{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T15:09:36Z","timestamp":1780499376636,"version":"3.54.1"},"reference-count":60,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,3]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>The growth of children is influenced by various factors, including infections like malaria, diarrhea, and respiratory tract infections (RTIs). This study aimed to assess the associations of these infections with the monthly growth velocity in Tanzanian children. We used data from 2,397 Tanzanian children enrolled in a randomized controlled trial and followed for 18 months (30,079 monthly visits). The exposure variables were infections, whereas the outcome variables were monthly height and weight velocities. Mixed-effects models were used to assess the relationships. The average height velocity was 1.58 cm per month, and average weight velocity was 358 g per month during the follow-up period. Malaria infection was association with a reduction of 0.14 cm\/month in height velocity (coefficient [95% CI]: \u22120.14 [\u22120.23 to \u22120.05]) but not significantly associated with weight velocity. RTIs were associated with a reduction of 0.10 cm\/month (coefficient [95% CI]: \u22120.10 [\u22120.15 to \u22120.04]) and a decrease of 37 g\/month (coefficient [95% CI]: \u221237 [\u221272 to \u22122.6]) in height and weight velocity, respectively. Diarrhea was also inversely associated with both height and weight velocity, with reductions of 0.26 cm\/month (coefficient [95% CI]: \u22120.26 [\u22120.35 to \u22120.17])] and 120 g\/month (coefficient [95% CI]: \u2212120 [\u2212177 to \u221262]), respectively. The findings demonstrate that malaria, respiratory infections, and diarrhea are associated with slower growth velocity in children. These results underscore the importance of integrated health care strategies to address these prevalent infections, because preventing them may contribute to healthier child growth and better overall health outcomes.<\/jats:p>","DOI":"10.4269\/ajtmh.25-0345","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T17:11:10Z","timestamp":1775581870000},"page":"1140-1147","source":"Crossref","is-referenced-by-count":0,"title":["Associations of Malaria, Diarrhea, and Respiratory Infections with Growth Velocity of Children in Tanzania"],"prefix":"10.4269","volume":"114","author":[{"given":"Honelgn Nahusenay","family":"Hiruy","sequence":"first","affiliation":[{"name":"Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enju","family":"Liu","sequence":"additional","affiliation":[{"name":"Institutional Centers of Clinical and Translational Research, Boston Children\u2019s Hospital, Boston, Massachusetts, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alemayehu","family":"Worku","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia;"},{"name":"School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim P.","family":"Manji","sequence":"additional","affiliation":[{"name":"College of Medicine, Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher P.","family":"Duggan","sequence":"additional","affiliation":[{"name":"Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA;"},{"name":"Center for Nutrition, Division of Gastroenterology, Hepatology and Nutrition, Boston Children\u2019s Hospital, Boston, Massachusetts, USA;"},{"name":"Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yemane","family":"Berhane","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wafaie W.","family":"Fawzi","sequence":"additional","affiliation":[{"name":"Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA;"},{"name":"Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA;"},{"name":"Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","article-title":"Tanzania Demographic and Health Survey and Malaria Indicator Survey 2022.","year":"2023"},{"key":"b2","series-title":"PLoS One","first-page":"e0267670","article-title":"Nutritional status of children under five years old involved in a seasonal malaria chemoprevention study in the Nanyumbu and Masasi districts in Tanzania","volume":"17","author":"Mmbando","year":"2022"},{"key":"b3","series-title":"BMC Res Notes","first-page":"583","article-title":"Coinfection of intestinal schistosomiasis and malaria and association with haemoglobin levels and nutritional status in school children in Mara region, Northwestern Tanzania: A cross-sectional exploratory study","volume":"10","author":"Kinung\u2019hi","year":"2017"},{"key":"b4","series-title":"J Health Popul Nutr","first-page":"222","article-title":"Feeding practices and factors contributing to wasting, stunting, and iron-deficiency anaemia among 3-23-month old children in Kilosa district, rural Tanzania","volume":"23","author":"Mamiro","year":"2005"},{"key":"b5","series-title":"BMC Pediatr","first-page":"118","article-title":"Childhood undernutrition in three disadvantaged East African Districts: A multinomial analysis","volume":"19","author":"Agho","year":"2019"},{"key":"b6","article-title":"A Trial of Zinc and Micronutrients in Tanzanian Children.","author":"Duggan","year":"2012"},{"key":"b7","series-title":"J