1921
Volume 71, Issue 2_suppl
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

There are a number of pathways, both direct and indirect, through which malaria infection could impact the course of child development, causing impairment and disability and adding to the burden of malaria. We present an overview of relevant studies that illustrate these pathways, updating the evidence previously presented. We conclude that before the mechanisms and numbers of affected children can be adequately defined, a wider range of potential pathways to impaired development need to be investigated. Only then can the calculation of the burden be evidence-based, rather than merely speculative. Priorities for future research are described. The calculation of the impact of malaria on child development also requires a degree of uniformity in the definition of outcome across studies. This is currently lacking, and suggestions are made for a common approach to the reporting of results.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.2004.71.2_suppl.0700071
2004-08-01
2017-11-23
Loading full text...

Full text loading...

/deliver/fulltext/14761645/71/2_suppl/0700071.html?itemId=/content/journals/10.4269/ajtmh.2004.71.2_suppl.0700071&mimeType=html&fmt=ahah

References

  1. Al Serouri AW, Grantham-McGregor SM, Greenwood B, Costello A, 2000. Impact of asymptomatic malaria parasitaemia on cognitive function and school achievement of schoolchildren in the Yemen Republic. Parasitology 121: 3337–3345.
  2. Boivin M, 2002. Effects of early cerebral malaria on cognitive ability in Senegalese children. J Dev Behav Pediatr 23: 1–12.
  3. Carter JC, Murira GM, Ross A, Mung’ala-Odera V, Newton CJRC, 2003. Speech and language sequelae of severe malaria in Kenyan children. Brain Injury 17: 217–224.
  4. Greenfield PM, 1997. You can’t take it with you: why ability assessments don’t cross cultures. Am Psychol 52: 1115–1124.
  5. Rogoff B, Chavajay P, 1995. What’s become of research on the cultural basis of cognitive development? Am Psychol 50: 859–877.
  6. WHO, 2001. International Classification of Functioning, Disability and Health. Geneva: World Health Organization. International Classification of Functioning, Disability and Health Checklist.
  7. Holding PA, Snow RW, 2001. Impact of Plasmodium falciparum malaria on performance and learning: review of the evidence. Am J Trop Med Hyg 64: 68–75.
  8. Boivin M, Giordani B, Ndanga K, Maky M, Menzeki M, Ngunu N, Muamba K, 1993. Effects of treatment for intestinal parasites and malaria on the cognitive abilities of schoolchildren in Zaire, Africa. Health Psychol 12: 220–226.
  9. Shiff C, Checkley W, Winch P, Premji Z, Minjas J, Lubega P, 1996. Changes in weight gain and anaemia attributable to malaria in Tanzanian children living under holoendemic conditions. Trans R Soc Trop Med Hyg 90: 262–265.
  10. Fernando S, Paranavitane S, Rajakaruna J, Weerasinghe S, Silva D, Wickremasinghe A, 2000. The health and nutritional status of school children in two rural communities in Sri Lanka. Trop Med Int Health 5: 450–452.
  11. Kvalsvig J, Cooppan R, Connolly K, 1991. The effects of parasite infections on cognitive processes in children. Ann Trop Med Parasitol 85: 551–568.
  12. Brooker S, Guyatt H, Omumbo J, Shretta R, Drake L, Ouma J, 2000. Situation analysis of malaria in school-aged children in Kenya - what can be done? Parasitol Today 16: 183–186.
  13. Lozoff B, 1989. Nutrition and behavior. Am Psycholt 44: 231–236.
  14. Smith A, Tyrell D, Coyle K, Willman J, 1987. Selected effects of minor illnesses on human performance. Br J Psychol 78: 183–188.
  15. Colbourne M, 1955. The effect of malaria suppression in a group of Accra schoolchildren. Trans R Soc Trop Med Hyg 49: 356–369.
  16. Archibald H, Bruce-Chwatt L, 1956. Suppression of malaria with pyrimethamine in Nigerian schoolchildren. Bull World Health Organ 15: 775–784.
  17. Magnussen P, Ndawi B, Sheshe AK, Byskov J, Mbwana K, 2001. Malaria diagnosis and treatment administered by teachers in primary schools in Tanzania. Trop Med Int Health 6: 273–279.
  18. Pasha O, Del Rosso J, Mukaka M, Marsh D, 2003. The effect of providing fansidar (sulfadoxine-pyrimethamine) in schools on mortality in school-age children in Malawi. Lancet 361: 577–578.
