ASSESSMENT OF IRON, ZINC AND ANTHROPOMETRIC INDICES OF PRESCHOOL CHILDREN IN OZUBULU, ANAMBRA STATE, NIGERIA

ABSTRACT

This study was aimed at assessing the iron, zinc and anthropometric indices of pre-school children aged 2 – 5 years in Ozubulu. A total of two hundred and forty (240) preschool children were randomly selected. Questionnaire, anthropometric measurements, biochemical analysis and 3–day weighed food intake were used for data collection. Two hundred and forty (240) questionnaires were distributed to mothers and caregivers of the selected children. Out of the 240 samples, sub samples of thirty children were randomly selected for biochemical assessment of iron and zinc status and for 3-day weighed food intake analysis. Iron status was assessed in terms of transferrinemia (serum iron, total iron binding capacity and percentage transferrin saturation) while zinc status was assessed using serum zinc.  WHO child growth standard and NCHS reference were used as standards. The result showed that prevalence of underweight and wasting for children 2 – 5 years was 1.7% and 11.8%, respectively using WHO standard. The overall prevalence of underweight and wasting was 3.3% and 10%, respectively by NCHS reference. Stunting affected only 0.8% using WHO Standard while none was stunted by NCHS reference. Sixty-seven percent (67%) of the pre-school children had low transferrinemia level (percentage transferring saturation <15%). Serum zinc result showed that 36.7% and 63.3% of the children had normal (>65μg/dl) and deficient (<65 μg/dl) zinc status respectively. The children took ≥143.3% and ≥ 155.5% of their FAO/WHO iron and zinc requirement values, respectively. Their zinc intakes was high but were mainly from plant staples. Intensified nutrition education, improved food processing and handling techniques and diversification of diet would drastically reduce malnutrition.

CHAPTER ONE

INTRODUCTION

                  Malnutrition is one of the most important global health problems affecting large numbers of children in developing countries. The World Health Organization defines malnutrition as “the cellular imbalance between supply of nutrient and energy and body’s demand for them to ensure growth, maintenance and specific functions” (Blecker et al., 2000). Malnutrition is synonymous with protein- energy malnutrition (PEM) and signifies an imbalance between the supply of protein and energy and the body’s demand for these to ensure optimal growth and function. A range of inadequacy states occurs as a result of interaction of diet and nutritional requirement.  Protein energy malnutrition (PEM) a consequence of various factors, is often related to poor quality of food, insufficient food intake, and severe and repeated infectious diseases, or, frequently, a combination of the three (de Onis and Blossner, 1997). The major outcomes of PEM during childhood may be classified in terms of morbidity, mortality, and psychological and intellectual development (Pollitt, Gorman, Engle, Martorell and Rivera, 1993) with important consequences in adult life.

             Protein energy malnutrition (PEM) affects a large proportion of children under age 5 years in the developing world. In children, protein–energy malnutrition is defined bymeasurements that fall below minus 2 standard deviations under thenormal weight for age (underweight), height for age (stunting)and weight for height (wasting)(Pinstrup-Anderson, Burger, Habicht and Peterson, 1993).  In developing countries,about 31% of children under 5 years of age are underweight, 38% have stunted growth and 9% are wasted (Brabin and Coulter, 2003). Protein– energy malnutrition usually manifestsearly, in children between 6 months and 2 years of age and isassociated with early weaning, delayed introduction of complementaryfoods, a low-protein diet and severe or frequent infections (Muller, Garenne, Kouyaté,  and Becher, 2003;Kwena et al., 2003).

           Pre-school children constitute the most vulnerable segment of any community. Their nutritional status is a sensitive indicator of community health and nutrition (Sachdev, 1995). Undernutrition among them is one of the greatest public health problems in developing countries. Undernutrition raises the likelihood that a child will become sick and will then die from the disease. Children whose weight-for-age is less than -1 SD are also at increased risk of death, and undernutrition is responsible for 44 to 60 percent of the mortality caused by measles, malaria, pneumonia, and diarrhoea. Morbidity attributable to undernutrition depends on the nature of the illness. Susceptibility to a highly infectious disease such as measles is unlikely to be affected by nutritional status: all individuals are equally likely to become infected if they are unvaccinated and naive. However, 5 to 16 percent of pneumonia, diarrhea, and malaria morbidity are attributable to moderate to severe underweight (Fishman et al., 2004).

                Micronutrient deficiencies (iron, iodine, vitamin A and zinc) are also majorpublic health problems in developing countries, however, vitaminsC, D and B- complex deficiencies have declined considerably in recentdecades (Diaz, Cagigas and Rodriguez, 2003; Levin, Pollitt, Galloway and McGuire, 1993).  Iron and zinc deficiencies are common in children in developing countries and are a significant contributor to morbidity and mortality (Black, 2003). Iron and zinc deficiencies are likely to occur in the same population. Iron and zinc are essential micronutrients for human growth,development, and maintenance of the immune system. Iron is neededfor psychomotor development, maintenance of physical activityand work capacity, and resistance to infection (Stoltzfus, 2001). Zinc isneeded for growth and for maintenance of immune function, whichenhances both the prevention of and recovery from infectiousdiseases (Black, 2003). Meat products are the best source of both ironand zinc. Consequently, iron and zinc deficiencies may coexistin populations that consume diets with insufficient amountsof animal products. The intake of these 2 micronutrientscould be improved through dietary diversification, food fortification or supplementation. If iron and zinc are to be provided together, it is importantto determine how they interact biologically.This is because they have chemically similar absorption and transportmechanisms, iron and zinc have been thought to compete for absorptivepathways (Standstorm, 2001).