Sahiledengle Biniyam, Mwanri Lillian, Petrucka Pammla, Tadesse Hiwot, Agho Kingsley Emwinyore
Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia.
Research Centre for Public Health Research, Equity and Human Flourishing, Torrens University Australia, Adelaide Campus, Adelaide, South Australia.
PLOS Glob Public Health. 2024 Mar 7;4(3):e0002831. doi: 10.1371/journal.pgph.0002831. eCollection 2024.
Ethiopia is currently known to be the most food-insecure country in sub-Saharan Africa, where childhood undernutrition remains endemic. While attention is increasingly being paid to childhood undernutrition in Ethiopia, a current surge of "triple burden of malnutrition" (TBM) has received less attention. The purpose of this study was to determine the prevalence of TBM and identify the associated factors in Ethiopia. Data were from the Ethiopian Demographic and Health Surveys (2005-2016) and a total of 20,994 mother-child pairs were examined in this study. The TBM was our primary outcome variable, which encompasses three types of nutritional problems-when a mother may be overweight/obese, while her child is stunted, wasted, or underweight plus has anaemia under the same roof. A multilevel logistic regression explored the individual- and community-level factors associated with TBM. Our study indicated that children under-five years of age were anaemic, stunted, wasted, and underweight [49.3% (95% CI: 48.7-49.9), 43.1% (95% CI: 42.4-43.7), 10.3% (95% CI: 9.9-10.7), and 27.6% (95% CI: 27.0-28.1)] respectively. The overall prevalence of TBM was 2.6% (95% CI: 2.39-2.83). Multilevel analyses revealed that TBM was more likely to occur among children aged 12-23 months (AOR: 2.54, 95% CI: 1.68-3.83), 24-35 months (AOR: 1.54, 95% CI: 1.03-2.29), children perceived by their mothers to be smaller than normal at birth (AOR: 1.94, 95% CI: 1.48-2.56), who experienced fever in the past 2 weeks (AOR: 1.58, 95% CI: 1.24-2.01), and lived in urban settings (AOR: 1.79, 95% CI: 1.13-2.86). Lower odds of TBM were reported among female children (AOR: 0.59, 95% CI: 0.47-0.72), and those who lived in rich households (AOR: 0.69: 95% CI: 0.49-0.98). TBM was found to be present in almost three percent of households in Ethiopia. Addressing the TBM through double-duty actions will be of critical importance in achieving malnutrition in all its forms in Ethiopia.
目前，埃塞俄比亚被认为是撒哈拉以南非洲地区粮食最不安全的国家，儿童营养不良在该国仍然普遍存在。虽然埃塞俄比亚对儿童营养不良的关注度日益提高，但当前“营养不良三重负担”（TBM）的激增却较少受到关注。本研究的目的是确定埃塞俄比亚TBM的患病率，并找出相关因素。数据来自埃塞俄比亚人口与健康调查（2005 - 2016年），本研究共调查了20994对母婴。TBM是我们的主要结果变量，它包括三种营养问题——当一位母亲可能超重/肥胖时，她的孩子却发育迟缓、消瘦或体重不足，再加上同时患有贫血。多层次逻辑回归分析探讨了与TBM相关的个体和社区层面因素。我们的研究表明，五岁以下儿童贫血、发育迟缓、消瘦和体重不足的比例分别为[49.3%（95%置信区间：48.7 - 49.9）、43.1%（95%置信区间：42.4 - 43.7）、10.3%（95%置信区间：9.9 - 10.7）和27.6%（95%置信区间：27.0 - 28.1）]。TBM的总体患病率为2.6%（95%置信区间：2.39 - 2.83）。多层次分析显示，TBM更有可能发生在12 - 23个月大的儿童中（调整后比值比：2.54，95%置信区间：1.68 - 3.83）、24 - 35个月大的儿童中（调整后比值比：1.54，95%置信区间：1.03 - 2.29）、母亲认为出生时比正常孩子小的儿童中（调整后比值比：1.94，95%置信区间：1.48 - 2.56）、过去两周内发烧的儿童中（调整后比值比：1.58，95%置信区间：1.24 - 2.01）以及居住在城市地区的儿童中（调整后比值比：1.79，95%置信区间：1.13 - 2.86）。女童（调整后比值比：0.59，95%置信区间：0.47 - 0.72）以及生活在富裕家庭的儿童（调整后比值比：0.69：95%置信区间：0.49 - 0.98）中TBM发生的几率较低。在埃塞俄比亚，近3%的家庭存在TBM。通过双重行动应对TBM对于在埃塞俄比亚消除各种形式的营养不良至关重要。
