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  • Title: Nutrition-related hair signs in Zairian preschool children and associations with anthropometry.
    Author: van den Biggelaar I, Van den Broeck J.
    Journal: Trop Geogr Med; 1995; 47(6):248-51. PubMed ID: 8650734.
    Abstract:
    To assess prevalence of hair dyspigmentation, decurling, thinness and frailty, a random sample of more than 4,000 preschoolers, representative for a large area in Northern Zaire, was examined clinically and anthropometrically. Isolated dyspigmentation, isolated thinness and the combination of both were the most frequent signs (> 5%). Prevalence of hair signs did not differ according to sex or season. Peak prevalence was found between ages 6 and 18 months, suggesting a relationship with weaning. Most hair signs, studied separately or as combinations, increased gradually with lowering weight-for-age (WFA) or weight-for-height but not with height-for-age. Isolated dyspigmentation, however, was unrelated to WFA or marasmus. All signs occurred also in children with 'normal' WFA (SD > -2). In these children, hair signs were associated with the presence of clinical muscle wasting. During October 1989 to March 1991, in an area with a high prevalence of protein energy malnutrition (PEM) in Northern Ubangi, Zaire, physical examinations of a random sample of 4238 preschoolers aged 0-5 years were conducted every 3 months while they were attending the under-5 clinics or during home visits in the rural health zone of Bwamanda. Interviews were also conducted with their mothers. The researchers aimed to determine the prevalence of hair dyspigmentation, decurling, thinness, and frailty in relation to season, sex, age, and anthropometrical and clinical nutritional status. The leading hair signs of PEM were thin hair (18.6%) and dyspigmentation (17.3%), followed by no hair (9.8%), decurling (5.4%), and brittle hair (0.6%). In fact, the combination of dyspigmentation and thin hair was present in about 6% of all children. Hair signs did not differ according to age or season. Hair signs peaked at the age of 6-18 months, suggesting a link to weaning. About 80% of children with marasmus or kwashiorkor had at least one hair sign. The prevalence of most hair signs both separately and as combinations rose steadily with falling weight-for-age (WFA) or weight-for-height but not with height-for-age. Isolated dyspigmentation was related to neither WFA nor marasmus. All hair signs were also present in children with normal WFA and were associated with clinical muscle wasting. These findings suggest that health workers should not ignore hair signs and/or clinical muscle wasting in children whose WFA is normal.
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