Department of Nutritional Sciences, Oklahoma State University, Stillwater, Oklahoma, USA.
Matern Child Nutr. 2017 Oct;13(4). doi: 10.1111/mcn.12409. Epub 2016 Dec 28.
Madagascar is among countries where the prevalence of stunting is dramatically high in under 5 years old children. This study investigated the determinants of child stunting based on the UNICEF framework on the causes of malnutrition. A cutoff at 24 months was used to separate the child population into two groups. By using the latest Demographic and Health Survey (2009), logistic regressions were performed to determine the variables associated with stunting. In 2009, 40.1% of the 1,863 children aged 0-23 months and 53.9% of the 2,911 children aged 24-59 months were stunted contributing to the 48.5% overall stunting prevalence in the sample. Girls were less likely to be stunted (adjusted odds ratio with confidence interval [AOR] = 0.69 [0.55-0.88] and 0.84 [0.72-0.97], p < 0.01) than boys; the risk of stunting increased with age. Regarding underlying predictors, increased maternal height was associated with lower odds of stunting in both age groups (AOR = 0.75 [0.68-0.83] and 0.69 [0.61-0.77], p < 0.001). Children living in households using iodized salt (>15 ppm) had lower risk of stunting in the younger group (AOR = 0.76 [0.61-0.94], p < 0.05). Children living in urban areas were less likely to be stunted in both age groups (AOR = 0.67 [0.51-0.88] and 0.73 [0.59-0.90] respectively, p < 0.01]. Region of residence was also a significant basic factor for stunting. This study contributes to the understanding of the determinants of child stunting in Madagascar. The results confirmed the need for specific interventions for each of the two age groups.
马达加斯加是五岁以下儿童发育迟缓患病率极高的国家之一。本研究根据儿童营养不良原因的儿基会框架，调查了儿童发育迟缓的决定因素。采用 24 个月的时间截点将儿童人群分为两组。利用最新的人口与健康调查（2009 年），采用逻辑回归确定与发育迟缓相关的变量。2009 年，0-23 个月龄的 1863 名儿童中 40.1%、24-59 个月龄的 2911 名儿童中 53.9%发育迟缓，导致样本中总发育迟缓率为 48.5%。与男孩相比，女孩发育迟缓的可能性较小（调整后的比值比置信区间[AOR]为 0.69[0.55-0.88]和 0.84[0.72-0.97]，p<0.01）；随着年龄的增长，发育迟缓的风险增加。关于潜在的预测因素，母亲身高增加与两个年龄组发育迟缓的几率降低有关（AOR 分别为 0.75[0.68-0.83]和 0.69[0.61-0.77]，p<0.001）。在较小的年龄组中，生活在使用碘盐（>15ppm）家庭中的儿童发育迟缓的风险较低（AOR 为 0.76[0.61-0.94]，p<0.05）。两个年龄组中，生活在城市地区的儿童发育迟缓的可能性较小（AOR 分别为 0.67[0.51-0.88]和 0.73[0.59-0.90]，p<0.01）。居住地区也是发育迟缓的一个重要基本因素。本研究有助于了解马达加斯加儿童发育迟缓的决定因素。研究结果证实，需要针对两个年龄组分别采取具体的干预措施。
