UNICEF Country Office, Nutrition Section , Port-au-Prince , Haiti.
Johns Hopkins Bloomberg School of Public Health, Department of International Health , Baltimore, MD , USA.
Glob Health Sci Pract. 2013 Nov 14;1(3):389-96. doi: 10.9745/GHSP-D-13-00069. eCollection 2013 Nov.
Undernutrition, a chief child killer in developing countries, has been a major public health problem in Haiti. Following the 2010 disasters (earthquake and cholera) and the intensive relief efforts to address them, we sought to determine the trends of child undernutrition in Haiti using data from the 2005-06 Haiti Demographic and Health Survey (HDHS) and from a Standardized Monitoring and Assessment of Relief and Transitions (SMART) survey in 2012. Growth data analyses included 2,463 (HDHS) and 4,727 (SMART) children ages 0-59 months. We calculated the prevalence of stunting, wasting, and underweight for each survey using World Health Organization 2006 growth standards. To account for sampling design, probability weights were applied to all analyses. Statistical significance was determined by non-overlapping confidence intervals around estimates. Stunting prevalence declined from 28.5% (95% confidence interval [CI] = 25.9, 31.3) in 2005-06 to 22.2% (95% CI = 20.2, 24.3) in 2012; wasting, from 10.1% (95% CI = 8.2, 12.7) to 4.3% (95% CI = 3.6, 5.2); and underweight, from 17.7 % (95% CI = 15.6, 20.1) to 10.5% (95% CI = 9.3, 11.9). Additionally, stunting declined more in rural areas, from 33.6% (95% CI = 30.1, 37.2) in 2005-06 to 25% (95% CI = 23.4, 26.7) in 2012, than in urban areas, from 18.6% (95% CI = 15.3, 22.5) in 2005-06 to 18.4% (95% CI = 16.7, 20.1) in 2012, for reasons that remain unknown. Results of the 2012 HDHS confirmed the observed trends. Thus, undernutrition among Haitian children under 5 declined significantly between 2005-06 and 2012. Our results should be interpreted in view of investments and changes that occurred in different sectors (within and outside health and nutrition) before and after the earthquake.
营养不良是发展中国家主要的儿童杀手，也是海地的一个主要公共卫生问题。在 2010 年灾害（地震和霍乱）及其应对工作之后，我们试图利用 2005-06 年海地人口与健康调查（HDHS）的数据以及 2012 年标准化监测和评估救济和过渡情况（SMART）调查的数据来确定海地儿童营养不良的趋势。生长数据分析包括 2463 名（HDHS）和 4727 名（SMART）0-59 个月大的儿童。我们使用世界卫生组织 2006 年生长标准计算了每个调查的发育迟缓、消瘦和体重不足的患病率。为了考虑到抽样设计，对所有分析都应用了概率权重。通过置信区间的非重叠来确定统计显著性。2005-06 年的发育迟缓患病率为 28.5%（95%置信区间[CI]为 25.9，31.3），到 2012 年下降到 22.2%（95% CI 为 20.2，24.3）；消瘦率从 10.1%（95% CI 为 8.2，12.7）下降到 4.3%（95% CI 为 3.6，5.2）；体重不足率从 17.7%（95% CI 为 15.6，20.1）下降到 10.5%（95% CI 为 9.3，11.9）。此外，在农村地区，发育迟缓的下降幅度更大，从 2005-06 年的 33.6%（95% CI 为 30.1，37.2）下降到 2012 年的 25%（95% CI 为 23.4，26.7），而在城市地区，从 2005-06 年的 18.6%（95% CI 为 15.3，22.5）下降到 2012 年的 18.4%（95% CI 为 16.7，20.1），原因尚不清楚。2012 年 HDHS 的结果证实了观察到的趋势。因此，2005-06 年至 2012 年期间，海地 5 岁以下儿童的营养不良状况显著下降。我们的结果应结合地震前后不同部门（卫生和营养内外）发生的投资和变化来解释。
