Low Height For Age Research Articles

Present and Past Helicobacter pylori Infection in Mexican School Children

In developing countries, more than 50% of children have serological evidence of Helicobacter pylori infection. However, serological tests for H.pylori did not differentiate between active and past infection. The objectives of this study were to estimate the frequency of active and past H.pylori infection utilizing functional urea breath test (UBT) and serological tests and evaluate factors associated with the infection. A total of 675 school children, 6-13years of age, participated. UBT was performed to detect active H.pylori infection. Blood samples were obtained to determine iron status and Immunoglobulin G (IgG) responses to the H.pylori whole-cell and to Cag A antigens by antigen-specific enzyme-linked immunosorbent assays. Weight, height, and sociodemographic characteristics were recorded. A total of 37.9% (95% Confidence Intervals (CI): 34.2-41.6) of school children had active or past H.pylori infection; of them, 73.8% (CI95% 68.4-79.2) were carrying CagA-positive strain, 26.5% (CI95% 23.2-29.8) had active infection, and 11.4% (95%CI: 9.0-13.8) had evidence of past H.pylori infection. School children with iron deficiency and low height for age had higher risk of H.pylori infection: [OR to active or past infection was 2.30 (CI 95% 1.01-5.23) and to active infection it was 2.64 (CI 95% 1.09-6.44)] compared to school children with normal iron status and height for age or with normal iron status but low height for age or with iron deficiency and normal height for age. The estimated prevalence of infection depends of the test utilized. Frequency of H.pylori infection and carrying CagA-positive strains was high in this population. Malnutrition was associated with active H.pylori infection.

Indicadores antropométricos em crianças e adolescentes com doença do refluxo gastroesofágico atendidos em um ambulatório especializado em São Luís, Maranhão, Brasil

Reflux Disease (GERD) is the retrograde flow of gastric contents into the esophagus, whose clinical manifestations may involve changes in the nutritional status of children and adolescents. The study aimed to assess the nutritional status through the weight for age (W/A), height for age (H/A) and body mass index for age (BMI/A) in the juvenile population with GERD, attending a gastroenterology clinic in Sao Luis (Maranhao, Brazil). A cross-sectional study with 40 children and teenagers diagnosed with GERD, during the month of May 2011. Anthropometric measurements weight and height were measured using a digital scale with a stadiometer. Nutritional status was classified using the indicators W/A, H/A and BMI/A. The indicator W/A revealed that 47.5% of patients were underweight for age, being mainly female (55.5%). The indicator H/A showed that 17.5% had low height for age. According to the indicator BMI/A, 55% were normal weight, 40% were underweight and 5% of children were overweight. In group with underweight, females predominated (44.4%). Take diet measures to prevent the GERD is important, because the disease can affect the nutritional status impairing the quality of life, growth and development of children and teenagers. Descritores: Refluxo gastroesofagico. Estado nutricional. Antropometria. Crianca. Adolescente

Estado nutricional e tempo de tela de escolares da Rede Pública de Ensino Fundamental de Niterói, Rio de Janeiro, Brasil

The aim of this study was to assess nutritional status, sedentary behavior (TV, computer, and videogame time and screen time as the sum of these first three) and physical activity using a questionnaire with youth (10 to 18 years of age) enrolled in public schools in Niterói, Rio de Janeiro State, Brazil. Anthropometry (body mass and stature), sedentary behavior, and information on physical activity were obtained in a probability sample of 10 to 18 year-old students (n = 328; 108 boys) stratified by school and selected in two stages (classes and students). Low height for age did not appear as a problem, but 25.7% of the youth presented excess weight (18% overweight and 7.7% obese). Total screen time did not differ between the sexes, but boys spent more time playing videogames than girls, regardless of age, while girls watched more TV. Boys spent twice as much time as girls of all ages in physical activity (three times more in the ≥ 14 year-old group). Screen time was significantly associated with excess weight. In conclusion, public school youth in Niterói show high prevalence rates of excess weight associated with inadequate lifestyle.

