2009～2010年云南省广南县0～5岁儿童营养不良状况及其影响因素

目的分析2009～2010年云南贫困农村地区0～5岁儿童营养不良状况及其影响因素。方法采用随机整群分层抽样的方法,抽取云南省广南县贫困县农村地区1002名0～5岁儿童,通过询问调查、血红蛋白检测和膳食调查进行问卷调查,并测量身高、体重,采用Z评分法进行营养状况评价,计算营养不良率。采用非条件Logistic回归多因素分析。结果 2009～2010年云南贫困农村地区5岁以下儿童低体重率为18.8%,生长迟缓率为34.3%,消瘦率为3.1%。排除了其他变量的影响后显示,2岁以下儿童未喂过母乳的比喂过母乳的儿童容易发生营养不良;2岁以下儿童过去7天添加辅食蔬菜和水果天数较多的比少的不容易发生营养不良;2岁以下儿童与同龄孩子比较情况好的比差的和差不多的不容易发生营养不良。结论云南贫困农村地区5岁以下儿童营养不良状况不容忽视。儿童营养不良的影响因素主要有2岁以下儿童的喂养方式、2岁以下婴幼儿辅食添加、2岁以下儿童与同龄孩子比较情况等。     

2009年云南贫困农村6岁以下儿童营养不良的影响因素

目的研究2009年云南贫困农村6岁以下儿童营养不良状况及其影响因素。方法采用多阶段分层整群随机抽样方法,通过问卷调查、体格测量、生化检测共调查1291名儿童,计算Z评分和营养不良率,用二分类变量Logistic回归进行因素分析。结果 2009年云南贫困农村6岁以下儿童生长迟缓率为13.4%,低体重率为11.5%,消瘦率为8.4%。儿童营养不良与出生体重、父母是否外出打工、添加辅食的早晚紧密相关,低出生体重(OR=2.947,95%CI=1.820~4.763)、父母外出打工(OR=1.282,95%CI=1.033~1.825)、添加辅食过晚(OR=1.892,95%CI=1.205~3.059)的儿童更容易发生营养不良。结论云南贫困农村6岁以下儿童营养不良状况不容忽视,是饮食、家庭环境、社会等多因素作用的结果,预防儿童营养不良的发生必须采取综合干预措施。     

甘肃贫困农村地区0～6岁儿童营养状况及影响因素分析北大核心CSCD

目的分析2006-2009年甘肃省贫困农村地区0～6岁儿童营养不良现状,探讨其影响因素。方法采用整群随机分层抽样的方法,抽取甘肃省4个贫困县农村地区4831名0～6岁儿童,通过调查表进行询问调查、血红蛋白检测等,并测量身高、体重,采用Z评分法进行营养状况评价,计算儿童营养不良率。采用非条件Logistic回归进行多因素分析。结果2006-2009年甘肃贫困农村地区6岁以下儿童营养不良率为24．4％～28．5％。男、女营养不良率仅2006年差异有统计学意义（χ2=7．385,P=0．007）。贫血患病率较2002年全国营养调查升高。1岁组、3岁组和6岁组儿童营养不良率较高。影响儿童营养不良的因素有地区、性别、年龄、民族、母亲文化程度、家庭饮用水源、出生体重。结论甘肃省贫困农村地区儿童营养状况仍不容乐观,应及早采取切实可行的干预措施。     

甘肃贫困农村地区0~6岁儿童营养状况及影响因素分析

目的分析2006—2009年甘肃省贫困农村地区0~6岁儿童营养不良现状,探讨其影响因素。方法采用整群随机分层抽样的方法,抽取甘肃省4个贫困县农村地区4831名0~6岁儿童,通过调查表进行询问调查、血红蛋白检测等,并测量身高、体重,采用Z评分法进行营养状况评价,计算儿童营养不良率。采用非条件Logistic回归进行多因素分析。结果 2006—2009年甘肃贫困农村地区6岁以下儿童营养不良率为24.4%~28.5%。男、女营养不良率仅2006年差异有统计学意义(χ2=7.385,P=0.007)。贫血患病率较2002年全国营养调查升高。1岁组、3岁组和6岁组儿童营养不良率较高。影响儿童营养不良的因素有地区、性别、年龄、民族、母亲文化程度、家庭饮用水源、出生体重。结论甘肃省贫困农村地区儿童营养状况仍不容乐观,应及早采取切实可行的干预措施。     

