title: Severe linear growth retardation in rural Zambian children: the influence of biological variables.
abstract: BACKGROUND
  The prevalence of stunting in preschool children in Zambia is high; stunting has detrimental effects on concurrent psychomotor development and later working capacity.
  
  
  OBJECTIVE
  Our objective was to investigate biological variables that may contribute to linear growth retardation in preschool children in Samfya District, Zambia.
  
  
  METHODS
  Children aged 6-9 mo (n = 108) and 14-20 mo (n = 102) attending mother-and-child health clinics were included. With a mixed-longitudinal design, they were followed up 9 and 21 mo later. Height and weight of children and their mothers were measured. Biochemical measures (eg, serum zinc, retinol, thyrotropin, iron, and acute phase protein concentrations), malaria parasitemia, and intestinal parasitosis were assessed.
  
  
  RESULTS
  Height-for-age z scores (HAZ) were low, indicating a high prevalence of stunting (36-79%). Ninety percent of the children were anemic, 53-71% had elevated acute phase proteins, and 80% had malaria parasitemia. Regression analyses showed that maternal height predicted the children's height at 6-9 mo (regression coefficient = 0.05; 95% CI: 0.02, 0.08). The children's height at an early age (6-9 and 14-20 mo) showed a strong relation with their height at later ages (22-30 and 34-41 mo). Serum micronutrient status did not show a significant relation with later HAZ.
  
  
  CONCLUSIONS
  Unlike other studies, we did not identify specific biological factors, such as health and micronutrient status, which contribute to the retardation of linear growth. The normal zinc and iodine statuses of the children suggest that at least these factors are not causal.
authors.affiliation: Departments of Pediatrics and Medical Microbiology and the Central Clinical Chemical Laboratory of the University Hospital Nijmegen St Radboud, Nijmegen, Netherlands.
authors.forename: J L
authors.initials: JL
authors.lastname: Hautvast
authors.forename: J J
authors.initials: JJ
authors.lastname: Tolboom
authors.forename: E M
authors.initials: EM
authors.lastname: Kafwembe
authors.forename: R M
authors.initials: RM
authors.lastname: Musonda
authors.forename: V
authors.initials: V
authors.lastname: Mwanakasale
authors.forename: W A
authors.initials: WA
authors.lastname: van Staveren
authors.forename: M A
authors.initials: MA
authors.lastname: van 't Hof
authors.forename: R W
authors.initials: RW
authors.lastname: Sauerwein
authors.forename: J L
authors.initials: JL
authors.lastname: Willems
authors.forename: L A
authors.initials: LA
authors.lastname: Monnens
mesh_terms: D000209:Acute-Phase Proteins / Q000032:analysis; D000367:Age Factors; D000886:Anthropometry; D002675:Child, Preschool; D015331:Cohort Studies; D003677:Deficiency Diseases / Q000097:blood; D006130:Growth Disorders / Q000097:blood / Q000453:epidemiology* / Q000469:parasitology; D006305:Health Status Indicators; D006801:Humans; D007223:Infant; D007455:Iodine / Q000097:blood; D007501:Iron / Q000097:blood; D018977:Micronutrients / Q000032:analysis*; D009752:Nutritional Status; D012044:Regression Analysis; D012424:Rural Population; D012959:Socioeconomic Factors; D014801:Vitamin A / Q000097:blood; D015024:Zambia / Q000453:epidemiology; D015032:Zinc / Q000097:blood
chemical_list: D000209:Acute-Phase Proteins; D018977:Micronutrients; D014801:Vitamin A; D007455:Iodine; D007501:Iron; D015032:Zinc