Table of Contents  
ORIGINAL ARTICLE
Year : 2017  |  Volume : 19  |  Issue : 1  |  Page : 56-59

Nutritional status of schoolchildren in Jos East Local Government Area of Plateau State, North Central Nigeria


1 Department of Paediatrics, Benue State University, Makurdi; Benue State University Teaching Hospital, Nigeria
2 Department of Paediatrics, University of Jos; Jos University Teaching Hospital, Nigeria
3 Jos University Teaching Hospital, Nigeria

Date of Web Publication7-Jun-2017

Correspondence Address:
Rose O Abah
Department of Paediatrics, Benue State University Teaching Hospital, Makurdi
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jomt.jomt_44_16

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  Abstract 


Background: Most nutritional surveys either focus on under-five children or adolescents aged 10–19 years. Few works have been reported among school-aged children of 6–12 years. In Nigeria, a recent demographic health survey only focused on under-five children. Thus, not much is discussed as regards the nutritional state of children aged 6–12 years.
Objective: To determine the prevalence and pattern of malnutrition among school-aged children in Jos East Local Government Area of Plateau State using the 2007 World Health Organization (WHO) standards for schoolchildren and adolescents.
Subjects and Methods: A cross-sectional descriptive study was conducted on schoolchildren aged 6–12 years from 10 schools. Sociodemographic data were collected using an interviewer-administered questionnaire. Height and weight were measured according to standard procedures. The height-for-age Z-score and the body mass index-for-age Z-score were generated from the WHO software Anthroplus®. Statistical Package for the Social Sciences version 17.0 software was used for data analysis.
Results: The mean age of the participants was 9.5 ± 1.8 years, and the male:female ratio was 1.1:1. The mean weight and height were 25.06 ± 4.56 kg and 128.07 ± 10.01 cm, respectively. The prevalence of stunting was 10.34%, overweight/obesity 4.47%, and thinness 1.39%. The adolescent age group (10–12 years) had a significantly higher (15.98%) prevalence of stunting than that of the preadolescent age group (3.66%).
Conclusion: Chronic undernutrition is a problem among the schoolchildren considered in this study with the adolescent age group bearing the greater burden.

Keywords: Nutrition, schoolchildren, status


How to cite this article:
Abah RO, Okolo SN, John C, Ochoga MO, Adah RO. Nutritional status of schoolchildren in Jos East Local Government Area of Plateau State, North Central Nigeria. J Med Trop 2017;19:56-9

How to cite this URL:
Abah RO, Okolo SN, John C, Ochoga MO, Adah RO. Nutritional status of schoolchildren in Jos East Local Government Area of Plateau State, North Central Nigeria. J Med Trop [serial online] 2017 [cited 2017 Aug 20];19:56-9. Available from: http://www.jmedtropics.org/text.asp?2017/19/1/56/207595




  Introduction Top


Malnutrition among schoolchildren is a major public health problem, especially in developing countries and countries in transition, with far-reaching negative effects on their overall educational achievement and productivity later in life.[1],[2] In general, school-aged children are often left out of national health and nutrition surveys, the result of which is the gross absence of nationally representative data on the nutritional status of schoolchildren globally.[1]

In developing countries, it is estimated that approximately 183 million children are underweight, 226 million are stunted, and 67 million are wasted.[3] In Sub-Saharan Africa, the rate of stunting is as high as 60%.[4] The figures from the 2013 Nigeria Demographic and Health Survey data showed that the rates of stunting, underweight, wasting, and overweight are 37, 29, 18, and 4%, respectively among the under-five children.[5] Compared to the 2008 Demographic and Health Survey (DHS) data, there is a decline in the rate of stunting, while underweight and wasting have increased.[6] Nutritional problems beginning in the preschool age, if not treated, may progress into school age with resultant negative effects on the general well-being and academic performance of the children.[7] Studies among schoolchildren from various parts of Nigeria, mostly urban and semi-urban areas, gave varying figures with stunting ranging from 11.1 to 52.7% and underweight between 10.3 and 43.4%.[8],[9],[10]

The World Health Organization (WHO) in 2007 developed a WHO growth reference for school-aged children and adolescents, which was in tandem with the 2006 WHO Child Growth Standards for under-five children and the body mass index (BMI) cutoffs for adults. This provides an appropriate tool for screening and monitoring of the nutritional status of school-aged children and adolescents internationally.[11] The WHO 2007 growth reference provides BMI-for-age to complement height-for-age in the assessment of thinness (low BMI-for-age), overweight and obesity (high BMI-for-age), and stunting (low height-for-age) in school-aged children and adolescents, because weight-for-age is inappropriate for monitoring the growth beyond childhood due to its inability to distinguish between relative height and body mass.[11] In Nigeria, only few studies among schoolchildren have adopted the growth reference as a tool for assessing nutritional status. This study is, therefore, aimed to determine the prevalence of malnutrition using the 2007 WHO reference chart among rural school-aged children.


  Subjects and methods Top


This cross-sectional, descriptive study of 6–12-year-old primary school children was conducted in Jos East Local Government Area (LGA) of Plateau State, North Central Nigeria. Jos East LGA with headquarters at Angware is a predominantly rural area.

Using a multi-staged Stratified sampling technique, 358 participants from 10 schools were randomly selected. Parental consent and the participants’ assent were obtained for the study. Using a semi-structured interviewer-administered questionnaire, sociodemographic information and information on food intakes were collected from each participant.

