Introduction: Millions of children worldwide die before they reach their fifth birthday. Approximately 50% of all deaths in children are associated with malnutrition. Although remarkable improvements have been seen in the past few decades, child malnutrition remains a major public health problem in Ethiopia. Malnutrition has been linked to various morbidities and as the underlying cause of 57% of mortality in the country. It is caused by complex and multidimensional biological, social economic, and environmental factors. There are scarce literatures examining the environmental factors, such as access to water and sanitation, on the likelihood of child malnutrition as measured by stunting, wasting, and underweight in Ethiopia, which the current study sought to investigate. Aim: The primary aim of this study was to examine the relationship between households’ access to water and sanitation facilities and the likelihood that a child will become stunted or wasted or underweight. Methods: The study utilized a nationally representative data from 2011 Ethiopia Demographic and Health Survey. The sample size was 9,611 children aged 0-59 months. A weighted descriptive statistical analysis was performed to examine the frequency distribution of the study’s primary independent variables (sanitation and water), dependent variables (childhood stunting, wasting, and underweight), and all other variables included in the study. Weighted bivariate analysis was conducted using logistic regression to quantify association between stunting, wasting, and being underweight and different independent variables. Weighted multivariate logistic regression analysis was performed to control for potential confounders while examining the relationship between the primary independent and dependent variables. Odds ratios, 95% confidence limits, and p-value were calculated. We considered three sets of potential confounders: child’s (child’s gender, child’s age, and child’s size at birth diarrheal disease, fever), maternal (maternal education) and household characteristics (maternal BMI, place of residence, wealth index, stool disposal, time to get water). Only variables that showed significant association (p-value Main results: Approximately 44%, 10%, and 29% of the children under-five years of age were stunted, wasted, and underweight, respectively. About 54% of the study population used unimproved source of drinking water and about 82% used unimproved sanitation facility. Our bivariate logistic analysis revealed that children in households with unimproved source of drinking water had higher odds of stunting compared to children in households with improved drinking water source (OR: 1.2; 95% CL 1.02-1.34). Adjustment for child’s characteristics yielded AOR: 1.2; 95% CL 1.0-1.4. Addition of maternal characteristics attenuated this association (AOR: 1.1; 95% CL 1.0-1.3 1.0; 95% CL 0.8-1.2). Finally, inclusion of household characteristics showed stunting was not associated with unimproved source of drinking water (AOR: 1.0; 95% 0.8-1.2). The bivariate analysis revealed household access to unimproved source of drinking water was not significantly associated with wasting (OR: 1.0; 95% CL 0.8-1.3) and underweight (OR: 1.2; 95% CL 1.0-1.4). Adjustment of child, maternal, and household characteristic showed an inverse association between source of drinking water and wasting (AOR: 0.7; 95% CL 0.6-0.9). In the bivariate analysis, access to unimproved sanitation was significantly associated with stunting (OR: 1.3; 95% CL 1.02-1.74) and underweight (OR: 1.5; 95% CL 1.1-2.1). Compared to children living in homes with access to improved sanitation facility, children in household with unimproved sanitation facility had 1.4 increased odds of being stunted (95% CL 1.1-1.9) after adjustment for child’s characteristics. Adjustment of child, maternal, and household characteristics attenuated this association (AOR: 1.1; 95% CL 0.8-1.5). Children in household with unimproved sanitation facility had higher odds of being underweight after adjusting for child characteristics (AOR: 1.6; 95% CL 1.2-2.2). Addition of maternal characteristic reduced the association (AOR: 1.5; 95% CL 1.1-2.0). Finally, the addition of household characteristics further attenuated this association (AOR: 1.4; 95% CL 1.1-1.9). Children from households with improved water but unimproved sanitation had higher odds of wasting and being underweight compared to children living in household with both services: AORs adjusted for child’s characteristics were 2.3 (95% CL 1.3-4.3) for wasting and 2.4 (95% CL 1.6-3.6) for underweight; when maternal characteristics were included, AORs were 2.2 (95% CL 1.2-4.1) and 2.1 (95% 1.4-3.3) for wasting and underweight, correspondingly; finally, when household characteristics were included AORs were 2.0 (95% CL 1.1-3.9) and 1.9 (95% CL 1.2-3.0), respectively. Conclusion: Our results suggest that household access to unimproved source of drinking water and sanitation increase the likelihood of malnutrition. Therefore, initiatives to increase access to improved sources of drinking water and sanitation facilities along with nutritional intervention could help alleviate the high burden of malnutrition in Ethiopia.

