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五岁以下儿童发育迟缓及严重发育迟缓的决定因素:来自2011年尼泊尔人口与健康调查的证据

Determinants of stunting and severe stunting among under-fives: evidence from the 2011 Nepal Demographic and Health Survey.

作者信息

Tiwari Rina, Ausman Lynne M, Agho Kingsley Emwinyore

机构信息

Nutrition Promotion and Consultancy Service, Kathmandu, Nepal.

出版信息

BMC Pediatr. 2014 Sep 27;14:239. doi: 10.1186/1471-2431-14-239.

Abstract

BACKGROUND

Stunting remains a major public health concern in Nepal as it increases the risk of illness, irreversible body damage and mortality in children. Public health planners can reshape and redesign new interventions to reduce stunting and severe stunting among children aged less than 5 years in this country by examining their determinants. Hence, this study identifies factors associated with stunting and severe stunting among children aged less than five years in Nepal.

METHODS

The sample is made up of 2380 children aged 0 to 59 months with complete anthropometric measurements from the 2011 Nepal Demographic and Health Survey (NDHS). Simple and multiple logistic regression analyses were used to examine stunting and severe stunting against a set of variables.

RESULTS

The prevalences of stunting and severe stunting were 26.3% [95% confidence Interval (CI): 22.8, 30.1] and 10.2% (95%CI: 7.9, 13.1) for children aged 0-23 months, respectively, and 40.6 (95%CI: 37.3, 43.2) and 15.9% (95%CI: 13.9, 18.3) for those aged 0-59 months, respectively. After adjusting for potential confounding factors, multivariable analyses showed that the most consistent significant risk factors for stunted and severely stunted children aged 0-23 and 0-59 months were household wealth index (poorest household), perceived size of baby (small babies) and breastfeeding for more than 12 months (adjusted odds ratio (AOR) for stunted children aged 0-23 months = 2.60 [95% CI: (1.87, 4.02)]; AOR for severely stunted children aged 0-23 months = 2.87 [95% CI: (1.54, 5.34)]; AOR for stunted children aged 0-59 months = 3.54 [95% CI: (2.41, 5.19)] and AOR for severely stunted children aged 0-59 months = 4.15 [95% CI: (2.45, 6.93)].

CONCLUSIONS

This study suggests that poorest households and prolonged breastfeeding (more than 12 months) led to increased risk of stunting and severe stunting among Nepalese children. However, community-based education intervention are needed to reduce preventable deaths triggered by malnutrition in Nepal and should target children born to mothers of low socioeconomic status.

摘要

背景

发育迟缓仍是尼泊尔主要的公共卫生问题,因为它会增加儿童患病、不可逆转的身体损伤和死亡的风险。公共卫生规划者可以通过研究发育迟缓的决定因素,重新规划和设计新的干预措施,以减少该国5岁以下儿童的发育迟缓和严重发育迟缓情况。因此,本研究确定了尼泊尔5岁以下儿童发育迟缓和严重发育迟缓的相关因素。

方法

样本由2011年尼泊尔人口与健康调查(NDHS)中2380名年龄在0至59个月且有完整人体测量数据的儿童组成。采用简单和多元逻辑回归分析,针对一组变量研究发育迟缓和严重发育迟缓情况。

结果

0至23个月儿童的发育迟缓和严重发育迟缓患病率分别为26.3%[95%置信区间(CI):22.8,30.1]和10.2%(95%CI:7.9,13.1),0至59个月儿童的患病率分别为40.6%(95%CI:37.3,43.2)和15.9%(95%CI:13.9,18.3)。在对潜在混杂因素进行调整后,多变量分析表明,0至23个月和0至59个月发育迟缓和严重发育迟缓儿童最一致的显著风险因素是家庭财富指数(最贫困家庭)、感知到的婴儿体型(小婴儿)以及母乳喂养超过12个月(0至23个月发育迟缓儿童的调整优势比(AOR)=2.60[95%CI:(1.87,4.02)];0至23个月严重发育迟缓儿童的AOR=2.87[95%CI:(1.54,5.34)];0至

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aeee/4263111/6e954b29008c/12887_2014_1207_Fig1_HTML.jpg

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