孟加拉国青少年学校营养项目的设计、方法及基线结果选取
Design, Methods, and Select Baseline Results from a School Nutrition Project for Adolescents in Bangladesh.
作者信息
Demuyakor Maku E, Jalal Chowdhury, Williams Anne M, Bouckaert Kimberley P, Whitehead Ralph D, Bhuiyan Muhammad M, Siraj Saiqa, Ara Riffat, Pike Vanessa, Jefferds Maria Elena D
机构信息
Nutrition Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States.
McKing Consulting Corporation, Atlanta, GA, United States.
出版信息
Curr Dev Nutr. 2023 Mar 30;7(4):100070. doi: 10.1016/j.cdnut.2023.100070. eCollection 2023 Apr.
BACKGROUND
The School Nutrition for Adolescents Project (SNAP) provided weekly iron and folic acid (WIFA) supplementation and menstrual hygiene management (MHM) support for girls; actions to improve water, sanitation, and hygiene (WASH) practices; and behavior change interventions to adolescents aged 10-19 y in 65 intervention schools in 2 districts of Bangladesh.
OBJECTIVES
We aimed to describe the project design and select baseline results of students and school project implementers.
METHODS
Girls (n = 2244) and boys (n = 773) in 74 schools (clusters) and project implementers [headteachers (n = 74), teachers (n = 96), and student leaders (n = 91)] participated in a survey assessing nutrition, MHM, and WASH knowledge and experience. Hemoglobin, inflammation-adjusted ferritin, retinol-binding protein, and serum and RBC folate (RBCF) levels in girls were measured. School WASH infrastructure was observed and drinking water was tested for .
RESULTS
IFA and deworming tablet intake in the last 1 and 6 mo were 4% and 81% for girls and 1% and 86%, respectively. Applying the Minimum Dietary Diversity for Women (MDD-W) tool, most (63%-68%) girls and boys achieved minimum dietary diversity. Fewer adolescents (14%-52%) had ever heard of anemia, IFA tablets, or worm infestation than project implementers (47%-100%). Girls (35%) missed school during menstruation; 39% reported of ever leaving school due to unexpected menstruation. The micronutrient status and deficiency severity varied: anemia (25%), RBCF insufficiency (76%), risk of serum folate deficiency (10%), deficiencies of iron (9%), and vitamin A (3%). WASH in school sustainable development goal (SDG) indicators achievement varied: basic drinking water service (70%), basic sanitation service (42%), and basic hygiene service (3%); 59% of sampled drinking water access points complied with WHO standards.
CONCLUSIONS
There is room for improvement of nutrition and health awareness, practices, micronutrient status, SDG basic WASH in-school services, and contamination in school drinking water.This trial was registered in clinicaltrials.gov as NCT05455073.
背景
青少年学校营养项目（SNAP）为女孩提供每周一次的铁和叶酸（WIFA）补充剂以及月经卫生管理（MHM）支持；采取行动改善水、环境卫生和个人卫生（WASH）做法；并对孟加拉国两个地区65所干预学校中10至19岁的青少年进行行为改变干预。
目的
我们旨在描述项目设计并选择学生和学校项目实施者的基线结果。
方法
74所学校（群组）中的女孩（n = 2244）和男孩（n = 773）以及项目实施者[校长（n = 74）、教师（n = 96）和学生领袖（n = 91）]参与了一项评估营养、MHM和WASH知识与经验的调查。测量了女孩的血红蛋白、炎症校正铁蛋白、视黄醇结合蛋白以及血清和红细胞叶酸（RBCF）水平。观察了学校的WASH基础设施并对饮用水进行了检测。
结果
在过去1个月和6个月中，女孩服用铁叶酸片（IFA）和驱虫药的比例分别为4%和81%，男孩分别为1%和86%。应用妇女最低饮食多样性（MDD-W）工具，大多数（63%-68%）女孩和男孩实现了最低饮食多样性。与项目实施者（47%-100%）相比，听说过贫血、IFA片或蠕虫感染的青少年较少（14%-52%）。35%的女孩在月经期间缺课；39%的人报告曾因意外来月经而离校。微量营养素状况和缺乏严重程度各不相同：贫血（25%）、RBCF不足（76%）、血清叶酸缺乏风险（10%）、铁缺乏（9%）和维生素A缺乏（3%）。学校WASH可持续发展目标（SDG）指标的达成情况各不相同：基本饮用水服务（70%）、基本卫生设施服务（42%）和基本卫生服务（3%）；59%的抽样饮用水接入点符合世卫组织标准。
结论
在营养与健康意识、做法、微量营养素状况、SDG基本校内WASH服务以及学校饮用水污染方面仍有改进空间。该试验已在clinicaltrials.gov上注册，注册号为NCT05455073。
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