Prevalence and Risk Factors of Low Bone Mineral Density Among Perinatally HIV-Infected Thai Adolescents Receiving Antiretroviral Therapy

Low bone mineral density (BMD) has been reported among 10%-54% of HIV-infected adolescents in developed countries. We studied the prevalence and predictors of low BMD among HIV-infected Thai adolescents receiving antiretroviral therapy. A cross-sectional study of lumbar spine (L2-L4) BMD as measured by dual-energy X-ray absorptiometry in Thai HIV-infected adolescents aged 12-20 years was performed. The BMD Z score was analyzed using age-matched healthy Thai children as a reference. Serum 25-hydroxyvitamin D was performed. Osteopenia was defined as BMD Z score ≤ -2. From October 2010 to February 2011, 101 adolescents, 50% male, with a median age of 14.3 (range: 13.0-15.7) years were enrolled. The median [interquartile range (IQR)] current CD4 T-cell count was 646 (506-796) cells per cubic millimeter and 90% had plasma HIV-1 RNA <50 copies per milliliter. The mean BMD among HIV-infected adolescents and controls were 0.855 and 0.980 g/cm (P < 0.001). The median (IQR) L2-L4 spine BMD Z score was -1.0 (-1.9 to -0.1), of which 24% had BMD Z score ≤ -2.0. The median (IQR) of 25-hydroxyvitamin D level was 24.8 (20.0-31.4) ng/mL, of which 25% had vitamin D level < 20 ng/mL. In multivariate analysis, the height for age Z score < -1.5 (adjusted odds ratio: 6.2; 95% confidence interval: 2.2 to 17.7) and history of World Health Organization clinical stage 4 before antiretroviral therapy (adjusted odds ratio: 3.7; 95% confidence interval: 1.3 to 10.7) were significantly associated with osteopenia. One fourth of HIV-infected Thai adolescents have osteopenia. Children with history of advanced-staging or having low height for age are at risk of osteopenia. Preventive measures to prevent osteopenia should be incorporated in routine care for these adolescents.

Nutritional status of young children in Mumbai slums: a follow-up anthropometric study

BackgroundChronic childhood malnutrition remains common in India. As part of an initiative to improve maternal and child health in urban slums, we collected anthropometric data from a sample of children followed up from birth. We described the proportions of underweight, stunting, and wasting in young children, and examined their relationships with age.MethodsWe used two linked datasets: one based on institutional birth weight records for 17 318 infants, collected prospectively, and one based on follow-up of a subsample of 1941 children under five, collected in early 2010.ResultsMean birth weight was 2736 g (SD 530 g), with a low birth weight (<2500 g) proportion of 22%. 21% of infants had low weight for age standard deviation (z) scores at birth (<−2 SD). At follow-up, 35% of young children had low weight for age, 17% low weight for height, and 47% low height for age. Downward change in weight for age was greater in children who had been born with higher z scores.DiscussionOur data support the idea that much of growth faltering was explained by faltering in height for age, rather than by wasting. Stunting appeared to be established early and the subsequent decline in height for age was limited. Our findings suggest a focus on a younger age-group than the children over the age of three who are prioritized by existing support systems.FundingThe trial during which the birth weight data were collected was funded by the ICICI Foundation for Inclusive Growth (Centre for Child Health and Nutrition), and The Wellcome Trust (081052/Z/06/Z). Subsequent collection, analysis and development of the manuscript was funded by a Wellcome Trust Strategic Award: Population Science of Maternal and Child Survival (085417ma/Z/08/Z). D Osrin is funded by The Wellcome Trust (091561/Z/10/Z).

