Background
Methods
Study setting
Study design
Enrollment
Nutritional status
Morbidity
Psychiatric evaluation of parents
Stimulation
Cognitive performance
Conceptual model: levels, blocks and variables
Statistical analysis
Ethical issues
Results
Description of the sample
N (%) | Mean (SD) | |
---|---|---|
Socioeconomic Level
| ||
Family material resources (Block 1)
| ||
Family income | ||
≤ 1 minimum monthly salary] | 126 (36.5) | 77.60 (11.39) * |
More than 1 minimum monthly salary | 219 (63.5) | 85.54 (14.20) |
Father's income | ||
none | 88 (25.4) | 78.66 (12.19)* |
any | 258 (74.6) | 83.98 (14.01) |
Family purchasing power | ||
Low | 76 (21.9) | 75,97 (10.64) |
Regular | 193 (55.8) | 81,49 (11.58) * |
Good | 77 (22.3) | 92,05 (16.43) |
Family Status (Block 2)
| ||
Maternal literacy | ||
none or ≤ 5 years of schooling | 98 (28.3) | 76.64 (11.39) * |
> 5 years of schooling | 248 (71.7) | 85.00 (13.90) |
Family type | ||
non-nuclear | 154 (44.5) | 80.73 (13.44)* |
Nuclear family | 192 (55.5) | 84.15 (13.84) |
Religion | ||
Catholic | 214 (61.8) | 82.00 (13.96) |
other beliefs | 132 (38.2) | 83.65 (13.38) |
Father's contact with the child | ||
None | 53 (15.7) | 77.28 (13.19)* |
Some | 285 (84.3) | 83.79 (13.68) |
CIDI: mood disorders among carers | ||
yes | 80 (23.6) | 83.48 (14.01) |
no | 259 (76.4) | 82.29 (13.76) |
Physical & Psychosocial Environment Level
| ||
Physichal environment (Block 3)
| ||
Household sanitary conditions | ||
Very poor | 69 (19.9) | 76.01 (11.16) |
Poor | 136 (39.3) | 81.78 (11.82) * |
Good | 141(40.8) | 86.69 (15.21) |
Neighbourhood sanitary conditions | ||
Bad | 71 (20.5) | 76.14 (12.16) |
Regular | 174 (50.3) | 81.11 (12.02)* |
Good | 101 (29.2) | 89.80(14.58) |
Psychosocial stimulation (Block 4)
| ||
Below the mean | 195 (56.53) | 78.51 (11.26) * |
Above the mean | 150 (43.47) | 87.73 (14.64) |
Child attendance at nursery school | ||
Never attended | 66 (19.07) | 72.71 (10.70) * |
Attended at some time | 280 (80.93) | 84.97 (13.35) |
Child Characteristics And Health Level
| ||
Child characteristics (Block 5)
| ||
Birth order | ||
Third or subsequent | 103 (29.8) | 79.06 (13.00)* |
First or second | 243 (70.2) | 84.41 (13.66) |
Sex | ||
Female | 157 (45.4) | 82.87 (12.91) |
Male | 189 (54.6) | 82.43 (14.43) |
Age | ||
Up to 59.68 months | 186 (53.8) | 83.99 (13.91)* |
More than 59.68 months | 160 (46.2) | 81.04 (13.42) |
Nutrition and infection (Block 6)
| ||
Birth weight | ||
≤ 2500 g | 50 (14.5) | 77.27 (14.12) * |
More than 2500 g | 296 (85.5) | 83.78 (13.39) |
Height for age | ||
≤ -2 Z scores | 72 (20.8) | 77.65 (15.19) * |
> -2 Z scores | 274 (79.2) | 83.94 (13.06) |
Weight for age | ||
≤ -2 Z scores | 87 (25.1) | 78.49 (14.11)* |
> -2 Z scores | 259 (74.9) | 84.02 (13.36) |
Weight for height | ||
≤ -2 Z scores | 62 (17.9) | 78.95 (14.09) |
> -2 Z scores | 284 (82.1) | 83.43 (13.56)* |
Diarrhoea prevalence: | ||
