The proposed study will be a cross-sectional study in the District of Matiari, Pakistan. Children ages 9-15 years will be identified from a Matiari District household census scheduled being conducted from December 2016- to May 2017 by the Department of Pediatrics and Child Health, Aga Khan University. Anthropometric measures, Tanner Stage, Hemoglobin concentration, blood draw as well as questionnaires will be assessed in all participants.
Study Type
OBSERVATIONAL
Enrollment
1,385
Matiari Research and Training Centre
Matiari, Sindh, Pakistan
Stunting
\< -2 Height-for-age z-score
Time frame: through study completion, an average of 1 year
Factors associated with impaired linear growth
To identify factors associated with impaired linear growth among girls between 9-14.9 years of age and boys 10-15.9 years of age living in Matiari
Time frame: through study completion, an average of 1 year
Anemia and micronutrient deficiencies
To determine the prevalence of anemia and micronutrient deficiencies among girls between 9-14.9 years of age and boys 10-15.9 years of age living in Matiari
Time frame: through study completion, an average of 1 year
Household Dietary Diversity Scale (HDDS)
The HDDS reflects household access to food variation and is a count of the food groups consumed over a given reference period. The value of this variable will range from 0 to 12 and represents the total number of food groups consumed.
Time frame: through study completion, an average of 1 year
Food Insecurity Experience Scale (FIES)
FIES was developed in 2013 by the FAO for global and country monitoring of the severity of food insecurity in the previous 12 months. Since 2014, the Gallup World Poll (GWP) has collected data using the FIES. The FIES consists of eight dichotomous questions and results range on a scale from mild to severe food insecurity. Results are classified based on the total number of affirmative responses ranging from 0-8. While the FIES does not measure food insecurity directly in children, estimates of the percentage of children living in food-insecure households are generally used.
Time frame: through study completion, an average of 1 year
Anxiety
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To access the presalence of anxiety we will be using the Screen for Child Anxiety Related Disorders (SCARED). This instrument contains 41 items and measures anxiety using four domains: panic/somatic, separation anxiety, generalized anxiety, and school phobia. A total score \>25 indicates an anxiety disorder.
Time frame: through study completion, an average of 1 year
Depression
To determine the prevalence of depression among girls between 9-14.9 years of age and boys 10-15.9 years of age living in Matiari. We will be using the Mood and Feeling questionnaire to assess depression. A score \> 27 may indicate the presence of depression.
Time frame: through study completion, an average of 1 year
Pubertal status
To determine the prevalence of pubertal status (pre-puberty, in-puberty, completing puberty) according to chronological age among girls between 9-14.9 years of age and boys 10-15.9 years of age living in Matiari using culturally sensitive methods. Puberty assessment for this study will be composed of two components: 1. Self-Assessment: All participants will be asked a series of questions similar to a medical history to determine their Pubertal Phase ; 2. Physical Assessment: Participants also willing to participate in a modified physical examination for Tanner Stage assessment. Puberty Phase classification after Tanner Stage assessment. Study staff will confirm assent and consent for each physical Tanner Stage assessment.
Time frame: through study completion, an average of 1 year