一项在埃塞俄比亚开展的鸡养殖干预和营养行为改变补充措施提高儿童生长的效果:一项整群随机试验。

A Chicken Production Intervention and Additional Nutrition Behavior Change Component Increased Child Growth in Ethiopia: A Cluster-Randomized Trial.

机构信息

Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA.

Department of Public Health, Purdue University, West Lafayette, IN, USA.

出版信息

J Nutr. 2020 Oct 12;150(10):2806-2817. doi: 10.1093/jn/nxaa181.

Abstract

BACKGROUND

Chicken production in the context of nutrition-sensitive agriculture may benefit child nutrition in low-income settings.

OBJECTIVES

This study evaluated effects of 1) a chicken production intervention [African Chicken Genetic Gains (ACGG)], and 2) the ACGG intervention with nutrition-sensitive behavior change communication (BCC) [ACGG + Agriculture to Nutrition (ATONU)], on child nutrition and health outcomes and hypothesized intermediaries.

METHODS

Forty ACGG villages received 25 genetically improved chickens and basic husbandry guidance; of these, 20 ACGG + ATONU villages in addition received a nutrition-sensitive behavior change and homegardening intervention; 20 control clusters received no intervention. We assessed effects of the interventions on height-for-age z scores (HAZ), weight-for-age z scores (WAZ), and weight-for-height z scores (WHZ) at 9 (midline) and 18 mo (endline) through unadjusted and adjusted ordinary least squares (OLS) regressions. We examined the interventions' effects on hypothesized intermediaries including egg production and consumption, dietary diversity, women's empowerment, income, child morbidities, anemia, and chicken management practices through OLS and log binomial models.

RESULTS

Data included 829 children aged 0-36 mo at baseline. ACGG + ATONU children had higher midline HAZ [mean difference (MD): 0.28; 95% CI: 0.02, 0.54] than controls. The ACGG group had higher HAZ (MD: 0.28; 95% CI: 0.05, 0.50) and higher WAZ (MD: 0.18; 95% CI: 0.01, 0.36) at endline than controls; after adjusting for potential baseline imbalance, effects were similar but not statistically significant. At endline, differences in ACGG + ATONU children's HAZ and WAZ compared with controls were similar in magnitude to those of ACGG, but not statistically significant. There were no differences in anthropometry between the intervention groups. ACGG + ATONU children had higher dietary diversity and egg consumption than ACGG children at endline. Both interventions showed improvements in chicken management practices. The interventions did not increase anemia, diarrhea, fever, or vomiting, and the ACGG + ATONU group at midline showed reduced risk of fever.

CONCLUSIONS

A chicken production intervention with or without nutrition-sensitive BCC may have benefited child nutrition and did not increase morbidity.This trial was registered at clinicaltrials.gov as NCT03152227.

摘要

背景

在营养敏感型农业背景下,进行家禽养殖可能有益于低收入环境下的儿童营养。

目的

本研究评估了 1)家禽养殖干预措施[非洲鸡种遗传增益(ACGG)],和 2)ACGG 干预措施联合营养敏感型行为改变交流(BCC)[ACGG+农业营养化(ATONU)]对儿童营养和健康结局的影响,并假设了中介因素。

方法

40 个 ACGG 村庄获得了 25 只经过基因改良的鸡和基本的养殖指导;其中,20 个 ACGG+ATONU 村庄除了获得营养敏感型行为改变和家庭园艺干预外,还获得了营养敏感型行为改变和家庭园艺干预;20 个对照集群没有接受任何干预。我们通过未调整和调整后的普通最小二乘法(OLS)回归,评估了干预措施对 9 个月(中期)和 18 个月(终期)时身高年龄 z 评分(HAZ)、体重年龄 z 评分(WAZ)和体重身高 z 评分(WHZ)的影响。我们通过 OLS 和对数二项式模型,研究了干预措施对假设的中介因素的影响,包括鸡蛋产量和消费、饮食多样性、妇女赋权、收入、儿童发病情况、贫血和鸡管理实践。

结果

研究纳入了 829 名 0-36 个月的儿童。ACGG+ATONU 儿童的中期 HAZ 更高[平均差异(MD):0.28;95%置信区间(CI):0.02,0.54],对照组儿童的 HAZ 更高。ACGG 组在终期时 HAZ(MD:0.28;95%CI:0.05,0.50)和 WAZ(MD:0.18;95%CI:0.01,0.36)均高于对照组;在调整潜在的基线不平衡后,效果相似,但无统计学意义。在终期时,ACGG+ATONU 儿童与对照组儿童的 HAZ 和 WAZ 差异与 ACGG 组相似,但无统计学意义。干预组之间的人体测量结果没有差异。ACGG+ATONU 儿童在终期时的饮食多样性和鸡蛋消费高于 ACGG 儿童。两项干预措施均改善了鸡管理实践。干预措施并未增加贫血、腹泻、发热或呕吐,ACGG+ATONU 组在中期时发热风险降低。

结论

家禽养殖干预措施联合或不联合营养敏感型 BCC 可能有益于儿童营养,且并未增加发病情况。本研究已在 clinicaltrials.gov 注册,编号为 NCT03152227。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d8a/7549301/91a223fc8e86/nxaa181fig1.jpg

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