  19. Konradsen F, van der Hoek W, Amerasinghe P, Amerasinghe F, 1997. Measuring the economic cost of malaria to households in Sri Lanka. Am J Trop Med Hyg 56: 656–660.
  20. Guyatt H, Snow R, Evans D, 1999. Malaria epidemiology and economics: the effect of delayed immune acquisition on the cost-effectiveness of insecticide-treated bednets. Philos Trans R Soc Lond B Biol Sci 354: 827–835.
  21. Kariuki SK, Lal AA, Terlouw DJ, ter Kuile FO, Ong’echa JM, Phillips-Howard PA, Orago AS, Kolczak MS, Hawley WA, Nahlen BL, Shi YP, 2003. Effects of permethrin-treated bed nets on immunity to malaria in Western Kenya. II. Antibody responses in young children in an area of intense malaria transmission. Am J Trop Med Hyg 64 (suppl): 108–114.
  22. Muntendam AH, Jaffar S, Bleichrodt N, van Hensbroek M, 1996. Absence of neuropsychological sequelae following cerebral malaria in Gambian children. Trans R Soc Trop Med Hyg 90: 391–394.
  23. Dugbartey AT, Spellacy FJ, Dugbartey MT, 1998. Somatosensory discrimination deficits following pediatric cerebral malaria. Am J Trop Med Hyg 59: 393–396.
  24. Holding P, Stevenson J, Peshu N, Marsh K, 1999. Cognitive sequelae of severe malaria with impaired consciousness. Trans R Soc Trop Med Hyg 93: 529–534.
  25. Taylor H, Schatschneider C, Petrill S, Barry C, Owens C, 1996. Executive dysfunction in children with early brain disease: outcomes post Haemophilus influenzae meningitis. Dev Neuropsychol 12: 35–54.
  26. Epstein H, 1986. Stages in human brain development. Brain Res 395: 114–119.
  27. Hudspeth W, Pribam K, 1992. Psychophysiological indices of cerebral maturation. Int J Psychophysiol 12: 19–29.
  28. Lartey A, Manu A, Brown K, Peerson J, Dewey K, 2000. Predictors of growth from 1 to 18 months among breast-fed Ghanaian infants. Eur J Clin Nutr 54: 41–49.
  29. Holding PA, Taylor HG, Kazungu S, Mkala T, Gona J, Mwamuye B, Mbonani L, JS, 2004. Assessing cognitive outcomes in a rural African population: development of a neuropsychological battery in Kilifi, Kenya. J Int Neuropsychol Soc 10: 1–15.
  30. Maj M, Janssen R, Satz P, Zaudig M, Starace F, Boor D, Sughondhabirom B, Ndetei D, 1991. The World Health Organisation’s cross-cultural study on neuropsychiatric aspects of infection with the immunodeficiency virus (HIV). Br J Psychiatry 159: 351–356.
  31. Stanton W, McGee R, Silva P, 1989. Longitudinal study of the interactive effects of perinatal complications and early family adversity on cognitive ability. Aust Pediatr J 25: 130–133.
  32. Mills A, 1993. The household costs of malaria in Nepal. Trop Med Parasitol 44: 9–13.
  33. Attanayake N, Fox-Rushby J, Mills A, 2000. Household costs of ‘malaria’ morbidity: a study in Matale district, Sri Lanka. Trop Med Int Health 5: 595–606.
  34. Chima R, Goodman C, Mills A, 2003. The economic impact of malaria in Africa: a critical review of the evidence. Health Policy 63: 17–36.
  35. Takakura M, Uza M, Sasaki Y, Nagahama N, Phommpida S, Bounyadeth S, Kobayashi J, Toma T, Miyagi I, 2001. The relationship between anthropometric indicators of nutritional status and malaria infection among youths in Khammouane Province, Lao PDR. Southeast Asian J Trop Med Public Health 32: 262–267.
  36. Verhoef H, West C, Veenemans J, Beguin Y, Kok F, 2002. Stunting may determine the severity of malaria-associated anemia in African children. Pediatrics 110: E48.
  37. Deen JL, Walraven GE, von Seidlein L, 2002. Increased risk for malaria in chronically malnourished children under 5 years of age in rural Gambia. J Trop Pediatr 48: 78–83.
