo | 12 mo | 2 y | 5 y | 7 y | 10 y | |
Child’s sex | 256 | ||||||
Female | −0.25 (0.18) | −0.31 (0.19) | −0.90 (0.13) | −0.41 (0.08) | −0.32 (0.07) | −0.42 (0.08) | |
Male | 0.09 (0.27) | −0.25 (0.17) | −0.74 (0.13) | −0.40 (0.09) | −0.29 (0.09) | −0.26 (0.09) | |
Difference [95% CI] | 0.34 [−0.29, 0.97] | −0.06 [−0.44, 0.56] | 0.16 [−0.20, 0.52] | −0.01 [−0.23, 0.25] | 0.03 [−0.20, 0.26] | 0.16 [−0.08, 0.40] | |
Socioeconomic characteristics
| |||||||
Wealth index | 254 | ||||||
Below median | −0.33 (0.20) | −0.40 (0.17) | −0.99 (0.12) | −0.57 (0.08) | −0.44 (0.08) | −0.43 (0.08) | |
Above median | 0.20 (0.24) | −0.16 (0.19) | −0.61 (0.14) | −0.21 (0.09) | −0.13 (0.08) | −0.20 (0.09) | |
Difference | 0.53 [−0.08, 1.15] | 0.24 [−0.26, 0.74] | 0.38 [0.02, 0.74] | 0.36 [0.12, 0.60] | 0.31 [0.09, 0.54] | 0.23 [−0.01, 0.47] | |
Land ownership | 255 | ||||||
No | −0.19 (0.16) | −0.38 (0.14) | −0.88 (0.10) | −0.48 (0.07) | −0.38 (0.06) | −0.41 (0.07) | |
Yes | 0.47 (1.10) | 0.08 (0.38) | −0.52 (0.20) | −0.08 (0.13) | 0.04 (0.12) | 0.00 (0.13) | |
Difference | 0.66 [−1.52, 2.85] | 0.46 [−0.32, 1.25] | 0.36 [−0.09, 0.81] | 0.40 [0.11, 0.69] | 0.42 [0.14, 0.69] | 0.41 [0.12, 0.70] | |
Mother’s educational level | 190 | ||||||
0-4 years | −0.01 (0.18) | −0.23 (0.16) | −1.02 (0.14) | −0.56 (0.09) | −0.42 (0.09) | −0.41 (0.10) | |
≥5 years | 0.08 (0.19) | −0.14 (0.21) | −0.41 (0.17) | −0.12 (0.10) | −0.08 (0.10) | −0.17 (0.10) | |
Difference | 0.09 [−0.43, 0.61] | 0.09 [−0.42, 0.61] | 0.61 [0.19, 1.03] | 0.44 [0.18, 0.70] | 0.33 [0.08, 0.59] | 0.24 [−0.04, 0.51] | |
Access to treated water | 255 | ||||||
No | 0.25 (0.24) | −0.30 (0.21) | −0.85 (0.19) | −0.58 (0.11) | −0.48 (0.10) | −0.43 (0.11) | |
Yes | −0.25 (0.18) | −0.35 (0.16) | −0.80 (0.10) | −0.32 (0.07) | −0.22 (0.07) | −0.28 (0.07) | |
Difference | −0.50 [−1.09, 0.09] | −0.05 [−0.57, 0.46] | 0.05 [−0.37, 0.46] | 0.26 [−0.01, 0.52] | 0.26 [0.01, 0.50] | 0.14 [−0.12, 0.40] | |
Access public garbage collection | 252 | ||||||
No | −0.52 (0.39) | −0.45 (0.27) | −0.78 (0.27) | −0.70 (0.16) | −0.60 (0.15) | −0.44 (0.14) | |
Yes | −0.02 (0.17) | −0.28 (0.15) | −0.80 (0.09) | −0.33 (0.07) | −0.23 (0.06) | −0.31 (0.07) | |
Difference | 0.50 [−0.32, 1.33] | 0.17 [−0.44, 0.77] | −0.02 [−0.58, 0.54] | 0.37 [0.04, 0.70] | 0.37 [0.05, 0.68] | 0.12 [−0.18, 0.43] | |
Maternal characteristics
| |||||||
Mother’s height | 232 | ||||||
a. 1st tertile: ≤154.0 cm | −0.67 (0.26) | −0.59 (0.23) | −1.17 (0.15) | −0.78 (0.12) | −0.64 (0.11) | −0.61 (0.11) | |
b. 2nd tertile: 154.1-159.4 cm | −0.20 (0.35) | −0.38 (0.23) | −0.81 (0.17) | −0.36 (0.09) | −0.29 (0.09) | −0.42 (0.11) | |
