The prevalence of obesity and associated risk factors among school children in primary schools in Lusaka, Zambia

Abstract

Obesity in children is a complex disorder characterised by the excessive fat accumulation that may impair health. Obesity is fast becoming a major public health concern in Zambia especially among the urban population. This is attributed to the changes in lifestyle and dietary habits. The objective of this study was to determine the prevalence of obesity and associated risk factors among primary school children of Lusaka District. This was a cross-sectional survey was conducted of children 7-12 years old in day primary schools in Lusaka District, Zambia over a period of six months (October 2017- March 2018). The study was conducted in 14 schools, using a stratified multistage sampling. Two schools, one government and one private were selected randomly from each of the seven constituencies of Lusaka district. The pupils in each school were selected randomly using a probability proportionate to size sampling strategy. A total of 556 eligible pupils were recruited. Information collected included anthropometric measurements, school head teacher reported, parent/guardian-reported, and child-reported questionnaires on lifestyle, diet and physical activity. The prevalence of obesity was 8.8 percent and overweight 12.6 percent among the participants with the burden increasing with age (OR = 1.35, 95%, CI = 1.05 – 1.74, P-value = 0.02). Boys had on average 38% reduced odds for overweight/obese weight compared to girls [Adjusted Odds Ratio (OR) = 0.62, 95% Confidence Interval (CI) = 0.40 – 0.97, P-value = 0.034]. Pupils in private schools had on average twice increased odds for overweight/obese weight (OR = 2.26, CI = 1.47 – 3.48, P-value < 0.001) and those that watched television for less than one hour had on average 55% reduced odds for overweight/obese weight (OR = 0.45, CI = 0.25 – 0.81, P-value = 0.007). The risk factors associated with obesity include female gender, enrolment in a private school and proloned watching of television. Primary preventive measures for childhood obesity should start early in childhood and address the school environment and socioeconomic determinants of parents contributing to childhood obesity. It is imperative that the level of physical activity needs to improve in schools through physical education and sporting activities. Parents need to limit time their children spend on the electronic gadgets and encourage physical activity in order to reduce the mortality and morbidity associated with obesity. Key words: Lusaka, Children, Obesity, Physical Activity, Diet, Lifestyle