Stunting, underweight and wasting among Integrated Child Development Services (ICDS) scheme children aged 3-5 years of Chapra, Nadia District, West Bengal, India

This study investigated age and sex variations in height and weight, levels of stunting, underweight and wasting among 533 (254 boys; 279 girls) 3- to 5-year-old rural children of Bengalee ethnicity at 11 Integrated Child Development Services centres of Nadia District, West Bengal, India. Height-for-age, weight-for-age and weight-for-height < -2 z-scores were used to evaluate stunting, underweight and wasting, respectively, following the National Center for Health Statistics (NCHS) Guidelines. Results revealed that boys were significantly heavier than girls at age 3 years. Significant age differences existed in mean height and weight in both sexes. Mean z-scores of height-for-age, weight-for-age and weight-for-height were lower than those of NCHS for both sexes at all ages. The overall (age and sex combined) rates of stunting, underweight and wasting were 23.9%, 31.0% and 9.4%, respectively. The rate of underweight and wasting was higher among girls (underweight = 35.1%, wasting = 12.2%) compared with boys (underweight = 26.5%, wasting = 6.3%). In general, the frequency of stunting increased with increasing age in both sexes. Based on the World Health Organization classification of severity of malnutrition, the overall prevalence of underweight was very high (>or=30%). The prevalence rates of stunting (20-29%) and wasting (5-9%) were medium. In conclusion, the nutritional status of the subjects is unsatisfactory. There is scope for improvement in the form of enhanced supplementary nutrition.     

Prevalence and correlates of the composite index of anthropometric failure among children under 5 years old in Bangladesh

The prevalence of stunting, wasting, and underweight are reported separately. However, the data of the multiple anthropometric failures combinations of these conventional indicators are scant. This study attempted to estimate the overall burden of undernutrition among children under 5 years old, using the composite index of anthropometric failure (CIAF), and to explore the correlates. The study used secondary data from the Bangladesh demographic and health surveys (BDHS), undertaken in 2014. CIAF provides an overall prevalence of undernutrition, which gives six mutually exclusive anthropometric measurements of height‐for‐ age, height‐for‐weight, and weight‐for‐age. Multivariable logistic regression was used to explore the correlates of CIAF. The overall prevalence of undernutrition using the CIAF was 48.3% (95% CI [47.1%, 49.5%]) among the children under 5 years old. The prevalence of anthropometric failure due to a combination of both stunting and underweight was 18.2%, wasting and underweight was 5.5%, and wasting, underweight, and stunting was 5.7%. The odds of CIAF were higher among young maternal age, having the poorest socio‐economic status, living in rural areas, higher order of birth, and received no vaccination compared with other counterparts. In Bangladesh, one out of two children has undernutrition, which is preventing the potential of the millions of children. Mothers who gave birth before age 20 living in the rural areas with belonging to lower socio‐economic status and whose children had a higher order of birth and receive no vaccination were observed as the main determinants of undernutrition. Nutrition sensitive interventions along with social protection programmes are crucial to deal the underlying causes of undernutrition.     

Fat patterning of Santhal children: a tribal population of West Bengal, India

A cross sectional study was undertaken to examine the body composition including fat patterning among 1012 Santal children, aged 5-12 years, in Puruliya district of West Bengal, India. The anthropometric variable measured included height, weight and skinfold thickness of triceps and subscapular. The body mass index (BMI) was also calculated. The measurements were used to estimate body fat percent (%BF) and fat-free mass (FFM) from skinfolds. Fat mass and FFM were each divided by height squared to produce the fat mass index (FMI) and fat-free mass index (FFMI). Maximum gaining of %BF and FFM was found at ages 11-12 years in both sexes. Difference of-FFM between 5 and 12 years of age was found to be highest in girls (18.7 kg) than in boys (14.92 kg). Body fat percentage of girls was significantly (p < 0.05) higher (except in 8 and 9 years old) than that of boys. FMI and FFMI of girls showed different pattern than that of boys. FFM and %BF showed significant (p < 0.01) relationship with all anthropometric variables. Results suggests a clear evidence of sexual dimorphism in fat patterning; girls showing a greater subcutaneous adiposity in comparison with boys. FMI and FFMI, both indices indicate an age-and sex-related variation among Santal children. The data of the present study could be serving as reference data in other studies of Santal children.     

