Undernutrition among Honduran children 12-71 months old / Desnutrición en niños hondureños de 12 a 71 meses de edad

In 1996, the Ministry of Health of Honduras conducted a national micronutrient survey that included anthropometric measurements to determine the nutrition status of children 12-71 months old. Among the 1.744 children who participated, 38 percent of them were stunted, including 14 percent who were severely stunted; 24 percent were underweight, of which 4 percent were severely underweight; and 1 percent were wasted, of which 0,1 percent were severely wasted. The country can be divided into three groupings based on the level of stunting and underweight: 1) lowest prevalence: Tegucigalpa, San Pedro Sula, and medium cities; 2) medium prevalence: other urban areas, the rural north, and the rural south; and 3) highest prevalence: the rural west. Using logistic regression analysis, the important determinants of stunting were found to be: mother/caretaker's and father's schooling, source of water, the dominion (geographic location and strata) in which the child lived, and the "possession score" for ownership of such items as a radio, television, refrigerator, stereo system, and electric iron. The predictors for underweight were micronutrient status, diarrhea, maternal/caretaker's schooling, type of toilet, and possession score. Historical data indicate that the national prevalence of chronic undernutrition has changed little over the last 10 years despite the number of national food and nutrition plans implemented and the significant improvements in health services. It is possible that these positive interventions have been offset by the slow progress in economic development. Future nutrition interventions should take into account household-level perceived needs and priorities in order to set realistic nutrition targets

Para determinar el estado nutricional de los niños de 12 a 71 meses de edad, el Ministerio de Salud de Honduras realizó en 1996 una encuesta nacional sobre micronutrientes en la que se incluyeron mediciones antropométricas. De los 1 744 niños que participaron, 38% presentaban retraso del crecimiento, grave en 14%; 24% bajo peso, grave en 4%, y 1% emaciación, grave en 0,1%. El país se puede dividir en tres zonas en función del nivel de retraso del crecimiento y bajo peso: 1) la de baja prevalencia, formada por Tegucigalpa, San Pedro Sula y ciudades medianas; 2) la de prevalencia intermedia, formada por otras zonas urbanas y las zonas rurales del norte y del sur, y 3) la de alta prevalencia, integrada por las zonas rurales del oeste. Mediante un análisis de regresión logística se identificaron los siguientes factores como determinantes importantes del retraso del crecimiento: el nivel de escolaridad de las madres/cuidadoras y de los padres, las fuentes de agua, la localización geográfica de la residencia del niño y la "puntuación de posesiones", referida a la posesión de aparatos como radios, televisores, refrigeradores, equipos de música o planchas eléctricas. A su vez, los factores que predijeron el bajo peso fueron el estado de los micronutrientes, la diarrea, el nivel de escolaridad de las madres/cuidadoras, el tipo de instalación sanitaria y la "puntuación de posesiones". Los datos históricos indican que la prevalencia nacional de desnutrición crónica ha cambiado poco en los últimos 10 años, pese a la importante mejoría de los servicios de salud y a la puesta en marcha de varios planes nacionales de alimentación y nutrición. Es posible que estas intervenciones positivas hayan sido contrarrestadas por los lentos progresos del desarrollo económico. Las futuras intervenciones nutricionales deberían tomar en consideración las necesidades y prioridades percibidas a nivel doméstico, con el fin de fijar objetivos nutricionales realistas.

Undernutrition among Honduran children 12-71 months old

In 1996, the Ministry of Health of Honduras conducted a national micronutrient survey that included anthropometric measurements to determine the nutrition status of children 12-71 months old. Among the 1 744 children who participated, 38 percent of them were stunted, including 14 percent who were severely stunted; 24 percent were underweight, of which 4 percent were severely underweight; and 1 percent were wasted, of which 0.1 percent were severely wasted. The country can be divided into three groupings based on the level of stunting and underweight: 1) lowest prevalence: Tegucigalpa, San Pedro Sula, and medium cities; 2) medium prevalence: other urban areas, the rural north, and the rural south; and 3) highest prevalence: the rural west. Using logistic regression analysis, the important determinants of stunting were found to be: mother/caretaker's and father's schooling, source of water, the dominion (geographic location and strata) in which the child lived, and the "possession score" for ownership of such items as a radio, television, refrigerator, stereo system, and electric iron. The predictors for underweight were micronutrient status, diarrhea, maternal/caretaker's schooling, type of toilet, and possession score. Historical data include that the national prevalence of chronic undernutrition has changed little over the last 10 years despite the number of national food and nutrition plans implemented and the significant improvements in health services. It is possible that these positive interventions have been offset by the slow progress in economic development. Future nutrition interventions should take into account household-level perceived needs and priorities in order to set realistic nutrition targets (AU) (AU)

