Transition between stunted and nonstunted status: both occur from birth to 15 years of age in Malawi children.

Abstract

The timing and frequency of stunting and possible catch-up growth are ambiguous in low-income settings. This study explored the timing and extent of becoming stunted and nonstunted between birth and 15 years of age in a resource-poor area of Malawi, south-east Africa. We followed 767 children from the foetal period until 15 years of age and examined the transition between stunted and nonstunted status and the pubertal stage at 15 years of age. We also plotted smoothed curves for the mean absolute deficits in centimetres and height-for-age standard deviation scores (HAZ) according to the World Health Organization's 2006 and 2007 references. Most two-year olds (80%) were stunted (HAZ < -2 SD), but this had declined to 37% at 15 years of age. During the three five-year intervals, new stunting cases ranged from 3.9 to 21.3% and the percentage who became nonstunted was 9.1 to 15%. The majority (85%) of the children, who were moderately stunted at two years of age, became nonstunted during the follow-up period. Only, 9% of boys and 20% of girls had reached advanced puberty by the age of 15. Becoming stunted and nonstunted status both occurred throughout the period from birth to 15 years of age in Malawi children. The small percentage who had reached advanced puberty by the age of 15 suggests significant further growth potential.