Ratoon stunting disease (RSD) is a serious disease that affects all sugarcane producing countries. The major symptom of RSD is plant growth reduction, which is only seen in ratoon plants, causing up to 80% biomass reduction depending on environmental conditions. The disease is due to Leifsonia xyli subsp. xyli (Lxx), a gram-positive and nutritionally fastidious bacterium that so far has been found to specifically colonize the xylem vessels of sugarcane. However, the successful early detection of this pathogen is currently the main challenge for RSD prevention. Breeding for resistance to RSD, although not in practice, is a viable control measure. Since sugarcane varieties differ in relation to their degree of colonization by Lxx and losses are directly related to population densities of the pathogen in the plant, a promising breeding strategy would be to select for genotypes that are resistant to bacterial multiplication. Thus, knowledge on the responses of sugarcane to RSD at the \"omics\" level is an essential starting step to identify key metabolic targets for breeding resistant varieties. The overall goal of this study is to determine the metabolic profiles of a susceptible (CB49-260) and resistant (SP80-3280) variety inoculated or not with Lxx and to compare the results with existing proteomic and transcriptomic data to define a core of targets (proteins, genes, and metabolites) that can be tested as markers of resistance in a collection of sugarcane varieties. Bacterial titers were quantified by Real-Time PCR (qPCR). The metabolites were profiled from the leaves and from the xylem saps collected at 30 and 120 days after inoculation (DAI). Untargeted analysis were performed with Gas Chromatography - Mass Spectrometry (GC-MS) and were carried out on leaves and sap from 120 DAI. Targeted analysis was executed with Liquid Chromatography - Tandem Mass Spectrometry (LC-MS/MS) on both tissues at both timepoints. To validate metabolomics results, a set of metabolites was chosen to be tested in vitro, in order to detect growth alterations caused to Lxx. qPCR confirmed the susceptibility of CB49-260 as it had higher titers than SP80-3280. Global analysis revealed that both varieties and tissues have different metabolic profiles but that those differences are more quantitative than qualitative. The targeted approach identified more amino acids, sugars, organic acids and phosphorylated compounds in the non-inoculated susceptible genotype, while the resistant one had higher abundance of phenolics. It was also shown that inoculation with Lxx results in more relative abundance of amino acids, organic acids, phosphorylated compounds and phenolics. Furthermore, a key amino acid for Lxx survival was related to inoculation on both varieties, as well as a known phenolic compound related to plant defense. Distinguished phenolics resulting from the targeted analysis were selected to evaluate their effect on Lxx growth in vitro. Although some compounds caused inhibition, further optimization of the methodology is needed to confirm these results. / O Raquitismo-da-soqueira (RSD) é uma grave doença que afeta todos os paises produtores de cana-de-açúcar. O principal sintoma do RSD é tamanho reduzido das plantas, observado apenas nas plantas-soca, o que pode resultar em perdas de biomassa em até 80%, dependendo das condições climáticas. A doença é causada por Leifsonia xyli subsp. xyli (Lxx), uma bactéria gram-positiva e fastidiosa, descrita até o presente momento como hospedeira natural apenas da cana-de-açúcar, colonizando principalmente os vasos do xilema. Todavia, a detecção precoce deste patógeno é o principal desafio para prevenção do RSD. O melhoramento genético para resistência ao RSD, apesar de viável, não é uma medida de controle adotada na prática. Como existe diferenças entre as variedades de cana em relação ao grau de colonização por Lxx e as perdas estão diretamente relacionadas ao título bacteriano, uma estratégia de melhoramento promissora é a seleção de genótipos que apresentam resistência à multiplicação bacteriana. Portanto, o conhecimento das respostas da cana-de-açúcar ao RSD em termos \"ômicos\" é um passo inicial primordial para a identificação de alvos-chave para melhorar variedades resistentes. O objetivo geral deste estudo foi determinar os perfis metabólicos de duas variedade, uma suscetível (CB49-260) e uma resistente (SP80-3280) inoculada ou não com Lxx e comparar os resultados com dados já existentes de proteômica e transcriptômica para definir um núcleo de alvos (proteínas, genes e metabólitos) que possam ser testados como marcadores de resistência em uma coleção de cana-de-açúcar. Os títulos bacterianos foram quantificados por PCR em tempo real (qPCR). Os perfis metabólicos foram elaborados a partir de folhas e fluído xilemático coletados aos 30 e 120 dias após inoculação (DAI). A análise não-direcionada foi realizada por cromatografia gasosa acoplada à espectrometria de massas (GC-MS), usando