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Resumo

Structural regression models are applied to longitudinal data to study reciprocal causal influences between malnutrition and infection in preschool children. Two models of three waves (time periods) are applied: a two‐variable model, the variables being acute malnutrition and diarrhea; and a three‐variable model, which includes chronic malnutrition as a third variable. Malnutrition is measured by standardized weight for age and standardized height for age, and enteric infection is measured by diarrhea. The latter is expressed as the number of days with diarrhea or fever divided by the number of days at risk in the trimester preceding anthropometric assessment. The data used in the analysis were gathered as part of a longitudinal study to estimate the effects of nutrition on mental and physical growth, conducted by the Institute of Nutrition of Central America and Panamá (INCAP) in rural Guatemala. The sample comprises 508 children with complete data from families residing in four rural villages. Results provide evidence of significant causal influence of both diarrhea on acute malnutrition and of acute malnutrition on diarrhea. A cumulative effect of acute malnutrition on chronic malnutrition that leads to growth retardation is identified. Accordingly, interventions aimed at decreasing the causal effect of infection on malnutrition, as well as interventions aimed at improving the nutritional condition of children, are required.

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