Factors associated with stunted growth in children below 11 years of age in Antioquia, Colombia, 2004 / Factores asociados con el retraso del crecimiento en menores de 11 años en Antioquia, Colombia, 2004

Objective: To explore some factors associated to stunted growth in children below 11 years of age in the Department of Antioquia. Methodology: Cross-sectional study using the databases of alimentary and nutritional profiles in homes of Antioquia in 2004, based on a representative random sample of homes in the department (95% reliability and error margin of 3%). For this study, 100% of the records of children below 11 years of age were used. A model of generalized equations estimation was constructed for stunted growth classified by a Z score smaller than -2 standard deviation with respect to p 50 of the 1978 NCHS (Centro Nacional de Estadísticas de la Salud - National Center for Health Statistics). Data were analyzed using the GLIMMIX Procedure: SAS version 9.1. Results: We found 18.6% of the children with stunted growth, 75% of the homes with male head of household, 70% of heads of household with maximum 5 years of schooling; 47% of homes were nucleated bi-parental, and 40% extensive with a 5-member median per home; 56.4% poor per unsatisfied basic needs, and 80% in alimentary insecurity. The factors associated to stunted growth were: female gender, 1-5 years of age, head of household with less than 6 years of schooling, more than 5 people in the home, more than two household members under 7 years of age, coming from a poor home per unsatisfied basic needs, belonging to a sub-region different from Medellin, food availability of less than 30 different foods per week, no production of food, and head of household under 40 years of age. Conclusions: Herein, we show evidence of the magnitude of poverty and association of precarious socioeconomic conditions with stunted growth in Antioquia. The study shows the importance of considering the correlated nature of the data for the construction of the model.

Objetivo: Explorar algunos factores asociados con el retraso del crecimiento en menores de 11 años en Antioquia, Colombia. Metodología: Estudio de corte transversal utilizando las bases de datos del perfil alimentario y nutricional de los hogares de Antioquia en el año 2004. Muestra representativa aleatoria de hogares por subregión del departamento (95% de confianza y error del 3%). Se tomó 100% de los registros de los menores de 11 años. Se construyó un modelo de estimación de ecuaciones generalizadas para el retraso del crecimiento clasificado por puntaje Z menor de -2 desviaciones estándar, con respecto al p 50 de la NCHS (Centro Nacional de Estadísticas de la Salud) 1978. Los datos se analizaron usando el procedimiento GLIMMIX: SAS versión 9.1. Resultados: Del total de niños, 18.6% tenían retraso del crecimiento, 75% de hogares con jefatura masculina, 70% de jefes con máximo 5 años de escolaridad; 47% de hogares nucleados biparental y 40% extensos, mediana de 5 integrantes por hogar; 56.4% pobres por necesidades básicas insatisfechas y 80% en inseguridad alimentaria. Los factores asociados con el retraso del crecimiento fueron: sexo femenino, edad entre 1 y 5 años, jefe con escolaridad menor de 6 años, más de 5 personas en el hogar, más de dos menores de 7 años en el hogar, provenir de un hogar pobre por necesidades básicas insatisfechas, pertenecer a una subregión diferente a Medellín, disponibilidad menor a 30 alimentos diferentes por semana, no producir alimentos y jefe de hogar menor de 40 años. Conclusiones: Se evidenció la magnitud de la pobreza y la asociación de condiciones socioeconómicas precarias con el retraso del crecimiento en Antioquia. Se demostró la importancia de considerar la naturaleza correlacionada de los datos para la construcción del modelo.

Validación de escala de la seguridad alimentaria doméstica en Antioquia, Colombia / Validation of a household food security scale in Antioquia, Colombia