The weight of each participant was taken with an electronic Tanita body fat monitor/scale (BF-662W, Tanita Corporation, Japan) with the participant being barefoot and wearing a set of light outdoor clothes. Measurement was taken to the nearest 0.1 kg, and the accuracy of the scale was ascertained daily with a standard weight. The height was measured to the nearest 0.1 cm using a portable stadiometer with the participant standing barefoot, back straightened, shoulders relaxed, and the head in Frankfort plane.

The height-for-age Z-score (HAZ) and the BMI-for-age Z-score (BAZ) for each participant were generated using the WHO software Anthroplus®, which is based on the 2007 WHO growth reference chart for children aged 5–19 years. On this chart, weight-for-age Z-score is available only up to 10 years of age. The HAZ of <−2SD is defined as stunting. The BAZ of <−2SD is thinness, >+1SD is overweight, and >+2SD is obesity. A participant is stunted if the HAZ is <−2SD, thin if the BAZ is <−2SD, overweight if the BAZ is >+1SD, and obese if the BAZ is >+2SD.[11]

Data analysis was performed using the Statistical Package for the Social Sciences version 17.0 software (SPSS Inc., Chicago, IL, United States), and the difference is significant at P-value of <0.05. The means of categorical variable were compared by chi-square test.


  Results Top


A total of 358 schoolchildren were recruited. Of these, 185 (51.67%) were males and 173 (48.32%) females, giving a male:female ratio of 1.1:1. The mean weight, height, and BMI of the children were 25.06 ± 4.56 kg, 128.07 ± 10.01 cm, and 19.59 ± 3.01 kg/m2. [Table 1] shows the distribution of the mean anthropometric indices of the children.
Table 1: Mean distribution of the weight, height, and BMI of the participants

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The nutritional status of the participants is shown in [Table 2]. No significant difference was found between the genders.
Table 2: Nutritional status of the participants by gender

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When compared across age groups, stunting (10.34%) was more prevalent among the adolescent age group (10–12 years), P = 0.001 [Table 3].
Table 3: Nutritional status by age groups

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  Discussion Top


The prevalence of stunting of 10.34% recorded in this study is comparable with the prevalence range of 11–14.9% noted in the works from other parts of Nigeria and the globe.[8],[9] It is, however, much lower than the prevalence rates of 52.7 and 50.0% recorded in Makurdi and Jos North[10],[16] both within North Central Nigeria. It is also lower than the prevalences of 50.3, 30.7, and 43.6% from Ghana, Ethiopia, and Malaysia, respectively.[17],[18],[19] Perhaps, the reason for the wide discrepancies between the prevalence of stunting recorded here and that from Makurdi, Ghana, and Ethiopia might have to do with the larger sample size and older age of the participants from those studies. Although the study from Jos North was among similar age group, the sample size was larger.

Stunting is the most prevalent form of malnutrition observed among this study population, and it is similar to what has been documented by other authors.[10],[16] Contrastingly, such an observation of vast prevalence differs with the observations of Abdulkarim et al.,[12] wherein overweight/obesity topped the chart, and in the study by Fetuga et al.,[9] stunting was third after underweight and thinness. Overweight/obesity in developing countries such as Nigeria is usually more common among the affluent in urban areas, and Abdulkarim et al.[12] worked among urban children, whereas the present study is among rural children.

The participants within the adolescent age of 10–12 years in this study had a higher rate of stunting than what the preadolescent participants had. This is in consonance with the findings of Ekhator et al.[13] and Mekonnen et al.[18] Adolescence is a period of rapid growth and development with an increased nutrient requirement. When the requirement is not sufficiently met, the result is undernutrition.The finding of overweight/obesity prevalence of 4.46% among these participants is similar to the 3.5% recorded by Fetuga et al.[9] in Sagamu but far lower than the 13.2% from Abuja by Abdulkarim et al.[12] The significant difference between this finding and the work from Abuja could be explained by the difference in age group (6–12 years vs. 10–19 years) as well as the rural vs. urban nature of the study locations. The problem of overweight/obesity is being documented in a rural setting and should be a wakeup call of how near the problem of double burden of malnutrition as recorded in other developing countries[20] is than before. Among these rural school-aged children, both spectrums of malnutrition (undernutrition and overnutrition) are evidently present.


  Conclusion Top


Chronic undernutrition, particularly stunting, is a problem among the schoolchildren considered in this study, and there is a need to find ways of intervening to reduce the burden, while ensuring that overweight/obesity does not become a problem. Though the sample is small, and it may not be appropriate to generalize the findings to all schoolchildren in the country, yet it does not invalidate the findings.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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Abdulkarim AA, Otuneye AT, Ahmed P, Shattima DR. Adolescent malnutrition: Prevalence and pattern in Abuja Municipal Area Council, Nigeria. Niger J Paediatr 2014;41:99-103.  Back to cited text no. 12
    
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Ekhator CN, Omuemu OV, Awunor NS. Assessment of the nutritional status of children in a rural community of Central Edo State, South-South part of Nigeria. Int J Community Res 2012;1:1-6.  Back to cited text no. 13
    
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Agbo HA, Envuladu EA, Zoakah AI. A comparative assessment of the epidemiology of malnutrition among pupils in public and private primary school in Jos North Local Government Area of Plateau State. Jos J Med 2012;6:34-8.  Back to cited text no. 16
    
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    Tables

  [Table 1], [Table 2], [Table 3]



 

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Introduction
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