Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Public Health, Berlin, Germany.
Research Department 2, Potsdam Institute for Climate Impact Research (PIK), Member of the Leibniz Association, Potsdam, Germany.
Am J Trop Med Hyg. 2023 Aug 14;109(4):945-956. doi: 10.4269/ajtmh.23-0152. Print 2023 Oct 4.
Diarrhea and respiratory illness are leading causes of mortality and morbidity among young children. We assessed the impact of a homestead food production intervention on diarrhea and acute respiratory infection (ARI) in children in Bangladesh, secondary outcomes of the Food and Agricultural Approaches to Reducing Malnutrition (FAARM) cluster-randomized trial. The trial enrolled 2,705 married women and their children 3 years or younger in 96 rural settlements (geographic clusters) in Sylhet Division, Bangladesh. The intervention promoted home gardening and poultry rearing alongside child nutrition and health counseling over 3 years (2015-2018). An 8-month food hygiene behavior change component using emotional drivers was delivered beginning in mid-2017. Caregiver-reported diarrhea and symptoms of ARI in the week preceding the survey were recorded every 2 months. We analyzed 32,460 observations of 3,276 children over 4 years and found that 3.9% of children had diarrhea and 3.4% had an ARI in the prior 7 days. There was no overall effect of the intervention on 7-day diarrhea period prevalence (odds ratio [OR], 0.92; 95% CI, 0.71-1.19), diarrhea point prevalence (OR, 1.03; 95% CI, 0.78-1.36), or 7-day ARI period prevalence (OR, 1.18; 95% CI, 0.88-1.60). There was no impact on diarrhea severity or differences in health-seeking behaviors. Our findings suggest that this homestead food production program was insufficient to reduce morbidity symptoms among children in a rural setting. More comprehensive water, sanitation, and hygiene measures, and behavioral recommendations may be needed to achieve impacts on child health.
腹泻和呼吸道疾病是导致幼儿死亡和发病的主要原因。我们评估了家庭粮食生产干预对孟加拉国儿童腹泻和急性呼吸道感染（ARI）的影响，这是粮食和农业方法减少营养不良（FAARM）集群随机试验的次要结果。该试验在孟加拉国锡尔赫特县的 96 个农村定居点（地理集群）招募了 2705 名已婚妇女及其 3 岁或以下的儿童。该干预措施在 3 年内（2015-2018 年）同时促进家庭园艺和家禽养殖以及儿童营养和健康咨询。从 2017 年年中开始，采用情感驱动的 8 个月食品卫生行为改变措施。在调查前的每两个月记录一次看护人报告的腹泻和前一周 ARI 症状。我们分析了 4 年期间 32460 次对 3276 名儿童的观察结果，发现 3.9%的儿童在过去 7 天内有腹泻，3.4%的儿童有 ARI。该干预对 7 天腹泻期患病率（优势比 [OR]，0.92；95%CI，0.71-1.19）、腹泻点患病率（OR，1.03；95%CI，0.78-1.36）或 7 天 ARI 期患病率（OR，1.18；95%CI，0.88-1.60）没有总体影响。腹泻严重程度也没有影响，也没有差异寻求卫生保健行为。我们的研究结果表明，这种家庭粮食生产方案不足以减少农村地区儿童的发病症状。可能需要更全面的水、环境卫生和个人卫生措施以及行为建议，才能对儿童健康产生影响。
