Prevalence and Aetiological Profile of Short Stature in School Children between 6-11 Years of Age- A Community Based Prospective Observational Study
SC11-SC16
Correspondence
Jasmine Kandagal,
4th Main, Shivagiri, Dharwad, Karnataka, India.
E-mail: jasminesmile18@gmail.com
Introduction: Growth is a complex process influenced by genetic background, different functions of the endocrine system, nutrition, the effect of any chronic disease, and the level of individual physical activity. Regular height measurement is one method to evaluate growth. Short stature might be the first sign of various pathological conditions. Early recognition of short stature allows early intervention, optimising the possibility of achieving good health and normal adult height. Community based studies utilising standard protocols are less common in India, as many studies are limited to children visiting tertiary care centres with complaints of short stature.
Aim: The present study aimed to assess the prevalence and aetiological profile of short stature in urban school children of Bangalore.
Materials and Methods: This prospective observational study was conducted among five schools in Devarajevanahalli, Bangalore, from November 2015 to January 2017. Written informed consent was taken from the principal. Children from 6-11 years were recruited into this study until the sample size was reached. A total of 1128 children were chosen for the study. Anthropometric measurements like height, weight, and Body Mass Index (BMI) were taken. Height was plotted on Indian Academy of Pediatrics (IAP) growth charts. Those with height <3rd centile were considered to have short stature. Children with short stature were followed after one year to see their height velocity. Children with height velocity of <25th centile were evaluated. A detailed history focussing on nutrition and a complete physical examination, along with relevant investigations, were done. The cause of short stature was assessed and grouped into physiological and pathological short stature. Continuous variables like height, weight, and BMI were presented as mean [standard deviation (SD)] and were compared using unpaired t-test. Categorical variables like gender and height velocity were expressed as actual numbers and percentages, and association was done using the Chi-square test. Height between age categories among boys and girls was compared using ANOVA test.
Results: Out of 1128 school children, 62 were found to be short. The prevalence of short stature was 5.50%. Among the 62 children, 31 remained short after one year. Out of the 31, only 22 children were investigated, as the remaining were not willing to undergo investigations. Out of the 22 children, pathological short stature was found in 13 (59.1%) and physiological short stature in nine (40.9%). In pathological short stature, chronic malnutrition with Iron Deficiency Anaemia (IDA) was present in 10 (45.5%). Hypothyroidism, idiopathic short stature, and uncontrolled asthma were seen in one case each (4.5%). In physiological short stature, familial short stature was found in 6 (27.3%) and constitutional delay of growth and puberty in 3 (13.6%).
Conclusion: The overall prevalence of short stature was 5.50%, representing a significant percentage of our society that needs proper attention. Chronic malnutrition with IDA was the most common cause of short stature in this study. As a significant percentage of children had treatable causes, growth monitoring with standard growth charts should be mandatory in all schools.