Is undernutrition a problem among Turkish school children?: Which factors have an influence on it?

Undernutrition is a frequent manifestation and an important health problem. The aim of this study was to analyse the variables of nutritional status among primary school children and to determine the risk factors associated with it. The study group was composed of 1576 students between 6 and 16 years of age. The prevalence of stunting, underweight, wasting were calculated according to WHO recommended cut-off points to define undernutrition. Chi-square tests, logistic regression analysis were used to investigate the relationship between the prevalence of undernutrition and the sociodemographic factors. The overall prevalence of stunting, underweight and wasting were found as 5.7, 4.6 and 1.0%, respectively. There were significant relationships between underweight and age, sex, number of family members, monthly family income. But, a significant correlation was found only between stunting and age. No correlation was found between wasting and sociodemographic factors. Undernutrition is still a common problem among primary school children in Istanbul. Identification of risk factors is essential for prevention of undernutrition.     

Height and weight of urban preschool children in relation to their mothers' educational levels and employment status in Rasht City, northern Iran

This study determined the relationship between anthropometric status of 3-5-year-old urban children and theirs mothers' educational levels and employment status in Rasht City, northern Iran. A total of 1319 children (638 girls and 681 boys) at the ages of 3 and 6 years in all day-care centres in Rasht City were studied, using a cross-sectional design. Height and weight of the children were measured, and data on mothers' educational levels, employment status and duration of any breastfeeding were collected. Height for age, weight for age and weight for height of the children were compared with the National Center for Health Statistics (NCHS) reference population of the United States, and z-values 12 years of schooling, OR = 1.87; 95% CI: 1.08-2.4) had higher relative risk for underweight than children of mothers with an intermediate level of education (5-12 years of schooling). Children of mothers with college education were also more at risk for development of stunting (OR = 1.41; 95% CI: 1.14-4.22). In addition, children of employed mothers were more likely to be underweight (OR = 1.52; 95% CI: 1.05-2.31), stunted (OR = 2.42; 95% CI: 1.21-6.35) and wasted (OR = 3.35; 95% CI: 1.21-5.58) than children of non-employed mothers. The relative risk for undernutrition was higher in the children of both less and highly educated mothers compared with children of mothers with an intermediate level of education. Mothers' employment was also negatively related to nutritional status of these children in day-care centres in Rasht City.     

Risk factors for undernutrition among children 0–59 months of age in Myanmar

The prevalence of childhood stunting in Myanmar is one of the highest among the countries of Southeast Asia. Cross‐sectional data from the Myanmar Demographic Health Survey 2015–2016 were used to examine risk factors for stunting, wasting, and underweight among children aged 0–59 months. The prevalence of stunting, wasting, and underweight was 29.0%, 7.3%, and 19.2%, respectively. Accounting for sampling design and weights, multivariable logistic regression was conducted with 35 household, maternal, and child characteristics. Current pregnancy and maternal height <145 cm, home delivery, child's small birth size recalled by mother, and older age (ref: 0–5 months) predicted both stunting and underweight. Larger than average birth size was protective for all stunting, wasting, and underweight. Maternal body mass index <18.5 kg m^?2 was a common risk factor for wasting and underweight. Lower wealth quintiles, maternal engagement in nonagricultural occupation, and male child predicted stunting only. Younger child age and not receiving vitamin A supplementation in the previous 6 months were risk factors for wasting only. Regional variation was also seen, with a higher odds of stunting in the West‐South Region, North‐East States, and West States, compared with the Central Regions. In Myanmar, socio‐economic and demographic factors, poor maternal nutritional status, and living in certain geographical locations are affecting children's undernutrition. It is recommended that interventions for growth faltering focus on the first 1,000 days of life; optimum maternal nutrition be ensured during and before pregnancy and at adolescence; societal support be provided for mothers in poverty or engaged in nonagriculture; and region‐specific undernutrition pathways be understood.     

