巴勒斯坦被占领土5岁以下儿童维生素A和维生素D缺乏的危险因素：一项横断面研究。

Chaudhry Aeysha, Hajat Shakoor, Rizkallah Najwa, Abu-Rub Ala'a

Department of Social & Environmental Health Research, The London School of Hygiene & Tropical Medicine, London, UK.

Lancet. 2018 Feb 21;391 Suppl 2:S3. doi: 10.1016/S0140-6736(18)30369-6.

BACKGROUND

Vitamin A and vitamin D are essential for a child's growth and development. However, research on micronutrients in the occupied Palestinian territory is scarce. The aim of this study was to ascertain the prevalence and risk factors of vitamin A and vitamin D deficiencies in children living in the occupied Palestinian territory.

METHODS

The Palestinian Micronutrient Survey in 2013 measured concentrations of vitamin A in 1054 children (569 children in the West Bank and 485 children in the Gaza Strip) and vitamin D in 150 children (75 children in the West Bank and 75 children in the Gaza Strip). Risk factors for deficiency were assessed in children aged 6-59 months using χ tests and logistic regression with each of the outcome variables of vitamin A and vitamin D deficiencies. A child was considered deficient if serum concentrations were less than 1·05 μmol/L vitamin A or less than 50 nmol/L vitamin D. Multiple logistic regression models were developed to identify independent risk factors. Ethical approval was obtained from the London School of Hygiene & Tropical Medicine.

FINDINGS

771 (73%) children in the survey had vitamin A deficiency, and 91 (61%) children had vitamin D deficiency. Compared with children living in the West Bank, children living in the Gaza Strip were more likely to be deficient in vitamin A (odds ratio 1·34, 95% CI 0·78-2·31) and vitamin D (1·96, 0·67-5·71). Vitamin A deficiency was 1·5 more likely in children with anaemia than in children who did not have anaemia (95% CI 1·08-2·10; p=0·047). Vitamin D deficiency was more common in children older than 1 years than in children aged 1 year or younger, and vitamin D deficiency was 2·72 times more likely in girls than in boys (95% CI 1·21-6·01; p=0·037).

INTERPRETATION

The study provides an initial assessment of the burden of vitamin A and vitamin D deficiencies in the occupied Palestinian territory. However, due to the small sample size, more robust research is needed. The observed low adherence to the full supplementation regimen warrants further research into methods of effective service delivery by health service providers.

FUNDING

None.

背景

维生素A和维生素D对儿童的生长发育至关重要。然而，关于巴勒斯坦被占领土上微量营养素的研究却很匮乏。本研究的目的是确定生活在巴勒斯坦被占领土上儿童维生素A和维生素D缺乏症的患病率及风险因素。

方法

2013年巴勒斯坦微量营养素调查测量了1054名儿童（约旦河西岸569名儿童，加沙地带485名儿童）的维生素A浓度以及150名儿童（约旦河西岸75名儿童，加沙地带75名儿童）的维生素D浓度。采用χ检验和逻辑回归分析对6至59个月大儿童缺乏症的风险因素进行评估，以维生素A和维生素D缺乏症作为各结果变量。若血清维生素A浓度低于1.05μmol/L或维生素D浓度低于50nmol/L，则认为该儿童存在缺乏症。建立多元逻辑回归模型以识别独立风险因素。研究获得了伦敦卫生与热带医学院的伦理批准。

研究结果

调查中771名（73%）儿童存在维生素A缺乏症，91名（61%）儿童存在维生素D缺乏症。与生活在约旦河西岸的儿童相比，生活在加沙地带的儿童更易缺乏维生素A（比值比1.34，95%置信区间0.78 - 2.31）和维生素D（1.96，0.67 - 5.71）。贫血儿童维生素A缺乏的可能性比未患贫血的儿童高1.5倍（95%置信区间1.08 - 2.10；p = 0.047）。1岁以上儿童维生素D缺乏症比1岁及以下儿童更常见，女孩维生素D缺乏的可能性是男孩的2.72倍（95%置信区间1.21 - 6.01；p = 0.037）。