开鲁县较贫困农村儿童生长发育监测

内蒙古开鲁县是国家食物与营养监测项目的一个较贫困农村监测点。为收集不同地区儿童营养状况的连续资料，按照国家项目组的要求，2000年7月对开鲁县415名5岁以下儿童及其住户进行了第二次现场监测。内容包括：5岁以下儿童身高、体重的测量和与儿童生长发育相关因素的 问卷调查。调查结果显示，5岁以下儿童的生长迟缓率（身高不足）为13．25％。低体重率为8．67％。调查前两周儿童呼吸系统疾病的患病率为16．87％，腹泻患病率为14．46％。2岁以下儿童辅食添加率分别是：谷类66．09％，乳类25．86％，蔬菜水果类61．49％，蛋类67．24％，禽畜肉类47．70％，鲁虾类30．46％，豆类24．71％。测定21名5岁以下儿童血红蛋白含量，贫血率21．33％。与1998年开鲁县监测结果比较，5岁以下儿童生长迟缓率无差异。低体重率，2000年高于1998年（P＜0．01）。调查前两周，呼吸系统疾病患病率无差异。腹泻患病率2000年高于1998年（P＜0．05）。     

Complementary Feeding and Growth of Infant and Young Child in China

Objective To understand the status and problems of complementary feeding and to explore the strategy of improving complementary feeding for infants and young children in China. Method Data of urban and rural children were selected from the China Food and Nutrition Surveillance System (CFNSS) dataset to describe the status of complementary feeding and growth of children. Logistic Regression was used to analyze the relationship between child growth and the complementary feeding pattern. Results Applications of foods that come from animals, vegetable/fruit and dairy product in complementary feeding were negatively correlated to the prevalence of stunting and underweight. Attributable risk (AR) of no application of vegetable/fruit in complementary feeding to stunting was 30.2%, to underweight 35.4%; AR of no application of foods from animal products in complementary feeding to stunting was 2g.2%, to underweight 11.7%; and the AR of no application of diary products in complementary feeding to stunting was 27.4%, to underweight was 15.9%. Conclusion Complementary feeding contributed to the improvement of infants and young children growth in China. There is an urgent need to develop health education in the public on infants and young children complementary feeding, in the mean time, it is pressing to pay attention and take actions to develop and promote affordable, acceptable, and accessible fortified complementary food in rural areas of China.     

Complementary feeding and growth of infant and young child in China

Objective To understand the status and problems of complementary feeding and to explore the strategy of improving complementary feeding for infants and young children in China. Method Data of urban and rural children were selected from the China Food and Nutrition Surveillance System （CFNSS） dataset to describe the status of complementary feeding and growth of children. Logistic Regression was used to analyze the relationship between child growth and the complementary feeding pattern. Results Applications of foods that come from animals, vegetable/fruit and dairy product in complementary feeding were negatively correlated to the prevalence of stunting and underweight. Attributable risk （AR） of no application of vegetable/fruit in complementary feeding to stunting was 30.2%, to underweight 35.4%; AR of no application of foods from animal products in complementary feeding to stunting was 28.2%, to underweight 11.7%; and the AR of no application of diary products in complementary feeding to stunting was 27.4%, to underweight was 15.9%. Conclusion Complementary feeding contributed to the improvement of infants and young children growth in China. There is an urgent need to develop health education in the public on infants and young children complementary feeding, in the mean time, it is pressing to pay attention and take actions to develop and promote affordable, acceptable, and accessible fortified complementary food in rural areas of China.     

内蒙古较贫困农村儿童生长发育调查

内蒙古开鲁是国家食物与营养监测项目的一个较贫困农村监测点。按照国家项目组的要求，我们于1998年5月对开鲁县445名6岁以下儿童及其住户进行了现场监测，内容包括：6岁以下儿童身高、体重和与儿童生长发育相关因素的问卷调查。调查结果显示，开鲁县儿童生长迟缓率（身高不足）为12．58％，低体重率为5．17％，调查前两周儿童呼吸系统疾病的患病率为20．90％，腹泻患病率为7．64％；两岁以下儿童的辅食添加率分别为：谷类71．74％，乳类41．83％，蔬菜水果类63．77％，蛋禽鱼类61．59％。与1998年全国监测结果比较，开鲁县6岁以下儿童的生长发育状况好于全国同类地区平均水平，儿童腹泻患病率和呼吸系统疾病患病率低于全国同类地区患病率，2岁以下儿童四类辅食添加率高于全国同类地区平均水平。     

