Immunisation and nutritional status of under-fives in rural Zambia.

In 1987 the nutritional status of Zambian children under 5 years of age was studied in 3 regions around Kamoto Hospital with the objective of exploring the prevalence if malnutrition and contributing factors such as maternal education and immunization status. Jumbe was within easy reach of the hospital with a relatively high standard of living. Masumba and Kakumbi were different areas in one region with their own health center further away from the hospital. Chibembe was isolated without good roads. The nutritional status of 1-5 year old children was measured by the Mid Upper Arm Circumference (MUAC). A questionnaire with 22 questions queried mothers about education, breast feeding, meals, water supply, and sanitation. A total of 1251 children were observed, 1222 under age 5, and 29 a little older. 40% of mothers had no education and 54% had some primary education (15.2% passed grade 4, 7.3% reached grade 6, and 18.2% finished grade 7). Less than 5% attended secondary school, and only 1% of mothers finished it. In Chibembe almost 50% of mothers had no education, secondary school education was the lowest of the regions, while in Jumbe was the highest. Immunizations included Bacillus Calmette-Guerin (BCG) at birth, diphtheria-tetanus-pertussis (DTP I, II, III, and a booster), oral polio vaccine (OPV) I, II, III, and a booster, and measles. The Chibembe region has the highest number of incomplete immunizations. In the Jumbe region unknown immunization presumably contributed to a higher number of older children. The nutritional status of children was the lowest in Chibembe region with a 10.8% rate of malnutrition and the lowest rate of maternal education. In Masumba/Kakumbi malnutrition was the lowest with 5.6%, while maternal education and complete immunization were the highest. The nutritional status of the completely immunized children was better. MUAC should be routinely employed for children under 5 years of age.