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Published on: January 29, 2018
Severe linear growth retardation in rural Zambian children: the influence of biological variables
J L Hautvast1, J J Tolboom, E M Kafwembe
1Departments of Pediatrics and Medical Microbiology and the Central Clinical Chemical Laboratory of the University Hospital Nijmegen St Radboud, Nijmegen, Netherlands.
Insights
High stunting rates in Zambian children are linked to maternal height and early growth, not specific biological factors. Further research is needed to understand the causes of linear growth retardation.
Area of Science:
- Pediatric Nutrition
- Growth and Development
- Public Health in Sub-Saharan Africa
Background:
- High prevalence of stunting in Zambian preschool children.
- Stunting negatively impacts psychomotor development and future capacity.
- Urgent need to identify contributing factors to linear growth retardation.
Purpose of the Study:
- Investigate biological variables associated with linear growth retardation.
- Examine factors in preschool children in Samfya District, Zambia.
- Assess the role of micronutrients, infections, and maternal factors.
Main Methods:
- Mixed-longitudinal study of 108 children (6-9 mo) and 102 children (14-20 mo).
- Follow-up assessments at 9 and 21 months.
- Measured child and maternal height/weight, serum zinc, retinol, thyrotropin, iron, acute phase proteins, malaria, and intestinal parasites.
Main Results:
- High stunting rates (36-79%), anemia (90%), elevated acute phase proteins (53-71%), and malaria parasitemia (80%).
- Maternal height significantly predicted child height at 6-9 months.
- Early child height strongly correlated with later height; serum micronutrient status did not correlate with later height-for-age z-scores (HAZ).
Conclusions:
- No specific biological factors, including health and micronutrient status, were identified as primary contributors to growth retardation in this cohort.
- Normal zinc and iodine status suggest these micronutrients are not the cause of stunting in this population.
- Findings contrast with other studies, highlighting the complexity of stunting in this region.
Background:
The prevalence of stunting in preschool children in Zambia is high; stunting has detrimental effects on concurrent psychomotor development and later working capacity.
Objective:
Our objective was to investigate biological variables that may contribute to linear growth retardation in preschool children in Samfya District, Zambia.
Design:
Children aged 6-9 mo (n = 108) and 14-20 mo (n = 102) attending mother-and-child health clinics were included. With a mixed-longitudinal design, they were followed up 9 and 21 mo later. Height and weight of children and their mothers were measured. Biochemical measures (eg, serum zinc, retinol, thyrotropin, iron, and acute phase protein concentrations), malaria parasitemia, and intestinal parasitosis were assessed.
Results:
Height-for-age z scores (HAZ) were low, indicating a high prevalence of stunting (36-79%). Ninety percent of the children were anemic, 53-71% had elevated acute phase proteins, and 80% had malaria parasitemia. Regression analyses showed that maternal height predicted the children's height at 6-9 mo (regression coefficient = 0.05; 95% CI: 0.02, 0.08). The children's height at an early age (6-9 and 14-20 mo) showed a strong relation with their height at later ages (22-30 and 34-41 mo). Serum micronutrient status did not show a significant relation with later HAZ.
Conclusion:
Unlike other studies, we did not identify specific biological factors, such as health and micronutrient status, which contribute to the retardation of linear growth. The normal zinc and iodine statuses of the children suggest that at least these factors are not causal.
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