中国5岁以下儿童营养不良的社会决定因素研究

目的： 了解中国5岁以下儿童营养不良与社会决定因素的关联程度，为制定进一步改善儿童营养不良的社会政策提供依据。方法： 从中国居民健康和营养调查（China Health and Nutrition Survey, CHNS）1991-2011年的纵向数据中提取2 434名5岁以下儿童，使用世界卫生组织igrowup软件计算儿童营养不良率，使用多因素非条件Logistic回归分析营养不良与社会决定因素的关联。结果： 20年间儿童整体低体重率和生长迟缓率分别下降了64.8%和67.8%，儿童低体重和生长迟缓得到显著改善。消瘦率一直维持在较低水平，女童营养不良率的降低幅度大于男童。非社会经济因素中，母亲身高低、儿童蛋白质摄入不足是营养不良的危险因素。社会决定因素中，居住在西部和中部、居住地城市化水平低、家庭收入低、母亲教育水平低是儿童营养不良的危险因素。结论： 为进一步改善儿童营养不良和缓解儿童健康不公平，需要重视儿童营养不良背后的社会决定因素，完善并实施改善儿童营养相关的社会政策，包括关注孕产妇和儿童的膳食营养、提高家庭生活水平和母亲教育水平、平衡地区间发展差距和资源分配等。     

中国5岁以下儿童营养不良的社会决定因素研究

目的： 了解中国5岁以下儿童营养不良与社会决定因素的关联程度,为制定进一步改善儿童营养不良的社会政策提供依据。方法： 从中国居民健康和营养调查（China Health and Nutrition Survey, CHNS）1991-2011年的纵向数据中提取2 434名5岁以下儿童,使用世界卫生组织igrowup软件计算儿童营养不良率,使用多因素非条件Logistic回归分析营养不良与社会决定因素的关联。结果： 20年间儿童整体低体重率和生长迟缓率分别下降了64.8%和67.8%,儿童低体重和生长迟缓得到显著改善。消瘦率一直维持在较低水平,女童营养不良率的降低幅度大于男童。非社会经济因素中,母亲身高低、儿童蛋白质摄入不足是营养不良的危险因素。社会决定因素中,居住在西部和中部、居住地城市化水平低、家庭收入低、母亲教育水平低是儿童营养不良的危险因素。结论： 为进一步改善儿童营养不良和缓解儿童健康不公平,需要重视儿童营养不良背后的社会决定因素,完善并实施改善儿童营养相关的社会政策,包括关注孕产妇和儿童的膳食营养、提高家庭生活水平和母亲教育水平、平衡地区间发展差距和资源分配等。     

The magnitude and trends of under- and over-nutrition in Asian countries

In order to understand the magnitude and trends of both under- and over-nutrition problems in Asian countries, we reviewed data available in a number of selected countries. In general, the prevalence of under-nutrition is declining in this region but is still heavy in many countries. The trends varied with complexity of individual countries. In China, the prevalence of underweight, stunting and wasting was 21.6%, 30.5% and 2.6% in children of 0-4 years old (90,662 subjects, 1987) . Another large-scale survey in 1992 (176,976 subjects) presented a prevalence of 17.1% , 33.5% and 4.5%, respectively. Recent studies showed a remarkable improvement in both underweight and stunting. The National Student Survey in 1995, however, showed that the prevalence of under-nutrition was 26.9% for schoolboys and 38.3% for schoolgirls (7-18 yr). There was an increase of 4.7% and 3 .5%, respectively, compared with the results of a similar survey conducted in 1985. The proportion of malnutrition in Chinese adults (BMI < 18.5) was 11.6% in 1982 and 9.0% in 1992 for urban areas, and 12.9% and 8.0% for rural areas, indicating a descending trend over the 10 years. The prevalence of underweight was the highest, over 50% among children below 6 years old, in both Bangladesh and India, between 50% and 20% in Malaysia, the Philippines, Thailand and Vietnam, and below 20% in Mongolia, Kazakhstan and Fiji. It showed a declining trend from the 1970s to the 1990s with an average annual reduction of 0.8 to 1.9 percentage points in these countries. The problem of over-nutrition is emerging quickly in this region, not only in some better-off countries but also in countries in economy transition. In China, the prevalence of overweight and obesity in young adults (BMI > 25) was increased from 9.7% to 14.9% for urban areas and from 6.15% to 8.4% for rural areas in a 10-year period (1982 - 1992), and the prevalence of overweight jumped from 3.38% and 2.75% in 1985 to 7.18% and 8.65% in 1995 for schoolboys and schoolgirls. In India, the increase of overweight and obesity in female adults was 5.0 percentage points from 1989 to 1994. The prevalence of overweight was 24.5% for male and 21.4% for female in Japan (1995), and 28.7% and 26.0% in Malaysia (1990). These results indicate that over-nutrition is a growing problem in this region. Many Asian countries are facing double challenges. They have to deal with both under-nutrition and over-nutrition problems. Among many possible interventions, the further strengthening mass education on healthy diet practice should be emphasized.     