An Analysis of Cross Sectional Survey Data of Stunting Among Palestinian Children Less Than Five Years of Age

The object of this study is to report on determinants of stunting, defined as low height for age, among children in the occupied Palestinian territories. Using 2006-2007 cross sectional survey data collected by the Palestine Central Bureau of Statistics and using multivariate mixed model techniques for logistic regression, the relationships of stunting to characteristics of 9,051 Palestinian children less than 5years of age living in the Palestinian territories were estimated. These characteristics included demographic and social characteristics of the child, geographic region, type of location (urban, rural, refugee camp) and food insecurity for each governorate. Listed in order of the greater contribution to the explained variation in stunting, children with lower birth weight (P<0.0001), age greater than 12months (P<0.0001), higher levels of food insecurity (P<0.0001), lower socio-economic status (P<0.0001), mother illiterate (P=0.004), urban areas (P=0.008), and absence of supplementation to breast feeding during the first 4months of the child's life (P=0.04) have significantly more stunting. Children living in refugee camps have lower rates of stunting than urban areas; however the difference does not reach statistical significance. The relationship between the child's gender and stunting is not statistically significant. Lack of food security is directly linked to stunting. The continuing incidence of food insecurity means that the deleterious effects of under-nutrition will continue to affect the children of Palestine. Removing the avoidable causes of food insecurity in the occupied Palestinian territories will alleviate under-nutrition and its deleterious effects.

1091P - Impact of Nutrition on Treatment Outcome in Acute Lymphoblastic Leukaemia of Childhood in Developing Country

ABSTRACT Background All conventional modalities of anti-cancer therapy interfere with normal nutrition. Therefore, malnutrition is a major problem in children with cancer. In this study we retrospectively analyzed 500 children suffering from Acute Lymphoblastic Leukemia (ALL), who were being intensively treated by National Cancer Institute protocol (MCP 841) during period beginning from August, 1999 to December, 2011, in a tertiary cancer institute. Our aim was to determine the nutritional status at preliminary diagnosis of ALL children and to study the influence of nutrition on complete remission, disease free survival (DFS) and chemotherapeutic toxicity. Procedure The variables studied were height for age (HFA), weight for age (WFA), mid-arm circumference (MAC), biceps skinfold thickness (BSFT) and serum albumin levels. The HFA, WFA, MAC and BSFT were taken as normal if they were between 3rd and 97th percentile curve of the growth chart as recommended by the Indian Council of Medical Research (ICMR). The albumin level was considered normal if the value was equal to or more than 3g%. Results It was observed that 16.8% children were low weight for age and 10.4% were low height for age during diagnosis. Low WFA (p value 0.001), low HFA (p value 0.0001) and low albumin (p-value 0.0001) were significant in DFS. Conclusion We conclude that malnutrition has high impact on ALL prognoses in developing countries. Major nutritional indicators are HFA, WFA, MAC, BSFT and serum albumin. Patients with malnutrition have less DFS duration, more chances for relapse and more therapeutic toxicity when compared to well-nourished children. Disclosure All authors have declared no conflicts of interest.

Multi‐country household food security score is associated with lower height for age Z scores

Childhood stunting results from chronic malnutrition and infections, and contributes to morbidity and mortality. While food security is an important correlate of child nutrition, development of cross-cultural measurement methods is challenging. This paper draws on data collected through the 8-country MAL-ED Network, investigating the relationships between malnutrition, diarrhea, and child growth and development. We administered a socioeconomic status survey in 800 households, including a recently validated nine-item food security questionnaire, and obtained anthropometric measurements on one child aged 24–60 months in each household. Six of the countries in our sample were not included in previous validation work of this measurement tool. In pooled analyses a ten point increase in food security score (range: 9–36) was associated with a 0.23 increase in height for age Z score (95% CI 0.09 to 0.37 SD), controlling for mother's education and water source. A test for heterogeneity revealed that this relationship was consistent across study sites (p=0.17). The association between food security and height-for-age Z score was not significant. The results provide evidence of the validity of using a simple household food security measure to investigate factors involved in the etiology of stunting across diverse cultural settings. This study is funded by the Bill & Melinda Gates Foundation.

