Nonlinear Physical Growth of Children from Infancy to Middle Adolescence in Low- and Middle-Income Countries

Senahara Korsa Wake, Temesgen Zewotir, Essey Kebede Muluneh


Background: The growth curve has a significant role in understanding the growth trajectories over time and examining the mathematical relationship between the outcome variable and time.

Study design: A longitudinal prospective cohort study.

Methods: This study aimed to identify a nonlinear growth curve that best represents the growth trajectories in children’s physical growth from ages 1 to 15 years. The data were obtained from the Young Lives study conducted in Ethiopia, India, Peru, and Vietnam. Nonlinear growth curves were studied through the families of three-parameter nonlinear mixed-effects models.

Results: The study examined the performances of different three-parameter nonlinear growth curves for the growth trajectory analysis, and the Logistic curve was chosen for the trajectory analysis. Gender and country differences had significant effects on the child’s growth. Females reached asymptotic height earlier and shorter than males. The mean height values at the end of the growth stage for children in Ethiopia, India, Peru, and Vietnam were 171.78, 170.37, 171.30, 174.31cm, respectively. Children in Ethiopia approached adult height earlier than those in India but later than children in Peru. However, no significant growth change was observed between children in Ethiopia and Vietnam. This indicates that children in Ethiopia and Vietnam have no significant differences regarding approaching adult height.

Conclusion: The study concludes that the Logistic curve was found to be the best growth curve to describe the growth trajectories. Children in all four countries exhibited different growth parameters.


Growth curves; Longitudinal data; Mixed-effect model; Physical growth

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