ABSTRACT
Background Body surface area (BSA) is used in clinical practice to prescribe medication, standardize measured parameters etc. Normogram has been the gold standard. However, there are several prediction equations in the published literature. A simple method giving an accurate estimation would help to assess BSA in day to day clinical practice efficiently. Objective To assess the accuracy of different equations for the estimation of BSA in a group of Sri Lankan children. Method Data collected in 3 different school surveys carried out between 2002 and 2005 were used. BSA estimated by 9 prediction equations described in the literature were compared with the BSA assessed by normogram. Results Two thousand three hundred and thirty eight girls and 639 boys, between the ages of 5-16 years, were assessed. The mean ages of the boys and girls were 10.3±1.47 years and 11.5±2.47 years respectively. The highest mean BSA estimation was given by Gehan & George equation (boys 1.14±0.20m2 and girls 1.2 ± 0.25m2) and lowest by Yu et al (boys 1.08±0.20m2 and girls 1.13±0.25m2). Estimates correlated highly with BSA assessed by normogram. When the estimates were compared with normogram, equation of Mattar gave the highest bias for both groups (females 0.0152m2 and males 0.0177m2). Mosteller equation gave relatively low bias (females 0.0077m2, and males 0.0072 m2). Conclusions All equations gave very good agreement between each other. Out of the equations, easiest to use in day to day clinical practice is the equation described by Mosteller. The maximum bias in estimation would lead to less than 5% error in determining drug doses which is negligible in day to day clinical practice. Mosteller equation is suitable for routine clinical use.
ABSTRACT
Objective To provide information on nutritional status and dietary and physical activity pattern of 8-12 year old school children in an urban area of Sri Lanka. Method Seven schools in Colombo were randomly selected. These schools showed a fair representation of children of all social levels. Students of years 4, 5, 6 and 7 were included. 50 students from each grade of each school were randomly selected and recruited into study. The purpose of study was explained to the students and any withdrawals allowed. Medical officers performed the anthropometric measurements. Height was measured using a stadiometer and weight using an electronic weighing scale. Medical assessment was done in all children who participated in study. To define obesity and overweight, sex and age specific body mass index (BMI) cutoffs recommended by International Obesity Task Force were used. Age and sex specific BMI 5th percentile from revised NCHS (2000) growth charts were used to define thinness. Information regarding physical activity, behaviour, feeding practices and socioeconomic factors were obtained using a pretested questionnaire filled by parent/guardian. Data was analyzed using Epi Info 2000 (CDC, USA) software. Results One thousand two hundred and sixty six children were recruited to the study. Data of 1224 subjects were used in the anthropometric analysis, while 1102 data sets were used in analysis of dietary and physical activity. Of the latter group 44% were boys. The children belonged to 3 types of schools based on type of administration. About 12% each were from ages 8 and 12; the rest were almost equally distributed among the other 3 age categories. More than 80% of mothers had a level of education above GCE (O/L). 60.8% watched television for 1-2 hours each day during weekdays and 39.5% watched television for 3-4 hours during weekends. More than 50% engaged in daily physical activity for more than one hour during weekdays as well as weekends. 80.1% attended tuition classes. A similar distribution was seen in all age groups. Although consumption of vegetables was high, fruit consumption was not satisfactory. Majority had eggs or fish as their main source of protein. Prevalence of obesity and overweight increased with increase in family income and thinness was high among low socio-economic groups. Dental caries was the commonest health problem. Highest prevalence was among children from public non-national schools (48.7%), whilst public national and private schools had a prevalence of 10.5% and 11.8% respectively. Of the skin lesions commonest was scabies. Conclusion The main factor that influenced the nutritional status and related behaviour was the socioeconomic standard. Health programmes should be designed targeting these groups.
ABSTRACT
BACKGROUND: As in many other Asian countries, Sri Lanka is in the phase of a rapid demographic, nutritional and epidemiological transition. As a result dietary habits and lifestyle are changing. These have led to new health problems in the region. Childhood overweight and obesity are examples of such problems. OBJECTIVE: To provide information on the nutritional status of 8-12 years old schoolchildren in an urban area of Sri Lanka. SUBJECTS AND METHODS: Seven schools situated in the city of Colombo were randomly selected. They showed a fair representation of children of all social levels. Fifty students from each grade (years 4, 5, 6, 7) of each school were randomly selected. Their height was measured using a stadiometer to the closest 0.1cm and weight measured using an electronic weighing scale (Seca, France) to the closest 100 g. Calibration was checked with a standard weight at each 25 measurements. Information regarding behaviour, feeding practices and socioeconomic factors were obtained by a questionnaire filled by the parent or the guardian. To define obesity and overweight, sex and age specific body mass index (BMI) criteria recommended by the International Obesity Task Force (IOTF) were used. The age and sex specific BMI 5th percentile from revised NCHS (2000) growth charts were used to define thinness. Weight and height Z score of less than -2 from the median of height for age and weight for age derived using the ANTHRO software (CDC, USA) were used to define stunting and underweight respectively. Data were analysed using Epilnfo 2000 (CDC, USA) computer package. RESULTS: Anthropometric data of 1 224 children (48% boys), and feeding practices and behaviour pattern data of 1 102 children (44% boys) were analysed. Obesity prevalence among boys (4.3%) was higher than in girls (3.1%). The prevalence of thinness was 24.7% in boys and 23.1% in girls. 5.1% of boys and 5.2% of girls were stunted. 7.0% of boys and 6.8% of girls were underweight. 66% of obese children and 43.5% of overweight children belonged to high-income category (monthly family income more than Rs. 20,000). Apart from family income, behaviour patterns did not significantly influence the nutritional status. CONCLUSIONS: Although the data are not representative of the entire country, nutritional transition is evident in the city of Colombo. Obesity and overweight in older children are some emerging nutritional problems that may be the consequence of emerging patterns of the lifestyle and diet in response to social and cultural changes.