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埃塞俄比亚克萨地区6至59个月大儿童中同时存在消瘦和发育迟缓及其他营养不良指标的患病率和决定因素

Prevalence and determinants of concurrent wasting and stunting and other indicators of malnutrition among children 6-59 months old in Kersa, Ethiopia.

作者信息

Roba Aklilu Abrham, Assefa Nega, Dessie Yadeta, Tolera Abebe, Teji Kedir, Elena Hemler, Bliznashka Lilia, Fawzi Wafaie

机构信息

College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia.

Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA.

出版信息

Matern Child Nutr. 2021 Jul;17(3):e13172. doi: 10.1111/mcn.13172. Epub 2021 Mar 16.

Abstract

Malnutrition is the leading cause of poor child health in Ethiopia, and progress to avert it is unacceptably slow. In addition, little is known about the magnitude and factors associated with concurrent wasting and stunting (WaSt). Therefore, this study aimed to assess the prevalence and factors associated with WaSt, wasting, stunting and underweight among children 6-59 months in Kersa Health and Demographic Surveillance System, Ethiopia. Data from a total of 1091 children and their parents' were analysed from a cross-sectional study. Household questionnaires and anthropometric measurements were used for data collection. Height-for-age, weight-for-height and weight-for-age indices are expressed as standard deviation units from the mean for the reference group. Multivariate analyses were conducted to identify factors associated with WaSt, wasting, stunting and underweight. Statistical significance was declared at p < 0.05. The prevalence of indicators of malnutrition was WaSt (5.8%), wasting (16.8%), stunting (53.9%) and underweight (36.9%). Children aged 6-17 months had a higher odds of wasting (adjusted odds ratio [aOR] 1.8, 95% confidence interval [CI] 1.12-2.75) compared with those aged 36-59 months, whereas children aged 18-35 months (aOR 2.4, 95% CI 1.65-3.47) and 36-59 months (aOR 1.6, 95% CI 1.07-2.37) had higher odds of stunting compared with those aged 6-17 months. Similarly, children aged 18-35 months (aOR 1.6, 95% CI 1.07-2.37) and 36-59 months (aOR 2.2, 95% CI 1.52-3.10) had higher odds of underweight compared with children aged 6-17 months. Households that did not treat drinking water at point of use were at higher odds of WaSt (aOR 3.3, 95% CI 1.16-9.27) and stunting (aOR 1.9, 95% CI 1.31-2.85) compared with those who did treat drinking water. Boys were more likely to be WaSt, wasted, stunted and underweight. Cough was associated with WaSt, wasting and underweight. Furthermore, maternal education, maternal occupation and maternal age were significantly associated with wasting. Maternal body mass index (BMI) of less than 18.5 kg/m and maternal BMI between 18.5 and 25 kg/m were associated with child stunting. In Kersa, the prevalence of WaSt, wasting, stunting and underweight is very high and requires urgent public health intervention. This study highlights point-of-use water treatment, maternal education, hygiene and sanitation, child health service utilization and maternal BMI as important areas to improve to target child malnutrition. Furthermore, a community-based programmatic and policy direction for early identification and management of WaSt in addition to other indicators of malnutrition is recommended.

摘要

营养不良是埃塞俄比亚儿童健康状况不佳的主要原因,而避免营养不良的进展极为缓慢,令人无法接受。此外,对于同时存在消瘦和发育迟缓(消瘦发育迟缓并存)的严重程度及相关因素,人们了解甚少。因此,本研究旨在评估埃塞俄比亚克萨卫生与人口监测系统中6至59个月儿童消瘦发育迟缓并存、消瘦、发育迟缓和体重不足的患病率及相关因素。对一项横断面研究中总共1091名儿童及其父母的数据进行了分析。通过家庭问卷和人体测量来收集数据。年龄别身高、身高别体重和年龄别体重指数以相对于参考组均值的标准差单位表示。进行多变量分析以确定与消瘦发育迟缓并存、消瘦、发育迟缓和体重不足相关的因素。当p < 0.05时具有统计学意义。营养不良指标的患病率分别为:消瘦发育迟缓并存(5.8%)、消瘦(16.8%)、发育迟缓(53.9%)和体重不足(36.9%)。与36至59个月的儿童相比,6至17个月的儿童消瘦几率更高(调整后的优势比[aOR]为1.8,95%置信区间[CI]为1.12至2.75);而与6至17个月的儿童相比,18至35个月(aOR为2.4,95% CI为1.65至3.47)和36至59个月(aOR为1.6,95% CI为1.07至2.37)的儿童发育迟缓几率更高。同样,与6至17个月的儿童相比,18至35个月(aOR为1.6,95% CI为1.07至2.37)和36至59个月(aOR为2.2,95% CI为1.52至3.10)的儿童体重不足几率更高。与对饮用水进行处理的家庭相比,未在使用点对饮用水进行处理的家庭出现消瘦发育迟缓并存(aOR为3.3,95% CI为1.16至9.27)和发育迟缓(aOR为1.9,95% CI为1.31至2.85)的几率更高。男孩出现消瘦发育迟缓并存、消瘦、发育迟缓和体重不足的可能性更大。咳嗽与消瘦发育迟缓并存、消瘦和体重不足有关。此外,母亲教育程度、母亲职业和母亲年龄与消瘦显著相关。母亲体重指数(BMI)低于18.5kg/m²以及母亲BMI在18.5至25kg/m²之间与儿童发育迟缓有关。在克萨,消瘦发育迟缓并存、消瘦、发育迟缓和体重不足的患病率非常高,需要紧急进行公共卫生干预。本研究强调在使用点进行水处理、母亲教育、个人卫生和环境卫生、儿童健康服务利用以及母亲BMI是改善儿童营养不良状况的重要领域。此外,建议制定一项基于社区的计划和政策方向,以便除其他营养不良指标外,对消瘦发育迟缓并存进行早期识别和管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/027b/8189198/6fd34fec6b7d/MCN-17-e13172-g002.jpg

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