Nutr","first-page":"2153","article-title":"Daily zinc but not multivitamin supplementation reduces diarrhea and upper respiratory infections in Tanzanian infants: A randomized, double-blind, placebo-controlled clinical trial","volume":"145","author":"McDonald","year":"2015"},{"key":"b8","series-title":"WHO Child Growth Standards: Growth Velocity Based on Weight, Length and Head Circumference; Methods and Development","year":"2010"},{"key":"b9","series-title":"Acta Paediatr","first-page":"82","article-title":"Zinc and diarrhea","volume":"81","author":"Hambidge","year":"1992"},{"key":"b10","series-title":"Diarrhea and Malnutrition Interactions, Mechanisms, and Interventions","first-page":"155","author":"Rahaman","year":"1983"},{"key":"b11","series-title":"Food Nutr Bull","first-page":"1","article-title":"Nutritional management of diarrhoea","volume":"16","author":"Mart\u00ednez","year":"1995"},{"key":"b12","series-title":"Bull World Health Organ","first-page":"721","article-title":"Absorption of vitamin A by children with diarrhoea during treatment with oral rehydration salt solution","volume":"64","author":"Reddy","year":"1986"},{"key":"b13","series-title":"J Immunol","first-page":"93.21","article-title":"Targeting metabolic reprogramming of respiratory syncytial virus infection","volume":"204","author":"Bahadoran","year":"2020"},{"key":"b14","series-title":"Nutrition","first-page":"248","article-title":"Systemic inflammation, growth factors, and linear growth in the setting of infection and malnutrition","volume":"33","author":"DeBoer","year":"2017"},{"key":"b15","series-title":"Malar J","first-page":"371","article-title":"Anaemia and malaria","volume":"17","author":"White","year":"2018"},{"key":"b16","series-title":"Curr Mol Med","first-page":"141","article-title":"Severe malaria: Metabolic complications","volume":"6","author":"Planche","year":"2006"},{"key":"b17","series-title":"Sci Immunol","first-page":"eaam8093","article-title":"Plasmodium products persist in the bone marrow and promote chronic bone loss","volume":"2","author":"Lee","year":"2017"},{"key":"b18","series-title":"Int J Health Geogr","first-page":"7","article-title":"Geostatistical modelling of the association between malaria and child growth in Africa","volume":"17","author":"Amoah","year":"2018"},{"key":"b19","series-title":"J Nutr","first-page":"625","article-title":"Active malaria morbidity management has limited impact on height status of preschool Senegalese children","volume":"140","author":"Fillol","year":"2010"},{"key":"b20","series-title":"Am J Clin Nutr","first-page":"550","article-title":"Severe linear growth retardation in rural Zambian children: The influence of biological variables","volume":"71","author":"Hautvast","year":"2000"},{"key":"b21","series-title":"J Infect Dis","first-page":"S848","article-title":"Pathogens associated with linear growth faltering in children with diarrhea and impact of antibiotic treatment: The Global Enteric Multicenter Study","volume":"224","author":"Nasrin","year":"2021"},{"key":"b22","series-title":"Infect Dis Poverty","first-page":"9","article-title":"The association between malaria and malnutrition among under-five children in Shashogo District, Southern Ethiopia: A case\u2013control study","volume":"6","author":"Gone","year":"2017"},{"key":"b23","series-title":"BMC Pediatr","first-page":"396","article-title":"The association of malaria morbidity with linear growth, hemoglobin, iron status, and development in young Malawian children: A prospective cohort study","volume":"18","author":"Bendabenda","year":"2018"},{"key":"b24","series-title":"Clin Infect Dis","first-page":"S41","article-title":"Moderate-to-severe diarrhea and stunting among children younger than 5 years: Findings from the Vaccine Impact on Diarrhea in Africa (VIDA) study","volume":"76","author":"Nasrin","year":"2023"},{"key":"b25","series-title":"Am J Clin Nutr","first-page":"134","article-title":"Impact of infection on the growth of children from 0 to 2 years in an urban West African community","volume":"47","author":"Rowland","year":"1988"},{"key":"b26","series-title":"Am J Epidemiol","first-page":"582","article-title":"Is prevalence of diarrhea a better predictor of subsequent 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malnutrition: Long-term effects of in-patient rehabilitation","volume":"80","author":"Sullivan","year":"1991"},{"key":"b1","article-title":"Tanzania Demographic and Health Survey and Malaria Indicator Survey 2022.","year":"2023"},{"key":"b2","series-title":"PLoS One","first-page":"e0267670","article-title":"Nutritional status of children under five years old involved in a seasonal malaria chemoprevention study in the Nanyumbu and Masasi districts in Tanzania","volume":"17","author":"Mmbando","year":"2022"},{"key":"b3","series-title":"BMC Res Notes","first-page":"583","article-title":"Coinfection of intestinal schistosomiasis and malaria and association with haemoglobin levels and nutritional status in school children in Mara region, Northwestern Tanzania: A cross-sectional exploratory study","volume":"10","author":"Kinung\u2019hi","year":"2017"},{"key":"b4","series-title":"J