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Nutritional Status and Basic 
Hygiene Practices of Rural School 
Age Children of Savar Region, 
Dhaka, Bangladesh 

 
Sahadat Hossain1, Fahad Ahmed2, 
Shakhaoat Hossain1, Tajuddin 
Sikder1 
 
1Department of Public Health and 
Informatics, Jahangirnagar University, 
Dhaka, Bangladesh; 
2Department of Environmental Sciences, 
Jahangirnagar University, Dhaka, 
Bangladesh 
 
 
 

 
Vol. 7, No. 1 (2018)   |   ISSN 2166-7403 (online)  
DOI 10.5195/cajgh.2018.282 |   http://cajgh.pitt.edu 

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Central Asian Journal of Global Health 
Volume 7, No. 1 (2018) |  ISSN 2166-7403 (online) | DOI 10.5195/cajgh.2018.282|http://cajgh.pitt.edu 

 
 

Abstract 

Introduction: School children in the  developing countries are susceptible to nutrition related health problems due to demographic 
and socio-economic factors, as well as limited access to food. Since BMI is a common proxy measure used to evaluate nutritional 
status, the aim of this study was to investigate the BMI categories in school-aged children in Dhaka, Bangladesh. 
Methods: A cross sectional study of 155 children, aged 6-12 years was conducted at Jahangirnagar University School in Dhaka, 
Bangladesh. The data collection was performed by in-person interviews and semi-structured questionnaires. Descriptive statistics, 
χ2 test, Fisher’s exact test, and One-Way ANOVA test were performed to compare the variables based on BMI percentiles. Data 
were analyzed using the Microsoft Excel program (version 2010). 
Results: Mean BMI of the students was 17.27 (SD=3.16). The prevalence of underweight and overweight/obesity was 11.0% and 
25.8%, respectively. Categories of BMI percentiles were associated with birth order (p=0.026), personal hygiene practices (washing 
hands after coming home from outside (p<0.001) and before meal (p=0.045)), brushing teeth (p<0.001), the number of food items 
consumed daily (p<0.001), and mothers’ occupation (p=0.006). In context of basic hygiene practice, 61.3 % of respondents washed 
hands after coming home from outside, and 93.5 % reported washing hands before the meals.  
Conclusions: This study revealed that more than one third of the students had abnormal BMI. BMI screening in rural schools needs 
to be recommended in early grades for all children. 

Keywords: Children; Nutritional status; Hygiene; Body Mass Index; Bangladesh 

 
Nutritional Status and Basic Hygiene 
Practices of Rural School Age 
Children of Savar Region, Dhaka, 
Bangladesh 

 
Sahadat Hossain1, Fahad Ahmed2, 
Shakhaoat Hossain1, Tajuddin 
Sikder1 
 
1Department of Public Health and 
Informatics, Jahangirnagar University, 
Dhaka, Bangladesh; 
2Department of Environmental Sciences, 
Jahangirnagar University, Dhaka, 
Bangladesh 

 
 

Research 

The school age (6–12 years old) is a dynamic 
period of growth and development,1 with rapid changes 
in physical, mental, and social skills.2 In the developing 
countries, the burden of morbidity and mortality 
associated with malnutrition and infectious diseases 
among the school age children is growing.3 
Undernutrition still remains a problem in school age 
children in developing countries, and is associated with 
stunted growth, lower body weights, and shorter 
heights.4, 5 A large proportion of children in these 
countries is impacted by anemia,6 vitamin A deficiency,7 

and parasitic infections8, which negatively impact their 
nutritional status,8 cognitive development, and school 
performance.9,10 

Though multiple factors are associated with 
malnutrition, poor hygiene practice is one of the major 
factors linked to malnutrition among the school age 
children.11, 12 Nutritional status of children in many 