folhas e extratos coletados aos 120 DAI. Já a análise direcionada foi efetivada via cromatografia líquida acoplada à espectrometria de massas em tandem (LC-MS/MS), em ambos tecidos e tempos de coleta. Para validar os resultados de metabolômica, um grupo de metabólitos destacado nas análises de metabolômica foi escolhido para testes in vitro e por fim detectar alterações no crescimento de Lxx. O resultado do qPCR confirmou a suscetibilidade da CB49-260, pois esta continha títulos superiores à SP80-3280. A análise global revelou que ambos variedades e tecidos possuem perfis metabólicos distintos, porém essas diferenças foram mais quantitativas que qualitativas. A análise direcionada identificou mais aminoácidos, açúcares, ácidos organicos e compostos fosforilados no genótipo suscetível não-inoculado, enquanto que o resistente apresentou maior abundância de compostos fenólicos. Também foi demonstrado que a inoculação com Lxx resultou em maior quantidade de aminoácidos, ácidos orgânicos, compostos fosforilados e fenólicos. Ademais, um aminoácido essencial à sobrevivência de Lxx foi relacionado à inoculação de ambas variedades, assim como um composto fenólico relacionado a defesa de plantas. O teste in vitro mostrou que, apesar de alguns compostos causarem inibição, é necessário aprimorar a metodologia utilizada para confirmar os resultados obtidos.

Atualmente, o Brasil é o maior produtor de cana-de-açúcar (Saccharum ssp.), no qual o estado de São Paulo é responsável por mais de 50% da produção. Esta cultura é hospedeira de diversos patógenos que podem limitar sua produção, dentre os quais se destaca a bactéria Leifsonia xyli subsp. xyli (Lxx), agente causal do raquitismo da soqueira (ratoon stunting disease - RSD). Pouco se sabe sobre a fisiologia deste organismo e quais as estratégias utilizadas por este para colonizar seu hospedeiro. No entanto, sabemos que para infectar e colonizar seus hospedeiros, é necessário que bactérias parasíticas superem estresses de diversas naturezas impostas durante estes processos, como os estresses oxidativo e o osmótico. Neste contexto, os objetivos deste trabalho foram identificar in silico e analisar a expressão in vitro, por qPCR, de genes relacionados a estes dois estresses. Uma análise da sequência do genoma de Lxx identificou 35 genes, sendo 8 relacionados ao estresse oxidativo, 9 relacionados ao estresse osmótico e 11 relacionados a estresse gerais, incluindo um cluster de 6 genes envolvidos na síntese de carotenoides. A expressão destes foi avaliada 60 minutos após exposição a 30mM de H2O2 ou 7% (p/v) de polietilenoglicol 6000 (PEG 6000). Sete genes foram avaliados como normalizadores das reações de qPCR. A quantificação do grau de peroxidação lipídica indicou que ambos os tratamentos resultaram em sensível peroxidação, muito embora o efeito do tratamento com PEG 6000 tenha sido maior do que o tratamento com H2O2. A exposição ao H2O2 aumentou a expressão dos genes katA (catalase), sodA (superóxido dismutase), msrA (Sulfóxido de metionina redutase) e msrB (Sulfóxido de metionina redutase) bem como de todos os genes responsáveis pela síntese de carotenoides. Por outro lado, todos os genes relacionados ao estresse osmótico foram menos expressos na presença deste composto. Já quando a bactéria foi exposta a PEG 6000, o oposto ocorreu, ou seja, os genes relacionados ao estresse osmótico, que são otsA (Trealose-6-fosfato sintase), otsB (Trealose fosfatase), treY (Malto-oligosil trealose sintase), treZ (Malto-oligosil trealose trealoidrolase), treS (Trealose sintase), proX (Proteína de ligamento em substrato, tipo ABC glicina betaína transportadora), proW (Proteína permease, tipo ABC glicina betaína transportadora), proZ (Proteína permease, tipo ABC glicina betaína transportadora) e Naggn (Amidotransferase), além dos genes do cluster carotenoide, foram mais expressos, ao passo que alguns dos genes ligados à resposta ao estresse oxidativo foram menos expressos. Verificou-se também, através de PCR convencional utilizando primers para amplificar as regiões entre os genes carotenoides, que estes são expressos como um RNA policistrônico, constituindo assim um operon. Estes resultados validam predições anteriores baseadas na análise in silico da sequência do genoma de Lxx, confirmando que Lxx possui mecanismos responsivos aos estresses osmótico e oxidativo aos quais é submetida durante o processo de infecção de seu hospedeiro. / Currently, Brazil is the largest producer of sugarcane (Saccharum spp.) and the state of São Paulo accounts for over 50% of the national production. This crop is host to many pathogens that may limit its production, among which the bacterium Leifsonia xyli subsp. xyli (Lxx), causal agent of ratoon stunting disease (RSD), is one of the most important. Little is known about the physiology of this organism and the strategies it uses to colonize its host. However, it is known that to infect and colonize their hosts, parasitic bacteria have to overcome stresses