Report of the Fifth Teaching Institute, Association of American Medical Colleges, by Helen H. Leeand Robert J. Glaser, editors. 262 pages, illustrated. Evanston, Ill., Association of American Medical Colleges, 1958. Cloth $5.00, paper $2.00
Micronutrient deficiencies and enteric infections negatively impact child growth and development. We enrolled children shortly after birth in a randomized, placebo-controlled, 2 × 2 factorial interventional trial in Haydom, Tanzania, to assess nicotinamide and/or antimicrobials (azithromycin and nitazoxanide) effect on length at 18 months of age. Cognitive score at 18 months using the Malawi Developmental Assessment Tool (MDAT), which includes gross motor, fine motor, language, and social assessments, was a secondary outcome. Here, we present the MDAT results of 1,032 children. There was no effect of nicotinamide (change in development-for-age Z score [DAZ] −0.08; 95% CI: −0.16, 0) or antimicrobials (change in DAZ 0.04; 95% CI: −0.06, 0.13) on overall MDAT score. The interventions had no effect on cognitive outcomes in subgroups defined by gender, socioeconomic status, birthweight, and birth season or on MDAT subscores. Further analyses are needed to identify targetable risk factors for impaired cognitive development in these settings.