Pramod Singh G C, Nair Manju, Grubesic Ruth B, Connell Frederick A
School of Public Health, B. P. Koirala Institute of Health Sciences, Dharan, Sunsari, Nepal.
Asia Pac J Public Health. 2009 Apr;21(2):144-52. doi: 10.1177/1010539509332063. Epub 2009 Feb 26.
Malnutrition continues to affect a large proportion of children in the developing world. The authors undertook this study to identify biologic, socioeconomic, and health care factors associated with underweight and stunting in young children in an the eastern Tarai (plains) district of Nepal. Data were collected via questionnaires from mothers of 443 children aged 6 to 36 months in Sunsari district. Multistage cluster sampling was used to select villages and children. Anthropometric measurements were made on both children and their mothers. Logistic regression was used to measure the independent (adjusted) effect of risk and protective factors on the odds of underweight or stunting. More than half (53.3%) of the children were found to be underweight (<2 standard deviations weight for age below reference median) and more than one third (36.6%) had stunting (<2 standard deviations height for age below reference median). Low maternal body mass index, child's age, higher birth order, and lower standard of living score were strong predictors of underweight, whereas mother's education >5 years and participation in vitamin A and nutritional programs were protective. Infant age, low maternal body mass index, and low standard of living score were significant risk factors for stunting, whereas mother's education >5 years was strongly protective. These results suggest that underweight and stunting are the result of a nexus of biological, socioeconomic, and health care factors.
营养不良仍然影响着发展中世界的很大一部分儿童。作者开展这项研究，以确定与尼泊尔东部特赖（平原）地区幼儿体重不足和发育迟缓相关的生物学、社会经济和医疗保健因素。通过问卷调查收集了孙萨里地区443名6至36个月大儿童的母亲的数据。采用多阶段整群抽样来选择村庄和儿童。对儿童及其母亲进行了人体测量。使用逻辑回归来衡量风险和保护因素对体重不足或发育迟缓几率的独立（调整后）影响。发现超过一半（53.3%）的儿童体重不足（年龄别体重低于参考中位数2个标准差），超过三分之一（36.6%）的儿童发育迟缓（年龄别身高低于参考中位数2个标准差）。低母体体重指数、儿童年龄、较高的出生顺序和较低的生活水平得分是体重不足的有力预测因素，而母亲受教育5年以上以及参与维生素A和营养项目具有保护作用。婴儿年龄、低母体体重指数和低生活水平得分是发育迟缓的重要风险因素，而母亲受教育5年以上具有很强的保护作用。这些结果表明，体重不足和发育迟缓是生物学、社会经济和医疗保健因素相互关联的结果。
