COMPARATIVE ASSESSMENT OF MICRONUTRIENT DEFICIENCIES AMONG PRESCHOOL CHILDREN IN RURAL AND URBAN COMMUNITIES: IDENTIFYING DIETARY, SOCIOECONOMIC, AND ENVIRONMENTAL RISK FACTORS

Abstract

Background: Preschool children continue to be a significant public health issue in low and middle income countries due to micronutrient deficiencies, and this is closely linked to environmental, nutritional and socioeconomic factors. Nutritional problems faced in rural and urban areas can be different because the food available in rural areas and the services and conditions in rural households may differ from those found in urban areas.

Objective: This study was aimed at comparing the micronutrient deficiency patterns among preschool children in rural and urban areas and determining factors associated with the micronutrient deficiency patterns.

Methods: A comparative cross sectional analytical study was carried out on 300 preschool children, age 2-5 years, at tertiary care hospital Lahore, Pakistan. There were equal numbers of people in rural and urban areas (n=150). Structured interviews, dietary assessment, anthropometric measurements and laboratory analysis of selected micronutrient indicators were used to collect data. Details of diet diversity, income status, education of parents, sanitation facilities and recurrent infections were gathered. Data were analyzed statistically, using SPSS software, including comparative tests and multivariable logistic regression for independent risk factors.

Results: There were higher prevalence rates of micronutrient deficiencies in rural children than in urban children. The prevalence of Iron Deficiency Anemia was 46.0% in rural group and 30.7% in urban group (p=0.008). The prevalence of vitamin D deficiency was 52.7% for rural children and 36.0% for urban children (p=0.006), and 38.7% for rural children and 24.7% for urban children were vitamin D deficient (p=0.012). Dietary diversity, household income, sanitation, and frequency of infections were significantly related to high risk of micronutrient deficiency. Multivariate logistic regression revealed that the following factors were independent risk factors for nutritional deficiency: rural residence, poor dietary diversity, and socioeconomic disadvantage.

Conclusion: Micronutrient deficiency burden in preschool children is higher in rural areas than in urban areas. The results reveal that early nutritional screening and community based nutrition interventions such as dietary improvement, maternal education, sanitation and equitable access to health services are important to combat micronutrient deficiencies among children in Pakistan. Introduction: Micronutrient deficiencies are a significant public health issue in preschool children, particularly in low-income countries.