Cao X, Rawalai K, Thompson A J, Hartel G, Thompson S, Paterson J H, Chusilp K
Nutrition Program, Australian Centre for International and Tropical Health and Nutrition, University of Queensland, Herston, Brisbane, Australia.
J Health Popul Nutr. 2000 Sep;18(2):85-92.
Diarrhoea is a major public health problem in Thailand. During November 1998-January 1999, a cross-sectional survey and a nested qualitative study were conducted to understand the relationship between feeding practices and weanling diarrhoea, and to describe the related local beliefs and practices in a subdistrict of northeast Thailand. A cluster-sampling method was used for selecting 156 weanlings aged 3-24 months. A structured interview was conducted with the main caregivers of these weanlings. The questionnaire used for the interview included items about feeding practices and diarrhoea-history of the weanlings in 2 months prior to the interview. Seven focus-group discussions with an opportunistic sample of the caregivers were held in the villages. A series of vignettes and unstructured questions were used for eliciting the local beliefs about weanling diarrhoea and its causes. Thirty-six (23%) of the 156 weanlings had diarrhoea in 2 months prior to the interview. The factors that were significantly related to reported weanling diarrhoea included consumption of unboiled water by weanlings (OR = 10, p = 0.03), not covering perishable foods (OR = 3, p = 0.02), and washing feeding utensils of weanlings without dishwashing detergent (OR = 3.1, p = 0.02), 'Su' and 'tongsia'--two common local terms--were used for describing different types of weanling diarrhoea. Many caregivers considered 'su' a natural occurrence in a child's development. The results suggest that some poor feeding practices may contribute to the higher risk of weanling diarrhoea in northeast Thailand. Some local beliefs about weanling diarrhoea may mask the true causes, and mislead messages about its prevention.
腹泻是泰国一个主要的公共卫生问题。在1998年11月至1999年1月期间，开展了一项横断面调查和一项嵌套定性研究，以了解喂养方式与断奶期腹泻之间的关系，并描述泰国东北部一个分区的相关当地观念和做法。采用整群抽样方法选取了156名3至24个月大的断奶婴儿。对这些断奶婴儿的主要照料者进行了结构化访谈。访谈所用问卷包括有关喂养方式以及访谈前两个月内断奶婴儿腹泻病史的问题。在各村与照料者的机会性样本进行了七次焦点小组讨论。使用一系列情景描述和非结构化问题来引出当地对断奶期腹泻及其病因的看法。在访谈前两个月内，156名断奶婴儿中有36名（23%）出现腹泻。与报告的断奶期腹泻显著相关的因素包括断奶婴儿饮用生水（比值比=10，p=0.03）、易腐食品未加覆盖（比值比=3，p=0.02）以及不用洗洁精清洗断奶婴儿的餐具（比值比=3.1，p=0.02）。“苏”和“通夏”是两个常见的当地术语，用于描述不同类型的断奶期腹泻。许多照料者认为“苏”是儿童发育过程中的自然现象。结果表明，一些不良喂养方式可能导致泰国东北部断奶期腹泻风险增加。一些关于断奶期腹泻的当地观念可能掩盖了真正病因，并误导有关其预防的信息。
