Nutritional status and common infections in infants in Burkina Faso: Interest of an 'overall morbidity score'

Objective: To study the overall impact of morbidity on the nutritional status of infants in a rural area of Burkina-Faso. Method: A cohort of children (n = 114) were monitored from age 6 months to 2 years in 30 villages in north-eastern Burkina Faso. Anthropometric measurements and the incidence of illness were recorded at 6, 9, 12, 15, 18 and 24 months. An overall morbidity score was constructed including the duration of common illnesses and their effect on appetite. Mixed linear regression models were used to analyse the relation between this score and both the weight-for-length (WFL) and the length-for-age (LFA) index. Results: After adjustment for potential confounders, the morbidity score at time T was strongly correlated with the WFL index at time T (P < 0.0001) and weakly correlated with the LFA index at time T + 1 (P = 0.06). When the morbidity score was divided into classes, at time T the mean WFL z-score for children with a high morbidity score was 0.34 z-scores lower than the one for healthy children (P < 0.0001); at time T + 1, the difference in the mean LFA z-scores between the same groups was 0.09 z-score (P = 0.02). However, similar results were obtained using simpler expressions of morbidity. Taken separately, diarrhoea or febrile illness had an effect on WFL (at time T), but only diarrhoea had an effect on LFA (at time T + 1). Conclusion: Morbidity was strongly correlated with weight loss in children in the short term and weakly correlated with a slowdown in growth. © 2008 Blackwell Publishing Ltd.