Prevalence and Correlates of Stunting among Primary School Children in Rural Areas of Southern Pakistan

Abstract

Protein-energy malnutrition is one of the leading causes of childhood morbidity and mortality in developing countries. The purpose of the present study was to measure the prevalence of stunting and its correlates among school children aged 6-12 years in the rural areas of southern Pakistan. We selected 1915 children aged 6-12 years enrolled in 32 primary schools in rural Sindh, Pakistan. Trained community health workers conducted child height and weight measurements and collected information from the parents. The Z-scores for the distribution of height-for-age, weight-for-age, and weight-for-height relative to those of National Center for Health Statistics/Center of Disease Control and prevention (NCHS/CDC) reference population were calculated. Out of 1915 children, 300 (16.5 per cent) were stunted. Female children compared to males were more likely to be stunted (prevalence ratio (PR) = 1.26; 95 per cent confidence interval (CI): 1.02-1.53). Children older than 7 years were more likely to be stunted (PR, 1.40; CI, 1.14-1.72). Fathers who were working as government employees (PR, 1.71; CI, 1.05-2.79), shopkeepers (PR, 2.00; CI, 1.22-3.26) and farmers (PR, 1.43; CI, 0.93-2.22) were more likely to have children who were stunted when compared to landlords. In rural areas of southern Pakistan, sex of child, age of the child, and father's occupation may be considered as important risk factors for stunting among school children aged 6-12 years.

Stunting among primary-school children: a sample from Baghdad, Iraq

“…In girls, the prevalence of stunting peaked at age 11 years, whereas in boys it rose steadily up to age 12 years. A similar age pattern was reported in studies demonstrating an increasing prevalence of stunting with age [6,11,13,16,18,20,23,24].…”

“…Among well-nourished children, sex differences are attributed to a normal pattern of dimorphism, with males tending to be taller and heavier than females [18]. Although the data were not statistically significant, girls in this cohort were more likely to be stunted than boys, suggesting that growth in girls may be more sensitive to environmental factors such as infectious diseases, to agespecific differences in catch-up growth between the sexes or to sex-related differences in diet and child care, findings that are reported in other studies [5,16,18,21,22].…”

“…Chronic undernutrition, as evidenced by the proportion of stunted children, was of mild prevalence in this school-aged cohort [16]. Although patterns of school attendance have not been described for this particular population, primary school enrolment in Iraq is 95% according to a report of the Ministry of Planning in 2004, and the dropout from school is about 30%, usually not in the early years of schooling [17].…”

Socio-Economic Inequalities and their Impact on Health in Pakistan

“…In addition to this study, malnutrition among children is the most important reason for poor health among the young ones in Pakistan which is extensively discussed in the studies conducted in different areas (Baig-Ansari et al, 2006;Khuwaja et al, 2005;Shah et al, 2003). Terrorism has devastated the physical and mental health of Pakistanis' and has shaken economy drastically (Hussain, 2010;Looney, 2004;Momani, 2004), whereas these activities have not only inducted many handicaps but also alter the lifestyles of the survivors (Riedel, 2008;Shah, 2010).…”

Nutritional Status Of Under-Five Children In Libya; A National Population-Based Survey

“…This seems to be true for moderate and severe stunting, but not for mild stunting. Other studies have shown increased stunting with age [37][38][39]. This could signify that while the detrimental environmental effects diminish with age, they do not completely disappear.…”