3.2. Identification and Summary of Growth Profiles
CLD
OBESE, CLD
Latent class analysis revealed a seven-class model which best explained weight-for-age, height-for-age and BMI-for-age trajectories, producing the closest entropy value to 1 where all classes contained at least 5% of the study population. The class sizes ranged from 50 (5.3%) to 265 (28.0%) individuals (Average-growth individuals had BMI, weight, and height closest to the average reference values, although WA and HA Z-scores were consistently around 0.5 SD below the reference. Z-scores were stable over the year of follow-up. The majority of HIV-negative individuals were in this profile. This was the profile with the largest number of individuals (28%).Taller (than other profiles) not thin individuals (7% of the sample) whose weight and BMI were around 1 SD above the reference, higher weight for their height, and HA Z-score was around 0.5 above the reference. Few were obese; five individuals had weight-for-age Z-score > 2 and eight individuals had BMI-for-age Z-score > 2. Height-for-age Z-scores of individuals in this profile reduced over follow-up whilst BMI Z-scores slightly increased. This profile was the second most common for school children but was rare among CWH. Most individuals were older females. Males in this profile had the highest total body fat percentage of all the profiles.Short not thin individuals (7% of the sample) whose BMI was around 1 SD above reference values and HA were around −1.5 SD below reference values. On average, at follow-up, height-for-age Z-scores fell whilst weight-for-age Z-scores remained stable in these individuals. This profile was more common in older females and in CWH. Not only did these individuals have higher weight in proportion to their height, the females in this profile had the highest total body fat percentage of all the profiles. There were no individuals with weight-for-age Z-score > 2 and only two individuals with BMI-for-age Z-score > 2.Stunted but not thin individuals with BMI around 0.5 SD below reference values who were both stunted and had lower weight. Weight-for-age Z-scores were stable over time, while height-for-age Z-scores increased slightly. This was the most common profile for CWH and could indicate a legacy of early growth faltering; this profile was equally common among males and females. This was the second largest profile, comprising 26% of individuals.Thin but not stunted individuals (11% of the sample) with BMI around 1.9 SD below reference values who had low weight but who were not stunted. All three anthropometry Z-scores increased slightly over follow-up among these individuals. This profile was more common among children aged 11–14 years at baseline and the trajectory could indicate a recent growth spurt and pubertal transition.Thin and stunted individuals were around 3 SD below reference values for both weight and height. There was some evidence that height-for-age Z-scores increased over time, but both weight-for-age and BMI-for-age Z-scores decreased over time, and there was heterogeneity in change over time. This profile was more common among CWH, males and older adolescents, and anthropometry indicated growth faltering. This profile was reasonably common, containing 16% of individuals.Very thin and stunted individuals had weight and height less than 4 SD below reference values at baseline. On average, these individuals’ Z-scores improved during follow-up, but there was greater heterogeneity in growth than for other profiles. Similar to profile 6, this profile was more common among males of older ages and indicated growth faltering. The majority of individuals in this profile had HIV with CLD. This was the rarest profile including 5% of individuals.