埃塞俄比亚莱阿姆查希霍区 5-14 岁儿童青少年急性和慢性营养不良的流行状况及其决定因素。
Prevalence and determinants of pre-adolescent (5-14 years) acute and chronic undernutrition in Lay Armachiho District, Ethiopia.
机构信息
Medical Ward, University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia.
Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
出版信息
Int J Equity Health. 2019 Sep 2;18(1):137. doi: 10.1186/s12939-019-1041-z.
BACKGROUND
In Ethiopia it is documented that 16% of all grade repetitions in primary school and 33.9% childhood deaths are associated with undernutrition. School aged children are often omitted from public health research. Thus, the present study was carried out to find out the prevalence and determinants of pre-adolescent (5-14 years) acute and chronic undernutrition in Lay Armachiho District.
METHODS
In this community based cross-sectional study, anthropometrics, individual and household characteristics data were collected from December, 2016 to January, 2017. A total of 848 school aged children (5-14 years) were included in the study. Z-scores for height-for-age (HAZ) and body-mass-index-for-age (BAZ) were calculated to illustrate stunting (chronic undernutrition) and thinness (acute undernutrition), respectively with Anthro Plus software version 1.0.4 using the WHO 2007 growth reference standard. Finally, backward stepwise multivariable logistic regression analysis was carried out to identify factors associated with stunting and thinness, individually.
RESULTS
The overall prevalence of stunting and thinness was 35.5 and 9.9%, respectively. The multivariable analysis showed that child age 10-14 years [AOR = 1.58, 95% CI: 1.17, 2.12] and lack of availability of a latrine at home [AOR = 1.60; 95% CI: 1.17, 2.20)] were associated with increased likelihood of stunting. Nevertheless, child's hand washing practice before eating [AOR = 0.67; 95% CI: 0.49, 0.91] was protective against stunting. Children who consumed diversified foods [AOR = 0.64; 95% CI 0.39, 0.97] were protected from thinness.
CONCLUSION
In Lay Armachiho district, one-third and one in every ten of school aged children were stunted and thin, respectively. Children age 10-14 years, lack of availability of a latrine at home and hand washing practices before eating were associated with stunting, while only dietary diversity was associated with thinness. Ensuring consistent hand washing practices before eating and ensuring availability of latrine should be improved in the region, which can assist in effectively tackling undernutrition. Finally, dietary diversification should be enhanced to rectify burden of acute undernutrition.
背景
在埃塞俄比亚，有记录显示，小学阶段有 16%的年级留级和 33.9%的儿童死亡与营养不良有关。学龄儿童通常在公共卫生研究中被忽略。因此，本研究旨在了解拉亚马奇霍区（Lay Armachiho District）青少年（5-14 岁）急性和慢性营养不良的流行情况和决定因素。
方法
在这项基于社区的横断面研究中，于 2016 年 12 月至 2017 年 1 月收集了人体测量学、个人和家庭特征数据。共有 848 名学龄儿童（5-14 岁）纳入研究。使用 Anthro Plus 软件版本 1.0.4 计算身高年龄 Z 评分（HAZ）和体重年龄 Z 评分（BAZ），以分别说明发育迟缓（慢性营养不良）和消瘦（急性营养不良），使用的是世卫组织 2007 年生长标准。最后，采用向后逐步多变量逻辑回归分析，单独确定与发育迟缓及消瘦相关的因素。
结果
发育迟缓及消瘦的总患病率分别为 35.5%和 9.9%。多变量分析显示，年龄在 10-14 岁的儿童（AOR=1.58，95%CI：1.17，2.12）和家中没有厕所（AOR=1.60；95%CI：1.17，2.20）与发育迟缓的可能性增加有关。然而，儿童在进食前洗手的习惯（AOR=0.67；95%CI：0.49，0.91）具有保护作用，可预防发育迟缓。食用多样化食物的儿童（AOR=0.64；95%CI 0.39，0.97）可预防消瘦。
结论
在拉亚马奇霍区，三分之一和十分之一的学龄儿童分别发育迟缓及消瘦。10-14 岁的儿童、家中没有厕所和进食前洗手的习惯与发育迟缓有关，而只有饮食多样化与消瘦有关。该地区应改善儿童在进食前持续洗手的习惯和厕所的供应，这有助于有效解决营养不良问题。最后，应加强饮食多样化，以纠正急性营养不良的负担。
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