Supplementary feeding with fortified spread among moderately underweight 6–18-month-old rural Malawian children

We aimed to analyse growth and recovery from undernutrition among moderately underweight ambulatory children receiving micronutrient-fortified maize–soy flour (Likuni Phala, LP) or ready-to-use fortified spread (FS) supplementary diet. One hundred and seventy-six 6–18-month-old individuals were randomized to receive 500 g LP or 350 g FS weekly for 12 weeks. Baseline and end of intervention measurements were used to calculate anthropometric gains and recovery from underweight, wasting and stunting. Mean weight-for-age increased by 0.22 (95% CI 0.07–0.37) and 0.28 (0.18–0.40) Z-score units in the LP and FS groups respectively. Comparable increase for mean weight-for-length was 0.39 (0.20–0.57) and 0.52 (0.38–0.65) Z-score units. Recovery from underweight and wasting was 20% and 93% in LP group and 16% and 75% in FS group. Few individuals recovered from stunting and mean length-for-age was not markedly changed. There were no statistically significant differences between the outcomes in the two intervention groups. In a poor food-security setting, underweight infants and children receiving supplementary feeding for 12 weeks with ready-to-use FS or maize–soy flour porridge show similar recovery from moderate wasting and underweight. Neither intervention, if limited to a 12-week duration, appears to have significant impact on the process of linear growth or stunting.     

The upper arm muscle and fat area of Santal children: an evaluation of nutritional status

Aims: The purpose of this study is to determine the growth pattern of upper arm muscle area (UAMA), upper arm fat area (UAFA) and upper arm muscle area by height (UAMAH) and assessment of magnitude of undernutrition on the basis of these parameters in Santal children.
Methods: UAMA and UAFA of 890 (473 boys and 417 girls) Santal children aged 5–12 years were calculated from mid-upper arm circumference and triceps skinfold.
Results: Growth curves of UAFA-for-age and UAMA by height in Santal boys and girls are placed at lower level of reference curve indicating severe undernutrition. The growth curves of UAMA-for-age in Santal children of both sexes do not indicate severe undermutrition. 17.13% Santal boys and 20.63% girls were truly undernourished on the basis of three Z-scores of height-for-age, weight-for-height and UAMAH of each subject. Santal children have more UAMA and less UAFA compared to similar undernourished children of Sugalis.
Conclusion: Growth curves of UAFA-for-age and UAMA by height are good indicators of nutritional status in Santal children. UAMA and UAFA may not be similarly affected in undernourished children of every community. A comprehensive approach to identify the truly undernourished child has been suggested from this study.     

胆道闭锁Kasai术后自肝生存患儿体格发育Z评分

目的 本研究旨在对胆道闭锁Kasai术后自肝生存患儿的体格发育进行评价,了解胆道闭锁Kasai术后自肝生存患儿营养状况.方法 本研究采用横断面调查方式,于2014年10月至2015年1月对首都医科大学附属北京儿童医院普外科胆道闭锁Kasai术后自肝生存定期门诊复查的96例患儿进行体格测量(身高/身长、体重).采用WHO Anthro Plus 2007软件,计算年龄别身高/身长Z评分(Height for Age Z-score,HAZ)、年龄别体重Z评分(Weight for Age Z-score,WAZ)、身高别体重Z评分(Weight for Height Z-score,WHZ).统计我中心Ksasi术后自肝生存患儿生长迟缓、低体重、消瘦的患病率.采用方差分析或t检验,描述不同分组Z评分结果差异.结果 ①纳入研究的96例Kasai术后自肝生存患儿HAZ、WAZ、WHZ均值分别为-0.38±0.17、0.33±0.17、0.88±0.17;②生长迟缓(HAZ＜-2)患病率为14.58％(14/96),低体重(WAZ＜-2)患病率为5.21％(5/96),消瘦(WHZ＜-2)患病率为3.13％(3/96);③以年龄(月)分组,6～12个月组患儿HAZ、WAZ、WHZ均值均为负值,分别为-0.27±0.12、-0.55±0.37、-0.30±0.25;④以术时年龄(d)分组,＜60 d、60～90 d组患儿的WHZ均值均为正值,分别为1.08±0.27、0.85±0.25,＞90 d组患儿WHZ均值为负值,-0.26±0.24.结论①胆道闭锁Kasai术后自肝生存患儿存在营养不良问题,其中生长迟缓问题更为突出;②6～12个月组患儿HAZ、WAZ、WHZ均值均低于国际标准值(0),并且6～12个月组患儿WAZ、WHZ明显低于13～24个月组和≥25个月组,因此Kasai术后自肝生存患儿婴儿期营养状况尤其值得关注;③术时年龄＞90d组患儿WHZ明显低于＜60d组和60～90d组,所以尽早手术对于提升患儿术后营养状况有帮助.     

