Obesity in primary school children in Accra Metropolis.

Abstract

Objectives: To determine the prevalence and socio-demographic aspects of obesity in primary school children in Accra Metropolis. Design: A descriptive cross-sectional survey was conducted on sample of 1123 children aged 6-10 years attending primary schools who were selected by multistage sampling using school registers and listings of primary schools by Accra Metropolitan Education Service. Setting: Four public and four private primary schools in Accra Metropolis. Subjects and Methods: In total, 1123 subjects (584 females and 539 males) participated. There was however 912 questionnaires available for further analysis. Socio-demographic data were obtained by self-administered questionnaire and measurements were made of weight, height and triceps skin fold thickness. Results: The mean age for males was 8.43 years and that for females 8.41years (p<0.001).The mean weight for males was 26.8kg and that for females 27.8kg (p<0.001). The mean BMI for males was 16. lkg/m2 and that for females 16.5kg/m2 (p<0.001). The mean skin fold thickness for males was 6.8mm and that for females 9.6mm (p<0.001). Crude prevalence of obesity (above 95 percentile) was 5% (by CDC- criteria 3.4%), prevalence of risk of overweight (above 85 and below 95 percenlile) was 10.2% (by CDC criteria 7%) and prevalence of underweight (below 5 percentile) was 4.8% (by CDC criteria 3.7%). The crude prevalence of obesity by skin fold thickness distribution was 5.3%. The rates of obesity (7% vs2.8%) and at risk of overweight (12.3% vs 7.8%) were higher in females than males. There were more obese and at risk of overweight subjects in the private schools 9.6% and 14.1% than that in public schools 1.1% and 6.8%, respectively. Obesity and risk of overweight were highest among Akan and Ewe tribes. Subjects of parents with tertiary education were more obese and at risk of overweight than their counterparts of parents with lower educational level. Conclusion: Obesity does not yet appear to be a major problem in primary school children in Accra. A significant number, a tenth of the children, were at risk o f overweight category. There was co- existence of obesity and underweight Economic status appeared to be an important determinant o f nutritional status. Female gender, Akan ethnical group, private schools and higher school fees, tertiary education o f the parents were associated with higher levels o f obesity and overweight. Further work is needed to ascertain the real reasons for observed differences.