Factors Influencing the Growth and Nutritional Status of Infants and Young Children in Rural Jordan (2 Volumes)

Abstract

This cross-sectional study describes the clinical, anthropometric and haematological findings of 3,734 Jordanian infants and young children in the rural port of Amman. The birth dates were known from the birth registry. The purpose of the study was to evaluate the growth and nutrition of= children ten years after a previous survey, since during the interval there have been dramatic social, economic and political changes in this area. Detailed tables and graphs for the following anthropometric measurements were constructed for children during the first year of life at one month intervals and for the whole group (0-5 years) at three month intervals: weight, height, weight/height ratio, head circumference, arm circumference and skinfold thickness (triceps, biceps, subscapular and suprailiac). The mothers' weights were also recorded and showed some significant relation to the children’s nutritional status. In addition, weight and height of birth of more than 700 new-borns from the lower middle class section of Amman were analysed; they were live born, normal, healthy singletons : they were recorded as a reference. Using Waterlow's public health classification the children of the main sample were divided into two major groups: the well-nourished and the malnourished. In each group a statistical examination was made of more than 80 variables, which covered a wide range of social, economic and environmental factors believed to contribute to the state of failure to thrive and malnutrition in this community. Many of these factors considered responsible for growth retardation and under nutrition in other communities in the developing world did not seem responsible in this community; however, there are some other variables which were found to be unique and specific to Jordan. They are described and discussed in some detail. lnfant feeding in this community is also witnessing some important changes; especially in respect to weaning age and the introduction of solids. Milk (other than mothers' milk) because it is prepared in unhygienic and unsanitary ways, is becoming a factor responsible for growth failure and under-nutrition. The introduction of solid foods together with breast feeding proved to be very efficient in growth promotion. The disease pattern of these children showed o high prevalence of diarrhoeal and upper respiratory tract diseases. Measles was an important predisposing factor to malnutrition. Measles vaccination proved its efficiency in protecting the children from malnutrition, unlike the other routinely used vaccines.