title: Could intervention by clinics such as Primeros Pasos affect the prevalence of childhood malnutrition in the developing world?
abstract: OBJECTIVE
  Guatemala is a country severely affected by malnutrition, particularly in its child population. The present study aimed to assess the impact of recognised aetiological factors on the prevalence of malnutrition and to establish the efficacy of a Guatemalan malnutrition clinic by examining the changes in the prevalence of malnutrition in the ten surrounding communities served by the clinic.
  
  
  METHODS
  Records of children (n 7681) aged 5-16 years seen by the clinic between 2004 and 2006 were examined. Anthropometric data for each child were taken from these records and used as an indicator for their nutritional status to estimate the change in rates of malnutrition during this period.
  
  
  RESULTS
  An overall reduction was seen in all forms of malnutrition over the 3-year period, although over 50 % of the study population remained malnourished in 2006. A consistent reduction was also seen in rates of moderate and severe malnutrition, but not in rates of mild malnutrition.
  
  
  CONCLUSIONS
  The results demonstrate that clinics such as Primeros Pasos can have a beneficial effect on schoolchildren, particularly those who are severely malnourished. A need has been highlighted for more research in this area, particularly how clinics such as Primeros Pasos can be best used in the fight against malnutrition.
authors.affiliation: Post-Graduate Centre, City Hospital, Dudley Road, Birmingham B18 7QH, UK. adam@s-mail.me.uk
authors.forename: Adam
authors.initials: A
authors.lastname: Seccombe
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hughes