Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, P,R, China.
BMC Public Health. 2014 Feb 5;14:121. doi: 10.1186/1471-2458-14-121.
Childhood undernutrition adversely impacts child health and is one of China's largest health burdens. However, there is limited information on the current rate of childhood undernutrition in rural Western China. The purpose of this study was to investigate the prevalence of childhood undernutrition and explore its association with socio-economic characteristics in Western China.
A total of 13,532 children of 0 ~ 36 months of age were recruited as subjects from 45 counties and 10 provinces in Western China with a 3-stage probability proportion to size sampling. The composite index of anthropometric failure (CIAF) was used to assess the childhood undernutrition. The association between socio-economic characteristics and childhood undernutrition was analyzed using a two-level logistic regression.
Based on CIAF, the prevalence of undernutrition among children under three years of age in rural Western China in 2005 was 21.7%. The two-level logistic analysis presented a large difference in undernutrition among the 10 provinces with the highest odds ratio in Guizhou (OR: 2.15, 95%CI: 1.50, 3.08). Older children had a higher prevalence of undernutrition. As compared to girls, boys were more likely to be undernourished (OR 1.27, 95% CI: 1.16, 1.39). The likelihood of undernutrition was lower in subjects of Han ethnicity as opposed to subjects of minority ethnicities (OR 0.77, 95%CI: 0.65, 0.90). In addition, the education levels of the mother as well as wealth index were both negatively associated with childhood undernutrition.
Childhood undernutrition still remains a large health challenge in rural Western China. This study has important policy implications for the Chinese government to improve childhood undernutrition in the surveyed areas.
儿童期营养不良对儿童健康有不良影响，是中国最大的健康负担之一。然而，关于中国西部农村地区儿童期营养不良的现状，信息有限。本研究旨在调查西部农村地区儿童期营养不良的流行情况，并探讨其与社会经济特征的关系。
采用三阶段整群概率比例抽样方法，从中国西部 10 个省的 45 个县抽取 0~36 月龄的 13532 名儿童作为研究对象。采用人体测量失败综合指数（CIAF）评估儿童营养不良。采用两水平逻辑回归分析社会经济特征与儿童营养不良的关系。
基于 CIAF，2005 年中国西部农村地区 3 岁以下儿童的营养不良患病率为 21.7%。两水平逻辑分析显示，10 个省份的儿童营养不良率存在较大差异，贵州的优势比最高（OR：2.15，95%CI：1.50，3.08）。年龄较大的儿童营养不良患病率较高。与女孩相比，男孩更容易营养不良（OR 1.27，95%CI：1.16，1.39）。与少数民族儿童相比，汉族儿童营养不良的可能性较低（OR 0.77，95%CI：0.65，0.90）。此外，母亲的教育程度和财富指数均与儿童期营养不良呈负相关。
儿童期营养不良仍然是中国西部农村地区面临的重大健康挑战。本研究对中国政府改善调查地区儿童期营养不良状况具有重要的政策意义。
