Win Hayman, Shafique Sohana, Probst-Hensch Nicole, Fink Günther
Swiss Tropical and Public Health Institute, Basel, Switzerland.
University of Basel, Basel, Switzerland.
PLOS Glob Public Health. 2022 Jul 1;2(7):e0000456. doi: 10.1371/journal.pgph.0000456. eCollection 2022.
The onset of COVID-19 severely disrupted economies and increased acute household food insecurity in developing countries. Consequently, a global rise in childhood undernutrition was predicted, especially among vulnerable populations, but primary evidence on actual changes in nutritional status remained scarce. In this paper, we assessed shifts in nutritional status of urban slum children in Bangladesh pre- and post- the country's first wave of COVID-19 and nationwide lockdown. We used two rounds of cross-sectional data collected before and after the pandemic's first year in two large slum settlements (Korail and Tongi) of Dhaka and Gazipur, Bangladesh (n = 1119). Regression models estimated pre-post changes in: 1) predictors of childhood undernutrition (household income, jobs, food security, dietary diversity, healthcare utilization, and hand hygiene); and 2) under-five children's nutritional status (average height-for-age z-score (HAZ) and weight-for-height z-score (WHZ), stunting, and wasting). Subgroup analysis was done by household migration status and slum area. Over the sample period, average monthly household income dropped 23% from BDT 20,740 to BDT 15,960 (β = -4.77; 95% CI:-6.40, -3.15), and currently employed fathers slightly declined from 99% to 95% (β = -0.04; 95% CI:-0.05, -0.02). Average HAZ among the slum children improved 0.13 SD (95% CI: 0.003, 0.26). Among non-migrant children in Tongi, the odds of stunting increased (OR = 2.01, 95% CI: 1.16, 3.48) and average WHZ reduced -0.40 SD (95% CI: -0.74, -0.06). Despite great economic hardship, and differential patterns of representativeness by household geography and migration status, slum children in Bangladesh generally demonstrated resilience to nutritional decline over the first year of the pandemic. While underlying threats to nutritional deterioration persisted, considerable job and income recovery in the post-lockdown period appeared to have cushioned the overall decline. However, as the pandemic continues, monitoring and appropriate actions are needed to avert lasting setbacks to Bangladesh nutritional progress.
新冠疫情的爆发严重扰乱了经济，并加剧了发展中国家家庭的急性粮食不安全状况。因此，预计全球儿童营养不良情况会增加，尤其是在弱势群体中，但关于营养状况实际变化的主要证据仍然很少。在本文中，我们评估了孟加拉国在第一波新冠疫情和全国封锁前后城市贫民窟儿童的营养状况变化。我们使用了在孟加拉国达卡和加济布尔的两个大型贫民窟定居点（科雷尔和通吉）在疫情第一年之前和之后收集的两轮横断面数据（n = 1119）。回归模型估计了以下方面的前后变化：1）儿童营养不良的预测因素（家庭收入、就业、粮食安全、饮食多样性、医疗保健利用和手部卫生）；2）五岁以下儿童的营养状况（平均年龄别身高Z评分（HAZ）和身高别体重Z评分（WHZ）、发育迟缓以及消瘦）。按家庭迁移状况和贫民窟地区进行了亚组分析。在样本期内，家庭月平均收入从20,740孟加拉塔卡降至15,960孟加拉塔卡，下降了23%（β = -4.77；95%置信区间：-6.40，-3.15），目前有工作的父亲比例从99%略有下降至95%（β = -0.04；95%置信区间：-0.05，-0.02）。贫民窟儿童的平均HAZ提高了0.13标准差（95%置信区间：0.003，0.26）。在通吉的非移民儿童中，发育迟缓的几率增加（比值比 = 2.01，95%置信区间：1.16，3.48），平均WHZ降低了-0.40标准差（95%置信区间：-0.74，-0.06）。尽管面临巨大的经济困难，且家庭地理位置和迁移状况的代表性模式存在差异，但孟加拉国的贫民窟儿童在疫情的第一年总体上表现出对营养状况下降的抵御能力。虽然营养恶化的潜在威胁依然存在，但封锁后时期可观的就业和收入复苏似乎缓冲了总体下降趋势。然而，随着疫情持续，需要进行监测并采取适当行动，以避免孟加拉国的营养进步遭受持久挫折。