  38. Williams T, Maitland K, Phelps L, Bennett S, Peto T, Viji J, Timothy R, Cleg J, Weatherall D, Bowden D, 1997. Plasmodium vivax: a cause of malnutrition in young children. QJM 90: 751–757.
  39. Sharp T, Harvey P, 1980. Malaria and growth stunting in young children of the highlands of Papua New Guinea. P N G Med J 23: 132–140.
  40. Galler J, Ramsey F, Forde V, Salt P, Archer E, 1987. Long-term effects of early kwashiorkor compared with marasmus. II. Intellectual performance. J Pediatr Gastroenterol Nutr 6: 847–854.
  41. Galler JR, Barret LR, 2001. Children and famine: long-term impact on development. Ambulatory Child Health 7: 85–95.
  42. Hendrickse R, Hasan A, Olumide L, Akinkunmi A, 1971. Malaria in early childhood. Ann Trop Med Parasitol 65: 1–20.
  43. Edirisinghe J, 1986. Infections in the malnourished: with special reference to malaria and malnutrition in the tropics. Ann Trop Pediatr 6: 233–237.
  44. Goyal S, 1991. Protein energy malnutrition and cerebral malaria. J Trop Pediatr 37: 143–144.
  45. Alam N, Wojtiniak B, Mujibur R, 1989. Anthropometric indicators and risk of death. Am J Clin Nutr 49: 994–998.
  46. Olumese P, Sodeinde O, Ademowo O, Walker O, 1997. Protein energy malnutrition and cerebral malaria in Nigerian children. J Trop Pediatr 43: 217–219.
  47. Lewallen S, Taylor T, Molyneux M, Semba R, Wills B, Courtright P, 1998. Association between measures of vitamin A and the ocular fundus findings in cerebral malaria. Arch Ophthalmol 116: 293–296.
  48. Man W-C, Weber M, Palmer A, Schneider G, Wadda R, Jaffar S, Mulholland E, Greenwood B, 1998. Nutritional status of children admitted to hospital with different diseases and its relationship to outcome in The Gambia, West Africa. Trop Med Int Health 3: 678–686.
  49. Genton B, Al-Yaman F, Ginny M, Taraika J, Alpers M, 1998. Relation of anthropometry to malaria morbidity and immunity in Papua New Guinean children. Am J Clin Nutr 68: 734–741.
  50. Nacher M, Singhasivanon P, Vannaphan S, Treeprasertsuk S, Phanumaphorn M, Traore B, Looreesuwan S, Gay F, 2001. Socio-economic and environmental protective/risk factors for severe malaria in Thailand. Acta Trop 78: 139–146.
  51. Villamor E, Mbise R, Spiegelman D, Hertzmark E, Fataki M, Peterson K, Ndossi G, Fawzi W, 2002. Vitamin A supplements ameliorate the adverse effect of HIV-1, malaria and diarrheal infections on child growth. Pediatrics 109: E6.
  52. Hadi H, Stoltzfus R, Dibley M, Moulton L, West K, Kjolhede C, Sadjimin T, 2000. Vitamin A supplementation selectively improves the linear growth of Indonesian preschool children: results from a randomized controlled trial. Am J Clin Nutr 71: 507–513.
  53. Rivera J, Gonzalez-Cossio T, Flores M, Romero M, Rivera M, Tellez-Rojo M, Rosado J, Brown K, 2001. Multiple micronutrient supplementation increases the growth of Mexican infants. Am J Clin Nutr 74: 657–663.
  54. Black M, 1998. Zinc deficiency and child development. Am J Clin Nutr 68: 464S–469S.
  55. Barrett D, Radke-Yarrow M, 1982. Chronic malnutrition and child behaviour: effectrs of early caloric supplementation on social and emotional functioning at school age. Dev Psychol 18: 541–556.
  56. Shankar A, Goodman S, Stoltzfus R, Brabin B, 2000. Safety of Iron Supplementation Programs in Malaria-Endemic Regions. Washington, DC: International Life Sciences Institute Press.
  57. Oppenheimer S, 2001. Iron and its relation to immunity and infectious disease. J Nutr 131: 616S–635S.
  58. Lozoff B, Jimenez E, Hagen J, Mollen E, Wolf A, 2000. Poorer behavioural and developmental outcome more than 10 years after treatment for iron deficiency in infancy. Pediatrics 105: E51.
