Demographic and socio-economic factors affecting the physical development, haemoglobin and parasitic infection status of schoolchildren in Sanliurfa province, Turkey

Abstract

A cross-sectional population-based survey was undertaken to evaluate the relationship between nutritional status and parasitic infections of schoolchildren and demographic, socio-economic factors in Sanliurfa province, southern Turkey. Nine hundred and eight schoolchildren took part in the survey: 57.2% boys and 42.7% girls. The children's mean z scores were as follows: height for age—0.8 (±1.0) and weight for age—1.0 (±0.9). The mean haemoglobin concentration was 123 g/l (±2.1) and the prevalence of parasitic infections was 55.1%. In total, 50.2% of children were hungry when they arrived at school and 13.4% worked after school. Over 70% (70.4%) of mothers and 18.1% of fathers were illiterate, 16.1% of fathers were unemployed and 46.3% of fathers were engaged in low-income labour. The mean number of children in each family was 5.4 (±2.5), and the mean number of children from each family who attended school was 2.1 (±1.1). The school-attendance ratio was 0.4 (±1.0). Data indicated that older children had significantly lower mean z scores of height ( P<0.0001) and weight for age ( P<0.0001) than younger children, and boys had significantly lower mean z scores of height for age than girls ( P<0.0001). Children living in shantytown areas had significantly lower mean z scores of height for age ( P<0.0001) and weight for age ( P<0.0001), lower mean haemoglobin concentrations ( P:0.003) and a worse parasitic infection status ( P<0.0001) than those living in apartment areas. Children who were hungry when they arrived at school had significantly lower mean haemoglobin concentrations than those who had eaten ( P:0.04). Multiple regression analyses indicated that mean z scores of height for age were significantly related to maternal (multiple R=0.183; P<0.0001) and paternal illiteracy (multiple R=0.216; P:0.004). Mean z scores of weight for age were significantly related to maternal illiteracy (multiple R=0.154; P<0.0001), as was parasitic infection status (multiple R=0.261; P<0.0001) and the number of children in the family (multiple R=0.267; P:0.005). Hunger status was significantly related to maternal (multiple R=0.095; P:0.016) and paternal illiteracy (multiple R=0.104; P:0.005), as was belonging to a large family (multiple R=0.104; P:0.009). These findings indicate that school health programmes may improve the nutritional and health status of schoolchildren. The participation of the local community, which such a programme would entail, may help to increase maternal awareness regarding the feeding of their children before sending them to school. School health programmes may also motivate parents to send their daughters to school, thus increasing maternal literacy in the future. In turn, better levels of maternal literacy will positively affect the socio-economic development of society.