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  • Title: Nutritional status of primary school children with endemic goitre in Caprivi, Namibia.
    Author: Jooste PL, Faber M, Badenhorst CJ, Van Staden E, Oelofse A, Schutte CH.
    Journal: Cent Afr J Med; 1994 Mar; 40(3):60-6. PubMed ID: 7923345.
    Abstract:
    The nutritional status of primary school children living in an endemic goitre area in eastern Caprivi, Namibia, was assessed by means of clinical, biochemical, anthropometrical and dietetic observations. An approximately 20 pc sample, consisting of 380 primary school children, aged six to 18 years and representing eight schools in the Cuando River area of eastern Caprivi, was included in the study. Their goitre prevalence of 34.5 pc has been reported earlier. A significantly lower mean thyroxine level in goitrous compared to non-goitrous children indicated that dietary iodine deficiency was the primary cause of the endemic goitre. The present paper focuses on the nutritional status of these primary school children. Anthropometrically, these children were severely undernourished, as indicated by a high prevalence of low (below the third NCHS percentile) weight and height for age values, ranging from 38.0 pc to 55.9 pc. Dietary analysis revealed a low energy intake as well as dietary deficiencies in folic acid (only girls), ascorbic acid, vitamin A, nicotinic acid, iron, riboflavin and calcium. A high percentage (43.9 pc of boys and 33.7 pc of girls) of the children were biochemically anaemic whilst less than one pc of the children showed clinical signs of anaemia. Nutritional intervention programmes in this area should not only treat and prevent the endemic goitre but also attend to the energy and micro-nutrient deficiencies in these children. In Namibia, a nutrition survey was conducted among 380 children aged 6-18 years at 8 primary schools along the Cuando River over about a 100 km stretch, in eastern Caprivi. This is a goiter-endemic area. 34.5% of the children had a goiter, which was the most significant nutritional condition in primary school children. This high prevalence of goiter indicated a dietary iodine deficiency. Iodine deficiency disorder can cause neurological damage ranging from mild intellectual impairment to full-blown cretinism. 38% were underweight and 55.9% were stunted (i.e., 3rd percentile of the National Center for Health Statistics). 2% had clinical signs of either kwashiorkor or marasmus. 43.9% of boys and 33.7% of girls were biochemically anemic, but less than 1% were clinically anemic. Mean standard hemoglobin level was 12.46 for girls and 12.31 for boys. Maize made up most of the diet and was eaten 2.7 times/day/child. Few children ate bread. Caloric intake was poor (39% and 45% of WHO recommendations for boys and girls, respectively). The diet did not contain enough folic acid for girls. Nutritional deficiencies in the diet also included ascorbic acid, nicotinic acid, iron, vitamin A, riboflavin, and calcium. Adequate nutritional intakes were limited to protein, thiamin, and vitamin B12 and, for boys, folic acid. These findings suggest that subsistence farming does not provide these children enough energy to maintain normal growth in children. This goiter-endemic area along the Cuando River needs educational and agricultural intervention programs to reverse endemic goiter and poor nutritional status. They should include treatment and prevention of goiter but also treatment and prevention of energy and nutrient deficiencies.
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