Oeolo Primary Healthcare, Jln. Tetu Neno, Timor Tengah Utara District, East Nusa Tenggara Province, 85662, Indonesia.
Department of Pharmacology, Faculty of Medicine, Universitas Airlangga, Jl. Mayjend Prof. Dr. Moestopo No 47, Surabaya, East Java, 60132, Indonesia.
F1000Res. 2020 May 4;9:324. doi: 10.12688/f1000research.23156.4. eCollection 2020.
Determination of stunting and wasting always uses the WHO growth standard in Indonesia. However, it is believed that Indonesian children are "below" the global standard, thus the WHO standard is not reliable to present the actual prevalence. This study aims to compare the prevalence and determinants of stunting and underweight using WHO growth standard and national Indonesian growth reference. This was a cross-sectional study carried out in Musi sub-district, East Nusa Tenggara province in July 2019. East Nusa Tenggara province had the highest prevalence of stunting and underweight in Indonesia. The study population were children under five, and total sampling method was used for this study. Length/height-for-age and weight-for-age were plotted using WHO standard and national Indonesian reference. Univariate and multivariate binomial logistic regression were used for statistical analysis. The prevalence of stunting and underweight were higher for the WHO standard than the national reference (53.9% vs 10.7% and 29.17% vs 17.7%; all p < 0.001). After adjusted for confounding factors, when the WHO standard was used, determinants of stunting were maternal mid-upper arm circumference below 23.5cm and maternal height below 150cm; determinants of underweight were intrauterine growth restriction, young maternal age during pregnancy, and multiple parities. When the national reference was used, no determinants was found for stunting; the determinants of underweight were intrauterine growth restriction and maternal education. The WHO standard is not suitable for representing child growth in Musi sub-district. Future studies should be done to re-evaluate the prevalence and determinants of stunting and underweight nationwide using the national Indonesian reference.
身材矮小和消瘦的确定始终使用印度尼西亚的世界卫生组织生长标准。然而，人们认为印度尼西亚儿童“低于”全球标准，因此世界卫生组织的标准不可靠，无法真实反映实际的流行率。本研究旨在比较使用世界卫生组织生长标准和国家印度尼西亚生长参考标准的身材矮小和消瘦的流行率和决定因素。这是 2019 年 7 月在东努沙登加拉省 Musi 分区进行的一项横断面研究。东努沙登加拉省是印度尼西亚身材矮小和消瘦患病率最高的省份。该研究人群为五岁以下儿童，本研究采用总抽样法。使用世界卫生组织标准和国家印度尼西亚参考标准绘制年龄别身长/身高和年龄别体重/身高。采用单变量和多变量二项式逻辑回归进行统计分析。与国家参考标准相比，世界卫生组织标准下身材矮小和消瘦的患病率更高（53.9%对 10.7%和 29.17%对 17.7%；均 P < 0.001）。在调整混杂因素后，当使用世界卫生组织标准时，身材矮小的决定因素是母亲中上臂围小于 23.5cm 和母亲身高小于 150cm；消瘦的决定因素是宫内生长受限、孕妇年龄较小和多胎次。当使用国家参考标准时，未发现身材矮小的决定因素；消瘦的决定因素是宫内生长受限和母亲教育程度。世界卫生组织标准不适合代表 Musi 分区的儿童生长情况。应进行进一步的研究，使用国家印度尼西亚参考标准重新评估全国范围内身材矮小和消瘦的流行率和决定因素。