Undernutrition among Honduran children 12-71 months old

In 1996, the Ministry of Health of Honduras conducted a national micronutrient survey that included anthropometric measurements to determine the nutrition status of children 12-71 months old. Among the 1.744 children who participated, 38 percent of them were stunted, including 14 percent who were severely stunted; 24 percent were underweight, of which 4 percent were severely underweight; and 1 percent were wasted, of which 0,1 percent were severely wasted. The country can be divided into three groupings based on the level of stunting and underweight: 1) lowest prevalence: Tegucigalpa, San Pedro Sula, and medium cities; 2) medium prevalence: other urban areas, the rural north, and the rural south; and 3) highest prevalence: the rural west. Using logistic regression analysis, the important determinants of stunting were found to be: mother/caretaker's and father's schooling, source of water, the dominion (geographic location and strata) in which the child lived, and the "possession score" for ownership of such items as a radio, television, refrigerator, stereo system, and electric iron. The predictors for underweight were micronutrient status, diarrhea, maternal/caretaker's schooling, type of toilet, and possession score. Historical data indicate that the national prevalence of chronic undernutrition has changed little over the last 10 years despite the number of national food and nutrition plans implemented and the significant improvements in health services. It is possible that these positive interventions have been offset by the slow progress in economic development. Future nutrition interventions should take into account household-level perceived needs and priorities in order to set realistic nutrition targets

Vitamin A deficiency and anemia among children 12-71 months old in Honduras

Vitamin A deficiency (VAD) and iron deficiency anemia (IDA) have been recognised as public health problems in Honduras for over 30 years. This paper, based on the 1996 National Micronutrient Survey on 1 678 children 12-71 months of age, presents the results for vitamin A status and anemia prevalence, as well as the level of vitamin A in sugar at the household level. The results showed that 14 percent of the children were subclinically vitamin A deficient (plasma retinol < 20 ug/dL) and 32 percent were at risk of VAD (plasma retinol 20-30 ug/dL). These data indicate that VAD is a moderate public health problem in Honduras. Logistic regression analysis showed that children 12-23 months old living in areas other than the rural south of the country were at greatest risk of subclinical VAD. Infection, indicated by an elevated alpha-1-acid-glycoprotein level, increased the risk of subclinical VAD more than three-fold. Children from households that obtained water from a river, stream, or lake were at twice the risk of subclinical VAD compared to other children. That same double risk was found for children from a household with an outside toilet. VAD can be controlled by fortifying sugar. Retinol levels in sugar at the household level were about 50 percent of those mandated by Honduran law. There appears to be a significant leakage of unfortified sugar into the market. This is particularly true in the rural north, where 33 percent of samples contained no retinol. Overall 30 percent of children were anemic (Hb < 11g/dL). Logistic regression analysis showed that children whose fathers lived with them but who had not attended at least grade 4 of primary school were at 33 percent greater risk of being anemic. Infection and being underweight increased the risk of being anemic by 51 percent and 21 percent respectively. Many of the anemic children had not been given iron supplements, suggesting health care providers may not be aware that anemia is widespread among young children and/or know how to diagnose it (AU)

Vitamin A deficiency and anemia among children 12-71 months old in Honduras

Vitamin A deficiency (VAD) and iron deficiency anemia (IDA) have been recognized as public health problems in Honduras for over 30 years. This paper, based on the 1996 National Micronutrient Survey on 1.678 children 12-71 months of age, presents the results for vitamin A status and anemia prevalence, as well as the level of vitamin A in sugar at the household level. The results showed that 14 per cent of the children were subclinically vitamin A deficient (plasma retinol 20 ug/dL) and 32 per cent were at risk of VAD (plasma retinol 20-30 ug/dL). These data indicate that VAD is a moderate public health problem in Honduras. Logistic regression analysis showed that children 12-23 monts old living in areas other than the rural south of the country were at greatest risk of subclinical VAD. Infection, indicated by an elevated alpha-1-acid-glycoprotein level, increased the risk of subclinical VAD more than three-fold. Children from households that obtained water from a river, stream, or lake were at twice the risk of subclinical VAD compared with other children. That same doubled risk was found for children from a household with an outside toilet. VAD can be controlled by fortifying sugar. Retinol levels in sugar at the household level were about 50 per cent of those mandated by Honduran law. There appears to be significant leakage of unfortified sugar into the market. This is particularly true in the rural north, where 33 per cent of samples contained no retinol. Overall, 30 per cent of children were anemic (Hb 11 g/dL). Logistic regression analysis showed that children whose fathers lived with them but who had not attended at least grade 4 of primary school were at 33 per cent greater risk of being anemic. Infection and being underweight increased the risk of being anemic by 51 per cent and 21 per cent, respectively. Many of the anemic children had not been given iron supplements, suggesting health care providers may not be aware that anemia is widespread among young children and/or know how to diagnose it