Anemia in Rural China's Elementary Schools: Prevalence and Correlates in Shaanxi Province's Poor Counties

Despite growing wealth in China, a significant share of children across rural China still have no access to iron-rich foods, vitamins, and other micronutrients. Such poor diets may result in high incidences of nutritional problems, including anemia. The objective of the study was to increase understanding of the extent of anemia, and identify structural correlates of anemia in poor Shaanxi province's primary schools. The article shows that the overall anemia rate is 21.5 percent when using a blood hemoglobin cutoff of 115 g/L (39 percent with a cutoff of 120 g/L). We find that those students that are boarding at school and eat lunch away from home are more likely to be anemic. Children with anemia are found to have lower height for age (HAZ) scores. If this part of Shaanxi province is representative of all poor counties in China, these findings mean millions of children in poor rural China may be anemic.

Acute malnutrition is common in Malawian patients with a Wilms tumour: A role for peanut butter

Children with cancer in resource limited countries are often malnourished at diagnosis. Acute malnutrition is associated with more infectious complications and an increased risk of morbidity and mortality in major surgery. All new patients with the clinical diagnosis of a Wilms tumour admitted in the Queen Elizabeth Central Hospital, Blantyre, Malawi from January 2007 until June 2008 were included. We documented anthropometric parameters, tumour size and serum levels of micronutrients at diagnosis. Corrected weight (body weight - tumour weight) was repeated after 4 weeks of preoperative chemotherapy. During therapy oral feeds were encouraged and a locally made ready to use therapeutic peanut butter-based food (chiponde) supplied. A high rate of acute malnutrition was found in patients with Wilms tumour at diagnosis (45-55%), much higher than in community controls (11%). Patients (40%) and community controls (37%) had a similar, high rate of stunting (low height for age), a sign of chronic malnutrition. Tumour size at diagnosis and the degree of acute malnutrition at diagnosis was correlated; patients with a larger tumour had more severe acute malnutrition (r = -0.88, P < 0.01). With a supply of chiponde, 7 of 18 patients had a >5% increase in corrected weight during preoperative chemotherapy. Patients with a more positive nutritional course had a better tumour response to chemotherapy (r = 0.52, P < 0.05). Surprisingly, few micronutrient deficiencies were found, except for low serum levels of vitamin A (44% of patients). Acute malnutrition, superimposed on chronic malnutrition, is common in patients with Wilms tumour in Malawi. Earlier presentation needs to be encouraged. Chiponde, a peanut butter based ready-to-use-therapeutic-food, is an attractive means of nutritional support which needs further study.

Perfil nutricional e fatores associados à ocorrência de desnutrição entre crianças indígenas Kaingáng da Terra Indígena de Mangueirinha, Paraná, Brasil

The goal of this study was to evaluate the nutritional status of indigenous children and to investigate factors associated with nutritional deficits. Weight and height measurements were obtained for 141 Kaingáng children from 0 to 5 years of age living on the Mangueirinha Indigenous Reserve in Paraná State, Brazil. Data on maternal and infant conditions and socioeconomic characteristics were also gathered through face-to-face interviews. Based on World Health Organization criteria (2006), 24.8% of the children presented low height-for-age (HA), 9.2% low weight-for-age (WA), 2.1% low weight-for-height (WH), and 2.1% low weight according to body mass index for age (BMIA). Based on NCHS criteria (1977), 19.9% of the children presented low HA, 9.2% low WA, and 1.4% low WH. 6.4% were overweight according to BMIA. Low birth weight and non-masonry housing construction were associated statistically with nutritional deficits. The Kaingáng children are subject to poor living conditions, associated with deficits in their nutritional profile.

