Does poor health nutrition affect school achievement in rural Jamaican children?

ABSTRACT

In recent years, increasing attention has been given to the effects of health and nutrition on schoolchildren's ability to learn. This study was conducted to determine whether nutritional status, anaemia and geohelminth infections were related to school achievement after controlling for a wide range of social variables. Eight hundred children were randomly selected from all those enrolled in grade 5 in 16 rural primary schools in Jamaica. School achievement was assessed by the Wide Range Achievement Test (WRAT). Children's weights and heights were converted to Z-scores using the NCHS references. Haemoglobin was measured using a haemoglobin photometer (Hemocue), and the presence and intensity (eggs per gram stool) of Trichuris trichura and Ascaris lumbricoides assessed by the Kato Thick Smear method. Socio-economic variables were assessed by questionnaire and observation, and school attendance obtained was from the class registers. The mean height-for-age of the children was -0.4 ñ 1.0 SD with 25.3 percent having heights <-ISD of the NCHS references. Fourteen point seven per cent (14.7 percent) of the children were anaemic (Hb < 1lg/dl), 38.3 percent were infected with Trichuris trichura and 19.4 percent with Ascaris lumbricoides. Height-for-age (p<0.001) was positively correlated with scores on the WRAT, and anaemia (p<0.05), Trichons and Ascaris infections (p<0.001) were associated with lower scores. In a multiple regression analysis, after controlling for attendance, sex, socio-economic status, possession of school books and uniform quality, the achievement of children with Trichuris infections was significantly worse than that of uninfected children in spelling, reading and the total WRAT score (p < 0.01). Height-for-age (p < 0.001) and anaemia (p < 0.05) contributed significantly to the variance in arithmetic. Despite the mild levels of undernutrition and the low intensity of the geohelminth infections, they were still associated with achievement. This suggests that efforts to increase school achievement levels in developing countries should include strategies to improve the health and nutritional status of children (AU)