Prevalence and Severity of Malnutrition in Pre-School Children in a Rural Area of Western Kenya

Abstract

Abstract. We determined the nutritional status of children less than five years of age in an area in rural western Kenya with intense malaria transmission, a high prevalence of severe anemia and human immunodeficiency virus, and high infant and under-five mortality (176/1,000 and 259/1,000). No information is available on the prevalence of malnutrition in this area. Three cross-sectional surveys were conducted between 1996 and 1998 to monitor the effect of insecticide-treated bed nets on child morbidity. Anthropometric indices are presented for 2,103 children collected prior to and during intervention (controls only). The prevalence of stunting (Z-scores for height-for-age [HAZ] <−2), wasting (Z-scores for weight-for-height [WHZ] <−2) and being underweight (Z-scores for weight-for-age [WAZ] <−2) was 30%, 4%, and 20%, respectively. This was severe (Z-score <−3) in 12% (stunting), 1% (wasting), and 5% (underweight) of the children. Few children less than three months of age were malnourished (<2%), but height-for-age and weight-forage deficits increased rapidly in children 3−18 months of age, and were greatest in children 18−23 months old (44% stunted and 34% underweight). While the mean HAZ and WAZ stabilized from 24 months of age onwards, they still remained substantially below the reference median with no evidence of catch-up growth. Malnutrition is likely to interact with infectious diseases, placing children 3−24 months of age at high risk of premature death in this area.

Prevalence and severity of malnutrition and age at menarche; cross-sectional studies in adolescent schoolgirls in western Kenya

“…Furthermore, mean z-scores for height-for-age tended to converge towards the median of the US reference curve in older girls and prevalence of thinness and stunting decreased with age. The prevalence of stunting in adolescent girls was approximately a third of that found in children under 5 y from the same study area in Asembo (Kwena et al, 2003). The prevalence of stunting was lower than the prevalence reported in one other study in African adolescent girls using the same reference data (Simondon et al, 1998).…”

“…Infant and under-5 mortality are considerably higher than in other parts of Kenya (176/1000 and 275/1000) (McElroy et al, 2001). Between 60 and 90% of the children under 5 y are anaemic at any time (Hbo11 g/dl) (Bloland et al, 1999a) and 30 and 20% are stunted or underweight (Kwena et al, 2003). No data are available of the nutritional status in adolescents.…”

Progression of stunting and its predictors among school-aged children in western Kenya

“…The southern boundary of the study area lies on Lake Victoria. The prevalence of stunting (HAZoÀ2), wasting (WHZoÀ2) and, underweight (WAZo-2) was 30, 4, and 20%, respectively among children under five in this study area (Kwena et al, 2003). The study area is populated predominately by individuals of the Luo ethnic group.…”

Study of risk factors of severe acute malnutrition (SAM) in children 6 months to 5 years of age and evaluation of effect of micronutrient supplementation (WHO protocol) on serum zinc and magnesium levels: a case control study

“…[2][3][4][5] Protein-energy malnutrition usually manifests early, in children between 6 months and 2 years of age and is associated with early weaning, delayed introduction of complementary foods, a low-protein diet and severe or frequent infections (Rice et al, Kwena et al, and Müller). 4,7,8 Although risk factors for malnutrition have been identified earlier, individual factors potentially change in specific areas over time and a current characterization of risk factors provides the basis for preventative intervention strategies. This will ensure that the best use is made of available resources.…”