贵州省农村婴儿体格发育水平及相关因素分析

目的：了解农村婴儿体格发育水平、营养不良患病率及与喂养方式的关系。方法：分层随机整群抽样调查农村婴儿2 511人,以中国7岁以下儿童生长标准为参数计算年龄别身高Z值（HAZ）、年龄别体重Z值（WAZ）和身高别体重Z值（WHZ）,Z〈-2判断为生长迟缓、低体重和消瘦,并分析其与喂养方式的关系。结果：贵州婴儿体格发育落后于参考标准,HAZ、WAZ 4月龄后明显左移,HAZ〈-2者在4月龄后逐渐增多达人群17%~21%,WAZ〈-2者在5月龄后达人群的13.5%~17.5%;生长迟缓率、低体重率、消瘦率分别为13.7%、10.0%和5.2%。营养不良的发生与喂养方式密切相关,4个月内纯母乳喂养、4个月后增加蛋白类食品、6个月后添加碳水化合物可降低生长迟缓、低体重的发病风险。结论：贵州农村婴儿体格发育落后,喂养不当所至的长期慢性营养不良是其主要因素。     

Application of the WHO Growth Reference （2007） to Assess the Nutritional Status of Children in China

Objective To assess the nutrition status of children and adolescents in China using the WHO growth reference （2007） in comparison with that defined by the International Obesity Task Force （IOTF） and the Working Group on Obesity in China （WGOC）. Methods Overweight and obesity were defined by age-, sex-, specific BMI reference developed by WHO （2007）, IOTF （2000）, and WGOC （2004）, respectively. Stunting and thinness were defined as height and BMI less than two standard deviations （SD） of the WHO growth reference （2007）, respectively. Data of children and adolescents aged 5 to 19 years （n=54 857, 28 273 boys, 26 584 girls） from the 2002 China National Nutrition and Health Survey （CNNHS） were used in the study. Results The prevalence of overweight, obesity, stunting and thinness among Chinese children and adolescents aged 5-19 years was 5.0%, 1.2%, 13.8%, and 7.4%, respectively when the WHO growth reference （2007） was used, whereas the estimated absolute total number affected by these 4 conditions were 14.6, 3.7, 40.6, and 21.8 million, respectively. The prevalence of overweight and obesity was 18.1% in large cities, while the stunting prevalence was 25.1% in rural 4. Obesity prevalence assessed by the WHO growth reference was higher than that as assessed by the IOTF reference, and obesity prevalence assessed by the WGOC reference was lower than that as assessed by the IOTF reference. Conclusion The nutritional status of children and adolescents is not equal in different areas of China. Stunting is still the main health problem of the poor, while overweight and obesity are the main health problems in large cities.     

