Okubo Tomoo, Janmohamed Amynah, Topothai Chompoonut, Blankenship Jessica L
UNICEF, Bangkok, Thailand.
UNICEF East Asia & Pacific Regional Office, Toronto, Ontario, Canada.
Matern Child Nutr. 2020 Oct;16 Suppl 2(Suppl 2):e12910. doi: 10.1111/mcn.12910. Epub 2020 Jun 30.
Thailand is now faced with a double burden of malnutrition. Using nationally representative data from the 2015-2016 Multiple Indicator Cluster Survey, we utilized multinomial logistic regression models to examine factors associated with stunting only, wasting only, overweight only, concurrent stunting and overweight, and concurrent stunting and wasting among children 0-59 months of age (n = 11,068). The prevalences of <5 stunting only (height-for-age Z score < -2 SD) and wasting only (WHZ < -2 SD) were 8.5% and 4.7%, respectively. The prevalence of <5 overweight only (WHZ > +2 SD) was 7.8%. Children 12-23 months (risk ratio [RR], 95% confidence interval [CI]: 1.47 [1.18, 1.83]; p < .01) and 24-35 months (RR, 95% CI: 1.56 [1.26, 1.94]; p < .001) were at increased risk for stunting only, compared with children 48-59 months. The strongest risk factor for stunting only was low birth weight (RR, 95% CI: 3.42 [2.86, 4.10]; p < .001). Children 0-5 months were at highest risk for wasting only, compared with children 48-59 months (RR, 95% CI: 2.91 [2.16, 3.92]; p < .001). Children 48-59 months and male children were more likely to be overweight only. Higher household wealth and smaller household size were also significant predictors of overweight only. A small proportion of children were concurrently stunted and overweight (1.3%) and concurrently stunted and wasted (0.6%). A multipronged approach focused on adequate prenatal care, improving breastfeeding and complementary feeding practices, and mitigating the growing burden of overweight is needed to address the double burden of malnutrition in Thailand.
泰国目前面临着营养不良的双重负担。利用2015 - 2016年多指标类集调查的全国代表性数据，我们运用多项逻辑回归模型，研究了0至59个月龄儿童（n = 11,068）中仅发育迟缓、仅消瘦、仅超重、并发发育迟缓和超重以及并发发育迟缓和消瘦的相关因素。仅5岁以下发育迟缓（身高别体重Z评分＜ -2标准差）和仅消瘦（WHZ＜ -2标准差）的患病率分别为8.5%和4.7%。仅5岁以下超重（WHZ＞ +2标准差）的患病率为7.8%。与48至59个月龄的儿童相比，12至23个月龄（风险比[RR]，95%置信区间[CI]：1.47[1.18, 1.83]；p＜.01）和24至35个月龄（RR，95% CI：1.56[1.26, 1.94]；p＜.001）的儿童仅发育迟缓的风险增加。仅发育迟缓的最强风险因素是低出生体重（RR，95% CI：3.42[2.86, 4.10]；p＜.001）。与48至59个月龄的儿童相比，0至5个月龄的儿童仅消瘦的风险最高（RR，95% CI：2.91[2.16, 3.92]；p＜.001）。48至59个月龄的儿童和男童仅超重的可能性更大。更高的家庭财富和更小的家庭规模也是仅超重的重要预测因素。一小部分儿童同时存在发育迟缓和超重（1.3%）以及发育迟缓和消瘦（0.6%）。需要采取多管齐下的方法，重点关注充分的产前护理、改善母乳喂养和辅食喂养习惯以及减轻超重负担的不断增加，以应对泰国营养不良的双重负担。