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 Total (%l)  Male (%) Female (%)  
Age Group 
   6 - 9 81 (52.3) 46 (51.1) 35 (53.8) 
   10 - 12 74 (47.7) 44 (48.9) 30 (46.2) 
Birth Order 
   1st 40 (25.8) 22 (24.4) 18 (27.7) 
   2nd 67 (43.2) 38 (42.2) 29 (44.6) 
   >2nd 48 (31.0) 30 (33.3) 18 (27.7) 
Family Structure    
   Small (≤ 4 Members) 127 (81.9) 75 (83.3) 52 (80) 
   Large (> 4 Members) 28 (18.1) 15 (16.7) 13 (20) 
Father’s Occupation 
   Service 77 (49.7) 45 (50) 32 (49.2) 
   Unemployed/Business/Other 78 (50.3) 45 (50) 33 (50.8) 
Mother’s Occupation 
   Service/Other 25 (16.1) 75 (83.3) 55 (84.6) 
   Homemaker 130 (83.9) 15 (16.7) 10 (15.4) 
Total 155 90 65 

Table 1. Socio-demographic characteristics of the participants 

developing countries is affected by hygiene status, such 
as lack of clean water, poor sanitation, poor hygiene 
practices, and lack of access to toilets.13 This is an 
especially important issue for children under the age of 
five, as water- and sanitation-related diseases are the 
leading causes of early morbidity and mortality.13  

Bangladesh, a densely populated developing 
country in South Asia, has experienced rapid 
demographic and epidemiological transition over the past 
few decades. It is facing paradoxical health challenges 
related to high prevalence of both underweight and 
overweight problems.14 According to the 2014 
Bangladesh Health and Demographic Survey, 33% of 
children in the country were underweight.15 On the other 
hand, a recent countrywide epidemiological study 
reported that among 6-15 years old children 9.5% were 
overweight and 3.5% were obese.16      

According to the World Health Organization 
(WHO), childhood obesity is a universal problem 
gradually affecting a large number of low-and middle-

income countries.17 The prevalence of childhood obesity 
is approaching an epidemic proportion in many 
economically developed countries such USA, Canada, 
Australia, and several European countries.18 However, its 
prevalence in developing countries oftentimes reaches 
epidemic proportions faster than in the developed 
world.19 It has been reported that overweight and obesity 
in childhood is associated with increased risk of both, 
premature mortality and morbidity in adults, particularly 
due to cardiometabolic factors.20 These studies suggest 
that even in a resource-poor setting like Bangladesh, 
where under-nutrition is still prevalent, overweight and 
obesity could emerge as a major public health challenge 
in the near future. 

Lack of information concerning nutrition and 
hygiene practices among school children in Bangladesh 
increases the complexity of providing appropriate public 
heath intervention programs. Although several studies on 
hygiene practices were performed with different 
population groups in Bangladesh,21, 22 to our knowledge,

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 Total (%) Underweight 
(%) 

Healthy 
weight (%)  

Overweight/ 
Obese (%)   

P value 95% CI 
 

Age group 
   6 - 9 81 (52.3) 6 (35.3) 51 (52.0) 24 (60.0) 

0.213 0.148 – 0.277 
   10 - 12 74 (47.7) 11 (64.7) 47 (48.0) 16 (40.0) 
Sex 
   Male 90 (58.1) 6 (35.3) 62 (63.3) 22 (55.0) 

0.077 0.035 – 0.119 
   Female 65 (41.9) 11 (64.7) 36 (36.7) 18 (45.0) 
Birth order 
   1st 40 (25.8) 5 (29.4) 17 (17.3) 18 (45.0) 

0.026a 0.001 – 0.051    2nd 67 (43.2) 8 (47.1) 47 (48.0) 12 (30.0) 
   >2nd 48 (31.0) 4 (23.5) 34 (34.7) 10 (25.0) 
Father’s occupation 
   Service 77 (49.7) 9 (52.9)  47 (48.0)  21 (52.5)  