More than 6 days/year | 53 (15.3) | 79.13 (15.27) |
Below | 293 (84.7) | 83.26 (13.39) |
Number of intestinal parasitic infection: | ||
None | 64 (18.5) | 87.31 (17.685)* |
One parasite | 206 (59.5) | 83.10 (12.22) |
Two | 56 (16.2) | 79.41 (12.34) |
Three or more | 20 (5.8) | 71.80 (10.57) |
Blocks And Variables | Univariable analysis | Multivariable analysis (by block) | ||
---|---|---|---|---|
R2 adjusted (%) | βu (95% CI) | R2 adjusted (%) | βk (95% CI) | |
Level 1 Socioeconomic status
| ||||
Material Resources (Block 1)
|
17.0
| |||
Family purchasing power | 15.5 | |||
Low | ||||
Regular | 5.51 (2.15; 8.88) | 4.4 (0.9; 7.8) | ||
Good | 16.0 (12.0; 20.0)* | 13.7 (9.3; 18.0)* | ||
Family income | 7.7 | |||
≤ 1 minimum wage | ||||
More than 1 minimum wage | 7.9 (5.0; 10.8)* | 4.0 (1.0; 7.0) | ||
Father without income | 2.6 | |||
None | ||||
Any | 5.3 (2.0; 8.6) | |||
Family Status (Block 2)
|
9.7
| |||
Mother's schooling | 7.5 | |||
none or ≤ 5 years | ||||
> 5 years | 8.3 (5.2; 11.4)* | 8.2 (5.1; 11.3)* | ||
Father-child contact | 3.0 | |||
None | ||||
Some | 6.5 (2.5; 10.5)* | 5.9 (2.1; 9.8)* | ||
Family structure | 1.5 | |||
non-nuclear | ||||
Nuclear family | 03.4 (0.5; 6.3)* | |||
Religion | 0.3 | |||
Catholic | ||||
other beliefs | -1.6 (-4.6; 1.3) | |||
CIDI mood disorders among carers (2001)**
| 0.0 | -1.9 (-3.6; 3.2) | ||
Level 2 Physical Environment and Psychosocial Stimulation
| ||||
Sanitary conditions (Block 3)
| ||||
Household | 12.7 |
15.3
| ||
Very poor | ||||
Poor | 4.9 (1.4; 8.5) | 3.7 (0.2; 7.3) | ||
Good | 13.6 (9.7; 17.5)* | 11.2 (7.1; 15.3)* | ||
Neighbourhood | 7.8 | |||
Bad | ||||
Regular | 5.8 (1.9;9.6) | 4.6 (0.8; 8.3) | ||
Good | 10.7 (6.9; 14.5)* | 7.0 (3.1; 10.9)* | ||
Psychosocial Stimulation (Block 4)
| ||||
HOME score (1999) | 16.3 | 0.9 (0.7; 1.2)* |
23.7
| 0.8 (0.6; 1.0)* |
Nursery school attendance | 12.3 | |||
Never attended | ||||
Attended at some time | 12.2 (8.7; 15.7)* | 9.8 (6.5; 13.0)* | ||
Level 3 Child characteristics and health
| ||||
Child's Characteristics (Block 5)
| ||||
Birth order | 2.9 |
2.3
| ||
Third or subsequent | ||||
First or second | 5.0 (1.9; 8.2)* | 5.0 (1.9; 8.2)* | ||
Sex | 00 | |||
Female | ||||
Male | -0.4 (-3.3; 2.4) | |||
Age | 1.1 | |||
Up to 59.68 months | ||||
More than 59.68 months | -2.9 (-5.9; -0.04) | |||
Nutrition And Infection (Block 6)
|
9.8
| |||
Birth weight | 2.8 | |||
≤ 2500 g | ||||
More than 2500 g | 6.5 (2.4; 10.6)* | 4.8 (0.8; 8.8)* | ||
Height-for-age (1998) | 3.9 | |||
≤ -2 Z scores | ||||
> -2 Z scores | 5.3 (2.5; 8.2)* | 5.3 (1.8; 8.8)* | ||
Weight-for-height (1998) | 1.5 | |||
≤ -2 Z scores | ||||
> -2 Z scores | 3.6 (0.5; 6.6)* | |||
Weight-for-age (1998) | 2.8 | |||
≤ -2 Z scores | ||||
> -2 Z scores | 4.2 (1.6; 6.9)* | |||
Diarrhoea prevalence (1997–1999) | 1.2 | |||
more than 6 days/year | ||||
0–6 days/year | 4.1 (0.1; 8.1)* | |||
