Roy S K, Fuchs G J, Mahmud Zeba, Ara Gulshan, Islam Sumaya, Shafique Sohana, Akter Syeda Sharmin, Chakraborty Barnali
Clinical Sciences Division, ICDDR,B: Centre for Health and Population Research, GPO Box 128, Dhaka 1000, Bangladesh.
J Health Popul Nutr. 2005 Dec;23(4):320-30.
This prospective randomized trial was carried out to test the efficacy of a specific intervention for reducing the extent of their malnutrition and to change behaviour of mothers relating to child-feeding practices, care-giving, and health-seeking practices under the Bangladesh Integrated Nutrition Project (BINP). The study was conducted in rural Bangladesh among 282 moderately-malnourished (weight-for-age between 61% and 75% of median of the National Center for Health Statistics standard) children aged 6-24 months. Mothers of the first intervention group received intensive nutrition education (INE group) twice a week for three months. The second intervention group received the same nutrition education, and their children received additional supplementary feeding (INE+SF group). The comparison group received nutrition education from the community nutrition promoters twice a month according to the standard routine service of BINP. The children were observed for a further six months. After three months of interventions, a significantly higher proportion of children in the INE and INE+SF groups improved (37% and 47% respectively) from moderate to mild or normal nutrition compared to the comparison group (18%) (p < 0.001). At the end of six months of observation, the nutritional status of children in the intervention groups improved further from moderate to mild or normal nutrition compared to the comparison group (59% and 86% vs 30%, p < 0.0001). As the intensive nutrition education and supplementation given were highly effective, more children improved from moderate malnutrition to mild or normal nutritional status despite a higher incidence of morbidity. The frequency of child feeding and home-based complementary feeding improved significantly (p < 0.001) in both the intervention groups after three months of interventions and six months of observation. Body-weight gain was positively associated with age, length-for-age, weight-for-length, frequency of feeding of khichuri, egg, and potato (p < 0.05). Ability of mothers to identify malnutrition improved from 15% to 99% in the INE group and from 15% to 100% in the INE+SF group, but reduced from 24% to 21% in the comparison group. Use of separate feed pots, frequency of feeding, and cooking of additional complementary feeds improved significantly in the INE and INE+SF groups compared to the comparison group after three months of interventions and six months of observation. It can be concluded from the findings of the study that intensive nutrition education significantly improves the status of moderately-malnourished children with or without supplementary feeding.
这项前瞻性随机试验旨在检验一项特定干预措施在孟加拉国综合营养项目（BINP）下减少儿童营养不良程度以及改变母亲在儿童喂养习惯、照料和寻求健康行为方面的效果。该研究在孟加拉国农村地区对282名6至24个月中度营养不良（年龄别体重在国家卫生统计中心标准中位数的61%至75%之间）的儿童进行。第一干预组的母亲每周接受两次强化营养教育（INE组），为期三个月。第二干预组接受相同的营养教育，其孩子还接受额外的补充喂养（INE+SF组）。对照组按照BINP的标准常规服务，每月从社区营养推广员那里接受两次营养教育。对这些儿童进一步观察了六个月。干预三个月后，INE组和INE+SF组中从中度改善为轻度或正常营养状况的儿童比例（分别为37%和47%）显著高于对照组（18%）（p<0.001）。在观察六个月结束时，与对照组相比，干预组儿童的营养状况从中度进一步改善为轻度或正常营养状况（分别为59%和86%，对照组为30%，p<0.0001）。由于所给予的强化营养教育和补充喂养非常有效，尽管发病率较高，但更多儿童从中度营养不良改善为轻度或正常营养状况。干预三个月和观察六个月后，两个干预组的儿童喂养频率和家庭自制辅食喂养频率均显著提高（p<0.001）。体重增加与年龄、身长别年龄、身长别体重、kichuri、鸡蛋和土豆的喂养频率呈正相关（p<0.05）。INE组母亲识别营养不良的能力从15%提高到99%，INE+SF组从15%提高到100%，而对照组从24%降至21%。干预三个月和观察六个月后，与对照组相比，INE组和INE+SF组在使用单独的喂食锅、喂养频率和额外自制辅食烹饪方面均有显著改善。从该研究结果可以得出结论，强化营养教育无论有无补充喂养都能显著改善中度营养不良儿童的状况。