Patterns in child stunting by age: A cross-sectional study of 94 low- and middle-income countries

Child stunting prevalence is primarily used as an indicator of impeded physical growth due to undernutrition and infections, which also increases the risk of mortality, morbidity and cognitive problems, particularly when occurring during the 1000 days from conception to age 2 years. This paper estimated the relationship between stunting prevalence and age for children 0–59 months old in 94 low- and middle-income countries. The overall stunting prevalence was 32%. We found higher stunting prevalence among older children until around 28 months of age—presumably from longer exposure times and accumulation of adverse exposures to undernutrition and infections. In most countries, the stunting prevalence was lower for older children after around 28 months—presumably mostly due to further adverse exposures being less detrimental for older children, and catch-up growth. The age for which stunting prevalence was the highest was fairly consistent across countries. Stunting prevalence and gradient of the rise in stunting prevalence by age varied across world regions, countries, living standards and sex. Poorer countries and households had a higher prevalence at all ages and a sharper positive age gradient before age 2. Boys had higher stunting prevalence but had peak stunting prevalence at lower ages than girls. Stunting prevalence was similar for boys and girls after around age 45 months. These results suggest that programmes to prevent undernutrition and infections should focus on younger children to optimise impact in reducing stunting prevalence. Importantly, however, since some catch-up growth may be achieved after age 2, screening around this time can be beneficial.     

Infant and young child feeding practices and nutritional status in Bhutan

In South Asia, childhood undernutrition persists while overweight is increasing. Internationally recommended infant and young child feeding (IYCF) practices promote healthy nutritional status; however, little is known about IYCF in Bhutan, investigated here using 2015 National Nutrition Survey data. WHO/UNICEF IYCF indicators, anthropometry and household socio‐economic status were available for 441 children <24 months. Stunting, wasting, and underweight prevalence (2) prevalence was 6%. In survey‐design‐adjusted analyses, 52% of mothers of 0‐ to 5‐month olds reported exclusive breastfeeding (EBF), with EBF less common for girls than boys (OR: 0.2 [95% CI: 0.1–0.9]). Although 61% of children were breastfed at 2 years and 75% of children >6 months met a minimum daily meal frequency, only 18% of children 6–23 months met minimum dietary diversity. IYCF was unassociated with risk of stunting, wasting, or underweight, possibly due to relatively low prevalence of anthropometric failure and small sample size. However, currently‐breastfed children were less often overweight [OR: ~0.1 (95% upper limit ≤1.0)]. Neither breastfeeding nor most complementary feeding practices differed by socio‐economic status, but children in the highest two fifth of a wealth index had 7.8 (1.3–46.9) and 5.3 (1.1–25.2) times greater odds than children in the lowest fifth of meeting minimum dietary diversity criteria. Low rates of EBF, given possible protection of breastfeeding against overweight, and inadequate dietary diversity offer evidence to guide future program interventions to improve nutritional status of young children.     