The nutritional status of Tanzanian children: A cross-sectional anthropometric community survey report

Anthropomorphic measurements have been found to be most useful in the assessment of nutritional and health status. Scattered cross-sectional community anthropomorphic measurements of rural preschool children from 8 regions of Tanzania were carried out in 1976 and 1977. This report involves 4766 preschool children and 341 school children who had their anthropomorphic measurements analyzed. The results showed that 2.4% of the preschool children had severe Protein Energy Malnutrition (PEM), whereas 42.6% suffered from mild to severe PEM. There were more underweight children among preschool girls than among the boys in all age groups, except in those aged 0-6 months. School girls, however, had fewer underweight children among them than school boys. This is a finding not reported in 4 other studies in Tanzania involving some 2000 preschool children, in the past. There is a cumulative stunting becoming maximum at the 18-30 month age group. The mean average "stunting" prevalence was 46.5% while the mean average "wasting" prevalence was 8.3%. There is a need to find out the reason why PEM prevalence among preschool children has not changed since about 15 years ago, while it is common knowledge that primary health care facilities have doubled or even quadrupled in quantity during the same period. It is rather expedient to find out if there is preferential treatment of preschool boys by parents.     

The prevalence of malnutrition among high and low altitude preschool children of southwestern Saudi Arabia

OBJECTIVE: To assess the current status of protein energy malnutrition (PEM) in the high and low altitude preschool children aged 12-71 months. METHODS: A cross-sectional study conducted during the year of 2003 and involved 572 and 469 preschool children of Southwestern Saudi Arabia born and living permanently at high and low altitude areas. Anthropometric measurements were carried out to assess the prevalence of PEM using 3 indicators such as underweight, wasting and stunting following World Health Organization standards. Prevalence differences were examined by age, gender, altitude, and parental socioeconomic status. RESULTS: The prevalence of the 3 types of PEM was significantly higher at low altitude than at high altitude and significantly higher among children born to illiterate than to educated parents. Older children were more underweight and stunted than younger children and underweight and wasting were significantly more common in boys than girls. Annual family income per person was negatively and significantly associated with underweight and stunting, but not with wasting. Multivariate analysis showed that after controlling for all sociobiological factors, low altitude remained a strong risk factor. CONCLUSION: The difference in PEM between high and low altitude preschool children could be related to the milder environmental conditions at high altitude and the higher incidence of tropical infections in lowland children. Future studies are required to verify these speculations, and to establish programs to control and prevent PEM in preschool children at low altitude.     

2005年至2014年中国7~18岁儿童青少年营养不良流行现状及趋势变化分析

目的：了解2005年至2014年中国7~18岁儿童青少年营养不良的流行现状及其变化趋势,为改善学生的营养状况提供依据。方法：利用2005年、 2010年和2014年3次“中国学生体质与健康调研”数据,按照2014年颁布的国家卫生标准《学龄儿童青少年营养不良筛查标准》（WS/T456-2014）, 对中国31个省市自治区（除港澳台）7~18岁儿童青少年的营养不良检出率分性别、分年龄、分地区和省市自治区以及年份进行分析,西藏自治区为藏族学生,其他30个省市自治区均为汉族学生。结果：2014年中国7~18岁汉族学生的营养不良检出率为10.0%,其中生长迟缓、中重度消瘦、轻度消瘦分别为0.8%、 3.7%、 5.5%,较2005和2010年营养不良检出率分别下降了5.0和2.6个百分点,其中生长迟缓、中重度消瘦、轻度消瘦分别下降1.0、 1.8、 2.2个百分点和0.4、 1.1、 1.2个百分点;2014年7~18岁男生营养不良检出率高于女生（11.1% vs. 8.9%）,乡村高于城市（11.0% vs. 9.1%）,7~9岁、10~12岁、13~15岁和16~18岁4个年龄段的检出率分别为10.5%、 9.0%、 9.1%、 11.5%,东、中、西部分别为9.0%、 9.2%和11.7%;我国学生营养不良主要以轻度消瘦为主,汉族和藏族学生的生长迟缓检出在营养不良中仅占到8.0%和7.5%; 2005年至2014年的3次调查中,中国7~18岁汉族和藏族学生的营养不良检出率均逐次下降,差异均有统计学意义（P<0.05）; 2005年至2014年全国31个省市自治区男女生的营养不良检出率较高,多集中在西南地区,东部省市自治区营养不良检出率较低;与2005年和2010年相比,2014年全国31个省市自治区营养不良检出率均出现下降,且营养不良检出率较高的地区逐渐减少,检出率较低的地区逐渐增多。结论：2005年至2014年全国31个省市自治区的7~18岁儿童青少年的营养不良检出率呈持续下降趋势,但总体检出率仍然较高,以消瘦型营养不良为主,生长迟缓检出率低,西南地区各省市自治区营养不良检出率较高。     

