Health and disease among Somali primary school children in Hargeisa

Figures & data

Table 1. Frequency of conditions resulting in referral of children screened.

Criteria for referral	Frequency (%) of referred children
Malnourished children with a body-mass-index (BMI) at least 3SD below the mean	115 (47.1)*
Vision impaired children (visual acuity < 0.5 at Snellen’s eye chart)	62 (25.4)**
Symptoms and/or signs of infection (e.g. skin, eye, ear, throat, UTI)	48 (19.7)
Symptoms of tuberculosis (weightloss, cough, haemoptysis, nightsweat, fever, chest pain, fatigue)	2 (0.8)
Any other abnormal finding	17 (7.0)***
Total	244 (100)

*Referrals based on direct readouts, by students, from WHO reference charts of BMI-for-age with z-scores. **Borderline cases were also referred ***Abdominal pain, headache, pale conjunctiva, enlarged lymph node, high blood pressure.

Table 2. Characteristics of pupils screened at two primary schools in Hargeisa, 2017.

Attribute		Frequency (%)
	Total participants	2093 (100)
Gender	Boys	1218 (58.2)
	Girls	875 (41.8)
	Missing information	0
Age groups	4–7	177 (8.4)
	8–11	824 (39.4)
	12–15	952 (45.5)
	16–19	140 (6.7)
	Missing information	0
Grades	1–4	924 (44.2)
	5–8	1166 (55.8)
	Missing information	3
Orphan status	Both parents alive	1921 (92.6)
	One parent dead	150 (7.2)
	Both parents dead	3 (0.1)
	Missing information	19
Nutritional status (BMI-for-age)*	Severely malnourished (Z-score < −3)	198 (9.5)
	Moderately malnourished (Z-score between −2 and −3)	324 (15.5)
	Not malnourished (Z-score −1 ≤)	1569 (75.0)
	Missing information	2
Vaccination status	Any vaccination received	1410 (67.3)
	Not vaccinated	531 (25.4)
	Don’t know	152 (7.3)
	Missing information	0
Visual acuity both eyes	< 0.5	38 (1.8)
	0.5–0.7	92 (4.4)
	0.8 ≤	1955 (93.8)
	Missing information	8
Dental status	Dental caries (obvious cavitation)	541 (26.0)
	No dental caries	1538 (74.0)
	Missing information	14
Absenteeism	Absent from school last month due to sickness	594 (28.4)
	No absent	1498 (71.6)
	Missing information	1
Visits health services	First time visiting health professionals, health clinic or hospital	971 (46.5)
	Previous visiting health professionals, health clinic or hospital	1116 (53.5)
	Missing information	6

*Calculated using the WHO AnthroPlus calculator

Table 3. Associations nutrition status and other variables.

Variables		Normal N (%)	BMI = −2 to −3 N (%)	BMI Z<-3 N (%)	Chi-square, p-value	Group trend-test, p-value	Missing
Age group	4–7	155 (87.6)	17 (9.6)	5 (2.8)	< 0.001	< 0.001	2
	8–11	660 (80.3)	109 (13.3)	53 (6.4)
	12–15	665 (69.8)	172 (18.1)	115 (12.1)
	16–19	89 (63.6)	26 (18.6)	25 (17.8)
Gender	Boys	825 (68.4)	238 (19.7)	144 (11.9)	< 0.001	< 0.001	2
	Girls	744 (84.2)	86 (9.7)	54 (6.1)	(0.000)	(0.000)
Visual acuity	< 0.5	25 (65.8)	7 (18.4)	6 (15.8)	0.31	0.13	10
	0.5 ≤	1539 (75.3)	316 (15.4)	190 (9.3)
Orphan	Both parents alive	1448 (75.5)	290 (15.1)	181 (9.4)	0.31	0.19	21
	One or both parents dead	107 (69.9)	29 (19.0)	17 (11.1)
Absenteeism	Yes	446 (75.1)	96 (16.2)	52 (8.7)	0.70	0.74	3
	No	1123 (75.1)	227 (15.2)	146 (9.7)
Caries	Yes	413 (76.4)	64 (11.8)	64 (11.8)	0.004	0.70	16
	No	1143 (74.4)	260 (16.9)	133 (8.7)
Vaccination	None	388 (73.1)	82 (15.4)	61 (11.5)	0.16	0.11	154*
	One or more	1064 (75.5)	223 (15.8)	122 (8.7)

Footnotes:

*Includes 152 reporting ‘don’t know’.

Table 4. Clinical diagnosis of children who presented for evaluation after receiving a referral.

Diagnosis (Criteria)	Frequency (%)
Severe malnourishment (BMI, Z-score −3)*	28 (22.2)
Impaired vision (Paediatric Snellen Chart Score < 0.5)**	27 (21.4)
Ear problems***	15 (11.9)
Trachoma (WHO simplified grading system of trachoma)	6 (4.8)
Allergic conjunctivitis	5 (4.0)
Other ailments****	10 (7.9)
Normal assessments	35 (27.8)
Total children referred who came for consultation at OPD	126 (100)

* All were given vitamin supplements, general nutritional advices and invitation to nutritional workshop. Haemoglobin blood test (Hb) was taken of the 20 most malnourished pupils. Only one had Hb lower than 12 g/100ml.

**All were referred to an optician.

***Ear problems: (acute otitis media, otitis externa, long-standing perforated tympani, ear wax).

****Other ailments: Urinary tract infection, bacterial tonsillitis, skin infection, persistent headache, heartburn with positive Helicobacter Pylori serology test, long persisting neck lump.