Concurrent wasting and stunting among under‐five children in Niakhar,Senegal

The study describes the patterns of concurrent wasting and stunting (WaSt) among children age 6–59 months living in the 1980s in Niakhar, a rural area of Senegal under demographic surveillance. Wasting and stunting were defined by z scores lower than ?2 in weight for height and height for age. Both conditions were found to be highly prevalent, wasting more so before age 30 months, stunting more so after age 30 months. As a result, concurrent WaSt peaked around age 18 months and its prevalence (6.2%) was primarily the product of the two conditions, with an interaction term of 1.57 (p < 10^?6). The interaction was due to the correlation between both conditions (more stunting if wasted, more wasting if stunted). Before age 30 months, boys were more likely to be concurrently wasted and stunted than girls (RR = 1.61), but the sex difference disappeared after 30 months of age. The excess susceptibility of younger boys could not be explained by muscle mass or fat mass measured by arm or muscle circumference, triceps, or subscapular skinfold. Concurrent WaSt was a strong risk factor for child mortality, and its effect was the product of the independent effect of each component, with no significant interaction.     

Nutritional status and dietary intake in tribal children of Bihar

OBJECTIVE: To assess the dietary intake and nutritional status in children of the tribal areas of Bihar. DESIGN: Cross sectional survey with two stage probability proportional to size sampling. SETTING: Study covered 396 villages from 17 tribal districts of Bihar. SUBJECTS: 1847 preschool children (0-6 Years) were studied. METHODS: 24 hours recall method was used to assess the nutrition intake and anthropometric measurements included height and weight. Nutritional intake was compared with Indian Council of Medical Research recommended dietary allowances (RDA) and nutritional status assessed by SD classification. RESULTS: The intake of protein was broadly in line with the recommended dietary allowances (RDA) in all age groups among children. However, the average intake of energy and other nutrients was lower in allage groups as compared to RDA. Calorie deficiency was 38% whereas protein deficiency was about 19%. More than half of the children were caloric deficient in Katihar, Bokaro, Godda and Singhbhum (east and west). The overall prevalence of stunting was about 60% and underweight about 55% and was comparable in boys and girls. However, wasting was more frequent in girls (urban - 34.5% vs. 16.3% and rural - 34.9% vs 18%). The level of malnutrition was not very different in rural and urban areas. CONCLUSION: The nutritional status and dietary intakes of tribal children in Bihar is very poor. Urgent remedial measures are required in this context, particularly on a war footing in especially vulnerable districts identified by this survey.     

Undernutrition among infants less than 6 months of age: an underestimated public health problem in India

In India most childhood nutrition recommendations and interventions are still not focused on infants under 6 months. Secondary data analyses of National Family Health Survey‐3 data from India were analysed to compare the prevalence of wasting, stunting and underweight in infants less than 6 months and 6–59 months. Our results revealed that wasting was higher (31%) in infants less than 6 months (P < 0.05) as compared with children between 6 and 59 months. Thirteen per cent of infants less than 6 months had severe wasting, 30% were underweight and 20% were stunted. Most infants (69%) were exclusively breastfed (EB) for the first 2 months, but exclusive breastfeeding dropped to 50% at 2–3 months and to 27% at 4–5 months. There was no statistically significant difference in wasting and stunting in the EB and not exclusively breastfed (NEB) groups. Significantly fewer EB infants were underweight (28%) compared with NEB infants (31%) (P = 0.030). However, among EB children, 29% had wasting and 21% were stunted. Eleven per cent of EB infants were severely underweight, 13% were severely wasted and 9% were severely stunted. Diarrhoea was significantly lower among EB infants compared with NEB infants (P < 0.05). We conclude that infants less than 6 months of age are vulnerable to suffer from acute severe malnutrition irrespective of their breastfeeding status and need to be seriously considered for inclusion in national guidelines for early detection and management of undernutrition.     

