Herrador Zaida, Sordo Luis, Gadisa Endalamaw, Moreno Javier, Nieto Javier, Benito Agustín, Aseffa Abraham, Cañavate Carmen, Custodio Estefania
National Centre of Tropical Medicine, Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Tropical Diseases Research Network (RICET in Spanish), Madrid, Spain.
National Centre of Epidemiology, ISCIII, Madrid, Spain; Department of Preventive Medicine and Public Health, Faculty of Medicine, Complutense University, Madrid, Spain; Network Biomedical Research Centers, Epidemiology and Public Health (CIBERESP in Spanish), Madrid, Spain.
PLoS One. 2014 Sep 29;9(9):e105880. doi: 10.1371/journal.pone.0105880. eCollection 2014.
Little information is available on malnutrition-related factors among school-aged children ≥5 years in Ethiopia. This study describes the prevalence of stunting and thinness and their related factors in Libo Kemkem and Fogera, Amhara Regional State and assesses differences between urban and rural areas.
In this cross-sectional study, anthropometrics and individual and household characteristics data were collected from 886 children. Height-for-age z-score for stunting and body-mass-index-for-age z-score for thinness were computed. Dietary data were collected through a 24-hour recall. Bivariate and backward stepwise multivariable statistical methods were employed to assess malnutrition-associated factors in rural and urban communities.
The prevalence of stunting among school-aged children was 42.7% in rural areas and 29.2% in urban areas, while the corresponding figures for thinness were 21.6% and 20.8%. Age differences were significant in both strata. In the rural setting, fever in the previous 2 weeks (OR: 1.62; 95% CI: 1.23-2.32), consumption of food from animal sources (OR: 0.51; 95% CI: 0.29-0.91) and consumption of the family's own cattle products (OR: 0.50; 95% CI: 0.27-0.93), among others factors were significantly associated with stunting, while in the urban setting, only age (OR: 4.62; 95% CI: 2.09-10.21) and years of schooling of the person in charge of food preparation were significant (OR: 0.88; 95% CI: 0.79-0.97). Thinness was statistically associated with number of children living in the house (OR: 1.28; 95% CI: 1.03-1.60) and family rice cultivation (OR: 0.64; 95% CI: 0.41-0.99) in the rural setting, and with consumption of food from animal sources (OR: 0.26; 95% CI: 0.10-0.67) and literacy of head of household (OR: 0.24; 95% CI: 0.09-0.65) in the urban setting.
The prevalence of stunting was significantly higher in rural areas, whereas no significant differences were observed for thinness. Various factors were associated with one or both types of malnutrition, and varied by type of setting. To effectively tackle malnutrition, nutritional programs should be oriented to local needs.
关于埃塞俄比亚5岁及以上学龄儿童中与营养不良相关的因素，目前所知甚少。本研究描述了阿姆哈拉州利博凯姆凯姆和福格拉地区发育迟缓与消瘦的患病率及其相关因素，并评估城乡之间的差异。
在这项横断面研究中，收集了886名儿童的人体测量数据以及个人和家庭特征数据。计算了用于评估发育迟缓的年龄别身高Z评分和用于评估消瘦的年龄别体重指数Z评分。通过24小时回顾法收集饮食数据。采用双变量和向后逐步多变量统计方法评估农村和城市社区中与营养不良相关的因素。
农村地区学龄儿童发育迟缓的患病率为42.7%，城市地区为29.2%，而消瘦的相应数字分别为21.6%和20.8%。两个地区的年龄差异均具有统计学意义。在农村地区，过去2周内发烧（比值比：1.62；95%置信区间：1.23 - 2.32）、食用动物源性食物（比值比：0.51；95%置信区间：0.29 - 0.91）以及食用家庭自产的畜产品（比值比：0.50；95%置信区间：0.27 - 0.93）等因素与发育迟缓显著相关，而在城市地区，只有年龄（比值比：4.62；95%置信区间：2.09 - 10.21）和负责食物准备的人员的受教育年限具有统计学意义（比值比：0.88；95%置信区间：0.79 - 0.97）。在农村地区，消瘦与家中孩子数量（比值比：1.28；95%置信区间：1.03 - 1.60）和家庭水稻种植情况（比值比：0.64；95%置信区间：0.41 - 0.99）在统计学上相关，而在城市地区，消瘦与食用动物源性食物（比值比：0.26；95%置信区间：0.10 - 0.67）和户主的识字情况（比值比：0.24；95%置信区间：0.09 - 0.65）相关。
农村地区发育迟缓的患病率显著更高，而消瘦患病率在城乡之间未观察到显著差异。多种因素与一种或两种类型的营养不良相关，且因地区类型而异。为有效解决营养不良问题，营养项目应针对当地需求。
