title: Nutrition Status of Primary School Students in Two Rural Regions of Guinea-Bissau.
abstract: BACKGROUND
  The nutrition status of primary schoolchildren in Africa has received relatively little attention in comparison to that of younger children. We surveyed primary school students in Guinea-Bissau, a nation that is among the poorest in the world.
  
  
  OBJECTIVE
  Anthropometry and prevalence of anemia and vitamin A deficiency were assessed in schoolchildren participating in International Partnership for Human Development's school feeding program in 2 regions of Guinea-Bissau.
  
  
  METHODS
  A cross-sectional survey of 32 schools in the regions of Cacheu and Oio was conducted in November 2011. Variables included age, gender, weight, height, hemoglobin, and retinol-binding protein concentrations. Z scores for height for age (HAZ), body mass index for age (BAZ), and weight for age were calculated using World Health Organization reference data.
  
  
  RESULTS
  Anthropometric assessment of 4784 students revealed stunting (HAZ < -2) in 15.5%, thinness (BAZ < -2) in 13.2%, and anemia in 42.0%. Stunting, thinness, and anemia were significantly more common in males, in students from Oio, and in older students. Vitamin A deficiency, detected in 21.5% of the population, was the only assessment that did not demonstrate significant differences between genders or regions. About 61.1% of all children had 1 or more indicators of undernutrition.
  
  
  CONCLUSIONS
  There are substantial rates of stunting, thinness, underweight, anemia, and vitamin A deficiency in primary schoolchildren in Guinea-Bissau, even among those participating in a school lunch program and particularly among males and older students. The results suggest the need for evaluating feeding programs and other methods to improve nutrition status in primary school students, especially in older students.
authors.affiliation: 1 Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.|2 Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Saltzman
authors.affiliation: 1 Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.|3 Global Food and Nutrition Inc., Washington, DC, USA.
authors.forename: Nina
authors.initials: N
authors.lastname: Schlossman
authors.affiliation: 2 Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA.
authors.forename: Carrie A
authors.initials: CA
authors.lastname: Brown
authors.affiliation: 4 International Partnership for Human Development, Leesburg, VA, USA.
authors.forename: Ionela
authors.initials: I
authors.lastname: Balan
authors.affiliation: 2 Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Fuss
authors.affiliation: 1 Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.|2 Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA.
authors.forename: Payal
authors.initials: P
authors.lastname: Batra
authors.affiliation: 4 International Partnership for Human Development, Leesburg, VA, USA.
authors.forename: Augusto
authors.initials: A
authors.lastname: Braima de Sa
authors.affiliation: 2 Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA.
authors.forename: Mary Kyla
authors.initials: MK
authors.lastname: Shea
authors.affiliation: 4 International Partnership for Human Development, Leesburg, VA, USA.
authors.forename: William M
authors.initials: WM
authors.lastname: Pruzensky
authors.affiliation: 4 International Partnership for Human Development, Leesburg, VA, USA.
authors.forename: Carlito
authors.initials: C
authors.lastname: Bale
authors.affiliation: 1 Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.|2 Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA.
authors.forename: Susan B
authors.initials: SB
authors.lastname: Roberts
keywords: anemia; malnutrition; schoolchildren; vitamin A deficiency