Giardiasis and other intestinal parasitic infections in relation to anthropometric indicators of malnutrition: a large, population-based survey of schoolchildren in Tehran

The morbidity of intestinal parasitic infections is greatest among children of school age and may have an adverse effect on growth. In the present, cross-sectional study, the association between previously undiagnosed intestinal parasitic infections and growth was assessed in 19,209 children attending elementary schools in Tehran. The physical growth of these children was investigated by recording body weights, heights and weight-for-age Z scores. Faecal samples were collected and each checked for intestinal parasites using four methods (the microscopical examination of a smear stained with Lugol's iodine, a smear prepared by formol-ether concentration, a wet smear in physiological normal saline, and a strip of adhesive tape that had been pressed against the subject's peri-anal region). The association between intestinal parasitic infection and growth was explored using multivariable models adjusted for the influence of age and polyparasitism. The prevalence of infection with any intestinal parasite was 18.4%. The prevalences of stunting (3.8% v. 2.8%), wasting (22.7% v. 20.4%) and the combination of stunting and wasting (3.7% v. 2.8%) were all significantly higher in the infected children than in the uninfected (P<0.01 for each). Although at least nine species of parasite were detected, only two, Giardia lamblia and Enterobius vermicularis, were each significantly associated with low height for age (stunting) and low weight for height (wasting). There were no such reductions with Ascaris lumbricodes, hookworm, Blastocystis hominis, Hymenolepis nana or Entamoeba coli infection. The data indicate fairly high prevalences of previously undiagnosed intestinal parasitic infections and highlight important interactions between nutrition and some of the parasites detected. School health programmes aimed at reducing the prevalences of parasitic infections (particularly giardiasis and enterobiasis) in schoolchildren, which may well have beneficial effects on growth and educational outcome, are clearly needed in Tehran.

Biology of the Tribal Groups of Rajasthan, India: 3. Assessment of Nutritional Status Using Heights and Weights

Cross-sectional investigation was carried out on 2221 samples consisting of 1133 males and 1088 females belonging to adolescent (8 + to 18+) age groups among the tribal groups, namely Minas, Bhils, Sahariyas, Garasias, Damors and Kathodis of Rajasthan. For the purpose of analysis, the subjects were classified into yearly intervals. Heights and weights were collected following the internationally accepted standards and based on the interrelationships of height, weight and age: height for age and weight for age, has been calculated and accordingly their nutritional status has been determined. While comparing the present study tribal groups for the mean values of heights and weights it was found that they were lower than the national and international standards. The present study shows a high prevalence of stunting (low height for age) and underweight (low weight for age) among both males and females. Females show a higher percentage prevalence of chronic malnutrition (<90), with respect to height and also underweight than the males. Most samples fall much below the normal (75 +) standards of weight for age. Thus, malnutrition is largely prevalent among the tribal groups of Rajasthan and the condition is further aggravated as it appears in combination with PEM.

Effect of maternal factors on nutritional status of 1-5-year-old children in urban slum population

<b>Objective:</b> To study the effect of various maternal factors on the prevalence of underweight and stunting among 1-5-year-old children in urban slum population. <b>Design:</b> Cross-sectional study. <b>Materials and Methods:</b> The study was carried out in three urban slums of Tripuri Town, Patiala. All 1-5-year children living in these slums were included, whose mother's demographic profile, weight and height were recorded. <b>Results:</b> Out of 482 children who participated in the study, 185 (38.38%) had low weight for age whereas 222 (46.06%) had low height for age. Both kinds of malnutrition were common in females than in males. Prevalence of malnutrition was more where mother's age was less than 20 years. Children of educated mothers were better nourished as compared to illiterate ones. <b>Conclusion:</b> Maternal factors significantly affect a child's nutritional status, thus encouraging the improvement in the social status of women so as to have healthy children and thereby a healthy future.

