Pradhan Pranil Man Singh, Dhital Rolina, Subhani Huma
Department of Community Medicine and Public Health, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
Department of Community and Global Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
BMJ Open. 2016 Sep 20;6(9):e011238. doi: 10.1136/bmjopen-2016-011238.
The objective of this paper was to review various nutritional interventions targeted at under-five children in countries that had suffered from natural disasters and to analyse their effect on nutrition-related outcomes.
Systematic review.
Countries that had suffered from natural disasters.
Children aged <5 years who were given any nutritional intervention to improve overall nutritional status after a natural disaster.
Primary nutrition-related outcomes were stunting, wasting and underweight. The secondary nutrition-related outcome was anaemia.
Of the 1218 studies that the reviewers agreed on, five matched the inclusion criteria and were included in this narrative synthesis. Four studies were longitudinal and one was cross-sectional in design. Food supplementation was an integral part of nutritional interventions in all the included studies. The most consistent nutritional outcome in all five included studies was reduced prevalence of wasting, followed by reduced prevalence of underweight in four, stunting in three and anaemia in one of the five included studies. The largest reduction in the prevalence of wasting and underweight was reported by the study in Sri Lanka. Overall, the quality of evidence ranged from moderate to weak.
Integrated nutrition interventions using locally available health resources yielded the best results. However, sound evidence on the most effective interventions is still lacking. Intervention studies with comparison groups are necessary to obtain more robust evidence on the effectiveness of nutrition interventions.
本文的目的是回顾针对遭受自然灾害国家中五岁以下儿童的各种营养干预措施,并分析其对营养相关结局的影响。
系统评价。
遭受自然灾害的国家。
五岁以下儿童,在自然灾害后接受了任何营养干预措施以改善总体营养状况。
主要营养相关结局为发育迟缓、消瘦和体重不足。次要营养相关结局为贫血。
在评审人员认可的1218项研究中,有五项符合纳入标准并被纳入本叙述性综述。四项研究为纵向研究,一项为横断面研究。在所有纳入研究中,食物补充都是营养干预的一个组成部分。在所有五项纳入研究中,最一致的营养结局是消瘦患病率降低,其次是四项研究中体重不足患病率降低,三项研究中发育迟缓患病率降低,五项纳入研究中有一项研究中贫血患病率降低。斯里兰卡的研究报告了消瘦和体重不足患病率的最大降幅。总体而言,证据质量从中等到薄弱不等。
利用当地可得的卫生资源进行综合营养干预产生了最佳效果。然而,关于最有效干预措施的可靠证据仍然缺乏。有必要进行有对照组的干预研究,以获得关于营养干预效果的更有力证据。