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过早发育迟缓的患病率及相关危险因素:2020年卢旺达人口与健康调查分析

Prevalence and associated risk factors of stunting too early: analysis of the 2020 Rwanda demographic and health survey.

作者信息

Ndahimana Raphael, Uwase Melissa, Muragire Roger, Uwase Alliance, Uwamahoro Edith, Flavia Bwiza, Niyonganyira Elysee, Esperance Ayinkamiye, Rusa Divine Umutesi, Mwiseneza Marie Josée, Gashaija Absolomon, Ngabonziza Godfrey, Ishimwe Japhet, Gad Binayisa, Kalisa Claude, Imanishimwe Joseph, Jean Muhire, Condo Jeanine, Habtu Michael

机构信息

Department of Epidemiology and Biostatistics, School of Public of Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.

Department of Clinical Medicine and Community Health, University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda.

出版信息

BMJ Nutr Prev Health. 2025 Apr 22;8(1):e000991. doi: 10.1136/bmjnph-2024-000991. eCollection 2025.

Abstract

BACKGROUND

Stunting in young children continues to be a public health concern in Rwanda. The effect of stunting in the first 1000 days of life has long-term consequences, including decreased brain development and a higher risk of developing diseases later in life. To design proper interventions, identifying the risk factors of stunting too early is paramount. The study thus aimed to identify the prevalence of stunting too early (6-23 months) and its associated risk factors.

METHODS

The research study analysed secondary data from the nationally conducted demographic health survey of 2019-2020, which was analysed by using bivariate analysis and multivariable logistic regression models to determine the factors associated with stunting that occurred too early. P value of <0.05, regression coefficients and their 95% CI were used to assess the level of significance as well as insights related to the strength and direction of the relationship between being stunted too early and other covariates.

RESULTS

A total of 1180 children aged 6-23 months were included in the analysis. The overall prevalence of stunting too early was 30% with a 95% CI of 27.4%-32.6%. Moreover, the prevalence of stunting was 29.0%, 20.0%, 23.0% and 35% among the 6 months, 7-8 months, 9-12 months and 13-23 months age groups, respectively. After adjusting for potential confounding variables, the following factors were independently associated with stunting too early: being male (aOR:2.3; 95% CI:1.68 to 3.00), not currently being breastfed (aOR:1.97, 95% CI:1.21 to 3.19), mothers aged 25-34 and more than 34 years (aOR:1.64; 95% CI:1.11 to 2.43) and (aOR:1.63; 95% CI:1.07 to 2.47), respectively, households with poor wealth index (aOR:2.61; 95%CI: 1.72 to 3.09), child age group of 13-23 months (aOR:2.00; 95% CI:1.14 to 5.51) and small child size at birth (aOR:2.36; 95% CI:1.42 to 3.92).

CONCLUSIONS

The prevalence of stunting too early was high, and the factors significantly associated with it were the sex and age of the child, the mother's age, low socio-economic status and small child size at birth. There is a need to address those factors through campaigns of health education, emphasis on girls' education for their empowerment and strengthening of nutritional programme implementation.

摘要

背景

幼儿发育迟缓仍是卢旺达的一个公共卫生问题。生命最初1000天的发育迟缓会产生长期后果,包括大脑发育减缓以及日后患疾病的风险增加。为了设计适当的干预措施,尽早识别发育迟缓的风险因素至关重要。因此,本研究旨在确定过早(6 - 23个月)发育迟缓的患病率及其相关风险因素。

方法

该研究分析了2019 - 2020年全国人口健康调查的二手数据,通过双变量分析和多变量逻辑回归模型来确定与过早发生发育迟缓相关的因素。P值<0.05、回归系数及其95%置信区间用于评估显著性水平以及与过早发育迟缓及其他协变量之间关系的强度和方向相关的见解。

结果

共有1180名6 - 23个月大的儿童纳入分析。过早发育迟缓的总体患病率为30%,95%置信区间为27.4% - 32.6%。此外,6个月、7 - 8个月、9 - 12个月和13 - 23个月年龄组的发育迟缓患病率分别为29.0%、20.0%、23.0%和35%。在调整潜在混杂变量后,以下因素与过早发育迟缓独立相关:男性(调整后比值比:2.3;95%置信区间:1.68至3.00)、目前未进行母乳喂养(调整后比值比:1.97,95%置信区间:1.21至3.19)、年龄在25 - 34岁及34岁以上的母亲(调整后比值比分别为:1.64;95%置信区间:1.11至2.43)和(调整后比值比:1.63;95%置信区间:1.07至2.47)、财富指数低的家庭(调整后比值比:2.61;95%置信区间:1.72至3.09)、13 - 23个月的儿童年龄组(调整后比值比:2.00;95%置信区间:1.14至5.51)以及出生时体型小的儿童(调整后比值比:2.36;95%置信区间:1.42至3.92)。

结论

过早发育迟缓的患病率很高,与之显著相关的因素是儿童的性别和年龄、母亲的年龄、社会经济地位低以及出生时体型小。有必要通过健康教育活动、强调女童教育以增强其权能以及加强营养计划的实施来解决这些因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1fd/12322549/f2417a8f6ad1/bmjnph-8-1-g001.jpg

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