加瓦尔喜马拉雅地区儿童营养不良的患病率。

Prevalence of undernutrition among children in the Garhwal Himalayas.

作者信息

Dutta Anuradha, Pant Kiran, Puthia Rekha, Sah Archana

机构信息

College of Forestry & Hill Horticulture, G.B. Pant University of Agriculture and Technology, Ranichauri Tehri Garhwal, Uttarakhand, India.

出版信息

Food Nutr Bull. 2009 Mar;30(1):77-81. doi: 10.1177/156482650903000108.

DOI:10.1177/156482650903000108

PMID:19445262

Abstract

BACKGROUND

Nutritional status is the best indicator of the global well-being of children. In India every third child is underweight, whereas in the Garhwal Himalayas only one-fifth of the children are nutritionally normal. Information regarding the causes of such low nutritional status in children of Garhwal is lacking.

OBJECTIVE

The present study was designed to identify factors that may influence the nutritional status of the children of the Garhwal Himalayas. Stunting, signifying long-term irreversible chronic undernutrition, was studied, along with wasting, which signifies acute undernutrition among children.

METHODS

Forty families from one town and one village in each of the three major agroclimatic situations (high, middle, and low hills) were selected at random (total 240 families). The nutritional status of 353 children (0 to 12 years of age) was assessed by nutritional anthropometry and compared with tables of weight-for-age and height-for-age z-scores (WAZ and HAZ) identifying wasting and stunting, respectively, and compared with the World Health Organization (WHO) Growth Reference charts 2007. Chi-square test was applied to analyze the effects of age, sex, altitude, and area on the nutritional status of children.

RESULTS

Of the 353 children studied, 38.2% belonged to the school-aged group, with 7% more girls than boys. Only 11.3% of the children had normal HAZ while 10.3% had normal WAZ. The largest percentages of children (31.8% HAZ and 29.1% WAZ) were clustered in the SD1 group, that is the severely stunted or wasted group. In every age group except the 9- to 12-year group, most of the children were found in the WAZ SD1 category. Gender appeared to influence the SD1 category significantly. There were 17.0% severely stunted girls (SD1), as compared to 14.8% boys; while the percentages of WAZ girls was 16.1% and boys was 13%. The situation in the urban areas was slightly better: 6.4% of the sample had normal HAZ and 7.1% had normal WAZ, compared with 4.4% and 4.6% of the rural children. In all three agroclimatic situations, the largest percentage of children fell in the HAZ SD1 (stunted) category (15.3% in the high hills, 7.3% in the middle hills, and 9.5% in the low hills). There is a significant effect of area (rural vs. urban) on stunting and wasting among children. The child's sex affects stunting only. The other two variables, altitude and age, do not show a significant relationship with stunting or wasting.

CONCLUSIONS

The rate of malnutrition among children in the Garhwal is very high. The majority are severely stunted and wasted, indicating a high prevalence of both chronic and acute malnutrition. Only the area of residence (rural or urban) had an influence on a child's nutritional status.

摘要

背景

营养状况是儿童整体健康状况的最佳指标。在印度，每三个儿童中就有一个体重不足，而在加瓦尔喜马拉雅地区，只有五分之一的儿童营养正常。目前尚缺乏关于加瓦尔地区儿童营养状况如此低下原因的相关信息。

目的

本研究旨在确定可能影响加瓦尔喜马拉雅地区儿童营养状况的因素。对表示长期不可逆慢性营养不良的发育迟缓以及表示儿童急性营养不良的消瘦情况进行了研究。

方法

在三种主要农业气候区（高山区、中山区和低山区）中，分别从一个城镇和一个村庄随机选取40个家庭（共240个家庭）。通过营养人体测量法对353名儿童（0至12岁）的营养状况进行评估，并与年龄别体重和年龄别身高z评分（WAZ和HAZ）表进行比较，分别确定消瘦和发育迟缓情况，并与世界卫生组织（WHO）2007年生长参考图表进行对比。应用卡方检验分析年龄、性别、海拔和地区对儿童营养状况的影响。

结果

在研究的353名儿童中，38.2%属于学龄组，女孩比男孩多7%。只有11.3%的儿童HAZ正常，而WAZ正常的儿童占10.3%。最大比例的儿童（HAZ为31.8%，WAZ为29.1%）集中在SD1组，即严重发育迟缓或消瘦组。除9至12岁年龄组外，在每个年龄组中，大多数儿童都属于WAZ SD1类别。性别似乎对SD1类别有显著影响。严重发育迟缓女孩的比例为17.0%（SD1），而男孩为14.8%；WAZ女孩的比例为16.1%，男孩为13%。城市地区的情况稍好一些：样本中有6.4%的儿童HAZ正常，7.1%的儿童WAZ正常，而农村儿童的这一比例分别为4.4%和4.6%。在所有三种农业气候区中，最大比例的儿童属于HAZ SD¬1（发育迟缓）类别（高山区为15.3%，中山区为7.3%，低山区为9.5%）。地区（农村与城市）对儿童发育迟缓和消瘦有显著影响。儿童的性别仅对发育迟缓有影响。另外两个变量，海拔和年龄，与发育迟缓或消瘦没有显著关系。