Severe linear growth retardation in rural Zambian children: the influence of biological variables

Background: The prevalence of stunting in preschool children in Zambia is h igh; stunting has detrimental effects on concurrent psychomotor development and later working capacity. Objective: Our objective was to investigate biological variables that may c ontribute to linear growth retardation in preschool children in Samfya Dist rict, Zambia. Design: Children aged 6-9 mo (n = 108) and 14-20 mo (n = 102) attending mot her-and-child health clinics were included, With a mixed-longitudinal desig n, they were followed up 9 and 21 mo later. Height and weight of children a nd their mothers were measured. Biochemical measures (eg, serum zinc, retin ol, thyrotropin, iron, and acute phase protein concentrations), malaria par asitemia, and intestinal parasitosis were assessed. Results: Height-for-age z scores (HAZ) were low, indicating a high prevalen ce of stunting (36-79%). Ninety percent of the children were anemic, 53-71% had elevated acute phase proteins, and 80% had malaria parasitemia. Regres sion analyses showed that maternal height predicted the children's height a t 6-9 mo (regression coefficient = 0.05; 95% CI: 0.02, 0.08). The children' s height at an early age (6-9 and 14-20 mo) showed a strong relation with t heir height at later ages (22-30 and 34-41 mo). Serum micronutrient status did not show a significant relation with later HAZ. Conclusion: Unlike other studies, we did not identify specific biological f actors, such as health and micronutrient status, which contribute to the re tardation of linear growth. The normal zinc and iodine statuses of the chil dren suggest that at least these factors are not causal.