Weakness of biochemical markers of nutritional and inflammatory status as prognostic indices for growth retardation and morbidity of young children in central Africa

Tonglet, René; Lembo, Erminia; Dramaix, Michèle; Hennart, Philippe

doi:10.1038/sj.ejcn.1600375

“…Tonglet et al (22) demonstrated that subsequent height growth (over 1 to 6 mo) was lower in children with high serum concentrations of AGP, which agrees with our observations. This was illustrated by the fact that a higher proportion of children appeared to have increased serum AGP concentration (60-71%) in comparison with raised serum CRP concentrations (50-60%).…”

Section: Discussionsupporting

confidence: 93%

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

Hautvast

¹

,

Tolboom

²

,

Willems

³

et al. 2000

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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), alpha1-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.

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“…Our observation that serum AGP was statistically significantly related to subsequent length increment, whereas CRP almost reached significance, may be explained by this reasoning. Tonglet et al (22) demonstrated that subsequent height growth (over 1 to 6 mo) was lower in children with high serum concentrations of AGP, which agrees with our observations. The fact that in our study children with increased serum CRP concentration combined with high malaria parasite density (!5000/ mL) had lower subsequent length increment in comparison with children with normal serum CRP concentration and no malaria parasitaemia indicates that in this population malarial illness is an important determinant of linear growth retardation.…”

Section: Discussionsupporting

confidence: 93%

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

Hautvast

¹

,

Tolboom

²

,

Willems

³

et al. 2000

SPAE

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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), alpha1-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.

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“…The prospective cohort study reported here was primarily designed to examine the value of anthropometric, clinical, biological, and dietary indicators in predicting short‐term morbidity of young children in rural Africa ( Tonglet 1994). Having demonstrated in a previous paper the weakness of biochemical markers of nutritional and inflammatory status as a means for risk scoring in children from the community ( Tonglet et al . 1997 ), we focus here on other possible predictors, some of which are anthropometric.…”

Section: Introductionmentioning

confidence: 99%

How useful are anthropometric, clinical and dietary measurements of nutritional status as predictors of morbidity of young children in central Africa?

Tonglet

¹

,

Lembo²,

Zihindula³

et al. 1999

Tropical Med Int Health

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Summaryobjective To identify useful predictors of morbidity of young children in central Africa. method Population-based follow-up study in Northern Kivu, Congo, of 842 children under two years of age who completed weekly follow-up interviews and health examinations during three months. Main outcome measures were crude and adjusted effects of summary measures of nutritional status on one-month cumulative incidence of malaria, respiratory illness, and diarrhoea.results Anthropometric indicators appeared to perform badly in predicting morbidity. In contrast, nonanthropometric variables such as growth as judged by the caretaker, child's diet at the time of examination, and occurrence of disease in the month preceding the interval of observation were useful.conclusions In the context of the 'Sick Child Initiative', simple tests and diagnostic tools to improve quality of both prevention and cure in first-level facilities need to be identified. Focusing on non-anthropometric indicators should be encouraged to offer a comprehensive appraisal of health status to all children.

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Weakness of biochemical markers of nutritional and inflammatory status as prognostic indices for growth retardation and morbidity of young children in central Africa

Cited by 4 publications

References 17 publications

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

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

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

How useful are anthropometric, clinical and dietary measurements of nutritional status as predictors of morbidity of young children in central Africa?

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