Bertrand W E, Mock N B, Franklin R R
Department of Biostatistics and Epidemiology, School of Public Health and Tropical Medicine Tulane University, New Orleans, Louisiana.
Int J Epidemiol. 1988 Sep;17(3):556-67. doi: 10.1093/ije/17.3.556.
In an effort to search for causes of malnutrition in the urban environment to guide intervention efforts, a study of more than 2000 mother/child pairs was conducted in Kinshasa, Zaire. Under the auspices of the Zairian National Nutrition Planning Center a representative sample of a large lower class urban population was interviewed at two points in time. One phase covered morbidity and nutritional status measurements for all children under five years of age. A second phase examined a complex set of socioeconomic and behavioural variables possibly linked to nutritional outcomes for a 20% sample of the households. After merging the data sets bivariate and multivariate regression analyses were performed twice, using the youngest child and the household as the unit of analysis respectively. Results showed that different complexes of variables predicted malnutrition as measured by three separate anthropometric measures. For so-called acute malnutrition (weight-for-height) morbidity, migration, and diarrhoeal knowledge, all emerged as significant predictors. Chronic malnutrition (height-for-age), however, was only significantly predicted by zone of residence, a level of living score, and recent morbidity when all major variables were considered in the regression model. Factors that were significant predictors of each of these two indices also were predictors of the third nutritional indicator, weight-for-age. Birth interval also was associated with this index. The findings here suggest more careful scrutiny of the nature, causes, interpretation and use of these widely accepted measures of nutritional status.
为了探寻城市环境中营养不良的成因以指导干预措施，在扎伊尔的金沙萨对2000多对母婴进行了一项研究。在扎伊尔国家营养规划中心的支持下，对一大城市下层人口的代表性样本在两个时间点进行了访谈。第一阶段涵盖了对所有五岁以下儿童的发病率和营养状况测量。第二阶段对20%的家庭样本研究了一系列可能与营养结果相关的复杂社会经济和行为变量。在合并数据集后，分别以最年幼的孩子和家庭为分析单位进行了两次双变量和多变量回归分析。结果表明，不同的变量组合可预测由三种不同人体测量方法衡量的营养不良情况。对于所谓的急性营养不良（身高别体重），发病率、迁移和腹泻知识均为显著预测因素。然而，在回归模型中考虑所有主要变量时，慢性营养不良（年龄别身高）仅由居住区域、生活水平得分和近期发病率显著预测。这两个指标各自的显著预测因素也是第三个营养指标年龄别体重的预测因素。生育间隔也与该指标相关。此处的研究结果表明，需要对这些广泛接受的营养状况衡量方法的性质、成因、解释和用途进行更仔细的审视。
