Leseba Nthatisi, Vermaak Kerry, Makatjane Tiisetso, Lebuso Mapitso
Department of Statistics and Demography, Faculty of Social Sciences, National University of Lesotho, Maseru, Lesotho.
Population Studies, School of Built Environment and Development Studies, University of KwaZulu-Natal, Durban, South Africa.
J Health Popul Nutr. 2025 May 24;44(1):168. doi: 10.1186/s41043-025-00901-7.
The United Nations Children's Fund (UNICEF) states that inadequate nutrition during the first 1,000 days of a child's life can contribute to stunted growth. Lesotho is currently experiencing a high prevalence of malnutrition across all age groups. Therefore, this study aims to investigate the prevalence and multilevel factors associated with stunting among children under five in Lesotho.
The study used the Lesotho Multiple Cluster Indicator Survey of 2018. The data was analysed using STATA version 14 software, and a multilevel logistic regression model was fitted. The Wald adjusted odds ratio (WAOR) with a P-value < 0.05 was also taken to indicate statistical significance.
The prevalence of stunting was 33.6% [95% CI 31.6 33.6] amongst the children under five years old in Lesotho. At an individual level, the odds of stunting are lower for the children that did not receive the minimum acceptable diet (MAD) (WAOR = 0.52; CI: 0.3, 0.9), the children born with greater than 3.8 kg birth weight (WAOR = 0.51; CI: 0.4, 0.6), and those that did not have respiratory infections (WAOR = 0.61; CI: 0.4, 1.0) compared to their counterparts. At the household level, the likelihood of stunting was the lowest for education beyond secondary (WAOR = 0.26; CI: 0.2, 0.4), the fifth household wealth (WAOR = 0.34; CI: 02, 03), the safe sources of drinking water (WAOR = 0.72; CI: 06, 09) and inadequate toilet facilities (WAOR = 0.62; CI: 0.5, 0.7) compared to their counterparts. Higher odds were observed amongst the children from rural areas (WAOR = 1.95; CI: 1.3, 2.1), and mothers not residing within the household (WAOR = 1.30; CI: 1.1, 1.6) compared to their counterparts. At the community level, decreased odds were associated with the children from the communities with high community maternal education (WAOR = 0.69; CI: 0.6, 0.8) and the community male education (WAOR = 0.56; CI: 0.5, 0.7), as well as those in the communities with low safety of drinking water sources (WAOR = 0.73; CI: 0.3, 0.5), adequate toilet facilities (WAOR = 0.66; CI: 0.5, 0.8) and high maternal media exposure (WAOR = 0.37; CI: 0.3, 0.5) compared counterparts. The children from communities with high community poverty were two times (WAOR = 2.04; CI: 1.7, 2.5) more likely to be stunted.
The findings suggest targeting community food availability and knowledge acquisition. Expanding information availability through mass media would improve the nutritional status of children in Lesotho.
联合国儿童基金会（UNICEF）指出，儿童生命最初1000天营养不足会导致生长发育迟缓。莱索托目前所有年龄组的营养不良患病率都很高。因此，本研究旨在调查莱索托五岁以下儿童发育迟缓的患病率及相关的多层次因素。
本研究使用了2018年莱索托多聚类指标调查。数据采用STATA 14版软件进行分析，并拟合了多层次逻辑回归模型。还采用P值<0.05的Wald调整比值比（WAOR）来表示统计学意义。
莱索托五岁以下儿童发育迟缓的患病率为33.6%[95%置信区间31.6, 33.6]。在个体层面，与未接受最低可接受饮食（MAD）的儿童相比，发育迟缓的几率较低（WAOR = 0.52；置信区间：0.3, 0.9），出生体重超过3.8千克的儿童（WAOR = 0.51；置信区间：0.4, 0.6），以及未患呼吸道感染的儿童（WAOR = 0.61；置信区间：0.4, 1.0）。在家庭层面，与其他家庭相比，发育迟缓的可能性在以下情况中最低：接受中学以上教育（WAOR = 0.26；置信区间：0.2, 0.4）、家庭财富处于第五等级（WAOR = 0.34；置信区间：0.2, 0.3）、有安全饮用水源（WAOR = 0.72；置信区间：0.6, 0.9）和卫生设施不足（WAOR = 0.62；置信区间：0.5, 0.7）。与其他儿童相比，农村地区的儿童（WAOR = 1.95；置信区间：1.3, 2.1）以及母亲不住在同一家庭的儿童（WAOR = 1.30；置信区间：1.1, 1.6）发育迟缓的几率更高。在社区层面，与其他社区相比，发育迟缓几率降低与以下社区的儿童有关：社区母亲教育程度高（WAOR = 0.69；置信区间：0.6, 0.8）、社区男性教育程度高（WAOR = 0.56；置信区间：0.5, 0.7），以及饮用水源安全性低（WAOR = 0.73；置信区间：).3, 0.5）、卫生设施充足（WAOR = 0.66；置信区间：0.5, 0.8）和母亲媒体曝光率高（WAOR = 0.37；置信区间：0.3, 0.5）的社区。社区贫困程度高的社区的儿童发育迟缓的可能性是其他儿童的两倍（WAOR = 2.04；置信区间：1.7, 2.5）。
研究结果表明应针对社区食物供应和知识获取。通过大众媒体扩大信息传播将改善莱索托儿童的营养状况。