Vitamin A deficiency and anemia among children 12-71 months old in Honduras / Deficiencia de vitamina A y anemia en niños de 12 a 71 meses de edad en Honduras

Vitamin A deficiency (VAD) and iron deficiency anemia (IDA) have been recognized as public health problems in Honduras for over 30 years. This paper, based on the 1996 National Micronutrient Survey on 1.678 children 12-71 months of age, presents the results for vitamin A status and anemia prevalence, as well as the level of vitamin A in sugar at the household level. The results showed that 14 per cent of the children were subclinically vitamin A deficient (plasma retinol < 20 ug/dL) and 32 per cent were at risk of VAD (plasma retinol 20-30 ug/dL). These data indicate that VAD is a moderate public health problem in Honduras. Logistic regression analysis showed that children 12-23 monts old living in areas other than the rural south of the country were at greatest risk of subclinical VAD. Infection, indicated by an elevated alpha-1-acid-glycoprotein level, increased the risk of subclinical VAD more than three-fold. Children from households that obtained water from a river, stream, or lake were at twice the risk of subclinical VAD compared with other children. That same doubled risk was found for children from a household with an outside toilet. VAD can be controlled by fortifying sugar. Retinol levels in sugar at the household level were about 50 per cent of those mandated by Honduran law. There appears to be significant leakage of unfortified sugar into the market. This is particularly true in the rural north, where 33 per cent of samples contained no retinol. Overall, 30 per cent of children were anemic (Hb < 11 g/dL). Logistic regression analysis showed that children whose fathers lived with them but who had not attended at least grade 4 of primary school were at 33 per cent greater risk of being anemic. Infection and being underweight increased the risk of being anemic by 51 per cent and 21 per cent, respectively. Many of the anemic children had not been given iron supplements, suggesting health care providers may not be aware that anemia is widespread among young children and/or know how to diagnose it

En Honduras, la deficiencia de vitamina A (DVA) y la anemia ferropénica (AF) han sido problemas de salud pública reconocidos desde hace más de 30 años. Este trabajo, que se basa en la Encuesta Nacional de Micronutrientes de 1996 aplicada a 1 678 niños de 12 a 71 meses de edad, presenta los resultados relacionados con la situación de la vitamina A y la prevalencia de anemia, así como con las concentraciones de vitamina A en el azúcar de consumo domiciliario. Según los resultados, 14% de los niños tenían deficiencia subclínica de vitamina A (retinol plasmático < 20 g/dL) y 32% estaban en riesgo de DVA (retinol en plasma 20­30 g/dL). Estos datos indican que en Honduras la DVA es un problema de salud pública de importancia moderada. Un análisis de regresión logística demostró que los niños de 12­23 meses de edad que no vivían en la zona rural del sur del país corrían el mayor riesgo de DVA subclínica. El tener una infección, reflejada en una elevación de las concentraciones de alfa-1-glucoproteína ácida, aumentó más de tres veces el riesgo de DVA subclínica. Los niños de hogares con agua extraída de ríos, arroyos o lagos mostraron un riesgo doble de DVA subclínica, en comparación con otros niños. Ese mismo riesgo doble se encontró en niños de hogares con el baño situado en el exterior. La VDA puede controlarse mediante la fortificación del azúcar. Las concentraciones de retinol en el azúcar de consumo domiciliario fueron de alrededor de 50% de las dictadas por la ley en Honduras. Hay una filtración importante de azúcar sin fortificar en el mercado, particularmente en la zona rural del norte, donde 33% de las muestras no tenían retinol. En general, 30% de los niños mostraron anemia (Hb < 11 g/dL). Un análisis de regresión logística reveló que los niños cuyos padres vivían con ellos pero no habían cursado por lo menos el cuarto año de primaria corrían un riesgo 33% mayor de tener anemia. La presencia de una infección y el tener insuficiencia de peso aumentaron el riesgo de anemia en 51 y 21%, respectivamente, lo cual indica que los proveedores de atención de salud no siempre saben que la anemia es un problema muy diseminado en niños pequeños ni tampoco saben diagnosticarla

Salud y pobreza en Honduras / Health and poverty in Honduras

Ponencia presentada al VI Congreso Latinoamericano y VIII Congreso Mundial de Medicina Social. Guadalajara, Jalisco, México, 20-23 de marzo de 1994