of various natures imposed during these processes, such as oxidative and osmotic stresses. In such context, the objectives of this study were to identify in silico and to analyze in vitro, by qPCR, the expression of Lxx genes related to these two stresses. The analysis of the genome sequence of Lxx identified 35 genes, of which 8 were related to oxidative stress, 9 to osmotic stress and 11 to general stress, including a cluster of 6 genes involved in the synthesis of carotenoids. The expression of these genes was assessed 60 minutes after exposure to either 30 mM of hydrogen peroxide (H2O2) or 7% (w/v) of polyethylene glycol 6000 (PEG6000). Seven genes were tested as normalizers of the qPCR reactions. The quantification of the level of lipid peroxidation in cells of Lxx indicated that both treatments induced substantial peroxidation, even though the effect of PEG6000 was greater than that of H2O2. The exposure to H2O2 resulted in higher expression of the genes katA (catalase), sodA (superoxide dismutase), msrA (sulfoxide methionine reductase) and msrB (sulfoxide methionine reductase), as well as all genes involved in the synthesis of carotenoids. On the other hand, the expression of all genes related to osmotic stress was reduced in the presence of this compound. When Lxx was exposed to PEG6000, the opposite was detected: the expression of the genes related to osmotic stress, otsA (Trehalose-6- phosphate synthase), otsB (trehalose phosphatase), treY (Malto-oligosil trehalose synthase) treZ (Malto-oligosil trehalose trehaloidrolase), treS (trehalose synthase), proX (ligament protein substrate, type ABC glycine betaine carrier), proW (permease protein, ABC type glycine betaine carrier), proZ (protein permease, type ABC glycine betaine carrier) and naggn (amidotransferase), along with the carotenoid genes was increased, while some of the genes linked to oxidative stress response were less expressed. It was also concluded through conventional PCR that the genes of the carotenoid cluster are expressed as a polycistronic RNA and, therefore, this arrangement constitutes an operon. These results validate previous in silico predictions that Lxx has mechanisms responsive to osmotic and oxidative stresses to which it is subjected during the process of infection of its host.

Background and objectives: The current and projected burden of cardiometabolic diseases in Asia is high, with a notable and rapidly increasing prevalence of associated risk factors among children in this region. Comprehensive evidence on cardiometabolic disease risk factors among children in Asia is required to ensure well-informed strategies to address the future burden of disease in this region. This thesis aims to increase the current understanding of cardiometabolic disease risk factors among children in Asia. Methods: Using previously collected data on 6903 children and 17 656 adults participating in the South East Asia Community Observatory health and demographic surveillance system (SEACO HDSS) in Malaysia, the characterisation, prevalence and sociodemographic determinants of key child risk factors were examined. Furthermore, a feasibility study building upon the SEACO framework (N = 203) was designed and implemented to explore the possibility of increasing the range of cardiometabolic measures obtained from children through the collection and analysis of biological samples from individuals in the HDSS. Results: There was a high burden of cardiometabolic disease risk factors among both adults and children in this population. Among children, prevalence estimates for the four key risk factors (overweight, obesity, underweight and stunting) differed considerably depending upon the anthropometric reference used to classify these measures, but were notable regardless of reference. Nutritional and household environmental indices, including child underweight and household sanitation facilities, were strongly associated with stunting risk in this population. Furthermore, children with parents who were obese or centrally obese had an approximately twofold increased risk of being obese. There was no clear evidence of association between measures of socioeconomic position and cardiometabolic disease risk factors among children. Finally, effective procedures were established for the collection, analysis and storage of biological samples from children and their family members in the HDSS, with implications for potential scale-up to facilitate more detailed characterisation of cardiometabolic disease risk. Conclusions: This work indicates a high burden of cardiometabolic disease risk factors among children in this population, identifies modifiable sociodemographic influences on these risk factors, highlights opportunities to more comprehensively characterise child cardiometabolic disease risk in this population, and hence informs future directions for research and strategies to address the growing burden of risk factors among children in this region.

