Original Communication
European Journal of Clinical Nutrition (2005) 59, 891–899. doi:10.1038/sj.ejcn.1602156; published online 25 May 2005
Nutritional status following malaria control in a Vietnamese ethnic minority commune
Guarantor: LQ Hung.
Contributors: LQH, PJdV, TQB, PTG, NVN, MTC and PAK participated in the field surveys, examined the people and collected data that were entered and analysed by LQH and PJdV. LQH, PTG, TQB, NVN and MTC were responsible for continued monitoring of the studies, regular visits in between surveys, discussions and quality control. PAK, PJdV and TQB were involved in study design and writing the paper was mainly done by LQH and PJdV with contributions from PAK, TQB, PTG, NVN and MTC.
L Q Hung1,2, P J de Vries1, P T Giao1,2, T Q Binh2, N V Nam3, M T Chong4 and P A Kager1
- 1Division of Infectious Diseases, Tropical Medicine & AIDS, Academic Medical Center, Amsterdam, The Netherlands
- 2Department of Tropical Diseases, Cho Ray Hospital, Ho Chi Minh City, Vietnam
- 3Center for Malaria & Goitre Control, Phan Thiet, Binh Thuan Province, Vietnam
- 4Bac Binh District Health Center, Cho Lau, Bac Binh District, Binh Thuan Province, Vietnam
Correspondence: PJ de Vries, Division of Infectious Diseases, Tropical Medicine & AIDS, Academic Medical Center F4-217, PO Box 22700, 1100 DE Amsterdam, The Netherlands. E-mail: p.j.devries@amc.uva.nl
Received 30 March 2004; Revised 3 February 2005; Accepted 26 March 2005; Published online 25 May 2005.
Abstract
Objective:
To study whether control of malaria leads to catch-up growth or an increase of obesity in a marginally nourished population.
Setting:
A Vietnamese ethnic minority commune in southern Vietnam.
Design:
Repeated annual anthropometric surveys were performed from 1995 to 2000. Z-scores for height, weight and BMI for age and weight-for-height were determined by using NCHS 1978 and CDC 2000 reference tables and by the LMS method.
Intervention:
Active malaria control that reduced the parasite carrier rate from 50% in 1994 to practically nil in 1998.
Results:
Inhabitants were generally of short stature and very thin. Using the US reference tables, the prevalence of moderate/severe stunting among children was 53/24% and of wasting 27/9% in the first survey in 1995. Physical condition and normal daily activities of most inhabitants were normal. The repeated LMS-Z-scores uncovered a significant recovery of stunting, extending into preadolescence, including the development of a pubertal growth spurt for girls and enhancement of pubertal growth in boys, after control of malaria. The mean (95% CI) annual increase of Z-height-for-age was 0.11 (0.09–0.12) for boys and 0.14 (0.13–0.15) for girls (P<0.001). As a consequence, weight-for-age and BMI Z-scores decreased without indication of developing obesity.
Conclusion:
Catch-up growth, extending into preadolescent age, was observed in a Vietnamese ethnic minority population with a chronic state of low food intake, without indication of developing obesity. The control of malaria was probably the most significant contribution to this catch-up growth.
Keywords:
anthropometry, malaria, wasting, stunting, BMI, Vietnam
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