Department of Civil, Architectural, and Environmental Engineering, Missouri University of Science and Technology, Rolla, MO, USA.
Independent Researcher, Quetzaltenango, Guatemala.
Int J Hyg Environ Health. 2018 Apr;221(3):391-399. doi: 10.1016/j.ijheh.2018.01.001. Epub 2018 Jan 5.
Guatemala has the sixth worst stunting rate with 48% of children under five years of age classified as stunted according to World Health Organization standards. This study utilizes two different yet complimentary system-analysis approaches to analyze correlations among environmental and demographic variables, environmental enteric dysfunction (EED), and child height-for-age (stunting metric) in Guatemala. Two descriptive models constructed around applicable environmental and demographic factors on child height-for-age and EED were analyzed using Network Analysis (NA) and Structural Equation Modeling (SEM). Data from two populations of children between the age of three months and five years were used. The first population (n = 2103) was drawn from the Food for Peace Baseline Survey conducted by the US Agency for International Development (USAID) in 2012, and the second population (n = 372) was drawn from an independent survey conducted by the San Vicente Health Center in 2016. The results from the NA of the height-for-age model confirmed pathogen exposure, nutrition, and prenatal health as important, and the results from the NA of the EED model confirmed water source, water treatment, and type of sanitation as important. The results from the SEM of the height-for-age model confirmed a statistically significant correlation among child height-for-age and child-mother interaction (-0.092, p = 0.076) while the SEM of the EED model confirmed the statistically significant correlation among EED and type of water treatment (-0.115, p = 0.013). Our approach supports important efforts to understand the complex set of factors associated with child stunting among communities sharing similarities with San Vicente.
危地马拉五岁以下儿童发育迟缓率居世界第六，根据世界卫生组织的标准，该国 48%的儿童被归类为发育迟缓。本研究采用两种不同但互补的系统分析方法，分析危地马拉环境和人口变量、环境肠道功能障碍（EED）和儿童年龄别身高（发育迟缓指标）之间的相关性。围绕儿童年龄别身高和 EED 的适用环境和人口因素构建了两个描述性模型，使用网络分析（NA）和结构方程建模（SEM）进行了分析。该研究使用了两个年龄在三个月至五岁之间的儿童群体的数据。第一个群体（n=2103）来自美国国际开发署（USAID）于 2012 年进行的“粮食换和平基线调查”，第二个群体（n=372）来自圣维森特健康中心于 2016 年进行的独立调查。年龄别身高模型的 NA 结果证实了病原体暴露、营养和产前健康的重要性，EED 模型的 NA 结果证实了水源、水处理和卫生类型的重要性。年龄别身高模型的 SEM 结果证实了儿童年龄别身高和儿童与母亲互动之间存在统计学上显著的相关性（-0.092，p=0.076），而 EED 模型的 SEM 结果证实了 EED 与水处理类型之间存在统计学上显著的相关性（-0.115，p=0.013）。我们的方法支持了为理解与圣维森特社区具有相似性的社区中与儿童发育迟缓相关的复杂因素而做出的重要努力。