0.845 0.788 – 0.902      Unemployed/Business/ 
   Other 78 (50.3) 8 (47.1)  51 (52.0)  19 (47.5)  
Mother’s occupation  
   Service/Others 25 (16.1)  6 (35.3)  18 (18.4)  1 (2.5)  

0.006a 0.000 – 0.019  
   Homemaker 130 (83.9) 11 (64.7)  80 (81.6)  39 (97.5)  
Washing hand after coming home from outside  
   Yes 95 (61.3)  11 (64.7)  46 (46.9)  38 (95.0)  

<0.001 0.000 – 0.019  
   No/Irregular  60 (38.7)  6 (35.3)  52 (53.1)  2 (5.0)  
Washing hand before meal  
   Yes 145 (93.5)  17 (100)  88 (89.8)  40 (100)  

0.045a 0.012 – 0.078  
   No/Irregular 10 (6.5)  -  10 (10.2)  -  
Washing hand after toilet with soap  
   Yes 152 (98.1)  17 (100) 95 (96.9) 40 (100) 

0.677a 0.604 – 0.751 
   No/Irregular 3 (1.9)  -  3 (3.1) - 
Brushing teeth per day 
   One time 140 (90.3)  17 (100)  97 (99.0)  26 (65.0)  

<0.001a 0.000 – 0.019 
   Two times 15 (9.7)  -  1 (1.0)  14 (35.0)  

Total 155 (100) 17 (11.0) 98 (63.2) 40 (25.8)   

aFisher’s Exact Test  

Table 2. Distribution of socio-demographic characteristics and hygiene practices by the categories of BMI percentile 

 

   

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none of the existing studies focused on the school aged 
children. Thus, due to the limited published data on the 
BMI status and basic hygiene practices of school aged 
children in rural Bangladesh, the goal of this study was 
to assess BMI status and basic hygiene practices in 
school age children studying at Jahangirnagar University 
School. 

 

Methods 

Study population  

Before the data collection, investigators 
obtained school management’s permission to approach 
prospective study participants. The school management 
notified students and their parents or guardians about the 
objectives of the study. At the time of data collection, we 
also took verbal consent from the respondents.  

In the initial recruitment step, the school’s 
management provided the research team with the list of 
enrolled students. Prospective participants were selected 
from this list based on the following inclusion criteria: 
age group of 6–12 years, record of being present in the 
school for at least 90% of the school days, and interest in 
participating. After creating a list of students that met the 
inclusion criteria, we obtained a simple random sample 
of the respondents who were later asked to participate in 
the interview.  

School children (155 participants, 90 males and 
65 females) from families with varied levels of income 
(high, middle, low, and extremely low) were enrolled 
into a cross-sectional survey study by using random 
sampling method in May-June of 2015 at Jahangirnagar 
University School, Savar region, Dhaka, Bangladesh.  

Measurements  

A pre-designed and pre-tested semi-structured 
questionnaire was used to interview the participants to 
collect information on socio-demographic 
characteristics, hygiene practices, and the number of food 

items consumed on the daily basis.  The semi-structured 
questionnaire was pre-tested with 25 children of 
comparable age and socioeconomic characteristics from 
a neighboring school. Necessary modifications were 
made to the questionnaire before the start of the data 
collection. To better understand the socio-demographic 
characteristics of the respondents, information related to 
their age, sex, birth order, and parents’ occupation was 
collected. Hygiene practices were assessed with the 
questions focusing on washing hands before a meal, after 
coming home from outside, and after using the toilet. For 
washing hands, there was a question assessing if soap or 
detergent was used for hand washing. In order to assess 
oral hygiene, respondents were asked how many times 
they brush their teeth in a typical day. To assess the 
dietary history, students were asked how many meals 
they typically consumed in a typical day. They were also 
asked to comment on the types of foods they consumed 
in a typical day, and how many food items their meals 
included.  

