Wamani Henry, Astrøm Anne Nordrehaug, Peterson Stefan, Tumwine James K, Tylleskär Thorkild
Centre for International Health, University of Bergen, Armauer Hansen Building, N-5021 Bergen, Norway.
BMC Pediatr. 2007 Apr 10;7:17. doi: 10.1186/1471-2431-7-17.
Many studies in sub-Saharan Africa have occasionally reported a higher prevalence of stunting in male children compared to female children. This study examined whether there are systematic sex differences in stunting rates in children under-five years of age, and how the sex differences in stunting rates vary with household socio-economic status.
Data from the most recent 16 demographic and health surveys (DHS) in 10 sub-Saharan countries were analysed. Two separate variables for household socio-economic status (SES) were created for each country based on asset ownership and mothers' education. Quintiles of SES were constructed using principal component analysis. Sex differentials with stunting were assessed using Student's t-test, chi square test and binary logistic regressions.
The prevalence and the mean z-scores of stunting were consistently lower amongst females than amongst males in all studies, with differences statistically significant in 11 and 12, respectively, out of the 16 studies. The pooled estimates for mean z-scores were -1.59 for boys and -1.46 for girls with the difference statistically significant (p < 0.001). The stunting prevalence was also higher in boys (40%) than in girls (36%) in pooled data analysis; crude odds ratio 1.16 (95% CI 1.12-1.20); child age and individual survey adjusted odds ratio 1.18 (95% CI 1.14-1.22). Male children in households of the poorest 40% were more likely to be stunted compared to females in the same group, but the pattern was not consistent in all studies, and evaluation of the SES/sex interaction term in relation to stunting was not significant for the surveys.
In sub-Saharan Africa, male children under five years of age are more likely to become stunted than females, which might suggest that boys are more vulnerable to health inequalities than their female counterparts in the same age groups. In several of the surveys, sex differences in stunting were more pronounced in the lowest SES groups.
撒哈拉以南非洲地区的许多研究偶尔报告称，男童发育迟缓的患病率高于女童。本研究调查了五岁以下儿童发育迟缓率是否存在系统性的性别差异，以及发育迟缓率的性别差异如何随家庭社会经济地位而变化。
分析了撒哈拉以南10个国家最近16次人口与健康调查（DHS）的数据。根据资产所有权和母亲教育程度，为每个国家创建了两个独立的家庭社会经济地位（SES）变量。使用主成分分析构建SES五分位数。使用学生t检验、卡方检验和二元逻辑回归评估发育迟缓的性别差异。
在所有研究中，发育迟缓的患病率和平均z分数在女性中始终低于男性，在16项研究中，分别有11项和12项的差异具有统计学意义。合并后的平均z分数估计值为男孩-1.59，女孩-1.46，差异具有统计学意义（p<0.001）。在汇总数据分析中，男孩的发育迟缓患病率（40%）也高于女孩（36%）；粗比值比为1.16（95%CI 1.12-1.20）；儿童年龄和个体调查调整后的比值比为1.18（95%CI 1.14-1.22）。与同一组中的女性相比，最贫困的40%家庭中的男童更有可能发育迟缓，但并非所有研究中的模式都一致，并且在调查中，SES/性别交互项与发育迟缓的评估并不显著。
在撒哈拉以南非洲地区，五岁以下男童比女童更容易发育迟缓，这可能表明在同一年龄组中，男孩比女孩更容易受到健康不平等的影响。在一些调查中，发育迟缓的性别差异在最低SES组中更为明显。
