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Nutritional status of primary school children with endemic goitre in Caprivi, Namibia
P L Jooste1, M Faber, C J Badenhorst
1Medical Research Council, National Research Programme for Nutritional Intervention, Parow, South Africa.
Insights
Children in eastern Caprivi, Namibia, suffer from severe undernourishment and widespread micronutrient deficiencies, alongside endemic goitre caused by iodine deficiency. Nutritional programs must address both goitre and these critical nutritional gaps.
Area of Science:
- Public Health
- Nutrition Science
- Pediatrics
Background:
- Endemic goitre is prevalent in eastern Caprivi, Namibia.
- Previous studies indicated iodine deficiency as the cause of goitre.
- This study focuses on the broader nutritional status of children in the region.
Purpose of the Study:
- To assess the overall nutritional status of primary school children in an endemic goitre area.
- To identify specific nutritional deficiencies beyond iodine.
- To inform targeted nutritional intervention programs.
Main Methods:
- Clinical, biochemical, anthropometrical, and dietetic assessments were conducted.
- A sample of 380 primary school children (aged 6-18) from eight schools was studied.
- Nutritional status was evaluated using weight-for-age, height-for-age, and biochemical markers.
Main Results:
- Children exhibited severe undernourishment with high rates of low weight and height for age (38.0 pc - 55.9 pc).
- Significant deficiencies were found in energy, folic acid, ascorbic acid, vitamin A, nicotinic acid, iron, riboflavin, and calcium.
- Biochemical anaemia was prevalent (43.9 pc in boys, 33.7 pc in girls), with low clinical manifestation.
Conclusions:
- Dietary iodine deficiency is the primary cause of endemic goitre.
- Children in this region suffer from severe undernourishment and multiple micronutrient deficiencies.
- Intervention programs must address both goitre and energy/micronutrient deficiencies for comprehensive child health.
Abstract:
The nutritional status of primary school children living in an endemic goitre area in eastern Caprivi, Namibia, was assessed by means of clinical, biochemical, anthropometrical and dietetic observations. An approximately 20 pc sample, consisting of 380 primary school children, aged six to 18 years and representing eight schools in the Cuando River area of eastern Caprivi, was included in the study. Their goitre prevalence of 34.5 pc has been reported earlier. A significantly lower mean thyroxine level in goitrous compared to non-goitrous children indicated that dietary iodine deficiency was the primary cause of the endemic goitre. The present paper focuses on the nutritional status of these primary school children. Anthropometrically, these children were severely undernourished, as indicated by a high prevalence of low (below the third NCHS percentile) weight and height for age values, ranging from 38.0 pc to 55.9 pc. Dietary analysis revealed a low energy intake as well as dietary deficiencies in folic acid (only girls), ascorbic acid, vitamin A, nicotinic acid, iron, riboflavin and calcium. A high percentage (43.9 pc of boys and 33.7 pc of girls) of the children were biochemically anaemic whilst less than one pc of the children showed clinical signs of anaemia. Nutritional intervention programmes in this area should not only treat and prevent the endemic goitre but also attend to the energy and micro-nutrient deficiencies in these children.