He Qiwei, Qi Xinran, Zhang Tiange, Tang Kun
Vanke School of Public Health, Tsinghua University, Beijing, China; Institute of International Development Cooperation, Chinese Academy of International Trade and Economic Cooperation, Beijing, China.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Nutrition. 2023 Nov;115:112182. doi: 10.1016/j.nut.2023.112182. Epub 2023 Aug 2.
Malnutrition in the Democratic Republic of the Congo (DRC) has declined over the past 2 decades. However, malnutrition inequality persists. Evaluating trends of socioeconomic disparities in malnutrition among children under 5 y of age in the DRC can help target meaningful interventions.
Data from the Multiple Indicator Cluster Survey (2001, 2010, 2018) assessed the prevalence of underweight, stunting, and wasting among children under 5. The Slope Index of Inequality (SII) and the Relative Index of Inequality (RII) measured socioeconomic inequalities. We evaluated trends in the entire national sample and stratified subsamples based on place of residence and wealth index quintiles. The final sample included 42 976 children.
The national prevalence of underweight and wasting decreased from 31% to 26% and 13% to 6% in rural and urban areas. However, trends in stunting prevalence varied between the two areas. Nutritional disparity widened between low- and high-income families (stunting RIIs: 0.61 in 2001, 0.37 in 2018; stunting SIIs: -0.20 in 2001, -0.40 in 2018; underweight RIIs: 0.53 in 2001, 0.35 in 2018; underweight SIIs: -0.21 in 2001, -0.28 in 2018). Urban areas experienced greater inequality than rural areas (stunting in urban RIIs: 0.41 in 2001, 0.33 in 2010, 0.25 in 2018).
Despite progress in reducing malnutrition, persistent socioeconomic disparities, particularly in urban areas, remain a serious public health concern in the DRC. Addressing the root causes of malnutrition and ensuring socioeconomically equitable access to nutrition is critical to promote the full potential of children.
刚果民主共和国(DRC)的营养不良状况在过去20年中有所下降。然而,营养不良不平等现象依然存在。评估刚果民主共和国5岁以下儿童营养不良的社会经济差异趋势有助于确定有意义的干预措施。
多指标类集调查(2001年、2010年、2018年)的数据评估了5岁以下儿童的体重不足、发育迟缓及消瘦患病率。不平等斜率指数(SII)和不平等相对指数(RII)衡量了社会经济不平等状况。我们评估了整个国家样本以及根据居住地和财富指数五分位数分层的子样本中的趋势。最终样本包括42976名儿童。
农村和城市地区体重不足和消瘦的全国患病率分别从31%降至26%以及从13%降至6%。然而,两个地区发育迟缓患病率的趋势有所不同。低收入和高收入家庭之间的营养差距扩大(发育迟缓RII:2001年为0.61,2018年为0.37;发育迟缓SII:2001年为-0.20,2018年为-0.40;体重不足RII:2001年为0.53,2018年为0.35;体重不足SII:2001年为-0.21,2018年为-0.28)。城市地区的不平等现象比农村地区更为严重(城市发育迟缓RII:2001年为0.41,2010年为0.33,2018年为0.25)。
尽管在减少营养不良方面取得了进展,但持续存在的社会经济差异,特别是在城市地区,仍然是刚果民主共和国严重的公共卫生问题。解决营养不良的根本原因并确保在社会经济方面平等获得营养对于发挥儿童的全部潜力至关重要。