- .,.OC::IOIW'
Basuto1and 1
AFR/ITUT/12 18 Jtu.1e 1962
ENGLISH ONLY
REPORT Oli A NUTRITION SURVEY COI>TDUCTED IN BASUTOLAI'])
FROfi 1956 TO 1960
by
Dr J. A. liunoz, \~IHO Senior tiedical Officer, and 1Iiss II. i\.I. Anderson, IillO Hutri tionist
8~854(66)
CONTENTS
l • 2.
TITT RODUCTI Ol'i" •••••• • •••• l'OLICY ll.DOPrED
o • • • • • • • • •
• • • • • •
• • • • • • • • •
• • •
ASSIG:riT1lEHT AND TERl\IIS OF P.EFERE ,~CE •••••• • ••••• 0
o .. o........
1 1 1
3. 4.
••••••••••••••••••••••••••••••
GEOGRAPHICAL, TOPOGRAPHICAL Al>ill CLI:'.Lli.TIC CHAP~CTERISTICS
5. 6. 7. 8. 10 •
GOVERNMENT
........................................ . o • • • • • • • • • •
••••••••••••••••••••••••••••••••••
3 4 5 7
DEPARTMENT OF l'.,EDICAL SEF.VICES ••••••••••
DEPAffi'1r:ENT OF LIVBS1'0CK AliD AGRICULTURAL SERVICES • • DEPARTMENT OF EDUCATIOB •••••••••••••••••••••••••••• HEIGHTS AND 1:.IEIGHTS ••• EIIDE~iiiC
9 10 14
9. VITAL STATIS'riCS, DYHA..iVIIC DE .:OGRAPHY • • • • • • • • • • • • • • • o • • • • • • • • • • • • • • • • • • • • • • • • • • • •
11 • 12. 13 • 14.
S1.IN -FOLD li:JEJJ..SURES •••••••••••••••••••
o • • • • • • • • • • • • •
17 18 20
GOITRE •••••••••••••••••••••••••••••
o..... ..
SERT.J.:" PROTEIN DOUliD IODiliE AJ.IID CHOLESTEROL LEVELS EFFECT OF FOTASSIUI'i~ IODATE OL ifOilllAL .AJ:fD GOITROUS SCHOOL CHILDREN \liTH REFERENCE .TO lHTGLLIGENCE AJ.ITJ) CHOLESTEROL· LiTVELS • • • • • • • • • • • • • • • • • • • • • • • • • • •
24
15. PELLAGRA STUDIES •••••••••••••••••••• 16. K\/ASHIOill<:OR .Al.ffi HARASI;illS 17. 18.
...........................
o •••••••••••••••
26 35 37 38 38 48
CLINICAL FINDINGS OF THE GEHERAL NUTRITIOH SURVEY •• NUTRIENT lliVELS TIT THE SERA OF THE POPULATION •••••• DIETARY STUDIES • •••••••••• 0 ••••••••••••••••••••••••
19. 20.
LONGITUDINAL .rffiTRITION SURVEY
•
..... 0
••••••••••••••••
21. 22. 23. 24.
COMPARISON OF DIFFERENT TYPES OF DIETS ••••••••••••• NUTRITION EDUCATION AND TRi'.JHING OF PERSOlil!.!..L •••••• SOCIO-AfTHROPOLOGICAL AND ECONOEICAL DA'l'A •••••••••• COn CLUSION .AJID SU11iARY ••••••••••••••••••••••••••••• RECOM1'!EJ:IIDAT IONS •••••••••••••••••••••••••••••••••••• ACEliJ'OI?T,"RDGEl:IE:l'lTS TABLES 1 to •••••••••••••• Q •••••••••••••••••••
51
52 52 53
25. 26.
55 57 59
0
ANNEXES:
49 ••••••• o • • •
• • • • • • • • • • •• ••• • •• •• •
,
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AFR/NUT/12 page 1 1. INTRODUGriON Dietary deficiencies have been known to exist in Basutoland for a long time. than fifty years ago Dr McFarlane reported the first cases of pellagra, in 1949 Dr Underwood-Ground reported kwashio~kor and in 1948 Dr Whitworth reported that the r~ore
average Mosotho child was three years behind the average London child, both in weight and in height. poor Basuto. Recent annual reports of the Department of Medical Services show that dietary deficiency diseases are on the increase, while reports from the Department of increase in importation of the staple food, maize. 2. ASSIGNMENT AND TERMS OF REFERENCE With this background the Government of Basutoland applied to the World Organization for "Technical Assistance towards a Nu~ri tional Heal~h
The last finding was confirmed by Dr Jacques in 1955 and supported by
Dr Pottiger who in the same year conducted studies among the children of weal thy and
Liye~tock
and Agricultural Services show reduction in production of food, coupled with an .
Survey
~d
Control Wi ~hin
the Territory in order to assess the problem and the best means of combating it" • .In reply to the application, Professor W. J. Darby and Dr B. Stew~t
were appointed by
WHO as nutrition consultants, and a visit was paid by them to Basutoland from 22 to 28 November 1954. · Amo'ne; dther recominendations made by the two consultants was that a general nutrition survey should be conducted. In answer to this recommendation, the .WHO Regional Office for Africa appointed Miss M. M. Anderson as non-medical nutritionist in January 1,956, and Dr J. A. Munoz as medical nutritionist in September 1956. Both members of the team worked together until January 1959 when Miss Anderson was seconded to FAO for a short period and assigned to a nutrition education programme in Thailand.
3.
POLICY ADOPI'ED
3.1 After arrival in Basutoland, the non-medical nutritionist made official contact with both British and Basuto authorities and colleoted local information 9n nutrition, public health, agriculture, education, etc. Pilot surveys and training of local personne When the medical nutritionist both in theory and in practical work, were commenced. conditions pertaining to:
arrived, a programme of work was planned so that knowledge could be gained on local
AFR/NUT/12 page 2 3.1.1 3.1.2 3.1~3
Geographical, topographical and climatic characteristics. Population, vital statistics, dynamic demography, etc. Heights and weights. Skin-fold measures.
3.1.4
3.1.5 Endemic goitre. 3··1 .6 Serum protein-bound iodine and cholesterol levels in goitrous and non-goitrous children. ').1. 7 ' Effect of potassium iodate on goitrous and non-goitrous school children with reference to intelligence, P.B.I. and cholesterol levels. 3.1.8 Pellagra. 3.1.9 Kwashiorkor and marasmus. 3.1.10 Clinical conditions related to malnutrition. 3.1.11 Nutrient levels in the sera of population. 3.1.12 Dietary pattern. 3.1.13 Socio-Anthropological and economical factors. 3.1.14 Public health. 3.1.15 Livestock and agriculture. 3.1.16 Education. 3.1.17 Administration. -3• 2 In most cases knowledge ·was gained by conducting surveys, for each of which a In each project of work, the title, background of the problem,
specific project of work was prepared and submitted to the WHO Regional Office and to the Government. objectives, material and methods to be used, duration, budget and personnel responsible were discussed in detail. By presenting these projects of work it was possible to keep the Regional Office and the Government ·informed of what was to be undertaken, to receive comments and, if necessary, to make modifications to the projects. Based on these projects of work it magnitud~
was possible to study the factors responsible for the occurrence and
of the
dietary deficiency diseases from a public health point of view, to check progress of work, to evaluate the surveys conducted and finally to draw conclusions and make recommendations.
AFR/Nill/12 page 3 The authors wish to state clearly that this report is, of necessity, heavily condensed due to many factors, not d~scussed
here, that were the subject of special. :
correspondence with the Organization. The authors are grateful to all those who, by their contributed to the success of the work. Having assess~d
constructive criticism,
the nutritional status of the
Basuto~
it was possible to recommend
the necessary measures which should be taken to combat malnutrition in Basutoland. 4. GEOGRAPHICAL, TOPOGRAPHICAL AND CLIMATIC CHARACTERISTICS
4.1 Basutoland is an enclave within the Republic of SQuth Africa (see map), its boundaries running with those of Natal Province to the Gast, Cape Province to the south, and Orange Freestate to the north and Hest. south latitude and 27°30' -east longitude. being mountainous. It is between 28 11 35' and 30°40' three quarters It comprises an area of 11 716 square miles,
of which about one quarter in -the tiest is lowland country, the remaining their sources in the mountains of Basutoland.
Many of the largest rivers in the Republic of South Africa have
4.2 The lowlands, 18.4% of the total area of the country at an elevation of 5000 to 6000 feet above sea level, cover 2160 square miles~ of which 821 square miles (30.0%) are arable, 1205 square miles (55.7%) are grazing lands and the remaining 134 square miles (6.~) are rocky hills, roads, houses, etc. The total area of arable and grazing Much of lands is reduced by "dongas" which are eroded channels starting on the slopes of the hills, penetrating deeply into tne arable and grazing' lands in the valleys. lowlands being heavily laden with silt during the rainy season. of land, situ~ted
the fertile top soil is lost to the country in this way; the streams and rivers of the In this narrow strip in the west of the territory, approximately 80% of the population is
domiciled. 4.3 Climatically~
Basutoland is characterized by four months of winter with heavy snow, These two seasons are broken by a short Rainfall
gales and blizzards especially in the mountains, and four months ·o f bright summer with pleasant days, heavy rains, hailstorms, etc. spring from September to October, and a short autumn from March to April.
is variable and averages twenty eight inches a year over the greater part of the country.
AJlR/NUTj 12 page 4
5.
GOVERNMENT worl~s
5.1 At the head of the Government is the Resident Comrnissioner who who is also the High Commissioner to the Republic of South Africa. who works in close co-operation with the principal or ward chiefs. The loc~
under the
Direction of the High Commissioner for Basutolana, Bechuanaland and Swaziland, and For administrative purposes the territory is divided into nine districts, each with a District Commissioner
authority in each district is the District Council which has certain Its members are elected from a single role for Basuto and non-B~suto,
local powers.
British subjects and British protected persons. As a·result of constitutional reforms which came into operation in March 1960, the territory has an Executive Council which is the main policy making body, and a Legislative Council, known as the Basutoland National Council. The Executive Council consists of the Resident Commissioner who acts as Chairman, the Government Secretary, Financial Secretary, Legal Se'c retary, three persons. chosen by the Basutoland National Council among their own number, and one person nominated by the Paramount Chief. and non-elected members. The former are elected by district councils sitting as The non-elected element is made up of three of p~rsons
The
Basutoland National Council consists of 80 members, divided equally between elected electoral colleges for that purpose.
the official members of the Executive Council {excluding the Chairman), the. Commissioner for Local Government, the 22 Principal and Ward Chiefs, and 14 nominated by the Paramount Chief.
,.
. The Basutoland National Council has power to legislate for all persons in Basutoland in r.espect of all matters, save the following which are matters for the High Commissioner: external affairs and defence, internal security, currency, public loans, customs and exqise, copyright, post and telegraphs and the recruitment etc. of officers to the Public Service. 5.2 The Basutoland Courts of Law consist of {a} the Court of Appeal, (b) the High Court, (c) the Subordinate Courts including the Courts of Judicial Commissioners, and (d) Basuto Courts. Appeals lie to the Privy Council by leave of the Chief Justice of the High Commission Territories who is also President of the Court of Appeal, and has jurisdiction in all cases, both civil and criminal, which arise in the Territory.
,. AFR/NUT/12 page 5
5.3 The land is held in trust for the Basuto available fGr settlement. and commercial enterprises.
by
the Paramount Chief and is not made
Sites are, however, granted for missions, schools, trading
5.4 There are no railways in Freestate.
Basutol~nd
with the exception of one mile of the
Sout~
African Railways which enters the country at M aseru, the capital town, from the Orange The districts of the lowlands are connected by a road which commences in Butha-Buthe in the north and runs to Quthing in the south. The two Governmental Administrative Headqual~ters
of the mountain districts are not Qacha's Nek is accessible by
connected directly by road with the lowlands of the west.
road from Matatiele in the Republic of South Africa, and a jeep service from Himeville in the Republic of South Africa through the Sani Pass to I'-'lokhotlong recently came into operation. A private air company, known as "Basuto-Air" operates scheduled flights from Maseru to Mokhotlong, Sehonghong, Semonkong and a number of other places, used principally by traders for transporting merchandise to and from their stores, and for mail service. The district headquarters are connected by telephone and telegraph services, with the exception of -Mokhotlong in the mountains which is c'oimected by radio.
6. 6.1
DEPARTMENT OF r.'JEDICAL SEJWICES In Basutoland there are 13 hospitals with a total of 915 beds. Of these hospitals,
9 are governmental and fall under the Department of Medical.Services and 4 are private and are run by the russians. There are ·u maternal and child. health clinic::;, 18 antenatal clinics, 20 venereal disease clinics, 4 health centres, 4 mountain dispe1w~1e~, 11 X-ray plants, 55 outpatient clinics attended by doctors, 43 attended by nurses, health assistants or medical aids, one leprosarium and one mental detention centre. 6.2 The staff of the Department of Medical Services consists of: medical officer of health and one medical officer of mental health, In the second division there are one pharmacist, one matron and her assistant, one sister tutor, three nursing sisters, one male mental nurse, seven ward sisters, in the first division,
the Director of Medical Services, one surgeon specialist, 20 medical officers, one
M'RjNUT/12
page 6 two health inspectors and a number of auxiliary and administrative personnel. In the third division there are four home -nutritionists, · six health assistants, three sanitation assistants, 29 dispensers, 64 staff nurses, 58 student nurses and a number of auxiliary and administrative personnel. , In ~ddition,
there are seven mission doctors and five private doctors in the
territory.
6.3 With the limited personnel and facilities available, the Department of Medical Services is responsible for both curative and preventive medicine. medicine is of necessity demanding most of the attention. For the improvement of the health of the population, increased attention be given to public health problems of which the following four are of major sho~id
At present, curative
i~portance:
communicable diseases, environmental sanitation and maternal and child health; all these are asso9iated with the fourth and most important public health problem which is malnutrition.
6.4 With regard to communicable diseases, the country is free from tropical diseases such as malaria, bilharzia etc., but outbreaks of typhoid fever, typh"s, diarrhoea, influenza, etc., do occur. semi-urban areas. Environmental sanitation is generally poor, sewage and refuse disposal are non-existent in rural areas and not entirely satisfactory in the Water supplies are often contaminated with human faeces, especially Ideal breeding places for flies are numerous and, as foods There are no markets, but produce is With the exception of Maseru and With a fe>lf exceptions, hygienic during summer when it -rains.
are seldom protected, contamination is frequent. - .' Mohale s Hoek there are no satisfactory abattoirs.
often sold in the streets without any protection.
conditions in public places and schools are not good.
6.5 The maternal and child health services are at present very limited, Ante and post natal care is given by the doctors at the hospitals, at the various clinics and at private clinics which are run by volunteers. the rural unqualified midwife. At village level the problem is left to In the interest of public health it is important that
this much needed service should be strengthened.
AFR/NT.Jr/ 12 page 7 Dr R. E. J. Clarke, Medical Officer-in-Charge, was awarded a WHO fello\<rship to enable him to visit maternal and child health programmes in different parts of the world. Dr Clarke returned recently and will be responsible for the organization of It is suggested that he should be assisted by two medical officers, The public health obstetrician and gynaecologist this programme.
one obstetrician and gynaecologist and one paediatrician, both with further specialization in public health. should be in charge of the maternal health, and the public health paediatrician should be in charge of the child health in the programme. These two public health officers should implement the maternal and child health programme and should assist the doctors in the territory in improving the diagnosis and treatment of gynaecologic. obstetric and paediatric cases. In the practical implementation of the maternal and child health programme, they should be assisted by public health nurses, midwives, and nutritionists who should, in turn, be responsible for the teaching and t~aining
of rural unqualified midwives in Until such time as it
maternal and child health, midwifery, hygiene and nutrition. to be the most practical approach to the problem.
becomes possible to provide qualified midwives to work at village level, this appears
6.6 Finally, it is suggested that every effort should be made by the Government to strengthen the health services by increasing the number of public health personnel, namely doctors, sanitary engineers, nurses and health inspectors, etc. emphasis on nutrition. High priority should be given for a medical officer to be trained in public health with special
7.
DEPARTII'lENI' OF LIVESTOCK AND
AGRICULTURAL SERVICES
7.1 Livestock and agricultural policies are formulated and implemented by this Department. The staff consists of: the director, the principal veterinar1 officer, the principal agricultural officer; soil conservation officer, wool and mohair officer, veterinary officer, statistics officer, agriculture officer, agricultural education officer, animal h~sbandry
and forestry officer, two senior agricultural and livestock
officers and two agricultural and livestock officers, ten district livestock and agricultural officers, 253 administrative personnel. demonstrators~
as well as a number of auxili.ary and
AFR/Nm/12 page 8 In 1955, an Agricultural Colle8e was opened, and from 1955 to 1960 fifty seven students graduated. There are at present 35 in the College. Entrance is limited The College can at to those wh6 have obtained a Junior Certificate (Standard 8). in the near future.
present accommodate forty students, but there are plans for extension of the College
7.2 Information collected in the survey revealed that: (a) Stoclc is distributed among families as follows: More than 20 cattle and 50 sheep........ . ............ From 10-20 cattle ~d 20-50 sheep.................... From 5-9 cattle and 10-19 sheep········~··~·········· From 2-4 cattle and 5-9 sheep •..••.•••.•••••.....•..• Less than 2 cattle and 5 sheep •...•....••..•...•....• (b) The country is at present considered overstocked.
4.6% 6.1% 16.1% 21.6% 51.6%
Grazing lands are in. poor ~
condition as it is impossible for the Government, with limited facilities, grazing lands as they are communal. pint per cow per day. NOTE: ,.
control
these vast areas, and cattle owners are not genuinel_y interested in improvement of the The average milk production is approximately one
The Government biennial livestock census for 1957 gave the following figures: Cattle Horses Mules Donkeys Sheep Goats 1
387 769 89 874 4 220 55 813 300 657 594 395
During, 1959, 7 223 109 lbs of wool \'lere exported to the value of £830 903 at the coast. The tptal quantity of mohair exported during the same year was 1 081 470 lb_ valued at £371 619 at the coast. (c) The average agricultural production per fmnily per year is ' as follows: Maize Sorghum Wheat
3.6 bags (1 bag= 200 lb) 1.9 bags (1 bag= 200 lb)
0.5 bags (1 bag= 200 lb) .
AFR/NtYr/12 page 9 Beans Peas (d) Although .steps have been tru~en
0.2 bags (l bag
=
200 lb)
0.3 bags (l bag = 200 lb) to control the serious soil erosion, it still
remains a major problem. (e) The percentages of various fuels used by the householders are as follows: Manure, wood and weeds Wood and \'Teeds Manure only Wood and coal (f) 51.7% 38.5%
7-9% 1.9%
Indigenous trees are almost extinct, the few trees present are exotic.
This
is the main reason why manure is used for fuel to the detriment of the soil. (g) Fruit such as peaches, pears, apples, plums, etc., and crops such as wheat,
peas, beans, potatoes and vegetables grow well in Basutoland. (h) The information available on stock, agricultural production, exports and
imports, wastage, etc., is insufficient to prepare a food balance sheet, but based on the limited information available and on data collected it was possible to estimate an agricultural target per annum (see Table 1). NOTE: The short ton of 2000 lbs was used to compute the figures and the estimate is In addition to the above, 4500 tons each of fat and sugar
for a population of 800 000.
are required to provide approximately 1/2 oz per capita per day of each. 7.3 At present the Department of Livestocl~
and Agricultural Services is devoting
- ,... , ·- '
special attention to the recently formed Progressive Farmers Association which is made up of farmers from all over the territory who are obviously-willing to develop their holdings scientifically. As this Association is made ·up·of volunteers seeking guidance and assistance, it offers a good medium for extension of not only agricultural but nutrition and health education as well.
8. 8.1
THE DEPARTMENT OF EDUCATION In Basutoland there are 1050 primary schools, of Nhich four are Government, five·
are committee controlled, 864 are aided mission and 177 are unaided mission schools.
AFR/NUT/12 page 10 The total enrolment is 128 248 children. The total enrolment is 1621 children. There are 21 secondary schools, of which
four are Committee controlled, 13 are aided mission and four are unaided mission schools. There are seven teachers' training schools, all There are There is of which are aided by missions, \'Ti th a total enrolment of 521 students. and. l8 are unaided mission schools. and 3 females are Basuto. The total enrolment is 688 students.
27 technical and vocational schools of which one is Goverl¥uent, 8 are aided mission a University College with an enrolment of 112 males and 27 females, of which 17 males In addition, there are 10 Basuto attending Universities in the Republic of South Africa, 14 attending Universities and Colleges in the United Kingdom, 3 in Southern Rhodesia, 3 in United States Universities and 3 in Indian Universities. 8.2 The staff of the Department of Education consists of the director, a vice principal, 5 education officers, 3 assistant education officers, 6 supervisors and one domestic science inspectress. 33 are post secondary. 8.3 From the above information it can be seen that 131 078 children attend school. This represents 16.3% of the total population so that the rate of literacy in Basutoland can be considered comparatively high. This makes the application of nutrition, agricultural and health education more simple. 9. VITAL STATISTICS , DYNAf.'I IC DE1'-10GRAPHY There is a total of 2636 teachers of which 2447 are primary, 82 secondary, 33 technical and vocational, 41 for teacher training, and
9.1 Basutoland has a population of 788 452, of which 99.63% are Basuto, 0.25% are Whites, 0.003% Asians and 0.09% of mixed race; of the 99.63% Basuto, 80.4% live in the territory and the remaining 19.5% (14.2% males and 5.3% females) live temporarily in · the Republic o~
South Africa where they are employed in industry.
Although a territorial
population census was conducted in 1956 and provided valuable and much needed information, public health data such as infant and child mortality, birth, fertility and death rates were not collected. As is generally known, these public health indices are of great assistance in assessing the nutritional status of the population so that it was necessary to gain some infornation in this field.
AFR/NT.Jr/12 page 11 9.2 For this purpose, a random sample of 29 villages in eight of the nine districts of the territory \'las studied. The number of the villages was determined to a certain One district had of I
extent by the time, personnel, and local facilities available. mountains, with very difficult means 'o f transport and SI?.ars~l,Y.
necessity to be omitted from the sample as it is not easily accessible, being in the populated.
9.3 A house-to-house census was conducted in the 29 villages (see map), and the data necessary to determine the sex and age group distribution of the population, absenteeism, infant and child mortality, crude death, fertility and birth rates were collected by questioning the householders as there is no compulsory registration in Basutoland. information collected by this method is not 100% reliable, thus the different rates based on it are also subject to discussion and criticism. obtaining some data in this field. There was no other way of So, even though the present information is not The The
sufficiently reliable, at least it provided some guidance and gave enough proof to recommend to the Government the establishment of a vital statistical section. findings are discussed below and must be taken as not sufficiently reliable. 9.4 Sex and Age Group Distribution of the Population The findings obtained are compared l'Ti th those of the 1956 census conducted by Taylor et al and are presented in Table 2. 9.4.1 The figures compare closely; the discrepancy in the over 50 years age group is probably due to the fact that the dom known. chrono~ogical
age of those in this group is sel-
The information gained gives a guide to the. number of people who fall
within the vulnerable or "stress" groups and is useful when planning national programmes. 9.4.2 Of the total population, 50.5% were below 14 years of age, 41.6% between 15 and This distribution follows a similar pattern
49 years and 7.8 above 50 years of age.
to that of other countries in Africa where such studies have been conducted.
9.4.3 The 1-4 years pre-school and school age group represents 61.6% of the total male population and only 39.4% of the total female population, while in the 15-49 years -vmrldng age group the position was reversed: 31.7% were males and 51.5% females. In the 50 years and over group, 6.6% were males and 9:1.% females. In the working age group, males were in the minority which may be due to the fact that, by the nature of
AFR/NTJr/12 page 12 their work, males are more exposed to death than females and that some of the men of this age leave Basutoland permanently in an attempt to improve their economical standing.
9.5 Absenteeism in the Territory 9.5.1. ~~
migratory labour is so prevalent in the territory, informatiop was gained in the same 29 villages in which population .,
o~
this . were
im~ortant asp~ct
~tudies
con?uc~~d •
. r fb.e findings are presented in Table 3 . . '
It was learnt that absenteeism is due mainly to economical, social and educational factors '.
The
peasant's are poor and produce from the lands is often insufficient to Bachelors require money to marry as a dowry is customarily given Boys are often employed to herd the stock and attend . '
support the families.
to the ·father of the bride. advanced than they.
school irregularly and, at a late age, only to find that girls of lower age are more In defence they seek employment in industry in the Republic of Finally, many of the males South Africa, save money and return with enhanced prestige. adventure.
and some of the females go to the cities of the Republic of South Africa to seek
9.5.2 Approximately 50% of the males and 14% -of the females of working age group were periodically absent from the country which meant that the 41% of the population which fell within the working age group was further reduced to 26% who were responsibie for 'producing enough food for the totnl population. Of this group, the proportion of males to females was 1 to 2.4, showing that the women, in addition to their routine household tasks and care of the children, were compelled to contribute largely to the agricultur~l
production.
9.5.3 These demographic data, together with other problems which are known to occur, such as soil exhaustion and erosion, minimal use of fertilizers, loitT
agricultural
production, lack of crop rotation, poor and primitive m ethods of agriculture, overstocldng, the unsatisfactqry land tenure system, the high percentage of malnourished people, the habit of consuming excessive amounts of alcoholic beverages without a wellbalanced diet by a large proportion of the population, and poor diet consumed generally, make it clear that proper action. gradua~
deterioration can only be prevented by immediate,
urgen~
and
AFR,/NUI'/12 page 13 9.6 Infant Mortality Information on infant mortality was not available so that it was necessary to devise means of collecting data on this problem. Age, sex ~d
dates of birth of all 1rlhen
members of the family and deaths were recorded on specially prepared protocols. to.
these dates were not known, a calendar of important events ih Basutoland was referred The infant mortality findings, for a period of seven years, are presented 1n Table 4. The weighted average infant mortality for the period of 7 years was 93.2 per 1000. This rate is considered high as Basutoland is free from tropical diseases. Malnutrition, diarrhoea, and respiratory diseases are the main causes of infant mortality.
9.7 Child Mortality Rate (1-4 years) The mortality rate of the 1-4 year age group was studied in the same .population for the same period, and the findings appear in Table 5. for the period was 136 per 1000. The weighted average rate
9.8 Crude Death Rate The crude death rate was studied from the same population, and findings are presented in Table 6. period studied. The table shows a small variation during the seven year The weighted average rate for the period was 8.6 per 1000.