HUBUNGAN KADAR SENG SERUM DENGAN TINGGI BADAN ANAK SEKOLAH DASAR PENDERITA GAKY

The incidence goiter starts to the extend in Urban area. Not all Elementary School children with goiterexperience of pursued growth. This indicates that besides low iodine content, there are other elements which also influence growth. This research intends to study the relationship between zinc the level of serum and height on elementary school children (8 – 12 year) in endemic goitre areas, in Malang Municipality. Data ware collected with cross-sectional study from August to December 2000. Blood and urine sample of twenty  children of each group were examined for zinc serumand iodine urine concentration. Information about diet pattern, socio-economical condition were obtained by structured questionairre for mother and children.This research used Independent T-test, Person Correlation test, and Multiple Regression for statistics analysis. The result showed that: (1). There were significant relationships between energy (r= 0.364, p = 0.012); protein (r = 0.481, p = 0.001) and zinc intake (r =0.491, p = 0.001) with height; (2). There were significant difference in energy (p = 0.014), carbohydrate (p = 0.042), lipid( p = 0.014), protein (p = 0.003), and zinc intake(p = 0.004) between the two groups examined. The conclusion was that lower height for age was possibly ascribed to lack of energy, protein, iodine and zinc intake. Key words:zinc serum, iodine urine, height for age, and goiter

Prevalence and intensity of intestinal parasitic infections in relation to nutritional status in Mexican schoolchildren

Undernutrition and intestinal parasitic infections affect childhood development and morbidity in many developing countries. Undernutrition may increase susceptibility to parasitic infections which in turn impair the nutritional status of the host. The relationship between intestinal parasitic infections and nutritional status in 400 Mexican schoolchildren was investigated. More than half of the children in the study showed intestinal parasites and polyparasitism. The prevalence of helminth infections was significantly higher in Oaxaca than in Sinaloa ( P < 0.05). Z scores for weight-for-age (WA) and height-for-age (HA) were much lower in children of Oaxaca than in Sinaloa ( P < 0.001). A significantly higher Z score for weight-for-height (WH), WA, and HA were found in non-infected versus infected children ( P < 0.05). Higher prevalences of intestinal infections were found in children with lower HA and WA than in normally nourished children ( P < 0.05). Higher intensities of Ascaris lumbricoides and Trichuris trichiura were found in the schoolchildren of Sinaloa than in Oaxaca ( P < 0.01). Negative and significant associations were found between Hymenolepis nana and T. trichiura infection (eggs per gram) and nutritional status. Intestinal parasitic infections may be regarded as main risk factors associated with poor nutritional status in Mexican schoolchildren.

Children's nutrition in Jamaica: do household structure and household economic resources matter?

This study assesses the influence of household structure and resource dilution characteristics on children's nutritional status in Jamaica. The study has two objectives: (1) to compare the impact of different types of household structures (e.g. single parent, two parent, cohabiting and extended) on child nutrition (low height for age); and (2) to examine whether household structure and household resources interact to affect child nutrition in this context. We use data from the Jamaica 1996 Living Standards Measurement Study Survey and a series of logistic regression models to test hypotheses derived from the current child well-being literature. The results show that living in a single-parent household and a cohabiting household increases the odds of stunting for children. The analysis also indicates that children in single-parent low-income families with siblings and low-income extended families with siblings are more likely to have low height for age. The key policy implication that emerges from this study is that household structure is important for understanding children's nutritional outcomes in the Caribbean.