  59. Algarin C, Peirano P, Garrido M, Pizarro F, Lozoff B, 2003. Iron deficiency anemia in infancy: long-lasting effects on auditory and visual system functioning. Pediatr Res 53: 217–223.
  60. Pollitt E, 1995. Functional significance of the covariance between protein energy malnutrition and iron deficiency anemia. J Nutr 125: 2272S–2277S.
  61. Grantham-McGregor S, Ani C, 2001. A review of studies on the effect of iron deficiency on cognitive development in children. J Nutr 131: 649S–668S.
  62. Biemba G, Dolmans D, Thuma P, Weiss G, Gordeuk V, 2000. Severe anaemia in Zambian children with Plasmodium falciparum malaria. Trop Med Int Health 5: 9–16.
  63. Ekvall H, 2003. Malaria and anemia. Curr Opin Hematol 10: 108–114.
  64. Walter T, De Andraca I, Chadud P, Perales C, 1989. Iron deficiency anemia: adverse effects on infant psychomotor development. Pediatrics 84: 7–17.
  65. Edgerton V, Gardner G, Ohira Y, Gunawardena K, Senewiratne B, 1979. Iron-deficiency anaemia and its effect on worker productivity and activity patterns. BMJ 2: 1546–1549.
  66. Lozoff B, Jimenez E, Wolf A, 1991. Long-term developmental outcome of infants with iron deficiency. N Engl J Med 325: 687–694.
  67. Seshadri S, Gopaldas T, 1989. Impact of iron deficiency on cognitive functions in preschool and school-aged children: the Indian experience. Am J Clin Nutr 50: 675–686.
  68. Stoltzfus RJ, Kvalsvig JD, Chwaya HM, Montressor A, Al-bonico M, Tielsch JM, Savioli L, Pollitt E, 2001. Effects of iron supplementation and anthelmintic treatment on motor and language development of preschool children in Zanzibar: double blind, placebo controlled study. BMJ 323: 1389–1393.
  69. Menendez C, Kahigwa E, Hirt R, Vounatsou P, Aponte J, Font F, Acosta C, Schellenberg D, Galindo C, Kimario J, Urassa H, Brabin B, Smith T, Kitua A, Tanner M, Alonso P, 1997. Randomised placebo-controlled trial of iron supplementation and malaria chemoprophylaxis for the prevention of severe anaemia and malaria in Tanzanian infants. Lancet 350: 844–850.
  70. van den Hombergh J, Dalderop E, Smit Y, 1996. Does iron therapy benefit children with severe malaria-associated anaemia? A clinical trial with 12 weeks supplementation of oral iron in young children from the Turani division, Tanzania. J Trop Pediatr 42: 220–227.
  71. Verhoef H, West C, Nzyuko S, de Vogel S, van der Valk R, Wanga M, Kuijsten A, Veenemans J, Kok F, 2003. Intermittent administration of iron and sulfadoxine-pyrimethamine to control anaemia in Kenyan children: a randomised controlled trial. Lancet 361: 86–87.
  72. Shankar A, 2000. Nutritional modulation of malaria morbidity and mortality. J Infect Dis 182: S37–S53.
  73. Nussenblatt V, Semba R, 2002. Micronutrient malnutrition and the pathogenesis of malarial anemia. Acta Trop 82: 321–337.
  74. Kasumba I, Nalunkuma A, Mujuzi G, Kitaka F, Byaruhanga R, Okong P, Egwang T, 2000. Low birthweight associated with maternal anaemia and Plasmodium falciparum infection during pregnancy, in a periurban area of low endemicity in Uganda. Ann Trop Med Parasitol 94: 7–13.
  75. Shulman C, Dorman E, Cutts F, Kawuondo K, Bulmer J, Peshu N, Marsh K, 1999. Intermittent sulphadoxine-pyrimethamine to prevent severe anaemia secondary to malaria in pregnancy: a randomised placebo-controlled trial. Lancet 353: 632–636.
  76. Verhoeff H, Brabin B, Chimsuku L, Kazembe P, Broadhead R, 1999. Malaria in pregnancy and its consequences for the infant in rural Malawi. Ann Trop Med Parasitol 93: S25–S33.
  77. Rogerson SJ, Pollina E, Getachew A, Tadesse E, Lema VM, Molyneux ME, 2003. Placental monocyte infiltrates in response to Plasmodium falciparum malaria infection and their association with adverse pregnancy outcomes. Am J Trop Med Hyg 68: 115–119.
