School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, P. O. Box: 79, 1000, Bahir Dar, Ethiopia.
GAMBY Medical and Business College, Bahir Dar, Ethiopia.
BMC Pediatr. 2019 Aug 28;19(1):300. doi: 10.1186/s12887-019-1677-2.
Acute undernutrition (wasting) is a condition in which a child becomes too thin for his or her height because of weight loss or failure to gain weight. Wasted children have greater risk of morbidity and mortality compared to their normal counterparts. There are significant number of children in Africa and Asia who suffered from all forms of malnutrition. This study aimed to determine the prevalence of wasting and its associated factors among 6-59 months of age children in Libokemkem district, Amhara region of Ethiopia.
A community based cross-sectional study design was employed from June 1st to August 30th, 2017. A total of 876 households were selected using stratified multistage sampling technique. Interviewer administered structured questionnaire was used to collect socio demographic and other characteristics of the participants. Anthropometric data from the children was collected using the procedure stipulated by World Health Organization/United Nations International Children's Emergency Fund. Kebeles, the smallest administrative unit of the country, were stratified in to two groups based on the presence and absence of rice production program. Then, the children were selected randomly from the households that have been included by using systematic random sampling technique. To assure the quality of data, pretest was done on 5.00% of the total sample size. Data were coded and entered using Epi Info version 7 software and exported to Statistical Package for Social Sciences version 20 software for further analysis. Bivariate and multivariate logistic regression analysis were employed to determine the significant association between independent and dependent variables. Binary logistic regression was run to identify candidate variable for multivariate logistic regression. Those variables with a p-value < 0.25 were entered in to multivariate analyses to check the association between independent and dependent variables. Significant association set at a p value < 0.05.
The total prevalence of acute malnutrition (wasting) was 7.10% and from this 2.50% were severely wasted. It was significantly higher among children in non-rice producing community at 11.80% (95% Confidence Interval (CI): 7.90, 13.88) than rice producing one at 3.34% (95% CI: 1.60, 5.65). Children whose mothers had no power to decide how income earned is used (Adjusted Odds Ratio (AOR) = 3.94, 95% CI: 2.12, 7.31), children who lived in areas with no rice production program (AOR = 3.16, 95% CI: 1.58, 6.33), children whose mother had no formal education (AOR = 3.64, 95% CI: 1.70, 7.79) were also significantly associated with wasting. Monthly income less than1500 Ethiopian birr (AOR = 4.14, 95% CI: 2.14, 7.99), presence of diarrheal disease for the last 15 days (AOR = 2.49, 95% CI: 1.34, 4.64) and complementary food starting before 6 months (AOR = 2.62, 95% CI: 1.26, 5.42) significantly associated with wasting.
There was substantial difference between rice producing program and non-producing program communities with regarding to wasting. Children from rice producing program communities have better nutritional status than their counterparts. Intervention needs to be conducted on mother's decision-making power over household income, mother's education, and on the productive agricultural practices like improved rice producing programs.
急性营养不良(消瘦)是指由于体重减轻或无法增加体重,儿童的身高相对于其体重过瘦的一种情况。与正常儿童相比,消瘦儿童的发病率和死亡率更高。在非洲和亚洲,有相当数量的儿童患有各种形式的营养不良。本研究旨在确定埃塞俄比亚阿姆哈拉地区利博克姆肯特区 6-59 个月儿童消瘦的流行率及其相关因素。
采用 2017 年 6 月 1 日至 8 月 30 日的社区横断面研究设计。采用分层多阶段抽样技术选择了 876 户家庭。使用访谈者管理的结构化问卷收集参与者的社会人口统计学和其他特征。使用世界卫生组织/联合国儿童基金会规定的程序收集儿童的人体测量数据。根据水稻生产计划的有无,将该国最小的行政单位基贝拉分为两组。然后,从使用系统随机抽样技术包含的家庭中随机选择儿童。为确保数据质量,对总样本量的 5.00%进行了预测试。数据使用 Epi Info 版本 7 软件进行编码和输入,并导出到统计软件包社会科学版 20 软件进行进一步分析。采用双变量和多变量逻辑回归分析确定独立和因变量之间的显著关联。二元逻辑回归用于确定多变量逻辑回归的候选变量。那些 p 值 < 0.25 的变量被纳入多变量分析,以检查独立和因变量之间的关联。将显著关联设定为 p 值 < 0.05。
急性营养不良(消瘦)的总患病率为 7.10%,其中 2.50%为严重消瘦。在非水稻生产社区,这一比例为 11.80%(95%置信区间(CI):7.90,13.88),明显高于水稻生产社区的 3.34%(95% CI:1.60,5.65)。母亲无权决定如何使用收入的儿童(调整后的优势比(AOR)= 3.94,95% CI:2.12,7.31)、生活在没有水稻生产计划地区的儿童(AOR = 3.16,95% CI:1.58,6.33)、母亲没有正规教育的儿童(AOR = 3.64,95% CI:1.70,7.79)与消瘦显著相关。每月收入低于 1500 埃塞俄比亚比尔(AOR = 4.14,95% CI:2.14,7.99)、过去 15 天存在腹泻疾病(AOR = 2.49,95% CI:1.34,4.64)和 6 个月前开始补充食物(AOR = 2.62,95% CI:1.26,5.42)与消瘦显著相关。
在水稻生产计划和非生产计划社区之间存在显著差异。来自水稻生产计划社区的儿童比同龄人具有更好的营养状况。需要对母亲对家庭收入的决策权、母亲的教育以及提高水稻生产计划等生产性农业做法进行干预。