Undernutrition is affecting Bumbire Island children, likely due to micronutrient deficiencies. The effects of linear growth deficit continue to accumulate throughout childhood and adolescent years.

Objectives: To analyze the nutritional status of Ugandan school-children in a crosssectional and longitudinal perspective, considering the effect of age imprecision.Materials and methods: Anthropometric measurements of 831 school-children (381 males and 450 females) were analyzed. A subsample of 246 children was measured in July 2014 and 2015. Stunting (based on height-for-age Z-scores), underweight (weight-for-age), and thinness (body mass index-for-age) prevalence were calculated. Three different ages were used: declared (from schools registers), attributed (based on multiple information sources), and bootstrap (from 10,000 replicates).Significant differences among malnutrition prevalence calculated with different ages and in different groups were assessed by means of bootstrap analysis. Longitudinal analysis was conducted using a paired t test.Results: The mean prevalence of malnutrition calculated with declared, attributed, or bootstrap ages were very similar: stunting (11.9-12.7); underweight (5.4-5.9); thinness (3.3-3.7); and obesity (0.7). Undernutrition was more prevalent among older children, while obesity was mostly associated with young age. Obesity was equally distributed among sexes, while undernutrition was more prevalent among females of up to 10 years of age and males above 10 years.The longitudinal analysis indicated a reduction in underweight and thinness, and an increase in stunting, especially among older children.Discussion: Age imprecision did not significantly affect malnutrition estimates.Despite the decline in the prevalence of thinness and underweight observed over a 1-year period, undernutrition persists, with an observed rise in stunting. On the other hand, obesity is starting to appear. Public health efforts are required to eliminate stunting and address the emerging burden of obesity. K E Y W O R D Sage error, malnutrition, school-children, Uganda

We agree with J. Cummins and A. Finaret when declaring that in our research (Comandini et al., 2019) we did not "mimic the methods used by large international demographic surveys." This would have been almost impossible, as our study was not based on household saplings as in the surveys, but was realized within institutions where many children were boarding, some of them from many years, many were orphans, and some came from the main slum of Kampala and had been selected there by the school for being the more in need (i.e., in most cases, especially of stunting, and the health impact of either policies, programs, or interventions.Until the goal of registering all children at birth will be satisfactory approached, a more solid consciousness of the relevance of age data within the nutritional and anthropological research community is to be hoped. A careful procedure to collect age data is strongly advisable. Furthermore, reports on nutritional status in children and adolescents from low-income countries should report a comment on the quality of age data. Such an approach would be particularly useful in studies on nutritional status in school children, where more scattered information is available. Indeed, the majority of the existing knowledge originates from data collected using methodologies different from the DHS ones, and without discussing the problem of age bias or imprecision. On the other hand, regrettably, DHS and MICS data are not suitable to analyze nutritional status in school children, as these children show different growth patterns and are influenced by different causal factors than those under the age of 5 years.