Figure 2. Repeated bouts of diarrhea linearly ablate “catch-up growth.

The use of ORT has dramatically reduced acute mortality from dehydration caused by the diarrhea that often results from infection with an enteric pathogen. However, rates of morbidity as a result of enteric infections remain as high as ever. The morbidity impact of enteric pathogens is related to their ability to impair nutritional status, presumably by directly impairing intestinal absorption and by causing diarrhea. Therefore, repeated infection with enteric pathogens has a lasting impact on the growth and development of a child. Although malnourished children can catch up if given a chance, those with frequent bouts of diarrhea as a result of repeated infection with enteric pathogens have this catch-up growth linearly ablated. Weight-for-age Z score < –3, children with a Z score more than 3 SD below mean weight-for-age value, considered severely malnourished; weight-for-age Z score > –3, children with a Z score less than 3 SD below mean weight-for-age value, considered not severely malnourished. Figure reproduced with permission from Lancet (5).