Growth in treated classical galactosemia patients

Decreased height and weight in treated children with classical galactosemia have been reported. However, growth has not been extensively studied. Patients might be at risk for an abnormal growth because of either disease-related intrinsic factors or diet-related factors. The objective was to gain insight in growth in treated children and adolescents with classical galactosemia. The studied population was a previously reported group of 40 classical galactosemia children. Prenatal growth was evaluated using length, weight and head circumference (HC) data from welfare centers or parents. Postnatal growth was evaluated using three height and weight measurements at baseline, 1 and 2 years to calculate growth velocities. Height Z-score was also corrected for target height Z-score (height Z-score divided by target height Z-score). Linear regression analysis was performed between growth velocities, IGF-I, IGFBP-3, dietary intake and galactose-1-phosphate-uridyltransferase activity. We found normal length (median 50.5 cm), weight (median 3,255 grams) and HC (median 33.9 cm) at birth. Mean height growth velocity was 0.87+/-1.2 for boys and -0.89+/-2.1 for girls, and mean weight growth velocity was 0.91+/-1.6 for boys and -0.74+/-1.3 for girls. Mean height corrected for target height was -1.5+/-0.9 in girls and -0.6+/-0.7 in boys. Height growth velocity was correlated with IGF-I (Pearson correlation= 0.499), IGFBP-3 (Pearson correlation 0.4) and height Z-scores corrected for target height Z-scores (Pearson correlation=0.550). Five children grew beyond the age of 18 years. In conclusion, prenatal growth was normal but postnatal growth was affected. Predicted final height is less than target height in most patients; however, target height might be reached for the children who grow beyond the age of 18. Decreased IGF-I and IGFBP-3 and or suboptimal hormonal replacement in girls might play a role.     

Prevalence and correlates of malnutrition among children in rural minority areas of China

BACKGROUND: Child growth retardation and malnutrition remain a matter of uttermost public concern in economically disadvantaged areas of China. The present study aimed to estimate the prevalence of protein-energy malnutrition with various anthropometric indices and examine its correlates in a large sample of poor rural minority children. METHODS: A total of 2019 children under 7 years of age belonging to the Hani, Yi, Hui, Miao ethnic minority groups and the Han major group were drawn from four poor rural minority counties in the Yunnan Province of China. Well-trained investigators completed child physical measurements and maternal interviews. Protein-energy malnutrition was defined as being underweight (weight for age), wasting (weight for height) and stunting (height for age) on the basis of reference data from the National Center of Health Statistics (NCHS)/World Health Organization (WHO). RESULTS: The respective prevalence of moderate and severe protein-energy malnutrition was 15.8 and 3.1% for underweight children, 31.8 and 19.2% for stunting and 0.9 and 0.5% for wasting. Stunting was most common in children aged 2 years. Boys were more likely to suffer from malnutrition. Logistic regression analyses showed that lower family income, lower parental height, belonging to the Miao, Yi and Hani ethnic groups compared with Han and poorer maternal child-rearing behavior significantly increased the risk for stunting of children. CONCLUSIONS: Protein-energy malnutrition is relatively high in the rural minority children of China. Chronic socioeconomic underdevelopment and genetic effects, rather than a severe or immediate lack of food, may lead to protein-energy malnutrition.     

Prevalence and predictors of underweight, stunting, and wasting among children aged 5 and under in western Kenya

The health and nutritional status of children aged 5 and under was assessed in three villages in Siaya District of western Kenya. A cross-sectional survey was conducted among 121 adults and 175 children during July 2002. Primary caretakers were interviewed during home visits to assess agricultural and sanitation resources, child feeding practices, and the nutritional status of their children aged 5 years and under. Through anthropometry, the prevalence of underweight, stunting and wasting were determined: 30 per cent were underweight, 47 per cent were stunted, and 7 per cent were wasted. Predictors of undernutrition were analysed using logistic regression controlling for age, sex, and SES, and four major findings emerged. First, children in their second year of life were more likely to be underweight and stunted. Second, children who were introduced to foods early had an increased risk of being underweight. Third, up-to-date vaccinations were protective against stunting, while reports of having upper respiratory infections or other illness in the past month predicted underweight. Finally, living with non-biological parents significantly increased risk of stunting. Emphasis should be placed on current immunization, prolonging exclusive breastfeeding, and improving access to nutrient-rich foods among adopted children and their families via community-based nutrition interventions.     

