Semali Innocent Antony, Tengia-Kessy Anna, Mmbaga Elia John, Leyna Germana
Department of Epidemiology and Biostatistics, School of Public Health and Social Sciences, P.O. Box 65014, Dar es Salaam, Tanzania.
Department of Community Health, School of Public Health and Social Sciences, P.O. Box 65014, Dar es Salaam, Tanzania.
BMC Public Health. 2015 Nov 21;15:1153. doi: 10.1186/s12889-015-2507-6.
The Millennium Development Goal No 4 (MDG 4) requires countries to scale up interventions addressing malnutrition and other immediate determinants of burden of disease among children to reduce child mortality by two thirds by 2015, which is this year. Whereas globally some achievements have been registered, under-nourishment remains a significant problem in some developing countries such as Tanzania. This study set out to estimate the extent of stunting and its associated determinants to assess the progress made thus far towards achieving MDG 4 in Tanzania.
A random sample of 678 households with under-five children was selected from two randomly selected wards of Kongwa district in Dodoma region, Tanzania. The WHO anthropometric calculator, which computes Z-scores using a reference population, was used to process the anthropometric measurement data taken from all the participants. Children with height for age Z-score of less than 2 were categorised as stunted and coded as 1 and the rest were coded as 0. Proportions of stunting were compared using the chi-square test to determine the association between stunting and the independent variables. Multivariate logistic regression analysis was carried out to determine the Adjusted Odds Ratio (AOR) of the independent determinants of stunting. The cut-off for significant association was set at p = 0.05. All these analyses used the STATA 12 software.
About half (49.7 %) of the children were stunted. This stunting was associated with belonging to households where the head of family was young (<35 years) (AOR = 0.67, 95 % CI 0.47-0.96, p = 0.031), young age of the mothers (AOR = 1.54, 95 % CI 1.06-2.24, p = 0.023), and economic variables such as owning a cellular phone (AOR = 0.66, 96 % CI 0.46-0.94, p = 0.023).
Stunting was highly prevalent in Kongwa district despite general improvements in child nutritional status at the national level. Household characteristics and economic status were found to play a major role in child health. In this regard, disaggregated analyses are therefore important in identifying resilient areas in need of concerted efforts for the MDG 4 to be achieved nationwide.
千年发展目标4（MDG 4）要求各国加大干预力度，解决儿童营养不良及其他直接导致疾病负担的因素，到2015年（即今年）将儿童死亡率降低三分之二。尽管全球已取得一些成果，但在坦桑尼亚等一些发展中国家，营养不良仍是一个重大问题。本研究旨在估计发育迟缓的程度及其相关决定因素，以评估坦桑尼亚在实现千年发展目标4方面迄今所取得的进展。
从坦桑尼亚多多马地区孔瓜区随机选取的两个病房中，随机抽取678户有5岁以下儿童的家庭。使用世界卫生组织人体测量计算器（该计算器使用参考人群计算Z分数）处理从所有参与者处获取的人体测量数据。年龄别身高Z分数小于2的儿童被归类为发育迟缓，并编码为1，其余编码为0。使用卡方检验比较发育迟缓的比例，以确定发育迟缓与自变量之间的关联。进行多因素逻辑回归分析，以确定发育迟缓独立决定因素的调整优势比（AOR）。显著关联的临界值设定为p = 0.05。所有这些分析均使用STATA 12软件。
约一半（49.7%）的儿童发育迟缓。这种发育迟缓与以下因素有关：户主年龄较小（<35岁）的家庭（AOR = 0.67，95%可信区间0.47 - 0.96，p = 0.031）、母亲年龄较小（AOR = 1.54，95%可信区间1.06 - 2.24，p = 0.023）以及拥有手机等经济变量（AOR = 0.66，96%可信区间0.46 - 0.94，p = 0.023）。
尽管全国儿童营养状况总体有所改善，但孔瓜区发育迟缓现象仍然普遍。家庭特征和经济状况在儿童健康方面起着重要作用。因此，进行分类分析对于确定需要共同努力以在全国实现千年发展目标4的薄弱地区很重要。