c. 3rd tertile: ≥159.5 cm | 0.33 (0.25) | 0.06 (0.24) | −0.58 (0.16) | −0.19 (0.11) | −0.06 (0.10) | −0.05 (0.09) | |
Difference (b-a) | 0.47 [−0.37, 1.32] | 0.21 [−0.41, 0.84] | 0.35 [−0.10, 0.80] | 0.41 [0.12, 0.71] | 0.35 [0.07, 0.63] | 0.18 [−0.13, 0.49] | |
Difference (c-a) | 1.00 [0.30, 1.70] | 0.65 [0.01, 1.29] | 0.58 [0.15, 1.01] | 0.59 [0.28, 0.90] | 0.58 [0.28, 0.88] | 0.56 [0.27, 0.84] | |
P for trend | 0.458 | 0.412 | 0.323 | 0.314 | 0.313 | 0.299 | |
Smoking during pregnancy | 231 | ||||||
No | 0.06 (0.19) | −0.17 (0.15) | −0.70 (0.11) | −0.35 (0.08) | −0.26 (0.07) | −0.32 (0.07) | |
Yes | −0.52 (0.26) | −0.65 (0.23) | −1.23 (0.16) | −0.64 (0.12) | −0.49 (0.12) | −0.51 (0.13) | |
Difference | −0.58 [−1.21, 0.05] | −0.48 [−1.03, 0.05] | −0.53 [−0.91, −0.15] | −0.29 [−0.57, −0.02] | −0.22 [−0.49, 0.05] | −0.19 [−0.49, 0.10] | |
Child characteristics
| |||||||
Child’s birth weight | 250 | ||||||
a. ≤2500 g | −1.23 (0.34) | −1.14 (0.35) | −1.89 (0.25) | −0.97 (0.12) | −0.74 (0.13) | −0.81 (0.16) | |
b. 2501-3500 g | −0.27 (0.19) | −0.47 (0.16) | −0.94 (0.12) | −0.53 (0.08) | −0.42 (0.08) | −0.43 (0.08) | |
c. >3500 g | 0.77 (0.17) | 0.25 (0.19) | −0.30 (0.14) | 0.02 (0.10) | 0.08 (0.10) | −0.01 (0.11) | |
Difference (a-b) | −0.96 [−1.72, −0.21] | −0.67 [−1.42, 0.08] | −0.95 [−1.50, −0.40] | −0.44 [−0.72, −0.16] | −0.32 [−0.62, −0.03] | −0.39 [−0.74, −0.03] | |
Difference (c-b) | 1.04 [0.54, 1.54] | 0.72 [0.23, 1.21] | 0.64 [0.27, 1.01] | 0.55 [0.30, 0.80] | 0.50 [0.26, 0.73] | 0.42 [0.16, 0.67] | |
P for trend | 0.163 | 0.146 | 0.108 | 0.061 | 0.050 | 0.043 | |
Child’s birth length | 189 | ||||||
a. 1st tertile: ≤48 cm | −0.60 (0.27) | −0.69 (0.23) | −1.46 (0.15) | −0.63 (0.11) | −0.48 (0.10) | −0.67 (0.10) | |
b. 2nd tertile: 49–50 cm | 0.44 (0.21) | −0.12 (0.19) | −0.52 (0.13) | −0.23 (0.09) | −0.15 (0.09) | −0.16 (0.10) | |
c. 3rd tertile: ≥51 cm | 1.20 (0.28) | 0.36 (0.29) | −0.15 (0.24) | 0.12 (0.18) | 0.18 (0.16) | 0.11 (0.16) | |
Difference (a-b) | −1.04 [−1.71, 0.37] | −0.57 [−1.15, 0.00] | −0.94 [−1.33, −0.54] | −0.40 [−0.68, −0.13] | −0.33 [−0.60, −0.07] | −0.51 [−0.80, −0.22] | |
Difference (c-b) | 0.76 [0.06, 1.45] | 0.47 [−0.21, 1.15] | 0.37 [−0.17, 0.91] | 0.35 [−0.05, 0.75] | 0.32 [−0.04, 0.69] | 0.26 [−0.11, 0.64] | |
P for trend | 0.051 | 0.053 | 0.053 | 0.019 | 0.016 | 0.020 | |
Age at cow’s milk introduction | 242 | ||||||
<3 months | −0.05 (0.27) | −0.44 (0.24) | −1.00 (0.15) | −0.48 (0.09) | −0.36 (0.09) | −0.44 (0.10) | |
≥3 months | −0.12 (0.21) | −0.22 (0.16) | −0.79 (0.11) | −0.42 (0.08) | −0.31 (0.08) | −0.32 (0.08) | |