By following standard procedures, 
anthropometric measurements (height and weight) were 
collected from all participants by trained field workers.23 
The ZZJKH-01 scale was used to measure the height and 
weight of the participants. At the time of measurement, 
the students were dressed in light clothing and their shoes 
were removed. To calculate Body Mass Index (kg/m2), 
weight was measured in kilograms and divided by the 
squared height in meters.24 Participants with a BMI < 5th 
percentile were classified as underweight, those with a 
BMI 5th to < 85th percentile was considered as healthy 
weight, BMI 85th to < 95th percentile were classified as 
overweight, and the BMI ≥ 95th percentile was 
categorized as obese.25  

Statistical Analysis  

Descriptive statistics were used to analyze the 
study results. Chi-square test and Fisher’s exact test were 
used to identify the significant relationship between 
categorical variables, including demographic (age, sex 

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Table 3. Comparison of mean BMI between categories of socio-demographic characteristics and daily food intake 

birth order, and parents’ occupation), anthropometric 
(BMI categories), nutrition, and hygiene. BMI was 
compared based on gender, parents’ occupation, and 
frequency of daily food intake categories using one-way 
ANOVA test. Data were processed and analyzed using 
the Microsoft Excel program (version 2010). All the p 
values were two-tailed and statistical significance was set 
at the conventional cut-off of p ≤ 0.05.  

 

Results 

A total of 155 children were interviewed (Table 
1) of which 90 were male (58.1%) and 65 were female 
(41.9%), 81 (52.3%) were aged 6-9 and 74 (47.7 %) were 
aged 10-12. Almost 82% of them were from the nuclear 
families with four or less members in the household, and 
43.2% of the children were in the second birth order. We 
found that 16% of mothers were employed outside of 
their households, whereas about 50% of fathers were 
involved in service jobs.   

The prevalence of underweight, healthy weight, 
and overweight/obese children was 11.0%, 63.2%, and 

25.8% respectively (Table 2). More than one-third of the 
students deviated from the healthy weight category. 
Female students were underweight (64.7%) more often 
than males, whereas male students were 
overweight/obese (55.0%) more often than females. The 
study showed that birth order was significantly 
associated with the categories of BMI percentile (p-
value=0.026; 95% CI: 0.001 - 0.051). Mother’s 
occupation was also a significant factor in determining 
the health status of the study students (χ²(2, 
N=155)=11.17, p=0.006). We found that almost 93% of 
students reported washing their hands before the meals. 
Similarly, about 98% students reported washing hands 
with soap after using toilet. In addition, the rate of hand 
washing after coming home from outside was relatively 
low (61%). Majority of the students (53.1%; χ²(2, 
N=155)=27.75, p<0.001) who were in the healthy weight 
category did not wash or irregularly washed hands after 
coming home from outside. The study revealed that 
90.3% of students reported brushing their teeth once per 
day, and 9.7% reported brushing their teeth twice per day.  

  
N Mean (±SD) 

95% Confidence interval for mean P valuea 
Lower bound Upper bound 

Gender 
   Male 90 17.63 (3.25) 16.95 18.31 0.092 
   Female 65 16.76 (2.97) 16.03 17.50 
Father’s occupation 
   Service 77 17.62 (3.55) 16.81 18.42  

0.169    Unemployed/Business/Other 78 16.92 (2.68) 16.31 17.53 
Mothers occupation 
   Service/Other 25 15.70 (2.16) 17.01 18.13  

0.006    Homemaker 130 17.57 (3.23) 14.50 15.96 
Daily food intake frequency    
   Less than 3 times  87 15.30 (1.59) 14.96 15.64  

<0.001 
 

   3 to 4 times  33 18.42 (2.19) 17.64 19.19 
   More than 4 times  35 21.08 (2.84) 20.10 22.05 
aOne-way ANOVA test      

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 Daily food intake frequency (%) P value 95% Confidence interval 

