Secondary sexual development of ‘Cape Coloured’ girls following kwashiorkor

Abstract

This report describes the secondary sexual development of 45 'Cape Coloured' female ex-kwashiorkor patients and 43 female controls. All patients were originally seen between five months and four years four months of age, treated and then followed up for 15 years after discharge. Age at menarche was available on 42 ex-patients and 33 controls, and age at peak height velocity (PHV) was available for 30 ex-patients and 15 controls. Maximum likelihood estimates of the mean age at entry to each pubertal stage were made, age at menarche was obtained directly from the subject records and age at PHV was obtained by fitting a non-linear growth function to the data for each subject. All subjects passed through the sequence of pubertal events in the normal order, i.e., no reversals were observed. Ex-patients were generally delayed in relation to controls but there were no significant differences for ages at entry to any of the pubertal stages. The subjects were combined for comparison to equivalent data on British girls. The South African girls were significantly delayed in the development of pubic hair and menarche but showed no significant differences for age at entry or duration of breast development and PHV. It is suggested that lack of delay in breast development may have selective advantages to females living in situations of chronic malnutrition.

Examination of US Puberty-Timing Data from 1940 to 1994 for Secular Trends: Panel Findings

“…6,7 Information on environmental factors including previous nutrition, body fat or size, and race are important in studies of puberty timing. Early severe protein-energy malnutrition presenting as marasmus (severe wasting and growth retardation as a result of insufficient intake) but not kwashiorkor (edematous protein-deficiency malnutrition) delays timing of puberty, at least in girls, [48][49][50] and chronic malnutrition during childhood through to puberty retards pubertal development in boys and girls. 51 Among chronically undernourished children, age at menarche was delayed by ϳ2 years among the girls and sexual maturity measures were delayed by ϳ3 years in boys.…”

Secondary sexual development of Cape Coloured boys following kwashiorkor

“…These data have been made available to the present authors who have already reported on the timing and magnitude of adolescent growth in height and weight and secondary sexual development of the females of the sample (Cameron, Moodie, Mann and Hansen 1985, Cameron, Jones, Mitchell, Moodie, Bowie, Mann and Hansen, 1986, Cameron et al 1988). This paper reports on the timing and pattern of secondary sexual development in boys of the same sample.…”

“…The ex-patients and controls have been described in detail by Keet, Moodie, Wittmann and Hansen (1971) and by Cameron et al (1986Cameron et al ( , 1988. Briefly, 221 patients between the ages of 5 months and 4 years 4 months were originally treated for kwashiorkor.…”

“…Most recently Cameron et al (1988) emphasized the cross-sectional nature of such data. Kulin, Bwiba, Mutie and Santner (1982) reported on the pubertal growth of Kenyan adolescents from "privileged" and "rural" environments.…”

“…In a recent paper the secondary sexual development of ex-kwashiorkor, so called Cape Coloured, female patients was described (Cameron, Mitchell, Meyer, Moodie, Bowie, Mann and Hansen 1988). These data were compared to a sample of females from similar nutritional and socioeconomic backgrounds who had not presented with the clinical signs and symptoms of kwashiorkor.…”