Difference | 0.07 [−0.60, 0.74] | −0.22 [−0.79, 0.34] | −0.21 [−0.58, 0.15] | −0.06 [−0.30, 0.18] | −0.05 [−0.28, 0.18] | −0.12 [−0.36, 0.13] | |
Morbidities 15 days before baseline visit: | |||||||
Diarrhea | 254 | ||||||
No | −0.01 (0.19) | −0.21 (0.16) | −0.83 (0.11) | −0.41 (0.07) | −0.29 (0.07) | −0.30 (0.07) | |
Yes | −0.26 (0.29) | −0.42 (0.22) | −0.78 (0.16) | −0.41 (0.10) | −0.37 (0.09) | −0.52 (0.11) | |
Difference | −0.24 [−0.92, 0.43] | −0.21 [−0.74, 0.32] | 0.05 [−0.33, 0.43] | 0.00 [−0.23, 0.24] | −0.08 [−0.30, 0.15] | −0.22 [−0.48, 0.04] | |
Vomiting | 254 | ||||||
No | −0.03 (0.17) | −0.21 (0.13) | −0.79 (0.10) | −0.43 (0.07) | −0.32 (0.06) | −0.33 (0.06) | |
Yes | −0.58 (0.30) | −0.81 (0.33) | −1.31 (0.29) | −0.32 (0.15) | −0.19 (0.14) | −0.48 (0.16) | |
Difference | −0.55 [−1.23, 0.13] | −0.61 [−1.30, 0.09] | −0.52 [−1.13, 0.08] | 0.10 [−0.22, 0.43] | 0.13 [−0.17, 0.44] | −0.15 [−0.48, 0.19] | |
Cough with fever | 252 | ||||||
No | −0.07 (0.17) | −0.24 (0.14) | −0.76 (0.10) | −0.40 (0.07) | −0.29 (0.06) | −0.30 (0.07) | |
Yes | −0.21 (0.38) | −0.53 (0.31) | −1.35 (0.21) | −0.57 (0.12) | −0.44 (0.13) | −0.65 (0.14) | |
Difference | −0.14 [−0.97, 0.68] | −0.28 [−0.96, 0.39] | −0.59 [−1.04, −0.13] | −0.17 [−0.45, 0.11] | −0.15 [−0.43, 0.14] | −0.35 [−0.65, −0.05] |
Adjusted mean HAZ (SE) according to age1,2
| ||||||
---|---|---|---|---|---|---|
6 mo | 12 mo | 2 y | 5 y | 7 y | 10 y | |
MODEL 1 (n = 231)3
| ||||||
Wealth index | ||||||
Below median | −0.37 (0.20) | −0.43 (0.17) | −1.01 (0.12) | −0.60 (0.09) | −0.47 (0.08) | −0.47 (0.08) |
Above median | 0.07 (0.25) | −0.29 (0.21) | −0.68 (0.16) | −0.30 (0.10) | −0.23 (0.09) | −0.30 (0.10) |
Difference [95% CI] | 0.44 [−0.18, 1.06] | 0.14 [−0.39, 0.67] | 0.33 [−0.06, 0.72] | 0.30 [0.06, 0.54] | 0.25 [0.02, 0.48] | 0.17 [−0.07, 0.40] |
Land ownership | ||||||
No | −0.37 (0.20) | −0.43 (0.17) | −1.01 (0.12) | −0.60 (0.09) | −0.47 (0.08) | −0.47 (0.08) |
Yes | 0.16 (1.12) | 0.00 (0.46) | −0.77 (0.27) | −0.29 (0.16) | −0.14 (0.15) | −0.13 (0.15) |
Difference | 0.53 [−1.68, 2.73] | 0.43 [−0.41, 1.28] | 0.24 [−0.24, 0.73] | 0.31 [0.01, 0.61] | 0.33 [0.06, 0.61] | 0.34 [0.05, 0.63] |
MODEL 2 (n = 231)4
| ||||||
Mother’s height | ||||||
a. 1st tertile: ≤154.0 cm | −1.12 (0.33) | −0.73 (0.26) | −1.33 (0.17) | −0.95 (0.13) | −0.80 (0.13) | −0.72 (0.12) |
b. 2nd tertile: 154.1-159.4 cm | −0.48 (0.33) | −0.45 (0.24) | −0.95 (0.17) | −0.52 (0.11) | −0.43 (0.10) | −0.52 (0.12) |
c. 3rd tertile: ≥159.5 cm | −0.02 (0.30) | −0.12 (0.30) | −0.73 (0.19) | −0.38 (0.12) | −0.25 (0.12) | −0.18 (0.11) |