5省农村与城市2938名婴幼儿喂养与体格发育关系的分析

本文对5省2938名3岁以下儿童的喂养、辅食添加情况与体格发育1年纵向观察进行综合分析。结果提示:目前城市母乳喂养率低而辅食添加情况却优于农村。城市母乳喂养的3个月婴儿体重与体重增长值高于混合喂养与人工喂养儿。农村因多数为母乳喂养,差别不显著。城市6～18个月婴儿辅食添加普遍,体格发育与辅食添加的关系不明显。农村婴儿在6～18个月阶段,体重及体重6个月增长值与蛋白类辅食的添加关系较为突出。     

聊城市农村6岁以下儿童的生长发育与家长喂养行为调查

目的 调查分析聊城市农村6岁以下儿童的营养和喂养现状,了解其生长发育中存在的主要问题,为进一步制定营养改善措施提供依据. 方法 利用中国疾病预防控制中心营养与食品安全所2008年在13省(自治区)30个贫困县(市)开展的“我国贫困地区6岁以下儿童的营养健康状况监测”,对聊城市农村303名儿童进行身高、体重的测量,并以问卷的形式对以上儿童的家长进行了喂养行为的调查. 结果 农村6～12个月为营养不良的高发期,并以长期慢性营养不良为主;聊城市农村营养不良率远低于全国水平. 结论 在婴幼儿辅食添加中聊城市农村地区在辅食的添加时间、添加辅食的质量和数量上存在着不科学合理的问题.     

少数民族地区儿童喂养及生长发育情况分析

目的 了解少数民族地区儿童喂养和生长发育的基本情况及5岁以下儿童营养不良的影响因素,为有关项目的 实施及改善儿童营养状况提供科学依据.方法 采用3阶段与规模成比例的概率抽样法,对1 239名5岁以下儿童看护人进行一对一的问卷调查,并为调查的儿童测量了身高和体重.结果 6个月以内纯母乳喂养率仅为17.5%,持续母乳喂养到1岁的比例为33.7%,6～8月龄辅食添加率为90.7%.5岁以下儿童中重度低体重发生率为10.0%,中重度生长迟缓发生率为23.8%.不同民族、不同家庭经济条件、不同年龄间儿童营养不良率有所不同.结论 调查地区的5岁以下儿童营养不良情况仍比较严重,在项目实施中应注意加强纯母乳喂养和辅食添加的指导.     

临夏县贫困农村5岁以下儿童营养状况分析

目的:评价临夏县贫困农村5岁以下儿童的营养状况,为改善该地区儿童营养状况提供依据。方法:采用整群抽样方法于2010年对临夏县贫困农村5个乡镇10个行政村所有5岁以下儿童的家庭进行问卷调查,以儿童身高和体重作为儿童营养状况的评价指标。结果:该地区5岁以下儿童消瘦、生长迟缓和低体重的患病率分别为2.3%、21.4%和8.1%,男童生长迟缓率(24.0%)高于女童(18.1%)(P<0.05);2岁以下儿童初乳喂养率63.1%。结论:临夏县贫困农村5岁以下儿童营养状况低于世界卫生组织儿童生长标准。应改进喂养方法,促进初乳喂养,建议纯母乳喂养至6个月,继续母乳喂养至2岁或更长时间,同时合理添加辅食。     

汉阴县O～5岁农村儿童营养不良状况研究

目的 分析汉阴县0～5岁农村儿童的营养不良状况及变化趋势.方法 采取整群抽样法在汉阴县抽取5个村的419名儿童,测量儿童身高体重,并对儿童抚养人进行问卷调查.结果 2009年汉阴县0～5岁儿童低体重率为4.30%,生长迟缓率为14.80%,消瘦率为3.34%;与2000年相比,儿童低体重率下降21.53%,生长迟缓率下降45.99%,消瘦率下降70.75%.2岁以下婴幼儿中有66.2%在5～8月开始添加辅食,添加谷薯类、豆类、奶及奶制品、蛋类、肉类、蔬菜和水果、营养补充剂的婴幼儿分别占88.6%、27.8%、69.6%、58.9%、38.6%、70.3%、33.5%.结论 汉阴县0～5岁农村儿童的营养不良率下降明显,但仍高于全国水平;2岁以下儿童辅食添加不合理.     

