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秘鲁6至59个月儿童贫血与发育迟缓的并发情况及相关因素

Concurrence of anemia and stunting and associated factors among children aged 6 to 59 months in Peru.

作者信息

Rivera Alessandra, Marín Víctor, Romaní Franco

机构信息

Faculty of Human Medicine, Universidad de Piura, Lima, Peru.

出版信息

PLOS Glob Public Health. 2024 Apr 2;4(4):e0002914. doi: 10.1371/journal.pgph.0002914. eCollection 2024.

Abstract

Anemia and stunting are two health problems in the child population; therefore, their concurrence needs to be quantified. We estimated the prevalence of concurrent anemia and stunting (CAS) in children aged 6-59 months and identified the factors associated with this condition. The data came from the Demographic and Health Survey of Peru (DHS), 2022. The study design was cross-sectional and included 19,191 children. Height and hemoglobin measurement followed the specifications of National Health Institute of Peru. To reduce error in measures, the anthropometry personnel was training, the quality of measuring equipment was ensuring, and protocolized techniques and procedures was applying. Hemoglobin concentration was measured in capillary blood using the Hemocue model Hb 201+. Stunting was defined as a height-for-age Z-score less than minus two standard deviations (SD) from the median, following the 2006 WHO child growth standard. Anemia was classified into mild (10.0 to 10.9 g/dL), moderate (7.0 to 9.9 g/dL), severe (< 7.0 g/dL), and no anemia (11.0 to 14.0 g/dL). We performed a bivariate analysis to evaluate factors associated with CAS. To include variables in the multivariate analysis, we applied a statistical criterion (p < 0.10 in the crude analysis) and an epidemiological criterion. We used a binary logistic hierarchical regression model. The prevalence of CAS was 5.6% (95%CI: 5.2 to 5.9). The modifiable factors associated with higher odds of CAS were: "poorest" (aOR: 3.87, 95%CI: 1.99 to 7.5) and "poorer" (aOR: 2.07, 95%CI: 1.08 to 3.98) wealth quintiles, mother with no formal education or primary (aOR: 2.03, 95%CI: 1.46 to 2. 81), father with no formal education or primary (aOR: 1.55, 95%CI: 1.16 to 2.07), no improved water source (aOR: 1.36, 95%CI: 1.10 to 1.68), no roof with improved material (aOR: 1.49, 95%CI: 1.12 to 1.98) and low birth weight (aOR: 7.31, 95%CI: 4.26 to 12.54). In Peru, five out of every 100 children suffer from anemia and stunting simultaneously; there are modifiable factors that, if addressed, could reduce their prevalence.

摘要

贫血和发育迟缓是儿童群体中存在的两个健康问题;因此,需要对二者并发情况进行量化。我们估算了6至59月龄儿童中贫血与发育迟缓并发(CAS)的患病率,并确定了与该情况相关的因素。数据来自2022年秘鲁人口与健康调查(DHS)。研究设计为横断面研究,纳入了19191名儿童。身高和血红蛋白测量遵循秘鲁国家卫生研究所的规范。为减少测量误差,对人体测量人员进行了培训,确保了测量设备的质量,并采用了标准化的技术和程序。使用Hemocue Hb 201+型号设备测量毛细血管血中的血红蛋白浓度。根据2006年世界卫生组织儿童生长标准,发育迟缓定义为年龄别身高Z评分低于中位数减两个标准差(SD)。贫血分为轻度(10.0至10.9 g/dL)、中度(7.0至9.9 g/dL)、重度(<7.0 g/dL)和无贫血(11.0至14.0 g/dL)。我们进行了双变量分析以评估与CAS相关的因素。为将变量纳入多变量分析,我们应用了一个统计标准(粗分析中p<0.10)和一个流行病学标准。我们使用了二元逻辑分层回归模型。CAS的患病率为5.6%(95%CI:5.2至5.9)。与CAS较高几率相关的可改变因素包括:“最贫困”(调整后比值比:3.87,95%CI:1.99至7.5)和“较贫困”(调整后比值比:2.07,95%CI:1.08至3.98)财富五分位数、未接受过正规教育或仅接受过小学教育的母亲(调整后比值比:2.03,95%CI:1.46至2.81)、未接受过正规教育或仅接受过小学教育的父亲(调整后比值比:1.55,95%CI:1.16至2.07)、无改善水源(调整后比值比:1.36,95%CI:1.10至1.68)、无改良材料屋顶(调整后比值比:1.49,95%CI:1.12至1.98)以及低出生体重(调整后比值比:7.31,95%CI:4.26至12.54)。在秘鲁,每100名儿童中有5名同时患有贫血和发育迟缓;存在一些可改变因素,若加以解决,可降低其患病率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ede/10986945/28d712175f3d/pgph.0002914.g001.jpg

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