Growth, morbidity and serum protein markers of immunostimulation in nepali children

Abstract

This study investigated the health and well-being of children aged five to twelve years living in two villages in Nepal. The research took a biocultural perspective, combining qualitative anthropological techniques with traditional and innovative quantitative measures: anthropometric status, morbidity reports and serum markers. The proportion of children in the sample classified as stunted and wasted was similar to the findings of other studies in Nepal, with much stunting, but little wasting. Median ACT values were low compared with other studies of children in developing countries, but fall within the normal range. Albumin values were lower than the normal UK range, but similar to other findings m developing countries. Statistical analysis of the anthropometric data in a multivariate model showed that there was significant seasonal variation for height-for-age, weight-for-height and weight-for-age. There was a village difference in weight-for-height and weight-for-age, but not height-for-age. A child’s age and jat were also associated with variation in weight-for-height, but not other measures. Surprisingly, there were no significant sex differences for any measure. Age and jat had a significant impact on reported morbidity levels, with younger children and high caste children reporting a greater frequency of morbidity. Morbidity, village and jat all had a significant impact on ACT levels; ill children had greater ACT than well children, Marpha children greater than Thini children, and high caste children greater than Tibeto-Burman and low caste children. The key findings of this thesis make connections between growth, serum markers of inflammation and morbidity. Firstly, levels of ACT were raised in conjunction with reported morbidity. This confirmed the value of ACT as an objective measure of infection and inflammation, permitting comparison between populations. Secondly, subsequent linear growth was negatively related to both ACT and reported morbidity. Several authors have hypothesized that a heavy infection burden in children may lead to impaired growth, possibly due to the development of mucosal enteropathy.