Difference (b-a) | 0.64 [−0.16, 1.43] | 0.28 [−0.35, 0.91] | 0.37 [−0.07, 0.82] | 0.43 [0.14, 0.72] | 0.37 [0.09, 0.64] | 0.20 [−0.10, 0.51] |
Difference (c-a) | 1.10 [0.35, 1.84] | 0.61 [−0.06, 1.28] | 0.60 [0.17, 1.03] | 0.57 [0.27, 0.87] | 0.55 [0.27, 0.84] | 0.54 [0.26, 0.81] |
P for trend | 0.252 | 0.222 | 0.172 | 0.157 | 0.153 | 0.147 |
MODEL 3 (n = 226)5
| ||||||
Child’s birth weight | ||||||
a. ≤2500 g | −1.78 (0.50) | −1.43 (0.47) | −2.13 (0.30) | −1.22 (0.13) | −0.96 (0.14) | −0.94 (0.16) |
b. 2501-3500 g | −1.23 (0.31) | −0.76 (0.26) | −1.35 (0.18) | −1.03 (0.13) | −0.88 (0.13) | −0.78 (0.14) |
c. >3500 g | −0.03 (0.33) | −0.25 (0.31) | −0.84 (0.22) | −0.50 (0.17) | −0.42 (0.16) | −0.47 (0.16) |
Difference (a-b) | −0.55 [−1.53, 0.43] | −0.67 [−1.64, 0.30] | −0.78 [−1.39, −0.16] | −0.19 [−0.49, 0.10] | −0.08 [−0.39, 0.22] | −0.16 [−0.51, 0.19] |
Difference (c-b) | 1.20 [0.62, 1.78] | 0.51 [−0.03, 1.05] | 0.51 [0.14, 0.88] | 0.53 [0.26, 0.78] | 0.46 [0.21, 0.70] | 0.31 [0.05, 0.57] |
P for trend | 0.279 | 0.262 | 0.221 | 0.180 | 0.162 | 0.141 |
MODEL 4 (n = 168)6
| ||||||
Child’s birth length | ||||||
a. 1st tertile: ≤48 cm | −1.10 (0.47) | −0.98 (0.33) | −1.76 (0.20) | −0.97 (0.16) | −0.79 (0.16) | −0.88 (0.15) |
b. 2nd tertile: 49–50 cm | 0.18 (0.48) | −0.93 (0.30) | −1.00 (0.22) | −0.76 (0.17) | −0.66 (0.15) | −0.56 (0.17) |
c. 3rd tertile: ≥51 cm | 1.07 (0.65) | −0.42 (0.36) | −0.72 (0.28) | −0.42 (0.21) | −0.35 (0.19) | −0.37 (0.18) |
Difference (a-b) | −1.28 [−1.91, −0.64] | −0.05 [−0.59, 0.50] | −0.76 [−1.18, -0.34] | −0.21 [−0.52, 0.09] | −0.13 [−0.41, 0.16] | −0.32 [−0.63, −0.01] |
Difference (c-b) | 0.89 [−0.03, 1.80] | 0.51 [−0.24, 1.26] | 0.28 [−0.22, 0.79] | 0.34 [−0.03, 0.70] | 0.31 [−0.03, 0.64] | 0.19 [−0.16, 0.54] |
P for trend | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 |
MODEL 5 (n = 213)7
| ||||||
Age at cow’s milk introduction | ||||||
<3 months | −1.62 (0.37) | −1.20 (0.35) | −1.52 (0.19) | −1.11 (0.15) | −0.98 (0.14) | −0.93 (0.16) |
≥3 months | −1.75 (0.30) | −0.62 (0.29) | −1.35 (0.21) | −1.08 (0.15) | −0.94 (0.14) | −0.84 (0.15) |
Difference | 0.13 [−0.51, 0.79] | −0.58 [−1.22, 0.06] | −0.17 [−0.53, 0.20] | −0.03 [−0.26, 0.20] | −0.04 [−0.26, 0.18] | −0.09 [−0.34, 0.15] |
MODEL 6 (n = 210)8
| ||||||
Diarrhea 15 days before baseline visit | ||||||
No | −1.80 (0.36) | −0.46 (0.28) | −1.32 (0.22) | −1.12 (0.16) | −0.96 (0.15) | −0.80 (0.16) |
Yes | −2.26 (0.49) | −0.47 (0.37) | −1.18 (0.27) | −1.13 (0.17) | −1.07 (0.16) | −1.04 (0.17) |
Difference | −0.46 [−1.27, 0.34] | −0.01 [−0.63, 0.61] | 0.14 [−0.28, 0.56] | −0.01 [−0.25, 0.23] | −0.11 [−0.35, 0.13] | −0.24 [−0.50, 0.02] |