Nutritional influences on growth and prevalence of anaemia in children during the war in Sarajevo.

Objective: To assess growth and prevalence of anaemia in hospitalised children during the war in Sarajevo.

Design: A random sample of children who were patients in the paediatric clinic over a period of six months (1 June to 31 December 1993) were anthropometrically measured and blood samples taken to determine prevalence of anaemia.

Setting: The study was conducted at the paediatric clinic, Kosevo Hospital, Sarajevo.

Subjects: The sample comprised 542 children aged from 0 to 14 years of whom 50.6% were boys and 49.4% were girls.

Interventions: The children were weighed and had their heights measured. Nutritional status was assessed through calculating the weight for height percentile and comparing these with international standards. Blood samples were taken and low haematocrit and haemoglobin values were used to indicate nutritional anaemia. The cut-off points used were: haematocrit < 0.34 (6 months-5 years) and < 0.35 (6-14 years); haemoglobin < 105 g/l (6 months-5 years) and < 110 g/l (6-14 years).

Results: On average, 69% of boys and 71% of girls fell within the 10th to 90th percentile range (weight for height). 7% of boys and 5% of girls were below the 5th percentile. A total of 24.7% children aged from six months to five years and 16% of children aged from six to 14 years had haematocrit values below the cut-off points. The highest percentage of children with low haematocrit values came from the six months to one year age group. Anaemia as defined by haemoglobin value was diagnosed in 10.6% of children aged from six months to five years and 9.6% of six to 14 year olds.

Conclusions: War and disruption of the food supply have not had the expected negative impact of child growth and prevalence of anaemia. Reasons for this may include: increased levels of breast feeding, distribution of supplementary food commodities enriched with micronutrients, and good parental care.