RESUMO
BACKGROUND: Under nutrition is a major problem among Indian schoolchildren. Yet, routine height and weight measurements in schools are nor used for growth monitoring. This study attempts to evaluate mid-upper-arm-circumference (MUAC) as a quick assessment tool against body mass index (BMI) in schoolchildren. OBJECTIVE: The objective of the study was to evaluate MUAC against BMI, height, and average skin fold thickness (ASFT) parameters and to estimate MUAC values across age, sex, and social categories. SUBJECTS AND METHODS: The study was conducted in 2017-2018 in four randomly selected Ashram schools and an urban school in Nashik district. Girls (1187) and boys (1083) from age 6-18 were included, and height, weight, skinfold thickness, and MUAC were measured. MUAC was done on the left arm with Shakir's tape and tailor's tape (for MUAC >25 cm). Epi Info 7.1 and Excel were used for the data analysis. RESULTS: MUAC had a consistently high correlation with BMI at all ages for boys (r = 0.8786, P < 0.0001) and girls (r = 0.8586, P < 0.0001). ASFT too was strongly correlated with MUAC (r = 0.5945, P < 0.0001). MUAC had strong but nonlinear correlation with heights in girls (r = 0.7751, P < 0.0001) and boys (r = 0.8267, P < 0.0001). MUAC was higher for girls than boys at all ages. MUAC values for scheduled tribe (ST) children were highly significantly lower than non-ST students. CONCLUSION: MUAC is a good and quick proxy tool for BMI and can serve as a sensitive nutritional indicator for school ages across socioeconomic categories. However, it is necessary to construct age-wise cutoff points and bandwidths using multicentric studies across income quintiles.
RESUMO
CONTEXT: In Ashram schools, scheduled tribes (ST) children from age 6 to 17 years belonging to various ethnic groups stay under common living and dietary provisions. However, there are scant reports on ethnotribal height differences. AIMS: The aims of the study are to (a) estimate height differences between schoolchildren of three major local STs, (b) compare heights and average skinfold thickness (SFT) of ST with non-ST and urban schoolchildren, and (c) compare median heights and weights of ST and non-ST schoolchildren with the Indian Academy of Pediatrics standards. SETTINGS AND DESIGN: Four Ashram schools and one urban school in Northwest Maharashtra. SUBJECTS AND METHODS: All children from age 6 to 17 years were included for height, weight, and mid-arm circumference (n = 2106). Data were processed with Excel and Epi info software for quantitative comparisons. STATISTICAL ANALYSIS USED: Quantitative methods including ANOVA were used for statistical comparison of heights. RESULTS: There were no differences among heights between ST students (ANOVA P > 0.05). However, there were significant differences between heights of boys and girls between ST and non-ST students across age groups (ANOVA P < 0.0001). ST boys and girls were mostly below 3rd or 10th percentile of IAP height and weight charts while non-ST children were between 25th and 50th percentiles. The average SFT values for prepubertal age groups were significantly lower in ST schoolchildren. CONCLUSIONS: ST students showed a significant growth disadvantage against general and other backward classes categories, although no intertribal anthropometry differences were observed.
RESUMO
CONTEXT: Heavy schoolbags are reported worldwide including India. The prescribed safe upper limit was 10% of student bodyweight. AIMS: This intervention study explored (a) impact of awareness measures among stakeholders and (b) any systemic constraints for reducing bag loads. SETTINGS AND DESIGN: This is a two-stage intervention study following a 2016-2017 baseline study of schoolbag weights in two rural schools. SUBJECTS AND METHODS: The study involved 175 students (male: 79 and female: 96) from 8th to 9th standards. The intervention consisted of sharing the baseline findings of schoolbag weight, guidelines, and necessary measures for the same. Thefirst intervention involved creating awareness among teachers regarding the harmful effects and the second intervention involved students. Bag weights were recorded on digital luggage scale in prelunch sessions in the following weeks after the intervention. STATISTICAL ANALYSIS: The impact of interventions was tested with (a) Paired t-test for mean bag weights and (b) Chi-square test for the proportion of heavy schoolbags. RESULTS: The mean baseline bag weight of 3.77 kg declined statistically significantly after successive interventions to 3.4 and 3.2 kg. The baseline proportion of 51% of heavy bags (>10% of body weight) declined to 38% and 29%. Despite interventions, 19% students in 8th carried heavier bags than the 3.4 kg cap set by Government guidelines. Subjects taught in 8th standard were above 6/day. CONCLUSIONS: Awareness programs for stakeholders only partially succeeded in reducing bag weights. Hence, reducing the daily subject load is necessary.
