School of Food and Advanced Technology, Massey University, Palmerston North4442, New Zealand.
Department of Food Science and Technology, College of Agriculture, Animal Sciences and Veterinary Medicine, University of Rwanda, PO Box 210, Musanze, Rwanda.
Br J Nutr. 2021 Oct 28;126(8):1203-1214. doi: 10.1017/S0007114520004961. Epub 2020 Dec 10.
We aimed to identify the factors influencing child height-for-age z-scores (HAZ) as a measure of child nutritional status in Rwanda, and to examine the role of child feeding and health practices. We conducted a cross-sectional study involving 379 children (aged 6-23 months) and their mothers in northwest Rwanda. Data were collected using a pre-tested, structured questionnaire. An infant and young child feeding practices index (ICFI) and health practices index (HPI) were developed and categorised into tertiles, and linear regression analyses were performed to assess their association with child HAZ. Overall, mothers of non-stunted children exhibited better feeding and health practices than those of stunted children. ICFI was positively associated with child HAZ. We found an adjusted mean HAZ difference of 0·14 between children whose mothers were in high ICFI tertile compared with those in low tertile. Neither HPI nor any of its components were significantly associated with child HAZ. Other factors that were positively associated with child HAZ were infant birth weight (P < 0·001) and maternal height (P < 0·001). Child age, sex (male) (P < 0·05) and altitude (P < 0·05) were negatively associated with child HAZ. Diarrhoea (P < 0·05) and respiratory infections (P < 0·05) were negatively associated with HAZ in younger children aged 6-11 months. Policies to reduce stunting in this population must focus on both pre- and postnatal factors. Appropriate child feeding practices, particularly breast-feeding promotion and improvement in children's dietary diversity combined with measures to control infections should be given priority.
我们旨在确定影响儿童身高年龄 Z 评分（HAZ）的因素，HAZ 是衡量儿童营养状况的指标，并研究儿童喂养和健康行为的作用。我们在卢旺达西北部进行了一项横断面研究，涉及 379 名 6-23 个月大的儿童及其母亲。使用预先测试的结构化问卷收集数据。制定了婴幼儿喂养实践指数（ICFI）和健康实践指数（HPI），并将其分为三分位数，然后进行线性回归分析，以评估它们与儿童 HAZ 的关系。总体而言，非发育迟缓儿童的母亲表现出更好的喂养和健康行为，而发育迟缓儿童的母亲则不然。ICFI 与儿童 HAZ 呈正相关。与 ICFI 低三分位数的儿童相比，ICFI 高三分位数的儿童的调整后平均 HAZ 差异为 0.14。HPI 及其任何组成部分均与儿童 HAZ 无显著相关性。与儿童 HAZ 呈正相关的其他因素包括婴儿出生体重（P < 0.001）和母亲身高（P < 0.001）。儿童年龄、性别（男）（P < 0.05）和海拔高度（P < 0.05）与儿童 HAZ 呈负相关。腹泻（P < 0.05）和呼吸道感染（P < 0.05）与 6-11 个月大的幼儿的 HAZ 呈负相关。针对该人群减少发育迟缓的政策必须同时关注产前和产后因素。应优先考虑适当的儿童喂养行为，特别是促进母乳喂养和改善儿童饮食多样性，同时采取措施控制感染。
