Department of Environmental and Occupational Health, Indiana University-Bloomington School of Public Health, Bloomington, Indiana, USA.
Global Environmental Health Research Laboratory, Indiana University-Bloomington School of Public Health, Bloomington, Indiana, USA.
Matern Child Nutr. 2024 Oct;20(4):e13683. doi: 10.1111/mcn.13683. Epub 2024 Jun 14.
Household food and water insecurity has been previously associated with adverse health consequences in children. However, these relationships are understudied in middle-income Latin American populations such as in Ecuador, where a high prevalence of food and water insecurity has been reported. Using cross-sectional data from 2018 Ecuadorian National Health and Nutrition Survey, we examined the association of household food insecurity (HFI), household water insecurity (HWI), and concurrent HFI-HWI with diarrhoea, respiratory illness (RI), and stunting in 20,510 children aged ≤59 months. HFI was measured using the Food Insecurity Experience Scale. HWI was defined when households responded negatively to one or more of four drinking water indicators. Maternal caregivers reported on child diarrhoea and RI episodes during the previous 2 weeks. Measured length or height was used to assess stunting. We constructed log-binomial regression models to estimate the associations of HFI, HWI, and concurrent HFI-HWI with child outcomes. Moderate-severe HFI was associated with a higher prevalence of diarrhoea (PR = 1.39; 95% CI: 1.18, 1.63) and RI (PR = 1.34; 95% CI: 1.22, 1.47), HWI with a higher prevalence of RI (PR = 1.13; 95% CI: 1.04, 1.22), and concurrent HFI-HWI with a higher prevalence of diarrhoea (PR = 1.30; 95% CI: 1.05, 1.62) and RI (PR = 1.45; 95% CI: 1.29, 1.62). Stunting was not associated with HFI, HWI nor concurrent HFI-HWI. These findings suggest that HFI and HWI can independently and jointly act to negatively affect children's health. Policies and interventions aimed at alleviating both food and water insecurity are needed to bring sustained health improvements in Ecuadorian children.
家庭食物和水不安全先前与儿童不良健康后果相关。然而，这些关系在中低收入拉丁美洲人群中研究较少，例如在厄瓜多尔，那里报告了高比例的食物和水不安全。我们使用 2018 年厄瓜多尔国家健康和营养调查的横断面数据，研究了家庭食物不安全（HFI）、家庭水不安全（HWI）以及同时存在的 HFI-HWI 与 20510 名≤59 个月大的儿童腹泻、呼吸道疾病（RI）和发育迟缓的关系。HFI 使用食物不安全体验量表测量。当家庭对四个饮用水指标中的一个或多个指标回答否定时，定义 HWI。母亲照顾者报告了过去 2 周内儿童腹泻和 RI 发作的情况。测量的长度或高度用于评估发育迟缓。我们构建了对数二项式回归模型来估计 HFI、HWI 和同时存在的 HFI-HWI 与儿童结局的关联。中度严重的 HFI 与腹泻（PR=1.39；95%CI：1.18，1.63）和 RI（PR=1.34；95%CI：1.22，1.47）的患病率较高相关，HWI 与 RI 患病率较高相关（PR=1.13；95%CI：1.04，1.22），同时存在的 HFI-HWI 与腹泻（PR=1.30；95%CI：1.05，1.62）和 RI（PR=1.45；95%CI：1.29，1.62）的患病率较高相关。发育迟缓与 HFI、HWI 或同时存在的 HFI-HWI 均无关。这些发现表明，HFI 和 HWI 可以独立和共同作用，对儿童健康产生负面影响。需要制定旨在减轻食物和水不安全的政策和干预措施，以持续改善厄瓜多尔儿童的健康状况。
