Thorne C J, Roberts L M, Edwards D R, Haque M S, Cumbassa A, Last A R
School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, UK.
Paediatr Int Child Health. 2013 Aug;33(3):151-60. doi: 10.1179/2046905513Y.0000000060.
Childhood malnutrition is the leading risk factor for the global burden of disease. Guinea-Bissau is a politically unstable country with high levels of childhood malnutrition and mortality.
To determine the nutritional status of children on three remote islands of the Bijagós Archipelago, Bubaque, Rubane and Soga, and to identify factors associated with malnutrition and anaemia in this population in order to provide a baseline for future public health interventions.
A cross-sectional, population-based, door-to-door household survey of randomly selected households was undertaken to collect data on children aged 0-59 months (n = 872). Dietary information was collected using a validated questionnaire. Anthropometric measurements were collected using World Health Organization techniques. Capillary blood samples were analysed using a Hemocue®, with anaemia defined as Hb<11 g/dl.
The prevalences of stunted, wasted and underweight children were 21.8%, 9.4% and 3.7%, respectively. These figures indicate moderate chronic malnutrition. The significant predictor variables for stunting were: age in months (OR 1.03), rural residence (OR 2.32), anaemia (OR 3.55) and residence on Soga island (OR 0.44). Stunting was more prevalent in males (25.4%) than in females (18.6%) (P = 0.03). The prevalence of anaemia was 80.2%. Age (OR 0.96), male gender (OR 1.81) and stunting (OR 2.87) were significant predictors. The Minimum Acceptable Diet was achieved by only 8.7% of children.
The prevalence of malnutrition on the Bijagós Archipelago is less than half that on the mainland. This study is the first to determine the prevalence of anaemia in Guinea-Bissau, which, at 80.2%, is of severe public health concern. Future research should focus on the aetiology of stunting and anaemia, especially the contribution of infectious diseases and mother-child interaction. Iron supplementation should be strongly considered in this population.
儿童营养不良是全球疾病负担的主要风险因素。几内亚比绍是一个政治不稳定的国家，儿童营养不良和死亡率很高。
确定比热戈斯群岛三个偏远岛屿布巴克、鲁巴内和索加儿童的营养状况，并确定该人群中与营养不良和贫血相关的因素，以便为未来的公共卫生干预提供基线。
对随机选择的家庭进行基于人群的横断面挨家挨户家庭调查，以收集0至59个月儿童（n = 872）的数据。使用经过验证的问卷收集饮食信息。使用世界卫生组织的技术进行人体测量。使用Hemocue®分析毛细血管血样，贫血定义为血红蛋白<11 g/dl。
发育迟缓、消瘦和体重不足儿童的患病率分别为21.8%、9.4%和3.7%。这些数字表明存在中度慢性营养不良。发育迟缓的显著预测变量为：月龄（比值比1.03）、农村居住（比值比2.32）、贫血（比值比3.55）和居住在索加岛（比值比0.44）。发育迟缓在男性（25.4%）中比在女性（18.6%）中更普遍（P = 0.03）。贫血患病率为80.2%。年龄（比值比0.96）、男性性别（比值比1.81）和发育迟缓（比值比2.87）是显著预测因素。只有8.7%的儿童达到了最低可接受饮食标准。
比热戈斯群岛的营养不良患病率不到大陆的一半。本研究首次确定了几内亚比绍的贫血患病率，高达80.2%，这是一个严重的公共卫生问题。未来的研究应侧重于发育迟缓和贫血的病因，特别是传染病和母婴互动的影响。应强烈考虑对该人群进行铁补充。
