الفهرس 
Physical , psychological and cognitiveOnly 14 pages are availabe for public view
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Abstract
This study aimed to identify risk factors of stunting among a group of adolescents (10-15 years old) attending stunting clinic, National Nutrition institute in Cairo and to compare percentages of other mal-nutritional disorders (eg., anemia and obesity) among two groups (stunted group and a control group) of adolescents.
A case control study was performed, the study was done in National Nutrition Institute. Cases were taken from the stunting clinic . Controls were taken from outpatient clinics . 150 cases and 300 controls were interviewed together with their guardians. An interview questionnaire was constructed and used to explore socio-economic risk factors ,24 hours recall and food frequency questionnaires were used to explore nutritional risk factors of stunting. Anthropometric assessment (weight and height ) was done. Results from recently done investigations were reported. Data was entered and analyzed using SPSS (statistical package for social sciences ) version 20 .
It was found that 57.3% of cases were males in comparison to 55% of controls . Mean height of cases was significantly lower than that of controls (132.76 ±7.6 centimeters versus 147.79± 9.3 centimeters).
The percentage of cases living in rural areas was significantly higher than controls (36% and 24% respectively ). There was a statistically significant difference as regards the care giving person; a lower percentage of cases (3.3%) versus (8.7 %) in controls obtained care from another person beside the mother.
No significant association was found between father’s occupation or marital status of the mother and the development of stunted growth among the study participants.
Regarding mother’s education, there was a higher percentage of illiterate mothers or had low grade education among cases (43.3 %) in comparison to (35.3%) among mothers of controls. This result was not statistically significant.
Cases showed a significantly higher percentage of housewife mothers (90.7%) compared to control group (78.3%). A higher percentage of cases were underweight for their age as compared to controls (40% vs 7.7% respectively). This difference was statistically significant. There was no significant difference as regards exposure of child /adolescent to passive smoking . As regards the source of drinking water ,cases were less likely to have water source inside the house (86%) compared to control group (92.3%) .This result was statistically significant.
There was a higher percentage of consanguinity between parents of cases (30%) than controls (12.7%) and the difference was statistically significant. A higher percentage of cases (56.6%) spent less than 1500 LE monthly compared to controls (44.7%) and the difference was statistically significant. There was a similar percentage of children working in both groups ; 10.7% in cases and 9.3% in controls. Mean number of persons living with study participant in their household was higher among cases than among controls (5.72±1.47 and 5.43±1.28) respectively. Regarding the mean number of siblings , cases had a higher mean (4±1.4) versus (3.6±1.33) among controls. These differences were statistically significant. As regards house crowding index, there was a higher mean of crowding index among cases (2.73±1.11) than among controls (2.6±0.92) yet this difference was not statistically significant.
As regards maternal age during pregnancy in the study participant, a higher percentage of cases were born to mothers younger than or equal to 18 years (13.3%) compared to controls( 7%) but this difference was not statistically significant. Regarding passive smoking during pregnancy ,there was no significant difference between cases and controls. A higher percentage of cases were born small in size (24%) compared to controls (20%) ,as stated by the mothers, but this result didn’t significantly differ between both groups. A higher percentage of cases were “third or more” in order among their siblings as compared to controls (23.3 versus 13.3%) and this result was statistically significant.
A higher percentage of cases had short parent(s) as compared to controls ( 35.4% and 14.6% respectively). Short stature sibling was also found in a higher percentage of cases in comparison to controls (25.3% and 8.3% respectively). These differences are statistically significant. There was no statistically significant relationship between both groups as regards the presence of chronic diseases as well as prolonged diarrheal illnesses.
Types of operations differed significantly between both groups . Percentage of study participants who had undergone operations with long post-operative recovery was higher in cases (6.7%) in comparison to controls (1.7%). As regards history of hospital admission , although a higher percentage of cases gave a history of previous hospital admission (26%) than controls (19.3%) yet the difference was not statistically significant.
Median number of hours of leisure time (study hours and hours spent watching TV or using computers) was more among cases (4.63 hours ) than among controls (4 hours) and this result was statistically significant.
Anemia was present in 59% of cases and in 56% of controls with no statistically significant difference.
Percentage of protozoal infection was higher among cases 62.2% versus 50 % of controls . There was a higher percentage of cases infected with helminthes 27 % versus 18.2% of controls but the difference was not statistically significant.
Dietary data analysis revealed that the majority of cases and controls consumed more than “recommended” level of proteins. Also a lower percentage of cases consumed “recommended” levels of RDA of carbohydrates than controls (25.4 % versus 32.7%) yet differences were not statistically significant.
As regards fat intake , the majority of both groups (cases and controls ) had daily intake of fat lower than recommended (67.3 % and 78.7% respectively ) .The difference between groups was statistically significant.
As regards daily intake of fibers , all study participants
(100% of cases and controls) had unsafe daily intake of fibers ( < 50% of recommended level). There was a lower percentage of cases had “recommended” level of RDA of iron than controls (29.9% versus 36% ) . The majority of both groups had lower daily intake of calcium than recommended. Intake of zinc was almost similarly distributed in both groups. Majority of both groups had an intake of selenium higher than recommended daily intake. No statistically significant difference was found as regards those micronutrients.
Majority of cases and controls had low daily intake of Vitamin B1 , Vitamin B2 and Vitamin D.
The most frequently consumed food item among cases and controls was meat and meat products (78.7 and 78 % respectively) followed by milk and milk products (45.3% of cases and 40.3% of controls) while the least frequently consumed food items in both groups was leafy vegetables (19.3% of cases and 5% of controls) .Difference in intake of different food items was not statistically significant (P value >0.05).
from the previous results the following can be recommended :
1. In order to lower stunting prevalence ,attention should be directed to high risk families for stunted growth (rural residence , parental short stature and low income). Efforts done for prevention of stunting should concentrate on children of these families in their early life years .
2. Health education sessions should be given to mothers during pregnancy about breast feeding , sound nutrition , hygiene and seeking health care early in course of diseases and/ or infections.
3. Regular anthropometric assessment for school children for early detection of height and weight abnormalities.