Association of anthropometric status and residential locality factors with cognitive scores of 4–6-year-old children in Kwazulu-Natal, South Africa

Abstract

Background: The Asenze study has the long-term goal of promoting better physical, cognitive and psychosocial functioning of children in a rural area in KwaZulu-Natal, 50 km from Durban, with a view to planning interventions to promote growth and development for very young children. The specific objective in this paper was to provide information for the Child Health and Development project of the Valley Trust to assist with intervention planning. The broader goal was to assess developmental delays in communities ravaged by the HIV epidemic. The Asenze study was designed in two phases from 2008 and 2012. The current paper reports on 1 581 4-6-year-old children in the baseline phase (2008-2010) in the five adjacent tribal areas in the study area. Method: The participants included all the 4-6-year-olds whose parents had consented to inclusion in the project and their caregivers. Data were derived from a brief questionnaire administered in the homes of participants, and subsequently from medical and psychological assessments of the children and their caregivers at the Asenze clinic. The association between child factors and other factors (geographic area, socioeconomic status (SES), parental level of education, the child's preschool education) on the one hand, and the child's cognitive performance (as measured by the Grover Counter and subtests of the KABC-11) were analysed. Linear regression models were employed to determine which predictor variables of interest in a model were associated with the children's cognitive scores as the dependent variables. Results: Based on the data, the principal factors associated with children's cognitive outcomes were height-forage z-score (HAZ), preschool education and the area of residence. Generally children who had low cognitive scores were more often stunted (as defined by the WHO anthropometric tables), had not had preschool education, and came from areas less favourable in terms of local infrastructure and access to employment opportunities and arable land. Conclusion: The finding from this cross-sectional analysis of baseline data showed that in addition to height for age and preschool education, which are commonly thought to impact on cognition, the local authority area where the children lived was associated with their scores on cognitive tests. This has implications for intervention planning. The functioning of local government in promoting the type of community development that will protect the rights of children should be taken into account.

The Asenze Cohort Study in KwaZulu-Natal, South Africa: protocol and cohort profile

“…While studying child cognitive and language outcomes by HIV exposure status in wave 1, Gruver et al [ 15 ] noted that for all outcome measures, HIV-exposed but uninfected children and HIV-unexposed children had comparable scores, while HIV infected children had significantly lower cognitive and language scores. Additionally, in wave 1, Ajayi et al [ 16 ] found that children with low cognitive scores were more often stunted, had no preschool education, and came from areas less favorable in terms of local infrastructure, access to employment, and arable land. Of note, it was reported that 61.2% of children had attended a crèche or preschool.…”

The impact of family support and organization on adolescents during school closure under Covid-19 lockdown regulations in an area of South Africa

“…Analyses of the first two waves of the Asenze study have shown that early health, nutrition and stimulation were important in developing cognitive skills during the preschool period [ 16 – 18 ]. In the present qualitative sub-study several themes emerged with respect to resilience under the crisis in the education system.…”

“…In the first wave of the Asenze assessments the cognitive development of the children was assessed using sub-studies of the KABC II, and higher scores were found not only to be associated with preschool attendance and nutritional status, but also with the area where the child lived [16][17][18]. In a path analysis of cognitive development across the first two waves nutritional status directly predicted cognitive development as measured by the KABC scores [17].…”

Anthropometry as Indicator of the Family Economic Condition

“…1 The difference in economy and lifestyle is significant in rural and urban areas, causing differences in nutritional status between the two. 25 The prevalence of nutrition is somewhat higher in rural than urban areas which is typical in developing countries. 23 Households in urban areas have more access to adequate sanitation and clean water as well as good parental education, thus supporting the creation of a better nutritional status.…”