Less than 3 times  3 to 4 times  More than 4 times   Lower Upper 
Age group  
   6 - 9 42 (48.3) 24 (72.7)  15 (42.9)  0.026 0.001 0.051 
   10 - 12 45 (51.7)  9 (27.3)  20 (57.1)  
Gender  
   Male 50 (57.5)  22 (66.7)  18 (51.4)  0.426 0.348 0.504 
   Female 37 (42.5)  11 (33.3)  17 (48.6)  
Birth order   
   1st 19 (21.8)  14 (42.4)  7 (20.0)   

0.174 
  

 
0.111 

  

 
0.234 

 
   2nd 41 (47.1)  10 (30.3)  16 (45.7)  
   >2nd 27 (31.0)  9 (27.3)  12 (34.3)  
Categories of BMI percentile    
   Underweight 17 (19.5)  - -  

<0.001a 
 

 
<0.001 

 

 
0.019 

 
   Healthy weight 68 (78.2)  21 (63.6)  9 (25.7)  
   Overweight/obese 2 (2.3)  12 (36.4)  26 (74.3)  
Washing hand after coming home from outside  
   Yes 39 (44.8)  22 (66.7)  34 (97.1)  <0.001a <0.001 0.019 
   No/irregular  48 (55.2)  11 (33.3)  1 (2.9)  
Brushing teeth per day 
   One time 85 (97.7)  30 (90.9)  25 (71.4)  <0.001a <0.001 0.019 
   Two times 2 (2.3) 3 (9.1)  10 (28.6)  
Total  87 (100)  33 (100)  35 (100)   
aFisher’s Exact Test 

Table 4. Association of daily food intake frequency with socio-demographic characteristics, BMI percentiles, and 
hygiene practices 

Table 3 shows that more than half of the 
students (56%) consumed less than three food items per 
day, and their average BMI was 15.30 (SD=1.59). On the 
other hand, 22.6% of students who consumed more than 
four items of foods daily had on average BMI of 21.08 
(SD=2.84).  

Table 4 summarizes the association of daily 
food intake frequency with other variables. Daily food 
intake frequency was significantly different between age 
groups, χ²(2, N=155)= 7.34, p=0.026, and categories of 
BMI percentile, χ²(4, N=155)= 76.08, p<0.001. The 
study showed that 74.3% of overweight/obese students 
consumed foods more than four times per day. No cases 

of underweight were reported among students who 
consumed food three or more times daily. All of the 
respondents reported that they ate rice regularly. Rice, 
fish, pulses, and beans (such as dry pea and lentils) were 
the most commonly consumed foods among the 
respondents who reported consuming two food items 
daily. Very few children reported consuming vegetables 
and fruits in their daily meals. We also found that there is 
a significant relationship between daily food intake 
frequency and the dental hygiene, χ²(2, N=155)= 17.11, 
p<0.001.    

 

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Discussion 

The key finding of this study is that more than 
one third of the students deviated from healthy body 
weight. Age, sex, birth order, mother’s occupation, hand 
hygiene, and total daily number of meals were 
significantly associated with BMI level. Female students 
were found to be underweight more often than male 
students, while male students were more often found to 
be overweight/obese. The findings of this study showed 
that the number of underweight students was six percent 
lower and the number of overweight/obese students was 
twice as high when compared to the recent large scale 
study conducted in Bangladesh.16 Additionally, the 
number of underweight in this study was lower than that 
reported in the countrywide epidemiological study, and 
the overall number of overweight/obese students was 
almost doubled compared to what was previously 
reported.26  These findings warrant additional 
investigation. 

In this study, it was found that more than half of 
the respondents (56%) who consumed foods less than 
three times per day had the average BMI of 15.30 kg/m2 
(SD=1.59), which has important implication for 
children’s nutritional status. Access to food is 
hypothesized to be the primary reason behind low food 
intake frequency. Published evidence suggests that food 
unavailability is associated with poor health status, lower 
cognitive and academic attainment, and psychosocial 
problems among school age children.27 A study in 
Malaysia showed that children in food-insecure 
households were 2.15 times more likely to be 
underweight.28 From previously published reports on 
food consumption patterns in Bangladesh, we found that 
the main sources of carbohydrate were rice and wheat, 
while fish, poultry, eggs, and pulses were the main 
sources of protein.29, 30 The overall personal hygiene 
practices reported in this study were similar to the 
previous studies among different population groups in 
the country.22, 31, 32  

A major strength of this study is that it followed 
the standard operating procedures with uniform 
methodology for data collection from all participants. 
The other strength is that participants of this study came 
from heterogeneous family background because the 
school consisted of high, middle, low, and extremely low 
family income children. Thus, our findings are 
generalizable to multiple population groups. 

