Nutritional status of rural children in the Lesotho Highlands.

ABSTRACT

A baseline cross-sectional study was done to evaluate the nutritional status of the population of the Mohale Dam catchment area before construction of the dam commenced. In this article we report on the anthropometric, clinical and dietary assessment of the children less than 15 years of age in the study population. A two stage stratified sampling technique was used to randomly select 29 of the 83 villages in the study area. Children under 15 years of age from 395 households, representing approximately 50% of households in the selected villages, were included in the study. Anthropometric measurements of body height and weight in relation to age and sex indicated undernutrition varying, with few exceptions, from high to very high levels in children under 15 years. Stunting, indicating chronic undernutrition, was of particular concern in children, even from the first year of life. Very few clinical signs of nutritional deficiencies were found except for a goitre prevalence of 17.5% in 10 to 14 year old children. This was supported by the very low urinary iodine excretion (median 1.3 micrograms/dL) which indicated a severe iodine deficiency. Dietary evaluation showed high initiation rates of breastfeeding as well as a long duration of breastfeeding. Complementary foods were introduced at an early age, resulting in low exclusive breastfeeding rates. Regular meals were reported but qualitative analysis of the diet showed that a too small variety of foods were eaten, with an irregular intake of protein-rich foods and milk. Quantitative data on 3- < 5-year-old children showed that micro-nutrient intakes were low and that the energy intake of these children was inadequate. The results showed that these nutritionally vulnerable children should be monitored for the impact of the dam construction on their nutritional status.

ABSTRACT

PIP The nutritional status of children under 15 years of age, from South Africa's Mohale Dam catchment area, was investigated in a cross-sectional baseline study conducted before dam construction began. 323 children, from 29 of the 83 villages in the study area, underwent anthropometric, clinical, and dietary assessment. The mean Z-score of height-for-age varied between -1.39 and -1.93 in the different sex and age groups. The percentage of children with a height-for-age less than -2 standard deviations (SDs) below the median of the reference population (indicating stunting) was 38.5-44.9% among boys and 30.7-37.0% among girls. Weight-for-height scores below -2 SDs (indicating wasting) occurred in 0.7-3.4% of children under 10 years old. 15-17% of children under 10 years old were underweight, but this rate increased to 34.8% in boys aged 12-15 years, and declined to 7.7% in older girls. The prevalence of stunting increased from 21.5% in the first year of life to 38.5% in the second year, while that of underweight increased from 7.7% to 19.2%. Goiter was present in 17.5% of 10-14 year olds, consistent with a median urinary iodine excretion of only 1.3 mcg/dl (severe iodine deficiency). Although breast feeding was widespread and of long duration, complementary foods were introduced early (mean, 4.0 months for liquids other than milk; 4.5 months for solids). Dietary analysis revealed irregular intake of protein-rich foods and milk, as well as a lack of variety; fewer than 10 foods represented almost the entire selection. The energy intakes of children 3-5 years old were inadequate. The high prevalence of stunting in this population indicates a need for interventions such as increased food availability and quality, salt iodization, adequate supplies of potable water, and treatment and prevention of infectious diseases. The impact of dam construction and resettlement on these nutritionally vulnerable children should be monitored.