Prevalence of short stature and malnutrition among Egyptian primary school children and their coexistence with Anemia

Abstract

Background: Under nutrition and overweight typically occur during nutritional transition periods in developing countries including Egypt. Short stature and anemia are public health concern due to its strong link with malnutrition which is a preventable risk factor. Objectives: to estimate the prevalence of overweight, obesity, underweight and short stature and its concurrence with anemia, also to determine the etiological profile of short stature among primary school children in Egypt. Methods: A cross-sectional study was carried out on 33,150 Egyptian children aged 6-11 years old from January 2018 to January 2020, allocated in 59 primary schools from diverse geographical districts in Egypt. Complete anthropometric measurements were conducted and applied according to WHO growth charts. Hemoglobin level was measured. Systematic approach to detect the etiology of short stature was applied randomly to a sample of 380 stunted children. Results: The prevalence of underweight was 8.2%, while obesity and overweight represented 21.8% (9.6 and 12.2% respectively). Overall short stature constituted 17%. The main etiologies of short stature were familial (40.8%) and constitutional (24.2%). Anemia was diagnosed in 26% of children; while concurrent anemia and stunting was reported in 9.9%. Regarding anemia and anemia with stunting were more common among girls (30.0% (OR = 1.50, CI95%: 1.43-1.58) and 11.4% (OR = 1.39, CI95%:1.29-1.49) respectively), who were living in rural areas (33.4% (OR = 1.96, CI 95%:1.87-2.06) &12.7% (OR = 1.72, CI 95%:1.60-1.85)) and those who had low socioeconomic status)34.6% (OR = 2.54, CI 95%:2.29-2.82) & 17.2% (OR = 3.32, CI 95%:2.85-3.88() respectively. Anemia with stunting was significantly higher among children aged ≥9 years old representing 12% (OR = 1.40, CI 95%:1.30-1.51).

Anthropometric Markers With Specific Cut-Offs Can Predict Anemia Occurrence Among Malaysian Young Adults

“…Blood hemoglobin estimation is not a feasible option to predict the occurrence of anemia in the entire large population of a nation affected by it, and the complexity of prediction of anemia among the mass hinders to sketch-out proper rapid remedial strategies. In this aspect, it may be considered that anemia holds a close association with body type and various anthropometric parameters (Micozzi et al, 1989 ; Smith et al, 1991 ; Collett-Solberg et al, 2007 ; Saxena et al, 2011 ; Chang et al, 2014 ; Sinha and Haldar, 2015 ; Virginia and Fenty, 2017 ; El-Shafie et al, 2020 ). Thus, anthropometric parameters can serve as surrogate predictors of anemia, which are simple, non-invasive, and rapid yet accurate.…”

Regional disparities in prevalence of obesity among school-aged children in Egypt: A country case study from The Eastern Mediterranean Region

“…Continued breastfeeding for 2 years has declined from 40% to 20% [4] and has been replaced by unhealthy foods and feeding practices. This has resulted in deterioration of the nutrition indicators in Egypt [19] confounded recently by short stature and anemia linked to the rising rates overweight and obesity [5].…”

“…sedentary lives and are exposed to TV and media ads with the surge in the urbanization of rural communities and the invasion of readymade and fast foods in the market of urban populations to mimic the trend of modernization in the west [20][21][22]. In the early 2000s, westernized communities became increasingly aware of the environmental risk factors of fast food restaurants on the increasing prevalence of obesity [23].…”

“…Foods being consumed from the school canteens, are usually unhealthy, fast, and packed foods with high saturated fat, sugar, and salt. Such unhealthy dietary practices predispose to the rising pandemic of overweight and obesity coupled with short stature and other related micronutrient deficiencies [3][4][5].The origins of obesity begin early in the childhood years. In countries like United States of America, obesity in children has tripled since the 1970s [6].…”

“…Foods being consumed from the school canteens, are usually unhealthy, fast, and packed foods with high saturated fat, sugar, and salt. Such unhealthy dietary practices predispose to the rising pandemic of overweight and obesity coupled with short stature and other related micronutrient deficiencies [3][4][5].…”