EFFECTS OF DIARRHEA ASSOCIATED WITH SPECIFIC ENTEROPATHOGENS ON THE GROWTH OF CHILDREN IN RURAL BANGLADESH

Village-based surveillance data from longitudinal studies in rural Bangladesh were used to evaluate the nutritional consequences of infectious diseaes, including diarrhea due to specific pathogens. The prevalences of specific illnesses were related to the ponderal and linear growth of young children for 2 mo. and 1 yr periods. Of the common illnesses, only diarrhea had a significant inverse relationship with increments of weight during 2 mo. periods and of length during 1 yr. Diarrhea accounted for 20% of the difference in linear growth between the study children and the international reference population during the first 5 yr of life. Diarrhea associated with enterotoxigenic Escherichia coli had a significant negative effect on the bimonthly weight gain of children in this community; shigellosis had the strongest negative effect on bimonthly and annual linear growth. Control of diarrhea due to enterotoxigenic E. coli and Shigella would substantially diminish diarrheal morbidity and improve the growth of children and thereby reduce the prevalence of protein-energy malnutrition.