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在埃塞俄比亚,家庭层面母婴对子的营养不良双重负担及其相关因素:一个需要全部门合作的紧迫公共卫生问题。

The dual burden of malnutrition and its associated factors among mother-child pairs at the household level in Ethiopia: An urgent public health issue demanding sector-wide collaboration.

机构信息

Department of Public Health, College of Medicine & Health sciences, Dire Dawa University, Dire Dawa, Ethiopia.

Department of Nutrition & dietetics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.

出版信息

PLoS One. 2024 Nov 4;19(11):e0307175. doi: 10.1371/journal.pone.0307175. eCollection 2024.

Abstract

INTRODUCTION

The coexistence of under-nutrition and over-nutrition in developing countries like Ethiopia results in the "mother-child pair double burden of malnutrition," with children experiencing either stunting, wasting or underweight while mothers face overweight or obesity. This poses a major public health challenge, prompting global health organizations to prioritize the issue and urge governments to act quickly. Despite this, there is a lack of research in Ethiopia on the double burden of malnutrition among mother-child pairs at the household level and the factors that worsen it.

OBJECTIVE

To assess the magnitude of double burden of malnutrition and its associated factors among mother-child pair at household level in East Ethiopia, 2022.

METHOD

A community-based cross-sectional study was conducted in East Ethiopia from April 15 to June 11, 2022. Multi-stage sampling was used, and data were collected through structured interviews. Child nutrition indicators were processed using WHO Anthro software. Binary logistic regression analysis was performed, calculating both crude and adjusted odds ratios to assess associations. Variables with a P value <0.05 in multivariable analysis were deemed statistically significant.

RESULT

The study revealed that coexisting malnutrition rates for (OM/SC), (OM/WC), and (OM/UC) were 8.5%, 7.0%, and 7.9% respectively. The double burden of malnutrition among mother-child pairs was found to be 12.3% [95% CI: 10.7, 13.7]. Marital status (divorced) [AOR = 1.80; 95% CI: 1.15, 2.82], child birth order (fourth or above) [AOD = 1.88; 95% CI:1.08, 3.26], number of under-five children in the household (five or more under-five children) [AOR = 1.58; 95% CI: 1.04, 2.39], poor maternal and child dietary diversity score [AOR = 2.76; 95% CI: 1.71, 4.45] and [AOR = 8.66; 95% CI: 4.85, 15.44], respectively, household food security status (food insecurity) [AOR = 3.68; 95% CI: 2.36, 5.75], and maternal stature (short stature) [AOR = 2.39; 95% CI: 1.65,3.45] were factors significantly associated with this burden.

CONCLUSION

The study emphasized the double burden of malnutrition affecting both mothers and children, a major public health concern in the area. Early-life nutrition is vital in preventing childhood under nutrition and adult obesity, leading to this dual burden. Breaking the cycle of malnutrition across generations is crucial. Policy makers should prioritize improving child nutrition and maternal health, stressing early-life nutrition to address the mother-child double burden of malnutrition.

摘要

简介

在埃塞俄比亚等发展中国家,营养不良和营养过剩同时存在,导致“母子营养双重负担”,儿童出现发育迟缓、消瘦或体重不足,而母亲则面临超重或肥胖问题。这构成了一个主要的公共卫生挑战,促使全球卫生组织优先关注该问题,并敦促各国政府迅速采取行动。尽管如此,埃塞俄比亚在家庭层面上对母子营养双重负担及其恶化因素的研究仍然不足。

目的

评估东埃塞俄比亚母子营养双重负担的程度及其相关因素,2022 年。

方法

2022 年 4 月 15 日至 6 月 11 日,在东埃塞俄比亚进行了一项基于社区的横断面研究。采用多阶段抽样,通过结构化访谈收集数据。儿童营养指标使用世卫组织 Anthro 软件进行处理。采用二元逻辑回归分析,计算粗比值比和调整比值比来评估关联。多变量分析中 P 值<0.05 的变量被认为具有统计学意义。

结果

研究显示,(OM/SC)、(OM/WC)和(OM/UC)共存的营养不良率分别为 8.5%、7.0%和 7.9%。发现母子营养双重负担率为 12.3%[95%CI:10.7,13.7]。婚姻状况(离婚)[AOR=1.80;95%CI:1.15,2.82]、儿童出生顺序(第四或更高)[AOD=1.88;95%CI:1.08,3.26]、家庭中 5 岁以下儿童人数(5 名或更多 5 岁以下儿童)[AOR=1.58;95%CI:1.04,2.39]、母婴饮食多样性评分较差[AOR=2.76;95%CI:1.71,4.45]和[AOR=8.66;95%CI:4.85,15.44]、家庭粮食安全状况(粮食不安全)[AOR=3.68;95%CI:2.36,5.75]和母亲身高(矮小)[AOR=2.39;95%CI:1.65,3.45]与这种负担显著相关。

结论

研究强调了影响母亲和儿童的营养双重负担是该地区一个主要的公共卫生问题。生命早期的营养对预防儿童营养不足和成人肥胖至关重要,导致了这种双重负担。打破代际间的营养不良循环至关重要。政策制定者应优先改善儿童营养和母婴健康,强调生命早期营养,以解决母子营养双重负担问题。

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