British Journal of Nutrition

Full Papers

Parasite and maternal risk factors for malnutrition in preschool-age children in Belen, Peru using the new WHO Child Growth Standards

Martin Casapíaa1, Serene A. Josepha2, Carmen Núñeza1, Elham Rahmea2a3 and Theresa W. Gyorkosa2a3 c1

a1 Asociación Civil Selva Amazónica, Urbanización Jardin 27, Iquitos, Peru

a2 Division of Clinical Epidemiology, McGill University Health Centre, Royal Victoria Hospital, V Building, 687 Pine Avenue West, Montréal, Québec H3A 1A1, Canada

a3 Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall, 1020 Pine Avenue West, Montréal, Québec, H3A 1A2, Canada

Abstract

Child malnutrition, including wasting, underweight and stunting, is associated with infections, poor nutrient intake, and environmental and socio-demographic factors. Preschool-age children are especially vulnerable due to their high growth requirements. To target interventions for preschool-age children in a community of extreme poverty in Peru, we conducted a household survey between October 2005 and January 2006 to determine the prevalence of malnutrition and its risk factors. Of 252 children < 5 years old, the prevalence of wasting, underweight and stunting was 26·6, 28·6 and 32·1 %, respectively, based on the new WHO Child Growth Standards. Risk factors for wasting were: (1) moderate–high intensity Trichuris infection (OR 2·50; 95 % CI 1·06, 5·93); (2) hookworm infection (OR 6·67; 95 % CI 1·08, 41·05); (3) age (OR6-month 1·27; 95 % CI 1·11, 1·46); (4) maternal education (secondary incomplete) (OR 5·77; 95 % CI 2·38, 13·99); and (5) decreasing maternal BMI (OR1 kg/m2 1·12; 95 % CI 1·02, 1·23). Risk factors for underweight were: (1) moderate–high intensity Trichuris infection (OR 4·74; 95 % CI 1·99, 11·32); (2) age (OR6-month 1·22; 95 % CI 1·07, 1·38); (3) maternal education (secondary incomplete) (OR 2·92; 95 % CI 1·40, 6·12); and (4) decreasing maternal BMI (OR1 kg/m2 1·11; 95 % CI 1·02, 1·21). Risk factors for stunting were: (1) age (OR6-month 1·14; 95 % CI 1·02, 1·27) and (2) decreasing maternal height (OR1 cm 1·12; 95 % CI 1·06, 1·20). Overall, risk factors for malnutrition included both child and maternal determinants. Based on these data, locally appropriate and cost-effective dietary, de-worming and educational programmes should be targeted to mothers and preschool-age children.

(Received January 19 2007)

(Revised April 30 2007)

(Accepted May 14 2007)

Correspondence:

c1 Corresponding author: Dr Theresa W. Gyorkos, Division of Clinical Epidemiology, McGill University Health Centre, fax +1 514 934 8293, email theresa.gyorkos@mcgill.ca

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