title: Age at menarche in relation to nutritional status and critical life events among rural and urban secondary school girls in post-conflict northern Uganda.
abstract: BACKGROUND
  Menarche age is an important indicator of reproductive health of a woman or a community. In industrial societies, age at menarche has been declining over the last 150 years with a secular trend, and similar trends have been reported in some developing countries. Menarche age is affected by genetic and environmental cues, including nutrition. The study was designed to determine the age at menarche and its relation to childhood critical life events and nutritional status in post-conflict northern Uganda.
  
  
  METHODS
  This was a comparative cross-sectional study of rural and urban secondary school girls in northern Uganda. Structured questionnaires were administered to 274 secondary school girls, aged 12 - 18 years to determine the age at menarche in relation to home location, nutritional status, body composition and critical life events.
  
  
  RESULTS
  The mean age at menarche was 13.6 ± 1.3 for rural and 13.3 ± 1.4 years for urban dwelling girls (t = -1.996, p = 0.047). Among the body composition measures, hip circumference was negatively correlated with the age at menarche (r = -0.109, p = 0.036), whereas height, BMI and waist circumference did not correlate with menarche. Paternal (but not maternal) education was associated with earlier menarche (F = 2.959, p = 0.033). Childhood critical life events were not associated with age at menarche.
  
  
  CONCLUSIONS
  Age at menarche differed among urban and rural dwelling school girls and dependent on current nutritional status, as manifested by the hip circumference. It was not associated with extreme stressful childhood critical life events.
authors.affiliation: Department of Paediatrics & Child Health, Paediatric Endocrinologist, Paediatrician, Lecturer, Gulu University, Faculty of Medicine, Gulu, Uganda. beachristo2003@gmail.com.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Odongkara Mpora
authors.forename: Thereza
authors.initials: T
authors.lastname: Piloya
authors.forename: Sylvia
authors.initials: S
authors.lastname: Awor
authors.forename: Thomas
authors.initials: T
authors.lastname: Ngwiri
authors.forename: Paul
authors.initials: P
authors.lastname: Laigong
authors.forename: Edison A
authors.initials: EA
authors.lastname: Mworozi
authors.forename: Ze'ev
authors.initials: Z
authors.lastname: Hochberg
mesh_terms: D000293:Adolescent; D000367:Age Factors; D015992:Body Mass Index; D049628:Body Size; D002648:Child; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D006615:Hip; D006801:Humans; D008016:Life Change Events; D008572:Menarche; D009752:Nutritional Status; D009765:Obesity; D050177:Overweight; D012424:Rural Population / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013851:Thinness; D014454:Uganda; D014505:Urban Population / Q000706:statistics & numerical data*; D055105:Waist Circumference; D014857:Warfare