Sustainable Healthcare Education Network, Centre for Sustainable Healthcare, Oxford, UK.
Imperial College London, London, UK.
Public Health. 2018 Sep;162:147-152. doi: 10.1016/j.puhe.2018.05.004. Epub 2018 Jul 31.
Previous research has identified a high prevalence of growth abnormality among Syrian refugees in refugee camps in Jordan and Lebanon. There are few published data describing the growth status of children who are refugees in Europe.
Refugees with up to 5 completed years of age in four refugee camps in Northern Greece were invited to participate in growth screening for clinical purposes. Mid-upper arm circumference (MUAC), weight for age (WFA), weight for height (WFH) and height for age (HFA) were measured. The World Health Organization (WHO) normal ranges and 'WHO Anthro' were used to calculate the prevalence of high WFH and low WFA, WFH, HFA, or MUAC.
In total 177 (27% of children under 5 years in the four camps) were included. The male-to-female ratio was 1:1.04. Weight and height data were recorded for 114 children, and MUAC was recorded for 106 children. Two children (1.9%; 95% confidence interval [CI] 1.0-3.7%) had a MUAC more than 2 standard deviations (2SD) below the WHO mean value. Ninety-five percent were in the normal range for WFA. Four (3.7%; 95% CI 1.4-9.4%) were underweight (>2SD below the WHO median). Seventeen (16%; 95% CI 9.5-24.9%) had a high WFH, and 4 (3.7%; 95% CI 1.4-9.6%) were 2SD below the WHO median. Nineteen children (17.4%) had a low HFA, including 3 children under 1 year of age (13% of those under 1 year).
Results demonstrated low prevalence of underweight for height, but high prevalence of stunting, suggesting chronic malnutrition. We recommend empirical micronutrient supplementation for children younger than 5 years and pregnant and breast-feeding women. Further research on the nutritional status of child refugees in camps in Greece is warranted to understand the cause of stunting and scope of any micronutrient deficiencies.
此前的研究已经发现，在约旦和黎巴嫩的难民营中，叙利亚难民中存在较高的生长异常发生率。然而，关于在欧洲避难的儿童的生长状况，仅有少量已发表的数据加以描述。
在希腊北部的四个难民营中，邀请年龄在 5 岁以下、接受临床生长筛查的难民参与研究。测量中上臂围（MUAC）、年龄别体重（WFA）、身高别体重（WFH）和年龄别身高（HFA）。使用世界卫生组织（WHO）的正常范围和“WHO Anthro”计算出高 WFH 和低 WFA、WFH、HFA 或 MUAC 的患病率。
共有 177 名（四个难民营中 5 岁以下儿童的 27%）儿童入组。男女性别比为 1:1.04。114 名儿童记录了体重和身高数据，106 名儿童记录了 MUAC 数据。有 2 名儿童（1.9%；95%置信区间 [CI] 1.0-3.7%）的 MUAC 低于 WHO 平均值 2 个标准差（2SD）。95%的儿童处于 WFA 的正常范围内。4 名儿童（3.7%；95%CI 1.4-9.4%）体重不足（低于 WHO 中位数 2SD）。17 名儿童（16%；95%CI 9.5-24.9%）的 WFH 较高，4 名儿童（3.7%；95%CI 1.4-9.6%）的 MUAC 低于 WHO 中位数 2SD。19 名儿童（17.4%）的 HFA 较低，其中 3 名儿童年龄在 1 岁以下（1 岁以下儿童的 13%）。
结果显示，身高别体重不足的发生率较低，但发育迟缓的发生率较高，提示存在慢性营养不良。我们建议对 5 岁以下儿童和孕妇及哺乳期妇女进行经验性微量营养素补充。有必要进一步研究希腊难民营中儿童难民的营养状况，以了解发育迟缓的原因和任何微量营养素缺乏的范围。
