Bukusuba John, Kaaya Archileo N, Atukwase Abel
School of Food Technology, Nutrition and Bio-engineering, Makerere University, Kampala, Uganda.
BMC Nutr. 2018 Mar 27;4:13. doi: 10.1186/s40795-018-0220-4. eCollection 2018.
Uganda ranks among the top 10 countries in the world for newborn and child mortality rates and among the top 34 for burden of stunting. This study was conducted to model the impact of stunting on child mortality in the southwest region of Uganda where the prevalence of stunting and child mortality are of great public health concern.
The study was conducted in Buhweju district in the southwest region of Uganda. The study was cross-sectional involving use of a structured household questionnaire, focus group discussions and interviews with key informants in order to gather relevant information on infant and young child feeding (IYCF) and coverage of antenatal care (ANC) and vaccination programs. The survey of stunting, vaccination and ANC services covered 221 children aged 6-59 months while the assessment of IYCF practices covered 83 children aged 0-23. The Lives Saved Tool (LiST) was used to estimate the impact of stunting on child mortality and cases of stunting averted.
The study findings indicated that only 33% of the mothers had knowledge of optimal IYCF and 39% of the sampled children were exclusively breastfed. The majority of the mothers (57%) breastfed their children for less than 2 years and only 31% of the mothers practiced appropriate introduction of complementary foods at 6 months. Only 17% of the 0-23-month-olds received a good standard of IYCF. Only 37% of the mothers reportedly attended ANC 4 times or more during pregnancy and among children aged 6-59 months, only 28% were fully vaccinated. The high impact LiST model estimated that 1297 children under 5 years would be saved and 24,850 cases of stunting averted in the study district.
The study concludes that IYCF practices and coverage of expanded programme on immunization (EPI) and ANC in the study population are sub-optimal thus the high prevalence of stunting and child mortality in the region. LiST demonstrated that prevention of stunting would reduce child mortality in rural Uganda. Therefore, increased investment in cost-effective child survival interventions targeting rural areas of Uganda would have a significant impact on stunting and child mortality.
乌干达在全球新生儿和儿童死亡率排名中位列前十，在发育迟缓负担方面位列前34。本研究旨在模拟发育迟缓对乌干达西南部地区儿童死亡率的影响，该地区发育迟缓和儿童死亡率的流行情况备受公共卫生关注。
该研究在乌干达西南部的布韦朱区开展。研究采用横断面研究方法，使用结构化家庭问卷、焦点小组讨论以及与关键信息提供者进行访谈，以收集有关婴幼儿喂养（IYCF）、产前保健（ANC）覆盖率和疫苗接种计划的相关信息。发育迟缓、疫苗接种和ANC服务调查覆盖了221名6至59个月大的儿童，而IYCF实践评估覆盖了83名0至23岁的儿童。使用挽救生命工具（LiST）来估计发育迟缓对儿童死亡率的影响以及避免发育迟缓的病例数。
研究结果表明，只有33%的母亲了解最佳IYCF，39%的抽样儿童为纯母乳喂养。大多数母亲（57%）母乳喂养孩子的时间不足2年，只有31%的母亲在孩子6个月时正确引入了辅食。在0至23个月大的儿童中，只有17%获得了良好标准的IYCF。据报道，只有37%的母亲在孕期进行了4次或更多次的ANC检查，在6至59个月大的儿童中，只有28%完全接种了疫苗。高影响LiST模型估计，在研究地区，5岁以下儿童中有1297名儿童将获救，24850例发育迟缓病例将得以避免。
研究得出结论，研究人群中的IYCF实践以及扩大免疫规划（EPI）和ANC的覆盖率不理想，因此该地区发育迟缓和儿童死亡率居高不下。LiST表明，预防发育迟缓将降低乌干达农村地区的儿童死亡率。因此，增加对针对乌干达农村地区的具有成本效益的儿童生存干预措施的投资，将对发育迟缓和儿童死亡率产生重大影响。