9.9 Fertility Rate The fertility rate of the same population for the same period is shown in Table 9,10
7. The weighted average was 130 per 1000. Birth Rate
The information on birth rate of the same population for the same period is shown in Table 8. The weighted average for the period was 31;4 per 1000. A 2% increase of the population has been estimated. NOTE: All the rates were computed in accordance with the definition given by A. Bradford Hill in "Principles of Medical Statistics". Again all these rates must be judged with caution because of the source of information. One positive result of this study was that the Government made immediate plans for the compulsory registration of births and deaths,
AFR/NUT/12 page 14 10. 10.1 the
HEIGHTS AND 1 •JEIGHTS The heights and weights of approximately 7000 individuals of both sexes and from From the public health point of vievr,
a few days old to 69 years of age were recorded. ~eights
and weights of the children are good indices of the nutritional status of
the population, and the preventive measures adopted should aim at improvement of the health of this group.
10.2
Heights A right angle triangle was used for measuring and heights 11-rere recorded in L'lches
to the nearest v.rhole inch, measurements being taken vri thout shoe::..
In cases >'lpere
measurements were exactly one half inch, readings were taken to the nearest even. inch, according to the method recommended by the United States Inter-department.al Comrni ttee on Nutrition for National Defense (USA/ICNND) .
. 10.3 "ltJeights Springless scales t-lfere used for Neighing. Weights vrere recorted in lbs to the
nearest whole pound, the weights beL"1g taken with minimum clothes and vli thout shoes. In cases where the 11-1eights were exactly half pound, recordings were to the nearest even pound, again in accordance 11-ri th the method recommended by the USA/ICNND.
10.4
The heights in inches of 3350 children and the weights in pounds of 3181 children, fro~
ranging. in ag.e
one mopth to 20 years, were taken and presented in Table 9.
Adult
weights taken \·rere omitted from the table, and the size of the sample in the under 2 years age group was too small to be broken dm-m into months. From Table 9,. the number
of cases and the mean heights and 1 ·'eights with their respective margins :::>f variation for Basuto males and females for each chronological year can be seen.
10.4.1
In the Project of Work entitled
11
Survey of the Heights and VJeights of the
Basuto", presented to AFRO and Basutoland Government in March 1958. two main objectives were stat~d,
namely:
(a) To assist in the assessment of the nutritional status; (b) To attempt to establish height and "\I·T eight standards for Basutoland, to be used for public health purposes.
AFR/rnir/ 12 page
15
In order to fulfil the two objectives mentioned above, it was necessary to compare the results of the heights and weights survey with reliable figures of any country or area where standards have been developed in accordance with: (a) {b) Statistical requirements, and based on a health well-nourished sample.
As the Institute de Nutrioion de Centro America y Panama - INCAP (Institute of Nutrition for Central America and Panama) has developed such standards in accordance with the above requirements and they have been used in developing countries, it was decided to use them as the best presently available for Basutoland as presented in Tables
10 and 11.
10.4.2 When comparing Table 9 (Mean and Standard Deviation of Heights and Weights of Basuto) with Tables 10 and 11 {Heights and Weights of INCAP Standard), it is easy to realize that the means for the Basuto sample are below the INCAP standard. the so-called "norma.l 11 that attend. schools. 0 0
This fact
was expected as the mean for Basutoland represents the majority of malnourished children,
10.4~2
In order to assess the sample from Basustoland better, as well as to explore
the possibility of establishing a standard for Basutoland, the heights and weights of the Basuto children were divided into five groups for each chronological year, and the results are presented in Tables
12 and 13.
10.5 In Table 12, the frequency distribution of heights of 1247 male and 2103 female Basuto children are compared with the standard of the Institut8 ~f
lJutrition for
Central America and Panama (D~CAP), and the over-all findings were as follows: Males Females Both
10.5.1 10.5.2 10.5.3 10.5.4 10.5.5 10.5.6
Taller than llJCAP Standard Equal to INCAP Standard One year retarded Two years retarded Three or more years retarded Of the total male group, and
8.1% 6.0% 25.0.% 26.3% 34.4.%
8.5% 7-5%
8.3%: . ;; 6. 7% 25.5% 27.0% 32.2%
26.0% 27.8% 30. CY/o
14.1% were equal to or taller than the standard,
85.7% were below.
AJJ'R/HTJT/ 12. page 16 10.5.7 ·Of the· t ·o tal female group, 16.0% 1-rere taller than. or equal to the standard, and 83.8% were below. 10.6 10.6.1 10.6.210 .'6'. 3 10.6.4 Weights were also compared 1-rith TITCAP Standard (See Table 13) and were tabulated into five groups as follows: Group I, heavier than the INCAP standard. Group II, equal weight to the INCAP standard. Group III, malnutrition grade I, from 10% t o 24% less ~V"eight than UJCAP standard. Group TV, malnutrition grade II, from 25% t o 39% less weight standard. tha~
the INCAP
10.6.5 Group V, malnutrition grade III, fram more than 40% less Height than the INCAP standard.
10.7
In Table 13, the frequency
dist~ibution
of the weights of 1190 boys and 1991 Males Females Both
girls are shown and the over-all findings were as follm'IS:
10.7.1 10.7.2 10.7.3 10.7.4 10.7.5 10.7.6
Heavier than the standard Equal to the standard Malnutrition Grade I Malnutrition Grade II Malnutrition Grade III Of the total male ~~oup,
8.0% 16.9% 43.6% 26.9% 4.3% 01'
10.2% 17.8% 39.>% 28.y(o 3-7% The 74.8;6 belo~tr
9.1% 17.?1% 41.6% 27.6% 4.0% were
24.9% were heavier than
equal to the TI\fCAP
standard and should be considered well-nourished.
obviously suffering from malnutrition grades I., II or III.
10.7.7 Of the total female group, 28._9% were heavier than or equal to the INCAP standard and should be considered well-nourished. The 71.7% below were obvious~y
s'l:!ffering from malnutrition grades I, II or III.
10. 7.8 The large per.centage of population that was equal to or above the INCAP height and weight.standards suggests that the rest of the population could, with better diets and enviro11mental conditions, also reach these standards. It can therefore be concluded that the INCAP height and weight standards could be used as the "local standards" for public health purposes lintil such a time as Basutoland develops its own standards. 1
AFR/NUT/12 page 17
10.8
In contrast with the above, the i:Jeans vf heights and \·Teights, with their respective standard deviations, obtained from the average so-called "normal 11 pop\,llation are of limited value for establishing "local standards" as they are largely influenced by the undernourishment or obesity of the population. illustration can be obtained when comparing Table 9 with Table 11. A clear For example,
in Table 9 the mean height for the eight-year old males \• ras 37 inches and mean weight was 46.7 lb which, according to the INCAP standard, should have been 50.4 inches and 56.2 lb respectively. In Table 12 it can be seen that the heights of 17.3% of the boys of.this age were 50.4 inches or more, and in Table 13 it can be seen that the weights of 32.4% of the boys of this age were 56.2 lb or more, sd that it would be inaccurate to use the "local means" as the local standards. 11. SKThi-FOW MEASUREMENTS
11.1
The thickness of the subcutaneous tissues is a good index of the calorie adequac y Measurements of 2255 individuals of both sexes and ranging in age from The subcutaneous tissue of the triceps, sub-scapular and the The findings e.re shmm in Table 16.
of the diet.
2 to 20 years were taken.
linea alba were measured with a Harpenc.len Sldn-Fol.d Caliper and measurements were recorded to the nearest 0.1 mm.
From the table it can be seen that the measurements of boys and girls are of similar pattern until the age of fifteen years, when there is a remarkable increase in the thiclQQ~Ss
of the subcutaneous
t~ssue
of the girls in all those places where
measurements were talcen.
These findings are in agreement with the individual dietary
studies conducted among thirty persons, of vrhich there were 5 males and 6 females in the 13-15 year age group, and 0 males and 10 fem ales in the 16-20 year age group. In
the 13-15 year age group the percentage of adequacy of calories was 71.1 for the females and 57.7 for the males. In the 16-20 year age group the percentage of adequacy of calories was 90.2 for the females and 64.4 for themales. 11. 2 The am skin fold thiclmess of male and female Basuto Y.fere compared vri th the Canadian standards and the findings are presented in Table 16A. From the table it can be seen that from 6 years of age, the means of the Basuto sample fell below the Canadian standard, but when the frequency distribution of the measurements talcen for each age group v.ras studied, it \'las found that a large percentage in each aGe group was equal to or above the Canadian standard, as can be seen from the fourth and fifth colun1ns of each sex in Table 16A.
nJ."I •/!·JU'J.j 12
page 18 11.3 As there were 36.1% of males and 33.6% of fem ales of the sample that were equal or thicker than the standru~d
used and for the srune reasons as discussed under height standa1~d
and weight studies, it can be concluded that the Canadian standard skin-fold thickness could, for public health purposes, be adopted as the is developed for Basutoland. "normal 11
for the Basuto until one
Once again it can be seen that the means of the so-called misleading and should not
individuals of an undernourished population can be 11
be .used as 12. 12.1
local standards".
ENDEMIC GOITRE The sample surveyed included more than 14 000 individuals of both sexes of all
ages from lowlands, foothills and mountains of the seven districts of the territory. The two districts which were omitted from the survey are mountainous and not easily accessible. These two districts are the least densely populated and probably have a e~demic
similar or higher incidence of
goitre.
12.2 The technique used in the St.l!'vey was that recommended by Perez, Scrimshaw and Munoz in the WHO Bulletin 1958, 18-27, 232 modified to suit local conditions, as described by Munoz and Anderson in the \1/HO Bulletin 1959, 21, 715-720. findings are presented in ·rable 17. From the table it can be seen that in all age groups, the percentage of positive cases -vras high. Even in the lowest age group the percentage was over The over-all
30%.
Unlike the
findings in many cot.mtries, "''here the number of females affected vras higher, in Basutoland there Nas no significant sex difference in any of the age groups. There was,
however, a significant difference in numbers affected (both male and female) in the different age groups, the average varying from 32% in the l-12 year age group to 9W~ in the 19 and over age group. 12.3 The pupils from 43 schools in seven di stricts of the lowlands lJTere examined and the incidence varied from O% in the European school children in Maseru, the capital to 72. 7% in a Basuto school in fiJafeteng in the south. 12.4 Of the positive cases, 95.6% were diffuse and 4.4% were nodular 01~ adenom atous. The nodular goitre ~o"'m,
Of the diffuse, 62.5% were ~~ade I, 33.3% grade II an~ 4.1% grade III. by the number of nodules).
were mainly grade I and II (nodular goitre Here classified according to size and not
AFR/NUT/12 page 19 12.5 The geographical distribution of endemic goitre is shown in Table 18. the north to over 50% in Quthing in the south. It can
be seen from the table that those affected varied from 30% in the Berea district in
12.6 The dietary studies show that large amounts of so-called goitrogenic foods of the brassica family such as cabbage, brussel sprouts, etc. were consumed throughout the year and that the average intaJ<;:e of coarse salt, of lm'l iodine content, >-ras lov-r, being approximately 5 gms per capita per day. 1
The diets Here of low nutritive value
with poor quality protein, derived mainly f1 om the maize which is the staple food. Indigenous plants were talcen regularly, wheat, sorghum and garden vegetables less frequently, peas and beans occasionally and meat, milk and eggs seldom or never.
12.7 In the European school in Maseru, no endemic goitre was found although some of the children were born and had lived all their lives in Basutoland.
12.8 Thus again one speculates as to •'lhether, in addition to iodine deficiency which is no doubt the main cause of endemic goitre, the biological value of the protein of the diet could be associated with the presence or absence of this condition. It appears that endemic goitre always occurs when the protein consumed is of poor biological value, hence the lower the biological value of.the protein, the higher the apparent tendency to develop endemic goitre.
12.9 Finally, there is no doubt that endemic goitre is a public health problem in Basutoland. Prophylactic measures should be taken to overcome the problem-, bear•ing in mind the following facts:
12.9.1 The high incidence in both sexes at all ages. 12.9.2 The constant prevalence throue;hout the territory. 12.9.3 The daily intal(e of foods 1r1hich might be goitrogenic. 12.9.4 The low intalce of coar::;e salt of lm'l iodine content (the highest being 1.39 parts of iodine to 100 000 p~rts
of
s~lt).
12.9.5 -The low nutritive value of the diet, with protein of poor biological v alue.
12.9.6 The hie;h incidence of signs of Vltamin A deficiency. 12. 9. 7
The calcium content of the Hater r.1ay interfere Hith the trappine; of iodine by the
thyroid gland. 12.9.8
The level of iodization should be not more than one part of iodine to 20 000 ·
Parts of salt o.nd not less than one part of iodine i:R 40 000--parts of salt.
AFR/NUT/12 page 20
13.
SERill1 PROTEIN BOUND IODINE .AND CHOLESTEROL lEVELS D-1 GOITROUS AND NON-GOITROUS CHILDREN st~vey
13.1 The findings obtained in the endemic goitre the kind co-operation of Dr R~search,
conducted showed that additional By
information on the physiological behaviour of the thyroid gland should be obtained.
\v.
Pollitzer of t he South African Institute for Medical
Johan11.esburg, it Has possil:>le to study tbe protein bound iodine and The sample was drawn from the same
cholesterol levels in the sera of 616 Basuto.
districts where the endemic goitre survey i'tas conducted and included normal and goitrous persons of bpth sexes, ranging in age from 4 to 25 years. Three blood srunples had t<h~en
haemolysed on a.ri'i val at the laboratory, aJJ.d in nine the amounts to enable the tests to be performed.
were too small
13.2
The results a.c cording to age, sex, thyroid condition, number of determinations and It can be seen that of a total of 616 P.B. I.
means for each group are shmm in Table 19.
determinations, there vrere 331 from males and 285 from females.
13.2.1
Of the 331 males, there Here 129 normals and 202 goitrous, of Nhich there were The mean
101 \'d th goitre grade I, 96 Hi th goitre grade II and 5 with goitre grade III.
values \'tere 4. 7, 4. 6 and 4. 5 mici'ogram.r:1es of P.B~I. per 100 ml of sera respectivel:,•.
13.2.2
Of the 285 females, there were 92 normals and 192 goitreus, of i'thich there vtere The mean
37 vrith goitre grade I, 140 uith goitre grade II and 15 vrith goitre grade III.
values of F.B.I. ;-rere 4.7, 4.0, 4.2 and 5.4 microgrammes per 100 ml of sera. respectively.
13.2.3
Judging from the meaJJ. values of all the groups given ·above, it appears that the
average P.B. I. levels are within normal range indicative of a euthyroid state in the Basuto sample studied.
13.3
If 4 to 8 microgrammes of F.B.I. per 100 ml of sera are taken as levels for·normal
population, the Basuto sample Has d istributed as shmm in Tables 20 and 21.
13.3.1 Table 20 shaHs that of the 129 normal males, there vrere 29 (22.4%) F.B.I. determinations that fell below 4 microgrammes, none above 8 microgrammes and 100 (78%) that fell i'li thin 4 to . 8 microgrammes.
13.3.2
Of the 101 males suffering from goitre grade I, there were 23 (23.0%) 1•rhose
F.B.I. levels fell below
4
microgrammes,
5 (5.o%)
that fell above
8
microgrammes and
73 (73. 0%) that fell Hi thin 4 to 8 microgrammes.
AFR/NUT/la page 21 13.3.3 Of the 96 males suffering from goitre grade II, there were 27 {28%) whose. P.B.I. levels fell below 4 microgrammes, none above 8 microgrammes a~d 69 (72.%) that fell within 4 and 8 microgrammes. 13.3.4 Of the 5 males suffering from goitre grade III, there were 2 (40%) whose P.B.I. levels fell below 4 microgrammes, none above 8 microgrammes· and 3 (60%) fell within 4 and 8 microgrammes. The results of the P.B.I. determination in the female group are shown in Table . 21. It can be seen that: ~hat
13.3.5 Of the 93 ·normal females there were 15 (16%) determinations 4 microgrammes, none above 8 microgramme~
fell below
and 77 (84%) fell within 4 and 8 microgrammes. that
13.3.6 Of the 37 females with goitre grade I, there were 14 (38%) determinations fell below 4 microgrammes, none above 8 microgrammes and 23 (6~)
that fell within 4 and
8 microgrammes. 13.3.7 Of the 14o females suffering from goitre grade II,· there were 49 (35%) determinations that fell below 4 microgrammes, 1 above 8 microgrammes and 91 (65%) that fell withi~
4 and 8 microgrammes.
13.3.8 Of the 15 females suffering from goitre grade III, there were 2 (13%) determinations that fell below 4 microgrammes, none above 8 microgrammes and 13 that fell within 4 and 8 microgrammes. 13.3.9 These findings clearly indicate that regardless of the thyroid condition, there were an over-all of 24% P.B.I. determinations in the male group and 28% in the female group that fell below 4 microgrammes of P.B.I. 13.3.10 The over-all mean for the P.B.I. determination that fell below 4 microgrammes was 2.8 microgrrunmes for the male group and 2.9 for the female group, with standard deviations of 1.0 and 1.1 respectively. 13.4 These results are summarized in Table 22, and it can also be seen that: 13.4.1 In the male group, 22.4% of the normals and 25.7% of the goitrous had P,B.I.
levels below 13.4.2
4
micr~grammes.
In the female group, 16.0% among the normals and 33.8% among the goitrous had
P.B.I. levels below
4 microgrammes.
AFR/Nilr/ 12 page 22 13.4.3 Of a total of 81 (24.4%) F.B.I. determinations that fell below 4 microgrammes in the male group, 35.8% were in the normals and is statistically significant at a level of 0.05. 13.4.4 Of a total of 80 (40%) F.B.I. determinations that fell below 4 micro~ammes in the females, 19.7% were in the normal group and difference is also statistically significant. 13.4.5 The F.B.I. levels of six cases, five males and one female were found to be above 25 microgrammes per 100 ml of blood. As no signs of thyrotoxicosis were found among these cases .it was presumed that iodine, in some form, had been trucen. 13.5 Comparison of the findings of the F.B.I. determinations with those of the endemic Further research .is 80.~ 64.~
in the goitrous.
This difference
were in the goitrous group.
This
goitre survey conducted suggest that a correlation might exist. thyroid condition in a population. NOTE:
needed to support the suggestion that F.B.I. levels could be a possible index of the
The method used for F.B.I. determinations was that of Ieffter (1954), modif.ied
by Meyer et al. ( 1955). . 13.6 Cholesterol determinations were done in the same sample as the P.B.I. studies.
A total of 621 blood samples were studied, of which 129 were from non-goitrous male , "normals" and 202 \'Jere from goitrous males; 93 were from non-goitrous female "normals" and 197 were from goitrous females. for each group. The findings are presented in Table 23. The. results are shown according to age, sex, thyroid conditions, number of determinations and means It can be seen that of a total of 621 cholesterol determinations there were 331 from males and 290 from females. 13.6.1 Of the 331 males, there were 129 normals and 202 goitrous, of which there were The respect~vely. pe ~
101 with goitre grade I, 96 with goitre grade II and 5 with goitre grade III. mean values were 1)4, 123, 128 and 140 mg of cholesterol 100 ml of blood
13. 6. 2 Of the 290 females there w·ere 93 normals and 197 goitrous, of which there were 37 with goitre grade I, 144 with goitre grade II and 16 with goitre grade III. The mean values were 143, 148, 139 and 136 mg of cholesterol per 100 m1 of blood respectively. 13.6.3 Judging from the mean values of all the ~~oups given above, it appears that hypocholesteremia is very prevalent among the Basuto sample studied.
AFR/Nill/ 12 page 23 13.7 If 150 to 280 mg of cholesterol per 100 ml of blood are taken as levels for . normal populations, the Basuto sample was distributed as shown in Table~ 24 and 25. Table 24 shows that: 13.7.1 Of the 129 normal males there were 89 (69%) cholesterol determinations that fell below 150 mg, none above 280 mg and 40 (31%) that fell within 150-280 mg. 13.7.2 Of the 101 males suffering from goitre grade I, there were 75 (74%) cholestercl determinations that fell belm'l 150 mg, none above 280 mg and 26 ( 26%) that fell within 150-280 mg. 13.7.3 Of the 96 males suffering from goitre grade II, there were 7~ (82.%) cholesterol determinations that fell below 150 mg, none above 280 mg and 17 (18%) that fell within 150.28o mg. 13.7.4 Of the 5 males suffering from goitre grade III, there were 3 (60%) cholesterol determinations that fell belm'l 150 mg, none above 280 mg and 2 ( 40%) that fell within 150-280 mg. In Table 25, the results of cholesterol determinations in the female group are shown. It can be seen that:
13.7.5 Of the 93 normal females there were 54 (57%) cholesterol determinations that fell below 150 mg, none above 280 mg and 39 (43%) that fell within 150~280 mg. 13.7.6 Of the 37 females suffering from goitre grade I, there were 22 (59%) cholesterol determinations that fell beloN 150 mg, none above 280 and 15 (41%) that f.ell within 150-280 mg. 13.7.7 Of the 144 females suffering from goitre grade II, there were 95 (6Q%) cholesterol determinations that fell below 150 mg, none above 280 mg and 49 (34%) that fell within 150-280 mg. 13.7.8 Of the 16 females suffering from goitre grade III, there were 13 (81%) cholesterol determinations that fell belo\'l 150 mg, none above 280 rag and 3 (19%) that fell within 150-280 mg. 13.7.9 These findings clearly indicate that regardless of the thyroid conditions, there were an over-all of 74% of cholesterol determinations in the male group and 63% in the female group that fell belo'!'T 150 mg.
A FR/NUT/12 page 24 13.7.10 The over-all mean for the cholesterol determinations that fell below 150 mg was 125 mg for the male group and 130 mg for the female group with standard deviations of 25 and 29 mg respectively. 13.8 The results are summarized in Table 26, and it can also be seen that: 13.8.1 ~evels
In the male group, 69,% in the normals and 78% in the goitrous had cholesterol below 150 mg.
13.8.2 In the female group, 57% in the normals and 66% in the goitrous group had cholesterol levels below 150 mg. 13.8.3 Of a ·total of 247 (74%) cholesterol determinations that fell below 150 mg in the male group, there were 36% in the normal group and 64% in the goitrous group. difference is statistically significant. 13.8.4 Of a total of 184 (63%) cholesterol determinations that fell below 150 mg in the female group, there were 28% in the normal group and This difference is statistically significant. 13.9 These studies show that, as in other underdeveloped countries .-rhere dietary intal<;:es are low, the majority (two-thirds) of the population have low cholesterol levels. This finding is supported by the dietary studies which show loW fat and cholesterol intruces. Another interesting observation is that the cholesterol levels were low although the incidence of endemic goitre in the population was high, as was shown by the goitre survey and P.B.I. studies conducted. This finding is contrar~ to the theory that hypothyroidism produces hypercholesteremia. 14. EFFECT OF POTASSIU1'1 IODATE ON NOill1AL AND GOITROUS scHOOL CHILDREN WITH REFERENCE TO INTELLIGENCE AND CHOLESTEROL LEVELS . Of the 679 children, This
72%
in the goitrous group.
14.1 The sample studied included 679 children of both sexes, ranging in age from 9 to 18 years and attending school from Standard II to standard VI. goitrous and 266 diffuse goitrous, grades I, II and III. 246 were males and 433 females, and according to thyroid condition there were 413 nonIn the non-goitrous group there were 175 males and 238 females, whilst in the goitrous group, there were 71 males and 195 females.
f.:FR/NUT/12 page 25 14.2 The sample was divided into t~w
similar groups with regard to sex, age, thyroid To one group,
condition and standard attended at school.
4 milligrammes of Potassium
Iodate, in tablet form, were given to each child each week, thus giving an average daily intake of 340 micrograrnmes of iodine per capita. equal number of placebo tablets B~fore
The other group was given an
(~dthout
any iodine) per child per week.
the iodine was given, the following studies were conducted:
14.3 An endemic goitre survey, during Hhich it was found that 30.5% of the boys and 48.8% of the girls were suffering from endemic goitre with. an-over-all incidence of 42. 2%. 14.4 Mental tests were given to 482 children of both sexes, non-goitrous and goitrous and from Standard II to VI. the goitrous groups. Standard II. In both sexes the non-goitrous groups scored higher than Out of a possible 108 score, the highest mean score was-·70.1 in
the male non-goitrous, Standard VI, and the lowest was 25.3 in the male goitrous, Individual scores ranged from 14, the lowest score in a goitrous girl, Standard II, to 108 which was scored by many boys and girls in Standards V and VI'. 14.5 P.B.I and cholesterol determinations were done in the sera of children, and the '·
results followed the same pattern as previous studies described in this report.
14.6 After 15 weeks of giving 340 microgrammes of iodine daily to one group and placebo to the other, the same studies were repeated and the results showed that:
14.6.1 r,he incidence of endemic goitre had decreased from 42.2% to
26.~.
14.6.2 The mean score in the mental tests improved from 59.47 to 83.36. group.
This improvement
in the score of mental tests was more marked in the non-goitrous than in the goitrous
14.6.3 Neither the serum P.B.I. nor the cholesterol
me~n
values changed after the This is an interest:i,ng
giving of iodine in either the normal or goitrous groups.
finding as it is known that the serum P.B.I. values rise immediately after _ the administration of iodine and that the values often remain high, in some cases for as long as one year after the tru~ing
of iodine has ceased.
14.7 Conclusion 14.7.1 Administration of 340 microgrammes of iodine decreased the incidence of endemic goitre and promoted increased intelligence in both normal and goitrous Basuto school
AFR/NUT/12 page 26 children, the improvement being more marted in the non-goitrous groups. group, incidence of endemic goitre remained the average marks of the mental test were recorded. 15. 15.1 PELLAGRA STUDIES same~
In the placebo
and no improvement.s in the
Pellagra is the most common dietary deficiency disease found in Basutoland. dis~ase
In
fact it occurs so frequently that the Basuto can recognise it and _calls it "Lefu-la-Pone" which means the
of the mealies.
