Linear growth retardation in Zanzibari school children

Rebecca J. Stoltzfus, Marco Albonico, James M. Tielsch, Hababu M. Chwaya, Lorenzo Savioli

Research output: Contribution to journalArticlepeer-review

68 Scopus citations


This paper describes the longitudinal changes in height and weight of children in school grades 1-3 on Pemba Island, Zanzibar, a poor rural population in which parasitic infections and anemia are highly prevalent. Heights and weights of children were measured at base line, and 6 and 12 mo later, and were compared with U.S. reference data. At base line, the prevalence of height-for-age z-score < -2 rose from 14% in 7-y-old children to 83% in 13-y-old children. Prevalence of weight-for-age Z-score < -2 in children < 10 y was ~10% or less. Median 6-mo height increments for Pembian boys were around the 5th percentile at age 8 and around the 10th percentile from age 9 to 13 y. Height increments for girls improved from below the 25th percentile to above the median in this age range. Based on the longitudinal yearly gains observed, boys accumulate a height deficit of 11.9 cm and girls 8.5 cm, relative to the reference population. In multivariate analyses, a small part of the variability in growth increments was explained by ascariasis and anemia (for weight gain) and schistosomiasis (for height gain). A review of other growth data from rural African Bantu populations provides supporting evidence that stunting occurs in older as well as younger children. It has been controversial whether school-based health and nutrition interventions could induce catch-up growth in already stunted children. Our results suggest that appropriate interventions might actually prevent stunting in late childhood.

Original languageEnglish (US)
Pages (from-to)1099-1105
Number of pages7
JournalJournal of Nutrition
Issue number6
StatePublished - 1997
Externally publishedYes


  • Africa
  • growth
  • school children
  • stunting

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics


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