Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana.
Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Matern Child Nutr. 2022 Apr;18(2):e13313. doi: 10.1111/mcn.13313. Epub 2022 Jan 10.
Heightened food insecurity in the hunger season increases the risk of severe acute malnutrition (SAM) in childhood. This study examined the association of season of birth with SAM in a Guinean Sahelian ecological zone. We analyzed routine health and sociodemographic surveillance data from the Navrongo Health and Socio-demographic Surveillance System collected between 2011 and 2018. January-June, the period of highest food insecurity, was defined as the hunger season. We defined moderate acute malnutrition as child mid-upper arm circumference (MUAC) between 115 mm and 135 mm and SAM as MAUC ≤ 115 mm. We used adjusted logistic regression to quantify the association between the season of birth and SAM in children aged 6-35 months. From the 29,452 children studied, 24% had moderate acute malnutrition. Overall, 1.4% had SAM, with a higher prevalence (1.8%) in the hunger season of birth. Compared with those born October-December, adjusted odds ratios (aOR) and 95% confidence interval (95% CI) for SAM were increased for children born in the hunger season: January-March (1.77 [1.31-2.39]) and April-June (1.92 [1.44-2.56]). Low birth weight, age at an assessment of nutritional status, and ethno-linguistic group were also significantly associated with SAM in adjusted analyses. Our study established that being born in the hunger season is associated with a higher risk of severe acute malnutrition. The result implies improvement in the food supply to pregnant and lactating mothers through sustainable agriculture or food system change targeting the hunger season may reduce the burden of severe acute malnutrition.
在饥饿季节，粮食无保障程度加剧，会增加儿童罹患严重急性营养不良的风险。本研究在几内亚萨赫勒生态区，调查了出生季节与严重急性营养不良之间的关联。我们分析了 2011 年至 2018 年期间纳夫龙戈健康和社会人口监测系统收集的常规卫生和社会人口监测数据。1 月至 6 月是粮食最无保障的时期，定义为饥饿季节。我们将中度急性营养不良定义为儿童中臂中部周长（MUAC）在 115 毫米至 135 毫米之间，严重急性营养不良定义为 MUAC 小于等于 115 毫米。我们使用调整后的逻辑回归来量化出生季节与 6 至 35 个月儿童严重急性营养不良之间的关联。在研究的 29452 名儿童中，24%患有中度急性营养不良。总体而言，1.4%患有严重急性营养不良，其中饥饿季节出生的儿童患病率更高（1.8%）。与 10 月至 12 月出生的儿童相比，1 月至 3 月（1.77 [1.31-2.39]）和 4 月至 6 月（1.92 [1.44-2.56]）出生的儿童患有严重急性营养不良的调整后优势比（aOR）和 95%置信区间（95%CI）更高。在调整后的分析中，低出生体重、营养状况评估时的年龄和民族语言群体也与严重急性营养不良显著相关。本研究表明，在饥饿季节出生与严重急性营养不良的风险增加有关。这一结果表明，通过可持续农业或针对饥饿季节的粮食系统变革，改善孕妇和哺乳期妇女的粮食供应，可能会降低严重急性营养不良的负担。
