biostudies-literatureBourdon CDepartment for International Development, UK GovernmentMedical Research CouncilWellcome Trust-Cancer Research UK Gurdon InstituteWellcome TrustMRCBill &amp;amp; Melinda Gates Foundation102530https://www.ebi.ac.uk/biostudies/studies/S-EPMC10950691biostudies-literatureUnknown70<h4>Background</h4>Growth faltering is well-recognized during acute childhood illness and growth acceleration during convalescence, with or without nutritional therapy, may occur. However, there are limited recent data on growth after hospitalization in low- and middle-income countries.<h4>Methods</h4>We evaluated growth following hospitalization among children aged 2-23 months in sub-Saharan Africa and South Asia. Between November 2016 and January 2019, children were recruited at hospital admission and classified as: not-wasted (NW), moderately-wasted (MW), severely-wasted (SW), or having nutritional oedema (NO). We describe earlier (discharge to 45-days) and later (45- to 180-days) changes in length-for-age [LAZ], weight-for-age [WAZ], mid-upper arm circumference [MUACZ], weight-for-length [WLZ] z-scores, and clinical, nutritional, and socioeconomic correlates.<h4>Findings</h4>We included 2472 children who survived to 180-days post-discharge: NW, 960 (39%); MW, 572 (23%); SW, 682 (28%); and NO, 258 (10%). During 180-days, LAZ decreased in NW (-0.27 [-0.36, -0.19]) and MW (-0.23 [-0.34, -0.11]). However, all groups increased WAZ (NW, 0.21 [95% CI: 0.11, 0.32]; MW, 0.57 [0.44, 0.71]; SW, 1.0 [0.88, 1.1] and NO, 1.3 [1.1, 1.5]) with greatest gains in the first 45-days. Of children underweight (<-2 WAZ) at discharge, 66% remained underweight at 180-days. Lower WAZ post-discharge was associated with age-inappropriate nutrition, adverse caregiver characteristics, small size at birth, severe or moderate anaemia, and chronic conditions, while lower LAZ was additionally associated with household-level exposures but not with chronic medical conditions.<h4>Interpretation</h4>Underweight and poor linear growth mostly persisted after an acute illness. Beyond short-term nutritional supplementation, improving linear growth post-discharge may require broader individual and family support.<h4>Funding</h4>Bill & Melinda Gates FoundationOPP1131320; National Institute for Health ResearchNIHR201813.EClinicalMedicineChildhood growth during recovery from acute illness in Africa and South Asia: a secondary analysis of the childhood acute illness and nutrition (CHAIN) prospective cohort.PMC10950691203077MR/M007367/1OPP1131320Mupere EAhmed TMaronga CTimbwa MOduol COBerkley JAWalson JLKazi ZAhmed DMohammad Sayeem Bin Shahid ASGnoumou BSMukisa JBamouni RMOuedraogo IBourdon CAber PVoskuijl WPSaleem AFMbale ENjunge JMBrals DMburu MAfsana SMMallewa MBanu SLwanga CChisti MJNgari MMAli SAJemutai JSukhtankar PNgao NTickell KDMwaringa SNjirammadzi JChimwezi EMolyneux SSalauddin Mamun GMHarawa PPHossain MIManyasi CDenno DMDiallo AHSinga BOThitiri JShaima SNShahrin LOtieno CAMcGrath CJLancioni CLMondal DMangale DITigoi CBandsma RHJKhan MAfalseChildhood growth during recovery from acute illness in Africa and South Asia: a secondary analysis of the childhood acute illness and nutrition (CHAIN) prospective cohort.<h4>Background</h4>Growth faltering is well-recognized during acute childhood illness and growth acceleration during convalescence, with or without nutritional therapy, may occur. However, there are limited recent data on growth after hospitalization in low- and middle-income countries.<h4>Methods</h4>We evaluated growth following hospitalization among children aged 2-23 months in sub-Saharan Africa and South Asia. Between November 2016 and January 2019, children were recruited at hospital admission and classified as: not-wasted (NW), moderately-wasted (MW), severely-wasted (SW), or having nutritional oedema (NO). We describe earlier (discharge to 45-days) and later (45- to 180-days) changes in length-for-age [LAZ], weight-for-age [WAZ], mid-upper arm circumference [MUACZ], weight-for-length [WLZ] z-scores, and clinical, nutritional, and socioeconomic correlates.<h4>Findings</h4>We included 2472 children who survived to 180-days post-discharge: NW, 960 (39%); MW, 572 (23%); SW, 682 (28%); and NO, 258 (10%). During 180-days, LAZ decreased in NW (-0.27 [-0.36, -0.19]) and MW (-0.23 [-0.34, -0.11]). However, all groups increased WAZ (NW, 0.21 [95% CI: 0.11, 0.32]; MW, 0.57 [0.44, 0.71]; SW, 1.0 [0.88, 1.1] and NO, 1.3 [1.1, 1.5]) with greatest gains in the first 45-days. Of children underweight (<-2 WAZ) at discharge, 66% remained underweight at 180-days. Lower WAZ post-discharge was associated with age-inappropriate nutrition, adverse caregiver characteristics, small size at birth, severe or moderate anaemia, and chronic conditions, while lower LAZ was additionally associated with household-level exposures but not with chronic medical conditions.<h4>Interpretation</h4>Underweight and poor linear growth mostly persisted after an acute illness. Beyond short-term nutritional supplementation, improving linear growth post-discharge may require broader individual and family support.<h4>Funding</h4>Bill & Melinda Gates FoundationOPP1131320; National Institute for Health ResearchNIHR201813.2024-01-01T00:00:00Z2024 Apr2025-04-04T20:07:37.986Z2025-04-04T20:07:37.986ZS-EPMC109506913851037310.1016/j.eclinm.2024.102530