OBJETIVO: Adaptar y validar en hogares de Antioquia, Colombia, una escala de seguridad alimentaria anteriormente aplicada en hogares de Caracas, Venezuela. MATERIAL Y MÉTODOS: El estudio se realizó en 44 municipios del departamento de Antioquia, Colombia, durante los años 2003 y 2004, en una muestra representativa de los hogares rurales y urbanos del departamento de Antioquia, constituida por 1 624 hogares con niños menores de 10 años; los hogares fueron seleccionados de manera aleatoria, con un índice de confianza de 95 por ciento y un error de 3 por ciento. Se validó la escala de seguridad alimentaria doméstica utilizada por Paulina Lorenzana en Venezuela, y se determinó la consistencia interna de la escala mediante el coeficiente de correlación de Spearman y el coeficiente alfa de Cronbach. La validez del constructo se estableció mediante el método de componentes principales para datos categóricos. Se utilizaron el procedimiento de Prinqual y el modelo de Rasch para definir los componentes y los ítems de la escala. RESULTADOS: El análisis factorial arrojó dos componentes: 1) las variables relacionadas con "inseguridad alimentaria sin hambre" que lo explican en 95 por ciento y 2) las relacionadas con "inseguridad alimentaria con hambre" que lo explican en 89.4 por ciento. El coeficiente alfa de Cronbach para el primer componente fue de de 0.95 y para el segundo de 0.89. Al ser analizados con el modelo Rasch, todos los ítems presentaron valores infit en un rango de 0.8 a 1.2. La escala se correlacionó significativamente con la disponibilidad de alimentos, el recurso de la limosna, el trabajo infantil, el tamaño del hogar y la ocupación del jefe de familia (p< 0.000). CONCLUSION: La escala puede considerarse un instrumento confiable para la valoración de la inseguridad alimentaria en los hogares de Antioquia.

OBJETIVE: To adapt and validate in households of Antioquia, Colombia, a food security scale previously applied in households of Caracas, Venezuela. MATERIAL AND METHODS: The study was carried out in 44 municipalities in the department of Antioquia, Colombia, in 2003 and 2004, with a randomly selected sample of 1 624 rural and urban households with children under 10 years of age, representative for family units located in the department of Antioquia. The sample was selected using a confidence interval of 95 percent and an error of 3 percent. Household food security scale previously used by Paulina Lorenzana in Venezuela were validated for this survey. Internal consistency of the scale was determined using the Spearman correlation coefficient and Cronbach's Alpha coefficient. Construct validity was established through principal components analysis for categorical data. Prinqual procedure and Rasch modeling were used to define the components and items in the scale. RESULTS: Factor analysis showed two components: 1) variables related to "food insecurity without hunger", which is explained in 95 percent; 2) variables related to "food insecurity with hunger", which is explained in 89.4 percent. Cronbach's Alpha coefficients for "food insecurity without hunger" and "food insecurity with hunger" were 0.95 and 0.89, respectively. When analyzed using Rasch modeling, all items showed infit values within a range of 0.8 and 1.2. The scale correlated significantly (p<0.000) with food availability, begging, children's labor, household size, and occupation of the head of household. CONCLUSIONS: The scale can be considered a reliable instrument for assessing food insecurity in Antioquia households.

[Validation of a household food security scale in Antioquia, Colombia]. / Validación de escala de la seguridad alimentaria doméstica en Antioquia, Colombia.

OBJECTIVE: To adapt and validate in households of Antioquia, Colombia, a food security scale previously applied in households of Caracas, Venezuela. MATERIAL AND METHODS: The study was carried out in 44 municipalities in the department of Antioquia, Colombia, in 2003 and 2004, with a randomly selected sample of 1 624 rural and urban households with children under 10 years of age, representative for family units located in the department of Antioquia. The sample was selected using a confidence interval of 95% and an error of 3%. Household food security scale previously used by Paulina Lorenzana in Venezuela were validated for this survey. Internal consistency of the scale was determined using the Spearman correlation coefficient and Cronbach's Alpha coefficient. Construct validity was established through principal components analysis for categorical data. Prinqual procedure and Rasch modeling were used to define the components and items in the scale. RESULTS: Factor analysis showed two components: 1) variables related to "food insecurity without hunger", which is explained in 95%; 2) variables related to "food insecurity with hunger", which is explained in 89.4%. Cronbach's Alpha coefficients for "food insecurity without hunger" and "food insecurity with hunger" were 0.95 and 0.89, respectively. When analyzed using Rasch modeling, all items showed infit values within a range of 0.8 and 1.2. The scale correlated significantly (p < 0.000) with food availability, begging, children's labor, household size, and occupation of the head of household. CONCLUSION: The scale can be considered a reliable instrument for assessing food insecurity in Antioquia households.