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孟加拉国学龄前儿童发育迟缓的患病率、决定因素及其城乡差异

Prevalence and Determinants of Stunting Among Preschool Children and Its Urban-Rural Disparities in Bangladesh.

作者信息

Akram Raisul, Sultana Marufa, Ali Nausad, Sheikh Nurnabi, Sarker Abdur Razzaque

机构信息

1 International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.

出版信息

Food Nutr Bull. 2018 Dec;39(4):521-535. doi: 10.1177/0379572118794770. Epub 2018 Aug 29.

DOI:10.1177/0379572118794770
PMID:30157677
Abstract

BACKGROUND

Despite improvements in the reduction of child stunting rates over the last decade, poor nutritional status still remains a public health concern in Bangladesh, where young children are the most vulnerable.

OBJECTIVE

The objective of this study is to capture the prevalence and determinants of childhood stunting and document its urban-rural disparities in the context of Bangladesh.

METHODS

The study used data from the Bangladesh Demographic and Health Survey of 2014. A bivariate analysis was performed to find out the differentials in prevalence of stunting, and multivariate logistic regression was performed to also assess the association of stunting with potential risk factors.

RESULTS

The overall prevalence of stunting was 36.3% and was significantly higher in rural (38.1%) areas than urban (31.2%) areas. In all 3 regression models, significantly higher odds were found among children aged 36 to 47 months compared to 6 to 12 months and among the children from the poorest households. In rural areas, male children were significantly more likely to be stunted (odds ratio = 1.31; 95% confidence interval: 1.12-1.53). Other significant risk factors for childhood stunting were maternal education and body mass index, children suffering from diarrhea, initial breast-feeding, and administrative divisions.

CONCLUSIONS

Disparities exist among urban and rural areas regarding stunting among the children younger than 5 in Bangladesh, which need to be reduced. Public health policies and interventions need to consider the risk factors in urban and rural areas separately.

摘要

背景

尽管在过去十年中儿童发育迟缓率的降低取得了进展,但营养不良状况在孟加拉国仍然是一个公共卫生问题,该国幼儿最为脆弱。

目的

本研究的目的是了解儿童发育迟缓的患病率和决定因素,并记录孟加拉国城乡地区在这方面的差异。

方法

该研究使用了2014年孟加拉国人口与健康调查的数据。进行了双变量分析以找出发育迟缓患病率的差异,并进行了多变量逻辑回归以评估发育迟缓与潜在风险因素的关联。

结果

发育迟缓的总体患病率为36.3%,农村地区(38.1%)显著高于城市地区(31.2%)。在所有3个回归模型中,与6至12个月的儿童相比,36至47个月的儿童以及最贫困家庭的儿童发育迟缓的几率显著更高。在农村地区,男童发育迟缓的可能性显著更高(优势比=1.31;95%置信区间:1.12-1.53)。儿童发育迟缓的其他显著风险因素包括母亲的教育程度和体重指数、患有腹泻的儿童、初乳喂养以及行政区。

结论

孟加拉国5岁以下儿童发育迟缓的城乡差异存在,需要缩小。公共卫生政策和干预措施需要分别考虑城乡地区的风险因素。

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