Introdução: A Organização Mundial da Saúde indica que a prevalência do déficit de altura tem diminuído no planeta nas últimas décadas, pouco se sabe ainda sobre os fatores associados a este declínio ou sua associação com a desigualdade social. Objetivo: Descrever a evolução do déficit de altura e da desigualdade socioeconômica em diferentes regiões do mundo. Métodos: A pesquisa foi baseada em dados secundários provenientes do programa Demografic Health Surveys DHS de 6 sub-regiões do mundo representando 24 países em um total de 48 pesquisas na década de 90 e na primeira década do século 21 com 377.151 crianças menores de 5 anos. Foi considerada como variável de interesse o Déficit de altura para idade considerado como a ocorrência deste índice inferior a -2 escore Z da distribuição de referência WHO-2006. Foram imputados através de modelo de regressão os valores faltantes das variáveis água para beber, esgoto sanitário e escolaridade materna. Foi estimado o Índice de Concentração para as variáveis déficit de altura, educação materna deficiente, água para beber insegura, esgoto domiciliar deficiente e ocorrência de doenças, tendo como variável de ranqueamento o Índice de Riqueza. Dados do poder de paridade de compra fornecidos pelo Banco Mundial foram utilizados para verificar as diferenças na evolução da desnutrição. Resultados: Nessa análise acerca da evolução da desigualdade socioeconômica do déficit de altura para idade em países em desenvolvimento constatou-se que: a) a prevalência do déficit de altura para idade decresceu em 87 por cento dos países; b) apenas 8 países (33 por cento ) aumentaram a diferença entre prevalência do déficit de altura nos quintos extremos c) quatorze países (58 por cento ) evoluíram com diminuição do déficit de altura e aumento do índice de concentração; d) Dois países que diminuíram a o déficit de altura e a desigualdade tinham os menores valores de escolaridade materna deficiente; e) 13 países (93 por cento ) daqueles que diminuíram déficit mas aumentaram a desigualdade possuíam indicadores de vulnerabilidade infantil deficientes. Conclusões: Os países em desenvolvimento apresentam redução no déficit de altura em crianças menores de 5 anos. A diminuição da desigualdade na riqueza e na escolaridade materna deficiente explicaram maior parte da melhoria da desigualdade do déficit de altura para idade. / Introduction: The World Health Organization indicates that the prevalence of stunting has decreased in recent decades on the planet, little is known about the factors associated with this decline or its association with social inequality. Objective: Describe the evolution of the high deficit and inequality in different parts of the world. Methods: The study was based on secondary data from Program \"demografic Health Statics - DHS\" 6 sub-regions of the world representing 26 countries in a total of 52 surveys in the 90s and the first decade of the 21st century with 377,151 children under 5 years. Was considered as the variable of interest \"deficit height / age\" considered as the occurrence of this index below -2 SCOREZ WHO-2006 reference distribution. Were imputed using regression model the missing values of variables to drink water, sanitary sewer and maternal education. It has been estimated the concentration index for the variables height deficit, poor maternal education, water to drink unsafe, poor household sewage and disease occurrence, with the ranking of the variable Wealth Index. Data parity purchasing power provided by the World Bank were used to verify the differences in the evolution of malnutrition. Results: In this analysis about the evolution of socioeconomic inequality of age for height deficit in developing countries it was found that: a) the prevalence of height for age decreased in 87 per cent of countries; b) only 8 countries (33 per cent ) increased the difference between prevalence of height deficit at the extremes the 5th c) fourteen countries (58 per cent ) evolved with decreased high deficit and increased concentration index; d) Two countries which decreased the deficit in height and inequality had the lowest values of poor maternal education; e) 13 countries (93 per cent ) of those who fell deficit but increased inequality had disabled child vulnerability indicators. Conclusions: Developing countries have reduced the height deficit in children under 5 years. The reduction of inequality in wealth and poor maternal education explained most of the improvement in inequality of age for height deficit.