Growth impairment at renal transplantation--a determinant of growth and final height

Long-term outcome of growth and final adult height (FH) are a major concern of children after a renal transplantation (Tx). We therefore studied the yearly measurements of height (Ht), expressed as the Z-score and bone age (BA), in 58 children (28 girls) transplanted in our departments and followed-up for 5-18 (mean 9.6) yr after the operation. Twenty-four children reached final adult height. Renal function was evaluated as the glomerular filtration rate (GFR), which is estimated from the clearance of inulin. The mean Ht Z-score at Tx was -1.3 in girls and -2.7 in boys and increased to -0.6 and -1.5, respectively, at 5 yr after Tx. The greatest increase, seen in the shortest children and those transplanted before 7 yr of age, occurred during the first 3 yr. Children aged 7-12 yr at Tx showed an increase in height during the first years after the transplant, while those transplanted at >12 yr of age were not growth-retarded and therefore did not change their Ht Z-score. The most growth-retarded were also the most BA retarded. The mean FH Z-score was -1.1. A direct correlation was seen between GFR at 1 yr after Tx and the increase in height Z-score from Tx to 1 and 5 yr after Tx. In summary, the increment in height following Tx was the greatest in the most growth-retarded children and most marked during the first 3 yr after the transplant. FH was within normal range in 75% of the children. A high Ht Z-score at Tx had a positive effect on FH. Thus, growth after Tx was affected by the degree of stunting at Tx and renal function after Tx.     

Nutritional status of adolescents among tea garden workers

Objective  The study was conducted to evaluate growth and nutritional status using weight and height based indicators among tea garden adolescent boys and girls of Assam aged between 10–18 years. Methods  A cross sectional study was carried out in the tea gardens of Dibrugarh district of Assam through house to house visit. Households were selected through two stage sampling design to reach out the adolescents. Height and weight were measured using standard procedures. Body mass index (BMI) was computed from height and weight. Height-for-age below 3^rd percentile values of NCHS reference was classified as stunting. BMI-for-age below 5^th percentile values of WHO recommended reference was classified as thinness. Results  Total numbers of 605 adolescents (boys-291, girls-314) participated in the study. School enrollment rate was only 59.2%. Prevalence of stunting was 47.4% and 51.9% among boys and girls respectively relative to NCHS reference, which reduced to almost 30% while Indian reference data was used. Prevalence of thinness was higher among boys (59.5%) than girls (41.3%) counterparts. Mean BMI among girls was higher at all ages than boys. Conclusion  Almost half of the adolescents were stunted and most of them were thin. Problem of overweight was seen in less than 0.5% of adolescents. Factors typical to underdeveloped society seems to contribute to the moderate to high prevalence of undernutrition among adolescents working in tea gardens.     

Comparative study of nutritional status of urban and rural Nigerian school children

Nutritional assessment in the community is essential for accurate planning and implementation of intervention programmes to reduce morbidity and mortality associated with under-nutrition. The study was, therefore, carried out to determine and compare the nutritional status of children attending urban and rural public primary schools in Ife Central Local Government Area (ICLGA) of Nigeria. The schools were stratified into urban and rural, and studied schools were selected by balloting. Information obtained on each pupil was entered into a pre-designed proforma. The weight and height were recorded for each pupil, and converted to nutritional indices (weight for age, weight for height, height for age). A total of 749 pupils (366 and 383 children from the rural and urban communities, respectively) were studied. The overall prevalent rates of underweight, wasting and stunting were 61.2, 16.8 and 27.6%, respectively. In the rural area these were 70.5, 17.8 and 35.8%, while in the urban they were 52.2, 15.9 and 19.8%, respectively. The mean nutritional indices (Weight for Age, Weight for Height and Height for Age) were found to be significantly lower among the rural pupils than urban pupils (P < 0.001 in each case). The present study shows that malnutrition (underweight, wasting and stunting) constituted major health problems among school children in Nigeria. This is particularly so in the rural areas. Therefore, prevention of malnutrition should be given a high priority in the implementation of the ongoing primary health care programmes with particular attention paid to the rural population.