Rima Fahmida Sultana, Kundu Satyajit, Tarannum Sumaiya, Jannatul Tabita, Sharif Azaz Bin
Department of Public Health, North South University, Dhaka, Bangladesh.
Public Health, School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, 4222, Australia.
Sci Rep. 2025 May 23;15(1):17881. doi: 10.1038/s41598-025-92068-8.
Consuming foods high in vitamin A and iron is crucial for children's growth and well-being. However, deficiencies remain a public health problem in Bangladesh. This study explores spatial variation and determinants of vitamin A and iron-rich food consumption among children aged 6-23 months. In this study, data from 2528 children from the Bangladesh Demographic and Health Survey (BDHS) 2022 was used. BDHS 2022 employed a cross-sectional study design to collect data. The outcomes measured were vitamin A and iron-rich foods consumption within 24 h preceding the survey by including factors such as mother's age, education, occupation, child age, sex, Antenatal care (ANC) visits, medical illness (diarrhea, fever, cough), use of deworming drugs, wealth index, place of residence, division etc. Spatial patterns were analyzed with ArcGIS version 10.8 and associated factors were assessed using multilevel mixed effect logistic regression model. The prevalence of vitamin A and iron-rich foods consumption was 72% (95% CI 0.70-0.74) and 61.8% (95% CI 0.60-0.64) respectively. Clustering of vitamin A (Moran's I: 0.055, p < 0.001) and iron-rich food (I: 0.101, p < 0.001) consumption was observed, with hot spots in Rangpur, Rajshahi, and Khulna. From the mixed effects logistic regression analysis, maternal employment (aOR = 1.6; 95% CI 1.2-2.0), maternal education (aOR = 2.0; 95% CI 1.1-3.5), paternal education (aOR = 2.0; 95% CI 1.4-3.0), ≥ 4 ANC visits (aOR = 1.7; 95% CI 1.1-2.6), older children aged 18-23 months (aOR = 4.0; 95% CI 3.0-5.3), deworming drugs (aOR = 1.6; 95% CI 1.2-2.2) and residing in Khulna (aOR = 2.3; 95% CI 1.5-3.5), Rajshahi (aOR = 1.9; 95% CI 1.2-2.9) have shown statistically significant association with increased consumption of vitamin A and iron-rich foods. Furthermore, a lower likelihood of iron-rich food consumption was observed among children having diarrhea (aOR = 0.7; 95% CI 0.5-0.9), compared to children who didn't have diarrhea. Poor consumption of vitamin A-rich foods was found in Chittagong (aOR = 0.6; 95% CI 0.4-0.98) and Sylhet (aOR = 0.6; 95% CI 0.4-0.9). The findings revealed significant disparities both in regions and protective factors associated with vitamin A and iron-rich food intake among children in Bangladesh. Understanding these spatial variations and key determinants can guide targeted interventions, particularly in cold spot regions, to improve child nutrition in Bangladesh.
食用富含维生素A和铁的食物对儿童的生长和健康至关重要。然而，在孟加拉国，这些营养素缺乏仍然是一个公共卫生问题。本研究探讨了6至23个月大儿童中维生素A和富含铁的食物消费的空间差异及其决定因素。在本研究中，使用了来自2022年孟加拉国人口与健康调查（BDHS）的2528名儿童的数据。2022年BDHS采用横断面研究设计来收集数据。所测量的结果是在调查前24小时内维生素A和富含铁的食物的消费量，纳入的因素包括母亲的年龄、教育程度、职业、孩子的年龄、性别、产前检查（ANC）次数、疾病（腹泻、发烧、咳嗽）、驱虫药的使用、财富指数、居住地点、行政区等。使用ArcGIS 10.8版本分析空间模式，并使用多水平混合效应逻辑回归模型评估相关因素。维生素A和富含铁的食物的消费 prevalence分别为72%（95%CI 0.70 - 0.74）和61.8%（95%CI 0.60 - 0.64）。观察到维生素A（莫兰指数I：0.055，p < 0.001）和富含铁的食物（I：0.101，p < 0.001）消费存在聚集现象，朗布尔、拉杰沙希和库尔纳出现了热点地区。从混合效应逻辑回归分析来看，母亲就业（调整后比值比aOR = 1.6；95%CI 1.2 - 2.0）、母亲教育程度（aOR = 2.0；95%CI 1.1 - 3.5）、父亲教育程度（aOR = 2.0；95%CI 1.4 - 3.0）、≥4次产前检查（aOR = 1.7；95%CI 1.1 - 2.6）、18至23个月大的较大儿童（aOR = 4.0；95%CI 3.0 - 5.3）、驱虫药（aOR = 1.6；95%CI 1.2 - 2.2）以及居住在库尔纳（aOR = 2.3；95%CI 1.5 - 3.5）、拉杰沙希（aOR = 1.9；95%CI 1.2 - 2.9）与维生素A和富含铁的食物消费量增加具有统计学上的显著关联。此外，与没有腹泻的儿童相比，腹泻儿童食用富含铁的食物的可能性较低（aOR = 0.7；95%CI 0.5 - 0.9）。在吉大港（aOR = 0.6；95%CI 0.4 - 0.98）和锡尔赫特（aOR = 0.6；95%CI 0.4 - 0.9）发现维生素A丰富食物的消费量较低。研究结果揭示了孟加拉国儿童在维生素A和富含铁的食物摄入方面，地区差异以及相关保护因素都很显著。了解这些空间差异和关键决定因素可以指导有针对性的干预措施，特别是在冷点地区，以改善孟加拉国儿童的营养状况。