"Lefu-la-Pone" has been studied as a public Clinical, epidemiological,
health problem throughout the four years of the survey.
dietary, therapeutic and socio-anthropological studies were conducted. 15.2 Clinically, the disease is characterized by the following signs and symptoms: symmetrical, sharply demarcated, hyperpigmented, desquamating, sunburnlike lowe~
Typica~
skin lesions on the exposed parts of the body; cheilosis, more frequently qf the
lip; angular stomatitis; seborrhoea especially of nose and fore head; hypertrophy or . atrophy of the fungiform and filliform papillae; magenta or red beef tongue; emaciation; a black papular condition resembling toad skin on the unexposed parts of the body was seen very often, especially in the vrorst cases; sensation of tautness; itching; pain in different parts of the body; dysphagia; burning sensation in the digestive tract; darl<:ening of the skin; constipation more frequent than diarrhoea; dementia, especially in cases where large amounts of alcoholic beverages were taken; weakness and debility. 15.3
Epidemiologically, pellagra is characterized by the following:
it attacks people
of both sexes and of all ages; it occurs throughout the territory; it is seasonal, occurring mainly from October to February vrith its peak in December, but cas~s
occur
all the year round; it recurs often with increased severity; it occurs more frequently among pregnant and lactating women, herdboys, agricultural workers and those who consume alcoholic beverages; it is on the increase (Annual Reports from the Health Services). It is estimated that during the pellagra season, 15% of the population It is obvious that the number of cases accompanied by dementia is on the suffer from "Lefu-la-Pone" and that 50% of the heavy drinkers are affected with the disease. increase, and more. severe forms of dementia occur each year. 15.4 Diets consumed by pellagrins were studied in individuals, families and institutions.
AFR/Nill/12 page 27
15.4.1
The diets of 17 pellagrins were studied.
Of these, 6 males and 7 females
were adults, one of each sex was in the 13-15 years age group, one female was in the 7-9· year age group and one girl was in the 3-4 year age group. A typical diet consumed by an adult female pellagrin is shown in Table 27. From
the table it can be seen that the contents of the diet were extremely limited, maize and spinach were the only foods consumed. Beer taken was recorded but not included in The
the computation as the nutritive value and alcoholic content were not known. protein consumed was all of vegetable origin.
An important characteristic of these
diets was the unbalanced intake of calories, animal protein, riboflavin and nicotinic acid. In addition to these specific individual studies the dietary histories of more than 100 pellagrins were recorded, and the dietary pattern was found to consist: (a} Regularly of mealie meal served as thick or thin porridge and spinach
(a green, leafy vegetable, usually indigenous). (b) (c) Occasionally of t>~hite
or brown bread, sorghum , pumpldn or other vegetables.
Rarely of dried beans or peas, meat. milh:, eggs, etc.
The habit of consuming large quantities of home-brewed alcoholic beverages (beer) was found fairly constant runong adult pellagrins, except the lactating woman. 15.4.2 Dietary surveys were carried out among 16 families in each of which there was at least one case of pellagra. The nutritive value of the diets consumed by each From the table it can be seen that:
family studied is shown in Table 28. (a)
The average calorie and protein Yalue of the diets of families with' ·cases of
pellagra was lower than that of the average Basuto family diet reported elsewhere (Table 37). (b) (c) per day. (b) (e) The mean calorie intake was 1533, ranging from 929 to 2283 per capita per day. The mean daily riboflavin intruce was 0.6 mg, ranging from 0.3 to 1.9 mg per The nicotinic acid and tryptophane intakes of the diet were low. The mean intake of animal protein was 8.1 grammes, ranging from 0 to 27.3, and
of vegetable protein (mainly maize) 38.3 gm, ranging from 20.5 to 58.4 gm per capita
capita per day.
AFR/NUT/12 page 28
15.5 The individual and family dietary studies conducted strongly support the theory that pellagra occurs when nicotinic acid and tryptophane a1~e
deficient in the diet.
The fact that in sor.1e parts of the 1-rorld, as in Central America, where maize is the staple food but pellagra does not occur as a public health problem has been attributed to the treatment of maize with lime as in the preparation of tortillas. that this alkaline hydrolysis available to such this theory. mind fact ~hat lib~rates
It is thought
the bound niacin so that it becomes freely Recent research tends to support
ru1
extent that pellagra is prevented.
Without denying this possibility, however, it is important to bear in in those areas in which maize is treated with lime, beans and coffee
(both rich sources of nicotinic acid) are consumed regularly and in large quantities so much so that these foods contribute substantially to the daily nicotinic acid and tryptophane intakes. It is interesting to note that in parts of Africa where maize untreated with lime is the staple food and large quantities of beans and sometimes milk are consumed, pellagra does not occur as a public health problem. It is felt, therefore, that specific attention should at all tj_mes be given to the amounts of nicotinic acid and tryptophane provided by the various collStituents of the diet in spite of the treatment 15~6
of
maize.
An institutional study was conducted in February 1959 when an outbreak of pellagra In order to overcome the problem, the After discussion
was reported on an Agricultural Experimental Station Farm which is situated 1-1/2 miles from Maseru, the capital of the territory. authorities requested the assistance of the WHO Nutrition Survey Team. studies. 15.6.1 Clinically and epidemiologically, it was found that of the 70 agricultural
it was decided to conduct a survey which included clinical, epidemiological and dietary
labourers on the farm, 22 were suffering from pellagra, of which 9 were mild, 6 moderate and 7 severe cases. hospital. Both sexes were equally attacked by the disease which h~d
broken
out three months prior to be survey and during which period 10 cases had been sent to All the labourers were under-weight. In addition to the signs of nicotinic
acid deficiency, signs of riboflavin, vitamin A, protein and calorie deficiencies were apparent among the pellagrins. Nany of. them reported that they had suffered numberous
attacks of pellagra in the past, each time with increased severity.
AFR/NUT/12 page 29
15.6.2 The dietary findings were as follows: Three meals a day were given, free of charge, during 6 days of the week. Each Norl<;:er was having 1/2 lb 1'1hite mealie meal three times each day and 1/3 lb "•<hite bea..11s once a ;reek. Although the "'orkers i-rere expected to supplement this diet, nothing else was consun1ed, with the exception of a few who brought small amounts (1-2 ozs) of cooked spinach from home and many who consumed alcoholic beverages after worl<;:. The nutritive value of the farm diet and the allowances recommended by INCAP are compared in Table 29. It can be seen that with the exception of calories, protein and iron, the diet was deficient in all nutrients. the quality was poor as it biological value of only 24. Although the quantity of protein intru(e was sufficient, ~'las
mainly derived from maize which is known to have a low The inadequate content in the diet of nicotinic acid and
tryptophane were the etiological factors responsible for the outbreru( of pellagra. Once again the unbalanced intake of calories, animal protein, thiamin, riboflavin and nicotinic acid in the diet was apparent. diet. This was further increased by consumption of excessive amounts of alcoholic beverages which raised the calorie content of the
15.7 During the last quarter of 1958, the \{HO nutrition experts were approached by the Director of the Flora Dried Milk Company, r1arquard, a commercial concern in the Republic of South Africa situated near the boundary of Basutoland, to seek assistance in the development of a pre-cooked enriched maize mixture. to meet the deficiencies found. produced by the company. After ~any
Based on the findings of
the nutrition survey conducted in Basutoland, the experts recommended various formulae trials, a suitable pre-cooked mixture was
15.7.1 Advantage was taken of the pellagra outbreal' at the Experimental Farm to test the acceptability, curative effect and other properties of the pre-cooked enriched mealie meal mixture. The test was made possible thanks to Mr G. Nicholson, the Director of the company, who generously donated the amounts of mixture necessary.
15.7.2 The enriched mixture was introduced into diet as follows: During the first three days, 25% of the ordinary meal was replaced by the enriched mixture and consumed by the labourers as hard porridge each day. As there were no complaints, the amount of mixture substitute Has increased to 50% during the follmdng
Mf'R/NUT/12 page 30 three days, after which the enriched mi.xture totally replaced the mealie meal in the diet, still without complaints. After three Heeks of-being fed on this mixture, all In this v1ay, the acceptability and curative pellagra cases were clinically cured.
effectiveness of the mi.'<ture \'iere established. The preventive effectiveness of the mixttwe has since been established as there has not been another outbreak of pellagl~a
on the farm
dLU~ing
the one and a half years Not only did the
in which the labourers have been given the em•iched mixture.
consumption of the enriched mixture prove that pellagra could be cured and prevented, but increased output of itTOrl;:, co-operation al"ld improved itmrking among the labourers were also reported by the authorities. So successful 1·ras the experiment that the use of the in the Mental Detention Centre at rllohale' s Hoek. em~iched
mixture was
~.
..-
recommended in the tuberculosis Ward of t:1.e Queen Elizabeth II Hospital, Maseru, and · The results obtained 1 ' lere equally successful and in some cases quite spectacular as described elseNhere in this report.
15.7.3 The composition of the final and most effective mixture appears in Table 30. 15.7.4 In Table
31 nutritive value of
1 pound of the enriched maize meal is compar~d
Ni th that of 1 pound of ordinary refined mealie meal, and 1 ·ri th the daily INCAP recommended allmrances for a male regular (at;ricultural) activity. From the table it can be seen that for an adult male of reGUlar agricultural activity, one pound (which is the average daily conswnptior,. of maize meal per capita) of pre-cooked em~iched
maize meal provides the full requirements of protein, a third
of ·'i'lhich is of animal origin, calcium, iron, riboflavin but fails to meet the recommended allmrances of calories, nicotinic acid, vitalnins A and C and fat. sportages could be met by supplementing a diet of the mixture vri th dried beans, vegetables and a little fat. These
15.7.5 The pre-cooked enriched maize meal, lmown commercially as sold by private trading stores throu~~out
11
Maluti Meal", is a1~e
the Territory.
As the proteins added
expensive and a certain' amount of the treight is lost in the preparation (Nhich includes pre-cooking), the mixture is of necessity sold at a higher price than the ordinary maize meal and this, of course, limits the consumption. The possibility of producing
AFR/NUT/12 page 31 the mixture locally and of introducing a Government subsidy so that the enriched meal could be sold more cheaply and hence be more widely consumed, is at present being investigated. As the results obtained in all the tests carried out proved successful, the experts feel that Government should give high priority to these investigations. Intoduction of cheap enriched meal appears the most imr~ediate
and practical way of
overcoming not only pellagra but all other problems of malnutrition in Basutoland. Ultimately, the solution to these problems lies in improved agricultural production so that the nutritional requirements of the population can be met. 15.8 In order to gain information on the response of pellagrins to different methods Cases were divided into 5 groups, each of which was given different
of treatment, therapeutic trials were conducted on more than 100 cases which had been studied clinically. treatment. Group I was put on to 150 mg daily of nicotinic acid alone. 500 mg of tryptophane daily. Group III Has given 15 g of food Group II was put on dailjr. In Group N, Group
to a recommended diet that provided an average of 20 mg of nicotinic acid and 300 to ~'east
consumption of alcoholic beverages was excluded from the customary daily diet. V - when the diagnosis was doubtful, placebo was given.
Mild cases were allocated to Group IV, those that could afford the recommended diet were put into Group II and the rest of the cases with the exception of those that had been treated with placebo and ctwed were distributed at random. between Groups I and III. For obvious reasons, it was not possible to distribute all cases at random among
the five groups. 15.8 Nevertheless the results showed clearly that:
15.8.1 Nocotinic acid has a rapid and definite curative effect and was at times the only therapeutic measure found to cure dementia, even in cases where the recommended diet and food yeast failed. from 300 to 500 mg daily. The nicotinic acid administered in these cases was increased
AFR/NUT/12 page 32
15. 8. 2 The group on the recommended diet follm·red closely on the results obtained with nicotinic acid, the only difference was that cure took longer 1 usually t>ITO to three weeks to recover and in some cases mental disorders did not disappear completely until nicotinic acid was given.
15.8.3 Food yeast took third place in the treatment of pellagra. 15.R.4 !n many instances, vrhere placebo was given, the symptomatological complaints disappeared after one 'l'reek.
15.8.5 The ingestion of substantial amounts of alcohol {in any form) precipitated ti1e appearance of pellagra.
15. 8. 6 Many mild cases were cured when this habit ceased and the 1 'rorst cases of pellagra were usually in heavy drinkers.
15.8.7 The part played by alcohol in precipitating the condition appears complicated. 15.8.R The alcohol might have interfered with the physiological process of digestion and metabolism of nutrients but it 'I'Tas
also found that those consuming large quanti ties
of alcohol did not eat regularly and were constantly in a state of semi-starvation.
15.9 In addition to the therapeutic tests mentioned ab0ve, three institutional feeding schemes, using the pre-cooked enriched mealie meal studies among pellagrins were conducted. mixtl~e
described under dietary .
One of those trials took place at the
Agricultural Experimental Station Farm, another at the Queen Elizabeth II Hospital in Maseru and the third at the Mental Detention Centre in Mchale's Hoek.
15.9.1 The trial conducted at the Agricultural Experimental Station Farm has described else>-rhere.
bee~
15.9.2 At the Queen Elizabeth II
~ospital
in Maseru, the maize meal in the diets of Rapid imp:::-ovement
the female tuberculosis patients was substituted by the mixture. introduction of the mixture into the diet in August 1959. were put on to the mixture with equally rapid improvements.
and gains in weight of up to 6 lb per week in some have been recorded since the · · All cases of malnutrition
AFR/ NT.Jr/ 12 page 33 15.9.3 In the Mental Detention Centre in Mchale's Hoek, where pellagra was raging The report
to such an extent that the majority of the inmates were affected with the disease, the picture has changed since the introduction of the enriched mixture. of the Mental Health Officer and the Superintendent of the Centre states: "In June 1959, pellagra was found to be a primary cause or a contributory factor in the mental conditions of meal.
73%
of the males and 71% of the females.
In the same·
month the enriched meal was introduced into the diet and replaced the ordinary mealie During the first month and despite influenza and colds which a number of patients The general physical and mental condition of the patients improved to sui'fered in the winter, the average gain in l·Teight of the males was 4-l/ 2 lb and of . females 8 lb. such an extent that within the following three months, 16 of the male and 9 of the female patients were discharged. The!'e were in fact more patients who were at this Of the remaining time able to be discharged if their relatives could have been traced. in the males and 18 lb in the females, the in the females 34 lb. high~st
14 male and ll female patients, the average gain in weight for the year was 7-l/2 lb gain in the males being 10 lb and They are Patients, according to their mental condition, are given duties The hi~!er
in the garden, make bricks and help in the general maintenance of the centre. also permitted to play football, basketball, etc. entirely of a domestic nature". 15.10 Socio-anthropological studies
gain in weight of the
females could be attributed to the less strenuous work done by them as their tasks were
These studies brought much interesting information to light. pellagra is seasonal in Basutoland, o~curring
As has been mentioned,
during the hot season starting in the ·
spring about September or October and continuing through the summer until autumn which starts about March. 15.10.1 The seasonal appearance of pellagra · can be explained by:
The severe winter \'lhich precedes the pellagra season demands increased calorie amo~ts
intake, thus the small
of food stored are rapidly consumed and by the time The heavy agricultural Hark (ploughing,
summer comes, supplies are almost exhausted.
harrowing, etc.) which needs to be done in the summer, the rainy season, calls for increased energy expenditure \'Thich is seldom met by the dietary intal;:e.
AFR/NUT/12 page 34 15.10.2 The actinic radiation is at its peak during the summer, and the rays of light beyond the violet end of the spectrum bring about biological changes which undoubtedly play an important role in the appearance of dermatitis in persons depleted of nicotinic acid and tryptophane. 15.10.3 During the summer, beer parties are more frequently held. the locally brewed alcoholic beverages by many, including some physicians. beverages is most prevalent. 11
The Basuto regard
beer" as food - "a good food" as it is called
The habit of taking large qu.a ntities of alcoholic Withput fear of being too far from '
Many connnence drinking early in the morning and continue
to drink through the pay, seldom taking any food. the week and that some of the villagers are drunk. 15.10.4
the truth it can be said that a beer party is held in each village almost every day of
Information gained in 32 villages, where 144 families were studied, showed
that, of the 456 adults,
238
spontaneously confessed to regular drinking of more than dranl~
the usual amounts of beer.
Of the 238 that
regularly, 60 approximately reported As "Lefu-la-pone" in its severe form The
that they had suffered from pellagra in the past.
is familiar to the Basuto, it can be assumed that the cases reported were genuine.
number of cases actually affected was obviously higher as it was found that for each severe case there was at least one mild or sub-clinical case, which would possibly not have been recognised by the patient. It can therefore be safely assumed that the expected morbidity rate of ·pellagra among beer drinkers is in the vicinity. of 50%. 15.10.5 Basuto babies are weaned on to fermented thin maize or sorghum porridge and this food habit continues throughout childhood. there are many traditional varieties. By the time they are adults there is a craving for stronger and more potent fermented foods in the form of Sesuto beer of Hhich Unfortunately, due to poverty and craving for Women, even those that are pregnant and even more potent beverages, these traditional brei'ls are often laced and an endless variety of concoctions are now available. lactating, are sometimes found to partake of these brews although, by custom, women of child-bearing age are not permitted to do so. 15.10.6 Although a system of licenced beer halls exist in Basutoland, the making and selling of beer is one of the sources of income frequently resorted to by most families.
AFR/NUT/l.?..:. page 35 The stronger and more potent. these bre~·rs
are, the more popular the house becomes.
A
great tragedy is said to have occurred when a brewer died suddenly and without disclosing the secret recipe by which a beer of such potency was produced that, after one pint, the happy consuwer was completely inebriated and had to be taken home in a· wheelbarrow. 16. KWASHIORKOR AND MAMSr-ros
Both kwashiorkor and marasmus occur in Basutoland; studies conducted show that: 16.1 Clinically, kwashiorkor is characterized by retardation of growth and development, Secondary skin or eye infections occur very commonly. Broncho-pulmonary
oedema, typical lesions of the skin, hair and nails and mental impairment (irritability or apathy). complications are the most frequent causes of death. 16.2 Epidemiologically, these diseases affect
2.% of the children from 2-6 years of I
age, they occur throughout the territory throughout the year but ·outbreaks appear from January to April with highest incidence in February. The reasons for the seasonal outbreru~s
are that the diets are poor, as discussed
elsewhere in this report, contamination of foods with human faeces is thought to be high·because of the poor environmental sanitation and the high increase of flies during the summer months and, finally, mothers are engaged in ploughing and harrowing at th:i,.s time of the year and the children are often neglected. kwashiorkor, marasmus or both. These conditions either jointly or separately bring about repeated attacks of diarrhoea which are followed by
16.3 The mortality rate is high due to negligence, improper therapeutical care at home, lack of knowledge of the relationship of the disease to the diet, as food, limited hospital facilities and poverty. when it is difficult, if not impossible, to cure them. \~-Tell
as lack of ·
Babies are often brought to hospitals
16.4 In k\-mshiorlcor, it was found that the diet was deficient in all nutrients with a gross imbalance in the calorie and animal protein intruces. protein intakes were usual. High calorie and low
AFR/NIH/12 page 36 Dietetically, in marasmus, it was found that semi-starvation continued over a long period and that diets consisted mainly of maize and sorghum porridge. 16.5 Foods for correct \'teaning of babies_ , such as milk, and the mothers had little knowledge of puericul ture. mea~,
eggs, fruit, vegetables,
etc. (see also information under weaning habits, individual dietary studies) were scarce Formerly, brashiorkor and marasmus were apparently less prevalent and this could be due to the fact that milk •' was . more plenti:(\11. and therefore given to the babies more frequently. 16.6 There is no doubt that; if l~shiorkor
and marasmus are to be eradicated, it mate~nal
i~
essential that suitable foods for weaning should be available and that instruction in nutrition should be given to the mothers through a well-organized health programme. 16.7 As alreagy reported, the infant and cl1ild mortality rate in Basutoland is high _ in spite of the absence of tropical diseases. The most frequent causes of death, as reported by the relatives of the deceased, were diarrhoea, swelling, whooping cough, pulmonary infections, fever of different types, diphtheria, haemorrhage and convulsions. F1any of these conditions are of the communicable type and therefore the obvious approach to their control is again through a well-organised maternal and child health programme. 16.8 Without going into detail as to how the maternal and child health programme could be operated, it is suggested that: 16.8.1 A public health doctor ~nth training in maternal and child health should be the chief of the maternal and child health section; 16.8.2 An obstetrician and gynaecologist ~~th training in public health should be responsible for the maternal health of the programme. 16.8.3 A paediatrician, with further training in public health, should be responsible for the health of the children. 16.8.4 The improvement of diagnosis and treatment of ob~ tetrical, gynaecologjcal and paediatric cases in hospitals should be part of the responsibilities of the obstetrician and paediatrician. and child
AFR/NUT/12 page 37
16.8.5 Two or more qualified midwives, with training in public health, should work under the guidance of the doctors and should give training in midliifery, hygiene and nutrition to the empirical or rural unqualified midwives, who are at - present carrying out their duties without.the necessary knowledge. NOTE: future. 17. CLINICAL FINDINGS OF THE GENERAL NUTRITION SURVEY Due to force of circumstances, these empirical or rural unqualified midwives
will probably continue to provide their services to villagers for some time in the
17.1 The sample studied was draWl! from seven districts of the lowlands but included some villages in the mountains. A total of 1107 individuals of both sexes and varying The INCAP Master Sheet in age from one month to 69 years were clinically examined. was used.
with 92 signs that are related to, or thought to be related to, dietary deficiencies Doubtful signs were recorded but have not been included in this report.
17.2 Clinical findings were tabulated according to sex and to the age groups used in the recommended dietary allowances. In this way, it was possible to determine in which Without this breakdown grou~s.
groups clinical signs of deficiencies were most prevalent and to what extent these signs were related to the dietary adequacies of the respective groups. into sex and age groups, it is not possible to determine the frequency distribution of clinical signs in relation to the dietary intakes of the various age
17.3 The age groups, sex, number and percentage of cases examined and affected in each of the groups are presented in Table 32. affected. affected. 17.4 The frequency distribution of the clinical signs of malnutrition according to sex and age group is presented in Table 33. nicotinic acid and vitamin A. All clinical signs found could be associated with deficiencies of calories, animal protein, fat, calcium, riboflavin, These findings correlate closely \'lith the _dietary findings which shoi'led low intakes of all nutrients mentioned, with the exception of the carotene From the table it can be seen that each age height and weight, skin fold thickness group was represented and that the age groups from 4 to 9 were the most severely These findings correspond with the and dietary studies which showed that the same age groups were the most seriously
AFR/NUT/12
page 38 intake which was fotmd seasonally high but with an over-aJ.l average which met the recommended allowances. This discrepancy may have been due to the fact that the amount of carotene converted was possibly low and/or that the vitamin A was not completely absorbed because of the low fat intake of the diet. 18. NUTRIENT LEVELS
IN THE SERA OF THE POPULATION
18.1 By the kind co-operation of Dr I. Bersolli<, Chief of the Liver Function Unit of the South African Institute for Medical Research, Johannesburg, it was possible to get information on the nutrient levels of the sera of 104 individuals. presented in Table The findings are leve~s ~ ~ub~ic
34.
It is interesting to note that protein and haemoglobin
were found normal which suggests that iron deficiency anaemia does not occur as health problem in Basutoland. to deficiency of either folic acid of vitamin Bl2 cannot be ruled out. were below normal.
However, the possibility of the occurrence of anaemia due As already
reported and as expected, the levels for total lipids, cholesterol and phospholipids The mean figure for antistreptolysin titre was also found low, suggesting that infection from streptococci in the population was low. Table 35 shows the mean biochemical values in sera of a population sample from the Republic of South 19. A~~ica
and is included for comparative purposes.
DIETARY STUDIES
19.1 Family, individual and institutional dietary studies were conducted as a part of the general nutrition survey. selected for this st~dy
Villages from lowlands, foothills and mountains were lo~ated.
and were, according to the local authorities consulted, repreThis fact was confirmed on
sentative of the districts in which they were from village to village.
completion of studies when it was found that the dietary pattern varied only slightly
In each village selected for study, the Chief was approached, the purpose. of the survey was explained and his co-operation as well as that of the villagers was requested. After approval had been given, a house-to-house census was conducted. Relevant A map information on age, sex, physiological state, occupation, etc., of each member of the family as well as births, deaths and abortions which had occurred were recorded. of the village, showing the position of roads, rivers, as private dwellings was plotted. householders. 11
dongas 11 , shops, schools as well
In this way, it was possible to localize all
AFR/NUT/12 page 39 After having studied the census forms, families to be included in the dietary study were carefully selected so that the sample included: or lactating women, infants, pre-school and school children; malnutrition had been reported in the past; as semi-urban areas; employed; tribes. NOTE:
families \'lith pregnant families where cases of various economic classes,
families
f~om
namely very poor, poor, middle, weal t hy and very t'lealthy; families from rural as well families ~.rhere
t he breadvfinner was permanently or temporarily and families of different
families whose sole income Nas from t1e lands;
It can be seen that this was a carefully selected sample \•Thich is contrary to The
the random sample m ethod which has been employed for this purpose in the past. health problems such as tuberculosis, malaria, habits etc., nutritional diseases affect population. ~Ti th
experts feel that, while the random sample method is good for the study of many pnblic etc~,
as these diseases attack the
population regardless of sex, age, race, religion, physiological cond1tion, food preference special groups of the The random sample method is not very satisfactory when the nutritional
status of the population needs to be assessed, the reasons being: In nutritional studies, preference should be given to pregnant and lactating women, infants and pre-school children, etc., the vulnerable groups, as they represent the future population and they should derive most benefit from preventive measures which might be applied. From the public health point of vie>·r, the aim should be to Furthermore, there are many other factors, such as maintain a good nutritional status of the population by applying preventive in preference to curative measures. dietary, clinical, epidemiological, economic, educational, social, agricultural, ethnological, topographical, ecological, religious, etc., that should be considered very carefully when choosing a sample for a general nutrition survey. When conducting
nutritional studies, time, personnel, expenditure and facilities available are limiting factors; attention should therefore be concentrated on the vulnerable groups of the population.
19.1.1
In the dietary survey conducted, each surveyor undertook to study five families
for periods varying from three to seven days, depending on the monotony of the diet, food habits, religious beliefs, economical standing, etc. were weighed and measured before and after px•eparation. In each household, foods The amounts of food consumed,
wasted, left over and fed to animals as l'fell as the meals attended by each of the family members or visitors were recorded on carefully prepared forms.
,-u!ri./NU'I :/ 12
page 40
During the survey information on lands.
livestock, crop production, the economic
situation and other socio-antropological factors with some bearing on nutrition was collected and recorded on forms which had been previously prepared. 19 •. 1.2 Final+y data was tabulated and, using the Sou~h
Afrioc>.n Food Table
~Y
F. W. Fox
and L. Goldberg, the nutritive value of the diets was computed. Composition Tables were used.
