The nutritional status of disabled children in Nigeria: a cross-sectional survey

Objective: To compare the nutritional status of disabled children in Nigeria with their non-disabled siblings and neighbours. A second aim was to investigate anthropometric techniques appropriate for disabled children in this situation. Design: A cross-sectional survey. Setting: Nasarawa and Plateau States and the Federal Capital Territory in Central Nigeria. Subjects: 311 children under 10 years of age were studied: 112 with various disabilities, 87 siblings and 112 neighbours. Methods: Selected anthropometric measurements, (height, weight, mid-upper arm circumference (MUAC), demispan and halfspan), and blood haemoglobin levels were assessed by trained personnel. All measurements of disabled subjects were compared to the non-disabled controls. Results: The disabled subjects had mean height for age (ht/age) and weight for age (wt/age) significantly lower than the control group (P < 0.05). These differences were due largely to the very low Z scores in children with neurological impairments, (ht/age = -3.07 (s.d. = 1.6); wt/age = -2.0 (s.d. = 1.2)). Measurement difficulties contributed to low height values in disabled children and halfspan was found to be a useful proxy for height in these children. MUAC results were higher for the children with disabilities due to polio than for controls. The mean haemoglobin levels were slightly but significantly higher (P < 0.05) in the disabled and sibling groups compared to the neighbourhood group. Conclusion: Disabled children with neurological impairments and consequent feeding difficulties are nutritionally at risk, but others are no worse off than their non-disabled peers in this area. Halfspans may serve as a useful proxy indicator for estimating height in some children with physical impairments.