Cross-sectional growth assessment of children in four refugee camps in Northern Greece

Background: Previous research has identified a high prevalence of growth abnormality among Syrian refugees in refugee camps in Jordan and Lebanon. There are few published data describing the growth status of children who are refugees in Europe. Methods: Refugees with up to 5 completed years of age in four refugee camps in Northern Greece were invited to participate in growth screening for clinical purposes. Mid-upper arm circumference (MUAC), weight for age (WFA), weight for height (WFH) and height for age (HFA) were measured. The World Health Organization (WHO) normal ranges and 'WHO Anthro' were used to calculate the prevalence of high WFH and low WFA, WFH, HFA, or MUAC. Results: In total 177 (27% of children under 5 years in the four camps) were included. The male-to-female ratio was 1:1.04. Weight and height data were recorded for 114 children, and MUAC was recorded for 106 children. Two children (1.9%; 95% confidence interval [CI] 1.0-3.7%) had a MUAC more than 2 standard deviations (2SD) below the WHO mean value. Ninety-five percent were in the normal range for WFA. Four (3.7%; 95% CI 1.4-9.4%) were underweight (>25D below the WHO median). Seventeen (16%; 95% CI 9.5-24.9%) had a high WFH, and 4 (3.7%; 95% CI 1.4-9.6%) were 2SD below the WHO median. Nineteen children (17.4%) had a low HFA, including 3 children under 1 year of age (13% of those under 1 year). Discussion: Results demonstrated low prevalence of underweight for height, but high prevalence of stunting, suggesting chronic malnutrition. We recommend empirical micronutrient supplementation for children younger than 5 years and pregnant and breast-feeding women. Further research on the nutritional status of child refugees in camps in Greece is warranted to understand the cause of stunting and scope of any micronutrient deficiencies. (C) 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.