Avalilação PREreview de Nutritional Follow-Up in Indigenous Children Under Five Years in Colombia

This preprint assesses the nutritional status and growth of 398 Wayúu children under the age of 5 in Manaure, Colombia. It reports high levels of chronic malnutrition, with the prevalence of stunting and being underweight far exceeding that of acute malnutrition. The analysis also includes a longitudinal component, following a subgroup of children over time, which found increasing nutritional risk.

This paper describes chronic malnutrition among Indigenous children and discusses the need for ongoing nutritional surveillance and a better understanding of the social and structural determinants influencing Indigenous children and families. The findings suggest that interventions for child malnutrition in Indigenous communities should be culturally appropriate and involve multiple sectors.

Although useful data have been collected from an understudied Indigenous population, highlighting an important public health issue, due caution must be used when interpreting the longitudinal findings, as longitudinal data were available for only 24 children (6.03% of the original cohort).

Major issues

• The follow-up subgroup was very small. Out of 398 children, only 24 (6.03%) were followed over time. This severely limits the generalizability of the longitudinal results. It is also possible that selection bias has been introduced. The reasons why the majority of children were not followed over time need to be explained in more detail.

• This is a prospective cohort study, but the main analysis is cross-sectional because most of the children were assessed only once, at baseline. It would be useful for the reader if the manuscript more clearly distinguished between the descriptive information from the children assessed at baseline and the information from the children who were followed over time.

• A major discrepancy exists between the researchers’ conclusions regarding declining nutritional health in children and the longitudinal evidence supporting these conclusions. The longitudinal study only followed 24 children in the follow-up analysis; therefore, the conclusions drawn from this analysis should be viewed with considerable caution.

• The sampling was based on convenience sampling. Consequently, the results of this study cannot be applied to other Indigenous children in Colombia. Nonetheless, the study provides interesting information regarding the communities in which the research was conducted.

Minor issues

1. The terms nutritional alteration, malnutrition, developmental delay, and nutritional risk are often mentioned together within the manuscript and would benefit from clearer explanation as individual terms.

2. Some of the information provided in the manuscript, such as the high prevalence of chronic malnutrition and the significance of social determinants, is repeated in several parts of the manuscript. These sections could be shortened to improve readability.

3. More information is needed on the large loss to follow-up, including the impact of migration between communities.

4. More detail is required about the methods used to analyze data from the two visits and the assumptions underlying these analyses.

5. The follow-up sample could be better described, including how many subjects had complete data for each variable.

Competing interests

The author declares that they have no competing interests.

Use of Artificial Intelligence (AI)

The author declares that they did not use generative AI to come up with new ideas for their review.