intervals for physical growth and for appearance of secondary
sexual characteristics. This was done by visiting the same
village/locality at an interval of six months and cover all
the children in that area. Repeat visits were made to contact
those children who were not covered during the scheduled visit.
Children who could not be contacted at 3 or more follow up
visits were considered as lost to follow up and were excluded
from the study for subsequent follow-ups.
Physical Growth Parameters
In this study following anthropometric measurements for
physical growth were taken at six monthly intervals.
Height (cm.) : Standing height
of a child was measured with anthropometer rod taken to nearest
millimeter (mm). The child was made to stand erect with heels
touching together without any foot wear.
Body weight (kg) : Weight
of the child was taken with minimal clothing using a lever
balance. Measurement was taken to the nearest 100 gm. value.
Chest circumference (cm.) :
It was measured with a fiber glass tape, at the level of xiphoid
to the nearest mm.
Mid-arm circumference (cm.) : It
was measured with a fiber glass tape at the mid point of the
acromian and olecranon on one side to the nearest mm.
Bi-acromial diameter (cm.) :
The distance between the most lateral margin of the acromial
process of the scapula with the subject standing, as he normally
does, was measured using anthropometer rod with two blades.
Bi-cristal diameter (cm.):
The distance between the most lateral points on the crest
of each ilium was measured using anthropometer rod with two
blades, with the child standing erect.
The children were also observed for sexual maturity at each
follow up visit. The presence or absence of secondary sexual
characteristics was recorded. Boys were observed for presence
of axillary hair, pubic hair, facial hair and change of voice
and girls for axillary hair, pubic hair and onset of menarche.
Genitalia development staging in boys was recorded as follows
Stage 1: Scrotum and penis
are about same size and shape as in early childhood and there
is little change in appearance