Background
Methods
Study sites and participants
Assessment of socio-economic and biological variables
Assessment of environmental variables and micronutrient status
Statistical analysis
Results
Characteristics of the preschoolers and their mothers
Number | Percent | |
---|---|---|
Sex (male) | 196/376 | 52.1 |
Ethnicity | ||
Black | 154/365 | 42.2 |
Brown | 189/365 | 51.8 |
White | 22/365 | 6.0 |
Birth order (3rd or subsequent) | 127/376 | 33.8 |
Socioeconomic status (extremely low) | 182/376 | 48.4 |
Dietary supplements | ||
Vitamin A | 204/376 | 54.3 |
Iron syrup within 6 months | 200/376 | 53.2 |
Helminth infection | 58/325 | 17.8 |
De-worming treatment within 6 months | 192/376 | 51.1 |
Anaemia | ||
< 5 years (Hb < 110 g/L) | 11/319 | 3.4 |
≥ 5 years (Hb < 115 g/L) | 3/40 | 7.5 |
Low Zn status (serum Zn < 9.9 μmol/L) | 13/358 | 3.6 |
Low Se status (serum Se ≤ 0.82 μmol/L) | 34/358 | 9.5 |
Mean (95 % CI) | ||
---|---|---|
Children | ||
HAZ Males | 0.13 (−0.03, 0.29) | |
HAZ Females | 0.23 (0.07, 0.39) | |
BMIZ Males | −0.33 (0.50, −0.16) | |
BMIZ Females | −0.07 (−0.25, 0.11) | |
n | % | |
Stunted (HAZ < −2SD) | 9/364 | 2.5 |
Mildly stunted (HAZ < −1 ≥ −2SD) | 32/364 | 8.8 |
Wasted (WHZ < −2SD) | 5/361 | 1.4 |
Mildly wasted (WHZ < −1 ≥ −2SD) | 49/361 | 13.6 |
Overweight (BMIZ > 1 ≤ 2SD) | 40/364 | 11.0 |
Obese (BMIZ > 2SD) | 12/364 | 3.3 |
Stunted or mildly stunted & overweight or obese | 7/41 | 17.1 |
Mothers | ||
Short (Height < 150 cm) | 25/312 | 8.0 |
Underweight (BMI < 18.5) | 13/312 | 4.2 |
Overweight (BMI ≥ 25) | 100/312 | 32.1 |
Obese (BMI ≥ 30) | 67/312 | 21.5 |
Short & overweight or obese | 13/25 | 52.0 |
Child-Mother Diads | ||
Wasted or mildly wasted children with overweight or obese mothers | 15/42 | 35.7 |
Overweight or obese children with overweight or obese mothers | 33/46 | 71.7 |
Correlation matrix of proposed variables for the SEM
Sex male | Black | White | Birth order | SES ex-low | Hel-minth | De-worm | Mat. Wt. | Mat. Ht. | Se | Zn | Hb | BMIZ | HAZ | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Sex (male) | 1.00 | |||||||||||||
Ethnicity (black) | 0.161 | 1.00 | ||||||||||||
Ethnicity (white) | −0.08 | −0.21 | 1.00 | |||||||||||
Birth order (≥3) | 0.08 | 0.09 | −0.08 | 1.00 | ||||||||||
SES (extremely low) | 0.05 | 0.05 | 0.05 | 0.151 | 1.00 | |||||||||
Helminth infection | 0.161 | 0.04 | −0.121 | 0.141 | 0.141 | 1.00 | ||||||||
De-worming treatment | −0.04 | 0.08 | −0.05 | 0.08 | 0.02 | −0.10 | 1.00 | |||||||
Maternal weight | −0.01 | −0.03 | 0.00 | 0.01 | −0.131 | 0.02 | 0.05 | 1.00 | ||||||
Maternal height | −0.00 | −0.04 | 0.04 | −0.221 | −0.04 | 0.00 | −0.01 | 0.332 | 1.00 | |||||
Serum Se | 0.131 | −0.01 | 0.03 | −0.06 | −0.07 | −0.151 | −0.01 | −0.09 | 0.05 | 1.00 | ||||
Serum Zn | 0.00 | 0.01 | 0.01 | −0.111 | −0.01 | −0.131 | 0.09 | −0.08 | 0.05 | 0.151 | 1.00 | |||
Haemoglobin (Hb) | 0.00 | 0.00 | 0.06 | −0.06 | −0.111 | −0.151 | 0.02 | 0.11 | 0.04 | 0.222 | 0.171 | 1.00 | ||
BMIZ | −0.02 | 0.04 | −0.07 | −0.06 | −0.201 | −0.03 | 0.07 | 0.282 | −0.05 | 0.05 | −0.06 | 0.181 | 1.00 | |
HAZ | −0.04 | −0.06 | −0.03 | −0.141 | −0.09 | −0.08 | 0.02 | 0.302 | 0.392 | 0.04 | −0.08 | 0.09 | 0.181 | 1.00 |
Direct and indirect effects of SEM variables on HAZ and BMIZ
HAZ | Direct | Indirect | Total |
p
|
Sex (male) | −0.03 | −0.021 | −0.04 | 0.219 |
Ethnicity (black) | −0.06 | −0.06 | 0.240 | |
Ethnicity (white) | −0.072 | −0.07 | <0.001 | |
Birth order | −0.06 | −0.06 | 0.205 | |
SES (extremely low) | −0.01 | −0.01 | 0.073 | |
Helminth infection | −0.091 | −0.012 | −0.09 | 0.014 |
De-worming treatment | 0.011 | 0.01 | 0.038 | |
Maternal height | 0.392 | 0.39 | <0.001 | |
Serum selenium | −0.021 | −0.02 | 0.027 | |
Serum zinc | −0.111 | −0.11 | 0.006 | |
BMIZ | Direct | Indirect | Total |
p
|
Sex (male) | −0.01 | 0.003 | −0.01 | 0.832 |
SES (extremely low) | −0.151 | −0.0011 | −0.15 | 0.001 |
Helminth infection | −0.0042 | −0.004 | <0.001 | |
De-worming treatment | 0.000 | 0.00 | 0.208 | |
Maternal weight | 0.212 | 0.21 | <0.001 | |
Serum selenium | 0.021 | 0.02 | 0.004 | |
Serum zinc | −0.06 | −0.06 | 0.267 | |
Haemoglobin | 0.142 | 0.14 | <0.001 |