Roba Aklilu Abrham, Başdaş Öznur
College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia.
Faculty of Health Sciences, Erciyes University, Kayseri, Türkiye.
Front Nutr. 2023 Sep 1;10:1073200. doi: 10.3389/fnut.2023.1073200. eCollection 2023.
Emerging evidence indicates that children can be concurrently wasted and stunted (WaSt), increasing their mortality risk. However, more is needed to know about WaSt in Ethiopia. Therefore, this study aimed to determine the trends and predictors of WaSt using Ethiopian Demographic and Health Survey datasets from 2000 and 2019.
The study included a total weighted sample of 34,930 children aged 6-59 months. Descriptive and weighted multilevel mixed-effects (fixed and random effects) logistic regression analyses were carried out. The Intraclass Correlation Coefficient (ICC) and the Median Odds Ratio (MOR) were calculated.
The prevalence of WaSt was 1,682 (4.82%) with a significantly decreasing trend, yielding a percent change of -57.51% (-69.37% to -23.52%) from 2000 to 2019. In the adjusted model, the odds of WaSt increased in boys, children with a shorter preceding birth interval, small birth size, delayed initiation of complementary foods, diarrhea, fever, and anemia, mother's lack of formal education, and being a farmer, and poor/middle wealth index, and lack of mass media exposure. WaSt was inversely related to the child's age. Adjusted ICC and MOR were 31.16% and 3.20%, respectively.
The study highlights the importance of considering individual and community-level factors to address WaSt, such as timely initiation of complementary foods, improving access to health services, quality diet, and prevention of communicable diseases. Furthermore, programs that have positive impacts on formal education and employment opportunities for girls, as well as that increase access to mass media, are required.
新出现的证据表明，儿童可能同时存在消瘦和发育迟缓（消瘦合并发育迟缓）的情况，这会增加他们的死亡风险。然而，对于埃塞俄比亚的消瘦合并发育迟缓情况，我们还需要了解更多。因此，本研究旨在利用2000年和2019年埃塞俄比亚人口与健康调查数据集来确定消瘦合并发育迟缓的趋势和预测因素。
该研究纳入了34930名年龄在6至59个月的儿童的总加权样本。进行了描述性和加权多级混合效应（固定效应和随机效应）逻辑回归分析。计算了组内相关系数（ICC）和中位数优势比（MOR）。
消瘦合并发育迟缓的患病率为1682例（4.82%），呈显著下降趋势，从2000年到2019年的百分比变化为-57.51%（-69.37%至-23.52%）。在调整后的模型中，消瘦合并发育迟缓的几率在男孩、前次生育间隔较短的儿童、出生体重小、辅食添加延迟、腹泻、发烧和贫血、母亲未接受正规教育、从事农民职业、财富指数低/中等以及缺乏大众媒体接触的儿童中增加。消瘦合并发育迟缓与儿童年龄呈负相关。调整后的ICC和MOR分别为31.16%和3.20%。
该研究强调了考虑个体和社区层面因素以解决消瘦合并发育迟缓问题的重要性，例如及时添加辅食、改善获得卫生服务的机会、优质饮食以及预防传染病。此外，还需要开展对女孩的正规教育和就业机会有积极影响以及增加大众媒体接触机会的项目。