This study has some limitations, including study 
implementation in small geographic area, insufficient 
data on dietary patterns of the local populations, and lack 
of ability to compare these data to the populations outside 
this rural area.  In addition, hygiene practices could have 
been over reported, as it is common with all self-reported 
practices in personal interviews. 

 Nutritional status of school age children 
should be closely monitored in order to improve their 
physical and mental health. Parents from all income 
categories (high, middle, low, and extremely low family 
income) should be trained to maintain healthy diet 
irrespective of their financial status, such as increasing 
consumption of plant proteins, dietary fiber, fresh fruits, 
and vegetables. In this study, very few children reported 
consuming vegetables and fruits in their daily meals, 
suggesting that most students do not fulfill their 
nutritional needs by current food consumption patterns. 

This study demonstrates that although basic 
self-reported hygiene practice of rural school age 
children is satisfactory and the prevalence of 
underweight is in relatively low, the prevalence of 
overweight/obesity is relatively high in comparison with 
previously reported countrywide statistics. The 
overweight and/or obesity of school aged children can be 
an emerging public health problem in Bangladesh. This 
represents a unique public health challenge that will need 
to be addressed with future targeted public health 
interventions. Nutrition programs and active lifestyle 
health policies should be focused on school-aged 
children, especially in rural Bangladesh. Health 
monitoring study for the school aged children would be 

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further conducted to better understand behavioral 
patterns of these children along with the general 
perception of obesity. This study can be viewed as a 
baseline work for other researchers focusing on 
childhood nutrition in Bangladesh and similar countries. 

 

References 

1. Hu X, Zhong J. The Study of Design of 
Children’s Anti-lost Clothing Based upon 
Ergonomics. 7th International Conference, 
DHM, Toronto, Canada. 2016; 9745:13-21. 

2. Hasan MM, Hoque MA, Hossain MA, Mollah 
AH, Islam MN. Nutritional status among 
primary school children of Mymensingh. 
Mymensingh Med J. 2013; 22: 267-74. 

3. Das P, Basu M, Dhar G, Mallik S, Pa R. 
Nutritional status and morbidity pattern of 
government primary school children in north 
Kolkata of West Bengal, India. South East Asia 
Journal of Public Health. 2012; 2:13-7. 

4. Degarege D, Degarege A, Animut A. 
Undernutrition and associated risk factors 
amongschool age children in Addis Ababa, 
Ethiopia. BMC public health. 2015; 15:375. 

5. WaterAid. Undernutrition and water, sanitation 
and hygiene (WASH). 2017; 
http://www.wateraid.org/np/~/media/Publicatio
ns/EU-docs/Undernutrition-and-water-
sanitation-and-hygiene-WASH.pdf?la=en-NP. 
(Accessed 5 March 2018). 

6. Singh V, West KP. Vitamin A deficiency and 
xerophthalmia among school-aged children in 
Southeastern Asia. Eur J Clin Nutr. 2004; 
58:1342-9. 

7. Brooker S, Clements AC, Hotez PJ, Hay SI, 
Tatem AJ, Bundy DA, et al. The co-
distribution of Plasmodium falciparum and 
hookworm among African schoolchildren. 
Malaria journal. 2006; 5:99. 

