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孟加拉国西南沿海地区5岁以下儿童的营养不良状况及其决定因素:一项基于社区的研究。

Malnutrition among under-5 children and its determinants in the southwestern coastal region of Bangladesh: A community-based study.

作者信息

Akter Shahinur, Nishu Nishana Afrin

机构信息

Sociology Discipline, Social Science School, Khulna University, Khulna, Bangladesh

Sociology Discipline, Social Science School, Khulna University, Khulna, Bangladesh.

出版信息

BMJ Open. 2025 Jan 14;15(1):e090174. doi: 10.1136/bmjopen-2024-090174.

Abstract

OBJECTIVE

The study examines the prevalence of stunting, the most common form of malnutrition and its determinants among children under-5 in the southwestern coastal region of Bangladesh.

DESIGN

Cross-sectional survey.

SETTINGS

Two coastal villages of the Bagerhat and Khulna districts of Bangladesh.

PARTICIPANTS

Participants were selected using the simple random sampling technique with the following criteria: mothers who had at least one under-5 child and resided in the study area for not less than three consecutive years.

OUTCOME MEASURES

To assess the nutritional status particularly, stunting (height for age) in children under-5, a standardised anthropometric measurement tool, such as a height-measuring vertical scale, was used and categorised into severely stunted, moderately stunted and normal height.

RESULTS

The study found that 57.5% of children were severely and 29% were moderately stunted. Findings revealed that mothers' age, prior experience of under-5 mortality, mothers' working status and age of the children were significant determinants of stunting prevalence among children under-5. Moreover, children of mothers aged 21-30 years (AOR = 2.190; 95% CI: 1.039 to 4.613; = 0.039) and children of mothers without prior experience of under-5 mortality (AOR = 4.426; 95% CI: 1.461 to 13.405; = 0.009) were more possibly to be severely and moderately stunted, respectively. Additionally, children of non-working mothers were more likely to be moderately (AOR = 4.037; 95% CI: 1.382 to 11.792; = 0.011) and severely stunted (AOR = 2.538; 95% CI: 1.033 to 6.238; = 0.042). Moreover, children aged ≤24 months (AOR = 0.151; 95% CI: 0.034 to 0.661; = 0.012) and 25-36 months (AOR = 0.195; 95% CI: 0.046 to 0.829; = 0.027) were less possibly to be moderately stunted.

CONCLUSION

The study recommends training young mothers on effective child-rearing practices, creating income opportunities for women in rural Bangladesh, implementing local awareness programmes about appropriate growth standards for children and expanding facility-based healthcare centres in rural areas for better access to quality healthcare.

摘要

目的

本研究调查了孟加拉国西南沿海地区5岁以下儿童中发育迟缓(最常见的营养不良形式)的患病率及其决定因素。

设计

横断面调查。

地点

孟加拉国巴盖尔哈德和库尔纳地区的两个沿海村庄。

参与者

采用简单随机抽样技术,按以下标准选取参与者:至少有一名5岁以下儿童且在研究地区连续居住不少于三年的母亲。

观察指标

为评估5岁以下儿童的营养状况,尤其是发育迟缓(年龄别身高)情况,使用了标准化人体测量工具,如身高测量垂直尺,并将其分为严重发育迟缓、中度发育迟缓及身高正常。

结果

研究发现,57.5%的儿童严重发育迟缓,29%的儿童中度发育迟缓。研究结果显示,母亲年龄、5岁以下儿童既往死亡经历、母亲工作状况及儿童年龄是5岁以下儿童发育迟缓患病率的重要决定因素。此外,21至30岁母亲的孩子(比值比=2.190;95%置信区间:1.039至4.613;P=0.039)和母亲无5岁以下儿童既往死亡经历的孩子(比值比=4.426;95%置信区间:1.461至13.405;P=0.009)分别更有可能严重发育迟缓和中度发育迟缓。此外,母亲不工作的孩子更有可能中度发育迟缓(比值比=4.037;95%置信区间:1.382至11.792;P=0.011)和严重发育迟缓(比值比=2.538;95%置信区间:1.033至6.238;P=0.042)。此外,年龄≤24个月(比值比=0.151;95%置信区间:0.034至0.661;P=0.012)和25至36个月(比值比=0.195;95%置信区间:0.046至0.829;P=0.027)的儿童中度发育迟缓的可能性较小。

结论

本研究建议对年轻母亲进行有效育儿实践培训,为孟加拉国农村妇女创造收入机会,开展关于儿童适当生长标准的当地宣传项目,并在农村地区扩大基层医疗保健中心,以更好地获得优质医疗服务。

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