When foods consumed did com~uted
not appear in the South African Table, the U.S.D.A., Professor Platt's and INCAP Food The percentage of adequacy of the diet was in accordance with the INCAP Recommended Dietary Allowances (1954). The. reasons for using
the INCAP Daily Dietary Recommended Allowances as standards for assessment of the percentage of adequacy of the nutritive value of these diets were the same as discussed in Heights in Point 10.4.1; and also because maize is the staple food in the INCAP area as in Basutoland. 19.2 Family Dietary Studies In this way 153 families in 18 villages were studied and the age group and sex distribution of family members are presented in Table 36. From the table it can be seen that both sexes were i'l'ell represented in each of the age groups. 19.2.1 The number of families studied in each of the villages varied (according to the personnel available for the survey). 19.2.2 The findings of each of the families in each of the villages. are available, but for this report these findings are pooled and averaged to represent each village. 19.2.3 The means and range of nutrient intake _of the 153 families studied in 18 villages appears in table 37, and the order of these means in table
38.
The percentage
of adequacy, cost of the diets together with the number of families and family members, the days spent and the time Basuto are: v~hen
the surveys were conducted as well as the name of the From these tables it is obvious that the ·diets of the
villages are shown in table 39.
AFR/NUT/ 12 page 41
19.2.4
Deficient in: Calories: The mean intake was 1826 with a. range of from 723 to
(a)
3844 per
capita per da;>'.
This deficiency was confirmed by the skin fold thickness and height The calorie intake was increased in the group
. and weight studies conducted.
at·the
population that drank locally-brewed alcoholic beverages every day but it was not possible to determine this increase as there are no figures available for the nutritive value and alcoholic content of locally-brewed beverages. It is possible that the calorie content of these "beers" was high and the diet would resemble that which produces kwashiorkor, namely, high calorie and low protein intakes. (b) 86.~
Protein:
The mean daily intake of protein was 59 g 1•anging from 15 to 141 g Of the vegetable protein,
per capita per day of which little was of animal origin.
was derived from maize which is of poor biological value. (c) Fat: The mean daily fat intake was very low, being only 27.2 g per capita A.."1imal fat as such seldom appeared in the diet This fat deficient diet could be
per day, derived mainly from maize. ~esponsible
of the Basuto, except in cases of rich families. in the winter months. (d) calo~ies
for the high in¢idence of signs of vitamin A deficiency found especially
Carbohydrate:
The mean daily carbohydrate int&<e of 386.7 g per capita per
day was within the daily recommended allowance (calculated on the basis of
7o%
of the
being derived from carbohydrates), but the mean tlaily.intakes of more than The carbohydrate and fat deficiencies
5o%
of the families were below this amount.
were responsible for the low calorie intake in the diets and also in part for the
74% of children suffering from malnutrition of different grades. (e) Calcium: The mean intake was 0.3 g with a range of from nearly nil to 3.9 g This calcium deficiency could be partly responsible for the per capita per day.
85%
of children found retarded, one or more years, in growth and development. (f) Riboflavin: The mean intake is 0.6 mg with a range of from 0.1 to 2. 7 miiliRiboflavin deficiency was frequently fo~d
grams per capita per day. meat, eggs, etc.
due to the fact
that the diet did npt contain foods that are good sources of this nutrient such as milk,
AFR/NrYr/ 12 page 42 (g) Nicotinic acid: The meru1. intake was 8.0 mg with a range of from 1 to 26.4
milligrams per capita per day which· is low especially in maize diets when tryptophane . -intake is low. These shortages were the obvious causes of pellagra. Foods rich in in nicotinic acid and tryptophane such as eggs. milk, meat etc., were seldom consumed.
19.2.5 Adequate in: (a) _Vitamin A: lesions due to the carotenes I '
The
me~
intake was 1.8 mg with a range of from nil to 9.6 milliIt is possible that some of complete~y
grams per capita per day. vit~in consu~ed
Notwithstanding the high carotene intakes. eye and skin
A deficiency were commonly found.
were not converted into vitamin A nor were they
assimilated because of the low fat content of the diet. (b) problem. (c) Vitamin C: were found. There was no clearly marked seasonal variation in the dietary pattern of the The mean intake was 60 mg with a range of from nil to 584 milliNo definite clinical signs of vitamin C deficiency (or scurvy) Thiamine: The mean intake was 0.9 mg with a range of from almost nil to .2.7 Thiamin deficiency did not occur as a public health
milligrams per capita per day.
grams per capita per day.
-
-
people and particularly in regard to intakes of vitamin A and C. the Ba,suto usually grew only one crop per year 1·1i th
This variation in limit~d
intakes was due to many factors, the most important of which were: with ru1d, a11
lands,
average lov< agricultural · This meant that many
production, food supplies were exhausted soon after harvesting. for the remainder of the year.
nutrients were in excess of requirements during the periods of :plenty and inadequate The solution of these difficulties appears to lie in the development of an agricultural system whereby the Basuto could produce crops at regular intervals throughout the year.
19. 2.6 . More than adequate in: (a) Iron: The mean intake ~~s 19 mg with a range of from 5 to 40 milligrams per This high iron intake is said to be associated with liver damages in
capita per day. the Africans.
AFR/NrYr/ 12 page 43 19.2.7 The nutritive value of the diet of the Basuto can be summarized as follows: deficient in all nutrients with the exception of carotene, thiamin, vitamin C and iron. These deficiencies were responsible for the retardation of growth and development affect~
the high incidence of malnutrition grades I, II and III. pellagra, k-washiorkor, marasmus, and the undernourishment that 19.2.8 nearly 75% of the population.
In the last four columns of Table 39 the expenditure on food consumed, either It can be seen
as produced or as purchased and the cost per capita per day are shown. one shilling in richer -homes, which, in USA currency, nearly 20 cents respectively per-capita per day. on food by rural and semi ...wba:n families. ·.. 19.2.9 The sources of Table 40. nut~~ents ~s
that the amount spent varied from 3-1/2 pennies in poor families to a little more than equivalent to nearly
5 and
It was found · that provided families
belonged to the same ·economic groupS there was little difference in the amount spent
in the diets of the families studied are shQwn in
From the table it can be seen that
8o%
of calories were derived from cereals Fats and
and that 64.4% of calo'ries were from maize-. nil.
Legumes contributed only 4.4%.
oils as such were seldom taken, consequently contribution from this source was almost Protein likewise was from maize with small contributions fl"Om other cereals such Animal protein was very lot-r and only small amounts of legumes The main source of calcium was milk but As the consumption of maize, as sorghum and wheat.
were taken as has been previously reported.
this was seldom.taken because it was not available.
sorghum and wheat was high, the intake of iron each day was in excess of requirements. Large amounts of green ieafy vegetables were consumed and these were the main source of carotene~- · ' .Only when meat and milk were included in the diet did the riboflavin and nicotinic acid intru(eS meet the requirements. and vegetables in season. 19.3 Individual Dietary Studies Dietary studies were conducted among 212 individuals in 6 villages of the lowlands and the age groups, sex, number of cases studied in each group and percentage of adequacy of the diets consumed are shown in Table 41. except iron and vitamin A. From the table it can be seen that the diets consumed by 25 children from 1-3 years old were deficient in all nutients The diets provided two-thirds of the requirement of protein The main sources of vitamin C were fruit ·
AFR/NUT/12 page 44 which again was mainly derived from maize. group are shown in Table 42. The average nutrient intakes for each age
19.3.1
A~art I
from the dietary data .
co~lected,
a great deal of time was devoted
~o
obtaining information about infant feeding and weaning practices, locally available foods used during the weaning period, food ha0its, food prejudices or pregnant and lQ.c_ t ating women, the mothers' that after some~imes th~ ~nowledge.
of puericulture, etc.
It was found that ·B asuto ~at
mothers. ;usw;lly .star.t ed-,weaning ·their . "babies towards the en of the first year and age of~two
years the children were -allowed to gr~dually
adult food.
Babies
were ,u:;;ua_llY weaned . on -;f:~l?ql:E?P~~d th,:i.n. sorghum or maize porridge, whieh were introduced as early as _ at six. months, ·thereafter new foods like vegetables· were introduced. This .practice develops the already mentioned strong liking for The lcnowledge of the mothers in
fermented foods at an early age and might be partially r ·e :sponsible for the craving for home-brewed beverages in the adult population. puericulture was ·extremely limited and many wrong ideas were prevalent among them·. Foods necessary for weaning babies correctly, such as milk, vegetables, fruit and eggs were scarce especially in winter. The habit of giving breast milk to the babies exte~ively.
up to two years of age is practised very
This practice when no _proper Adequate satisfactory .. • After this w~ight
supplementary feeding is given is more harmful than beneficial. continue until the baby is we~~ed,
supplementary feeding should accompany breast feeding from an early age and should regardless of when this takes place. a~parent.
long period of breast feeding with poor supplementary feeding, the babies lose and retardation in growth and development become '
These are signs of pre-
kwashiorkor and, if this period is prolonged or if there are other precipitating causes such as acute summer diarrhoea, co1waunicable diseases, administration of purgatives, etc., kwashiorkor, marasmus or a combination of both develop.
19.3.2 The findings of the individual dietary studies of 18 children in the 4-6 year . . . ·group showed that the diets were drastically low in calcium and riboflavin and that
although calories and proteins were supplied in more generous quantities, they were insufficient to promote growth and development. These findings were corroborated by the height, weight and skin thickness studies discussed elsewhere in this report.
AFR/NUT/12 page 45
19.3.3 In the 7•9 year age group, 20 individual dietary studies were conducted and it was found that the diets were deficient in calcium and riboflavin, less adequate in nicotinic acid and thiamin, more adequate in calories and protein (though little of this was of animal origin) and more than adequate in iron and vitamin A. The dietary The deficiencies apparent in the 4-6 age group were even more marked in this .group.
reason f0r the low nutritive value of the diets of these age groups were the scarcity of good protein foods, poverty, ignorance and, more often, the necessity for the mother to divide her time between her home and her agricultural duties.
19.3.4
In the
10-12 year age group, the diets of 13 boys were studied and findings protei~
showed that intakes of calories,
calcium, thiamin, riboflavin and nicotinic TI~CAP
acid were drastically low, that calcium was one fifth ot the requirement and that only the iron and vitamin A intalces reached the recommended allowances. The diets of the 9 girls studied in the same age group showed the same dietary deficiencies, although riboflavin and nicotinic acid intakes were a little higher.
19.3.5 In the 13-15 year age group, the diets of 6 girls and 5 boys were studied. again the same deficiencies were found. The characteristics that emerged were that
Here
after the age of 6 years the diet became less and less adequate for each age group up to the age group 16-20 years where the diet was, with the exception of calcium and riboflavin, more adequate in all nutrients.
19.3.6 The diets of 10 females and 9 males were studied in the 16-20 years age groui?. In the adult group the diets of 51 f enales and 28 males were studied and ~r~re found to follow the same pattern as the 16-20 age group. The inadequate calorie intruce of the males might have been complemented by the calorie content of the beer taken.
19.3.7 The diets of four pregnant women were studied and nutrient intakes requirements.
\~ere
found
to be lower in calories, protein, calcium and riboflavin than their physiological Unfortunately the number studied in this sample was small, in spite of From the information the efforts made to include more pregnant women in the survey. Pregnant women were given no privileges concerning food intakes.
gained, as well as from observations in family studies conducted, it appeared that the
AFR/NUT/12 page 46
19.3.8 Of the lactating women, 14 cases were studied and the percentage of adequacy repqrted in the table represents. their average intakes during different periods of lactation. that, With the exc.e ption of iron and vitamin A, all nutrients were found deficient, the fir.st three months of lactation, women were consuming better diets with ~apita
but, after breaking down the studies into different periods of lactation, it was found d~ing
at times intakes. of up to 4000 calories per diet beqame poor.
per day.
After this period, the that by custom tnothe'r s
This finding was confirmed when it was
l~arnt
are, for the first three months after the birth of the baby, given complete rest and large quanti ties of food, similar to that taken by the family, but with the addition of thin sorghum porridge which becomes an important item in the diet. It is interesting to note that when lactating women were given rest and when tpe customary food taken was increased, they could, provided they were free of disease, produce mille sufficient in quantity. and quality to allow their babies to grow and develop normally for the first five or six months of life as and weight studies conducted among the infants. \~S
confirmed in the height
19.4 Institutional Dietary Surveys Institutional dietary surveys were conducted at the following places:
19.4.1 The Experimental Station Farr.1 near Maseru on the occasion of an outbrea};: of pellagra (February 1958). These studies were discussed under Pellagra Studies.
19.4.2 The Pitseng Boarding School in Leribe district in the north of Basutoland in · October 1959, where a three days dietary survey was conducted at both hostels of the Institution. At the first hostel there were 132 students of the following age groups: 4-6 years
(19 males and 16 females), 7-9 years (12 males and 14 females), 10-12 years (1 male and 6 females), 13-15 years ~1 male and 13 females), 16-20 years (no males and 49 females) and in the 21 years and over there was only 1 female. The foods served were thick · mealie meal porridge, thin mabele {sorghum) porridge, whole maize, dried peas a~d beans, potatoes, bread, sugar, fat and milk. season. ~·1eat
Vegetables and fruits were plentiful when in The mean nutritive value
was served once a month and on special occasions.
of the diets consumed per capita per day, the INCAP recommended allowances for the same groups and the percentage of adequacy of the diets consun1ed by the students at the
AFR/NUT/12 page 47 first hostel are shown in Table 43. more adequate t~n
From the table it oan be seen the diet, although Calcium
that consumed by the families, followed the same pattern.
and vitamins A and C were quite inadequate, riboflavin and nicotinic acid failed to meet the recommendeq allowance and iron was excess. little was of animal origin. At the second hostel, the 16 male students were of three age groups: 13-15 years Although the protein intake \'tas adequate,
(7 students), 16-20 years (8 students) and 21 years and over (1 student and 1 female cook and 1 male labourer who ate at the hostel). same those served at the first hostel. The foods served were found to be the The m ean nutritive value of the diets consumed per
capita per day, the JNCAP recommended allowances for the same age groups and the percentage of adequacy of the diets consumed by the students are shown in Table·· 44. From the table it can be seen that the calories, iron, thi&ain and vitamin C ~~re in excess of requirements, calcium, riboflavin and vitamin A were drastically low and nicotinic acid failed to meet the recommended allowances. Based on the findings in both hostels, the necessary recommendations for improvements in the diet were. made to the authorities and were gratefully received.
19.4.3 The High School in Maseru {June 1960) where four day dietary studies were conducted at both the girls and the boys hostels. At the" girls' hostel, there were 97 students and 4 servants (who ate at the hostel). The stud~~~s were of the following age groups: 13-15 years (20 students), 16-20 years The foods served were: ~.,..ith
(73 students) and 21 years and over (4 students and 4 servants). tea with sugar.
for breakfast each day, brown bread, fermented mealie meal porridge
sugar and _black
For lunch for four days of the week steamed bread and sour milk and for The mean nutt'it:l.ve value of the diets It was found that
the remaining three days meat (with bone), samp (coarsely crushed maize) and cowpeas. For supper, brown bread and black tea with sugar. consumed per capita per day, the INCAP recommended allowances for the same groups and the percentages of adequacy of the diets consumed are shown in Table 45. preparation and leftover. served. the diet was extremely monotonous, there was a great deal of wastage both in the Fresh fruit or vegetables which could have helped to balance the deficiencies of calcium and vitamins A and C which occurred in the diet were not
'R/NUT/12 .ge 48 In the boys' hostel there were 138 students and 2 male and 3 female servants (who ~e
at the hostel).
The age groups of the students were as follows:
13-15 years
3 students), 16-20 years (93 students), 21 years and over (37 students, 2 male and 3 amale servants). The foods served were: for breru{fast each day, brown bread, white For lunch, bro\~
ealie meal porridge with sugar and black tea with sugar. erved daily with alternately cowpeas, meat and milk. ea with sugar.
bread was
For supper, brown bread and black
The mean nutritive value of the diets consumed, the INCAP recommended Here again the diet was most monotonous, the wastage, both was excessive. The calcium and vitamin A and O· deficiencies
.llowances for the same age groups and the percentage of adequacy of the diets consumed Lre presented in Table 46. .n preparation and ~ound ~eftover,
in the diet could have been reduced if fresh fruit or vegetables had been served,
The necessary recommendations were made to the authorities concerned. 20. 20.1 A LONGITUDINAL NUTRITION SURVEY Sporadic nutrition surveys, if well conducted, will no doubt provide valuable
information pertaining to the time in which the survey was conducted but, as a community is not a static entity, a great number of important events occurring outside of the survey period are missed. In contrast with the sporadic surveys usually conducted, the longitudinal nutrition survey has a great many advantages which can be listed as follows: (a) It gives a comprehensive picture of the local characteristics of nutritional
problems in a given area from the clinical, epidemiological, dietary, socio-anthropological and agricultural aspects and clearly shovre the inter-relationship of these characteristics throughout the year. (b) It allows for study of the appearance and progress of nutritional diseases and
their relation to other nosological entities under existing ecological conditions during one complete agricultural cycle. (c) It provides the opportunity for a follow-up of the weights of pregnant and
lactating women, infants and pre-school children. (d) It makes possible a study of the monthly dietary pattern and its relation to
seasonal variation, agricultural production, socio-anthropological factors as well as height and weight and clinical conditions of those consuming the diets,
AFR/Nm/ 12
page 49 (e) It enables the surveyors to become intimately associated with the families
under study and therefor.e to obtain man: accurate information, thus eliminating the i n accuracies which inevitably occur in a sporadic survey where families under study terLCi to present a distorted picture either to create the impression of wealth or of povert3r. (f) It serves as a measure with which to compare findings from other areas at
any one time of the year. NOTE: The experts recommend that a longitudinal study should be included in each
country where nutritional surveys and programmes are under way so that the nutritional status can be more accurately assessed and programmes more effectively directed and evaluated. As far as finance is concerned, the longitudinal study should not be more expensive than the sporadic surveys as the same personnel would be required for ·both types of surveys. The clinical studies conducted included physical examination and the children from the village school. sample. recc~ding
of
heights and weights of all members of tpe families studied in the survey as well as These studies showed that during the summer Labo~ers
months when food was scarce there was an over-all average loss of 7% of weight in the The weight loss was regained in the autumn when crops were harvested. returning from the mines lost an average of lo% of their weight within the first two months of their stay at home on the staple diet of maize, wild spinach and locally bre't'red beer. The weight gain of pregnant women was less than the expected 20%. after the weight ?rapped steadily. During the first
three months of lactation the weight gain by the lactating woman was high but thereInfant heights and weights for the first six months followed the INCAP standard for well-nourished children but after six months retardation of growth an4 development commenced and became increasingly more marked with increase in age (this and more specific information was presented in detail in the Quarterly Reports). Clinical signs of malnutrition were found more prevalent during the periods of low dietary consumption and loss of weight. The size of the liver tended to follow this When food Pattern and the incidence of endemic goitre also appeared to be influenced. was more plentiful, the skin fold thickness followed the same pattern.
AFR)NUT/12 page 50 20.2 Epidemiologically, it was learnt that nutritional time. Cases of malnutrition and of ~tarvat:i,on deficiencie~
were seasonal, Both
pellagra occurr?d in summer and pre-hvr.ashiorkor cases were seen at about the same were seen throughout the year. sexes and all ages were affected. 20.3 The diets of five families with an average total of 32 raembers, of which 20 were females and 12 males, were studied throughout one year. The total number of members of families varied from 27 in July 1956 to 41 in May of work and others returned. The ages
1957. Ti1is fluctuation was due
to the fact that many of the adults migrated to the Republic of South Africa in search
or
the individuals studied varied from birth to
70 years and included adults of both sexes, t\vo lactating women, one pregnant woman, three infants and several pre-school and school children. 20.4 From the economical point of view, two families were moderately well off, one family was poor and two families were very poor. The breadwinner of one of.the In addition she was a The other moderately moderately wealthy families was a former s.cbool teacher, a widow who was able to produce sufficient maize and sorghwn to last throughout the year. dressmaker and earned money by sewing for the village women. throughout the year.
\'leai thy family also produced sufficient maize, sorghum and beans for consumption The remaining families exhausted their food surplus very rapidly All the families had vegetable gardens but vegetables and had to purchase basic cereals from the traders and supplement the diet with weeds and vegetables from the gardens. were only obtained seasonally. 20.4.1 The nutritive value of the diets of the five families was computed each month nutritive
and records have been kept, but for the sake of brevity in this report, the
value of the diets of all five families were pooled and averaged for each of the twelve months, and the percentage of adequacy of these diets \vi th the costs is presented in Table 47. The diet was characterized as follm'l's: calorie intakes were about three quarters of the requirements. from ma1ze. Protein intakes appear to have met the requirements fairly t1t10
regularly through the year, but approximately
thirds of the protein was derived Thiamin intakes met minimum
Calcium intakes were drastically low while intakes of iron and vitamin A
(mainly carotene) were above INCAP recommended allowances.
AFR/NrYr/12
page 51 requirements. Riboflavin and nicotinic acid intakes were consistently low and even Intal<es of vitamin C varied considerably and were
more so from October to December.
markedly low from September to November when fresh vegetables were scarce. Food intake was largely influenced by availability. diverse, were harvested, produce was rapidly consumed. ~fuen
crops, which were rarely
Three possible explanations for
this behaviour could be given, the first being "!.,i:1at the body having been deprived of essential nutrients for so long a period was craving for replenishment, the second being that agricultural production was low and insufficient to maintain the family throughout the year and the third being the laclc of storage facilities which encouraged rapid consumption. These dietary findings clearly reveal reveal the etiology of nutritional deficiency diseases and explain some of the epidemiological characteristics such as seasonal appearance, severity, progress through the year, sequence of outbreaks of pellagra and kwashiorkor and the endemicity of malnutrition and retardation of growth and development. Clinical, dietary, epidemiological and endemic characteristics in other areas corresponded closely with those of the Mesapela village. 21.
COMPARISON OF DTI'FERENI' TYPES OF DIETARY STlJDIES A comparison of the average nutritive values of diets studied in institutions,
f~~ilies
in 18 villages,
f~ilies
in one village for ont year and families with cases of
pellagra is shown in Table 48.
From the table it is obvious that the diets of those in
institutions were relatively more adequate but with shortages of calcium, riboflavin and vitamin A and C which could have been improved if fresh vegetables had been served. The diets of families in the villages and the longitudinal study among five families in one village ran closely parallel with excesses of iron and vitamin A and shortages of calcium, riboflavin and vitamin A and C which could have been improved if fresh vegetables had been served. The diets of fmnilies in the villages and the longitudinal In all cases the In families where study among five families in one village ran closely parallel with excesses of iron and vitanJin A and shortages of calcium, riboflavin and nicotinic acid.
Protein intates i'lere quantitatively adequate but the quality was poor.
cases of pellagra occurred the diets were found to be extremely poor and deficient in all nutrients excert iron and vitamins A and C. This can be explained by the fact th~t
the diets of these families were made up of maize and large quantities of indigenous Plants. The over-all dietary pattern i·.ras obviously similar.
,,J.?n/ ~
UT/ 12 page 52 22. NUTRrriONAL EDUCATION AND TRATIID'JG OF PERSONNEL
22.1 All programmes dealing with betterment of living conditions require education in the subjects concerned, whether these are nutrition, agriculture or health, etc. It is in fact impossible to achieve any neglected. following: 22.2 22.3 Numerou~ meas~~e
of success if this essential aspect is
Although nutrition educat;Lo_ n .was not :nentioned in the terms of reference
the experts, in addition to having conducted the nutrition survey, devoted tine to the
meetings and discussion at higher levels of
ad~inistration
were held.
Courses, lectures, etc., were 3ive1 1 to acriculture officers and demonstrators, Exhibitions, making use of film strips,
chiefs, progressive farmers and women's associations, school teachers, students of domestic science and school children. flannelgraphs, et~
were held during agricultural shows.
22.4 Two series of articles were published through the local press, one dealt with the nutritive value of local foods and the second ~dth
production of these foods.
22.5 During the period of the survey, four ladies •, and three men were appointed at different times. Four of these were later appointed prermanently as home nutritionists The remaining three were on a temporary basis. Grade I and \'dll continue the worl> in nutrition under the public health officer, after the departure of the experts.
All seven of the local personnel were taught basic knowledge in nutrition and \'lere trained in conducting surveys, analysis and interpretation of findings and methods used in teaching nutrition. 23.
SOCIO-ANTHROPOLOGICAL AND ECONOrJIIC FAGrORS
23.1 Mention has been made of a few socio-antthopological and econom ic factors, which are closely associated with nutrition, agriculture and health. 23~2
One factor which has not been mentioned and Hhich is of paramount importance is the ~~Y
role played by the witch-doctors in the Basuto
of life.
Without any doubt, this
group of the population is quite the most influential. struggle for po\'Ter. people.
Their advice is constantly
sought in all activities, be they concerned with agriculture, health, litigation or This being the case, attempts should be made to gain their confidence
and co-operation in programmes planned for the improvement of · .living conditions of the
AFR/NTJr/12 page 53 24. CONCLUSIONS AND SilllJMARY
In the body of the report mention has been made, in very brief form, of all different nutrition surveys conducted in Basutoland during a period of four years. These surveys include: 24.1 24.1.1 General nutrition survey, embracing: Clinical nutrition survey. Individual dietary studies. Institutional dietary studies. 24.1.3 Agric~t~e and livestock data. 24.1.4 Vital 24.1.6 24.2 ~tati~tical
24.1.2 Dietary - Family dietary studies.
data.
24.1.5 Socio-anthropological data. Educational information. 24.1.7 Economic standing. Height and weight survey. thickness~ survey.
24.3 Skin fold 24.5 24.6
24.4 Endemic goitre survey. Protein- bound iodine studies. Plasma cholesterol studies.
24.7 Pellagra survey. 24.8 Kwashiorkor -and maras~us studies. The clinical nutrition survey clearly showed that the population eiamined was suffering from deficiencies in calories, protein, vitamin A, riboflavin and nicotinic acid. Vitamin C, thiamin and vitamin D deficiencies were not seen as a public health problem. These clinical findings population. ~'lere
more prevalent among the vulnerable groups of the After harvesting periods the nutritional status of The geographical distribution of these deficiencies
This fact became more apparent regarding the nicotinic acid deficiency.
Seasonal variations were observed. the population improved notoriously. covers the whole country.
Iodine deficiency was also very common.
24.1.2 The family dietary studies shm,red a low nutrient intake in calories, protein, special animal protein, vitamin A, riboflavin and above their requirements and in other nil. fa~ilies nico~inic
acid.
Regarding vitamin C
and thiamine the intal<e in some families during certain periods of the year was well, during certain periods it was almost Fat intake as such appears to be low for all fami:es throughout the year.
