南非三家公立医院住院 5 岁以下儿童营养不良的流行情况及相关因素分析。
Prevalence and factors associated with malnutrition among under 5-year-old children hospitalised in three public hospitals in South Africa.
机构信息
Division of Family Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg.
出版信息
Afr J Prim Health Care Fam Med. 2020 Nov 27;12(1):e1-e7. doi: 10.4102/phcfm.v12i1.2444.
BACKGROUND
Malnutrition is a significant risk factor for ill health among children under 5 years of age and the consequences are significant.
AIM
The aim of this study was to determine the prevalence and factors associated with malnutrition among under-5-year-old hospitalised children.
SETTING
This study was set at Sebokeng, Kopanong and Heidelberg hospitals, Sedibeng district, South Africa.
METHODS
This was a cross-sectional study comprising 306 hospitalised under-5-year-old children. Information on socio-demography, feeding practices, immunisation and clinical problems was obtained from caregivers and medical records. Anthropometric measurements were also performed.
RESULTS
Most participants were male (59.8%), had normal birth weights (80.0%), come from a household with a monthly income R2000 (about 150 US dollars) (50.3%), up-to-date immunisation (97.4%), breastfed for 6 months (57.4%) and were fed 3-4 meals/day (66.7%) and, at most, one snack/day (63.4%). Acute malnutrition accounted for 9.5% (n = 29) of admissions. Among these, 82.8% (n = 24) had severe acute malnutrition. On test of association, monthly household income (p = 0.01), mother's and father's employment status (p = 0.01; p = 0.01), breastfeeding history (p = 0.01) and having diarrhoea in index admission (p = 0.01) were significantly associated with malnutrition admission. In multivariate regression analyses, not being breastfed (odds ratio [OR] = 3.9; 95% confidence interval [CI]: 1.23-12.29; p = 0.02) and diarrhoea at index admission were independently associated with malnutrition (OR = 23.3; 95% CI: 6.85-79.43; p = 0.01).
CONCLUSION
A significant proportion of participants had malnutrition and were subjected to suboptimal feeding practices. Healthcare providers in primary care need to entrench dietary education and anthropometric screening in all clinic visits for children 5 years old, particularly when they present with diarrhoea or are not being breastfed.
背景
营养不良是 5 岁以下儿童健康不良的一个重要危险因素，其后果十分严重。
目的
本研究旨在确定住院 5 岁以下儿童营养不良的流行率和相关因素。
地点
本研究在南非塞波肯、科潘农和海德堡医院，塞迪本地区进行。
方法
这是一项横断面研究，共纳入 306 名住院 5 岁以下儿童。从照顾者和病历中获取社会人口统计学、喂养方式、免疫接种和临床问题方面的信息。还进行了人体测量学测量。
结果
大多数参与者为男性（59.8%），出生体重正常（80.0%），来自家庭月收入为 2000 兰特（约合 150 美元）（50.3%），免疫接种及时（97.4%），母乳喂养 6 个月（57.4%），每天 3-4 餐（66.7%），每天最多 1 次零食（63.4%）。急性营养不良占入院人数的 9.5%（n=29）。其中，82.8%（n=24）患有严重急性营养不良。在关联检验中，家庭月收入（p=0.01）、母亲和父亲的就业状况（p=0.01；p=0.01）、母乳喂养史（p=0.01）和指数入院时腹泻（p=0.01）与营养不良入院显著相关。多元回归分析显示，未母乳喂养（比值比[OR] = 3.9；95%置信区间[CI]：1.23-12.29；p=0.02）和指数入院时腹泻与营养不良独立相关（OR=23.3；95%CI：6.85-79.43；p=0.01）。
结论
相当一部分参与者存在营养不良，并接受了不理想的喂养方式。初级保健医疗保健提供者需要在所有 5 岁以下儿童就诊时加强饮食教育和人体测量筛查，特别是当他们出现腹泻或未接受母乳喂养时。
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