Number of intestinal parasitic infection | 6.2 | -4.6 (-6.5; -2.7)* | -4.0 (-5.8; -2.2)* |
Variables | Model A (Blocks 1 and 2) | Model B (Blocks 1, 2 and 3) | Model C (Blocks 1, 2 and 4) | Model D (Blocks 1, 2, 3 and 4) | Model E (Blocks 1, 2, 3, 4 and 5) | Model F (Blocks 1, 2,3,4 and 6) | Model G (Blocks 1, 2, 3, 4, 5 and 6) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
R2
| β(95% CI) | R2
| β(95% CI) | R2
| β(95% CI) | R2
| β(95% CI) | Change β ** | R2
| β(95% CI) | R2
| β(95% CI) | R2
| β(95% CI) | Change β*** | |
Level 1 Socioeconomic status
| ||||||||||||||||
Socioeconomics
|
20.2
|
26.3
|
30.1
|
34.4
|
39.8
|
35.3
|
40.3
| |||||||||
Family purchasing power
| -60.9 | -25.0 | ||||||||||||||
Low | ||||||||||||||||
Regular | 3.9 (0.5; 7.3)** | 2.7 (-0.5; 6.0)** | 2.5 (-0.6; 5.6)** | 1.5 (-1.6; 4.6)** | 0.4 (-2.6; 3.5)** | 1.3 (-1.7; 4.4)** | 0.3 (-2.7; 3.3)** | |||||||||
Good | 13.3 (9.3; 17.4) | 9.5 (5.2; 13.7) | 8.1 (4.1; 12.1) | 5.2 (1.1; 9.3) | 5.1 (1.1; 9.1) | 5.0 (0.9; 9.1) | 4.9 (0.9; 8.9) | |||||||||
Family characteristics
| ||||||||||||||||
Mother's schooling
| ||||||||||||||||
None or ≤ 5 years
| ||||||||||||||||
> 5 years
| 5.4 (2.3; 8.5) | 5.7 (2.8; 8.6) | 3.9 (1.1; 6.7) | 3.9 (1.1; 6.7) | -27.7 | 3.6 (0.9; 6.3) | 3.7 (1.0; 6.5) | 3.5 (0.8; 6.1) | -66.0 | |||||||
Father-child contact
| ||||||||||||||||
None | ||||||||||||||||
Some | 4.8 (1.1; 8.5) | 4.3 (0.7; 7.8) | 4.1 (0.7;7.5) | 3.5 (0.2; 6.8) | -27.0 | 3.9 (0.6; 7.1) | 3.6 (0.3; 6.9) | 3.9 (0.6; 7.1) | -8.5 | |||||||
Level 2 Physical environment and Psychosocial stimulation
| ||||||||||||||||
Sanitary conditions
| ||||||||||||||||
Household
| ||||||||||||||||
Very Poor | ||||||||||||||||
Poor | ||||||||||||||||
Good | 5.9 (1.7; 10.1) | 4.7 (0.7; 8.7) | 4.7 (0.9; 8.5) | 4.2 (0.2; 8.1) | 4.3 (0.5; 8.2) | -40.0 | ||||||||||
Neighbourhood
| 0.4 (-0.8; 3.0)** | 0.7 (-2.5; 4.0)** | 1.2 (-1.9; 4.4)** | 0.2 (-3.0; 3.5)** | 0.9 (-2.2; 4.1)** | |||||||||||
Bad | ||||||||||||||||
Regular | ||||||||||||||||
Good
| 6.2 (2.5; 9.9) | 5.8 (2.4; 9.3) | 6.1 (2.8; 9.5) | 6.0 (2.6; 9.4) | 6.2 (2.9; 9.6) | -22.4 | ||||||||||
Psychosocial stimulation
| 5.0 (0.0; 1.5)** | 4.5 (1.1; 7.8)** | 5.3 (2.1; 8.5)** | 4.5 (1.2; 7.8)** | 5.3 (2.1; 8.5)** | |||||||||||
HOME score (1999) | ||||||||||||||||
Nursery school attendance
| 0.6 (0.3; 0.8) | 0.5 (0.3; 0.7) | 0.5 (0.3; 0.8) | 0.5 (0.3; 0.7) | 0.5 (0.3; 0.7) | 00.0 | ||||||||||
Never attended | 7.8 (4.5; 11.1) | 7.3 (4.1; 10.5) | 8.4 (5.2; 11.5) | 6.9 (3.7; 10.1) | 8.0 (4.9; 11.2) | -12.0 | ||||||||||
Attended at some time | ||||||||||||||||
Level 3 Child characteristics and Health
| ||||||||||||||||
Nutrition and Infection
| ||||||||||||||||
Birth weigh
| ||||||||||||||||
≤ 2500 g | ||||||||||||||||
More than 2500 g | ||||||||||||||||
Height-for-age
| 6.6 (3.3; 9.9) | 3.5 (0.5; 6.5) | 6.0 (2.7; 9.4) | |||||||||||||
≤ -2 Z scores | ||||||||||||||||
> -2 Z scores | 2.9 (-0.2; 5.8) |