Departments of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, CT.
Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, CT.
Adv Nutr. 2017 Sep 15;8(5):770-779. doi: 10.3945/an.117.016121. Print 2017 Sep.
Food and nutrition insecurity becomes increasingly worse in areas affected by armed conflict. Children affected by conflict, or in war-torn settings, face a disproportionate burden of malnutrition and poor health outcomes. As noted by humanitarian response reviews, there is a need for a stronger evidence-based response to humanitarian crises. To achieve this, we systematically searched and evaluated existing nutrition interventions carried out in conflict settings that assessed their impact on children's nutrition status. To evaluate the impact of nutrition interventions on children's nutrition and growth status, we identified published literature through EMBASE, PubMed, and Global Health by using a combination of relevant text words and Medical Subject Heading terms. Studies for this review must have included children (aged ≤18 y), been conducted in conflict or postconflict settings, and assessed a nutrition intervention that measured ≥1 outcome for nutrition status (i.e., stunting, wasting, or underweight). Eleven studies met the inclusion and exclusion criteria for this review. Five different nutrition interventions were identified and showed modest results in decreasing the prevalence of stunting, wasting, underweight, reduction in severe or moderate acute malnutrition or both, mortality, anemia, and diarrhea. Overall, nutrition interventions in conflict settings were associated with improved children's nutrition or growth status. Emergency nutrition programs should continue to follow recent recommendations to expand coverage and access (beyond refugee camps to rural areas) and ensure that aid and nutrition interventions are distributed equitably in all conflict-affected populations.
在受武装冲突影响的地区,粮食和营养安全状况日益恶化。受冲突影响或身处战乱环境的儿童面临着营养不良和健康状况不佳的不成比例负担。正如人道主义应对审查所指出的,需要对人道主义危机做出更有力的循证应对。为了实现这一目标,我们系统地搜索和评估了在冲突环境中开展的现有营养干预措施,并评估了它们对儿童营养状况的影响。为了评估营养干预对儿童营养和生长状况的影响,我们通过 EMBASE、PubMed 和 Global Health 利用相关文本词和医学主题词组合来确定已发表的文献。本综述的研究必须包括儿童(年龄≤18 岁)、在冲突或后冲突环境中进行,并评估了至少有 1 项营养状况结果(即发育迟缓、消瘦或体重不足)的营养干预措施。有 11 项研究符合纳入和排除标准。确定了 5 种不同的营养干预措施,它们在降低发育迟缓、消瘦、体重不足、严重或中度急性营养不良的发生率或两者兼有、死亡率、贫血和腹泻方面显示出适度的效果。总的来说,冲突环境中的营养干预措施与改善儿童营养或生长状况有关。紧急营养方案应继续遵循最近的建议,扩大覆盖范围和获取途径(超越难民营到农村地区),并确保在所有受冲突影响的人群中公平分配援助和营养干预措施。