Less diarrhoea but no change in growth: 15 years' data from three Gambian villages

Aims-To review diarrhoea presentations and nutritional status in young rura l Gambian children over a 15 year period as a test of an earlier hypothesis that reduced diarrhoea prevalence would lead to improved growth and a redu ced prevalence of malnutrition. Subjects and methods-Growth and morbidity were documented routinely in 1190 children under 2 years of age attending the Dunn Nutrition Group clinic at Keneba between 1979 and 1993. Results-The numbers of presentations with diarrhoea (1069 in 1979; 220 in 1 993) and the proportion of clinic attendees with diarrhoea (30% in 1979; 8% in 1993) fell steadily between 1979 and 1993. However, at both 1 year old, mean weights (Z scores: 1979, -1.8; 1993, -1.8) and mean lengths (Z scores : 1979, -1.3; 1993, -1.7), and at 2 years old, mean weights (Z scores: 1979 , -2.0; 1993, -1.9) and mean lengths (Z scores: 1979, -2.0; 1993, -2.1) did not change noticeably over the 15 year period. Conclusion-Major progressive reductions in clinic presentations with diarrh oea have not been associated with improved nutritional status in this popul ation of young rural Gambian children.