Sserwanja Quraish, Kamara Kassim, Mutisya Linet M, Musaba Milton W, Ziaei Shirin
Programmes Department, GOAL Global, Khartoum, Sudan.
National Disease Surveillance Programme, Ministry of Health and Sanitation, Freetown, Sierra Leone.
Nutr Metab Insights. 2021 Sep 30;14:11786388211047056. doi: 10.1177/11786388211047056. eCollection 2021.
Undernutrition accounts for at least 50% of the annual global under-five mortality burden. Although disparities in the childhood stunting between urban and rural areas in Sierra Leone have been documented, information on factors associated with these differences is lacking. We aimed to determine rural-urban correlates of stunting among children under the age of 5 in Sierra Leone.
We analyzed data from 2019 Sierra Leone demographic and health survey (SLDHS) focusing on under-five children. We conducted multivariable logistic regression to examine rural-urban factors associated with childhood stunting.
Prevalence of stunting was 31.6% (95% CI 29.8-33.2) in rural areas and 24.0% (95% CI 21.6-26.1) in urban areas. Within the rural areas, children of stunted mothers (aOR = 2.37; 95% CI 1.07-5.24, < .05), younger mothers aged 15 to 19 years (aOR = 2.08; 95% CI 1.17-3.69, < .05), uneducated mothers (aOR = 1.87; 95% CI 1.28-2.71, < .01), as well as older children (24-59 months) (aOR = 1.83; 95% CI 1.48-2.27, < .001), and boys (aOR = 1.37; 95% CI 1.12-1.66, < .01) were more likely to be stunted compared to those of non-stunted, older, post-primary education mothers and those who were less than 24 months and girls respectively. While urban children whose fathers had lower education (aOR = 1.94; 95% CI 1.10-3.42, < .05), whose mothers were more parous (para 2-4) (aOR = 1.74; 95% CI 1.03-2.95, < .05), and boys (aOR = 1.48; 95% CI 1.06-2.08, < .05) were more likely to be stunted compared to their counterparts with fathers that had tertiary education, mothers of low parity and girls, respectively.
Stunting is more prevalent in the rural areas compared to the urban areas. Sex of the child was the only significant factor in both rural and urban areas. Our study findings suggest that programs designed to reduce stunting should aim for integrated yet context specific interventions in rural and urban areas.
营养不良至少占全球每年五岁以下儿童死亡负担的50%。尽管塞拉利昂城乡地区儿童发育迟缓的差异已有记录，但缺乏与这些差异相关因素的信息。我们旨在确定塞拉利昂五岁以下儿童发育迟缓的城乡相关因素。
我们分析了2019年塞拉利昂人口与健康调查（SLDHS）中五岁以下儿童的数据。我们进行了多变量逻辑回归分析，以研究与儿童发育迟缓相关的城乡因素。
农村地区发育迟缓的患病率为31.6%（95%置信区间29.8 - 33.2），城市地区为24.0%（95%置信区间21.6 - 26.1）。在农村地区，与母亲未发育迟缓、年龄较大、接受过小学后教育的儿童以及分别小于24个月和女孩的儿童相比，母亲发育迟缓的儿童（调整后比值比[aOR]=2.37；95%置信区间1.07 - 5.24，P<0.05）、15至19岁的年轻母亲的儿童（aOR = 2.08；95%置信区间1.17 - 3.69，P<0.05）、未受过教育的母亲的儿童（aOR = 1.87；95%置信区间1.28 - 2.71，P<0.01）、年龄较大的儿童（24 - 59个月）（aOR = 1.83；95%置信区间1.48 - 2.27，P<0.001）以及男孩（aOR = 1.37；95%置信区间1.12 - 1.66，P<0.01）更易发育迟缓。而在城市地区，与父亲接受过高等教育、母亲低生育次数的儿童以及女孩相比，父亲教育程度较低的儿童（aOR = 1.94；95%置信区间1.10 - 3.42，P<0.05）、母亲生育次数较多（2 - 4次）的儿童（aOR = 1.74；95%置信区间1.03 - 2.95，P<0.05）以及男孩（aOR = 1.48；95%置信区间1.06 - 2.08，P<0.05）更易发育迟缓。
农村地区发育迟缓比城市地区更为普遍。儿童性别是农村和城市地区唯一的显著因素。我们的研究结果表明，旨在减少发育迟缓的项目应针对农村和城市地区制定综合且因地制宜的干预措施。
