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      Prevalence of and Risk factors for Stunting among School Children and Adolescents in Abeokuta, Southwest Nigeria

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          Abstract

          Stunting adversely affects the physical and mental outcome of children. The objectives of the study were to determine the prevalence of and risk factors associated with stunting among urban school children and adolescents in Abeokuta, Nigeria. Five hundred and seventy children aged 5-19 years were selected using the multi-stage random-sampling technique. Stunting was defined as height-for-age z-score (HAZ) of <-2 standard deviation (SD) of the National Center for Health Statistics reference. Severe stunting was defined as HAZ of <-3 SD. The mean age of the children was 12.2+3.41 years, and 296 (51.5%) were males. Ninety-nine (17.4%) children were stunted. Of the stunted children, 20 (22.2%) were severely stunted. Identified risk factors associated with stunting were attendance of public schools (p<0.001), polygamous family setting (p=0.001), low maternal education (p=0.001), and low social class (p=0.034). Following multivariate analysis with logistic regression, low maternal education (odds ratio=2.4; 95% confidence interval 1.20-4.9; p=0.015) was the major contributory factor to stunting. Encouraging female education may improve healthcare-seeking behaviour and the use of health services and ultimately reduce stunting and its consequences.

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          Physical Status: The Use and Interpretation of Anthropometry

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            Anthropometric reference data for international use: recommendations from a World Health Organization Expert Committee.

            The World Health Organization (WHO) convened an Expert Committee to reevaluate the use of anthropometry at different ages for assessing health, nutrition, and social wellbeing. The Committee's task included identifying reference data for anthropometric indexes when appropriate, and providing guidelines on how the data should be used. For fetal growth, the Committee recommended an existing sex-specific multiracial reference. In view of the significant technical drawbacks of the current National Center for Health Statistics (NCHS)/WHO reference and its inadequacy for assessing the growth of breast-fed infants, the Committee recommended the development of a new reference concerning weight and length/height for infants and children, which will be a complex and costly undertaking. Proper interpretation of midupper arm circumference for preschoolers requires age-specific reference data. To evaluate adolescent height-for-age, the Committee recommended the current NCHS/WHO reference. Use of the NCHS body mass index (BMI) data, with their upper percentile elevations and skewness, is undesirable for setting health goals; however, these data were provisionally recommended for defining obesity based on a combination of elevated BMI and high subcutaneous fat. The NCHS values were provisionally recommended as reference data for subscapular and triceps skinfold thicknesses. Guidelines were also provided for adjusting adolescent anthropometric comparisons for maturational status. Currently, there is no need for adult reference data for BMI; interpretation should be based on pragmatic BMI cutoffs. Finally, the Committee noted that few normative anthropometric data exist for the elderly, especially for those > 80 y of age. Proper definitions of health status, function, and biologic age remain to be developed for this group.
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              The World Health Organization Global Database on Child Growth and Malnutrition: methodology and applications.

              For decades nutritional surveys have been conducted using various definitions, indicators and reference populations to classify child malnutrition. The World Health Organization (WHO) Global Database on Child Growth and Malnutrition was initiated in 1986 with the objective to collect, standardize, and disseminate child anthropometric data using a standard format. The database includes population-based surveys that fulfil a set of criteria. Data are checked for validity and consistency and raw data sets are analysed following a standard procedure to obtain comparable results. Prevalences of wasting, stunting, under- and overweight in preschool children are presented using z-scores based on the National Center for Health Statistics (NCHS)/WHO international reference population. New surveys are included on a continuous basis and updates are published bimonthly on the database's web site. To date, the database contains child anthropometric information derived from 846 surveys. With 412 national surveys from 138 countries and 434 sub-national surveys from 155 countries, the database covers 99% and 64% of the under 5 year olds in developing and developed countries, respectively. This wealth of information enables international comparison of nutritional data, helps identifying populations in need, evaluating nutritional and other public health interventions, monitoring trends in child growth, and raising political awareness of nutritional problems. The 15 years experience of the database can be regarded as a success story of international collaboration in standardizing child growth data. We recommend this model for monitoring other nutritional health conditions that as yet lack comparable data.
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                Author and article information

                Journal
                J Health Popul Nutr
                JHPN
                Journal of Health, Population, and Nutrition
                International Centre for Diarrhoeal Disease Research, Bangladesh
                1606-0997
                2072-1315
                August 2011
                : 29
                : 4
                : 364-370
                Affiliations
                [1] 1Department of Paediatrics and Child Health
                [2] 2Department of Community Health and Primary Care, College of Medicine, Lagos State University, PMB 21266, Ikeja, Lagos, Nigeria
                Author notes
                Correspondence and reprint requests should be addressed to: Dr. Idowu O. Senbanjo Paediatrics Gastroenterology/Hepatology/Nutrition Unit Department of Paediatrics and Child Health College of Medicine, Lagos State University PMB 21266, Ikeja, Lagos Nigeria E-mail: senbanjo001@ 123456yahoo.com Tel: +234 08067777363
                Article
                jhpn0029-0364
                10.3329/jhpn.v29i4.8452
                3190367
                21957675
                735b1a62-48e2-4b04-aee1-4f49447cb684
                © INTERNATIONAL CENTRE FOR DIARRHOEAL DISEASE RESEARCH, BANGLADESH

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Original Papers

                Nutrition & Dietetics
                child nutrition disorders,adolescent,nigeria,stunting,nutrition disorders,child,community-based studies,risk factor,cross-sectional studies

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