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Departments of International Health and * Biostatistics, Emory University, Rollins School of Public Health, Atlanta, GA 30322
1To whom correspondence should be addressed.
We used data from the 1996 Honduras National Micronutrient Survey to investigate the co-occurrence of vitamin A deficiency (VAD), anemia and stunting in a representative sample of Honduran children 15 y old. Observed frequencies of co-occurrence were compared with frequencies expected by chance in children 1235.9 mo old (n = 633) and 3659.9 mo old (n = 610) for the three possible two-way combinations of the problems and the three-way combination. Observed frequencies were greater than expected frequencies for all eight comparisons, and all comparisons except for that of stunting and anemia in younger children were significant. The observed frequency of the three-way co-occurrence was 8.4% compared with an expected co-occurrence of 8.1% in younger children (P < 0.05) and 4.8% compared with 4.2%, respectively, in older children (P < 0.001). Although there was statistical evidence for co-occurrence, differences between expected and observed prevalences were small for most comparisons. Our findings suggest that having one or two problems does not appreciably increase the probability of having another. The efficiency of nutrition interventions aimed at these conditions would not be improved by targeting children with any one of the conditions; rather, the three conditions should be treated as virtually independent when designing programs. Replication of this study in other settings is warranted.
KEY WORDS: anemia stunting vitamin A deficiency Honduras children
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