Health Popul Nutr","first-page":"222","article-title":"Feeding practices and factors contributing to wasting, stunting, and iron-deficiency anaemia among 3-23-month old children in Kilosa district, rural Tanzania","volume":"23","author":"Mamiro","year":"2005"},{"key":"b5","series-title":"BMC Pediatr","first-page":"118","article-title":"Childhood undernutrition in three disadvantaged East African Districts: A multinomial analysis","volume":"19","author":"Agho","year":"2019"},{"key":"b6","article-title":"A Trial of Zinc and Micronutrients in Tanzanian Children.","author":"Duggan","year":"2012"},{"key":"b7","series-title":"J Nutr","first-page":"2153","article-title":"Daily zinc but not multivitamin supplementation reduces diarrhea and upper respiratory infections in Tanzanian infants: A randomized, double-blind, placebo-controlled clinical trial","volume":"145","author":"McDonald","year":"2015"},{"key":"b8","series-title":"WHO Child Growth Standards: Growth Velocity Based on Weight, Length and Head Circumference; Methods and Development","year":"2010"},{"key":"b9","series-title":"Acta Paediatr","first-page":"82","article-title":"Zinc and diarrhea","volume":"81","author":"Hambidge","year":"1992"},{"key":"b10","series-title":"Diarrhea and Malnutrition Interactions, Mechanisms, and Interventions","first-page":"155","author":"Rahaman","year":"1983"},{"key":"b11","series-title":"Food Nutr Bull","first-page":"1","article-title":"Nutritional management of diarrhoea","volume":"16","author":"Mart\u00ednez","year":"1995"},{"key":"b12","series-title":"Bull World Health Organ","first-page":"721","article-title":"Absorption of vitamin A by children with diarrhoea during treatment with oral rehydration salt solution","volume":"64","author":"Reddy","year":"1986"},{"key":"b13","series-title":"J Immunol","first-page":"93.21","article-title":"Targeting metabolic reprogramming of respiratory syncytial virus infection","volume":"204","author":"Bahadoran","year":"2020"},{"key":"b14","series-title":"Nutrition","first-page":"248","article-title":"Systemic inflammation, growth factors, and linear growth in the setting of infection and malnutrition","volume":"33","author":"DeBoer","year":"2017"},{"key":"b15","series-title":"Malar J","first-page":"371","article-title":"Anaemia and malaria","volume":"17","author":"White","year":"2018"},{"key":"b16","series-title":"Curr Mol Med","first-page":"141","article-title":"Severe malaria: Metabolic complications","volume":"6","author":"Planche","year":"2006"},{"key":"b17","series-title":"Sci Immunol","first-page":"eaam8093","article-title":"Plasmodium products persist in the bone marrow and promote chronic bone loss","volume":"2","author":"Lee","year":"2017"},{"key":"b18","series-title":"Int J Health Geogr","first-page":"7","article-title":"Geostatistical modelling of the association between malaria and child growth in Africa","volume":"17","author":"Amoah","year":"2018"},{"key":"b19","series-title":"J Nutr","first-page":"625","article-title":"Active malaria morbidity management has limited impact on height status of preschool 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status, and development in young Malawian children: A prospective cohort study","volume":"18","author":"Bendabenda","year":"2018"},{"key":"b24","series-title":"Clin Infect Dis","first-page":"S41","article-title":"Moderate-to-severe diarrhea and stunting among children younger than 5 years: Findings from the Vaccine Impact on Diarrhea in Africa (VIDA) study","volume":"76","author":"Nasrin","year":"2023"},{"key":"b25","series-title":"Am J Clin Nutr","first-page":"134","article-title":"Impact of infection on the growth of children from 0 to 2 years in an urban West African community","volume":"47","author":"Rowland","year":"1988"},{"key":"b26","series-title":"Am J Epidemiol","first-page":"582","article-title":"Is prevalence of diarrhea a better predictor of subsequent mortality and weight gain than diarrhea incidence?","volume":"144","author":"Morris","year":"1996"},{"key":"b27","series-title":"Am J Trop Med Hyg","first-page":"233","article-title":"Diarrhea prevalence and child growth faltering are associated with subsequent adverse child developmental outcomes in Bangladesh (CHoBI7 Program)","volume":"106","author":"George","year":"2021"},{"key":"b28","series-title":"Am J Trop Med Hyg","first-page":"749","article-title":"Impact of rotaviral diarrhea on child growth in sub-Saharan Africa and South Asia in the Global Enteric Multicenter Study","volume":"110","author":"Sobi","year":"2024"},{"key":"b29","series-title":"Am J Epidemiol","first-page":"1129","article-title":"Diarrhea in early childhood: Short-term association with weight and long-term association with length","volume":"178","author":"Richard","year":"2013"},{"key":"b30","series-title":"Acta Paediatr Scand","first-page":"1025","article-title":"The treatment of persistent diarrhoea and malnutrition: Long-term effects of in-patient rehabilitation","volume":"80","author":"Sullivan","year":"1991"}],"container-title":["The American Journal of Tropical Medicine and 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