Peer-reviewed article
Coverage of vitamin A supplementation, deworming and immunisations: Associations with nutritional status among urban children younger than 5 years in Nelson Mandela Bay, Eastern Cape Province, South Africa
S W Mclaren, L Steenkamp ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5This study looked at children under 5 in urban Nelson Mandela Bay, South Africa, to see how many had received vitamin A supplements, deworming treatment and immunisations. It also checked whether missing these services was linked to poor growth, measured as stunting, wasting or being underweight. The study found that older children were more likely to have missed vitamin A and deworming, but not immunisations. Missing these services was not linked to worse growth outcomes, but low birthweight was strongly linked to stunting risk.
Key points
- Prevalence of underweight was 2.5%, stunting 11.2%, and wasting 1.1% among the 1,496 children analysed.
- Older age categories had poorer coverage of vitamin A supplementation and deworming, but not immunisations.
- There were no significant differences in growth measurements between children with delayed vitamin A, deworming or vaccinations and those who were up to date.
- Low birthweight was strongly associated with stunting risk (odds ratio 4.658, p<0.001).
- The study recommends closer follow-up for children born with low birthweight due to their higher risk of stunting.
Limitations
The study is cross-sectional and descriptive, so it cannot show cause and effect between service coverage and growth outcomes; it also relies on retrospective clinic card data which may be incomplete.
Abstract
Background. Even though immunisation coverage is tracked through the district health system in South Africa (SA), limited information is available regarding interventions linked to the Expanded Programme on Immunisation (EPI) and the impact on the nutritional status of children <5 years of age. Objectives. To describe coverage of immunisations, vitamin A supplementation and deworming among children <5 years old in an urban area of Nelson Mandela Bay, Eastern Cape Province, SA. A secondary objective was to investigate whether a history of missed immunisations, vitamin A supplementation or deworming was associated with wasting or stunting in children. Methods. A descriptive study was conducted between September 2015 and February 2016, where cross-sectional anthropometrical data were collected from 1 513 children in 32 pre-schools, together with a retrospective analysis of the participants’ Road-to-Health/clinic cards to collect data on immunisation, vitamin A and deworming. Participants were categorised into 3-month age intervals to facilitate data analysis. Ethical approval was obtained from the Nelson Mandela University Research Ethics Committee (Human). Results. Data of 1 496 children were included in the analysis. The prevalence of underweight was 2.5% (n=37), while 11.2% (n=167) were stunted and 1.1% (n=16) were wasted. There were associations between age category and delayed vitamin A supplementation (χ2=32.105; df=19; n=836; p=0.03) and deworming (χ2= 45.257; df=17; n=558; p<0.001), but there was no association between delayed vaccinations and age category. There were no significant differences in anthropometrical indicators for children with delayed vitamin A supplementation, deworming and vaccinations compared with children in this sample who were up to date regarding the relevant indicators. However, weight-for-age, height-for-age and weight-for-height z-scores and stunting risk were associated with low birthweight (LBW) (odds ratio (OR) 4.658; p<0.001). Conclusion. Coverage of vitamin A supplementation and deworming but not immunisations was poorer among children in older age categories. A history of delayed vitamin A, deworming and vaccinations was not associated with the anthropometrical status of children. Children with LBW should be considered for more rigorous follow-up, as they are at higher risk of stunting.