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通过生长混合模型对1987年至2016年39个亚洲国家五岁以下营养不良儿童百分比的趋势变化进行建模。

Modeling trend changes in percent of under five-year-old children with malnutrition amongst 39 Asian countries from 1987 to 2016 via growth mixture model.

作者信息

Keshani Parisa, Shahraki Hadi Raeisi

机构信息

Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.

Department of Epidemiology and Biostatistics, Faculty of Health, Shahrekord University of Medical Sciences, Rahmatieh Educational Complex, Shahrekord, Iran.

出版信息

BMC Nutr. 2022 Apr 29;8(1):38. doi: 10.1186/s40795-022-00530-x.

Abstract

PURPOSE

Malnutrition is an important public health issue and the main cause of child morbidity and mortality, especially in developing countries. The present study aimed to model trend changes in percentage of the malnourished children under 5 among 39 Asian countries during 1987 to 2016.

METHODS

Information about percentage of the malnourished under 5 years children based on under-weight (weight for age) malnutrition for 39 Asian countries were extracted from Gapminder web site during 1987 to 2016. To cluster Asian countries based on trend changes, Growth Mixture Model (GMM) was implemented. All the statistical analyses were performed in Mplus 7.4 software and P < 0.10 in likelihood ratio test (LRT) was considered as statistically significant.

RESULTS

Based on P-value of LRT, the model with 3 clusters was selected. Although, cluster 3 with 9 countries had higher intercept in 1987 and the worst situation in malnutrition, they gained a sharp decrease (- 0.93) in percentage of malnourished children under five annually. The slope of - 0.64 for cluster 1 countries indicate a moderate decrease annually in percent of children with malnutrition. The other 20 countries with slope of - 0.29 in their linear trend belonged to cluster 2 which shows slow decrease in the percentage of children with malnutrition.

CONCLUSION

The investments in public health and education programs, as well as political commitment and government proper response in line with needs and demands are crucial to promote food security, nourishing diets and improving child nutrition. Certainly, most of them are still a long way from eradicating malnutrition.

摘要

目的

营养不良是一个重要的公共卫生问题,也是儿童发病和死亡的主要原因,尤其是在发展中国家。本研究旨在对1987年至2016年期间39个亚洲国家5岁以下营养不良儿童的百分比趋势变化进行建模。

方法

从Gapminder网站提取了1987年至2016年期间39个亚洲国家基于体重不足(年龄别体重)的5岁以下儿童营养不良百分比信息。为了根据趋势变化对亚洲国家进行聚类,实施了生长混合模型(GMM)。所有统计分析均在Mplus 7.4软件中进行,似然比检验(LRT)中P < 0.10被认为具有统计学意义。

结果

根据LRT的P值,选择了具有3个聚类的模型。虽然,包含9个国家的聚类3在1987年的截距较高且营养不良情况最差,但它们5岁以下营养不良儿童的百分比每年急剧下降(-0.93)。聚类1国家的-0.64斜率表明营养不良儿童百分比每年适度下降。线性趋势斜率为-0.29的其他20个国家属于聚类2,这表明营养不良儿童的百分比下降缓慢。

结论

对公共卫生和教育项目的投资,以及符合需求的政治承诺和政府的适当应对措施,对于促进粮食安全、营养饮食和改善儿童营养至关重要。当然,它们中的大多数距离消除营养不良仍有很长的路要走。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb08/9052463/32b0dcb441e6/40795_2022_530_Fig1_HTML.jpg

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