School of Health Care Sciences, Department of Public Health, Sefako Makgatho Health Sciences University, Molotlegi St, Ga-Rankuwa Zone 1, Ga-Rankuwa 0208, South Africa.
Int J Environ Res Public Health. 2019 Aug 21;16(17):3021. doi: 10.3390/ijerph16173021.
Overweight and obesity are increasing at an alarming rate in South Africa, while childhood undernutrition remains persistently high. This study determined the magnitude and predictors of stunting and underweight among schoolchildren in the Dikgale and Health Demographic Surveillance System Site, a rural site in South Africa.
A cross sectional study using multistage sampling was conducted among 508 schoolchildren and their mothers. Anthropometric measurements were taken from children and their mothers, while sociodemographic information was obtained from mothers using a questionnaire. The World Health Organization Anthro Plus was used to generate height-for-age and weight-for-age z-scores to indicate stunting and underweight, respectively, among the children. Maternal overweight and obesity were assessed using body mass index. Bivariate and multivariate logistic regression analyses were used to evaluate the predictors of stunting and underweight among schoolchildren.
Twenty-two percent (22%) of children were stunted and 27% were underweight, while 27.4% of the mothers were overweight and 42.3% were obese. The odds of being stunted were lower in younger children, whereas having a mother who was overweight/obese and had a short stature increased the odds of stunting. Access to water, having a refrigerator, and having a young mother were protective against being underweight. Having a mother who was overweight/obese increased the odds of being underweight.
The study showed a high prevalence of stunting and underweight among children, and overweight and obesity among mothers, indicating a household double burden of malnutrition. The age of the child and maternal overweight/obesity and short stature were predictors of stunting and underweight, while having a younger mother and access to water and a refrigerator were protective against being underweight. The need for an evidence-based and feasible nutrition program for schoolchildren, especially those in rural schools, cannot be over-emphasized.
南非超重和肥胖问题的发生率正以惊人的速度上升，而儿童营养不足的问题仍然持续存在。本研究旨在确定南非农村 Dikgale 和人口监测系统站点的学童中发育迟缓症和体重不足的发生率和预测因素。
采用多阶段抽样方法，对 508 名学童及其母亲进行了横断面研究。从儿童及其母亲身上获取人体测量学数据，同时通过问卷从母亲那里获取社会人口统计学信息。使用世界卫生组织 Anthro Plus 软件生成身高年龄别 z 评分和体重年龄别 z 评分，以分别表示儿童的发育迟缓症和体重不足。采用体质指数评估母亲超重和肥胖。采用单变量和多变量逻辑回归分析评估学童发育迟缓症和体重不足的预测因素。
22%的儿童发育迟缓，27%的儿童体重不足，27.4%的母亲超重，42.3%的母亲肥胖。年龄较小的儿童发育迟缓的几率较低，而母亲超重/肥胖且身材矮小则会增加发育迟缓的几率。获得水源、拥有冰箱和母亲较年轻是预防体重不足的保护因素。母亲超重/肥胖会增加体重不足的几率。
该研究表明，儿童中发育迟缓症和体重不足的发生率较高，而母亲中超重和肥胖的发生率也较高，这表明家庭面临双重营养不良负担。儿童的年龄、母亲的超重/肥胖和身材矮小是发育迟缓症和体重不足的预测因素，而母亲较年轻和获得水源和冰箱是预防体重不足的保护因素。强调需要为学童，特别是农村学校的学童制定基于证据且可行的营养计划是非常重要的。
