Dow University of Health Sciences, Karachi, Pakistan.
Ziauddin University, Karachi, Pakistan.
BMC Public Health. 2024 Mar 19;24(1):848. doi: 10.1186/s12889-024-18359-3.
Multidimensional factors such as socioeconomic or environmental factors influence malnutrition. Several studies have strongly linked malnutrition to poverty. Some international studies point to the worse nutritional status of urban slum children than rural children. Limited data is available regarding the nutritional status of slum children in Karachi. This study aimed to determine characteristics of malnourished children in an urban squatter settlement in Karachi, Pakistan.
A case- control study was carried out at the primary healthcare center of a squatter settlement in Karachi, Pakistan. All children under five years of age visiting the primary healthcare center were recruited consecutively. Cases were defined as children with z scores < -2 SD of WHO reference measurements of WFA, HFA, WFH and OFC. The controls were similar in terms of age group but had z scores between - 2SD and + 2SD. A self- structured risk factor questionnaire that included information about sociodemographic, economic and environmental factors as well as child- related characteristics was researcher administered via face-to-face interviews with the mothers of children. Univariate and multivariate logistic regression analyses were conducted. Crude and adjusted odds ratios were calculated with 95% confidence interval.
A total of 280 participants including 140 cases and 140 controls participated in the study. A larger proportion of the sample originated from individuals with low household income. After adjusting for the confounders, childhood malnutrition was significantly associated with a low education level of father (aOR 4.86, 95% CI 2.23-10.60), a monthly income less than 25,000 PKR (89 USD) per month (aOR 7.13, 95% CI 1.67-30.54), pour pit latrine type of toilet (aOR 4.41, 95% CI 2.67-7.3), less than six months of exclusive breast feeding (aOR 3.578, CI 1.58-8.08), inappropriate weaning age (aOR 3.71, 95% CI 1.53-9).
Malnutrition in children under five years of age in the community is associated with low family income, low paternal education, poor toilet facilities, lack of exclusive breastfeeding and inappropriate weaning age. The implementation of poverty reduction programs, sanitation provision at affordable rates, community-based breast feeding and weaning education intervention are urgently required to efficiently improve children's nutritional status.
社会经济或环境等多维因素会影响营养不良。多项研究表明营养不良与贫困密切相关。一些国际研究表明，城市贫民窟儿童的营养状况比农村儿童更差。目前有关卡拉奇贫民窟儿童营养状况的数据有限。本研究旨在确定巴基斯坦卡拉奇一个城市棚户区中营养不良儿童的特征。
在巴基斯坦卡拉奇一个棚户区的基层医疗中心进行了病例对照研究。连续招募所有 5 岁以下的儿童。病例定义为 WHO 参考身高别体重（WFA）、身高别年龄（HFA）、体重别身高（WFH）和头围（OFC）的 z 分数<-2SD 的儿童。对照组在年龄组方面相似，但 z 分数在-2SD 和+2SD 之间。研究人员通过面对面访谈，使用母亲提供的自我结构化风险因素问卷收集有关社会人口、经济和环境因素以及儿童相关特征的信息。采用单变量和多变量逻辑回归分析。计算了粗比值比（OR）和调整比值比（aOR），置信区间为 95%。
共有 280 名参与者，包括 140 名病例和 140 名对照。样本中较大比例的个体来自收入较低的家庭。在调整混杂因素后，儿童营养不良与父亲受教育程度低（aOR 4.86，95%CI 2.23-10.60）、月收入低于 25000 巴基斯坦卢比（89 美元）（aOR 7.13，95%CI 1.67-30.54）、使用露天坑式厕所（aOR 4.41，95%CI 2.67-7.3）、6 个月以下纯母乳喂养（aOR 3.578，CI 1.58-8.08）和不适当的断奶年龄（aOR 3.71，95%CI 1.53-9.00）显著相关。
社区中 5 岁以下儿童的营养不良与家庭收入低、父亲受教育程度低、卫生设施差、缺乏纯母乳喂养和不适当的断奶年龄有关。迫切需要实施减贫计划、以负担得起的价格提供卫生设施、开展以社区为基础的母乳喂养和断奶教育干预，以有效改善儿童的营养状况。
