Am J Epidemiol. 2019 Nov 1;188(11):1953-1960. doi: 10.1093/aje/kwz179.
Changes in precipitation patterns might have deleterious effects on population health. We used data from the Uganda National Panel Survey from 2009 to 2012 (n = 3,223 children contributing 5,013 assessments) to evaluate the link between rainfall and undernutrition in children under age 5 years. We considered 3 outcomes (underweight, wasting, and stunting) and measured precipitation using household-reported drought and deviations from long-term precipitation trends measured by satellite. We specified multilevel logistic regression models with random effects for the community, village, and individual. Underweight (13%), wasting (4%), and stunting (33%) were common. Reported drought was associated with underweight (marginal risk ratio (RR) = 1.18, 95% confidence interval (CI): 1.04, 1.35) in adjusted analyses. Positive annual deviations (greater rainfall) from long-term precipitation trends were protective against underweight (marginal RR per 50-mm increase = 0.94, 95% CI: 0.92, 0.97) and wasting (marginal RR per 50-mm increase = 0.93, 95% CI: 0.87, 0.98) but not stunting (marginal RR per 50-mm increase = 1.00, 95% CI: 0.98, 1.01). Precipitation was associated with measures of acute but not chronic malnutrition using both objective and subjective measures of exposure. Sudden reductions in rainfall are likely to have acute adverse effects on child nutritional status.
降水模式的变化可能对人口健康产生有害影响。我们使用了 2009 年至 2012 年乌干达国家面板调查的数据（3223 名儿童提供了 5013 次评估），评估了降雨与 5 岁以下儿童营养不良之间的关系。我们考虑了 3 个结果（体重不足、消瘦和发育迟缓），并使用家庭报告的干旱和卫星测量的长期降水趋势偏差来衡量降水。我们指定了具有社区、村庄和个体随机效应的多层次逻辑回归模型。体重不足（13%）、消瘦（4%）和发育迟缓（33%）很常见。报告的干旱与体重不足有关（调整后的边缘风险比（RR）=1.18，95%置信区间（CI）：1.04，1.35）。与长期降水趋势相比，每年正的偏差（降雨量增加）对体重不足（每增加 50 毫米的边缘 RR=0.94，95%CI：0.92，0.97）和消瘦（每增加 50 毫米的边缘 RR=0.93，95%CI：0.87，0.98）具有保护作用，但对发育迟缓没有影响（每增加 50 毫米的边缘 RR=1.00，95%CI：0.98，1.01）。降水与急性但非慢性营养不良的测量值有关，使用了客观和主观的暴露测量值。降雨量的突然减少可能对儿童营养状况产生急性不良影响。