Epidemiology of birth defects among children in 8 provinces in China]

In 1988, birth defects (BD) among 85,170 children aged 0-14 were investigated in eight provinces and cities of China. The overall prevalence rate was 15.13% in urban, 15.40% in rural areas. The prevalence rate of BD was significantly higher in males than in females (16.66% vs 13.70%). The prevalence rate of BD was significantly higher in mothers aged > or = 35 years than in mothers aged < 35. 20 of 82 categories of BD accounted for > or = 1% of all BD. The 3 leading BD were: cutis angioma, congenital heart disease and indirect hernia. The incidence of mental retardation was significantly higher in children with BD than in children without BD.     

湖北省居民贫血状况研究

目的 使用中国居民营养与健康状况调查(2002)湖北省地区数据,分析湖北省居民的贫血状况.方法 采用国际血液标准化委员会(ICSH)推荐的氰化高铁血红蛋白法测定8 755例血红蛋白浓度,分析湖北省城乡、不同性别及不同年龄段居民贫血患病率.结果 2002年湖北省居民贫血患病率为23.7%,高于全国平均水平(20.1%);男性贫血患病率为20.2%,女性为26.6%,女性高于男性(P<0.01);城市居民贫血患病率为22.1%(男性17.0%,女性26.7%),农村居民贫血患病率为24.9%(男性23.0%,女性26.6%),农村高于城市(P<0.01).结论 无论是男性还是女性,城市还是农村,湖北省居民的贫血患病水平均高于相应全国平均水平.湖北省农村男性贫血患病率高于城市男性,农村女性贫血患病率低于城市女性.     

重庆地区儿童肥胖症患病率及其与血压的关系

目的：了解重庆地区城市和农村儿童肥胖的发病情况及其与血压的关系。方法：对重庆地区37785名7-17岁儿童进行流行病学调查。测量指标包括：身高、体重、血压。结果：（1）城市儿童中,超重13．16％,肥胖3．73％,农村儿童中,超重5．26％,肥胖0．90％。（2）男性儿童的超重肥胖患病率13．16％,女性8．39％。（3）超重肥胖组的收缩压及舒张压高于P90和P95者明显高于正常体重组。结论：重庆地区城市儿童超重肥胖患病率高于农村儿童,男性儿童超重及肥胖患病率高于女性,超重肥胖组儿童的血压升高者明显多于正常体重组,对超重肥胖儿童应加强行为干预。     

Prevalence of Undernutrition and Related Dietary Factors among People Aged 75 Years or Older in China during 2010-2012

Objective Undernutrition is highly prevalent among older people. The aim of this study was to estimate the prevalence of undernutrition in elderly Chinese residents and explore the relationship between undernutrition and dietary factors. Methods Data were collected from 2,552 elderly people aged 75 years and over from the Chinese Nutrition and Health Surveillance during 2010-2012 using questionnaires, anthropometric measurement, and individual consecutive 3-day 24-hour dietary records. Results The present study showed that 10.5% of participants had undernutrition. The prevalence was higher among the population living in rural areas, those living in the South region, those who smoked, and those with low income levels. Most participants failed to meet the Chinese Dietary Reference Intakes for energy (66.1%) and protein (72.1%). When comparing quartiles of food intake, high rice consumption [odds ratio ( OR )=2.44, 95% confidence interval ( CI ): 1.35-4.40)], animal oil intake ( OR=1.60, 95% CI : 1.18-2.17), and high fat intake from animal sources ( OR=1.56, 95% CI : 1.06-2.31) were positively associated with underweight whereas high wheat consumption (OR=0.44, 95% CI : 0.26-0.74), a proper proportion (24%-32%) of energy intake from fat ( OR=0.54, 95% CI : 0.35-0.83), and high fat intake from plant sources ( OR=0.67, 95% CI : 0.46-0.99) were inversely related. Conclusion The prevalence of undernutrition was high among elderly Chinese people, especially in rural areas. Dietary factors, such as high consumption of rice, were associated with undernutrition.     

