CHARACTERISTICS OF HUMAN ECOLOGICAL, CHILD CARING PRACTICES AND NUTRITIONAL STATUS OF CHILDREN 0–60 MONTHS AND THEIR MOTHERS IN A LOWLAND BOLIVIAN COMMUNITY

Abstract

A multifaceted, cluster-sample population survey was carried out among 600 children aged 0 to 60 months (mo) and their respective mothers or female caretakers in the province of Ichilo, Santa Cruz, in the lowlands of Bolivia. The purpose was to document attitudes, practices, and nutritional and health status on which to base cost-effective intervention strategies to reduce child morbidity and mortality. Rural poverty, perhaps less severe than in the Bolivian high altitudes, is found in Ichilo Province’s tropical lowlands. In children 0–60 mo, approximately one-fifth (22.5%) were severely stunted with rates increasing with age, 6.5% were severely undernourished, and 1.2% were severely wasted. Close to half (41.7%) of children (95% CI 37.7–45.6%) were anemic with rates lowest in the first semester of life (11.9%) and highest in the 2nd and 4th semesters (65.3%), tapering down to 22% by the 5th year. Forty percent of women were anemic. An infection prevalence of 62.1% was found in a subgroup of 131 children providing fecal samples and in 74.8% in the corresponding adults in the dyads. Fecal organisms found included protozoa (Entamoeba histolytica, Giardia lamblia) and helminths (Ascaris lumbricoides, Trichuris trichuria and hookworms). Breastfeeding was exclusive for 3 to 6 months, and 50% of children exclusively breastfed were completely weaned at 15 months. Almost 80% of the study group population experienced an episode of acute infectious illness every 2 weeks. Our findings indicate that cost-effective public-health interventions directed at anemia, growth faltering, recurrent infections, and intestinal parasites are warranted.

Keywords:

• Child Health
• Anemia
• Anthropometry
• Growth
• Intestinal Helminths
• Breastfeeding
• Bolivia

Acknowledgment

Financing for the survey was provided by the Global Bureau of the U.S. Agency for International Development through a Child Survival grant, cooperative agreement number FAO-A-00-99-00039-00. The authors are grateful to Dr. Kerry Schulze, Ms. Lily Riva Clement, Dr. Michelle Dreyfuss, and Ms. Evelyn Mayorga for technical assistance with the design, preliminary handling, and analysis of the data. Dr. Mabel Morales is also acknowledged for her able assistance in data collection and management in the field.

Notes

1Frerichs,Becht, and Foxman, 1981; Mock et al., 1985; Sommerfelt et al., 1991; McCann and Bender, 1992; McCann et al., 1994; Forste, 1998.

2Gibson, Rosalind S. 1990. Principles of Nutritional Assessment. New York: Oxford University Press.

396.3% responded “within the first hour” when asked how long after birth had their child begun breastfeeding, vs. 88.8% who responded that breastfeeding began during the first mo.

4The term “acceptable” was informally defined as the capability to read several sentences without difficulty.