Nutrient intake is also related to seasonal variations with its maximum immediately after harvesting and its lowest when stores 1t1ere depleted. The individual dietary studies shmV'ed that adults consumed the major part of the foods, and pre-school childPen the minor part. In all ages the nutrient intakes were below recommended allowances with the exception of girls 16-20 years old. The institutional dietary studies showed that the nutrient intake of this section of the population was higher than that of individuals and family nutrient intakes. 24.1.3 The agriculture and livestock information collected showed that cereals, vegetables, fruit, pulses etc. grow well in Basutoland provided that proper care is taken. Milk, meat, eggs and poulty production is low, mainly due to poor breeding and At present the country is considered overstocxed, land grazing is not The estimated total agricultural production per year for the whole country improper feeding. sufficient.
is well belmV' their nutritional requirements. 24.1.4 The analysis of the vital statistics collected (even this is not 100% reliable) showed that infant and child mortality are very high. A great majority of the population The majority of males in the There is no compulsory
of Basutoland is young, and females are in the majority.
working age group are temporarily absent from the territory. registration
ot
births and deaths.
Kwashiorkor, marasmus, diarrhoea and infectious diseases appear to be the principal causes of infant and child mortality. 24.1.5 Socio.anthropological information collected showed that nutrition, health,
agriculture, education etc., are greatly influenced by strong beliefs, taboos, magic ideas, charms, etc., that are deeply rooted among the Basutos.
AFR/NUT/12 page 55 24.1.6 Information col~ected
on education showed that there is a great desire among . \
tha Basuto to get some form of education.
It has been said that the Basuto are the
ones with the highest degree of literacy among the African population of the whole continent.
24.1,7 Information collected on economic standing showed that a great majority of the population is p~or.
24.2 The height and weight study showed that almost two thirds of the young population is two or three.y~ars
retarded in growth and development, and suffering from
malnutrition grades I, II and III.
24.3 The skin fold thiclcness survey showed that there was a clear indication of calorie •. I
deficiency in a great percentage of the population.
24.4 The endemic , . goitre survey showed that 41.7% of the population is suffering fron1 iodine deficiency.
24.5 Protein bound iodine studies showed that F.B.I. values are low in a section of the population studied.
24.6 Plasma cholesterol studies showed low figures in the population surveyed. 24.7 The pellagra survey showed that this dietary deficiency is very prevalent among the population and mostly affects the stress groups. Seasonal outbreaks occur ·during the summer, and the disease appears to be on the increase.
24.8 Kwashiorkor and/or marasmus affect approximately 2.% of the children. Among the food habits that seem to be one of the most dangerous, from the public health point of view, is the frequent drinking, in large amounts, of home brewed alcoholic beverages by a large 25. RECOMMENDATIONS sect~on
of the population.
In the light of the interpretation of the findings of the surveys conducted it is recommended that:
AFR/NUT/12 page 56 25.1 The registration of all births and deaths should be made compulsory. 25.2 The Department of Medical Services should undertake to establish a section of vital statistics.
25.3 The agricultural production should.pe increased in order to provide the found to be short in the diet of the Basuto. UNICEF. The This could be accompl~shed
nutr~e~ts
by the
implementation of the expanded nutrition prograr.ll!le 'l'lith the assistance of WHO, FAO and
first draft of this programme was prepared by the \<THO nutrition team and the
Government officers concerned Hith agriculture, health and education. 25.4 A national nutrition council or similar body .should be established in order to co-ordinate the nutritional policy of the Government. 25.5 For public health purposes, well reputed standards cf beights, weights and skin fold measures should be used as a guide ·to measure progress of the nutritional status of the population.
25.6 Iodized salt should be introduced in Basutoland as soon as possible in accordance with specifications discussed ~n thi~
report.
25.7 Every effort should
~e
made in order to ·introduce or produce locally an enriched
maize meal mixture • . This maize meal mixture ·should be enriched with the foods that will provide the nutrients found deficient in the diet of the Basuto. 25.8 The matern~l
and child health
s~rvices
should be strengthened by increasing
personnel so that these services can reach a greater percentage of the rural population.
25.9 The health services should be expanded by increasing the number of personnel t>Tith public health training. 25.10 High priority should be given to the implementation with tne assistance of WHO,
FAO, UNICEF to the expanded nutrition programme of 'I'Thich the first draft was prepared by the WHO nutrition team in co-ordination with local authorities.
AFR/NUT/12 page 57 25.11 Education in health, nutrition and agriculture should be extended and suitable
teaching material developed as outlined in the expanded nutrition programme. 25.12 The production of foods, found short in the diet of the Basuto, should be increased as described in the draft plan of operation of the expanded nutrition programme. 25.13 Application for fellowships should be made to WHO, FAO, UNICEF and any other agencies so that local personnel can be trained to the needs required.
26.
ACKNOWLEDGEMENTS The experts are indebted to the Government of Basutoland for making the survey
possible and for their hospitality and help at all times, and in particular to Dr R. Jacobson, O.B.E., Director of Medical Services, and Drs R. E. J. Clarke and R. Standing for their unfailing assistance given throughout the assignment, to Mr D. Gampbell, Director, and to the staff of the Department of Agricultural and Livestock Services for their enthusiasm and constant co-operation and to Mr D. Day, the Director of Education, for interest shown. Deep gratitude is felt for the tu~derstanding
and support given by both the former
Paramount Chieftainess A. Mantsebo Seeiso and the present Paramount Chief C. Bereng Seeisc and their advisers, and more recently by the newly appointed Executive Council members. Sincere thanks are expressed to the Missionaries who, by help and generous hospitality, greatly facilitated the work of the experts. The advice and assistance given by Dr Burgess and Dr J. M. Bengoa of the WHO Nutrition Section, Geneva, and by the Director and staff of the Africa, are greatly appreciated. Special thanks are due to the Chief Librarian of the WHO Headquarters office, Geneva, who by forwarding the latest scientific literature kept the experts informed of recent developments in the field of nutrition. The information supplied on request by the Government of the Republic of South Africa proved helpful. ~lfHO
Regional Office for
AFR/NUT/12 page 58
Finally, recognition is given to r1r C.
~!Jorojele,
Statistician of the Department
of Agricultural and Livestock Services, for his able assistance and to the local team, f·i rs E. Mabathoana, Misses r1. Mofolo, M. Nchee and M. Mohapi, Messrs R. B. Fobo, B. Table and B. Moeketsi for the valuable work done, without which it would not have been possible to carry out the assignment.
AFRjrTUT /12 p:~.ge
59
TABLE I
Present agricultural production and agricultural target per year FOODS Milk Eggs Meat Estimates Present Production P.er year Unknown Target per annum Per capita per day
18 250 000 gallons 12 000 obo dozen 18 250 tons 36 500 tons
1/2 pint 1/2 egg 2 ounces 4 ounces
. I
Unknown Unknown Unknmm
Fresh Vegt. Beans .Potatoes -··
920 tons
J8 250 tons 18 250 tons 36 500 tons 27 300 tons 27 300 tons 36 500 tons I
2 ounces 2 ounces 4 ounces 3 otinces 3 ounces 4 ounces 4 ounces I
Peas
9 100 tons 2 625 tons 30 000 tons 20 ooo tons 70 000 tons .
Wheat Sorghum Maize Fruit
130 900 trees
36 500 tons
TABLE 2
Sex and age group distribution of the Basuto population .
Age Groups in Years
Percentages WI:IO Survey Social Survey Male I ; f I
Female
Male
"Female
Age Groups in Years
Percentages \'v'HO Survey Social Survey r1ale Female Male Female
-30-39 40-49 50-59 60 & + Unknown
0-4 5-9 10-14 15..19 20-29
22.2 20.9 18.5 7.3 7.6
15.1 14.6 9.7
20.8 18.5 15.2 9-9 7-3
16.9 12.1 10.0 10.4 15.6
7.3 9.5 4.0 2.7 0,2 r
12.1 11.0 5.1 4.0 I
8.3 7.1 7.1 6.0 0.3
10.6 8.8 8.1 7.4 0.1 -
9·9 18.5
0:1
AFR/NUT/12 page 60 TABLE
3
Numbers of Basuto of working age absent from Basutoland Age in Years 18-40 NALES <"i
FEMALES
ABSENTEES%
--
In 311
Out 307
j Total In
Out 124
Total 868
Males 49.6
Females
J
I,
618
l 744
- ----14.2
TABLE
4
Basuto Infant (0-1 year) Mortalit~ Rate from 1951 to 1957 Years of Mortality rate per 1000 1951 59 1952 1953 101 1954 66 1955 . 1956 62 113
1957 116
I
119
TABLE
5 ---.-
Basuto Child (1-4 years) Mortality Rate from 1951 to 1957 Years of 1951 195~
1953
1954
1955
1956
1957
-Mortality rate per 1000 114 153 144 93 139 155 154
AFR/Nrrr/12 page 61 TABLE
6
Basuto Crude Death Rate from 1951 to 1957 I
Years of Crude death rate per 1000
1951 5
1952
1953 8 I
1954 1. 1955
l
1956 11
1957 7
I
I
10
! I
I
10 !
I I iI
·6
__l ,
,.
:-
TABLE
7
Basuto Fertility Rate from 1951 to 1957 -
-
-
Years of . .. -
.
1951 132
1952 153
1953
1954
1955 118
1956 139
1957 96
Fertility rate per 1000
153 I 124
-
TABLE
8
Basuto Birth Rate from 1951 to 1957 Years of Birth rate per 1000 1951 1952 1953 1954 1955 1956 1957
I
I
--
AFR/NUT/12 page
62 TABLE 9
Mea1W with margin of variation of heights and weights of Basuto children AGE HEIGHTS (in) No. Hths of Cases fiJeans riJarg. o.f var •.
MALES WEIGHTS (lb) No. of Cases ·r. 1 arg. .of Means var, +
FEHALES
'r
HEIGHTS (in) No. of Cases I·1eC4'1.S riJar·g.
'
WEIGHTS (1b) of var. +
No. of Cases Means
+
riJarg. of var. +
1-6 7-12 13-23 2 Yrs 3 Yrs 4 Yrs 5 Yrs I
20 56 44 64 70 71 98 77 54 75 73 73
25.2 27.8 29.2 32.5 34.7 37.7 39.1 42.6 45.7 37.0 48.5 49.8 51.4 53.3 54.8 58.5 60.2 62.4 62.9 64.7 65.6 64.2
1.1 0.6 0.6 0.5 0.8 0.8 0.7 0.7 1.2 0.6 0.8 0.8 0.4 0.6 0.7 0.8 0.9 0.7 0.8 0.7 0.8 1.2
21 48 37 59 71 70 101 79 43 71 64 63 54 95 70 74 64 79 54 50 34
15.8 19.4 20.4 24.6 27.5 :;0.5 34.0 40.6 42.9 46.7 52.3 56.0 59.0 65.2 67.3 83.6 91.2 03.2 09.4 18.1 ~25.8
1.7 0.8 1.6 0.8 1.0 1.3 0.9 1.5 2.3 1.5 1.8 2.7 2.2 2.1 2.9 3.7 4.8 3.4 4.1 4.0 6.4 6.7
32 62 37 61 69 62 79 60 92 120 86 178 140 155 184 184 197 166 129 70 51 17 2231 I
20.7 27.0 29.0 31.9 34.3 37.3 39.1 42.8 45.3 46.3 47.9 49.6 51.5 53.5 55.8 58.8 60.0 60.7 60.8 61.5 61.3 61.2
l.l
30 60 34
14.0 17.5 19.1 22.7 26.7 30.7 33.6 39.1 43.1 45.4 49.1 53.9 58.5 64.1 72.6 90.1 98.6
1.2 0.7 1.0 0.7 0.8 0.8 0.9 1.9 1.3 1.2 1.9 1.4 1.6 1.5 1.8 2.3 2.0 2.2 3.0 -4.7 4.5 7.8
0.6 1.0 0.5 ' 0.6 0.6 0.7 1.0 0.7 0.5 0.8 0.4 0.5 0.4 0.4 0.4 0.4 0.4 0.5 0.5 0.8 1.5
59 69 61 79 63 89 123 88 175 146 153 178 197 197
6 Yrs 7 Yrs 8 Yrs 9 Yrs 10 Yrs 11 Yrs 12 Yrs 13 Yrs 14 Yrs 15 Yrs 16 Yrs 17 Yrs 18 Yrs 19 Yrs 20 Yrs Total
67 98 78 82 67 78 66 55 36 15 1417
161 106.8 129 111.8 71 114.2 49 115.8 19 123-5 22:;0
16 P-26.3 1317 I
I
AFR/i.tYL' /12 page
63
TABLE
10
ThTCAP STANDARD FOR HEIGHrS AND WEIGHTS OF GIRLS
Age in
Height em
Weight 1b 7-5 8.6 10.6 12.3 14.1 15.7 17.0 17.9 18.7 19.4 20.0 20.7 21.4 21.8 22.5 22.9 23.4 24.0 24.5 26.0 kg
AGe Years 7-3 Years i
Height in 47. 8 48.4 48.9 49.6 50.2 50.8 51.4 52.0 52.5 53.1 53.7 54.3 54.9 55.5 56.1 56.7 57.3 57.9 58.5 59.0 em
Weight 1b 50.9 52.5 53.8 55.1 ..
-
kg
0 r1onth 1 Month 2 - Non~hs :
19.8 22.2 . 21.2 23.4 24.3 21~. 9
.. 3.4 3.9 4.8 5.6 6.4 7.1 -
50.2 53.8 57.0 59.4 61.8 63.7 65.6 67.5 69.0 70.4 71.8 73-3 74.5 75-5 76.5 77.5 78.5 79.5 8o.5 83.5
121.5 123.0 124.5 126.0 127~5 1~9.0
23.1 2:,5.8 24.4 25.0 25.6 '
7-6 Years 7-9 Years -
)·Months 4 Months
8-0. Years 8-3 Years 8-6 Yekrs 8-9 Years 9-0 Years 9-3 Yem.,s 9-6 Years 9-9 Years 10-0 Years 10-3 Years 10-6 Yet.rs 10-9 Years . 11-0 Years 11-3 Years 11-6 Years 11-9 Years 12-0 Years
56.4 I
-
5 Months 6 f-ionths . 7 Months 8 Months 9 Honths 10 Months 11 Months 1-0 Years 1-1 Years 1-2 Years 1-3 Years 1-4 Yea:rs 1-5 Years 1-6 Years
25.8 26.6 .2'{.2 27.7 28.3 28.8 29.3 29.7 30.1 30.5 30.9 31.3 31.7
-
7-7 8.1 8.5 8.8 -
130.5 132.0 133.5 135.0 136.5 138.0 139.5 141.0 142~5
58.4 . 29-5 .. 60.0 27.2 61.7 63.5 65.0 66.6 68·.4 70.1 28.0 28.8 29.5 30.2 31.0 31.8
9.1 9.4 ..
9-7 9.9 10.2 10.4 10.6 10.9 -
7L7 · 32.5 73.2 33.2 34.0 35.2 56.5 37.8 39.2
144.0 145·5 147.0 148.5 150.0
.
75'. o I
77.6 80.5 83.3 86.4
11.1 "11.8
1-9 Years· 32.9
AFR/NUT/12 page 64
TABLE 10 (Continued) Height in 2-0 Years 2-3 Years 2-6 Years 2-9 Years 3-0 Years 3-3 Years 3-6 Years 3-9 Years 4-0 Years 4-3 Years 4-6 Years 4-9 Years 5-0 Years em
Age
Weight 1b 27.6 28.7 29.8 30.9 32.0 33.1 34.2 35.3 36.4 37:5 38.6 39.7 4o.8 41.9 4).0 44.145.4 46.5 47.6 48.7 49.6 kg -
Age Years
Height in em
Weight 1b 89.1 91.9 94.8 97-9 100.1 102.3 104.5 106.9 109.1 111.4 113.6 114.7 115.1 115.8 116.4 116.9 117.1 117.3 117.7 118.0 kg
-
34.2 35.1 36.0 36.8 37.9 37.3 39.0 39.) 39.9 40.9 41.5 42.0 42.5 43.1 43.7 44.3 44.9 45.5 46.,1 46.6 47.2
87.0 89.3 91.5 9.3.5 95.5 97.4 -
12.5 13.0 13.5 14.0 14.5 15.0 15.5 16.0
12-3 Years 59.6 12-6 Years 60.2 12-q Years 60.8 13-0 Years 61~4
..
151.5 153.0 154.5 156.0 156.8 157.5 158.2 159.0 159.5 160.0 160.5 161.0 161.0 161.0 161.0 161.0 161.0 161.0 161.0 161.0
4o.4 41.7 43.0 44.4 45.4 46.4 47.4 48.5 49.5 50.5 51.5 52.0 52.2 52.5 52.8 6).0 ·--
13-3 Years 61.7 13-6 Years 61.9 13-9 Years 62.3 14-0 Years 62.6 '14-3 Years 62.8 14-6 Years 63.0 14-9 Years 63.2 15-0 Years 63.4 15-3 Years 63.4 15-6 Years 63.4 15-9 Years 63.4 16-0 Years 63.4 16-3 Years 63.4 16-6 Years 63.4 16-9 Years 63.4 17-0 Years 63.4
·---
99.0 100.7 102.5 104.0 105.5 106.8 108.0 109.5 111.0 112.5 114.0 115.5 117.0 118.5 120.0
--
-
16.5 17.0 17.5 18.0 -
18.5 19.0 19.5 20.0 20.6 21.1 21.6 22.1 22.5
5-3 Years
5-6 Years -
5-9 Years 6-0 Years 6-3 Years
I --
53.1 53.2 53.4 53.5
I
6-6 Years 6-9 Years 7-0 Years
AFR/NUT/12 page 65
TABLE ll INCAP STANDARD FOR HEIGHI'S AND WEIGhTS OF BOYS
Age months and Years 0 Month 1 Month 2 rllonths 3 Months 4 Months 5 Months 6 Months 7 Months 8 Months 9 Months 10 Months ll Months 1 Year 1..1 Year l-2 Years 1-3 Years 1-4 Years 1-5 Years 1-6 .Years 1-9 Years .
Height in 20.0 21.3 22.8 24.1 25.1 25.9 26.6 27.4 27.0 28.0 29.0 26.2 29.8 29~9
Weight 1b 7-7 9.3 11.7 13.7 15.4 16.8 17.9 19.0 20.1 20.9 21.6 22.3 23.2 23.6 24.3 24.7 25.1 25.6 .
Age Years 7-31 Years I I
Height in 48.6 49.2 49.8 50.4 51.3 52.2 53-7 52.7 53.2 53-7 54.2 54.755-7 55.8 56.2 56.7 57.2 em
vleir.ht 1b 52.0 53.6 54.9 56.2 57.6 58.9 60.8 61.7 63.5 65.0 66.6 68.4 70.1 71.7 73.2 75.0 77.0 78.9 80.7 82.7 l"g ..
em
kg
51.0 54.2 58.2 61.2 63.7 65.7 67. _ 6 69 . .5 71.9 72.0 73.0 74.0 76.0 77.0 78.0 79.0 80.0 81.0 82.0 85.0
3.5 .4.2 . 5-3
123.5 125.0 126.5 128.0 130.3 132.5 133-9 134.0 135.2 136.5 137.8 139.0 141.5 141.8 .. 142.8 144.0 145.2 146.5 147.8 149.0
" 23.6 24.3 24.9 25.5 26.5 26.8 27.7 28.0 28.8
.7-6 Years 7-9 Years 8-0 Years 8-3 Year.s .8-6 Years .8-9 Years ..
l
..6.2 . 7.-D 7.6 8.1 .
-
8.6 9.1 9-5 9.8 10.1 10.5 10.7 11.0 11.2
-.
9-0 Years 9-3 Years 9-6 Years 9-9 Years 10-0 Years 19-3 Years
29.5 3().2 31.0 31.8 32.2 33-2 34.0 ·--
)0.8 31.1 31.5 31.9 32-3 33-5
.
10-6 Years 19-9 Year9 ll-0 Years ll-3 Years
11.4 11.6 .. 11.8 12.5
-
34.9 35.8 36.6 37-5 I
11-6 Years . 57.7 ll-9 Years 12-0 Years 58.2 58.7
26.0 27.6
AFR/NT.Jr/ 12 page 66
TABLE 11 (continued) Age months and Years 2-0 Years Height in
Weight
Age l<g Years in
Height em
Weight
em
1b 29.1 3().0 31.1 32.2 33.1 34.2 35.3 36.4 37.5 38.6 39.7 40.8 41.9 43.0 44.1 45.2 46.3 47.4 48.5 49.6 50.7
1b
l<:g
34.6 95.4 '
88.0 90.0 92.0 94.0 96.0 98.0 100.0 101.5 103.0 105.0 107.0 108.5 110.0 111.5 113.0 114.5 116.0 117.5 119.0 . 120.5 . 122.0
13.2 13.6 14.1 14.6 15.0 15.5 16.0 16.5 17.0 17.5 17.0 18.5 19.0 19.5 20.0 20.5 21.0 21.5 22.0 22.5 23.0
12-3 Years 12-6 Years 12-9 Years 1)-0 Years 13-3 Years 13-6 Years 13-9 Years 14-0 Years 14-3 Years 14-6 Years 14-9 Years 15-0 Years 15-3 Years 15-6 Years 15-9 Years 16-0 Years 16-3 Years 16-6 Years 16-9 Years 17-0 Years
59.1 59.5 59-9 60.6 61.1 61.6 62.1 62.6 63. 1 63.6 64.1 64.2 64.6 65.5 66.1 66.5 66.8 67.2 67.4 67.7
150.2 151.5 152.8 154.0 155.2 156.5
85.1 38.6 87.8 39.8 90.2 40.9 92.6 42.0 95.9 45.5 99.2 45.0
2-3 Years 2-6. Years 2-9 Years 3-0 Years · 3-3 Years 3-6 Years 3-9 Years 4-0 Years 4-3 Year.s 4-6 Years 4-9 Years 5-0 Years 5-3 Years 5-6 Years 5-9 Years 6-0 Years 6-3 Years 6-6 Years 6-9 Years 7-0 Years ..
36.2 97-2 ~7.8
'
38.6 I
39.4 39.9 40.5 41.3 42.1 42.7 ~3-3 ~3-9 .
157.8 102.5 46.5 159.0 105.8 48.0 160.2 109.1 49.5 161.5 112.5 51.0 162.• 8 115.8 . 52.5 164.0 119.1 '· 54.0 165.2 121.7 55.2 166.5 124.6. 56.5· ~
...
- --
44.5 45.0 45.1 46.2 46.8 47.4 48.0
167.8 127.4 · 57.8 169.0 130.1 59.0 169.8 ' 132.1 59.9 .
170.6 145.1 60.8 171.2 135.8 61.6 172.0 137.8 62.5
r TABLE 12 Frequency distribution of heights of Basuto children compared with INCAP Standards. Age in Years Number of children M
%taller than the standard M
%Equal to the standard M
Percentages of children retarded
1 Year M
2 Years F M
3 Yrs & more M
Total percentages of children 3 Years retarded Taller/Equal M
F
F
F
F
F
F
M
F
2 3 4 5 6 7
64 70 71 98 •77 54 75 74 ~-3
84 107 84 79 60 92 120 86 . 177 140 147 181 184 197 166 129
6.2 8.5 9.8 6.1 12. 9 18.5 9-3 10.8 8.2 4.4 4.0 5.1 12.1 14. 9 5.1 3.0
25.0 6.5 7.1 7.5 3_ 1 .6 19.5 li.6 6.9 2.9 7.1 0.6 1.6 4.8 7.6 10.2
6.2 8.5 5.6 4.1 1.2 11.2 - 8.0 8.1 2.7 1.4 3.0 1.2 1.2 8.1 14.1
14.2 11.2 3.5 15.1 25.0 10.8 3.3 5.8 2. 9 1.4 4.0 1.1 3.8 9.1 6.6 13.9
87.5 42. 8 42.2 16.3 40.2 35.1 25.3
60.7 61.6 38.0 27. 8 6.6 48.8 38.3 40.0 36.6 47.9 20.7 18.5 32.0 29.7 24.6 28.3 17.3 24.3 34.1 16.4 25.6 22.7 '
12.4 20.5 44.0 35.4 20.0 13.0 41.6 5.6 25.5 24.6 16.6 25.3 7.1 --
39.2 17.7 10.6 22.6 --
87.5 82.8 84.4 89.7 85.5 70.2 82.6 81.0 88.9 93-5 92.7 93.4 86.5 76.0 80.7 83.2
60.7 82.1 89.1 7_7.1 43.2 69.6 84.9 87.0 94.1 91.4 93.1 97.1 91.2 83.1 82.9 75.1 ~ ro ..... 0 '0
17.0 15.4 10.2 14.1 29.6
13.9 16.6 7.9 :5.0
56.6 )0.3
8 ·..._:·..
17.3 - 14.9 18.9 10.9 -5.-8 7.0 6.3 13.3 23.0 19.2 16.6 12.7 5.8 8.5 4.6 2.7 8.6 16.7 16.8 24.7
9 10 11
16.2- 33.-7 10.9 17~9
31.-.3 -- 35.1- c 22.0 33.8 45.0 22.4 41.9 36.9 14.7 19.8 17.0 53.4 47.3 59.1 60.2 37.8 46.2 34.6 51.5 27.6 35.0 53.0 41.4 38.0 55·3 41.5 43.4
32.7 11.4 19.7 13.8 16.3 13.1 21.6 14.7
67 98 78 82 67 78 66
12 13 14 15 16 17
16.3 8.9 14.6 13.4 20.5 9.0
--
I 10. 8 I 13.6
TABLE 12 (continued) Number of children M
%taller than the standard M
% Equ,al to the standard M
Percentages of children retarded 1 Year M
Age in
2 Years F M
3 Yrs & more M
Total percentages of children 3 Years Taller/Equal retarded I
Years 18 Total Grand Total I
F
F
F
F
F
M
F
M
F
55 1247
70 2103 3350
1.8 8.1 '
12.8 8.5
7.2 6.0 6.7
22.8 7.5
23.6 25.0 25.5
20.0 26.0 1
16.3 26.3 27.0
18.5 27.8
50.9 34.1~
25.7 3().0
9.0 14.1
35.6 16.0 15.0
90.8 85.7
64.2 83.8
8.3
32.2
I
84.7
TABLE 13 Frequency distribution of weights of Basuto children compared with INCAP Standards. Number of Age in Years cases M Unde~%eight
Percentages higher than standard M
Percentages equal to the standard M
10-24 I
:
grades in percentages
25-39% II F
40%
III · M
Total percentage 3 grades of Normals underweight F M
F
F
F
M
F
M
F
M
F
9 3 4 5 6 ~
59 71 132 94 78 43 68 62 60 53 91 66 72 63 75
59 69 59 78 65 85 122 86 165 144 149 169 181 202 162 I
6.8 8.5 14.3 8.5 16.6 13.9 7.4 8.1 5.0 1.9 6.6 4.5 9-7 9.5 4.0
10.1 8.7 11.8 5.1 16.8 9.4 8.2 4.6 6.1 3.5 1.3 2.2 12.2 6.9 23.4
11.8 19.7 28.0 12.8 23.1 )0.2 25.0 22.5 13.3 16.9 13.2 6.1 8.3 12.7 18.7
10.1 69.5 17.4 56.3 15.2 37.1 14.1 51.1 21.5 37.2 21.2 32.6 9.8 44.1 10.5 53.2 4.2 53.3 9.0 39.6 8.7 40.7 5.9 30.3 22.6 36.1 33.2 25.4 29.6 38.7
38.9 42.0 47.4 51.3
11.8 14.1 20.4
32.2 26.1 22.0 1.4 0.75
8.5 5.8 3.4
18.6 28.2 42.3 21.3 39-7 44.1 32.4 )0.6 17.3 18.8 19.8 10.6 18.0 22.2 22.7
20.2 26.1 27.0 '19.2 38.3 )0.6 18.0 15.1 10.3 12.5 10.0 8.1 34.8
81.3 71.8 59.4 78.8 60.2 55.8 67.6 69.3 81.6 81.1 80.3 89.4 82.0 77.8 77.4
79.6 --·
73-9 72.8 80.8 21.5 69.4 81.9 84.9 89.6 87.4 89.7 91.1 65.9 59.9 46.9
26.6 - 29.5 . 1.0 21.7 20.9 23.5 16.6 26.6 41.5 36.3 51.5 43.1 36.5 33.3 I
o.o o.o o.o 2.4 5.8 3.8 2.7 9-3 10.6 4.8 0.5
1
26.1 52.9 50.8 51.2 47.3 35.4 33-5 28.9 34.2 39.6 38.5
35.4 16.5 28.7 27.9 37-5 49.3 46.9 52.2 27.0
1.3 2.3
.....
