Central University of South Bihar, SH-7, Gaya Panchanpur Road, Karhara, Post. Fatehpur, Gaya, Bihar 824236, India.
School of Public Health, University of Minnesota, 420 Delaware St SE, Minneapolis, MN 55455, USA.
J Nutr Sci. 2023 Feb 23;12:e25. doi: 10.1017/jns.2023.9. eCollection 2023.
The combined burden of stunting and wasting in children under five years is a serious public health concern. The present study aimed to estimate the joint burden of stunting and wasting among children aged 6-59 months and explore its spatial variation across Nepal. The 2016 Nepal Demographic and Health Survey data was used to study acute and chronic childhood malnutrition. A Bayesian distributional bivariate probit geoadditive model was designed to study the linear association and geographical variation of stunting and wasting among 6-59 months, children. Child-related factors such as low birth weight, fever in the last 2 weeks preceding the survey and fourth or greater birth order were associated with a higher likelihood of stunting. The likelihood of a child being stunted was significantly less in the wealthiest households, having improved toilet facilities, and if mothers were overweight. Children from severely food insecure households were significantly more likely, and children from poorer households were significantly less likely to suffer both acute and chronic malnutrition simultaneously. Results from spatial effect showed that children from Lumbini and Karnali had a higher burden of stunting, and the likelihood that achild would have been wasted was significantly higher in Madhesh and Province 1. Immediate nutritional efforts are vital in low-income and severely food insecure households to lessen the risk of stunting and wasting in under children. Disproportionate geographic variations in stunting and wasting warrant sub-regional-specific nutrition intervention to achieve nutrition targets and reduce the burden of childhood malnutrition across the country.
五岁以下儿童发育迟缓与消瘦并存问题严重，令人担忧。本研究旨在评估尼泊尔 6-59 月龄儿童发育迟缓与消瘦并存问题的综合负担，并探索其在尼泊尔的空间变化。本研究使用 2016 年尼泊尔人口与健康调查数据来研究急性和慢性儿童营养不良问题。设计了贝叶斯分布二元概率比例地理加性模型来研究 6-59 月龄儿童发育迟缓与消瘦的线性关联和地理变化。儿童相关因素（如低出生体重、调查前两周内发烧和第四胎或以上出生顺序）与发育迟缓的可能性增加相关。在最富裕的家庭中，儿童发育迟缓的可能性显著降低，而拥有改良卫生设施和母亲超重的儿童，其发育迟缓的可能性则显著降低。来自严重粮食不安全家庭的儿童发生急性和慢性营养不良的可能性显著增加，而来自较贫困家庭的儿童同时发生急性和慢性营养不良的可能性显著降低。空间效应的结果表明，来自蓝毗尼和卡纳利的儿童发育迟缓负担更高，而在马德希和第一省，儿童消瘦的可能性显著更高。在低收入和严重粮食不安全家庭中，需要立即开展营养干预，以降低儿童发育迟缓与消瘦的风险。发育迟缓与消瘦在地理上的不均衡分布，需要针对特定地区开展营养干预，以实现全国营养目标，降低儿童营养不良负担。
