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加纳五岁以下儿童营养不良及其决定因素的流行病学

The epidemiology of undernutrition and its determinants in children under five years in Ghana.

机构信息

Ghana Health Service, Bolgatanga, Upper East Region, Ghana.

Department of Family and Consumer Sciences, Faculty of Agriculture, University for Development Studies, Tamale, Ghana.

出版信息

PLoS One. 2019 Jul 31;14(7):e0219665. doi: 10.1371/journal.pone.0219665. eCollection 2019.


DOI:10.1371/journal.pone.0219665
PMID:31365528
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6668784/
Abstract

BACKGROUND: Understanding the burden and contextual risk factors is critical for developing appropriate interventions to control undernutrition. METHODS: This study used data from the 2014 Ghana Demographic and Health Survey to estimate the prevalence of underweight, stunting, and wasting. Single multiple logistic regressions were used to identify the factors associated with underweight, wasting and stunting. The study involved 2720 children aged 0-59 months old and mother pairs. All analyses were done in STATA/IC version 15.0. Statistical significance was set at p<0.05. RESULTS: The prevalence of underweight, wasting and stunting were 10.4%, 5.3%, and 18.4% respectively. The age of the child was associated with underweight, wasting and stunting, whereas the sex was associated with wasting and stunting. Normal or overweight/obese maternal body mass index category, high woman's autonomy and middle-class wealth index were associated with a lower odds of undernutrition. The factors that were associated with a higher odds of child undernutrition included: low birth weight (<2.5 kg), minimum dietary diversity score (MDDS), a higher (≥4th) birth order number of child, primary educational level of husband/partner and domicile in the northern region of Ghana. CONCLUSION: There is still a high burden of child undernutrition in Ghana. The age, sex, birth weight, birth order and the MDDS of the child were the immediate factors associated with child undernutrition. The intermediate factors that were associated with child undernutrition were mainly maternal related factors and included maternal nutritional status and autonomy. Distal level factors which were associated with a higher odds of child undernutrition were the wealth index of the household, paternal educational status and region of residence. We recommend that interventions and policies for undernutrition should address socioeconomic inequalities at the community level while factoring in women empowerment programmes.

摘要

背景:了解负担和背景风险因素对于制定适当的干预措施来控制营养不良至关重要。

方法:本研究使用 2014 年加纳人口与健康调查的数据来估计消瘦、发育迟缓以及消瘦的发生率。采用单因素多项逻辑回归来确定与消瘦、消瘦和发育迟缓相关的因素。该研究涉及 2720 名 0-59 月龄的儿童及其母亲对。所有分析均在 STATA/IC 版本 15.0 中进行。统计显著性设置为 p<0.05。

结果:消瘦、消瘦和发育迟缓的发生率分别为 10.4%、5.3%和 18.4%。儿童年龄与消瘦、消瘦和发育迟缓有关,而性别与消瘦和发育迟缓有关。正常或超重/肥胖的母亲体质指数类别、较高的妇女自主权和中产阶级的财富指数与较低的营养不足风险相关。与儿童营养不足的较高风险相关的因素包括:低出生体重(<2.5kg)、最低饮食多样性评分(MDDS)、较高(≥4 个)出生顺序的儿童数量、丈夫/伴侣的小学教育程度和加纳北部地区的住所。

结论:加纳儿童仍然存在严重的营养不足问题。儿童的年龄、性别、出生体重、出生顺序和 MDDS 是与儿童营养不足直接相关的因素。与儿童营养不足相关的中间因素主要是与母亲相关的因素,包括母亲的营养状况和自主权。与儿童营养不足的较高风险相关的远因因素是家庭的财富指数、父亲的教育程度和居住地区。我们建议,针对营养不足的干预措施和政策应在社区层面解决社会经济不平等问题,同时考虑妇女赋权方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e766/6668784/60f9e14970da/pone.0219665.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e766/6668784/60f9e14970da/pone.0219665.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e766/6668784/60f9e14970da/pone.0219665.g001.jpg

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本文引用的文献

[1]
The effect of maternal and child factors on stunting, wasting and underweight among preschool children in Northern Ghana.

BMC Nutr. 2017-4-4

[2]
Prevalence and determinants of undernutrition among children under 5-year-old in rural areas: A cross-sectional survey in North Sudan.

J Family Med Prim Care. 2018

[3]
Effect of Male Involvement on the Nutritional Status of Children Less Than 5 Years: A Cross Sectional Study in a Rural Southwestern District of Uganda.

J Nutr Metab. 2017

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Int J Environ Res Public Health. 2017-12-23

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Birthweight, HIV exposure and infant feeding as predictors of malnutrition in Botswanan infants.

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Int J Environ Res Public Health. 2017-8-1

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Nutr Health. 2017-9

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Determinants of overweight with concurrent stunting among Ghanaian children.

BMC Pediatr. 2017-7-27

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