Zaba Tomás, Buene Dino, Famba Elda, Joyeux Mathieu
UNICEF Mozambique, Maputo, Mozambique.
FEWSNET, Maputo, Mozambique.
Matern Child Nutr. 2021 Jan;17(1):e13060. doi: 10.1111/mcn.13060. Epub 2020 Jul 17.
Factors associated with acute malnutrition are complex and wide-ranging particularly in developing countries. In Mozambique, contextual factors associated to children acute malnutrition are yet to be fully investigated and the evidences used to better inform prevention programme. The objective of this study is to identify key factors associated with acute malnutrition among 6- to 59-month-old children living in nine districts in rural Mozambique assessed in the 2018 seasonal nutrition assessment. We analysed Standardized Monitoring and Assessment for Relief and Transition (SMART) nutrition survey data of 1,116 children from three districts and rapid nutrition assessment (RNA) data of 3,884 children from six districts of Mozambique. We used a multiple logistic regression analysis to respond to the research question. Experiencing diarrhoea [odds ratio (OR) = 4.54; P = 0.001] was the only variable associated with acute malnutrition from the SMART survey dataset, whereas in the RNA, fever (OR = 3.0; P = 0.000) access to sanitation (OR = 0.118; P = 0.037), experiencing shock in the household (OR = 0.5; P = 0.020), diarrhoea (OR = 2.41; P = 0.001) and cough (OR = 1.75; P = 0.030) were the variables with significant association to acute malnutrition. We believe that the findings were influenced by the proportion of acute malnutrition in each survey type. Study findings confirm the association between acute malnutrition and child's health outcomes that are generally linked to poor living conditions and independent effects of shocks. This highlights the need for policy and programme to implement integrated, cross-sectoral approaches to tackling child acute malnutrition, particularly addressing community level conditions such as water and sanitation.
与急性营养不良相关的因素复杂且广泛，在发展中国家尤为如此。在莫桑比克，与儿童急性营养不良相关的背景因素尚未得到充分调查，也缺乏用于更好地为预防计划提供信息的证据。本研究的目的是确定在2018年季节性营养评估中对莫桑比克农村九个地区6至59个月大儿童进行评估时，与急性营养不良相关的关键因素。我们分析了来自三个地区的1116名儿童的标准化救济与过渡监测和评估（SMART）营养调查数据，以及来自莫桑比克六个地区的3884名儿童的快速营养评估（RNA）数据。我们使用多元逻辑回归分析来回答研究问题。在SMART调查数据集中，腹泻（比值比[OR]=4.54；P=0.001）是与急性营养不良相关的唯一变量，而在RNA数据中，发烧（OR=3.0；P=0.000）、卫生设施的使用情况（OR=0.118；P=0.037）、家庭中出现休克情况（OR=0.5；P=0.020）、腹泻（OR=2.41；P=0.001）和咳嗽（OR=1.75；P=0.030）是与急性营养不良有显著关联的变量。我们认为，研究结果受到每种调查类型中急性营养不良比例的影响。研究结果证实了急性营养不良与儿童健康结果之间的关联，这些健康结果通常与生活条件差以及休克的独立影响有关。这突出表明，政策和计划需要采取综合、跨部门的方法来应对儿童急性营养不良问题，特别是要解决社区层面的条件，如水和卫生设施问题。
