Socioeconomic status, anthropometric status, and psychomotor development of Kenyan children from resource-limited settings: a path-analytic study

Abstract: Background—Sub-optimal physical growth has been suggested as a key pathway between the effect of environmental risk and developmental outcome. Aim—To determine if anthropometric status mediates the relation between socioeconomic status and psychomotor development of young children in resource-limited settings. Study design—A cross-sectional study design was used. Subjects—A total of 204 (105 girls) children from two resource-limited communities in the Coast Province, Kenya. The mean age of these children was 29 months (SD=3.43; range: 24–35 months). Outcome measure—Psychomotor functioning was assessed using a locally developed and validated measure, the Kilifi Developmental Inventory. Results—A significant association was found between anthropometric status (as measured by weight-for-age, height-for-age, mid-upper arm circumference, and head circumference) and psychomotor functioning and also between socioeconomic status and anthropometric status; no direct effects were found between socioeconomic status and developmental outcome. The models showed that weight, height and to a lesser extent mid-upper arm circumference mediate the relation between socioeconomic status and developmental outcome, while head circumference did not show the same effect. Conclusion—Among children under 3 years living in poverty, anthropometric status shows a clear association with psychomotor development while socioeconomic status may only have an indirect association

Assessing cognitive outcomes in a rural African population: development of a neuropsychological battery in Kilifi district, Kenya

The ability to measure neuropsychological outcomes in a comparable manner in different cultural groups is important if studies conducted in geographically diverse regions are to advance knowledge of disease effects and moderating influences. The purpose of this study was to evaluate the application of neuropsychological test procedures developed for use in North America and Europe to children in a rural region of Kenya. Our specific aim was to determine if these methods could be adapted to a non-Western culture in a manner that would preserve test reliability and validity. Procedural modifications yielded reliable tests that were sensitive to both the sequelae of cerebral malaria and to children's social and school backgrounds. Results suggest that adaptations of existing tests can be made in such a way as to preserve their utility in measuring the cross-cultural sequelae of childhood neurological diseases