A COMPARATIVE STUDY OF THE NUTRITIONAL STATUS OF APPARENTLY HEALTHY PRESCHOOL CHILDREN IN URBAN AND RURAL COMMUNITIES OF IMO STATE

Abstract

The preschool age group have been identified as vulnerable nutritionally, as this is the period of a child’s most rapid growth and development. Since, there is paucity of studies on the nutritional status of pre-school children in Imo State, one of the states in the South East geopolitical Zone of Nigeria, it became imperative to fill this knowledge gap. A crosssectional study to determine the nutritional status of apparently healthy preschool children aged 2-5 years in urban and rural communities of Imo State was carried out over a period of 3 months, from September to November 2011.
A total of 600 pre-school children in nursery schools located in Owerri Municipal LGA (urban) and NgorOkpala LGA (rural) were studied. The aim was to determine the prevalence of malnutrition in this preschool children and compare the rural/urban prevalences as well as identify any influence of certain socio-demographic parameters like age, sex, socio-economic status on the prevalence. Anthropometric measurements such as weight, height, mid-upper arm circumference (MUAC) and socio-economic data were collected. The measurements were converted into weight-for-age, height-for-age, weight-for-height and mid-upper arm circumference indices which were used to assess the nutritional status of the subjects. Malnutrition was categorized using WHO recommended Z-score criteria. Social classification was done using Oyedeji’s criteria. Prevalence of obesity was determined using BMI-for-age Z score.
The male: female distribution of the study group was 270 (45.0%): 330 (55.0%) giving a ratio of 1:1.2. Their ages ranged from 2 to 5 years (mean age 2.5+1.2 years). There was significant difference in the means of all the anthropometric indices between the preschool children from the urban and rural schools (p<0.000). The preschool children from the urban schools had higher mean for all the anthropometric indices. The mean anthropometric indices for the preschool children from the urban and rural schools were- weight-for-age 16.77+3.80kg and 14.44+2.41kg, height-for-age 104.21+9.23cm and 98.49+9.42cm, weight-for-height 101.45+10.66% and 95.85+10.83%, MUAC 16.05+1.64cm and 14.94+1.00cm respectively.
Using the Z score criteria, the overall prevalence of stunting, underweight, wasting and overweight were 3.5%, 4.0%, 10.7% and 3.8% respectively. The prevalence of undernutrition; stunting, wasting and underweight were significantly higher (p=0.004, 0.017, 0.012 respectively) amongst the preschool children from the rural schools (5.7%, 13.7% 6.0%) than those from the urban schools (1.3%, 7.7%, 2.0%). While, the prevalence of overnutrition in the form of overweight was higher amongst children in the urban schools 5.3% compared to 2.3% of the children from the rural school, though the difference was not statistically significant (p=0.056).
Undernutrition was commoner in males, as the male preschool children were more stunted, underweight and wasted than the females, while more females were overweight. The prevalence of under-nutrition was lowest in preschool children from the upper socioeconomic class (classes I-II) with stunting, wasting and underweight rates of 2.6%, 8.3%, 3.4% respectively, compared to the rates of 4.0%, 12.1%, 4.0% respectively in those from lower socioeconomic class (classes IV-V). However, statistically significant difference was observed only with wasting (p=0.01).
In contrast, prevalence of overweight was highest in the upper socioeconomic class. Of the 23 (3.8%) children found to be overweight, 12 (4.5%) belonged to upper socioeconomic class, while 8 (4.0%) were from the lower socioeconomic class.
The prevalence of obesity was 1.7%. There was no difference between the urban and rural prevalence of obesity nor between prevalence of obesity and the different socio-economic classes. Obesity rate was higher amongst females and in the 5 year age group, though these differences were not statistically significant (p>0.05).
The high prevalence rate of wasting obtained in this present study which by WHO classification of community prevalence is in the very high and high prevalence category for the rural and urban areas respectively calls for urgent attention as UNICEF advocates emergency feeding when wasting rate is over 10%.
It is recommended that an urgent nutritional intervention programme be planned and targeted at pre-school children in nursery schools and in the community for both the rural and urban areas of Imo State. Periodic surveillance of the nutritional status of these children is also necessary for monitoring of the effectiveness of the intervention programmes.

A COMPARATIVE STUDY OF THE NUTRITIONAL STATUS OF APPARENTLY HEALTHY PRESCHOOL CHILDREN IN URBAN AND RURAL COMMUNITIES OF IMO STATE