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孟加拉国0至23个月儿童发育迟缓相关的个体、母亲及家庭层面因素。

Individual-, maternal- and household-level factors associated with stunting among children aged 0-23 months in Bangladesh.

作者信息

Mistry Sabuj Kanti, Hossain Md Belal, Khanam Fouzia, Akter Fahmida, Parvez Mahmood, Yunus Fakir Md, Afsana Kaosar, Rahman Mahfuzar

机构信息

Research and Evaluation Division, BRAC, BRAC Centre, 75 Mohakhali, Dhaka 1212, Bangladesh.

College of Pharmacy and Nutrition, The University of Saskatchewan, Saskatoon, SK, Canada.

出版信息

Public Health Nutr. 2019 Jan;22(1):85-94. doi: 10.1017/S1368980018002926. Epub 2018 Nov 8.

Abstract

OBJECTIVE

Childhood stunting remains a major public health concern in Bangladesh. To accelerate the reduction rate of stunting, special focus is required during the first 23 months of a child's life when the bulk of growth takes place. Therefore the present study explored individual-, maternal- and household-level factors associated with stunting among children under 2 years of age in Bangladesh.

DESIGN

Data were collected through a nationwide cross-sectional survey conducted between October 2015 and January 2016. A two-stage cluster random sampling procedure was applied to select 11 428 households. In the first stage, 210 enumerations areas (EA) were selected with probability proportional to EA size (180 EA from rural areas, thirty EA from urban slums). In the second stage, an average of fifty-four households were selected from each EA through systematic random sampling.

SETTING

Rural areas and urban slums of Bangladesh.ParticipantsA total of 6539 children aged 0-23 months.

RESULTS

Overall, 29·9 % of the children were stunted. After adjusting for all potential confounders in the modified Poisson regression model, child's gender, birth weight (individual level), maternal education, age at first pregnancy, nutrition (maternal level), administrative division, place of residence, socio-economic status, food security status, access to sanitary latrine and toilet hygiene condition (household level) were significantly associated with stunting.

CONCLUSIONS

The study identified a number of potentially addressable multilevel risk factors for stunting among young children in Bangladesh that should be addressed through comprehensive multicomponent interventions.

摘要

目的

儿童发育迟缓仍是孟加拉国主要的公共卫生问题。为加快发育迟缓的降低率,在儿童生命的前23个月(即大部分生长发生的阶段)需要特别关注。因此,本研究探讨了孟加拉国2岁以下儿童发育迟缓相关的个体、母亲和家庭层面的因素。

设计

数据通过2015年10月至2016年1月期间进行的全国横断面调查收集。采用两阶段整群随机抽样程序选取11428户家庭。在第一阶段,按与枚举区域(EA)规模成比例的概率选取210个枚举区域(180个来自农村地区,30个来自城市贫民窟)。在第二阶段,通过系统随机抽样从每个EA平均选取54户家庭。

地点

孟加拉国的农村地区和城市贫民窟。

参与者

共有6539名0 - 23个月大的儿童。

结果

总体而言,29.9%的儿童发育迟缓。在修正的泊松回归模型中对所有潜在混杂因素进行调整后,儿童性别、出生体重(个体层面)、母亲教育程度、初孕年龄、营养状况(母亲层面)、行政区划分、居住地点、社会经济地位、粮食安全状况、使用卫生厕所情况和厕所卫生条件(家庭层面)与发育迟缓显著相关。

结论

该研究确定了孟加拉国幼儿发育迟缓的一些潜在可解决的多层面风险因素,应通过综合多成分干预措施加以解决。

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