Diagnóstico de ingreso y evolución nutricional de los beneficiarios de la Corporación para la Nutrición Infantil (CONIN)

The nutritional impact of CONIN nutritional recovery centers must be evaluated, considering the current epidemiological situation in Chile and the new therapeutic focus giving more emphasis to ambulatory treatment. To analyze the nutritional status of children treated at traditional CONIN centers, the reason for their admission and the factors associated with changes of weight for age index during the hospitalization. During the year 2000, the records of 561 patients discharged from the traditional CONIN centers throughout the country were retrospectively analyzed. The changes in weight and height during admission and the possible factors influencing these changes, were determined. The average lapse of stay was 3.9 months; 78% of children had concomitant diseases at admission and 18.7% required to be admitted in a general hospital. One third was admitted with normal weight or even overweight according to the weight for age index, and 31.1% was undernourished. During admission in CONIN, the number of undernourished patients was reduced by 50%, while the proportion of children with normal nutritional status increased by 15% (p < 0.001). On admission, 7.8% of children had a low height for age, evidencing a chronic undernutrition. This figure did not change on discharge. The increase of weight/age and weight/height was substantially higher in children with a greater initial deficit (p < 0.001). Admission to a CONIN center had a low nutritional impact, and a high risk of a lengthy stay. The most favorable impact could be appreciated in children that were effectively undernourished. Admissions are motivated mainly by social issues, over and above nutritional problems.

Review of the status of malnutrition and trends in Ethiopia

Background: The problem of malnutrition in Ethiopia is on the increase due to low agricultural production, low and inadequate food consumption and high disease burden. Objective: To synethisize available information on nutritional assessment in Ethiopia Methods: Trends in nutritional status assessed from three National Nutrition Surveys conducted in 1983, 1992 and 1998 by the Central Statistical Authority (CSA) and other pocket surveys on Protein Energy Malnutrition (PEM) and Micronutrient deficiencies. Results: For the nation as a whole no major progress has been made in reducing the prevalence of child malnutrition over the last 17 years. The mean prevalence of stunting (low height for age) for all the regions increased from 59.8% in 1983 to 64% in 1992. The very recent survey of 1998 showed a decline in the level stunting i.e. 52% compared to the previous years. The prevalence of underweight children among 6-59 months olds fell from 37.3% in 1983 to 46.9% in 1992 and to 42% in 1998. Prevalence of wasting for all the regions combined had also increased. Breast-feeding and weaning practices revealed that the problem of early stunting in Ethiopia is mainly due to delayed introduction of complementary foods in the first year of life. Pocket studies on the prevalence of micronutrient deficiencies indicate that iron deficiency anemia, Iodine Deficiency Disorders and vitamin A deficiency are of major problems of public health significance. Conclusion: To reduce malnutrition rapidly requires focused and systematic action in the areas of health, food security, child and maternal care. A co-ordinated effort of all sectors will be needed to overcome the problem. Due to this lack of co-ordination both in addressing the problem and addressing the basic and underlying causes, malnutrition is on the increase in this country. (Ethiopian Journal of Health Development, 2001, 15(2): 55-74)

Childhood malnutrition and postwar reconstruction in rural El Salvador: a community-based survey.

The 1992 peace settlement that ended the civil war in El Salvador included land redistribution and other provisions designed to improve the socioeconomic status of ex-combatants and vulnerable civilians. To describe associations between postwar social and economic assistance programs, especially land reform, and current child health status as reflected by nutrition in a population of resettled rural refugees. A population-based cross-sectional survey of child nutritional status and principal elements of the reconstruction process. A single rural municipality in northern El Salvador. A representative sample of 761 children younger than 5 years, living in 27 villages. Prevalence of stunting (low height for age) in children younger than 5 years. Prevalence of stunting was 32.4%. Stunting was significantly more prevalent among children whose families cultivated less land (odds ratio [OR] for stunting per additional hectare of redistributed land cultivated, 0.64; 95% confidence interval [CI], 0.44-0.93). Less than half of newly transferred land was being cultivated by its owners. Most of the children (84.7%) lived in families cultivating 2 hectares or less of redistributed land. Stunting was also more prevalent among children whose households lacked piped water (adjusted OR, 2.72; 95% CI, 1.87-3.96) vs those who had had piped water since before the cease-fire. Malnutrition, particularly stunting, persisted at high levels and was strongly associated with delay in full cultivation of redistributed land and in provision of water.