  78. Diagne N, Rogier C, Sokhna C, Tall A, Fontenille D, Roussilhon C, Spiegel A, Trape J-F, 2000. Increased susceptibility to malaria during the early postpartum period. N Engl J Med 343: 598–603.
  79. Mann L, 1986. Pregnancy events and brain damage. Am J Obstet Gynecol 155: 6–9.
  80. Hagberg G, Hagberg B, Olow I, 1976. The changing panorama of cerebral palsy in Sweden 1954–1970. III. The importance of foetal deprivation of supply. Acta Paediatr Scand 65: 403–408.
  81. Adams-Chapman I, Vaucher Y, Bejar R, Benirschke K, Baergen R, Moore T, 2002. Maternal floor infarction of the placenta: association with central nervous system injury and adverse neurodevelopmental outcome. J Perinatol 22: 236–241.
  82. Schendel D, 2001. Infection in pregnancy and cerebral palsy. J Am Med Womens Assoc 56: 105–108.
  83. Taylor HG, Klein N, Hack M, 2000. School-age consequences of birth weight less than 750 g: a review and update. Dev Neuropsychol 17: 289–321.
  84. Breslau N, Chilcoat H, Del Dotto J, Andreski P, Brown G, 1996. Low birth weight and neurocognitive status at six years of age. Biol Psychiatry 40: 389–387.
  85. Taylor HG, Klein N, Minich N, Hack M, 2000. Middle-school-age outcomes in children with very low birthweight. Child Dev 71: 1495–1511.
  86. Hack M, Flannery D, Schluchter M, Cartar L, Borawski E, Klein N, 2002. Outcomes in young adulthood for very-low-birth-weight infants. N Engl J Med 346: 149–157.
  87. Hack M, Taylor G, Klein N, Mercuri Minich N, 2000. Functional limitations and special health care needs of 10 to 14 year old children weighing less than 750 grams at birth. Pediatrics 106: 554–560.
  88. Shulman CE, Marshall T, Dorman EK, Bulmer JN, Cutts F, Peshu N, Marsh K, 2001. Malaria in pregnancy: adverse effects on haemoglobin levels and birthweight in primigravidae. Trop Med Int Health 6: 770–778.
  89. Fried M, Muga R, Misore A, Duffy P, 1998. Malaria elicits type 1 cytokines in the human placenta: IFN-gamma and TNF-alpha associated with pregnancy outcomes. J Immunol 160: 2523–2530.
  90. Thorsen P, Schendel D, Deshpande A, Vogel I, Dudley D, Olsen J, 2001. Identification of biological/biochemical marker(s) for preterm delivery. Paediatr Perinat Epidemiol 15: 90–103.
  91. Steketee R, Nahlen B, Parise M, Menendez C, 2001. The burden of malaria in pregnancy in malaria-endemic areas. Am J Trop Med Hyg 64: 28–35.
  92. Paul MA, McCarthy AE, Gibson N, Kenny G, Cook T, Gray G, 2003. The impact of Malarone and primaquine on psychomotor performance. Aviat Space Environ Med 74: 738–745.
  93. Newman RD, Hailemariam A, Jimma D, Degifie A, Kebede D, Rietveld AEC, Nahlen BN, Barnwell JW, Steketee RW, Parise ME, 2003. Burden of malaria during pregnancy in areas of stable and unstable transmission in Ethiopia during a nonepidemic year. J Infect Dis 187: 1765–1772.
  94. Hernandez-Diaz S, Werler MM, Walker AM, Mitchell AA, 2000. Folic acid antagonists during pregnancy and the risk of birth defects. N Engl J Med 343: 1608–1614.
  95. Andersen DH, Blanc WA, Crozier DN, 1956. A difference in mortality rate and incidence of kernicterus among premature infants allotted to two prophylactic antibacterial regimens. Pediatrics 18: 614–625.
  96. Parise ME, 2002. Safety of Sulfadoxine-Pyrimethamine (sp) during Pregnancy: What Do the Data Show? Arusha, Tanzania: The Third Multilateral Initiative on Malaria Conference.
  97. Marsh K, 1992. Malaria - A neglected disease? Parasitology 104: S53–S69.
  98. Taylor M, Pillai G, Kvalsvig J, 1995. Targeted chemotherapy for parasite infestations in rural black preschool children. S Afr Med J 85: 870–874.
