Sive A A, Subotzky E F, Malan H
Department of Paediatrics and Child Health, University of Cape Town.
S Afr Med J. 1993 Mar;83(3):180-3.
The social, family and medical backgrounds of 53 children hospitalised with kwashiorkor were compared with those of 106 children hospitalised for non-nutritional diseases to determine risk factors for severe nutritional disease in children presenting to a teaching hospital. The control children were matched for age, sex, race and the non-nutritional illness complicating the course of the children with kwashiorkor; in 80% of cases the reason for admission was either gastro-enteritis or pneumonia. A major difference between the groups was the educational status of the mothers. Only 57% of the mothers of the children with kwashiorkor were literate compared with 93% of the controls; 25% as opposed to 47% were married, and 36% as opposed to 72% received support from the father. There were no differences in the mothers' ages or use of contraception, or in the number of children they had. In all except 1 instance the child with kwashiorkor was the youngest or only child in the family, and the average sibling interval was 53 months. The types of dwellings occupied by the families were similar, but overcrowding was worse in the kwashiorkor group. Family income was below the household subsistence level in the vast majority of both groups, but significantly more of the kwashiorkor group had minimal cash income. Significantly fewer of the children with kwashiorkor had been breast-fed or adequately immunised, and 60% had previously been hospitalised for dehydrating diarrhoea. This study demonstrates that in an urban environment the traditional factors of large families and displacement by a younger sibling are not associated with kwashiorkor.(ABSTRACT TRUNCATED AT 250 WORDS)
将53名因夸希奥科病住院的儿童的社会、家庭和医学背景，与106名因非营养性疾病住院的儿童的背景进行比较，以确定在一家教学医院就诊的儿童患严重营养疾病的风险因素。对照儿童在年龄、性别、种族以及使夸希奥科病患儿病情复杂化的非营养性疾病方面进行了匹配；80%的病例中，入院原因是肠胃炎或肺炎。两组之间的一个主要差异是母亲的教育程度。夸希奥科病患儿的母亲中只有57%识字，而对照组为93%；25%已婚，而对照组为47%，36%得到父亲的支持，而对照组为72%。母亲的年龄、避孕措施的使用情况或子女数量没有差异。除1例外，所有患夸希奥科病的儿童都是家中最小的孩子或独子，平均兄弟姐妹间隔为53个月。两个家庭居住的房屋类型相似，但夸希奥科病组的拥挤情况更严重。两组绝大多数家庭的收入都低于家庭维持生计水平，但夸希奥科病组中现金收入极少的家庭明显更多。患夸希奥科病的儿童中，曾接受母乳喂养或充分免疫的明显较少，60%曾因脱水腹泻住院治疗。这项研究表明，在城市环境中，大家庭和弟弟妹妹取代的传统因素与夸希奥科病无关。（摘要截取自250字）