La thèse examine les déterminants nutritionnels et environnementaux de retard de croissance aux enfants en Afrique de l'Est. Je vais examiner le retard de croissance en utilisant une analyse épidémiologique des données secondaires (e.g. données de DHS) et l'analyse des données biochimiques liés à micronutriments et l'état de l'entéropathie. Pendant l'année scolaire 2015-2016, j'ai publié trois manuscrits liés à un retard de croissance en Ethiopie, a recueilli des échantillons de selles dans le cadre d'une étude cas-témoins en Tanzanie, et a reçu un financement pour analyser ces échantillons. Les analyses de laboratoire se fera en Novembre-Décembre 2016. Cette étude en Tanzanie examinera à la fois les facteurs nutritionnels et environnementaux associés à la croissance linéaire. / The thesis examines nutritional and environmental determinants of childhood stunting in East Africa. I will examine stunting by using epidemiologic analysis of secondary data (i.e. DHS data) and the analysis of biochemical data related to micronutrient and enteropathy status. During the 2015-2016 academic year, I published three manuscripts related to stunting in Ethiopia, collected stool samples as part of a case-control study in Tanzania, and received funding to analyze these samples. Laboratory analysis will be done in November-December 2016. This research study in Tanzania will examine both the nutritional and environmental factors associated with linear growth.

Undernutrition is a global public health challenge. In Somalia, undernutrition is chronic with the situation often graded for emergency response. The purpose of this study was to provide contextual evidence regarding trends of prevalence and predictors of undernutrition in South Central Somalia. Following the UNICEF conceptual framework of determinants of undernutrition, the study examined which individual, household, and society factors were associated with undernutrition. Using secondary data from cross-sectional nutritional surveys implemented by the Somalia Food Security and Nutrition Analysis Unit from 2007 to 2012, a sample of 75,756 and 60,856 children aged 6-59 months was used in analyzing trends in prevalence and predictors of undernutrition respectively. Linear regression was used to examine trends, while Generalized Estimation Equations were used to determine predictors of undernutrition. Results of this study showed that from 2007 to 2012, there was a declining trend in the prevalence of stunting (R2 = 0.73; p < 0.05) while there was no significant trend in terms of underweight and wasting. When individual, household, and society factors were considered simultaneously, diarrhea, child gender, diet diversity, and minimum meal frequency were significant predictors of underweight; child gender and meal frequency significantly predicted stunting while wasting was significantly predicted by diarrhea, malaria, and diet diversity. Geographical region and livelihood system were significant predictors of undernutrition. The study findings provide evidence to inform nutrition policy and programs that could result in eliminating disparities in child nutrition and reducing undernutrition, ultimately improving survival and development of children in Somalia.

Thesis (MPH.) --University of Limpopo, 2008. / Childhood malnutrition is one of the conditions that have been identified by the world health organisation to be given high priority in terms of their control and management. This study aimed to determine the prevalence of childhood malnutrition in a rural village of Regae in the Limpopo province. The study found that stunting and underweight are 17.5% whilst wasting is at 12.9% in the village. Key words: childhood malnutrition, stunting, wasting, underweight, socioeconomic factors, educational level. / N/A

Thesis (Ph.D. (Human Movement Science))--North-West University, Potchefstroom Campus, 2008.

Objectives: The goal of this project was to determine the nutritional needs of preschool age children to help guide intervention development. The research aims were 1) to examine and describe young child (ages one to five) nutritional status as it relates to key nutrients associated with stunting and wasting; 2) to determine what key macro- and micro-nutrient deficiencies (primarily iron and zinc) are associated with wasting and stunting. Methodology: Study sample: Sixty-seven families with children ages one to five who participating in routine health care clinic visits during the UK Shoulder to Shoulder Global health brigade visits. Study design: A cross-sectional survey was conducted collecting demographic data, medical history, and dietary intake. Objective measures of height/length and weight were completed; and blood samples were drawn to measure serum micronutrient levels. Nutrition Data System for Research (NDSR) identified nutrient intakes for analytical comparison based on growth parameters. Nutritional and health status were compared to food security and World Health Organization growth reference points of standard deviations on Z-scores of height-for-age and weight-for-age. Analyses: Chi Square, ANOVA, and binary logistic regression tests were run using Statistical Analysis System (SAS) Results: Low serum levels of zinc and iron corresponded to low levels of dietary intake of zinc and iron, limited food security and moderate stunting z = -0 to 1.99 Standard Deviation. Conclusion: This study will inform a comprehensive nutritional intervention for this population. The evidence that specific nutrients are limiting will focus the health promotion objectives.