8. Awill-bethi S, Bundy D. Intestinal nematode 
infection and anaemia in developing countries. 
BMJ 2007; 334:1065-6. 

9. Pollitt E. Early iron deficiency anemia and 
later mental retardation. Am J Clin Nutr. 1999; 
69:4-5. 

10. Singh M. Role of micronutrients for physical 
growth and mental development. Indian J 
Pediatr. 2004; 71:59-62. 

11. Mustufa MA, Jamali AK, Sameen I, Burfat 
FM, Baloch MY, Baloch AH, et al. 
Malnutrition and poor oral health status are 
major risks among primary school children at 
Lasbela, Balochistan, Pakistan. Journal of 
health, population, and nutrition. 2017; 36:17. 

12. Marshak A, Young H, Bontrager EN, Boyd 
EM. The Relationship Between Acute 
Malnutrition, Hygiene Practices, Water and 
Livestock, and Their Program Implications in 
Eastern Chad. Food and nutrition bulletin. 
2017; 38:115-27. 

13. Brown J, Cairncross S, Ensink JH. Water, 
sanitation, hygiene and enteric infections in 
children. Archives of disease in childhood. 
2013; 98:629-34. 

14. Khan SH, Talukder SH. Nutrition transition in 
Bangladesh: is the country ready for this 
double burden. Obesity reviews : an official 
journal of the International Association for the 
Study of Obesity. 2013; 14 Suppl 2:126-33. 

15. MOHFW. Demographic and health survey. 
National Institute of Population Research and 
Training, Ministry of Health and Family 
Welfare Dhaka, Bangladesh. 2014; 
https://dhsprogram.com/pubs/pdf/FR311/FR31
1.pdf. (Accessed 5 March 2018). 

16. Bulbul T, Hoque M. Prevalence of childhood 
obesity and overweight in Bangladesh: 
findings from a countrywide epidemiological 
study. BMC pediatrics. 2014; 14:86. 

17. WHO. The double burden of malnutrition: 
Policy brief. World Health Organization. 2017; 
http://apps.who.int/iris/bitstream/10665/25541
3/1/WHO-NMH-NHD-17.3-eng.pdf?ua=1 
(Accessed 5 March 2018). 

18. Sultan K, Habiba T. Prevalence of overweight 
and obesity in infancy. Bangladesh Med Res 
Counc Bull. 2008; 34:69-70. 

19. Bhurosy T, Jeewon R. Overweight and obesity 
epidemic in developing countries: a problem 
with diet, physical activity, or socioeconomic 
status? Scientific World Journal. 2014; 
2014:964236. 

http://www.library.pitt.edu/
http://www.pitt.edu/
http://www.library.pitt.edu/articles/digpubtype/index.html
http://www.upress.pitt.edu/upressIndex.aspx
http://www.wateraid.org/np/%7E/media/Publications/EU-docs/Undernutrition-and-water-sanitation-and-hygiene-WASH.pdf?la=en-NP
http://www.wateraid.org/np/%7E/media/Publications/EU-docs/Undernutrition-and-water-sanitation-and-hygiene-WASH.pdf?la=en-NP
http://www.wateraid.org/np/%7E/media/Publications/EU-docs/Undernutrition-and-water-sanitation-and-hygiene-WASH.pdf?la=en-NP
http://apps.who.int/iris/bitstream/10665/255413/1/WHO-NMH-NHD-17.3-eng.pdf?ua=1
http://apps.who.int/iris/bitstream/10665/255413/1/WHO-NMH-NHD-17.3-eng.pdf?ua=1


 
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20. Reilly JJ, Kelly J. Long-term impact of 
overweight and obesity in childhood and 
adolescence on morbidity and premature 
mortality in adulthood: systematic review. 
International journal of obesity. 2011; 35:891-
8. 

21. Raihan MJ, Farzana FD, Sultana S, Haque 
MA, Rahman AS, Waid JL, et al. Examining 
the relationship between socio-economic 
status, WASH practices and wasting. PloS one. 
2017; 12:e0172134. 

