Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
Department of Emergency and Critical Care Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
PLoS One. 2023 Nov 29;18(11):e0294689. doi: 10.1371/journal.pone.0294689. eCollection 2023.
Stunting is a major public health concern, particularly in low and middle-income countries. Globally, nearly 149 million under-five children are suffering from stunting. Despite it can occur in all age groups, the impact is more severe among children age less than 24 months as this period is critical time of very rapid growth and development. Therefore, this review aimed to determine the pooled prevalence and determinants of stunting among children during this critical period in Ethiopia.
The literature search was conducted using international electronic data bases (pumed, Google scholar, CINHAL, Hinari, open Google) and the hand search of reference lists of eligible articles. The presence of heterogeneity between studies was evaluated using Cochrane Q-test and I2 test statistics and sensitivity analysis was also checked. Small study effect was checked through graphical and statistical test. Sub-group analysis was performed to handle heterogeneity.
This study included 14 studies with a total sample size of 8,056 children. The overall pooled estimate of stunting was 35.01(95% CI: 24.73-45.28, I2 = 98.98%) in the country with the highest prevalence in Amhara region. Increased Child's age (OR = 3.83; 95% CI: 2.47-5.18, I2 = 97.76%), no maternal education (OR = 2.90; 95%CI: 1.59-4.20, I2 = 89.73%), no maternal postnatal follow up (OR = 1.81; 95% CI:1.51-2.10) less than four food diversity of the child (OR = 2.24;95%CI; 1.94-2.55,I2 = 21.55%), low maternal body mass index, failure to colostrum and exclusive breast feeding, two and more under five children in the household and poor wealth index of the family were significant factors of stunting.
The pooled prevalence of stunting among children during their critical time is high. Increased Child's age, no maternal education and no maternal postnatal follow up, less than four food diversity of the child, low maternal body mass index, failure to colostrum and exclusive breast feeding, two and more under five children in the household and poor wealth index of the family were determinants of stunting. Therefore, providing continuous maternal postnatal follow up, increase awareness of mothers on importance of colostrum and exclusive breast feeding, feeding of children the recommended variety of foods and at large to improve the wealth status of the households are crucial interventions to meet national and international targets of zero stunting in children less than 2 years.
发育迟缓是一个主要的公共卫生问题，特别是在中低收入国家。全球有近 1.49 亿五岁以下儿童发育迟缓。尽管它可能发生在所有年龄组，但在 24 个月以下的儿童中，影响更为严重，因为这个时期是生长和发育非常迅速的关键时期。因此，本综述旨在确定埃塞俄比亚这一关键时期儿童发育迟缓的综合患病率和决定因素。
使用国际电子数据库（pumed、Google Scholar、CINHAL、Hinari、open Google）和合格文章参考文献列表的手工搜索进行文献检索。使用 Cochrane Q 检验和 I2 检验统计量评估研究之间的异质性，并进行敏感性分析。通过图形和统计检验检查小研究效应。进行亚组分析以处理异质性。
本研究共纳入 14 项研究，总样本量为 8056 名儿童。该国最高流行地区是阿姆哈拉地区，发育迟缓的总患病率为 35.01%（95%CI：24.73-45.28，I2 = 98.98%）。儿童年龄增加（OR = 3.83；95%CI：2.47-5.18，I2 = 97.76%）、母亲未接受教育（OR = 2.90；95%CI：1.59-4.20，I2 = 89.73%）、母亲产后随访不足（OR = 1.81；95%CI：1.51-2.10）、儿童食物多样性不足 4 种（OR = 2.24；95%CI：1.94-2.55，I2 = 21.55%）、母亲体重指数低、初乳和纯母乳喂养失败、家庭中两个或两个以上五岁以下儿童以及家庭贫困指数低是发育迟缓的显著因素。
在儿童关键时期，发育迟缓的综合患病率较高。儿童年龄增加、母亲未接受教育和产后随访不足、儿童食物多样性不足 4 种、母亲体重指数低、初乳和纯母乳喂养失败、家庭中两个或两个以上五岁以下儿童以及家庭贫困指数低是发育迟缓的决定因素。因此，提供持续的母亲产后随访、提高母亲对初乳和纯母乳喂养重要性的认识、为儿童提供推荐的多种食物，并在更大程度上改善家庭的财富状况，是实现国家和国际零 2 岁以下儿童发育迟缓目标的关键干预措施。
