Agueh V D, Makoutode M, Diallo P, Soton A, Ouendo E M
Institut Régional de Santé Publique, Cotonou, République de Bénin, BP.
Rev Epidemiol Sante Publique. 1999 Jun;47(3):219-28.
The aim of this study was to find the needs and priorities for interventions to improve children's nutritional state in a secondary city in Bénin. It addressed the issues of the magnitude and distribution of infant malnutrition and related maternal factors. It also aimed to identify an easy to use and low cost, but valid, technique to diagnose malnutrition in children.
First of all, the prevalence of infant malnutrition was assessed with a representative sample of 492 children aged less than 36 months, in all four communities of the city. Then the sensitivity and specificity of arm circumference were studied and the associations between the children's anthropometric indices were assessed. Secondly in a sub-group of 200 couples of mothers and children, an analysis was conducted to show the links between the indices of mothers' nutritional status, some of their social and economical variables, and the children's anthropometric indices.
The prevalences of wasting and stunting and all other forms confounded among children aged 0-3 years were respectively 5.7%, 22% and 25.9%. They represented 44.7% for the arm circumference. Wasting was more prevalent among children aged 6-23 months (9.6%) than those aged less than 6 months (1.1%) and those of 24 to 36 months (5.2%). The boys had a higher prevalence of stunting (25.1%; p = 0.049) than the girls (18.1%). The correlation between children arm circumference and their indices weight/height, weight/age and height/age were all significant (p < 0.001), but they were higher for weight/age (r = 0.48) and weight/height (r = 0.36) than for height/age (r = 0.30). Low, but significant correlation (r ranged from 0.17 to 0.25) were observed between anthropometric indices of mothers and children. Mothers' instruction level had a tendency to be associated positively and significantly with children z-score weight/height. The effect of socio-economic level on children's nutritional status was significant only at p < 0.10. Unlike the condition observed in the big cities of under-developed countries in general, the central area of Ouidah was more affected by infant malnutrition than peripheral area recently urbanized.
Infant malnutrition appears to be a really public health problem in this town and children at weaning age are more affected. The interventions to improve children's nutritional status must concern, not only children with malnutrition, but also their mothers. Those interventions must also improve mother's knowledge and practices about weaning foods and their instruction and socioeconomic levels. The cut-off-point 12.5 cm of arm circumference seems to be more appropriate to diagnose wasting among children aged less than 12 months; 13.5 cm is better for 12-36 months aged children.
本研究旨在找出贝宁一座中等城市中改善儿童营养状况干预措施的需求和重点。研究涉及婴儿营养不良的严重程度和分布以及相关的母体因素问题。研究还旨在确定一种易于使用、低成本但有效的儿童营养不良诊断技术。
首先，在该市所有四个社区中，对492名年龄小于36个月的儿童进行代表性抽样，评估婴儿营养不良的患病率。然后研究臂围的敏感性和特异性，并评估儿童人体测量指标之间的关联。其次，在200对母婴组成的子群体中，进行分析以显示母亲营养状况指标、她们的一些社会和经济变量与儿童人体测量指标之间的联系。
0至3岁儿童中消瘦、发育迟缓以及所有其他混合形式的患病率分别为5.7%、22%和25.9%。臂围占比为44.7%。6至23个月大的儿童中消瘦更为普遍（9.6%），高于6个月以下（1.1%）和24至36个月（5.2%）的儿童。男孩发育迟缓的患病率（25.1%；p = 0.049）高于女孩（18.1%）。儿童臂围与体重/身高、体重/年龄和身高/年龄指标之间的相关性均显著（p < 0.001），但体重/年龄（r = 0.48）和体重/身高（r = 0.36）的相关性高于身高/年龄（r = 0.30）。母亲和儿童的人体测量指标之间观察到低但显著的相关性（r范围为0.17至0.25）。母亲的教育水平倾向于与儿童的体重/身高z评分呈正相关且显著相关。社会经济水平对儿童营养状况的影响仅在p < 0.10时显著。与一般欠发达国家大城市的情况不同，维达的中心地区比最近城市化的周边地区受婴儿营养不良的影响更大。
婴儿营养不良在这个城镇似乎确实是一个公共卫生问题，断奶期儿童受影响更大。改善儿童营养状况的干预措施不仅必须关注营养不良的儿童，还必须关注他们的母亲。这些干预措施还必须提高母亲关于断奶食品的知识和做法以及她们的教育水平和社会经济水平。对于诊断12个月以下儿童的消瘦，臂围临界点12.5厘米似乎更合适；对于12至36个月大的儿童，13.5厘米更好。
