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. 2014 Nov 1;59 Suppl 4(Suppl 4):S261-72.
doi: 10.1093/cid/ciu437.

The MAL-ED cohort study: methods and lessons learned when assessing early child development and caregiving mediators in infants and young children in 8 low- and middle-income countries

Laura E Murray-Kolb  1 , Zeba A Rasmussen  2 , Rebecca J Scharf  3 , Muneera A Rasheed  4 , Erling Svensen  5 , Jessica C Seidman  2 , Fahmida Tofail  6 , Beena Koshy  7 , Rita Shrestha  8 , Angelina Maphula  9 , Angel Orbe Vasquez  10 , Hilda P da Costa  11 , Aisha K Yousafzai  4 , Reinaldo B Oria  11 , Reeba Roshan  7 , Eliwasa B Bayyo  12 , Margaret Kosek  10 , Sanjaya Shrestha  8 , Barbara A Schaefer  1 , Pascal Bessong  9 , Tahmeed Ahmed  7 , Dennis Lang  13 ; MAL-ED Network Investigators
Collaborators, Affiliations

The MAL-ED cohort study: methods and lessons learned when assessing early child development and caregiving mediators in infants and young children in 8 low- and middle-income countries

Laura E Murray-Kolb et al. Clin Infect Dis. .

Abstract

More epidemiological data are needed on risk and protective factors for child development. In The Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) cohort study, we assessed child development in a harmonious manner across 8 sites in Bangladesh, Brazil, India, Nepal, Pakistan, Peru, South Africa, and Tanzania. From birth to 24 months, development and language acquisition were assessed via the Bayley Scales of Infant and Toddler Development and a modified MacArthur Communicative Development Inventory. Other measures were infant temperament, the child's environment, maternal psychological adjustment, and maternal reasoning abilities. We developed standard operating procedures and used multiple techniques to ensure appropriate adaptation and quality assurance across the sites. Test adaptation required significant time and human resources but is essential for data quality; funders should support this step in future studies. At the end of this study, we will have a portfolio of culturally adapted instruments for child development studies with examination of psychometric properties of each tool used.

Keywords: child; cognitive development; infant; low-and middle-income countries; methods.

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Figures

Figure 1.
Figure 1.
Theoretical framework for the relation between infection with enteropathogens and child development (only postnatal events are illustrated).
Figure 2.
Figure 2.
Cognitive data collection scheme; domain tested (time to administer).
Figure 3.
Figure 3.
Visual scale used to depict answer choices for the Infant Temperament Scale.
See this image and copyright information in PMC

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