Demographic, socioeconomic and nutritional status of preschool children attending early childhood development centres in Emali, Kenya

In rural African towns such as Emali and the surrounding counties, deterioration in food security is evident due to severe rainfall deficits over the last several years in this semi-arid climate. The 2008-09 Kenyan Demographic and Health Survey (DHS) indicated that 38% of preschoolers in the Emali region are chronically malnourished defined by height-for-age Z scores <-2 SD. Malnutrition during childhood results in increased morbidity, and impaired physical and mental development, which together have a negative impact on health and productivity in adulthood. In an effort to combat malnutrition among preschoolers, ChildFund began supplying two daily meals to preschoolers attending their Early Childhood Development Centres in Emali and surrounding counties in 2002. However, the nutritional status of the preschoolers is unknown. Therefore, the objective of this study was to assess the anthropometric and selected micronutrient status from fasting blood samples of the 514 preschool children from 23 preschools, along with their socioeconomic, health and hygiene characteristics. We also assessed and evaluated the dietary adequacy of the school meals currently provided to the children by ChildFund, which is assumed to provide the majority of energy and nutrients, for the purpose of providing recommendations to enhance the energy and nutrient supply. Of the preschoolers, 55% and 41% were from the Kamba and Maasai tribes, respectively. Almost 50% of Maasai households were in the lowest wealth quintile, had no education, or access to improved toilets compared to <2% of Kamba (P<0.001). Among the Kamba children, the prevalence of stunting was higher compared to the Maasai children (20 vs. 13%; P=0.027), whereas wasting was higher in the Maasai than in the Kamba (6 vs 11%). Chronic infection affected at least 28% of the preschoolers in each tribe. The prevalence of anaemia was much higher in the Maasai (39%) than the Kamba preschoolers (6%), most of which was attributed to iron deficiency based on depleted iron stores and elevated tissue iron levels. Only 12% of the Maasai and 7% of the Kamba children had zinc deficiency, and vitamin A deficiency was also low in both tribes (