Darsene Hiwot, Geleto Ayele, Gebeyehu Abebaw, Meseret Solomon
MCHN Directorate, Federal Ministry of Health, Addis Ababa, Ethiopia.
School of Public Health, College of Health and Medical Science, Haramaya University, Harar, Ethiopia.
Arch Public Health. 2017 Jul 10;75:29. doi: 10.1186/s13690-017-0198-4. eCollection 2017.
Undernutrition among children continues to be a major public health problem in developing countries. In Ethiopian, 44% of under-five children were stunted while 29% and 10% were underweight and wasted respectively. However, predictors of undernutrition among children were not clearly known in the study area. Therefore, this study was aimed at determining prevalence and predictors of undernutrition among children aged 6-59 months in Hawassa town.
A community based cross-sectional study was conducted among 811 randomly selected children paired with their mothers/caregivers. Mothers/caregivers were interviewed to obtain social-demographic data and feeding practice. Anthropometric measurement was conducted to obtain anthropometric data. Data were entered into EPI info 6.04 and exported to SPSS 16 for analysis. Bivariate logistic regression analysis with Crude Odds Ratio at 95%CI was used to assess presence of association among variables. Multivariate logistic regression analysis with Adjusted Odds Ratio at 95%CI was conducted to determine predictors of undernutrition and association was declared significant at ≤ 0.05.
The result of our study indicated that 39.3%, 15.8% and 6.3% of children were stunted, underweighted and wasted respectively. Multivariate logistic regression analysis identified male sex, mother older than 35 years, not fed on colostrum, cessation of breastfeeding before two years of age, frequency of complementary feeding per day and diarrheal morbidity in the last 12 months were statistically associated with stunting. Maternal education, family sizes and diarrheal morbidity in the past 12 months were significantly associated with underweight. Similarly, frequency of complementary feeding per day, age at cessation of breastfeeding, preceding birth interval and not fed on colostrum were associated to wasting.
The prevalence of undernutrition; stunting, underweight and wasting, among under-five children is very common in the study area. Inappropriate feeding practice and diarrheal morbidity were found to be the main risk factors for undernutrition. Appropriate factor specific interventions including counseling on optimal child feeding practice and diarrhea prevention should be strengthened in the study area.
儿童营养不良仍是发展中国家的一个主要公共卫生问题。在埃塞俄比亚，44%的五岁以下儿童发育迟缓，而体重不足和消瘦的儿童分别占29%和10%。然而，在该研究地区，儿童营养不良的预测因素尚不清楚。因此，本研究旨在确定哈瓦萨镇6至59个月儿童营养不良的患病率及其预测因素。
对811名随机选取的儿童及其母亲/照料者进行了一项基于社区的横断面研究。通过对母亲/照料者进行访谈以获取社会人口学数据和喂养习惯。进行人体测量以获取人体测量数据。数据录入EPI info 6.04并导出至SPSS 16进行分析。采用95%置信区间的粗比值比进行二元逻辑回归分析，以评估变量之间的关联。进行95%置信区间的调整比值比的多变量逻辑回归分析，以确定营养不良的预测因素，且当P≤0.05时，关联被判定为显著。
我们的研究结果表明，分别有39.3%、15.8%和6.3%的儿童发育迟缓、体重不足和消瘦。多变量逻辑回归分析确定，男性、母亲年龄大于35岁、未喂初乳、两岁前停止母乳喂养、每天辅食喂养频率以及过去12个月内的腹泻发病率与发育迟缓在统计学上相关。母亲教育程度、家庭规模以及过去12个月内的腹泻发病率与体重不足显著相关。同样，每天辅食喂养频率、停止母乳喂养的年龄、上次生育间隔以及未喂初乳与消瘦相关。
在该研究地区，五岁以下儿童营养不良（发育迟缓、体重不足和消瘦）的患病率非常普遍。发现不适当的喂养习惯和腹泻发病率是营养不良的主要危险因素。在该研究地区应加强适当的针对具体因素的干预措施，包括关于最佳儿童喂养习惯的咨询和腹泻预防。