7 8 9 "
o.o
o.o 1.7
10 11 12 13 14 15 16
o.o 3-3 7.6 2.0
-
19.8 15.9 7.4 5.4
4o.o 53.0
---
o.o
TABLE 13 (continued) Ntunber of cases M
Age in Years
Percentages Percentages equal to higher than standard the standard r- . ~~~
.. Unde~%eigh~ grad~~~n percenta1%s
10-24 I
2S-
40
II F
III F M F
Total percentage 3 grades of Normals unde~eight_ M F M F
-l 1
F
F ' '
M
F
M
I
17 18 Total
53 50 1190
127 69 1991 3181
9.4 2.2 8.0
29.9 23.1
18.8 20.0 16.9
29.9 39.1 17.8
37-5 52.0
35.4 34.7
. 24.5 22.0
M
i
··-·-
2.3 1.4
7.5 4.0 4.3 4.0
2.3 1.4 3.7
28.2 22.0 24.9 26.4
59.8 62.2 i
71.6 88.0
40.0 37.5 71.7
-Grandt Total
110.2 9.1
43.6 I 39.7 41.6
26.9 28.3
28.0 ' 74.8
.
l
.17.3
I
27.6
I
l
73.2
----
AFR/NUT/12 page TABLE 14 A. VERAGE WEIGHTS OF. MEN NI TH CLOTHES MsTROPOLI Tl\N UFt .- - - - - - - - - . .
71
Age
s•
s•11 s• s• s•11 s.- si s•11 s• 1 2a 3n 4 5• 6~ 7
·-·
5' s• 6 • 6' 61 6' 6• ; 8" 9n 10 1 11 11 68 I 2 3 4" 51 I 51
----·-·::.
.
- - ' - - 4.:--.- ,
IS Ul7 J09 112 115 118 122 126 130 134 138 142 147 152 157 162167 172177 16109111 114 117120124 128 132136 140144 149154 159164 169174 179 I7 18 19 20 21 22 Ill 113 116119122126 113 115118 121 124 128 liS 117 120 123 126 130 ll1 119 122 12S 128 132 1[8 120 I 23 126 130 134 J/9 121 124 127 131 135 231£0 IE2125 128 132 136 24 121 123 126 129 133 137 122124 123 125 124 126 12S 127 126 128 126 127 128 129 130 129133 130 134 131 134 132 13S 133 136 133 134 134 134 135 135 135 136 136 137 137 136 137 137 137 !38 138 138 139 140 140 140 130134 132 136 134 138 136 140 138 141 139 142 140143 141 144 138142146 151 140 144 148 !53 142 146 rso· ISS 144 148 IS2 156 I4S 149 153 IS7 146 ISO 1S4 1 S8 147 lSI ISS JS9 148 152 IS6 160 156 158 160 161 162 163 164 163 161 163 165 166 167 168 169 171 166 171 176 [68 173 178 110 17S 180 171 176 181 172 Jn 182 173 178 183 175 180 185 177 182 187 181 183 185 186 187 188 190 192
2S 26 27 28 29
131 141 I4S 149 153 157 162167 173 179 184 189 194 138 142 146 138142146 139 143 147 140 144 148 140 141 141 141 142 142 142 143 144 144 144 144 148 145 149 145149 145 149 146 150 146 146 147 148 148 148 ISO 154 ISO 154 lSI ISS 152 156 !58 163 158163 159 164 160 16S 168 174 180 169175181 170 176 182 171 177 183 178 179 180 181 182 184 185 186 187 188 186 191 196 187192197 188 193 198 189 194 199 190 196 191 197 192198 193 199 194 200 201 202 203 204 206
30 126 128 130 31 127 129 131 32127129131 33 127 129 131 34 128 130 132 35 36 37 38 39 40 41 42 43 44 45 128 128 129 129 130 130 130 130 131 131 132 f32 132 132 133 133 134 134
152 156 161 153 157 ;6 15~ 158 [63 154 159 164 ISS 160 165 160 160 161 162 162 162 163 163 164 164 J65 f65 166 166 166 166 165 165 166 167 167 167 168 168 169 169 170 170 171 171 171 171
166 172 lo7 173 168174 169 175 170 176
1so rss ISO 151 152 152 !52 155 156 157 157 157 158 158 !58 159 160
110 176 182 189 195 201 201 170 171 172 173 173 174 174 175 175 176 176 177 178 179 179 182 183 184 185 185 189 190 191 192 192 193 193 194 194 195 195 196 197 198 199 200 200 201 201 202 202 203 204 204 204 201 202 203 204 205 206 207 208 208 209 209 210 211 211 211 207 208 209 210 211 212 2.13 214 214 215 215 216 217 217 217
131 133 131 133 132 134 132134 133 135
135138 141 145149153 135 138 141 145 149 153 136 139 142 146 ISO 154 136 139142146 ISO 154 137 140 143 147 151 155 !43 144 144 144 144 147 !51 148 152 148152 148 152 ]48 !52
180186 180 186 181 187 181 187 182 188
46 133 47 ]34 48134 49 134 so 134
135 137 140 136 138 141 136138141 '136 138 141 136 138 141
ISS 160 156 161 [56 161 156 161 156161
176 182 177 183 177183 177 183 177183
188 195 [89 196 190197 190 197 190197
NOTE Deduct I Inch for shoes and 8 pcunds ftr clothes to determine nude weight.
p,ffijlJUT/ 12 page
72 TABLE 15 AVERAGE WEIGHTS OF \\'OIAEN IVITH CLOTHES METROPOLITAN liFE
•
Age 4' 4' 4• 8" . 9" 10 11 11 11 IS 101 103 16 102 104 . . 17 '103 105 · 18.104 106 19 105107 lOS 106 107 108 109 106 108 109 !10
sa
s• s• 111
2~ 3~
5'
s• 5' s• s• s• s• 411 5~ 6'~ 711 811 9" 118 120 122 123 124 122 126 130 134 124 128 132 136 125 129 133 137 126 130134 138 127131 135139
s• s• 10 II. 6'
107 109 109 Ill Ill 113 112114 Ill 113115
112 114 116 ll7 JIB
115 11.7 119 120 121
138 142 147 152 139 143 148 153 140 144 149. 1'54 · 141 145 ISO (55 142145151 ISS
20 '[06 108 110 112 Il4 116 119 122 125 128 1!32 136 140 143 147 151 (56 21 107 109 Ill 113 liS 117 120 /23 126 /29 133 137 141 144 148 152 156 22107109111113 115117120123 /26 129 (33 137 141 145149153 157 23 108 110 112 114 116 118 121 124 127 130 IJ4 138 142 146 .ISO !53 157 24109111113 1151·17119 121124127130134138142146150 154158~ 25 109 Ill 113 115 117 119 121 124 128 131 135 139 143 147 151 154 158 26 110 112 114 116 118 120 122 125 128 131 135 139 143 !47151 ISS 159 27 110 112 114 116 118 120 122 125 129 132136 140 144 148 152 ISS 159 28111113115117119121123126130133137141145149153156160 29 II I 113 II 5 117 II 9 I 21 I 23 I 26 13 0 13 3 13 7 14 I 14 5 14 9 I 53 I 56 16 0 30 31 32 33 34 112 114 116 118 120 122 124 121 131 134 138 142 113115117119121 123125128132135139 14J 113 115 117 1 .19 121 123 125 !28 132 IJ6 1~0 144 114 116 II 8 I 20 12 2 I 24 126 I 29 133 13 7 141 I 45 115117 119121 123 125127130134138 142146 146 ISO 141151 148 !52 14 9 153 ISO 154
154 157 !61 154157161 155 158 162 !56 159 16 2 !57 160163
35 115 117 119 121 123 125 127 130 134 138 142 146 ISO !54 157 160 163 36 1!6 118 120 122 124 126 128 131 135 139 143 147 151 ISS 158 161 164 37116118120122124 126 129132136 14 0 144 148152156159 162!65 38117119121 123125127130133 137141 145149153 157160163166 39 JIB 120 !22 124 126 128131 !34 138142146 ISO 154 158161 164 167 40 41 42 43 44 1!9 121 J 20 122 120 122 121 123 122124 124 125 I 25 126 126 123 125 124 126 124 126 125127 126 128 126 127 I 27 128 128 127 129 132 135 128 130 !33 136 128 130 133 136 !29 131 134 137 130132135138 138 139 13 9 140 140 138 142 146 ISO 154 !39 143 147 151 ISS 139 143 147 151 155 140144 148152156 141 145149153 !57 l41 142 14 2 143 143 144 144 144 144 144 145 146 14 6 147 147 148 148 148 148 148 149 15;.1 ISO 154 I 51 I 55 152 156 152156 152 156 !52 157 152 157 152157 153 158 157 158 I 59 160 161 158 161 164 167 !59 162 165 168 159 162166 169 160163167170 161 164 168 171 161 164 168 171 162165169 172 163 16 6 17 0 173 164 167 171 174 165168 172175' (16
45 122 46 123 47 I 23 48 124 49124
128 130 132 135 129 131 133 136 I 29 131 13 3 13 6 130 132 134 ']37 130132134 137
50 125 127 129 131 51 125 127 129 131 52 125 127 129 131 53 1251Z7 129131 54 125127 129131
133 135 138 141 133 135 138 141 133 135 138 141 133135138141 133135138141 I
161 165 !69·(73 162 166 170 174 162 166 /10 174 162166170174 163 167171174
177 177 177 177
55125127 129131 133 135138 141 144 148 153 !58 163 167171 174 177 + over
1
NOTE
Deduct I 1/2 inches fer shoes and 4 pcunds for clothes to determine nude weight.
AFR/NTR/12
page 73 TABLE 16
Means and standard deviations of skin fold thickness of Basuto
C~ildren I
Age in Years 2
A R 1) 1.iales Nos 35 33 36 56 -48 34 34 34 37 23
B .li G K
ABD0 I Females Males
E H
Females
Males
Females
x
SD nos
x
SD 2.3 1.8 2. 2 1.6 1.3 1. 0 1.6
N os 34 32 34 49 49 36 33
:X
SD 1.3 1.5 I
No s 35 2 8 3o 39 41 5-l 72 51 93
x 6.1
SD 1.8 1.3 u.3 1,1 1. 0 0. 3 I. 2 .3
Nos
x
SD 2.1 2.3 1.9 1.8 1.0 0.3 0.7 I.I 0.7 u. 9 I. 2 I. 5 2. 3 2. (
ll:os 35 30 37 39 48
x 5.9 7,I 5.0 5. 2 4.0 3.9 4.5 4.7 4.7 5.4 6.4 6.5 7.8
SD 2. 0 I. 9 I ~3 1.-7
10.5 1.7 9.7 2. 5 9.1 2. 2
37 I0.4 28 37 37 40 53 68 51 100 73 86 116 83 9.9
6.4 4.8 5. 4 5. 0 4. 2 3.9 4. 0 4, 5
32 6.2 35 6.1 34 ),4 57 5.6 48 4.0 39 4.0 33 4. 0 34 4. 2 37 11. 2 23 t~ .
3 4
b.O 5.1 5.1 4.5 4.4
9,1 8. 6
.' [I
5 6 7 8 9 10 II
8.3 1.8 5,8 1.3 5. 9 I. 4 5,6 I. I 5. 5 I. 2 5.3 I. I
1.0 1.0 0.7 0.8 0. 9 0. 7
6,3 6.1 6, 2 6 .I
o.a 0.9 I. 0 1.6 I. 7 2. 2 3.5 3.6
55 67 50
4.7 4.9 4.7 5.3 5. 2 6. 2 8.8 9.7
I. 2 34 2. 2 I. g 2. 6 2.1 3. 9 5. 9 34 23 58 49 57 ]2
6. 9 6.8 7. 4 8. 0 8. 6
4. 4 4. I 4. 7 4. 8 5, .,
I. I 1.6 I. 'I 2. I 5. 0 5.3 6. 1 5.4 5. 1 5. 0
94 74 86 117 87
5. 2 1. 6 5.8 1.7 5. 7 2.0 6.5 I. 5 6.I I. 2
O .ti I 74 I. 2 1. 4 1.3 I. 2 1. 6 85 11 8 85 122
9
12 13 14 IS 16 17 18 I9 20 TOTAL
58 48 57 52 56 45 40 27 10 763 I I
55 4.7 47 5.1 59 6.3 48 b.3 55 7.3 50 8.1 42 8.3
D.O 8.8 9.! 9,1 5.9 5.3 2. 2
120 13. 5 I 04 17. 0
5. 4 6. 4
117 18.3 97 22. 2 68 24.5 3b
6.2 1.5 6,4 1.7 6.7 1.8 7.3 2. I 7.9 2.0 I.
8.C 55 6, J
104 10. 5 73 14. 7 39 14. 8 21 15. 0
2, 0 2. 6 2. 5 3. 2 1.3 I
73 18. 8 '
46 40
o. O 1. 0 D.7 8.1 9, 0 1.3
39 19.9 21 14.9
5. 0 4. I 2.4 I I
22.8
27 10
2. 0 2. 0
2o 7. 5 10 8. 9 754 I I
20 23. 2 10 17.5 i
8 20.0
8 15. o j2. 5 117 9
1174 I
- I 752
I
i
j
I
1165 I
r .. J..
· c"'/"'"',.,/ u.l , ..:.\. ...
..L. 0 t:..
page 74 TABLE
16
A
Comparisons of Canadian and Basuto arm skin-fold thickness recorded in millimetres Age in Years Means Canada Basuto IVIALES
FEr '!ALES ! -
Cases
Total +
fileans
Cases
j Total +
I
= 7 5
cases Canada jBasuto
12 0 /
=
] cases
2 3 4 5 6 7 8 9 10 11
9.4 ; 9.0 8.3 . 7.5 7.4 6.9 6.8 7.1 7.1 7-9 8.0 8.3 7.5 6.5 6.4 6.4 6.0 6.0 Totals
10.5' 9- 7' 9.1 8.3 5.8 5.9 5.6 5.5 5-3 5.2 5.8 5.7 6.5 6.1 6.2 6.4 6.7 7-3
I
7 13 16 18 38 20 . 29 . 30 35 20 53 . 43 47 31 . 26 26 20 . 10 482
21 15 13 31 3 7 2 1 1 2 3 5j
35 33 36 56 48 ·34 34 34 ·37 23 58 48 57 52 57 45 . 40 27 754
9-5 9.6 9-3 8.8 8.8 8.5 8.9 9.4 9.5 10.0 10.5 11.2 .-11.3
10.4 9.9 9.1 8.6 6.3 6.1 6.2 6.1 6.9 6.8 7.4 8.0 8.6
6 5 3 5 7 6 5·
19 14 12 17
37 28 37 37 40 53 68 51 100
-
7 7 7 7 3 3 l
22 15 33 43 60 49 87 68 73
I 4 3 2 9 3 9 6 1
-
1 2
J 2I 4. 5 5· 8
l
4
-·73
' 12 "13 ' 14 15 16 17 . 18 . 19
86 116 f.
2 9 16 8 2
105 61 57 44 21 8 8 775 I
sl 12 15 11 18 12 180
17 55 57 49 30 12 318
83 120 104 73
11.3 . 13.5 13.3 17.0 13.3 . 18.8 13.6 13.6 Total~
.
3 3 1 1 73
19.9 14.9
39 21 ·1166
5
I
I 92
Percentages
63.9 12.2 23.9
-
Percentages
j66.4
!6.3
27.3
-
r THYROID I-
TABLE
17
AFR/Nr.Jr/ 12 page 75
Endemic goi.tre .in B_asuto school children CONDITION
Sex
Age Groups 1-i2
Normal Nodular
Grades II
I 2648 1862 143 4653 1472 1358 343 3173 7826 I
I
I rr_ r 1
!
I
Diffuse I
-
Grades
·- No. of tives
Total cases
-,------ posi-:III
II
Percentage of positives.
8
1"/.l
4
-
934 1058 100 2092 512 714 223 ,1449 ~
311 698 61 1061 1::;o 323 155 614 1675
34 124 12 170 14 22 13 49 219
1287 1878 173 3338 665 1061 394 2120 5458
3935 3740 316 7991 2137 2419 737 5293 k13284 t
32.7 50.2 54.7 41.7 31.1 43.8 53.4 40.0 41.0 i
(J)
.-i
ttl Ei (J)
13-18 ..
2
IZ.
19 + Females
10 3 2 2 7 17
4
1
Total 1"/.l
..
1-12 13-18 19 +
(J)
.-i
::E:
ttl
1 1 5
1
Total Males Grand Total
13541
TABLE 18
Geographical distribution of endemic goitre in Basutoland Population present
"DISTRIGrS
2% to be examined
Number examined
Percentage positive
1 Butha-Buthe 2 Leribe 3 Mokhotlong 4 Berea . 5 Maseru 6 Mafeteng 7 Qacha's Nek 8 Mchale's Hoek 9 Quthing
32 520 99 175 44 285 73 030 125 559 77 799 44 408 76 514 52 108 .. . ~
770 1 983
1 524 2 365
32.2 33.3
1 460 2 511 !
1 714 3 537 1 809
30.0 47.4 43.9
1 555
1 530 1 ')42 ...
I
43.9 ·-·
-
1 157 1 078 13 284 ;
~tal .
·-
..
50.7 41.1
585 396
I
10 851
AFR/NUT/12 page 76 TABLE
19
Sera P .B .I. levels in 616 ~"i trous and non goi trous Basuto Age
Normals in Years No.
I I
,_ No. 1
I.fAL:CS
FEI\I.ALES
Goi t:rous Grades I II
-- - Formals III ' I I
Goitrous Grades -
X
x
I I
4
--
5 6
l
6.8
4~1_ I I
IHo. :X No. I ' I 1 2.8 I i-
x
ITo. .1 ~
I """ No.
II
x
,
III
No.
x
No.
l x
_I
1
---· --
2 1 ;
4-9 6.8 --
11 5.2 3
2 3.1! 2 6.5 3 ' 5.1 l 5.0
h--·
.7 8 9
5·3 -
:
l
3.8 f-- -
l 1.5
5 4.0 3 3 .8 5 4-7 6 5.3 17 5.3 9 4.5
2 3 5
· --
--
f.---
3.1 4.4 4.4 5.3 4.8 4.0 4.6 I 4.6 4.9 4.6 4.3 l I
2 4 9
4 .l 4- 5 3.9 2 2.5 4 3. 7 2
- - :----·- - -- -l 5 .o 5 2.5 3 4.6 ··- .
10 11
5 4.8 6
5 .2
2 8 5
5
s .o 4-4
5.2
12 13 14 15 16 17 18 19 20 21 22 23 24 25
9 4.6
10 10 13 '
3 4-5 7 4.6 3 4.2 9 3 .s 5 4.1
18 3.4 10 4.0 I 25 4.5 21 4.6 2 I
5 5.8
s.o 4.6
16 4.5' 11
6 4_~ 16 11
-
4.8
5.2
4.6 i 9 ,..---
2 4.8 13 . 5.1 11
17 5 .o 7 4.4 13 4.6 13 3.8 1 5.0
11: 4-5
9
14.6 4.9
12 4.7 14
-- --26 4.3 ,___ 5 4.9 _ __ -·-
4 5 .o
~----
3.8
3 5 5 I
15 4.3 1 4 .5 -
e! 2 -
I
3 5.9 -~·
.-
3.9 15 i
2 4-9
4.6 4.0
12 4.6 2
1 7.4 -- ---
11 I 5 .3 : 6 2 6.4 1
s.oi 3.8 - f--
5 .o
1 5.7 I
4.6
1 3.8 1 3.2 l
-- i-- -
1---
4.5
l l
3.2 3 .f,l i 9~
I
I
! 4.5 5 4.6 I
-
Tot. 129 I . 4 •71101 ~ .7
! 93
!4. 7 i
I
37 14 .o 140 4.2
I !
~i15
-1----
5.~
TABLE 20 goitrous and non goitrous Basu to males
AFR/Nffl/12 page 77
Cases of P .B .I. that were below, equal or above 4-8 microgra.runes in
f T H Y R 0 I D C 0 l~ I! I T I 0 :N I Age~-----------~------------------------------------.---------------! in Yrs lTormal G 0 I T R 0 U S G R A D E S I 1 1-------I------.-!- - --I------;---I--I--I------i TOTJ._LS I 1 I : ....,.-;--+----r-.--1--+;--1
L__ --+-r_-ro__ .-+-4-8 - r---4-r-+_8+-r_.o_.-+--4_-_8-1--4--+-_+B -r-H -o__ • _4-_B-+---4-+'·_t-8--t-i'-io-+._4_-8j- 4 _i+8 1 4 l l
I
No. 4-8 1
-4 1
1
+8
j l
5 l l l l 2 2 ~-+--+--+---+~~-4--~--+--r--+---~--r·~--T---r-,---r---r--~--~-- ~
--~--~---~-+--~-- r·---f---~·--f---~--~~--+--+--~~--r---r-~~~-- l
I
-~~---l--t---l-+--+~~-2-r----+--2+--r---~----r-~-+--+--~---~-~~l--53-+-_l~-12 __+-l- ·l
~--8--t---5-+---5+-2·~-4---3+_3___+--~-24---~-2+-4-~---+--r-~-1_0+--6-+-4--r---l 9 3 12 1 1 3 12 7 3 4 I f----+---+-----l---t--~~-+--+~l--~-4---4--+-~-4---+--~+---+---+---r-- 1
~-4---+---+~~4---+---+-~-4---+--~-4-·+--+---+--~--r-~~~---+---:
7
3
2
_1_
2
l
l
3
10
5 6
4 1 6 15 2 6 3
5 6
5 5 7 5 5 9
5 l 2 2 8 5
4
1
15 13 14 13 34 28 19 14
2 1 6
-- --t---l----l---f---+---+---+--i---4---+--~-l--+--~--~-t--t---r---Jr----+----
11
2 6 2 3 2
12 13 14 15 16 17 18 19 20 21 22
17 9
9 5
l-----4--+--~-~ --~-~--+--~-~-~----+--+~~--t---+--r-;---+---T----r--
- --r---~--~--+-~---~---1--r--l----~--~-4--+-~--4--+--r--,r----J---+--~
5
16 11
13 3 10 1
6 11 ll
1 l 1
16 l 1
12 4
38 30 2 2
8 4 1 l
9
7 7 11
2 2
33 28 37 32
17 7
16 1 4 3
9 9 3
9
4 10 10 1 1
12 8
3 5
14 15 6 1
3 1
1 2 1
1 1
34 24 30 18 2 1
13 13 1
10 3 6 7 1
r--+--4---~~--lr---1---+--+,--lr---+---+--~,-~--r---t--+-~--4---1---+---
11 4 5 1 1
38 25 \13
11
7
2I 2
j
2
~-+---+---+---+--r-~-~
2 2 l
2 1 1 1
~-+----1-----t---t--t--4-+--3-+--1--+-1 i
- --r--4--+--~--~---~----
1
:=23=:,=========:=:==1=:==::1=:=::=======~+-=======-~~ 1 --rt=====1:~~~:~-l_·~~~~24 1 1 I
l
1
1
_l I
2
1
1· 1
25
1
1
1-rr·_ ot __.-+-12_9-+-1_0_ 0--l-29-+--+l-0_1-;--73_,_2_3-+--5+--96--+_6_9_-1-;--J~~+J_ ____
I
1
1 I
1
-1 +---1---~ \74j241
331 245 81
7~
78 1 22
77 2315
72,28 1 \
J6o \4ol
5--1 ~
AFR/NTJr/ 12
page
78
TABLE 21
Cases of F.B.I. that were below, equal or above 4-8 microgrammes in goitrous and non-goitrous Basuto females Age in Yrs No. 4-8 Normal I
-
THYROID
CONDITION GRAD. E S TOTALS II III
GOITROUS
-4 +8 No. 4-8 -4 +8 No.
4-8 -4 +8 No. 4-8 -4 1+8 No. 4-8 -4 +8 2 l
5 '6 7 -8 9 10 ll
2 l
2 1
2 1 0
l
l
1
l
2 2
2
2 4 9 5
2 3 7 5 8 10 10 10 9 2 5 4 1 3 3 2 1 1 l I
2 3 10 8 9 l 4
I
l
2 4 I
2 2 2 2 6 3 4 3 5 2 l l
1 5 3 18 10 25 21 26 15 12 2 1
l
2
2
1 2
4 l
7 18 10
2 3 7 3 .
12 10 13 10 14 13 15 13 16 11 17 18 19 20 Tot .93.
2
6 12 7 19 16 3 6
31 10 ·'15 27 2 4 5 1 3 l
-
23 4
2 3 4 3 1 l l
43 47 47 21 19 7 l
34 9 33 14 30 17 15 5 16 3 6 1 1
9 5
5
16 10 ll
3 5 5
4 3
l
9 2 1
77 15 84 16
37
23 14 62 38
140
91 49
1
15
13
2
285 2C2 82 74 13 1
%
I 65
35
87 13
AFR/NUT/12 page 79
TABLE 22 Number of P .B. I. determinations cases and percentage below 4 microgrammes '
Thyroid conditi?n
Number of determinations M F
Means and S.D'S Males SD Females X
Totals
Number of cases below 4 microgrammes M F
Percentage below microgra.mmes M F Tot.
