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埃塞俄比亚农村6至23个月儿童发育迟缓与贫血的患病率及影响因素:一项多层次分析

Prevalence and determinants of stunting and anaemia in children aged 6-23 months: A multilevel analysis from rural Ethiopia.

作者信息

Guja Habtamu, Belgiu Mariana, Baye Kaleab, Stein Alfred

机构信息

Faculty of Geo-information Science and Earth Observation (ITC), University of Twente, Enschede, The Netherlands.

Center for Food Science and Nutrition, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia.

出版信息

Matern Child Nutr. 2025 Jan;21(1):e13736. doi: 10.1111/mcn.13736. Epub 2024 Oct 8.

Abstract

Low- and middle-income countries shoulder the greatest burden of stunting and anaemia in children. This calls for prompt and effective intervention measures, while the contributing factors are not fully understood. This study evaluates determinants spanning from individual-, household- and community levels including agroecology and antinutrients as unique sets of predictors. Primary data were collected from 660 rural households representing the midland (ML), highland, and upper highland (UHL) agroecological zones from northern Ethiopia. The study relates several predictors to stunting and anaemia in children aged 6-23 months. We found 49.1% and 49.7% of children were stunted and anaemic, respectively. Children living in the ML are approximately twice more likely to be stunted adjusted odds ratio (AOR: 1.869; 95% CI: 1.147-3.043) than in the UHL. The risk of stunting increases by 16.3% and 41.9% for every unit increase in phytate-to-zinc and phytate-to-iron molar ratios, respectively. A 10% increase in mean aggregated crop yield was observed to reduce the likelihood of stunting occurrence by 13.6%. Households lacking non-farm income-generating opportunities, travel longer time to access the marketplace and poor health service utilisation were associated with increased risk of stunting. Low diversity of child's diet, age of the child (18-23 months) and mothers at a younger age are significantly associated with stunting. Risk of anaemia in children is high amongst households with unimproved water, sanitation, and hygiene practices, younger age (6-11 months) and mostly occurs amongst boys. Children in the ML had a 55% reduced risk of being anaemic (AOR: 0.446; 95% CI: 0.273-0.728) as compared to the UHL. Therefore, the influence of these factors should be considered to tailor strategies for reducing undernutrition in children of 6-23 months in rural Ethiopia. Interventions should go beyond the administrative boundaries into targeting agroecological variation.

摘要

低收入和中等收入国家承担着儿童发育迟缓与贫血的最大负担。这就需要迅速采取有效干预措施,然而其影响因素尚未完全明晰。本研究评估了涵盖个体、家庭和社区层面的决定因素,包括农业生态和抗营养物质,将其作为独特的预测因素集。从代表埃塞俄比亚北部中部(ML)、高地和高海拔地区(UHL)农业生态区的660户农村家庭收集了原始数据。该研究将多个预测因素与6至23个月大儿童的发育迟缓和贫血情况相关联。我们发现分别有49.1%和49.7%的儿童发育迟缓和贫血。与高海拔地区相比,生活在中部地区的儿童发育迟缓的调整优势比(AOR:1.869;95%置信区间:1.147 - 3.043)高出约两倍。植酸与锌以及植酸与铁的摩尔比每增加一个单位,发育迟缓风险分别增加16.3%和41.9%。平均作物总产量每增加10%,发育迟缓发生的可能性降低13.6%。缺乏非农业创收机会、前往市场的时间较长以及卫生服务利用率低的家庭,发育迟缓风险增加。儿童饮食多样性低、儿童年龄(18 - 23个月)以及母亲年龄较小与发育迟缓显著相关。在水、环境卫生和个人卫生条件未改善的家庭中,儿童贫血风险较高,年龄较小(6 - 11个月),且大多发生在男孩中。与高海拔地区相比,中部地区的儿童贫血风险降低了55%(AOR:0.446;95%置信区间:0.273 - 0.728)。因此,应考虑这些因素的影响,为埃塞俄比亚农村6至23个月大儿童量身定制减少营养不良的策略。干预措施应超越行政边界,针对农业生态差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bb5/11650036/5daacc647005/MCN-21-e13736-g001.jpg

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