Linear growth retardation in Zanzibari school children.
This paper describes the longitudinal changes in height and weight of children in school grades 1-3 on Pemba Island, Zanzibar, a poor rural population in which parasitic infections and anemia are highly prevalent. Heights and weights of children were measured at base line, and 6 and 12 mo later, and were compared with U.S. reference data. At base line, the prevalence of height-for-age Z-score < -2 rose from 14% in 7-y-old children to 83% in 13-y-old children. Prevalence of weight-for-age Z-score < -2 in children < 10 y was approximately 10% or less. Median 6-mo height increments for Pembian boys were around the 5th percentile at age 8 and around the 10th percentile from age 9 to 13 y. Height increments for girls improved from below the 25th percentile to above the median in this age range. Based on the longitudinal yearly gains observed, boys accumulate a height deficit of 11.9 cm and girls 8.5 cm, relative to the reference population. In multivariate analyses, a small part of the variability in growth increments was explained by ascariasis and anemia (for weight gain) and schistosomiasis (for height gain). A review of other growth data from rural African Bantu populations provides supporting evidence that stunting occurs in older as well as younger children. It has been controversial whether school-based health and nutrition interventions could induce catch-up growth in already stunted children. Our results suggest that appropriate interventions might actually prevent stunting in late childhood.
Stoltzfus
R J
RJ
Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD 21205, USA.
Albonico
M
M
Tielsch
J M
JM
Chwaya
H M
HM
Savioli
L
L
D000293:Adolescent; D000740:Anemia / Q000150:complications / Q000453:epidemiology; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006130:Growth Disorders / Q000453:epidemiology* / Q000209:etiology; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010272:Parasitic Diseases / Q000150:complications / Q000453:epidemiology; D015995:Prevalence; D013636:Tanzania / Q000453:epidemiology