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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Progression of stunting and its predictors among school-aged children in western Kenya
European Journal of Clinical Nutrition, Volume 59, No. 8, Year 2005
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Description
Objectives: The objectives of this study were (1) to assess whether a cohort of school-aged children experiences progression of stunting over a 2-y-period of observation and (2) to identify baseline nutritional and body composition risk factors for the progression of stunting. Methods: As part of a large-scale, randomized controlled trial assessing the impact of insecticide-treated bednets (ITNs) on nutritional status, we longitudinally followed a cohort of school-aged children over a 2-y-period in western Kenya. Anthropometric measurements were made at four time points from which Z-scores for height-for-age (HAZ), weight-for-age (WAZ), and body mass index (BMIZ) were calculated. Two measures of body composition, upper arm fat area and upper arm muscle area, were derived from mid-upper arm circumference (MUAC) and triceps skinfold thickness. Results: Subjects experienced a mean change in HAZ from baseline to 9 months of -0.16 [-0.19, -0.13], from baseline to 16 months of -0.18 [-0.22, -0.15], and from baseline to 24 months of -0.36 [-0.41, -0.31]. Thus, the average individual's change in HAZ at the three follow-up time points is significantly less than zero, meaning that, on average, the cohort is deviating further from NCHS reference medians over time. The baseline nutritional measure that explained the greatest amount of variance in the progression of stunting was the upper arm muscle area Z-score (F=8.1; P=0.005). Conclusions: This longitudinal study provides further evidence from a distinct ecological setting regarding the progression of undernutrition during middle childhood in the developing world. It suggests that school-aged children in the developing world do not experience catch-up growth or remain stable. Rather, they continue to deviate from NCHS standards, accruing greater height deficits with age. In addition, absolute lean body mass explained the most variability in the progression of stunting, which supports cross-sectional findings from other studies. © 2005 Nature Publishing Group. All rights reserved.
Authors & Co-Authors
Friedman, Jennifer F.
United States, New York
Institute of International Education, Usa
United States, Providence
The Warren Alpert Medical School
Phillips-Howard, Penelope A.
United States, Atlanta
National Center for Infectious Diseases
Kenya, Nairobi
Kenya Medical Research Institute
Mirel, Lisa B.
United States, Atlanta
National Center for Infectious Diseases
Terlouw, Dianne Janette
United States, Atlanta
National Center for Infectious Diseases
Okello, Norman
Kenya, Nairobi
Kenya Medical Research Institute
Vulule, John M.
Kenya, Nairobi
Kenya Medical Research Institute
Hawley, William A.
United States, Atlanta
National Center for Infectious Diseases
Nahlen, Bernard L.
United States, Atlanta
National Center for Infectious Diseases
ter Kuile, Feiko O.
United States, Atlanta
National Center for Infectious Diseases
Kenya, Nairobi
Kenya Medical Research Institute
Netherlands, Amsterdam
Universiteit Van Amsterdam
Statistics
Citations: 49
Authors: 9
Affiliations: 5
Identifiers
Doi:
10.1038/sj.ejcn.1602161
ISSN:
09543007
Research Areas
Food Security
Maternal And Child Health
Study Design
Cross Sectional Study
Cohort Study
Phenomenological Study
Study Approach
Quantitative
Study Locations
Kenya