SEARCHCOHORTpediatrics, public health

cohort·pediatrics, public health, epidemiology, nutrition, clinical nutrition·PMC10174535

Characterising school-age health and function in rural Zimbabwe using the SAHARAN toolbox

PLOS ONE · 21 authors, 5 centres

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TL;DR

The SAHARAN toolbox was deployed in a cross-sectional cohort of 80 school-age children in rural Zimbabwe to assess growth, body composition, physical function, and cognition.

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The SAHARAN toolbox was deployed in a cross-sectional cohort of 80 school-age children in rural Zimbabwe to assess growth, body composition, physical function, and cognition. The toolbox was feasible and acceptable following minor modifications. Lean mass index and skinfold thickness were related to WAZ and BMI Z-score but not HAZ. Total physical score was associated with unit rises in HAZ (beta 1.29, 95% CI 0.75 to 1.82, p<0.001) and lean mass index (beta 0.50, 95% CI 0.16 to 0.83, p=0.004), but not skinfold thicknesses. Few relationships were found between growth and cognitive function. The caregiver questionnaire identified high levels of adversity and food insecurity. Limitations include the small sample size and cross-sectional design, which preclude causal inference.

STUDY TYPE

cohort

SPECIALTY

pediatrics

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ORIGINAL PAPER

PMC10174535

Characterising school-age health and function in rural Zimbabwe using the SAHARAN toolbox

PLOS ONE

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ABSTRACT

Introduction We developed the School-Age Health, Activity, Resilience, Anthropometry and Neurocognitive (SAHARAN) toolbox to address the shortage of school-age assessment tools that combine growth, physical and cognitive function. Here we present i) development, acceptability and feasibility of the SAHARAN toolbox; ii) characteristics of a pilot cohort; and iii) associations between the domains measured in the cohort. Methods Growth was measured with anthropometry, knee-heel length and skinfold thicknesses. Bioimpedance analysis measured lean mass index and phase angle. Cognition was assessed using the mental processing index, derived from the Kaufman Assessment Battery for Children version 2, a fine motor finger-tapping task, and School Achievement Test (SAT). Physical function combined grip strength, broad jump and the 20m shuttle-run test to produce a total physical score. A caregiver questionnaire was performed in parallel. Results The SAHARAN toolbox was feasible to implement in rural Zimbabwe, and highly acceptable to children and caregivers following some minor modifications. Eighty children with mean (SD) age 7.6 (0.2) years had mean height-for-age (HAZ) and weight-for-age Z-scores (WAZ) of -0.63 (0.81) and -0.55 (0.85), respectively. Lean mass index and total skinfold thicknesses were related to WAZ and BMI Z-score, but not to HAZ. Total physical score was associated with unit rises in HAZ (1.29, 95% CI 0.75, 1.82, p<0.001), and lean mass index (0.50, 95% CI 0.16, 0.83, p = 0.004), but not skinfold thicknesses. The SAT was associated with unit increases in the mental processing index and child socioemotional score. The caregiver questionnaire identified high levels of adversity and food insecurity. Conclusions The SAHARAN toolbox provided a feasible and acceptable holistic assessment of child growth and function in mid-childhood. We found clear associations between growth, height-adjusted lean mass and physical function, but not cognitive function. The SAHARAN toolbox could be deployed to characterise school-age growth, development and function elsewhere in sub-Saharan Africa.

CITATION EXPORT

Joe D. Piper, Clever Mazhanga, Gloria Mapako et al.. Characterising school-age health and function in rural Zimbabwe using the SAHARAN toolbox. PLOS ONE. (2023). https://doi.org/10.1371/journal.pone.0285570

AUTHORS

21 · 5 CENTRES

Joe D. Piper, Clever Mazhanga, Gloria Mapako, Idah Mapurisa, Tsitsi Mashedze, Eunice Munyama, Marian Mwapaura, Dzivaidzo Chidhanguro, Eddington Mpofu, Batsirai Mutasa, Melissa J. Gladstone, Jonathan C. Wells, Lisa F. Langhaug, Naume V. Tavengwa, Robert Ntozini, Andrew J. Prendergast, Javier Brazo-Sayavera, Javier Brazo-Sayavera, Javier Brazo-Sayavera, Javier Brazo-Sayavera, Javier Brazo-Sayavera

1 Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
2 Blizard Institute, Queen Mary University of London, London, United Kingdom
3 Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
4 Population Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
Universidad Pablo de Olavide, SPAIN

EDITOR / REVIEWER

Javier Brazo-Sayavera