2002年与2007年陕西省农村6岁以下儿童营养不良状况比较

目的调查分析2002年与2007年陕西省农村6岁以下儿童营养不良状况,为政府有关部门制订儿童营养相关政策提供依据。方法分别对2002、2007年陕西省农村668名6岁以下儿童进行身高和体重测量,根据结果进行描述性统计分析。结果 2002年检测到的6岁以下儿童低体重率为5.2%,生长迟缓率为10.8%,消瘦率为5.2%;2007年6岁以下儿童低体重率为1.4%,生长迟缓率为2.8%,消瘦率为0.6%。2007年6岁以下儿童的低体重率、生长迟缓率、消瘦率较2002年分别下降了73.1%、72.8%和88.5%。结论 2007年6岁以下儿童的低体重率、生长迟缓率、消瘦率比2002年明显降低。     

Epidemiological Survey of the Prevalence of Non-fatal Injury among Children Aged 5-14 Years in China

ObjectiveTo determine the prevalence of non-fatal injuries among children aged 5–14 years in China.MethodsData of 21 973 children aged 5–14 years were extracted from the Fourth National Health Service Survey of China carried out between June 15 and July 10, 2008. Injury-related indicators included: history of ever having had an injury, and injury frequency, cause, location and severity.ResultsThe overall prevalence of non-fatal injuries among the children in the previous 12 months was 17.0 per 1000 subjects. The leading causes of non-fatal injuries were falls, animal bites, traffic accidents, falling objects and burns. The majority of children sustained only one injury. The main place of injury was at home in 40% and 54% of urban boys and girls, respectively, at school in 48% of rural boys, and at home and at school each in 33% of rural girls. Medical treatment for one day was the main option for 80% of urban boys and girls, 84% of rural boys, and 72% of rural girls.ConclusionNonfatal injuries among children aged 5–14 years are a serious public health concern in China.     

Prevalence and risk factors for giardiasis among primary school children in Damascus, Syria

OBJECTIVE: To evaluate the prevalence of giardiasis in primary school children in Damascus city and the countryside, and to investigate the possible risk factors for giardiasis infection. METHODS: A cross-sectional study was carried out on school children from 23 primary schools in Damascus, between March and June 2006. Data were collected from 1469 children of both genders from urban and rural regions using structured questionnaires, anthropometric measurements, and laboratory analysis of fecal samples. The parasites were detected using a single-stool sample by direct wet examination under light microscope. RESULTS: Two hundred and six (14%) of 1469 children were infected with Giardia lamblia, while 119 (8.1%) were found infected with other sorts of intestinal parasites. No correlation was found between giardiasis and age, gender, residence in urban or rural areas, availability of piped water or sewage system. In contrast, both mother's (p=0.003) and father's (p=0.018) levels of education, and the number of siblings in-home (p=0.014) were found significant predictors of giardiasis. As for children's nutritional status, 6.6% were found to have significant stunting, 1.8% had underweight, and 4.7% had wasting. Giardiasis, however, was not found a predictor of these conditions. CONCLUSION: The Damascus region could be classified as medium-prevalence area for Giardia infections. Thus, the local administrators need to pay more attention to the prevention of parasitic infections along with improvement in education, environmental, and sanitary conditions.     

芜湖地区儿童行为问题与家庭环境的相关研究

目的:了解芜湖地区儿童行为问题的发生与家庭心理环境之间的相关性。方法:采用分层随机整群抽样法,由父母填写Conners儿童行为问卷(父母版)、家庭环境量表中文版(FES-CV),对芜湖地区6 381名3～16岁儿童进行测查。结果:芜湖地区儿童行为问题的检出率为25.25%,三县儿童的行为问题显著高于市区;市区儿童家庭的亲密度等八项因子分显著高于三县,而矛盾性显著低于三县;较家庭环境中的其他因素相比,家庭的矛盾性与儿童行为问题的发生有较为密切的联系,其余较为密切的有知识性、组织性、亲密度。结论:精神环境良好的家庭,其子女行为问题较少,家庭成员之间矛盾冲突越多,其子女的行为问题亦越多。