ArticleJournal of global health2017
Developmental and behavioural problems in children with severe acute malnutrition in Malawi: A cross-sectional study.
Article in Journal of global health, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 4 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
32 citing papers in PubMed, 4 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- Guideline
- Pooled it
- Neurodevelopmental, cognitive, behavioural and mental health impairments following childhood malnutrition: a systematic review.BMJ global health · 2022Pooled it
- Ready-to-Use Therapeutic Food (RUTF) Containing Low or No Dairy Compared to Standard RUTF for Children with Severe Acute Malnutrition: A Systematic Review and Meta-Analysis.Advances in nutrition (Bethesda, Md.) · 2021Pooled it
- Understanding modifiable caregiver factors contributing to child development among young children in rural Malawi.Maternal & child nutrition · 2024Trial
- Low linoleic acid foods with added DHA given to Malawian children with severe acute malnutrition improve cognition: a randomized, triple-blinded, controlled clinical trial.The American journal of clinical nutrition · 2022Trial
- Trial
- Trial
- Predictors of Psychomotor Developmental Delay Among Under-Five Children With Severe Acute Malnutrition in a Food Insecure Setting in DRC: Exploratory Analysis of Children From EfRAMAS Trial.Maternal & child nutrition · 2026Article
- Time to Recovery From Severe Acute Malnutrition to Normal Nutritional Status and Its Predictors Among Children Aged 6-59 Months in North-East Ethiopia.Maternal & child nutrition · 2025Article
- Environmental change, aquatic conditions, and household food security: Evidence from Lake Malawi.Population and environment · 2025Article
- Correlates of early child development among children with stunting: A cross-sectional study in Uganda.Maternal & child nutrition · 2024Article
- Comparing motor development in children with hydrocephalus after treatment with ventriculoperitoneal shunt and endoscopic third ventriculostomy: a cross-sectional study.Malawi medical journal : the journal of Medical Association of Malawi · 2024Article
- Novel approach to assess sarcopenia in children with inflammatory bowel disease.Frontiers in pediatrics · 2024Article
- Predictors of change in early child development among children with stunting: Secondary analysis of a randomized trial in Uganda.PLOS global public health · 2024Article
- Article
- Training Packages and Patient Management Tools for Healthcare Staff Working with Small, Nutritionally At-Risk Infants Aged under 6 Months: A Mixed-Methods Study.Children (Basel, Switzerland) · 2023Article
- Neurodevelopment assessment of small for gestational age children in a community-based cohort from Pakistan.Archives of disease in childhood · 2023Article
- Instruments to identify risk factors associated with adverse childhood experiences for vulnerable children in primary care in low- and middle-income countries: A systematic review and narrative synthesis.PLOS global public health · 2022Article
- Article
Corrections and comments
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Authors and funding
7 authors at 6 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEarly childhood development provides an important foundation for the development of human capital. Although there is a clear relation between stunting and child development outcomes, less information is available about the developmental and behavioural outcomes of children with severe acute malnutrition (SAM). Particularly an important research gap exists in Sub-Saharan Africa where there is a high prevalence of SAM and a high rate of co-occurring HIV (human immune deficiency virus) infection. Our first objective was to assess the prevalence and severity of developmental and behavioural disorders on a cohort of children admitted to an inpatient nutritional rehabilitation centre in Malawi. Our second objective was to compare the developmental and behavioural profiles of children with the two main phenotypes of SAM: kwashiorkor and marasmus.
methodsThis was a cross-sectional observational study including all children hospitalized with complicated SAM in Blantyre, Malawi over an 8-month period from February to October 2015. At discharge, children were assessed with the well-validated Malawi Developmental Assessment Tool (MDAT) for gross motor, fine motor, language and social development. In children ≥24 months, emotional and behavioural problems were measured using the Strengths and Difficulties Questionnaire (SDQ).
results150 children (55% boys) with SAM were recruited; mean age of 27.2 months (standard deviation 17.9), 27 children (18%) had pre-existing neurodisabilities (ND) and 34 (23%) had a co-occurring human immune deficiency virus (HIV) infection. All children with SAM experienced profound delays in the gross and fine motor, language and social domains. Linear regression analysis demonstrated that children with kwashiorkor scored 0.75 standard deviations lower (95% confidence interval -1.43 to -0.07) on language MDAT domain than children with marasmus when adjusted for covariates. The prosocial behaviour score of the SDQ was low in children with SAM, indicating a lack of sensitive behaviour in social interactions.
conclusionsChildren with SAM have severe developmental delays after a hospital admission. Our results indicate that there might be a significant difference in developmental attainment between children with kwashiorkor and with marasmus. Future studies exploring longer-term outcomes and testing possible intervention strategies are urgently needed.
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