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布基纳法索儿童发育迟缓及相关健康结果风险区的地理定位

Geographic targeting of risk zones for childhood stunting and related health outcomes in Burkina Faso.

作者信息

Margai Florence M

机构信息

Department of Geography, Binghamton University, Binghamton, NY, USA.

出版信息

World Health Popul. 2007 Apr;9(2):64-82. doi: 10.12927/whp.2007.18943.

Abstract

Several studies seeking alternative intervention strategies for chronic food insecurity in food-poor nations now advocate the simultaneous evaluation of multiple causative agents to identify and monitor at-risk populations. This study attempted to do so using a three-tiered conceptual framework that expressed childhood nutritional health outcomes as a function of basic, underlying and immediate causes that are manifested at the regional%community level, the household level and the personal level. Focusing on stunting (short stature) as a direct cumulative indicator of food insecurity, the geographic patterns of this nutritional health outcome were mapped using empirical data from Burkina Faso. The spatial analysis revealed several isolated pockets of at-risk populations. Further analysis using logistic regression methods revealed significant disparities in childhood vulnerability based on factors such as urbanization, geographic accessibility, poverty, maternal education and occupation, environmental health, and age, gender and dietary intake of the child. Contrary to research expectations, there were no observed relationships between childhood nutritional health outcomes and the biophysical characteristics of the communities. The odds ratios of stunting in the marginal areas with harsh environmental conditions were comparable to those observed in the wetter, crop-intensive regions. Overall, the findings underscore the need for broadening the scope of research beyond physical environmental conditions to include more socio-economic and anthropogenic factors that result in long-term effects of food insecurity, particularly among young children.

摘要

一些针对粮食匮乏国家慢性粮食不安全问题寻求替代干预策略的研究,现在主张同时评估多种致病因素,以识别和监测高危人群。本研究试图使用一个三层概念框架来做到这一点,该框架将儿童营养健康结果表示为在区域/社区层面、家庭层面和个人层面表现出来的基本、潜在和直接原因的函数。以发育迟缓(身材矮小)作为粮食不安全的直接累积指标,利用布基纳法索的实证数据绘制了这一营养健康结果的地理分布图。空间分析揭示了几个孤立的高危人群聚集地。使用逻辑回归方法的进一步分析显示,基于城市化、地理可达性、贫困、母亲教育程度和职业、环境卫生以及儿童的年龄、性别和饮食摄入等因素,儿童脆弱性存在显著差异。与研究预期相反,未观察到儿童营养健康结果与社区生物物理特征之间的关系。环境条件恶劣的边缘地区发育迟缓的优势比与在较湿润、作物密集地区观察到的优势比相当。总体而言,研究结果强调有必要扩大研究范围,超越自然环境条件,纳入更多导致粮食不安全长期影响的社会经济和人为因素,尤其是对幼儿的影响。

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