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埃塞俄比亚索马里地区牧民社区幼儿的营养状况和肠道寄生虫。

Nutritional status and intestinal parasites among young children from pastoralist communities of the Ethiopian Somali region.

机构信息

Jigjiga University One Health Initiative, Jigjiga University, Jigjiga, Ethiopia.

Human and Animal Health Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland.

出版信息

Matern Child Nutr. 2020 Jul;16(3):e12955. doi: 10.1111/mcn.12955. Epub 2020 Feb 5.

Abstract

Pastoralist children in the Ethiopian Somali Regional State (ESRS) are at high risk for undernutrition and intestinal parasitic infections (IPIs). We assessed the nutritional status and its association with IPIs in 500 children <5 years of age in a clustered cross-sectional study in Adadle district, ESRS. Stool samples were microscopically examined for IPIs and biomarkers for iron and vitamin A status, anthropometry, and food variety score (FVS) were assessed. Median (interquartile range [IQR]) FVS was 2.0 (2.0, 4.0), and 35% of children were exclusively breastfed up to age 6 months. Prevalence of stunting, wasting, underweight and mid-upper arm circumference (MUAC) <12.5 cm was 30, 34, 40, and 16%, respectively. Median (IQR) haemoglobin, ferritin, and retinol-binding protein concentrations were 9.5 g dL (8.2, 10.9), 6.2 μg L (4.0, 10.2), and 0.8 μmol L (0.67, 0.91), respectively. Prevalence of anaemia, iron, and vitamin A deficiency was 75, 91, and 30%, respectively. IPIs' prevalence was 47%; the most prevalent IPIs were Giardia lamblia (22%) and Ascaris lumbricoides (15%). Giardial infections but not A. lumbricoides increased the risk for MUAC <12.5 cm (adjusted odds ratio [aOR]: 3.50, 95% confidence interval [CI] [2.21, 5.54]). The odds for anaemia were 97% (aOR: 0.03, 95% CI [0.03, 0.07]) and 89% (aOR: 0.11, 95% CI [0.11, 0.23]) less for children with FVS >2 or with exclusive breastfeeding up to 6 months, respectively. Undernutrition and IPIs are alarmingly high in <5 years of age children in ESRS. Giardial infections and low nutritional adequacy of the diet seem to be major contributing factors to the precarious nutritional status and should be addressed by appropriate interventions.

摘要

埃塞俄比亚索马里州(ESRS)的牧民儿童面临营养不良和肠道寄生虫感染(IPI)的高风险。我们在 ESRS 的 Adadle 区进行了一项聚类横断面研究,评估了 500 名 5 岁以下儿童的营养状况及其与 IPI 的关系。对粪便样本进行了寄生虫感染和铁及维生素 A 状态的生物标志物、人体测量学和食物种类评分(FVS)评估。FVS 的中位数(四分位距 [IQR])为 2.0(2.0,4.0),35%的儿童在 6 个月龄前纯母乳喂养。发育迟缓、消瘦、体重不足和中上臂围(MUAC)<12.5cm 的患病率分别为 30%、34%、40%和 16%。血红蛋白、铁蛋白和视黄醇结合蛋白浓度的中位数(IQR)分别为 9.5g/dL(8.2,10.9)、6.2μg/L(4.0,10.2)和 0.8μmol/L(0.67,0.91)。贫血、铁和维生素 A 缺乏的患病率分别为 75%、91%和 30%。IPI 的患病率为 47%;最常见的 IPI 是蓝氏贾第鞭毛虫(22%)和蛔虫(15%)。贾第鞭毛虫感染而不是蛔虫感染增加了 MUAC<12.5cm 的风险(调整后的优势比[aOR]:3.50,95%置信区间[CI] [2.21,5.54])。贫血的几率分别降低了 97%(aOR:0.03,95%CI [0.03,0.07])和 89%(aOR:0.11,95%CI [0.11,0.23]),分别是 FVS>2 或 6 个月内纯母乳喂养的儿童。<5 岁儿童的营养不良和 IPI 非常高。贾第鞭毛虫感染和饮食营养充足性低似乎是造成脆弱营养状况的主要因素,应通过适当的干预措施加以解决。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5ef/7296781/e625203cc8ca/MCN-16-e12955-g001.jpg

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