Alam Md Badsha, Khanam Shimlin Jahan, Rana Md Shohel, Khandaker Gulam, Kabir Md Awal, Khan Md Nuruzzaman
Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Trishal, Mymensingh, Bangladesh.
Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Australia.
Lancet Reg Health Southeast Asia. 2024 Apr 8;25:100401. doi: 10.1016/j.lansea.2024.100401. eCollection 2024 Jun.
Children with disabilities face an increased risk of adverse health outcomes and poor anthropometric deficits, although the focus on them is limited in the South Asian context thus far and need newer and more evidence. This study investigates the effects of disability on adverse health outcomes and anthropometric deficits among 2-4 years aged children in South Asian countries.
We analyzed data from 93,180 children aged 2-4 years across Bangladesh, Nepal, Pakistan, and Afghanistan using Multiple Indicator Cluster Surveys (2017-2023). Disability status was the primary exposure, and outcomes included adverse health outcome (acute respiratory infection, diarrhea, fever), anthropometric deficit (stunting, wasting, underweight), and healthcare service sources during adverse health events (care received from skilled healthcare personnel, care received from non-professional personnel, and care received from health facility workers other than skilled healthcare personnel). Using multilevel and multinomial logistic regression models, we examined associations between exposure and outcome variables, adjusting for covariates.
We found average disability prevalence in South Asia was 8.7% (8.3-9.0; n = 8072), varying from 3.4% (3.0-3.8; n = 446) in Bangladesh to 12.3% (11.4-13.3; n = 1259) in Afghanistan. Common health issues included fever (n = 24,982, 26.8%, 26.2-27.4) and diarrhea (n = 14,081, 15.1%, 14.7-15.6), while prevalent poor anthropometric deficits were stunting (n = 39,766, 42.7%, 42.0-43.3) and underweight (n = 22,390, 24.0%, 23.5-24.5). Children with disability had 1.30 (95% CI: 1.21-1.40) to 1.60 (95% CI: 1.47-1.75) times and 1.17 (95% CI: 1.05-1.29) to 1.39 (95% CI: 1.30-1.48) times higher likelihoods of adverse health outcomes and anthropometric deficits, respectively, with variations observed among countries and different disability types. Individuals with disability were 1.16 (95% CI: 1.00-1.35) to 1.26 (95% CI: 1.01-1.58) times more likely to receive healthcare services from skilled healthcare personnel compared to health facility workers other than skilled healthcare personnel.
This study findings emphasizes the need for community-level awareness programs to improve anthropometric well-being and healthcare of the children with disability.
This research did not receive any specific funds.
残疾儿童面临着更严重的健康不良后果风险以及较差的人体测量指标缺陷，尽管迄今为止在南亚背景下对他们的关注有限，且需要更新的、更多的证据。本研究调查了残疾对南亚国家2至4岁儿童健康不良后果和人体测量指标缺陷的影响。
我们使用多指标类集调查（2017 - 2023年）分析了孟加拉国、尼泊尔、巴基斯坦和阿富汗93180名2至4岁儿童的数据。残疾状况是主要暴露因素，结果包括健康不良后果（急性呼吸道感染、腹泻、发热）、人体测量指标缺陷（发育迟缓、消瘦、体重不足）以及健康不良事件期间的医疗服务来源（接受熟练医护人员的护理、接受非专业人员的护理以及接受除熟练医护人员外的医疗机构工作人员的护理）。我们使用多层和多项逻辑回归模型，在调整协变量的情况下，研究暴露因素与结果变量之间的关联。
我们发现南亚地区残疾的平均患病率为8.7%（8.3 - 9.0；n = 8072），从孟加拉国的3.4%（3.0 - 3.8；n = 446）到阿富汗的12.3%（11.4 - 13.3；n = 1259）不等。常见的健康问题包括发热（n = 24982，26.8%，26.2 - 27.4）和腹泻（n = 14081，15.1%，14.7 - 15.6），而普遍存在的人体测量指标缺陷是发育迟缓（n = 39766，42.7%，42.0 - 43.3）和体重不足（n = 22390，24.0%，23.5 - 24.5）。残疾儿童出现健康不良后果和人体测量指标缺陷的可能性分别高出1.30倍（95%置信区间：1.21 - 1.40）至1.60倍（95%置信区间：1.47 - 1.75）和1.17倍（95%置信区间：1.05 - 1.29）至1.39倍（95%置信区间：1.30 - 1.48），不同国家和不同残疾类型之间存在差异。与除熟练医护人员外的医疗机构工作人员相比，残疾个体从熟练医护人员处获得医疗服务的可能性高出1.16倍（95%置信区间：1.00 - 1.35）至1.26倍（95%置信区间：1.01 - 1.58）。
本研究结果强调需要开展社区层面的宣传项目，以改善残疾儿童的人体测量指标状况和医疗保健。
本研究未获得任何专项资金。
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