Soboksa Negasa Eshete, Gari Sirak Robele, Hailu Abebe Beyene, Mengistie Alemu Bezatu
Ethiopian Institute of Water Resources, Addis Ababa University, Addis Ababa, Ethiopia.
School of Public Health, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia.
Environ Health Insights. 2021 Mar 3;15:1178630221999635. doi: 10.1177/1178630221999635. eCollection 2021.
Inadequate water supply, sanitation, hygiene practices, and diarrhea are related to malnutrition, but there is limited evidence in Ethiopia about their association. Thus, the objective of this study was to describe childhood malnutrition and the association with diarrhea, water supply, sanitation and hygiene practices.
A case-control study design was performed from December 2018 to January 2019 in Kersa and Omo Nada districts of the Jimma Zone, Ethiopia. Both children aged 6 to 59 months were chosen randomly from malnourished and well-nourished children in 128 cases and 256 controls, respectively. Bodyweight, length/height, mid-upper arm circumference, and presence of edema of the children were measured according to the WHO references. Then, the nutritional status of the children was identified as a case or control using the cutoff points recommended by the WHO. To see the association-dependent and independent variables, logistic regression analysis was used.
A total of 378 children were included in this study (98.44%). Malnutrition was significantly increased among children who delayed breastfeeding initiation(AOR = 3.12; 95% CI: 1.62-6.00), had diarrhea (AOR = 9.22; 95% CI: 5.25-16.20), were living in households indexed as the poorest (AOR = 2.50; 95% CI: 1.12-5.62), defecated in a pit latrine without slab/open pit (AOR = 2.49; 95% CI: 1.17-5.30), collecting drinking water from less than/equal to 1 km distance (AOR = 4.77; 95% CI: 1.01-22.71) and sometimes practiced hand washing at the critical times (AOR = 2.58; 95% CI: 1.16-5.74) compared with their counterparts. However, lactating during the survey (AOR = 0.35; 95% CI: 0.18-0.67), water collection from unprotected sources (AOR = 0.22; 95% CI: 0.05-0.95) and collection and disposal of under-5 children feces elsewhere (AOR = 0.06; 95% CI: 0.01-0.49) significantly reduced the likelihood of malnutrition.
Early initiation of exclusive breastfeeding, diarrhea prevention, and the use of improved latrine and handwashing practices at critical times could be important variables to improve the nutritional status of children.
供水不足、卫生设施、卫生习惯与腹泻均与营养不良有关，但在埃塞俄比亚，关于它们之间关联的证据有限。因此，本研究的目的是描述儿童营养不良及其与腹泻、供水、卫生设施和卫生习惯之间的关联。
2018年12月至2019年1月，在埃塞俄比亚吉马地区的克尔萨和奥莫纳达区进行了一项病例对照研究。分别从128例营养不良儿童和256例营养良好儿童中随机选取6至59个月的儿童。根据世界卫生组织的参考标准，测量儿童的体重、身长/身高、上臂中部周长和水肿情况。然后，根据世界卫生组织推荐的临界点，将儿童的营养状况确定为病例或对照。为了观察关联的相关和独立变量，使用了逻辑回归分析。
本研究共纳入378名儿童（98.44%）。与对照组相比，母乳喂养开始延迟的儿童（调整后比值比[AOR]=3.12；95%置信区间[CI]：1.62 - 6.00）、患有腹泻的儿童（AOR = 9.22；95% CI：5.25 - 16.20）、生活在最贫困家庭的儿童（AOR = 2.50；95% CI：1.12 - 5.62）、在没有板的坑式厕所/露天坑中排便的儿童（AOR = 2.49；95% CI：1.17 - 5.30）、从小于/等于1公里距离处收集饮用水的儿童（AOR = 4.77；95% CI：1.01 - 22.71）以及有时在关键时期洗手的儿童（AOR = 2.58；95% CI：1.16 - 5.74），其营养不良发生率显著增加。然而，在调查期间进行母乳喂养（AOR = 0.35；95% CI：0.18 - 0.67）、从不安全水源收集水（AOR = 0.22；95% CI：0.05 - 0.95）以及在其他地方收集和处理5岁以下儿童粪便（AOR = 0.06；95% CI：0.01 - 0.49）可显著降低营养不良的可能性。
尽早开始纯母乳喂养、预防腹泻以及在关键时期使用改良厕所和洗手习惯可能是改善儿童营养状况的重要变量。
