The objective of this study was to assess the nutritional status of adolescent boys and girls in a rural community in Bangladesh. Between December 1996 and January 1997, a cross-sectional survey was carried out in 803 households, each containing at least one adolescent, sampled consecutively from four purposely-selected villages in Rupganj Thana, Narayanganj district. Initially, the guardians of 1483 healthy and unmarried 10-17 year old adolescents (51% boys and 49% girls) were interviewed about family structure and socio-economic status. Out of these children, 906 (47% boys and 53% girls) from 597 households were weighed, had their height and MUAC measured and were clinically examined. Blood was then collected from 861 adolescents for haemoglobin estimation. The median monthly income per person in these 597 families was approximately Taka 554 (US $12). Twenty seven per cent of the household heads were labourers, 21% were solvent farmers, 14% ran small scale businesses and 6% were unemployed. Sixty seven per cent of adolescents were thin (defined as BMI < 5th centile of WHO recommended reference) with 75% boys and 59% girls being affected. The percentage of thin adolescents fell from 95% at age 10 years to 12% at age 17 years. The prevalence of stunting (height for age < 3rd centile NCHS/WHO) was 48% for both boys and girls and rose from 34% at age 10 to 65% at age 17. On clinical examination angular stomatitis was present in 46%, 27% had glossitis, 38% had pallor, 11% had dental caries, 3.2% had an conspicuously enlarged thyroid and 2.1% had eye changes of vitamin A deficiency. According to INACG (International Nutritional Anaemia Consultative Group, 1985) cut-off values, 94% of the boys and 98% of the girls were anaemic. We conclude that rural Bangladesh adolescents suffer from high rates of malnutrition and almost universal anaemia. Nutritional interventions to target this population are urgently required.

Background: Rapid increases in hospital and cesarean deliveries threaten an already falling exclusive breastfeeding rate (EBR) in Bangladesh. There is neither a sustained Baby-Friendly Hospital Initiative (BFHI) nor any community support for breastfeeding mothers. Our aim was to find out whether breastfeeding support after hospital delivery and subsequently by mobile phone at home is effective in improving EBR in infants under six-months of age. Methods: A quasi-experimental study was carried out in 2010 at the Centre for Woman and Child Health (CWCH), Savar, Bangladesh. A total of 129 mothers delivered at CWCH were recruited in pre-intervention phase and their infants followed up between 0 and 5 months of age in the community for exclusive breastfeeding (EBF), anthropometry and illness. An intervention package was then implemented with postpartum support for first hour breastfeeding initiation, correction of position and attachment and face-to-face counseling in hospital followed by mobile phone support by two trained Research Assistants once every 15 days after discharge up to six months of age. During the intervention phase, 164 pregnant women delivered at CWCH were recruited and followed up as in the pre-intervention phase. Results: In the pre-intervention phase among 114 infants, 66 (58%) were found to be exclusively breastfed. In the intervention phase among 151 infants, 118 (78%) were exclusively breastfed (p = 0.000). In the pre-intervention phase EBR at less than one month and five months were 85 and 42% as in the intervention phase these EBR were 89 and 71% respectively. Wasting (weight-for-height Z-score < − 2.00), stunting (height-for-age Z-score < − 2.00), and underweight (weight-for-age Z-score < − 2.00) was 17 (15%), 7 (6%), and 14 (13%) respectively in the preintervention phase. In the intervention phase wasting, stunting, and underweight was 16 (11%), 16 (11%), and 15 (10%) respectively. Therefore, there was no statistically significant differences in nutritional status of the infants in the two phases. There was also no significant differences in child morbidity (pneumonia and diarrhea) between the two phases. Conclusion: A combination of hospital support and mobile phone counseling in the community sustained higher rates of EBF in the community after hospital delivery.

The age at menarche and its association with nutritional status in a rural area of Bangladesh was determined. A cross-sectional study was conducted in four villages of Rupganj Thana of Narayanganj district. Data was collected through October to December 1996 using a pre-tested structured questionnaire interview schedule, and nutritional status was measured by weight, height, body mass index (BMI) and physical examination. Data were obtained on 436 adolescent girls aged 10-17 years. Among them, 165 (37.8%) girls had commenced menarche. The mean age at menarche as determined by retrospective recall was 13 years SD 0.89 (n = 165). The median age at menarche determined by the status quo method was 13.0. Among the adolescents 60.1% were thin (BMI < 5th centile WHO recommended reference) and 48.2% were stunted (< 3rd centile NCHS/WHO). The mean weight and BMI were significantly higher among the menstruating girls of 13, 14 and 15 years (p < 0.01) than non-menstruating girls. The mean height was found to be significantly higher at 11-14 years among the menstruating girls (p < 0.05). A lower prevalence of angular stomatitis was found among the menstruating adolescent girls compared with the non-menstruating girls, 36.4% versus 46.5%, although this was statistically non-significant (odds ratio = 0.66, 95% CI 0.43-1.00). For glossitis, no significant difference was found. Among the menstruating girls 12.1% were suffering from menorrhagia and 31.5% from dysmenorrhoea. We conclude that the age of menarche among this rural Bangladeshi community is not as delayed as expected. Not surprisingly, menarche is associated with better nutritional status. The surveyed population had extremely high rates of undernutrition which suggests that adolescents in this and similar situations require specific intervention programmes to improve their nutritional status.

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