Prevention and treatment of childhood malnutrition in rural Malawi: Lungwena nutrition studies

Malawi is one of the poorest countries in the world with poor health and nutritional indicators. It is sometimes only surpassed by countries under conflict. Such a situation necessitated a search for local causes of undernutrition which heavily contribute to childhood mortality in Malawi. Literature showed that certain aspects of undernutrition had not been wholly explained. The determination of when growth faltering starts had been hampered by lack of an appropriate reference standard. This raised a question when growth faltering actually start, as preventive strategies had to be instituted early in the development of the problem. For this, local studies were needed. The review highlighted the fact that determinants of malnutrition may not have the same importance in all settings and thus preventive strategies that work in one place may not work in all settings. This meant that determination of local causes and effective interventions was one way of alleviating the problem. It had been standard to consider underweight and stunting as being resultant from the same causal factors. The epidemiology of wasting and stunting and the relationship of weight and height gain suggested possible difference in aetiology and a need to develop a clear understanding of their relationship, which in turn could help in developing effective interventions.