NUTRITIONAL STATUS OF ADOLESCENT SCHOOL GIRLS AND ITS DETERMINANTS IN A RURAL AREA OF IMO STATE

Abstract

The study is a descriptive cross-sectional survey of the nutritional status of
adolescent school girls in Ogbaku, a rural community near Owerri, the Imo State
capital in the South East zone of Nigeria. The survey was conducted over the
period of October to November 2009. A total of 229 girls between 11 and 19 years
resident in the community were studied. These were drawn from the only public
girls’ school and one of the private co-educational schools in the town.
Clinical assessment and anthropometric measurements were done. In addition,
blood samples for haemoglobin, serum iron, total iron binding capacity(TIBC), and
serum ferritin were collected. Stool samples were taken for analysis for helminths.
Socio-economic data were also obtained from the girls. Body mass index
percentiles and height-for-age z-scores of the WHO reference113 were used to
determine the nutritional status. A combination of low serum ferritin and low
transferrin saturation were used to determine iron deficiency. Social classification
was done using the Olusanya criteria.57
The mean age of the girls was 15.8 ± 1.8 years while the means for height, weight
and BMI were 157.66± 7.6 cm, 49.1± 7.8 kg, and 19.73 ± 2.5kg/m2 , respectively.

Average age at menarche was 13.39 ± 1.1 years. Haemoglobin ranged from 8.9 to
16.1g/dl with a mean of 11.0 ± 1.1g/dl. The mean serum iron, TIBC and ferritin
values were 71.5µg/dl, 371.5µg/dl and 37.4µg/ml, respectively.
The study showed a prevalence of underweight, overweight and stunting of 16.6%,
6.1% and 7.0%, respectively. None of the subjects was obese. There was a direct
relationship between the BMI status and age, one increasing with the other. The
prevalence of underweight was significantly increased by younger age(p=0.001)
and low social class(p=0.001). Similarly, the prevalence of stunting was increased
by younger age(p=0.022) and by low social class(p=0.026). Greater household size
also led to significantly higher prevalence of underweight (p= 0.020).
On logistic regression analysis, the factors that significantly influenced the
nutritional status of the girls were early adolescence(age 11 to 13 years), family
size 10 or greater, and social classes III and V. Students who were in early
adolescence had 8.3 times higher likelihood of being underweight than those in late
adolescence(CI= 2.716-25.3). Girls whose family sizes were 10 or greater were 3
times as likely to be underweight as those with family sizes 1 to 3(CI=1.130
8.210). The risk of undernutrition in adolescents belonging to social III was 6.8
times more than those in social class I (CI=1.28-36.6), while girls in social class V
had 6.6 times (CI= 1.836-23.79) more risk of underweight than their counterparts
in social class I.
Anaemia was widely prevalent at 77.8 percent while the prevalence of iron
deficiency was 13.9 percent. Iron deficiency anemia was seen in 12.5 percent of
the girls. Of the socio-economic parameters, only maternal education significantly
affected iron status(P=0.019). Among the girls who had attained menarche, 16.3%
were underweight compared with 83.7% who were of normal weight and above.
Additionally, 100 percent of girls in social class I had attained menarche compared
with 89.2 percent in class V. Hookworm was the most common intestinal parasite
identified with a prevalence of 13 percent.
The findings in this study indicate that the current state of nutrition in this
community is poor, especially in the lower socio-economic strata. Hence deliberate
actions aimed at ameliorating the heightened effects of the currrent economic
downturn on poor families are needed. Also desirable is periodic nutritional
survey of the children in order to detect areas of need for specific intervention.

NUTRITIONAL STATUS OF ADOLESCENT SCHOOL GIRLS AND ITS DETERMINANTS IN A RURAL AREA OF IMO STATE