Sahiledengle Biniyam, Mwanri Lillian
Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia.
Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide Campus, SA 5000, Adelaide, Australia.
PLOS Glob Public Health. 2024 Jun 4;4(6):e0003305. doi: 10.1371/journal.pgph.0003305. eCollection 2024.
Undernutrition significantly contributes to failure to thrive in children under five, with those experiencing multiple forms of malnutrition facing the highest risks of morbidity and mortality. Conventional markers such as stunting, wasting, and underweight have received much attention but are insufficient to identify multiple types of malnutrition, prompting the development of the Composite Index of Anthropometric Failure (CIAF) and the Composite Index of Severe Anthropometric Failure (CISAF) as an aggregate indicators. This study aimed to identify factors associated with CIAF and CISAF among Ethiopian children aged 0-59 months using data from the 2019 Ethiopia Mini Demographic and Health Survey. The study included a weighted sample of 5,259 children and used multilevel mixed-effects negative binomial regression modeling to identify determinants of CIAF and CISAF. The result showed higher incidence-rate ratio (IRR) of CIAF in male children (adjusted IRR = 1.27; 95% CI = 1.13-1.42), children aged 12-24 months (aIRR = 2.01, 95%CI: 1.63-2.48), and 24-59 months (aIRR = 2.36, 95%CI: 1.91-2.92), those from households with multiple under-five children (aIRR = 1.16, 95%CI: 1.01-1.33), poorer households (aIRR = 1.48; 95%CI: 1.02-2.15), and those who lived in houses with an earthen floor (aIRR = 1.37, 95%CI: 1.03-1.82). Similarly, the factors positively associated with CISAF among children aged 0-59 months were male children (aIRR = 1.47, 95% CI = 1.21-1.79), age group 6-11 months (aIRR = 2.30, 95%CI: 1.40-3.78), age group 12-24 months (aIRR = 3.76, 95%CI: 2.40-5.88), age group 25-59 months (aIRR = 4.23, 95%CI: 2.79-6.39), children from households living with two and more under-five children (aIRR = 1.27, 95%CI:1.01-1.59), and children from poorer households (aIRR = 1.93, 95% CI = 1.02-3.67). Children were more likely to suffer from multiple anthropometric failures if they were: aged 6-23 months, aged 24-59 months, male sex, living in households with multiple under-five children, and living in households with poor environments. These findings underscore the need to employ a wide range of strategies to effectively intervene in multiple anthropometric failures in under-five children.
营养不良是导致五岁以下儿童发育迟缓的重要因素，多种形式营养不良的儿童面临着最高的发病和死亡风险。传统指标如发育迟缓、消瘦和体重不足受到了广泛关注，但不足以识别多种类型的营养不良，因此促使人们开发了人体测量失败综合指数（CIAF）和严重人体测量失败综合指数（CISAF）作为综合指标。本研究旨在利用2019年埃塞俄比亚小型人口与健康调查的数据，确定埃塞俄比亚0至59个月儿童中与CIAF和CISAF相关的因素。该研究纳入了5259名儿童的加权样本，并使用多级混合效应负二项回归模型来确定CIAF和CISAF的决定因素。结果显示，男性儿童（调整后的发病率比值比[IRR]=1.27；95%置信区间[CI]=1.13-1.42）、12至24个月龄儿童（aIRR=2.01，95%CI：1.63-2.48）和24至59个月龄儿童（aIRR=2.36，95%CI：1.91-2.92）、来自有多个五岁以下儿童家庭的儿童（aIRR=1.16，95%CI：1.01-1.33）、贫困家庭儿童（aIRR=1.48；95%CI：1.02-2.15）以及居住在泥土地面房屋中的儿童（aIRR=1.37，95%CI：1.03-1.82）的CIAF发病率较高。同样，0至59个月儿童中与CISAF呈正相关的因素包括男性儿童（aIRR=1.47，95%CI=1.21-1.79）、6至11个月龄组（aIRR=2.30，95%CI：1.40-3.78）、12至24个月龄组（aIRR=3.76，95%CI：2.40-5.88）和25至59个月龄组（aIRR=4.23，95%CI：2.79-6.39）、来自有两个及以上五岁以下儿童家庭的儿童（aIRR=1.27，95%CI：1.01-1.59）以及来自贫困家庭的儿童（aIRR=1.93，95%CI=1.02-3.67）。如果儿童年龄在6至23个月、24至59个月、男性、生活在有多个五岁以下儿童的家庭以及生活在环境较差的家庭中，则更有可能遭受多种人体测量失败。这些发现强调了需要采用广泛的策略来有效干预五岁以下儿童的多种人体测量失败情况。
