Department of Public Health & Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan.
Department of Math's, Stats & Computer Science, The University of Agriculture Peshawar, Pakistan.
Braz J Biol. 2021 Jul 9;82:e249971. doi: 10.1590/1519-6984.249971. eCollection 2021.
Stunting is a significant public health problem in low- and middle-income countries. This study assessed the prevalence of stunting and associated risk factors of stunting among preschool and school-going children in flood-affected areas of Pakistan. A cross-sectional study was conducted by visiting 656 households through multi-stage sampling. Respondent's anthropometric measurements, socio-demographic information and sanitation facilities were explored. A logistic regression model was used to determine determinants of stunting, controlling for all possible confounders. The overall prevalence of stunting in children was 40.5%, among children 36.1% boys and 46.3% of girls were stunted. The prevalence of stunting in under-five children was 50.7%. Female children (OR=1.35, 95% CI:0.94-2.0), children aged 13-24 months (OR=6.5, 95% CI: 3.0-13.9), mothers aged 15-24 years (OR=4.4, 95% CI: 2.6-7.2), joint family (OR=2.1, 95% CI: 1.4-3.0) did not have access to improved drinking water (OR=3.3, 95% CI: 1.9-5.9), and the toilet facility (OR=2.8, 95% CI, 1.9-4.3), while the children from district Nowshera (OR=1.7, 95% CI: 0.9-3.2) were significantly (P<0.05) associated in univariate analysis. The regression model revealed that child age, maternal age, family type, quality of water, and toilet facility, were the significant (P<0.05) factors contributing to child stunting in the flood-hit areas. Identification of key factors might be helpful for policymakers in designing comprehensive community-based programs for the reduction of stunting in flood-affected areas. In disasters such as flood, the detrimental consequences of the stunting problem could be even more on children. Evidence-based education and care must be provided to the families in the flood-affected regions to reduce the stunting problem. The determinants of stunting should be targeted by making comprehensive policies regarding proper nutrition, livelihood, clean water, and sanitation facilities in flood-hit regions.
发育迟缓是中低收入国家的一个重大公共卫生问题。本研究评估了巴基斯坦受洪水影响地区学龄前和学龄儿童发育迟缓的流行率及相关危险因素。通过多阶段抽样,对 656 户家庭进行了横断面研究。调查了应答者的人体测量指标、社会人口统计学信息和卫生设施。使用逻辑回归模型确定发育迟缓的决定因素,同时控制所有可能的混杂因素。儿童发育迟缓的总体患病率为 40.5%,其中男孩为 36.1%,女孩为 46.3%。五岁以下儿童发育迟缓的患病率为 50.7%。女童(OR=1.35,95%CI:0.94-2.0)、13-24 月龄儿童(OR=6.5,95%CI:3.0-13.9)、15-24 岁母亲(OR=4.4,95%CI:2.6-7.2)、联合家庭(OR=2.1,95%CI:1.4-3.0)无法获得改良饮用水(OR=3.3,95%CI:1.9-5.9)和厕所设施(OR=2.8,95%CI,1.9-4.3),而来自瑙谢拉区的儿童(OR=1.7,95%CI:0.9-3.2)在单因素分析中差异有统计学意义(P<0.05)。回归模型显示,儿童年龄、母亲年龄、家庭类型、水质和厕所设施是导致洪灾地区儿童发育迟缓的重要(P<0.05)因素。确定关键因素可能有助于决策者制定针对洪灾地区儿童发育迟缓的全面社区综合方案。在洪水等灾害中,发育迟缓问题对儿童的不利后果可能更为严重。必须向受灾地区的家庭提供基于证据的教育和关怀,以减少发育迟缓问题。应通过制定洪灾地区适当营养、生计、清洁水和卫生设施的综合政策,针对发育迟缓的决定因素采取行动。