The association of malaria morbidity with linear growth, hemoglobin, iron status, and development in young Malawian children: a prospective cohort study

Table 5 Association of infectious disease morbidity from 6 to 18 mo with developmental delay at 18 mo

Independent Variables	Developmental delay^a
	(N = 2016)
	Fine motor delay		Gross motor delay		Language delay		PSED delay
	Risk ratio^b	P-value	Risk ratio^b	P-value	Risk ratio^b	P-value	Risk ratio^b	P-value
	(95% CI)	P-value	(95% CI)	P-value	(95% CI)	P-value	(95% CI)	P-value
Incidence^c of ‘presumed’ malaria	1.03 (0.96 to 1.09)	0.435	1.04 (1.00 to 1.09)	0.059	0.99 (0.94 to 1.06)	0.926	0.95 (0.88 to 1.02)	0.145
> 1 malaria episodes (vs no malaria episode)	0.96 (0.78 to 1.19)	0.723	1.06 (0.89 to 1.27)	0.508	1.00 (0.82 to 1.23)	0.971	0.82 (0.66 to 1.03)	0.094
Incidence^c of diarrhea	1.01 (1.00 to 1.02)	0.011	1.01 (1.00 to 1.02)	< 0.001	1.00 (0.99 to 1.01)	0.129	1.00 (0.99 to 1.01)	0.953
Incidence^c of ARI	0.99 (0.97 to 1.01)	0.367	0.99 (0.98 to 1.01)	0.445	0.99 (0.97 to 1.01)	0.338	1.02 (1.00 to 1.04)	0.025
Other predictors^d
Female sex (vs. male)	1.13 (0.91 to 1.41)	0.253	1.50 (1.22 to 1.85)	< 0.001	0.92 (0.74 to 1.14)	0.438	0.77 (0.61 to 0.96)	0.023
LAZ at age 6 mo	0.90 (0.81 to 1.00)	0.059	0.82 (0.73 to 0.91)	< 0.001	0.87 (0.78 to 0.97)	0.014	0.97 (0.86 to 1.08)	0.533
WLZ at age 6 mo	0.84 (0.76 to 0.93)	0.001	0.97 (0.88 to 1.07)	0.517	0.97 (0.88 to 1.07)	0.542	0.92 (0.83 to 1.03)	0.145
HFIA score	0.98 (0.96 to 0.99)	0.034	0.99 (0.98 to 1.01)	0.702	1.01 (0.99 to 1.03)	0.091	1.02 (0.99 to 1.04)	0.075
Child’s mood	0.38 (0.29 to 0.49)	< 0.001	0.67 (0.55 to 0.83)	< 0.001	1.08 (0.89 to 1.33)	0.435	0.78 (0.63 to 0.97)	0.023
Activity level	0.92 (0.67 to 1.25)	0.587	0.67 (0.51 to 0.87)	0.003	0.91 (0.65 to 1.29)	0.610	1.57 (1.12 to 2.21)	0.009

ARI acute respiratory infection, CI confidence interval, HFIA household food insecurity access, LAZ length for age z-score, PSED Profile of Social and Emotional Development
^aDefined as the bottom 25% of our sample
^bObtained by modified poisson regression (with a robust variance estimator)
^cTotal episodes/child years at risk
^dOnly predictors that showed statistical significance in any of the multivariate models are presented. Other variables entered in the regression, but not significant in any model, were: hemoglobin concentration; iron status; maternal education; interaction with the assessor during the Kilifi Developmental Inventory (KDI) assessment; and whether the child received an intervention (lipid-based nutrient supplements) during the study period

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