  99. Ettling M, McFarland D, Schultz L, Chitsulo L, 1994. Economic impact of malaria in Malawian households. Trop Med Parasitol 45: 74–79.
  100. Sachs J, Malaney P, 2002. The economic and social burden of malaria. Nature 415: 680–685.
  101. Murray M, Murray A, Murray N, Murray M, 1978. Diet and cerebral malaria: the effect of famine and refeeding. Am J Clin Nutr 31: 57–61.
  102. Binka F, Ross D, Morris S, Kirkwood B, Arthur P, Dollimore N, Gyapong J, Smith P, 1995. Vitamin A supplementation and childhood malaria in northern Ghana. Am J Clin Nutr 61: 853–859.
  103. Shankar A, Genton B, Semba R, Baisor M, Paino J, Tamja S, Adiguma T, Wu L, Rare L, Tielsch J, Alpers M, West KJ, 1999. Effect of vitamin A supplementation on morbidity due to Plasmodium falciparum in young children in Papua New Guinea: a randomised trial. Lancet 354: 203–209.
  104. Murphy S, Breman J, 2001. Gaps in the childhood malaria burden in Africa: cerebral malaria, neurological sequelae, anemia, respiratory distress, hypoglycemia, and complications of pregnancy. Am J Trop Med Hyg 64: 57–67.
  105. World Health Organization, 1998. The World Health Report 1998—Life in the 21st Century: A Vision for All. Geneva: World Health Organization.
  106. Berkman D, Lescano A, Gillman R, Lopez S, Black M, 2002. Effects of stunting, diarrhoeal disease, and parasitic infection during infancy on cognition in late childhood: a follow-up study. Lancet 359: 564–571.
  107. Stoch M, Smythe P, Moodie A, Bradshaw D, 1982. Psychosocial outcome and CT findings after gross undernourishment during infancy: a 20-year developmental study. Dev Med Child Neurol 24: 419–436.
  108. Pollitt E, 2000. Developmental sequel from early nutritional deficiencies: conclusive and probability judgements. J Nutr 130: 350S–353S.
  109. Benson E, 2003. Intelligence across cultures. Monitor Psychol 34: 56–58.
  110. Taylor HG, Burant CJ, Holding PA, Klein N, Hack M, 2002. Sources of variability in sequelae of very low birth weight. Neuropsychol Dev Cogn Sect C Child Neuropsychol 8: 163–178.
  111. Pollitt E, 2001. The developmental and probabilistic nature of the functional consequences of iron-deficiency anemia in children. J Nutrit 131: 669S–675S.
  112. Rutter M, 1987. Continuities and Discontinuities from Infancy. New York: John Wiley & Sons.
  113. van Hensbroek MB, Palmer A, Jaffar S, Schneider G, Kwiatkowski D, 1997. Residual neurologic sequelae after childhood cerebral malaria. J Pediatr 131: 125–129.
  114. Brewster D, Kwiatkowski D, White N, 1990. Neurological sequelae of cerebral malaria in children. Lancet 336: 1039–1043.
  115. Bondi F, 1992. The incidence and outcome of neurological abnormalities in childhood cerebral malaria: a long-term follow-up of 62 survivors. Trans R Soc Trop Med Hyg 86: 17–19.
  116. Holmbeck G, 1997. Toward terminological, conceptual, and statistical clarity in the study of mediators and moderators: Examples from the child-clinical and pediatric psychology literatures. J Consult Clin Psychol 65: 599–610.
  117. Taylor H, Alden J, 1997. Age-related differences in outcomes following childhood brain insults: an introduction and overview. J Int Neuropsychol Soc 3: 555–567.
  118. Byrnes MB, 2001. Structural Equation Modeling with AMOS: Basic Concepts, Applications, and Programming. Mahwah, NJ: Lawrence Erlbaum Associates.
  119. Grantham-McGregor S, Powell C, Walker S, Himes J, 1991. Nutritional supplementation, psychosocial stimulation, and mental development of stunted children: the Jamaican Study. Lancet 338: 1–5.
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.2004.71.2_suppl.0700071
Loading
/content/journals/10.4269/ajtmh.2004.71.2_suppl.0700071
Loading

Data & Media loading...

  • Received : 21 Aug 2003
  • Accepted : 22 Jan 2004

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error