莱索托五岁以下儿童贫血与发育迟缓的联合建模：一项横断面案例研究。
Joint modelling of anaemia and stunting in children less than five years of age in Lesotho: a cross-sectional case study.
作者信息
Gaston Rugiranka Tony, Habyarimana Faustin, Ramroop Shaun
机构信息
School of Mathematics, Statistics and Computer Sciences, University of KwaZulu-Natal, Private Bag X01, Pietermaritzburg CampusScottsville, 3209, South Africa.
Health Economics and HIV/AIDS Research Division (HEARD), University of KwaZulu-Natal, Westville Campus, Private Bag X01, Westville, 3629, South Africa.
出版信息
BMC Public Health. 2022 Feb 11;22(1):285. doi: 10.1186/s12889-022-12690-3.
BACKGROUND
Anaemia and stunting remain jointly a serious health issue worldwide especially in developing countries. In Lesotho, their prevalence is high, particularly among children less than 5 years of age.
OBJECTIVES
The primary objective was to determine the association between anaemia and stunting, and identify factors relating to both conditions among children younger than 5 years in Lesotho.
METHODS
This cross-sectional study used secondary data from 3112 children collected during the 2014 Lesotho Demographic Health Survey (LDHS). Haemoglobin (Hb) levels were adjusted for altitude and a level less than 11 g per deciliters (11 g/dl) was determined as the cutoff for being anaemic. A child with the height-for-age z score (HAZ) below minus two standard deviations (SD) was considered to have stunting. We linked factors relating to anaemia and stunting using a multivariate joint model under the scope of the generalized linear mixed model (GLMM).
RESULTS
The prevalence of anaemia and stunting in children younger than 5 years were 51% and 43% respectively. The multivariate results revealed a strong association between anaemia and stunting. In addition, maternal education, urban vs. rural residence, wealth index and childbirth weight significantly impacted childhood stunting or malnutrition, while having fever and/or diarrhoea was linked to anaemia. Lastly, age was shown to have a significant effect on both stunting and anaemia.
CONCLUSION
Anaemia and stunting or malnutrition showed linked longitudinal trajectories, suggesting both conditions could lead to synergetic improvements in overall child health. Demographic, socio-economic, and geographical characteristics were also important drivers of stunting and anaemia in children younger than 5 years. Thus, children living in similar resources settings as Lesotho could benefit from coordinated programs designed to address both malnutrition and anaemia.
背景
贫血和发育迟缓仍是全球范围内，尤其是发展中国家严重的健康问题。在莱索托，其患病率很高，特别是在5岁以下儿童中。
目的
主要目的是确定贫血与发育迟缓之间的关联，并找出莱索托5岁以下儿童中与这两种情况相关的因素。
方法
这项横断面研究使用了2014年莱索托人口与健康调查（LDHS）期间收集的3112名儿童的二手数据。根据海拔高度对血红蛋白（Hb）水平进行了调整，并将每分升低于11克（11 g/dl）的水平确定为贫血的临界值。年龄别身高Z评分（HAZ）低于负两个标准差（SD）的儿童被认为发育迟缓。我们在广义线性混合模型（GLMM）的范围内，使用多变量联合模型将与贫血和发育迟缓相关的因素联系起来。
结果
5岁以下儿童的贫血和发育迟缓患病率分别为51%和43%。多变量结果显示贫血与发育迟缓之间存在密切关联。此外，母亲的教育程度、城乡居住情况、财富指数和出生体重对儿童发育迟缓或营养不良有显著影响，而发烧和/或腹泻与贫血有关。最后，年龄对发育迟缓和贫血均有显著影响。
结论
贫血与发育迟缓或营养不良呈现出相关的纵向轨迹，表明这两种情况都可能有助于整体儿童健康状况的协同改善。人口、社会经济和地理特征也是5岁以下儿童发育迟缓和贫血的重要驱动因素。因此，生活在与莱索托资源状况相似环境中的儿童，可能会从旨在解决营养不良和贫血问题的协调项目中受益。
Zotero 插件