Abstract
Nutrition programmes in resource poor settings mainly focus on children under the age of five years and this has resulted in limited information on nutritional and micronutrient status of school children in areas with high burden of HIV infection. This cross-sectional study assessed the prevalence of, and factors associated with stunting, thinness, overweight, underweight and selenium deficiency in school aged children from a high HIV burden peri-urban area in Zimbabwe, a low income country. Seven to 10 year old children from a prevention of mother-to-child transmission of HIV cohort had their serum selenium levels determined by mass spectrometry in a cross-sectional study. Height, weight, mid-upper-arm and head circumferences were measured to determine the prevalence of stunting, thinness, underweight and wasting. WHO growth standards were used to define the children's nutritional status. A total of 318 children including 21 (7%) HIV infected were assessed. The prevalence of stunting, thinness and underweight was 12%, 4% and 8% respectively. The prevalence of Selenium deficiency (serum Selenium <0.89 μmol/L) was 48% and it was found to be high in all the children despite their HIV status. Stunting was associated with HIV infection and orphan hood. There was no difference in height or weight between the HIV uninfected (exposed and unexposed) children who were in comparison both taller and heavier than the HIV infected children. Chronic malnutrition and selenium deficiency were prevalent in this cohort of children. Further studies are recommended to guide the need for selenium supplementation. Setting up health programmes to identify malnutrition in school aged children should be a priority.
Highlights
Malnutrition defined as under-nutrition in this article is a global public health problem underlying many childhood deaths [1]
This was a sub-study in the Better Health for African Mothers and Children (BHAMAC) study which investigated the role of sexually transmitted diseases on vertical transmission of HIV and is described elsewhere [29]
The minimum sample size required for estimating the prevalence of malnutrition in this population of children with a confidence interval of 95% and a margin of
Summary
Malnutrition defined as under-nutrition in this article is a global public health problem underlying many childhood deaths [1]. Global underweight figures have been showing declining trends in children under 5 years, underweight rates continue to rise in Africa. In Zimbabwe, malnutrition is a major problem exacerbated by the declining economy and the HIV/AIDS epidemic [3]. National statistics for under five children show that 32% are stunted, 3% are wasted and 10% are underweight according to the Zimbabwe demographic health survey 2010/2011 [4]. These figures have remained unacceptably high in the past two decades. Nutrition programmes in resource limited settings have been focusing mainly on under-five children resulting in a gap of knowledge on the burden of malnutrition and information on micronutrient deficiencies among the school-aged children those from areas with a high burden of HIV infection
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