Nutritional status following malaria control in a Vietnamese ethnic minority commune

Objective: To study whether control of malaria leads to catch-up growth or an increase of obesity in a marginally nourished population. Setting: A Vietnamese ethnic minority commune in southern Vietnam. Design: Repeated annual anthropometric surveys were performed from 1995 to 2000. Z-scores for height, weight and BMI for age and weight-for-height were determined by using NCHS 1978 and CDC 2000 reference tables and by the LMS method. Intervention: Active malaria control that reduced the parasite carrier rate from 50% in 1994 to practically nil in 1998. Results: Inhabitants were generally of short stature and very thin. Using the US reference tables, the prevalence of moderate/ severe stunting among children was 53/24% and of wasting 27/9% in the first survey in 1995. Physical condition and normal daily activities of most inhabitants were normal. The repeated LMS-Z-scores uncovered a significant recovery of stunting, extending into preadolescence, including the development of a pubertal growth spurt for girls and enhancement of pubertal growth in boys, after control of malaria. The mean (95% CI) annual increase of Z-height-for-age was 0.11 (0.09 - 0.12) for boys and 0.14 (0.13 - 0.15) for girls (P<0.001). As a consequence, weight-for-age and BMI Z-scores decreased without indication of developing obesity. Conclusion: Catch-up growth, extending into preadolescent age, was observed in a Vietnamese ethnic minority population with a chronic state of low food intake, without indication of developing obesity. The control of malaria was probably the most significant contribution to this catch-up growth.