Protein energy malnutrition and nutritional anaemia in preschool children in rural KwaZulu.

The prevalence of protein energy malnutrition (PEM) and nutritional anaemia was investigated in 392 black children, aged 13--60 months, living in a poor rural area. Breast feeding was practised extensively in the population (median duration 14 months). The overall prevalence of PEM was 16,4%, but severe PEM occurred in only 2,7% of the children. Anaemia was present in 6,7% of children, and was almost invariably associated with iron deficiency. Biochemical evidence of iron, folate and vitamin B12 deficiency was detected in 36%, 14,8%, and 0,3% of children respectively. Anaemia was almost confined to the 1-year-old group, but biochemical evidence of iron deficiency, while highest in this age group, continued into the 2-4-year age group. No relationship was found between ecological factors such as income, educational status, etc. and any of the anthropometric, biochemical or haematological variables. The prevalence of PEM and anaemia in these poor rural children is lower than that of a comparable group of underprivileged urban children, thus emphasizing that city slum conditions are producing considerable nutritional problems in their wake. It is of importance to investigate further why some children who are severely deprived in many ways do not necessarily manifest a proportional degree of nutritional deprivation.