Tot X
SD
x
SD
Tot.
Normal
129 93 222 4.7 1.1 4.7 0.9 101 37 138 4.7 '1.3 4.0 1.1 96 140 236 4.5 1.1 4.2 1.8 I
4.7 1.0 4.3 1.3 4.3 1.6 5.0 1.5 4.5 11.3
29 23 27 2 81
15 14 49 2 80
44 22.4 37 22.7 76 28.1 4 40.0 161 24.4
16.0 37.8 35.0 13.3 28.4 ... .
20.2 26.8 32.2 20.0 26.2
gg 8
g..
H
I II III
5 15 20 4.6 1.0 5.4 1.6 331 ·285 616 4.7 1.2 4.4 1.5
TOTAL I
TABLE 26 Number of cholesterol determinations, cases and percentage below 150 mg Number of determinations M Normal [i]
~1eans
and S.D'S Totals X
Thyroid condition
Males SD
Females X
Number of cases below 150 mg M F Tot. M
Percentage below
150
mg
F
Tot X
SD
SD
F
Tot.
129 93 222 134 22.5 143 29.5 138 25.8 89 54 I
143 97 . 174 18 4~ ....
68.9 57.1 74.2 59.4 82.2 65.9 60.0 81.2 74.3 63.1
64.0 70.2 72 ~ 5
gj ..
101 37 138 123 28.5 148 30.8 135 29.7 75 22 96 142 238 128 29.3 139 30.7 133 30.6 79 95 5 16 21 14o 27.5 136 33.2 138 49.5 3 15
-B-·
H
It III
-
76.1 69.1
TOTAL
331 288 619 132 26 .6 140 30.5 136 28.8 246 £B4
AFR/NUT/12 page 80 TABLE 23
Sera cholesterol levels in 621 goitrous and non-goitrous Basuto MALES Age FEI.~ALES
Goitrous Grades Normal
Goitrous Grades
in Years 4 5
I I
II
III
1Tormal
I No.
II X
III
No.
X
No.
x 158 137
lfo. I
x 136
No .
x
x I 24 155
!
Ho.
No.
x
No.
x
-
I I 3 5 3 5
ISO ISO 148 120 120 102 127 138 13S 129 134 137 139 131 146 120
I 2 2 3 I
2 I -·
6 7 8 9 10 II 12 13 14 IS 16 17 18 19 20 21 22
114 114 109 132 116 136 136 146 131 136 134 138 138 14 5 I 22 2 3 14 7 2 14 2 14 2 139 13 2 14 2 143 148 148 143 14 5 128 144
I
148
2
132
-
' I 18 139 14 2 I 22 4 9 2
161 ISO 168 141 13 s 176 13 2 151
I
155 I 18 14 s I 24 164 14S 133 144 148 137 129 180 2 4S 53 24 29 30
s 6 9
s 2 8
4 2 3 7 3 9
s 3 18 10 2S 22 28 15
6 17 9 IS II 17 7 12 13 I
s 10
s 6 II
s 16 8 9 5 15
-124 13S 119 117 140 116 138 140 2 14 2 10 13 13
4 5 3 2
II 12 8
I 2 133 141
II 3 5
s
·-
I
252
12 2
II 2 2 I I
6 I
s
I
ISU 113 101 97 123 i
23 24 25
I
139
I I
TOTAL I
129
134
101
96
128 I
5
140
93
143
37
148
I
14 4
139
16
136
AFR/NUT/12 page 81 TABLE 24
Cases of cholesterol levels that were below, equal or above 150-280 mg in goitrous and non-goitrous Basuto males Age in Years No. ISO/ 280 I 50 280
T II
Y R 0 I
I D
C 0 lf D I 'i' I 0 N
-
I Normal i
G 0 IT R 0 U
s II ISO/ 280 0
GRADE
s III ISO/ 280
TOTALS
-
+
No.
ISO/ 280 ISO
-
+
280
No. I
ISO I
-
+
280
No.
ISO
-
+
280 No. I 2
ISOi 280 ISO 0 I
-
+
280
4
s 6
I I
0 I 2 I
I
I I I
r 2 2 I I I I
2 2
3 '
7 8 9 10
3 5 3
.0 0 0
2 '
s I 2 4
3 9
0 0 0 I
s ..
3 I ..
3 I
2
I
10
s 8 17 9 IS II
,. 7
3
.3
I I I
7 IS IS 34 19
6 14
II 12
s s 9
0 0 2 I 2 3
s .5 ...
s 2 8
I
2 7
13 27 13 28 20
-
13
s s 2
12
7 4 4
0 0
8
4 13
5
s 16
s II
6 9 II I2 &
H IS
6 II II 12
s 2
37 2 I I 32 37 -
s 2
6 10
8 "'6 .
8 9 IS . IS
6 9
16 17 18 19 20 21 22
' " It ·-· 7
s-. -2
0 4
zs 31 30
7 12 13 I
s 9
10 :6 7 I
!5 1• 1
I
0 I
I I
3S 37
3 7 0
8 II
,2
I I 0
2
7
6 I
-· 4 2 I
6 I -
s I
30
12 I 0
lB
4 2
3 2 0 I I
2
0 I 0 0
2 .. -
..
-
t
I ·-·
0
I ·-
I
23 24 25 Tota Is 129 I
---.. 0
I
r . -! .I I I
.
-
t
I
0 0 0
I-
- -··
I I '
'
2 I
2 I 246
'
0
40
.89
JQJ _ --25-. 7S
96
17 18
79 82 I
s
2 40
3 60
331
86 26 I
'/.
31
69
26 ' 74 I
I
!74
AFR/NUT/12 page 82
TABLE 25 Cases of cholesterol levels that were below, equal or above 150-280 mg in goitrous and non-goitrous Basuto females • a•
l
THYROID Age in Years GOITRE Normals
CONDITION GRADES ·II TOTALS III
-
No 280
.
.
150/
5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
2 1
+ 15Q/ 150/ + 150/ + 150/ + + 150 280 No. 280 150 280 No. 280 150 280 No. 280 1_5_0 ..2_80 No 280 ltSO 280 1 1 2 .1 1
-
- -·--
-· .. ·I
-
-
-
1 1
...
1 1 2
.1 1 1 , 2
0
1
1
3
2
1 2 2 2
1 2
2 2 4 2 3 7 3 -9 5 -
1
4 9 5 10 10 13 13 11 3 5 5
1 2
1 2
1 5
1 0 1 3 3 5 2 15 7 15 15 18 8 7 2
7 18 10 31 27 2 4 5 3 2 0 1 0 1 1 2
4 ·3 4 14 5 5
7 3 6
2 1 2 3 2 1 7 4 2 5
3 18 10
4 4 6
8 23 9 18 19 24 16 .32 "16 33 '
6 7 7 6 2 4 2
25 10 22 7
43 48 49 21 20 7 1
6 5 1 1 3
3 5 2 1
28 10 15 7 5 0 1
9 12 8 12
1
1
12
I 2
3 1
4
:
1
Total 93
%
39 43
54 57
37
15 41
22
50
I
144 49 34
95 66
16
3 19
13 81
290 106
~84
37 63
... L __
AFR/NUT/12 page 83 TABLE 27 Contents and nutritive value of a typical diet consumed by a pellagrin N u T Food Consumed (Raw weight) Wild Spinach Garden Spinach !Mealie Meal !sugar (white) R
I
E N T
s Nica. Vit.c mg mg
Wgt. Calor. Prot. oz units -··.
Fat. gm
gm
Calc. Iron. Vita. Thia. Ribo. gm mg mg mg mg
- ..
.
0.9 6.9 15.8 1.3.
6 46
0.61 0.1 3.9 o.o
o.o
0.2
-o.8
.
-
0
-· · -·- . --- - -- - ·· 0.1 0.2 14.8
0.7 ·0.1
1612 140 1804 2552 10.6
41.1 .14.2 o.o
3-3 .0.1 12.6 o.o o.o
6.1 o.o o.o 0.3 o.o o.o 6.9 0.5 1.2 1.3 ~8.4
0.5 0.2 0.0 o.8
0.5 113.2 3.2 o.o o.o o.o
Consumed p.p.p. day 24.7 ~CAP-Requirements
45.6 14.9 55.6 82.0
0.2 16.1 0.8 10.4
3.9 128.0 '46 \
1.4 12.8
%of
Adequacy
125.0 154.8 575.0
57.1 30.4 278.2
TABLE 29 Nutritive value and adequacy of farm diet compared with INCAP allowances
I Nutrients INCAP Recom.
MALES Consumed %Adequate INCAP Recom.
FEMALES Consumed %Adequate
Calories Protein g Calcium g Iron mg Vitamin A mg Thiamin mg Riboflavin mg Nic. Acid mg Vi tarnin C mg 0
2683 .
2266 57-9 0.7 18.3 o.o 0.4 0.2 3.8 o.o
84.5 104.6 20.0 183.0 o.o 24.7 13.6 25.0 o.o
2313 50 0.7 10.0 1.3 1.2 1.2 12.0 45.0
2266 57.9 0.1 18.3 0.0 0.4 0.2 3.8 0.0
98.2 115.2 14.3 183.0 o.o 30.9 15.8 31.3 o.o
50.0 0.5 10.0 1.3 1.5 1.4 15.0 50.0
AFR/NUT/12 page 84
28 Average daily nutrients intakes of families with Pellagrins TABLE
N U T R' I ... .
E
N. T S Thia. mg
.. Family Names 'Mamputi Jonas . " 'Neko Ti1ane 'Neko 'Neko Morea Moshe Lepeko1a Pe1a Teboho Mojaki 'Majoalana Makotoko 'Mamatseliso Mchale Lepau Total Mean -·
Calor. Units.
Prot. g
Fat. g
Calc. g
Iron . mg
Vita. mg
Ribo. N. Actd Vit.C mg mg mg
1 919 28.4 1 545 59.6 ..
24.7 ..
0.5 0.1 .0.3 0.2 0.1 0.3 0.2 0.1 0.2 0.2 0.5 o.4 0.2 0.1 0.7 o.4
23.9 8.3 .21.0 10.6 19.0 22.4 32.3 8.0 32.5 9.9 7.9 12.0 18.0 11.5 16.2 13.3
1.4 1.9 3-7 0.1 1.3 0.4 1.1 4.0 0.2 4.4 2.8 1.0 4.2 2.3 0.9 3-7 33.6 2.1
1.0 . :1,..9 . 0.9 0.4 o.8 o.8 1.0 0.3 1.0 0.4 0.4 0.7 1.5 0.4 0.5 1.0 12.5 0.8
0.7 0.5 0.6 0.4 0.3 0.6 0.4 0.4 0.5 0.5 1.1 1.9 o.6 0.3 0.4 0.9
8.4 10.6
25.1 87.5
77.9 ·-
1 221 6$.8 1 534 45.7 949 48.3 1 8~8
14.9 3Q.6 7.1 17.8 16.6 8.2 21.4 10.0 20.7 18.3 52.7 14.7 17.4 21.9
7-5 161.2
5.9 6.4 10.7 12.6 2.6 10.7 4.1 1.9 6.7 8.3 3.2 4.2 4.4
0.1 2.3.3 97.1 21.5 73.7 46.5 80.0 55.2· 19.8 88.1 41.0 795.2 76.3 169.2 1(5. 7
41:.7
1 789 67.3 929 48.4 1 672 50.0 1 157 37.4 1 079 64.7 1 571 46.5. 2 283 ,,.o 1 424 33;.0 1 915 47,2 1 68.5 26.0
24 530 743.3 374.9 1 533 46.4 23.4
0.4 1266.8 0.2 16.7
9-9 108.3 0.6 6.8
AFR/NUT/12 page 85 TABLE 30 · Ingredients and nutritive value of the enriched mealie meal mixture
.
Ingredients Maize Meal Sour Milk Skim Milk Pr Whey Powder Eggs Fish Flour
--
Wgt • in
lb 40 25 2 Ll 2
NUTRIENTS Calor. Protein Fat Calc. Iron Vit.A Thia. g g g units mg mg mg 65 280· 1 664.0 7 725 4 108 2 343 1 079 482 540 3.2 13.4 14.7 4.6 o.4 0.2 36.5 512 o.o 12.8
-
Ribo. Niac. Vit.c mg mg mg 6.4 128 o.o
395-5 422 4o4.o 85.2 81.0 104.0 11.3 8.1 83.7 4.0 108~6
7.5 5.4 6.5 0.1
4.0 19.5 4.0 22.2
12.5 150.0 13.0 80.0 5.9 0.5 17.6 o.o o.o o.o
-
0.1
3.4 16.9 0.6 0.4 1.6 1.6
ll •2 1 2
17.1 1.8 35.2 o.o 578.3 7.4
-
....
Approx. Total
'
44
81 017 2 635.7
25.2 68.2 177-5 230
TABLE 31 Nutritive value of enriched maize meals and INCAP allowances
Wgt. Ingredients in lb l1ixture Maize Meal Rec. Allow. INCAP l l Calor. Protein units l 841 l 632 2 900 g 59.9 41.7 55.0
NUTRIENTS Fat g Calc. g Iron Vit.A Thia. Ribo. INiac. Vit.c mg mg mg 0.6 mg 1.6 mg mg
24.7 0.8 14.4 0.1 50.0 0.7
15.4 0.2 12.8 o.o 10.0 1.3
4.0 5.2 3.2 o.o
0.3 t 0.2
! 1.511.4 15.0 50.0 _j
AFR/NUT/12 page 86 TABLt.; 32 Distribution of population examined clinically I
AGE
SEXES
II
N? •_ of CASES
I
1' of to tal EJW1ITNED
-~a tion ~ 1
.AFFE,CTED . ~
l-11 months 1--3 years
Both Both
· · 15 30
1.5 2.~
l.l 6.7 T-----------12.1 18.8 10~4
1------------+--------r------,____________ Both 4-6 years 52 4~6
7-9 years 10-12 years
Both Male Female :Male Female Male
68 128 113 153 148 98
6.2 11.5 10..•2 13.8 13.2 8.8
.
8. 9 10.0 8.8 5.7
13-15 years 16-20 years
--------r--------;-----~-------r-----------~
Female 113 10.2 5.3 t------------+---------r-------+-----------;-----------:Male 6.7 4.4 75 21-+ years Female 10.2 6.6 114
36 Sex and dietarJ age groups Distribution of the members of the fami1ie's TABLE
stud_t~d
-------------------~---------.----------.
Age
Sex .. · i 1 b of Sample ; 10.5 1
r----------r--
1
1-3
- - 4-6 7-9 10-12
I
i
Both
lloth--+---9--.-4--~ 9.1 4.9 5-5 2.4
r-------------19.8 'f~ (pre-school)
Group·
Both Male
-----------~~------~------------1
1--------+--------- .,
Female
·13-15 16-20
1-----------+------------
Male
35.1 a;; (school)
!
------------· :Male ________,_ 3.7 -
Female
3.8
Female 5 .6 r----2-l_&_·_o_v_e_r~i---Ii~~----1-5-.-6--
I
___________ 44-5 % (adult) ~---
! _Female 28.9 1 · - - - - - _____ _____! __________ ;___
- ------
.
AFR/NUT/12 page 87 TABLE 33 Frequency distribution of clinical findings - Sex and dietary age groups I
No. of Signs 1--
Mns
I 1-3 M. l·
Years 4-6 II
I
Total 13-15 16-20 ~I
Cllnical Signs
1-11
7-9 1\1
10-12
21-+ T-1 F
M!F SCALP
F
F I!I IF I 6 6
F
M
F
Both
I
I
4
Desquamation EYES
3
2
6
10
3
2 '
39
6
Crust on eye Iids Ph ot oph obi a PAU EBRAL C01~JU1•IC T I VA
2
I I
I 2 3
2 6
3 5
5 3
4 4 I
18
7
2
27
9 10
i nf Iammati on Folliculosis BULBAR CONJUNC TI V A
I
I
2
3 I
I 2
I 3
I I
I 2
II
2
II
12 13 14 IS 16 18 19 20 21
Thickness Blue-Black Spots Gei.Vascularizati on Type '1A.; Vascu I ari zat i on Pi g ~ entat ion Type ·•A " Limb.Corn.Opacities Limb.Corn.Vascularizati on Limb. Corn. Brown Rin g Pterygium SKI rl I I I I
2 3 4 4
I
12 10 12 14 10 10 13 I 9 13 lb 4
12 7 10
13 8 5
15 7 9
10 6
15
18
41 2 3 4 I
72
221
10 I 2 3 4
3 12 3 16 2 18 22
96 6
3 6
4
8 IS
79 168 157 49 10 66 6
II
Iu I 14 17
13 8 8
23 7 2 -
I
8
3 I
13
10 I
IS 3 I
8 15 10 I 7 I 5
-
5 I
5
2
I 5
I
3
5
3
4
8 10
~
5
8
I
6 (j
OF THE FACE I I I 4 b
22
SJborbi t .Pigmentation Nasolabial Pigmentation F0 IIi cuI OS is Depigmt.Spots Type I Oepigmt.Spots Type II Depigmt.Spots Type II I Nas olabial Seb orrhea Acne I 10 12 6 9 14 4
I I
23 24 26 27
2 II
I ICJ 9 8
9 84 75 43 -
IS II
2 I I 21
3
I
2
14 4
13 9
10
2 I IS 13
28
8
6
29 30
12 10 17
10 15
7 10
lOS
I
I I
I
2 13 I
18 jl2
1'1
85
AFR/NUT/12 page
88
TABLE
33 (contd) Years 1~3 U· F
Frequency distribution of clinical findings - sex and dietary age-groups No. of Si gns 31 32 33 34 I
i
Clinical Signs LI p
l
Months
! M · }i'
1-ll
4-6 l\1 F
7~9 ·ID-]2 !13-15 16-2J
M F 12 3 5 2
M F
M F 7 I 6 I 2 I
I
s I I I 2 5 6 10 I 2 3 4 2 I 3 3 13 2 3 9
21-+! r,1 Fl ;
Totals Both
Angular Stomatitis Red Striation/Mucosa Pallrur Puckering, f oldings, etc. ORAL CAVITY Genera I Gingivitis TONGUE
II I
I I
2
4
5 I
85 IS
l I
9 3
I I
I 2
I
I 2 I
37 -- ~ ~~-~
I I
24 J
-
36 40 41 42 43
Red ~.agent a
I I
I
I I 2 3 4
3 17 47 23 113 102 112 102 II 2
2 0
2 5
3
4 I
I
I I I
I J
Pall our Swelling Fissuring Filii. Pap. Atrophy Filii. Pap. Hypertr ophy Fungi. Pap. Atrophy Fungi. Pap. Hypertrophy TEETH 3 3
2 2 I 3
8 3
9 3 J 4
5 5 9
---..
2 6 9 7 9 8
3 16 10 10 7 5 10
44 45 46
7 10 12 II 7 IS 12 II
14 6
JS II
4 8 5 4 4 8
7 10 12 II 9 II
12 13 9 6
9 9
-
47 48
7 10 9 II
5 10 II 10 7
5 4
7
7 I 5 12
13
49
Carles Loss of teeth Ena111el Spots Mal-implantation Deformities '
15
17
19 2
14 20 22 3 6 6 8 5 8 5 7
19 5 5 8
17
20
25 IS I
188 52 63 79 54
so 51 52 53
4 9 6
7 10
--
6 4 I
5
7 3
6 6
4 II 9
2 5
2 I
4 3
7 10
12 10
2
4
4 6 25 25 19
S~ IN
IN GENERAL I
55 56 57 58 61
Xerosis Crazy Pavement Furfur. Desquamation Fall. Hyperkeratosis Gen. Hyperkeratosis Pellagra Dermatitis Atrophy of the skin ! I
2
3
2 I II
2
3
4
5 19
29 20 2
5 6 5 6 3 I
7 9
10
12 IS
II 20 25 18 20 13 25 18 14 12
20 20 14
7 9 II
1 0 12 15 3 I
19 21
9
IS
13
--
202 149 27
I I2
I
5
2 10
4 I
I I !
62
S nCI AL STUGY
--
I
63
17
4 10
5 12
8 5 !4 I
55
·r
AFR/NUT/12 page 89 TABLE
33 (contd)
Frequency distribution of clinical fi1,dings - sex and dietar;:r age groups I
I I
No of Signs SUBCUTANEOUS Tl SSUE Clinical Signs
; i ; __ onths 1-
Years
! I
1-ll M
1-3 1'/I '
4-6 M
I 7-9 Ivi F 19
10-1~13-15 l\I
Totals
16-20
-
21-+ -
F
F
F
F
M
F
Ivi
F
M
Both
1
F
7 344 3 59
I
66
Diminished Loss of Turgwr ABDOMEN I
I I I
17 13
1·7
31
so
so 51
17 17
10 9
-55 41 55 56
10 12 23 13
6
--·
67
II . 28
12 59
5
6
68 I
Hepatomegal ia
3
4 31 3
2
5
3 2
I . I
2
21 2
69 . . Sp I en omega Ii a 70 71 Pr otud ing Depressed NAILS 10 13 ·16 3 IS 3 II
I
13 5
13 4
43 37 2 I
7
J
5
I
218 22
-I
I
12 I 5 6 I
1 - - - --
I I
n 76
White Spots SKELETON Bone-Aches REF LEX
6'
7
8
6
10 10
2
83
1
I I
4 - I - r--
2
5 '3
3
I
-l ~q __j 12 I -·
81 f-·-----
8iminished-Patellar Diminished·Achi I les Diminished-Vibratory Sense OEOEI.iA
I 3 2
I 2 I
2 2 2
I 2 2
3 I I
4 l
I !
82
II
83
-
I
9
86 f-· ~--
General or I oca I MUSCULAR SYSTEI,
2
6
8
8
10
0
40 -
I 4 9 I 5 48' 43 II
87
Poor Uevel opment Scapula Alata Poor Gen. Posture Lnder Height Under Weight Poor Nutrition Status Other findings Tota I Findings
58 23
56 80 24 I
76 33 55
95 97 55 47 27 29
47 42 29 26 18 16
52 54 II
21 23 16
28 22 29
810 348 469
88 89
15 43
28 51
8 14
8
41
43! 43
13
I
90 91 92 93
--
SPEC! AL STIJOY SPECIAL STUDY
I
6
I
3
39
28
60 55 38 10 12 IS I
35 10
67 55 6
32 31 2 I
34
13
17 I 28
541
!
I
I
! 28 I
14 7 1228_i 1 213 14181384 1s86 J91 b931o II , b 25 !571 I I '
'"
4
_____ J. I
71-'1
~
I
125 ,409 33Sj471 i
6o35 I
'l'ABIE
34 Anti· Haemo· strep· gI o· toly· bin sin g Titre
Age, number of cases and means of biochemical values in the sera of Basuto population Age in Years No. of Cases Tot a I
Ph os· Ch ole· C/P Li oids sterol pho· Ratio Lipid I
--
Globulin Chol estero! Tota I · Prot. Alpha Beta Albumin Alpha Beta g
% 6. 2~ 0,47 6. 25 6.86 6.65 b. 56 6.3 5 b,95 7.18 7.10 6.79
- ·---1 % 6.40 6. 00
.g 0.39 0.38 0. 38 D . 23 0.33
Gamma g %
2 % I
g
%
g
I
3 2 2 5 10 9 2 2 4
396 394 37 2 347 33 0 34 2 3 27 344 339 363 3 52 311 314 343 3~1
I 19
181 179 166 174 155 164 166 160 16 2
0.67 0,79 0.69 0.64 0.64 0,69 li, 6 2 0.70 0. 7) 0.59 0.65 O. G 3 0.63 0,68 0.71 0.70
34.7 30.0 3 2.0 37.0 31.3
65.4 70.0 68.0 71.0 69.0 69.7 67.5 60.0 57.5 63 .o o4. 9 66.5 66,3 53.4 22.7 69.8 63.9
44.1 46.1
2.76 2.64
42. 2
o. 97
12.0 I l 1.0 / r, , (J
t7. 2 I. I 21.7 21.3 1.4 1.3
25.0 18.7 I 2. 5
13.1 13.0 12.8 14.2 13.3 13.2 -
2
13 5 114
I 2. 2 0.79 10.4 0.65 10.8 0.69 10,36 I 0.68
0.9 1.0
- ~ 3 4 5 6 -·
45. 9 2. 87 53.6 3.68
6. 05 3,44 4.92 5.36 7. 50 8.1 0 b. 33
16.4
112 98 11 4
13.8 0.1 13.0 0. 9 21,7 5 1.0 12.5 U.d I~. 95
19.5 1.3 20.2 1.4 25 .~
13.0 85.9 98.4
50.9 3.38 47, 0 3. 09 43.55 2. 77
.
34. 2 3 2. 5 40.0 42. \) 37.0 3s. 2 33.5 33.8 3 2. 0 31.6 30,3 36.2
0.35 10.18
o. 77
1.4
102 112 122 92 100 401 204 115 128 126 107
.48 13.80 G.88 0,56 13.55 0.95
22.6
1.4 - 20.6 37.5 29.37
13.0 14. L I 2. 7 13.0 3.88 13.43 14.4 5 13.90 14.37 14.15 13.8
--
7 8 9 10 II 12 13 14
44.55 3. 07 48. 0 3. 45 48 . 08 3. 42 45. 75 3.II 40.93
1.1
18.85 1.3 23.33 1.6
-
0, 45 10.15 0. 39
o. 73
13.7 1.0 12.5 0.9 13.77 0.9 16.83 I. I
4 11 4
154 14 2 161 177 163. 180 183 158
5.ti3 6. 72
IU .O S 0.71
23.7 5 0.7 19.37 22.24 24.28 26.44 24.74 1.5 1.7 1.8 1. 8 62.5 50.0 30.0 37.5 29.6 87.5 23.19
0,45 II. 56 G.78 0.44 0.41 II. 58 II. 27 2. 28
6,80 6.90 7.40 6.99 7,05 7.14
2.77
6.40 5. 95
-
9 3 9 4
41.05 2.87 41.8 3.09
o. 77
15.3 5 I. I 15.4 7 I. 2 15.7 5 I~ I
6.14 6. }8
0.45 II. 74 0.87
43,66 3. 05 41.7 46.9 2. 94 3.12
0.46 11.48 0.81 0,49 0.47 12.55 0.88 12. 27 0.88
22.55 l.b 23. 23 19.69 1.6 1.4
IS 16
149 375
7. }3 6.73
15.5 I .I 14.5 1. 0
9
o. 71
AFR/NUT/12 page 91
TABLE
34 (continued) Anti- Haer.~o strep- gleGamma toly· bln sin g % mg Titre
Ages, number of cases and means-of biochemical values in the sera of Basuto population Age in No. of Tota I Ch cl ester ol Beta Total Prot.
