Shah Syed M, Selwyn Beatrice J, Luby Stephen, Merchant Anwar, Bano Rashida
Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
Pediatr Int. 2003 Feb;45(1):49-53. doi: 10.1046/j.1442-200x.2003.01652.x.
Protein-energy malnutrition remains an important underlying cause of death among preschool children in Pakistan. The present study aimed to estimate the prevalence of stunting and its correlates and to explore the role of sex bias in remote rural villages of south Pakistan.
We selected 1878 children less than 3 years of age through stratified random sampling from 64 villages having the number of children enrolled proportionate to the size of each village, in rural Sindh, Pakistan. Trained investigators completed child physical measurements and a maternal interview. The Z-scores for the distribution of height-for-age (stunting) and weight-for-height (wasting) were estimated relative to those of the National Center for Health Statistics/Center for Disease Control (NCHS/CDC) reference population.
A total of 483 (26%) of the 1878 children were wasted, 977 (55%) were stunted and 259 (15%) were both wasted and stunted. Mothers who were illiterate were more likely to have children who were stunted (odds ratio (OR) = 1.27, 95% confidence interval (CI) 1.11-1.61). Fathers who earn less than Rs. 1000 (US $20) per month (OR = 1.35, 95% CI 1.12-1.66) were more likely to have children who were stunted. Children living in an overcrowded house were more likely to be stunted (OR = 1.44, 95% CI 1.18-1.75). Male children compared to females were equally likely to be stunted (57 vs 55%, OR 1.03, 95% CI 0.86-1.25).
In this region of lower Sindh, stunting is more common than wasting. Female illiteracy, poor household income and overcrowding are important risk factors for stunting. The prevalent belief that in rural Pakistan, parents pay attention to feeding male children at the cost of female children is not proven by these data.
蛋白质能量营养不良仍是巴基斯坦学龄前儿童死亡的一个重要潜在原因。本研究旨在估计发育迟缓的患病率及其相关因素，并探讨性别偏见在巴基斯坦南部偏远乡村的作用。
我们通过分层随机抽样，从巴基斯坦信德省农村地区的64个村庄选取了1878名3岁以下儿童，每个村庄入选儿童数量与村庄规模成比例。经过培训的调查人员完成儿童身体测量和对母亲的访谈。相对于美国国家卫生统计中心/疾病控制中心（NCHS/CDC）参考人群，估计年龄别身高（发育迟缓）和身高别体重（消瘦）分布的Z分数。
1878名儿童中，共有483名（26%）消瘦，977名（55%）发育迟缓，259名（15%）既消瘦又发育迟缓。文盲母亲的孩子更有可能发育迟缓（优势比（OR）=1.27，95%置信区间（CI）1.11 - 1.61）。月收入低于1000卢比（20美元）的父亲的孩子更有可能发育迟缓（OR = 1.35，95% CI 1.12 - 1.66）。居住在拥挤房屋中的儿童更有可能发育迟缓（OR = 1.44，95% CI 1.18 - 1.75）。与女性儿童相比，男性儿童发育迟缓的可能性相同（57%对55%，OR 1.03，95% CI 0.86 - 1.25）。
在信德省较低地区，发育迟缓比消瘦更为常见。女性文盲、家庭收入低和居住拥挤是发育迟缓的重要危险因素。这些数据并未证实巴基斯坦农村地区普遍认为的父母以牺牲女性儿童为代价而关注喂养男性儿童的观点。
