乌干达一家医院唇腭裂婴儿的营养不良患病率及相关因素：一项横断面研究
The prevalence and factors associated with malnutrition among infants with cleft palate and/or lip at a hospital in Uganda: a cross-sectional study.
作者信息
Tungotyo Martin, Atwine Daniel, Nanjebe Deborah, Hodges Andrew, Situma Martin
机构信息
Mbarara University of Science and Technology (M.U.S.T), Mbarara, Uganda.
Comprehensive Rehabilitation Services for Uganda (CoRSU) Hospital, Kisubi, Uganda.
出版信息
BMC Pediatr. 2017 Jan 13;17(1):17. doi: 10.1186/s12887-016-0775-7.
BACKGROUND
To determine the prevalence and factors associated with malnutrition among infants with Cleft palate and/or cleft lip (CP+/-L) at Comprehensive Rehabilitation for Uganda Hospital (CoRSU) in Uganda.
METHODS
This was a cross-sectional study done on infants with CP+/-L and their caretakers admitted between November 2013 and October 2014 at CoRSU hospital which was the study setting. A questionnaire was answered by the infants' caretakers. The main outcome measure, malnutrition was defined and classified based on Z-scores obtained using the W.H.O Z-calculator in which weights of the infants in kilograms and lengths in centimeters respectively were placed. The values obtained were expressed as a proportion using all enrolled infants with CP+/-L as denominator. Multivariable analysis was used to determine the risk factors.
RESULTS
A total of 44 infants with CP+/-L were enrolled. Of these, 77% were below 4 months of age and 97.7% were immunized. The male-to-female ratio was 1.06:1. About 59% had unilateral CP+/-L. A total of 93.2% were delivered at term with 69.4% having a birth weight greater than 3 kg. Generally, 68% were malnourished, with the highest burden among females (71.4%), infants below 4 months (73.5%) and those with unilateral CP+/-L (77%). About 57% had moderate-to-severe malnutrition. There was delayed supplementation to breast milk, with cow-milk as the main supplemental feed for all the infants. In the multivariable analysis, factors associated with malnutrition included, having caretakers lacking nutritional information post-delivery (OR = 3.8, p = 0.17), low birth weight (OR = 3.4, p = 0.20), and having less than 10 feeds/day (OR = 4.9, p = 0.09).
CONCLUSION
CP+/-L infants born in Uganda suffer a high-burden of malnutrition. Preventional strategies are needed with focus on proper feeding information. Research on cost-effective feeds, feeding methods and reasons behind gender disparities in these infants is also required.
背景
确定乌干达综合康复乌干达医院（CoRSU）唇腭裂（CP+/-L）婴儿的营养不良患病率及相关因素。
方法
这是一项对2013年11月至2014年10月在CoRSU医院住院的CP+/-L婴儿及其看护者进行的横断面研究，该医院为研究地点。由婴儿看护者回答一份问卷。主要结局指标营养不良根据使用世界卫生组织Z计算器获得的Z评分进行定义和分类，分别将婴儿的体重（千克）和身长（厘米）代入其中。获得的值以所有纳入的CP+/-L婴儿为分母表示为比例。采用多变量分析确定危险因素。
结果
共纳入44例CP+/-L婴儿。其中，77%年龄小于4个月，97.7%接受了免疫接种。男女比例为1.06:1。约59%为单侧CP+/-L。共有93.2%足月分娩，69.4%出生体重超过3千克。总体而言，68%营养不良，女性（71.4%）、4个月以下婴儿（73.5%）和单侧CP+/-L婴儿（77%）中营养不良负担最高。约57%有中度至重度营养不良。母乳喂养补充延迟，所有婴儿均以牛奶作为主要补充饲料。在多变量分析中，与营养不良相关的因素包括，看护者在产后缺乏营养信息（OR = 3.8，p = 0.17）、低出生体重（OR = 3.4，p = 0.20）以及每天喂养次数少于10次（OR = 4.9，p = 0.09）。
结论
在乌干达出生的CP+/-L婴儿营养不良负担较重。需要采取预防策略，重点关注正确的喂养信息。还需要对这些婴儿进行具有成本效益的喂养、喂养方法以及性别差异背后原因方面的研究。
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