埃塞俄比亚五岁以下儿童的营养状况:系统评价与荟萃分析

Nutritional Status of Under Five Children in Ethiopia: A Systematic Review and Meta-Analysis.

作者信息

Abdulahi Ahmed, Shab-Bidar Sakineh, Rezaei Shahabeddin, Djafarian Kurosh

机构信息

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, International Campus (TUMS-IC), Tehran, Iran.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Ethiop J Health Sci. 2017 Mar;27(2):175-188. doi: 10.4314/ejhs.v27i2.10.

Abstract

BACKGROUND

Undernutrition is the outcome of insufficient food intake and recurrent infectious diseases. The baseline levels of undernutrition remain so high that Ethiopia still needs to continue substantial investment in nutrition.Therefore, the aim of this study was to obtain estimates of over-time trends in the prevalence of undernutrition in Ethiopia and to determine risk factors for undernutrition among children of under five years of age.

METHODS

Cross-sectional studies published in English from 1997 to 2015 focusing the prevalence of stunting, wasting and underweight in children aged 0-5 years (n = 39,585) in Ethiopia were included in this systematic review and meta-analysis. We searched in PubMed and Scopus databases and other articles manually. Two review authors independently selected studies for inclusion, extracted data and assessed the risk of bias in the included studies. The protocol number of the study is PROSPERO 2015: CRD42015027940.

RESULTS

Eighteen studies were included and the overall pooled prevalence estimate of stunting, underweight and wasting was 42.0% (95% CI: 37.0, 46.0), 33.0 % (95% CI: 27.0, 39.0) and 15.0% (95% CI: 12.0, 19.0), respectively. The sensitivity analyses resulted in the prevalence of stunting, 40% (95% CI: 32.0, 48.0; I2=99.19%), prevalence of underweight, 33%(95% CI: 24.0, 42.0; I=99.34%) and wasting rate equal to 19%(95% CI: 14.0, 24.0; I2=99.19%). Cumulative analysis revealed a stabilization trend of stunting and underweight (1996-2010) followed by an upward trend (2010-2014). Child age, child sex, complementary food, poor dietary diversity, diarrheal diseases, maternal education, maternal height, residential area and socio- economic status were significant risk factors for undernutrition.

CONCLUSION

The result of the meta-analysis of thes observational studies revealed that the trend of undernutrition in Ethiopia indicates that there is an increment of chronic malnutrition cases in recent years, and the prevalence of undernutrition remains extremely high. Thus, the implementation of policies to reverse child undernutrition should get maximum emphasis.

摘要

背景

营养不良是食物摄入不足和反复感染性疾病的结果。营养不良的基线水平仍然很高,以至于埃塞俄比亚仍需继续在营养方面进行大量投资。因此,本研究的目的是获取埃塞俄比亚营养不良患病率随时间变化趋势的估计值,并确定五岁以下儿童营养不良的风险因素。

方法

本系统评价和荟萃分析纳入了1997年至2015年以英文发表的关于埃塞俄比亚0 - 5岁儿童(n = 39,585)发育迟缓、消瘦和体重不足患病率的横断面研究。我们在PubMed和Scopus数据库以及其他文章中进行了手动搜索。两位综述作者独立选择纳入研究、提取数据并评估纳入研究的偏倚风险。该研究的方案编号为PROSPERO 2015: CRD42015027940。

结果

纳入了18项研究,发育迟缓、体重不足和消瘦的总体合并患病率估计分别为42.0%(95%置信区间:37.0, 46.0)、33.0%(95%置信区间:27.0, 39.0)和15.0%(95%置信区间:12.0, 19.0)。敏感性分析得出发育迟缓患病率为40%(95%置信区间:32.0, 48.0;I² = 99.19%),体重不足患病率为33%(95%置信区间:24.0, 42.0;I² = 99.34%),消瘦率为19%(95%置信区间:14.0, 24.0;I² = 99.19%)。累积分析显示发育迟缓和体重不足在1996 - 2010年呈稳定趋势,随后在2010 - 2014年呈上升趋势。儿童年龄、儿童性别、辅食、饮食多样性差、腹泻病、母亲教育程度、母亲身高、居住地区和社会经济地位是营养不良的重要风险因素。

结论

这些观察性研究的荟萃分析结果表明,埃塞俄比亚营养不良的趋势表明近年来慢性营养不良病例有所增加,且营养不良患病率仍然极高。因此,应高度重视实施扭转儿童营养不良的政策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fa6/5440832/f224b841dca6/EJHS2702-0175Fig1.jpg

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