Sanin Kazi Istiaque, Khanam Mansura, Rita Razia Sultana, Haque Md Ahshanul, Ahmed Tahmeed
Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
Front Nutr. 2023 Jan 9;9:999520. doi: 10.3389/fnut.2022.999520. eCollection 2022.
Undernourishment is disproportionately spread within Bangladesh, making some regions like Sylhet more vulnerable than the rest of the country. We aimed to assess the trend of diverse associated factors related to childhood stunting, wasting, and being underweight. Furthermore, we have compared the estimated factors between Sylhet, the most vulnerable region, and other parts of Bangladesh.
We performed a secondary data analysis where data were derived from the nationally representative cross-sectional surveys: Bangladesh demographic and health survey (BDHS) 2007, 2011, 2014, and 2017-18 rounds. The outcome variables were childhood undernutrition, including stunting, wasting, and being underweight. Descriptive statistics such as mean, standard deviation, frequency, and proportion were used to summarize the data. All variables were summarized by BDHS survey time points. We used multiple logistic regression models to measure the associated factors with childhood stunting, wasting, and being underweight.
The percentage of children under the age of 5 years who were stunted declined from 40% in 2007 to 31% in 2018. Similar trends are observed in the decrease in the percentage of underweight children, dropping from 39% in 2007 to 22% in 2018. Wasting dropped to 8% in 2018 after years of critically high levels (17%). According to the results of the regression analyses, urban residence, child's age and gender, morbidity, maternal BMI, maternal and paternal education, decision-making ability, use of contraceptives, the occurrence of domestic violence, antenatal care, c-section, and birth interval, as well as geographic region, were all linked to childhood malnutrition.
The Sylhet division falls short in several critical associated indicators, including parental education, maternal BMI, obtaining at least four ANC, women empowerment, and usage of contraceptives. Policymakers must concentrate on region-specific planning and proper intervention to achieve a more uniform improvement across the country.
营养不良在孟加拉国的分布极不均衡，使得像锡尔赫特这样的一些地区比该国其他地区更易受影响。我们旨在评估与儿童发育迟缓、消瘦和体重不足相关的各种因素的趋势。此外，我们还比较了最脆弱地区锡尔赫特与孟加拉国其他地区之间的估计因素。
我们进行了二次数据分析，数据来自具有全国代表性的横断面调查：2007年、2011年、2014年以及2017 - 18年轮次的孟加拉国人口与健康调查（BDHS）。结果变量为儿童期营养不良，包括发育迟缓、消瘦和体重不足。使用均值、标准差、频率和比例等描述性统计方法来汇总数据。所有变量均按BDHS调查时间点进行汇总。我们使用多元逻辑回归模型来衡量与儿童发育迟缓、消瘦和体重不足相关的因素。
5岁以下发育迟缓儿童的百分比从2007年的40%下降到了2018年的31%。体重不足儿童百分比的下降也呈现类似趋势，从2007年的39%降至2018年的22%。在经历多年的极高水平（17%）后，消瘦率在2018年降至8%。根据回归分析结果，城市居住情况、儿童年龄和性别、发病率、母亲体重指数、父母教育程度、决策能力、避孕药具的使用、家庭暴力的发生、产前护理、剖宫产、生育间隔以及地理区域均与儿童期营养不良有关。
锡尔赫特分区在几个关键相关指标方面存在不足，包括父母教育程度、母亲体重指数、至少接受四次产前检查、妇女赋权以及避孕药具的使用。政策制定者必须专注于针对特定地区的规划和适当干预，以在全国实现更均衡的改善。
