Berhanu Getnet, Mekonnen Solomon, Sisay Mekonnen
Albuko district health office, South Wollo, Albuko, Ethiopia.
2Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
BMC Nutr. 2018 Jul 5;4:28. doi: 10.1186/s40795-018-0236-9. eCollection 2018.
The prevalence of under nutrition is very high in developing countries especially in women and under five children. Stunting alone affected an estimated 154.8 million (22.9%) under five children globally in 2016. It is one of the main undernutrition and health problems facing children in Ethiopia. Hence, the aim of the current study was to assess the prevalence and associated factors of stunting among preschool children from food secure and food insecure households in Albuko district, northeast Ethiopia.
This study was addressed by a community based comparative cross sectional study design which was conducted among preschool children in Albuko district from March to April 2017. Simple random sampling was used to select the five representative kebeles. To reach study participants, systematic sampling technique was utilized. Pretested and structured questionnaire was used to collect data. Height measurement was collected for each child. Anthropometric indicator, height-for-age was determined for children using current WHO growth standards. Adjusted odds ratio (AOR) with its 95 % confidence interval (CI) was computed to assess the strength of the association. To identify the associated factors of stunting, multivariable logistic regression models were built. In the multivariable analysis, variables with a P-value of <0.05 were considered statistically significant.
The overall combined prevalence of stunting among preschool children in the study area was 39.3% [95%CI; 36.3, 42.3%]. A higher stunting prevalence was observed among preschool children from food insecure households [42.8%, 95%CI; 38.4, 47.2%] than food secure ones [35.9%, 95%CI; 31.7, 40.1%]. Having uneducated mothers, large family size, and male sex were common factors significantly associated with stunting in both food secure and insecure households. While child birth order and the amount of water (<40 litters) for use were significantly associated with stunting among preschool children living in food secure households, and lesser child age, lack of extra food during pregnancy/lactation, and low dietary diversity score (DDS below four food groups) were significantly associated with stunting among preschool children from food insecure households.
The present study showed that stunting is an important public health problem among preschool children from both food secure and insecure households in Albuko district. Though productive safety net program (PSNP) is a proven strategy in reducing the burden of childhood undernutrition/stunting, this study showed that there is no significant variation in the magnitude of stunting. However, it does not mean that PSNP interventions are not important in reducing the prevalence of stunting. Therefore, strengthening maternal nutrition, family planning utilization, and maternal education and enhancing dietary diversity, water sanitation and hygiene are critical interventions to reduce the level of stunting among under five children.
营养不良在发展中国家的患病率非常高,尤其是在妇女和五岁以下儿童中。仅发育迟缓一项,2016年全球就估计有1.548亿(22.9%)五岁以下儿童受影响。这是埃塞俄比亚儿童面临的主要营养不良和健康问题之一。因此,本研究的目的是评估埃塞俄比亚东北部阿尔布科区粮食安全和粮食不安全家庭中学龄前儿童发育迟缓的患病率及其相关因素。
本研究采用基于社区的比较横断面研究设计,于2017年3月至4月在阿尔布科区的学龄前儿童中进行。采用简单随机抽样选择五个有代表性的社区。为了接触研究参与者,采用了系统抽样技术。使用经过预测试的结构化问卷收集数据。为每个儿童测量身高。根据世界卫生组织当前的生长标准确定儿童的身高别年龄这一人体测量指标。计算调整后的优势比(AOR)及其95%置信区间(CI)以评估关联强度。为了确定发育迟缓的相关因素,建立了多变量逻辑回归模型。在多变量分析中,P值<0.05的变量被认为具有统计学意义。
研究区域学龄前儿童发育迟缓的总体合并患病率为39.3%[95%CI;36.3,42.3%]。粮食不安全家庭的学龄前儿童发育迟缓患病率[42.8%,95%CI;38.4,47.2%]高于粮食安全家庭的学龄前儿童[35.9%,95%CI;31.7,40.1%]。母亲未受过教育、家庭规模大以及男性性别是粮食安全和不安全家庭中与发育迟缓显著相关的常见因素。虽然孩子的出生顺序和用水量(<40升)与粮食安全家庭中学龄前儿童的发育迟缓显著相关,但年龄较小、孕期/哺乳期缺乏额外食物以及饮食多样性得分低(低于四个食物组的饮食多样性得分)与粮食不安全家庭中学龄前儿童的发育迟缓显著相关。
本研究表明,发育迟缓是阿尔布科区粮食安全和不安全家庭中学龄前儿童面临的一个重要公共卫生问题。尽管生产性安全网计划(PSNP)是减轻儿童营养不良/发育迟缓负担的一项经证实的战略,但本研究表明发育迟缓的严重程度没有显著差异。然而,这并不意味着PSNP干预措施在降低发育迟缓患病率方面不重要。因此,加强孕产妇营养、计划生育利用、孕产妇教育以及增加饮食多样性、改善水卫生和个人卫生是降低五岁以下儿童发育迟缓水平的关键干预措施。