坦桑尼亚儿童的婴幼儿喂养方式与腹泻之间的关联。
The association between infant and young child feeding practices and diarrhoea in Tanzanian children.
作者信息
Ogbo Felix Akpojene, Nguyen Hillary, Naz Sabrina, Agho Kingsley E, Page Andrew
机构信息
1Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571 Australia.
Prescot Specialist Medical Centre, Makurdi, Benue State Nigeria.
出版信息
Trop Med Health. 2018 Jan 30;46:2. doi: 10.1186/s41182-018-0084-y. eCollection 2018.
BACKGROUND
Diarrhoea is a leading cause of child mortality in Tanzania. The association between optimal infant feeding practices and diarrhoea has been reported elsewhere, but the evidence has been limited to promote and advocate for strategic interventions in Tanzania. This study examined the association between infant and young child feeding (IYCF) practices and diarrhoea in Tanzanian children under 24 months.
METHODS
The study used the Tanzania Demographic and Health Survey data to estimate the prevalence of diarrhoea stratified by IYCF practices. Using multivariable logistic regression modelling that adjusted for confounding factors and cluster variability, the association between IYCF practices and diarrhoea among Tanzanian children was investigated.
RESULTS
Diarrhoea prevalence was lower in infants aged 0-5 months whose mothers engaged in exclusive breastfeeding (EBF) and predominant breastfeeding (PBF) compared to those who were not exclusively and predominantly breastfed. Infants aged 6-8 months who were introduced to complementary foods had a higher prevalence of diarrhoea compared to those who received no complementary foods, that is, infants who were exclusively breastfed at 6-8 months. Infants who were exclusively and predominantly breastfed were less likely to experience diarrhoea compared to those who were not exclusively and predominantly breastfed [adjusted odds ratio (AOR) 0.31, 95% confidence interval (CI) 0.16-0.59, < 0.001 for EBF and AOR = 0.30, 95% CI 0.10-0.89, = 0.031 for PBF]. In contrast, infants aged 6-8 months who were introduced to complementary foods were more likely to experience diarrhoea compared to those who received no complementary foods (AOR = 2.91, 95% CI 1.99-4.27, < 0.001).
CONCLUSIONS
The study suggests that EBF and PBF were protective against diarrhoeal illness in Tanzanian children, while the introduction of complementary foods was associated with the onset of diarrhoea. Strengthening IYCF (facility- and community-based) programmes would help to improve feeding behaviours of Tanzanian women and reduce diarrhoea burden in children under 2 years.
背景
腹泻是坦桑尼亚儿童死亡的主要原因。其他地方已报道了最佳婴儿喂养方式与腹泻之间的关联，但这些证据在坦桑尼亚促进和倡导战略干预措施方面一直很有限。本研究调查了坦桑尼亚24个月以下儿童的婴幼儿喂养（IYCF）方式与腹泻之间的关联。
方法
该研究使用坦桑尼亚人口与健康调查数据来估计按IYCF方式分层的腹泻患病率。通过多变量逻辑回归模型对混杂因素和聚类变异性进行调整，研究了坦桑尼亚儿童中IYCF方式与腹泻之间的关联。
结果
与未进行纯母乳喂养（EBF）和主要母乳喂养（PBF）的母亲所生的0至5个月婴儿相比，进行EBF和PBF的母亲所生的婴儿腹泻患病率较低。与未添加辅食的婴儿（即6至8个月纯母乳喂养的婴儿）相比，6至8个月开始添加辅食的婴儿腹泻患病率更高。与未进行EBF和PBF的婴儿相比，进行EBF和PBF的婴儿患腹泻的可能性较小[调整后的优势比（AOR）为0.31，95%置信区间（CI）为0.16 - 0.59，EBF时P < 0.001；AOR = 0.30，95% CI为0.10 - 0.89，PBF时P = 0.031]。相比之下，与未添加辅食的婴儿相比，6至8个月开始添加辅食的婴儿患腹泻的可能性更大（AOR = 2.91，95% CI为1.99 - 4.27，P < 0.001）。
结论
该研究表明，EBF和PBF对坦桑尼亚儿童的腹泻疾病具有保护作用，而添加辅食与腹泻的发生有关。加强基于机构和社区的IYCF项目将有助于改善坦桑尼亚妇女的喂养行为，并减轻2岁以下儿童的腹泻负担。
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