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发育迟缓,不止于急性腹泻:柬埔寨的十二指肠贾第鞭毛虫。

Stunting, Beyond Acute Diarrhoea: Giardia Duodenalis, in Cambodia.

机构信息

Institut Pasteur du Cambodge, Laboratory of Medical Biology, 5 Boulevard Monivong, P.O. Box 983, Phnom Penh 12100, Cambodia.

United Nations Children's Fund (UNICEF), Integrated Early Childhood Development, Exchange Square, 5th Floor, No. 19&20, Street 106, Sangkat Wat Phnom, Khan Daun Penh, Phnom Penh 12100, Cambodia.

出版信息

Nutrients. 2018 Oct 3;10(10):1420. doi: 10.3390/nu10101420.

Abstract

BACKGROUND

The adverse outcomes of malnutrition on the development of a child are well acknowledged as are the broad variety of contextual factors that may impact child nutritional status. Adequate nutrient intake and the adoption of appropriate water, sanitation and hygiene measures are largely documented for their positive influence on health. Improved sanitation and protection from human feces can significantly lower the incidence of diarrhea and environmental enteropathy. However, the impact of excessive exposure to animal feces on child health is less well documented.

OBJECTIVES

This study tests the hypothesis that there is a positive association between exposure to animal feces, morbidity and anthropometric outcomes in children under 5 years of age, in Cambodia. It aims to improve insights that can contribute to discerning high-impact policies that promote children can develop to their full potential.

METHODS

Data for this study was drawn from the third follow-up round of the MyHealth project cohort study that is conducted in six districts of three Cambodian provinces (Phnom Penh, Kratie and Ratanak Kiri). The analysis included a sample of 639 children under 5 years of age.

RESULTS

The presence of livestock and more particularly, pigs near the main household dwelling was found a risk factor associated with infection (23%). infection was found to be a protective factor for acute diarrhea, yet, associated with stunting in the univariate model.

CONCLUSIONS

Preventive measures that protect from extensive exposure to animal feces may be most effective to prevent infection with and consequent stunting, thereby improving the potential for a healthy development in young Cambodian children. The results support the need for cross-sector policy measures that reinforce comprehensive early childhood interventions towards improving nutritional status as part of a wider set of child welfare and development measures.

摘要

背景

营养不良对儿童发育的不良后果是众所周知的,而可能影响儿童营养状况的广泛的各种环境因素也是众所周知的。充足的营养摄入以及采取适当的水、环境卫生和个人卫生措施,对健康有很大的积极影响。改善环境卫生和防止接触人类粪便,可以显著降低腹泻和肠病性肢皮炎的发病率。然而,动物粪便过度暴露对儿童健康的影响却没有得到很好的记录。

目的

本研究检验了一个假设,即在柬埔寨,儿童接触动物粪便与其发病和人体测量结果之间存在正相关关系。其目的是增进对能够促进儿童充分发挥潜力的高影响力政策的理解。

方法

本研究的数据来自 MyHealth 项目队列研究的第三轮随访,该研究在柬埔寨三个省(金边、桔井和腊塔纳基里)的六个区进行。分析包括 639 名 5 岁以下儿童的样本。

结果

在主家庭住所附近有牲畜,特别是猪,被发现是感染的一个危险因素(23%)。感染被发现是急性腹泻的保护因素,但在单变量模型中与发育迟缓有关。

结论

预防措施可以防止广泛接触动物粪便,这可能是预防感染和随后发育迟缓的最有效方法,从而提高了柬埔寨幼儿健康成长的潜力。研究结果支持需要采取跨部门政策措施,加强全面的儿童早期干预措施,以改善营养状况,作为更广泛的儿童福利和发展措施的一部分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e1a/6213534/6fa1f63f76fb/nutrients-10-01420-g001.jpg

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