Growth and diarrhoeal disease surveillance in a rural Ghanaian pre-school child population

Abstract

This paper is a report of the first year of follow-up on 250 pre-school children in a village in Ghana. The mean weight for age and the mean height for age at the start of the study, ranged between 81 and 97% and 91 and 101·4% of the median WHO reference standards respectively. Classified according to Waterlow (1973) 59·6% of the children were normal, 27·2% were thin, 8·9% were stunted, 3·4% were wasted and 0·9% were stunted and wasted. The mean velocity of height gain was 26·8 cm/year at birth; 9·6 cm/year at age of six months and thereafter the rate decreased almost linearly to a rate of 5cm/year at the age of 60 months. The curve for weight velocity had a similar shape to that of the height. The rate was on the average 5 kg/year at birth, and 1·7 kg/year at age of six months. Children over 30 months of age gained approximately, 0·5 kg/year compared to an expected gain of about 2 kg/year. The mean incidence of diarrhoeal diseases was 1·9 episodes per child per year. 34·4% of the cohort did not report on any episode of diarrhoea over the one year period. Highest incidence occurred in children between the ages of 7 and 12 months. Children who were less than 80% of the standard weight for age at the start of the study had significantly more diarrhoeal episodes than the rest. The mean incidence of diarrhoeal diseases per year increased as both height for age and weight for height decreased. It is suggested that primary intervention against diarrhoeal morbidity might be better aimed at improving childhood nutrition.