GI obu I in Albu m in I
Phos~ Ctfol e- pho· C/P Lipids Rati o sterol Yrs. Cases LipiQ Alpha
Alpha
Beta 2 l mg
%
- --- 1 ., j mg mg I
.%
%
mg
17 18 19 20
6
376 361 109 392
122 129 107 102
171
o. 71
36.4 64.7 7.2 43.9 3.15 6.02 0.44
11.90 0.86 14.69 1.1 23. so I. 7 II. 5 14.94 I. I 22. I0 1.6 18.75 14.37
3 2 I
184 . 0.69 167 207 0.64 ,o.49
35. 5. 64.7 7.34 40.9 3.00 8.90 0.65 13.5 0.99 14.54 33. 0 67.0 7. 20 36.1 2.60 5.70 0.41 48. 0 52.0 7.2 42.3 3.04 5.1 0 0.37
9.95 0. 72 17.50 1.3 30.70 2. 2 I 17.50 13.85
13. so 0.97 17.80 1.3 21.30 1.5 100
15.10
NB. -
Indicates Few missing
TABlE
35
Ages, number of cases and m e_ a ns of biocher:li.c al values in the sera ,--
of people from Alexandra Towns hip 7 South Africa 5 7 9 II 13 20 7 12 8 9 6 '
460 186 473 408 437 466 477 464 418
154 ' 165 J 53
0.74 26.9 62
! 7. 52
4 8 ~9
3.66 4.59 0.35
I0.6 · 0.74 12.9 . L-.99 II. 2 L.76 11.68 0.91
14.8 1.12 13.2 I. 58 317 IS. 2 1.16 21. 5 1.93 16.8 I. 23 15.8 I. 23 I 5. I 1.14 24.1 23.6 173
13.6~ 12. s 1
' 188 !96 199
0.8 2 29.9 70.5 7.7 37 : 2 3. 07 4. u9 0.39
10 12 14
156 199
o.is 0.65
27.9 72.1 29~ 5
7.3 4 2. 5 3~15 S.bS 0.41
I. 76 477 13.8 1. 78 298 13.9
70.5 7.5 42. 3 3.17 6. 55 0.45
1 39 190 140 148 187
0.88 27.3 72.8 7.8 43~3 3. 27 6.03 0.4 5 I I. 2l 0.84 0.77 3 2. 5 67.5 8. 27 39~6
24.2 I. 52 428 14.0
IS 17
3.02 6.3 5 1.18
12.25 o. 93 II. 7 0.94
16.5 1.3 2 25.2 I. 93 395 12.6 15.4 I. 23 27.7 2. 23 309 14.4 26.2 2.07 25.4 2-.03 144 14.3 I
220 . 0.69 38.7 71.4 8.04 39~ 5 3~ I7 5. 53 0.44
l
l 18 19
152 220 136
0.76 25.6 73.6 7.9 4 2~ 9 2;39 5.3710.4 2 II. 2 0.89 14.0 1.11 '
192 i 0.69 27.9 72.2 8.07 4 2. 2
3~4015.1910.42 I '
I
II. 5 0.92 i 15.6 I. 28
r 26 2 14.7 1
AFR/NT.Jr/12 page 92
TABLE
37 11
Means and range of nutrient intakes in Basuto diets Ca Ior i es Units
... -I
~ !---
+
X
Protein g Calcium I
g
Iron • X
mg +
I • I +
- -l. X
I
I
j •
' X
- 1
Vit.
Au mg +
Thiamin mg
Ri bo. mg
!iacin mg +
- X
+
- X
X
1296 1038 ltl27 40 26 2211 55 44
56 0.1 D. I D. 2 13
1 0.4 D. 2 0.8 U.2 0.1 D. 5_ 6 2 12 8 19 1.0 O.Oj2.9 i
- -' - + X
j Vft.
ucn
mg +
22 0 16 5·
tiS
2 1947 1703
.3
1844 1552 2269 57 43
61 0.1 0.1 0.2 18 13_E 0.7 U.ll 1.3 0.6 0.4 0.9 0.3 0.9 0.4 .. 68 0.3. 0.1 ~ . o. 1 16 . 13 21 2.1 0.6 l.b 0.9 0.7 1.1 0.7 0.4 1.3 I
7 4 12 7 3 10 ...
27
83 32 10•, 210 179 90
- ..
--
-
4 2241 1152 3844 75 35 141 0.8 D. I 3.9 18. II 32 2.6
1.3 6.7 0.9 0.5 1.8 0.8 0.2 2. 2 12 4 26 100 31 8 5 18 113 21 8 3 19 8 5 II 18 2
--
.5 1895 1622 2030 72 55 129 0.3 o.o .1.3 20. 16 30 1.6 0.3 3.5 0.9 0.7 I. 5 0.5 0.2 p.7 6 1664 1000
24 21 59 25 100 0.3,0.1 0.6 19 24 2 64 51 83 0.3 0.2 o.s 21 78 D. 2 D. I 0.5 22 I
9 .31 1.1 0.1 3.3 1.0 0.4 I. 5 0.5 0.2 1.3 18 26 0.6 o.o 1.4 0.9 0.6 I. 2 0.6 0.3 0.9 9 37 0.7 o.o!z.1
7 1752 1377
29 2 120 14 3 40 I 78 87
--
8 14 27 896 2606 60 23
1.4 0.5 2. 2 0.5 o. 2 2.7 10 4 19 10 3 26 10 4 14
9 2373 1578 3202 81 52 120 0.3 o. z 1 o.6 26 10 1858 1523 II
19 36 I. I o.o 3.0 1.3 0.7 2.0 0.6 0.3 1.1
2382 61 40
96 0.3 0.1 jo.7 19 12 29 2.3 0.7!5.8 0.9 0.6 1.6 0.7 0.4 1.6
-1911 93 5 3174 54 24 2600 52 25
88 0.2 0.1 0.4 16 80 0.2 0.1 0.7 17 89 o. 2 0.1 0.5 18
7 29 1.9 0.9,4.1 0,6 0. 2 I. I 0.5 0.1 0.7 6 2 13 9 26 1.8
'
53 20 118 46 19 -
82 ~
12 1371 I024 13 /4
o.o
4.5 0.8 0.4 I. 2 0.6 0.2 1.3 7 4 12
47 4 I04
1736 944 2837 55 36 24 25 1913 3182 91 81 2017 54 39
9 26 2.8 0.4 8.1 0.8 0.3 2.7 o.s 0.2 o. 9 8 4 13 110 21 388 I. 7 0.6 2.5 0.9 0.6 I. 0 15 5 21 76 17
101 0.4 0.2 0.6 30 25 33 2.1 0.6 7.I 68 0.4 0.1 79 o. 2 0.1
218
15 1787 1631 16
0.8 19 12 34 ~.3 12.3 6.2 0.7 0.3 I• I 1.1 o. 2 2. 5 9 4 14 0.5 20 8 32 I. 2 o.o s. 2 1.0 0.4 1.9 0.5 0.3 0.7 9 6 13 8 33 2.1 0.2 4.0 o. 5 o.o 0.6 0.7 0.3 I. I 5 2 II I
95 47 152 59 0 161 56 II 88
154 5 949 1919 52 28
17 1523 929 2282 43 26
so 0.2 o.o 0.4 14 81 0.3 o.o 0.7 18 0.3 19
[8
1514 723 2349 48 , IS 1826 59
5 40 2.7 0.3 9.6 I
1.3 0.2 1.9 0.6 0. 2 I. 2 8 I 20 116 14 584 0.9 0.6 8 60
1.8
J_
I
AFR/NTR/12 page 93
Til.BLE
38
rc;,-;~~ts--Pr~-;lCa~iu:- g ~;ron · ;
(Ordering of means) and range of nutrient i n takes in Basuto diets --·- ' ·1 A ~-;--·T-hia m in mg~;o~-~~-----,,-N-ia-c-in_m_gor---g I Vi t. C m
__x_l t296l 723
. '
I +
- , -]- -~-- -c-:-X I + X ~--= X 1 - - -~ ! . +
rr---+-=,-----, --=-~-~ !I + X
vit.
I
+
X
- l---~r : L+
X .
+
X
- 14 0 16 0 18 I
---27 65 78 82
I I
!
~--~
1427 40
ts 50 0.1 o.o o:2
13
s t9 d.s;o.o 1.3 0.4 o.ojo.6 c:.t 0.1 o.4
sit
10
- --+-~~-+-r--r--~--~
22 2 29 2 40 3 46 4
-
87
---
88
90 I 04
47 5 53 If 56 14 59 17 76 t9
-
104 118 120 I 52
-
83 20 19tt 1578 2837 64 44 100 0.3 0.1 0.3 c~.l
161 t79 210
0.7 20 0.7 21
13 33 t6 ,34 I
2.3 0.6 6.2 1.0 0.6\t.9 0.7 0.3 1.3 tO 14 2.6 0.7 6.7 2.7 0.9 7.t 1.3 0.6 2.0 0.7 0.3 1.6 10 5
19
95 2t
----+---r-~--+-4--4--+--+--~~--+--~~~~1--4--+--+--r-~-+-+--r-~~~+-~
1947 1622 3174 72 51 lOt - - - - - - - --
20 tOO 21
224t t63t
3t42 75 52 120 0.4 0.2 0.8 22 t8 36 t--- - - --
---- - - - - - - - --
2373 t707 3208 8t
55 t29 0,4 0,2 1,3 26 3.9
t9 37
~- 2425
1913
384~_ _:_~ ~ t40 -~~ 0.2 o.t
30~~~ t9 Itt
2,8 1t,3 8,t
I
t.3 0.7 2.2 0.7 0.4 2.2 10 5 21 I 10 31 · 2t8 - ----+-+--+--+--+-1---t---+---1 1,4 0,7 2,5 0,8 0,4 2.5 t2 5 26 113 32 388
G"0!3.3-lz.3 9.6
: _~-~~.i ~4~ 1 23~~j__:J_ _26 ._ 87_! o~_3
i 0.8
!3o
1.8
:a. 2
4.4
i~~~-7~7 o.9 0.3 i t.5
a.9 o.o
o-.6---~.f-2-J+,-s+l-s--i-2-6-t-1-16-t-47-+-58-40.1 It .2 sl3 ~'-s_.__o_ ·o-'--t4.......~-t_s3__
AFR/NUT/12 page 94
TABI£
39 of Basutoland :
Percentage of adequacy and costs of diets of 152 families in 18 village I 1 1
I
ij
I 1No
)Fam " I ! 1
Iof.
, of 1 \ C 10 ! T I I Persons - of'! ,1. A . F T i: I M L 0 M ·Days. E D.j
Ho.
! j
ip R 0 T.
C
I ) V
I
1--1+-P-ha_m_on_g_ _ _-+-_3 _1112 2 Khanyane 3 IJafikeng
23· 6 '8/56 2~
~ 7
A R , L 0 T. c~ N' iiAil 10124
I
H I A.
Til R 1 !N I 8 C. D. A
II
V I
1
I
\-·--.---~-----ii Pur,. T0i: chased a1
Cost in Shillings
, i l,
Per ~ap.
I !
T. 1 Pro'i\ 11 j duced
!
per Day
68~1 92 78 90 9l
! r-- ' IQ 161
100 40114_ 57 59 55 20 61 47 57
SO 35 !68
. I I I I 2D_I_1_14 !_d_+--s_;_ll_d-l--26_/l_o_-'-ifd+._s4 d
4 13 !6
4 0/56 1/57
ll/7~d 7.6/0ld
39/4d 58/9ld
50/ll~d 5~d 134/JOd 173/8d 53/447 /~ d
1--+----------~-+-+-~~+-~-----
r-33 ISl !75 75 200 82
5 13 15 28
2
2
9~d 4
1--4+-Ph_a_l_oa_ne ______
+-1-1+-17+3-2-+-4-9_~4-+2-/_57-+--107. _ 5 3 I 9 22 6 I 4/57 6 5/57 93 78
127 89 167 113
53 106
2t'BII47/8~d 25/ll~d zJ l14/3~d I
ll~d 7d
_ _
5 I Mamathe 1s 6 Laphoh I oane 7 11Jesapela
27 18 5 I 14 79
90 3 I 79 91 35 72
-+---------+,----r-··~+--~~-~-~~-+--·~---+--~4-~--+--~~r---~----+-~
4
8/s- d 2
1
I IS 33 60 93 5
97 30 183 112 30 255
36
238/8~d 209/0~d 29/3~ d
9~d
4 2 ~+-------~-+-4-l--+--+--4--4--+---r-+--+---r-T--r-~--4-~~--~-r--~-IS 23 38 316/57 86 50 82 43
~-----------1--4~--~~·-+,---+--4--4--4---~~~~+--~--~.-~-l----+----r-~
76
o6144/0ld
73/4~d
7ld
r-8+-T-Ih_a_be_lt_· 9 Tebe I i 10
----+-9+-28-t-36-t-6...:..4+--7--t-7-/_S7-+-7-9+--9~6-t-Z-O+-I-99'-t--50-t-117 6 1.5 11 11 9 l3 34 57
35 86
291£00/7~~ 19/il~d 280/7~~~13/0ld 153/ old 9d I
1 7/57 11.3 7 11/57 91
139 33 151 102 30 179
79 1m 41 192 88 47
8~ 90
8' 130/II II 1/Sld
T. Y. Reserve Thabana• Ts 1 ooana
2
J82/3d
1 293/8- d 2
9d
I
II
I 2 Maknetha' s 13 Seboche /~arakabe i
H
1'5
I·Aatsieng
~- Thaba·Bosiu
I7
I
22 23 145
i 4
\!0/59, 73! 89' 20 192
I 92
83 133
77
125,43/4~d
AFR/NUT/12 page 95
TABLE No. of No. of Persons I
39 (contd )
No.
Fam. 17 Tl a I i 1 s
IM , F 25
- of Tot. 52 129 588 Days
T I M
L
A L
E
D.
p R 0 T •.
c A L
I c. 1
I R 0 N
Iv I
T H
r. "AI;
I
R I 8
N
vI I T. "Cn 125
I
--
I
A.
o.
c. A
I
Cost in Sh i II i ngs Pro· duced 59/3d Purchased 20/8d
Tiltal
Per Cap. per Day
I I
I
9 27
3 1/59 75 5 4/60 87 74
76 a1
22 140 33 170 22 183
175 42 49 225 118 42 14 2 I 83 1
47
79/ II d 6id 2
181 Taung
23
48 81
, I
Totals ___
153 976 388 _L •
Means 86
99
l !
i
74 247 36 5/9~d 64/0~d I 29 Ill /91d 51/0ld 2 2
429/IO~d 7~d q 16 2/1 Od .. 81d 2
41 . 75
l
AFR/NTJr/12 page
96
TABLE 41 Percentage of adequacy of individual dietary studies Age Group in Years No. Sex of Case
I I
!
-NUTRIENTS Calor.. .Prot.
I Calci 23.7 27 .5 26.6 30.0 21.0 38.5 17.7 36.6 31.0 49.2 36.4 23.8 !
.I
Iron
I
! I Vi t .A Thiam.J Rib( • lnic. A. Vit.C
!
--
1-3 Both 4-6 Both
25 18 20 13 9 5 6 9 12 28 51 4 I
76.0 83.1 77.2 70.0 63.0 57.7 71.1 64.4 90.2 75.2 1100.1 81.2 60.0 I
66.5 75.2 72.3 72 .o 59.0 67.7 64.1 80.3 82.1 135.9 110.2 77.6 60.2
107.1 130 .o
60.0 I I
44.0 45.0 40 .o 39.0 50 .o 55-7 27 .o 38.6 42.7 50.1 50.8 52.2 35.0 1 1
63.6 71.1 67.7 54.0 66.0 52.4
86.0 61.1 73.2 __ 58.0 77 .o -,. ,.._
163.8 113 .o . 72.5 152 .o 120 .0 149.0 95 .o 72 .o 90.0 66.0 41.0 45.0 80.6
7-9 Both I
M F
10-12 :M
111.3 158.4
93.1
13-15 F
107.3 163.8 72.5 154.0 108.0 57.5 150.0 182.3 88.2
71.0 100 .o 56 .1 86.3 67.8 89.6
!1
16-20 - -· I
F Il F
20 & over Pregnant
231.0 153.8 76.9 201.01141.0 155 ·7 218.8 161.4. 95 .2 I
--
71.0 103.0 87 .o 150.9 - -~-
94.0 79.1 62.6
-
104 .4 J15 •~67 .2 ·149 .6 ) I
La.cta ting
14
15.0
AFR/NUT/12
page 97
TABLE
42 day
Average nutrients consumption per person per
Age Group 54 in Years l-3 Both No. of Calorie Protein Cases g g; 25 18 20 13 9 5 6 843 1247 1467 1687 1400 1732 1778 2_061 1• 894 2047 2033 2030 1800 l
NUTRlEbTS Calcium Iron Vi t. A Thiam. Ribo. g mg mg mg mg 0.237 0.275 0.266 0.360 0.260 0.540 0.230 0.440 0.310 0.345 0.256 0.308 0.271 7 .5 i 0.78 12.1 15.2 17.9 11.4 16.7 16.1 20 .o 19.5 23.1 31.3 21.8 22.6 0.9 0.36 0.58 0.66 0.50 0.50 1.21 0.87 0.92 -0 ·97 1.07 0.94 0 .95 0-94 I
l l
Nic. A. mg 3.82 5.69 6.77 6.50 7.26 7.87 8.53 8.99 9.49 9.94 8.90 12.53 10.08
Vit. mg
c
I
26.6 37.6 43.4 50.6 41.3 57.6 51.3 68.3 57.5 74-7 55.1 58.2 54.2
0.44 0.54 0.60 0.70 0.90 1.17 0.54 0.81 0.77 0.73 0.61 0-94
21.51 21.40 28.94 23.30 38.60 - - · ,I
4-6 Both 7-9 10-12 F l\1
Eoth M
I
1.2 0.8 l.O
1
2.10 2.13 0.14 2.37 2.00 ----2.3 3 .5 2.0
13-15 .F Ivi
9 10 28 51 4
16-20 F M F
21 & over
55.90 --49.96 ---44.11 - - ---44-79 -65.03 67.90 74.88 47.10
Pregnant Lactating
-
i
14
o .n
AFR/NUT/12 page
98 TABLE 43 Nutritive value of diets of inmates of Pitseng (First Hostel)
-
----
NUTRIE!T TS DIETS Calorie Protein Calcium Units Consumed llT CAF Recormn. g g
Ir~n I Vi t. mg mg
I
A! Thia.m.l Ribo. mg mg
Nic. A mg
Vit.
c
mg
1904 1954 97
63.8 64.2 99
0.4 1.0 40 i
19.8 11.2 . 117 i'
0.6 1.1 54 'i
1.0 I
0.8 1.2 67
6.2
-- 1-·
0.3 45 0 ·1 -
1.0 100
10.4
%Adequacy I ·-·
! i I
I
60
----
TABLI; -~
44
1Tutri tive value of diets of inmates of Pi tseng (Second Hostel) N UTRIENTS DIETS Calorie Protein Calcium Units Consum.ed L .C.b.P Hecorrun. ~~Adequacy
Iron mg
Vi t. A Thiam. Ribo. mg mg mg
Nic. A Vi t. C mg mg
g
g
3113 2910 107
71.6 78.9 91
I 0.2 I
36.5
0.1
I i
-
2.0
0.5 2.0
10.0 14.6 - --- . !--· -
74.2
-I
l.l
13.2 -
1.3
I 1.5
59.5 - --
I I
18
190
!
16
l 133
25 I
I 75 :
!
125
AFR/NUT/12 page 99 TABLE i
45
Nutritive value of diets ef girls at -Maseru -High School J:lfUTRIENTS .DIErS Calorie Protein j Calcium Units f-.·
! Iron\ Vi t. A
., Vi·;.-;- ' Thiam. Ribo. .. Fie. A rug
I
g ·
!
g
mg
mg
mg
mg
mg
Consumed 1-
2178 2171 100.2
76.2 70.4
0.4 1.0
17 .o
0.1 1.3 7 .6
1.2 1.8 -64.0 I
0.8 1.8 45-5
19.3 11.1 t---·--
-----49.6 19.7 i
9.8
nrc.AI: Recomm. 'fo Adequacy
13.2 128.8
I 108.2 I 37 .o
173.8
-
TABLE 46 Hutri tive value of the diets of boys at 1\faseru High School
-rJUTRIE1'1TS DIETS Calorie Units 1---
Protein Calcium g g
Iron mg
Vi t. A Thiarn. Ribo. .
ITic. A ··- ·
Vi t. C mg
Consumed INCAP Recomm. ~o
2141 3027 70 ·1 i
79.9 76.1 104.9
0.2 1.1 23.1 i
mg
mg
mg
mg
18.5 12.2 151.6
0.1 1.3 7 .6
1.3 1.5 85.3
0.9
20.4 15.3 ' I
9.1
-- 1--
--.
~
1.9
60.2 ---
Adequacy
I 48.9
133.1
15 .o
AFR/NUT/12 page 100
'TABLE
47
Percentage adequacy and .cost of diets of five families in liiesapela village throughout one year
' o.l
I
Month of Year
I
• f .l
i~o .
I July August
No. of Fam.
of c Persons .. No. A of l F Tot. Days o. 18 18 19 20 22 18 22 19 22 18 24 Z3
I
p R
c il l
0 T.
c.
I R 0 N
Iv . T II H Ik T. I 11 1
R I B
N
1
V
Cost in Shi II ings
I
I
"·
o.
c. k
T. ll,:.."
I
Poe Cap.
1
h oduced
~ur-
chased
Tota I
per Lay 6!d 2
I 2 3 4
1956 1956
5
9 12 II II
27
7 7 4 4
82 83 100 92 85 79 69 94 75 71
85 40 153 93
164 '73 33 139 61
55" 187
83/?~ d
22/b~d
l t:6/l~ 4
5
3o 30 31 34 30 34
18 163
32 64 33 49 29 55 27 40
126 107/5d 52 52/4d 58 46/4~d 4
14/12d __ _L 12V?·d
6~d 4 - ----- t--·-·-
September 1956 October November December January February March Apri I
5 5 5 5 5 5 5 5 5 5 60
96 36 149 92 20 18! 84 81 10 194 20 ISO
46 64 1081 69 108 48
-
2;ol 2 2/2d
54 /~d
1956 1956 1956 1957 I957 1957 1957 I957 1957
48/6~d 4
-- i- · - 42
5/ld -
4;ld
5 6 7 12 12 12 II
3 4
65 if 2/41d 4 4
3/0~d l/4d 4/6
45/5~d sld 4 38/0ld 3~d ~
290 46 34 ·- -
46 125 36/8!d 66 42/IOld 4
·---r----
4
~--- -..
3 3 3 5
8 9 10 II
30 36 31 41 38 14 13 17 IS 149
~r 79
175 158
-
--
55 33 64 ..
•17 /4!d 5ld 4 --· 2 ·- . 4
97 3 5 160 310 70 48 66 213 85 37 93 I
232 60/3ld 4 238 66/4d
9/6ld
69/9~d l~d 4 78/2ld 8ld 4 4
79 31 176
' 240 104/1 old 4
11/I C ~d 19/b~d
--- - ·-
-- ~-
20 136
23 91 83 38 71 1181130
121 /4~d
9!d 2
l·.lay June
7 ' 91 3
118 44 L60
so
102 283 118/0Jd
51/ll~d 170/~d 7~d 29/3~d 14 j4d
12 .
Totals and beans
86!1121301ai4 50,82 43,75 66 ' I ) 243 982 1 53 , 791 ;182!158 ! 72j36! o5 j l44l 1
44/0~d
73/4~1
-r.--Pid
91~3U
67/l~d
'
8 1/Sjd 16ldj
AFR/NUT/12 page 101
TABLE 48 Nutritive value and adequacy of four classes of Basuto diets NUTRIENTS Dietary studies Calorie Units Institutions Families Longitudinal I ellagrins Protein Calcium g g Iron mg Vi t. A mg
I Th:..am. Ribo. mg mg
Nic. A Vi t. C mg
mg
2334 1826 1734 1533
72.9 59.2 53.8 46.4
0.3 0.3 0.3 0.2
22.9 19.2 18.2 16.7
0.2 1.8 1.9
1.4 0.9 0.8 0.8
0.8 o.6 0.6 0.6
-- ---- - - -----
12.5 8.3
23.4
60.6 - - - ··
7-9 6.8
66.2
.
I
3 .1
105.7 ---
Percentage of adequacy of nutrients Ins ti tu tions Families Longitudinal Pellag.rins
88 86 79 61
94 99 91 -·-
27 22
176 183 182 133
175 142 -
-
100 83 72 j
40 41 36 ·- f - · - - - •
93 75
I
I
41 129 -- --144
30 60
158 140
66
52_l__33
r-----r--l 65 47 177 _j
I
AFR/NUT/12 page 102
Tli..BLE
49
Sources of nutrients in the diet of Basuto families r- .
FOODS CUJ.!SUl'\'ICD Maize Sorghum ~-
~
---------···-- "I J
Percentage of nu trien t from eaeh source Calcium 20.6 4.7 ·-·-·
Calorie Protein -
--·72.6 3.3 5.3 48.6
Iron Vit. 1;.
I
Thi~m.l Ribofl.j N~c. -~ IVi t -~~-=~ 32.4 9.5
64.4 6.8 8.5 -....
i I
0.1
~fueat
6.9 13.7 18.6 33.2 --
-
10-1-~8.1 5.9 0.4 5.4
20.71 I ,__.. -+-----+-- ---- - - - --1- - - ---! I 12.9 5.8 15.8 I 0.5 95.2 1.3 2.8 15.1 9.0 6.4
~--,9.5
21.4
I
25.3
1.4 -----
Legumes Veg. & Fruits
4.4 3.0 3.3 I ..
~
5.6 2.4 3.5 7 .l 0 .l
---t·-···-. ----------· - ~~~·- ., 10.7 17.5 7.4
-92~~
Milk Meat Eggs Sugar Fats & Oils Miscellaneous I '
-----
G.6 0.1 2.3 0.2 0.2
1.9 ··-
12.7 2.2 1 1---- - - + - - - - I 22.9 0.2
0 .l 0.2
1-----
~~-~0.1
-
-
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f•1AP OF BASU'I'OLAND
.Points (') show villages where studies were condueted.