22. Halder AK, Tronchet C, Akhter S, Bhuiya A, 
Johnston R, Luby SP. Observed hand 
cleanliness and other measures of handwashing 
behavior in rural Bangladesh. BMC public 
health. 2010; 10:545. 

23. WHO. Physical Status: The use and 
interpretation of Anthropometry. World Health 
Organization. 2018; 
http://www.who.int/childgrowth/publications/p
hysical_status/en/. (Accessed 5 March 2018). 

24. Lohman T, Roche AF, Martorell R. 
Anthropometric Standardization Reference 
Manual. Human Kinetics Books, Champaign, 
Ill. 1988; ISBN: 0873221214, 9780873221214. 

25. CDC. Healthy Weight: About Child & Teen 
BMI. Centers for Disease Control and 
Prevention, USA. 2015; 
https://www.cdc.gov/healthyweight/assessing/b
mi/childrens_bmi/about_childrens_bmi.html. 
(Accessed 5 March 2018). 

26. de Onis M, Blossner M, Borghi E. Prevalence 
and trends of stunting among pre-school 
children, 1990-2020. Public health nutrition. 
2012; 15:142-8. 

27. Jyoti DF, Frongillo EA, Jones SJ. Food 
insecurity affects school children's academic 

performance, weight gain, and social skills. J 
Nutr. 2005; 135:2831-9. 

28. Ali Naser I, Jalil R, Wan Muda WM, Wan Nik 
WS, Mohd Shariff Z, Abdullah MR. 
Association between household food insecurity 
and nutritional outcomes among children in 
Northeastern of Peninsular Malaysia. Nutr Res 
Pract. 2014; 8:304-11. 

29. Basak JK, Titumir RAM, Baten MA, Dey NC. 
A Review Study on Food Consumption and 
Hovered Nutrition in Bangladesh: Progress and 
Determinants of Food Security. Bangladesh J 
Environ Sci. 2015; 29:29-36. 

30. BIRDEM. Dietary Guidelines for Bangladesh. 
Bangladesh Institute of Research and 
Rehabilitation in Diabetes, Endocrine and 
Metabolic Disorders. 2014; http://dab-
bd.org/news-
photos/Dietary_Guidelines_for_Bangladesh.pd
f. (Accessed 5 March 2018). 

31. Zohura F, Bhuyian SI, Monira S, Begum F, 
Biswas SK, Parvin T, et al. Observed 
Handwashing with Soap Practices Among 
Cholera Patients and Accompanying 
Household Members in a Hospital Setting 
(CHoBI7 Trial). The American journal of 
tropical medicine and hygiene. 2016; 95:1314-
8. 

32. Nizame FA, Nasreen S, Halder AK, Arman S, 
Winch PJ, Unicomb L, et al. Observed 
practices and perceived advantages of different 
hand cleansing agents in rural Bangladesh: ash, 
soil, and soap. The American journal of 
tropical medicine and hygiene. 2015; 92:1111-
6. 

 

 

 

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http://www.pitt.edu/
http://www.library.pitt.edu/articles/digpubtype/index.html
http://www.upress.pitt.edu/upressIndex.aspx
http://www.who.int/childgrowth/publications/physical_status/en/
http://www.who.int/childgrowth/publications/physical_status/en/
http://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/about_childrens_bmi.html
http://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/about_childrens_bmi.html
http://dab-bd.org/news-photos/Dietary_Guidelines_for_Bangladesh.pdf
http://dab-bd.org/news-photos/Dietary_Guidelines_for_Bangladesh.pdf
http://dab-bd.org/news-photos/Dietary_Guidelines_for_Bangladesh.pdf
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	Nutritional Status and Basic Hygiene Practices of Rural School Age Children of Savar Region, Dhaka, Bangladesh
	Abstract
	Keywords: Children; Nutritional status; Hygiene; Body Mass Index; Bangladesh
	Nutritional Status and Basic Hygiene Practices of Rural School Age Children of Savar Region, Dhaka, Bangladesh
	Research

