Effects of acute diarrhea on linear growth in Peruvian children

William Checkley*, Leonardo D. Epstein, Robert H. Gilman, Lilia Cabrera, Robert E. Black

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

136 Scopus citations


Linear growth retardation during childhood is a determinant of short stature and impaired capacities in adults of developing countries. To study the effect of diarrhea on height during childhood, the authors followed a birth cohort of 224 Peruvian children for 35 months with records of daily diarrhea and monthly anthropometry. This study was conducted from April 1995 to December 1998. At 24 months of age, study children were 2.5 cm shorter than the US National Center for Health Statistics/World Health Organization growth reference. A diarrheal prevalence of 2.3% in the first 24 months of life explained 2-27% of this growth deficit. There was a 2-month delay before the effects of diarrhea on height became manifest. Height deficits were proportional to diarrheal prevalence. For example, children ill with diarrhea 10% of the time during the first 24 months were 1.5 cm shorter than children who never had diarrhea. In addition, the adverse effects of diarrhea on height varied by age. Diarrhea during the first 6 months of life resulted in long-term height deficits that were likely to be permanent. In contrast, diarrhea after 6 months of age showed transient effects. Study results indicate that diarrhea control, especially during the first 6 months of life, is likely to improve linear growth in Peruvian children.

Original languageEnglish
Pages (from-to)166-175
Number of pages10
JournalAmerican Journal of Epidemiology
Issue number2
StatePublished - 15 Jan 2003
Externally publishedYes

Bibliographical note

Funding Information:
Work for this study was supported by a National Research Service Award from the National Institutes of Child Health and Development (F31-HDO8488) awarded to Dr. William Checkley, an International Centers for Tropical Disease Research (ICTDR) grant from the National Institutes of Allergy and Infectious Diseases awarded to the Johns Hopkins Bloomberg School of Public Health (U01-A135894), and the anonymous RG-ER fund, supported by agencies concerned with childhood health in developing countries.


  • Child development
  • Developing countries
  • Diarrhea
  • Growth
  • Growth disorders
  • Infection


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