中国部分农村地区5岁以下儿童喂养状况调查

目的 评估当地儿童喂养状况以及喂养相关资源利用情况,找出问题,并提出建议.方法 于2006年11月采用参与式农村评估定性研究方法,在5个省市随机选择了20个村进行调查,对187名母亲及其5岁以下的儿童进行了喂养评估.结果 这些地区儿童母乳喂养率:0～6个月为73.68%,6～12个月为57.69%,12～24个月为39.13%;6个月以上儿童辅食撮入量不足率为61.31%.结论 农村地区在母乳喂养和辅食添加方面存在较多问题,喂养知识和喂养技术有待提高.参与式农村评估方法可在搜集信息的同时,提高参与人群的儿童喂养认知水平.     

我国中西部4省(自治区)农村3岁以下儿童贫血状况及其影响因素分析

目的了解我国中西部农村地区儿童的贫血状况,并对其影响因素进行分析。方法采用多阶段分层随机抽样方法,筛选出1272名3岁以下儿童对其家庭进行问卷调查及血红蛋白测定。所得资料进行χ2检验和Logistic回归分析。结果 3岁以下儿童贫血患病率为46.3%,6～12月龄为3岁以下儿童贫血患病率的高峰,以后贫血患病率随月龄增加而下降。单因素分析显示儿童民族、看护人、体重低下、生长迟缓、过去2周内腹泻、母亲贫血、6个月龄内喂养方式、辅食添加种类(配方奶粉、普通牛奶、铁米粉、动物肉类、水产品)及辅食添加方式与3岁以下儿童贫血有统计学关联。多因素Logistic回归分析显示体重低下(OR=1.581,95%CI:0.967～2.586)、过去2周内腹泻(OR=2.143,95%CI:1.453～3.160)和母亲贫血(OR=2.211,95%CI:1.611～3.036)均是儿童贫血的危险因素,6个月龄内混合喂养(OR=2.184,95%CI:1.561～3.055)和人工喂养方式(OR=5.282,95%CI:2.507～11.131)相对于母乳喂养是儿童贫血的危险因素;而添加普通牛奶(OR=0.721,95%CI:0.524～0.991)和添加铁米粉(OR=0.599,95%CI:0.496～1.055)是儿童贫血的保护因素。结论我国中西部农村地区3岁以下儿童贫血患病率较高,应开展多种形式的健康教育、加强农村儿童系统保健管理,积极防治儿童常见病、多发病等将有助于改善儿童贫血状况。     

Nutrition: basis for healthy children and mothers in Bangladesh

Recent data from the World Health Organization showed that about 60% of all deaths, occurring among children aged less than five years (under-five children) in developing countries, could be attributed to malnutrition. It has been estimated that nearly 50.6 million under-five children are malnourished, and almost 90% of these children are from developing countries. Bangladesh is one of the countries with the highest rate of malnutrition. The recent baseline survey by the National Nutrition Programme (NNP) showed high rates of stunting, underweight, and wasting. However, data from the nutrition surveillance at the ICDDR,B hospital showed that the proportion of children with stunting, underweight, and wasting has actually reduced during 1984-2005. Inappropriate infant and young child-feeding practices (breastfeeding and complementary feeding) have been identified as a major cause of malnutrition. In Bangladesh, although the median duration of breastfeeding is about 30 months, the rate of exclusive breastfeeding until the first six months of life is low, and practice of appropriate complementary feeding is not satisfactory. Different surveys done by the Bangladesh Demographic and Health Survey, United Nations Children's Fund (UNICEF), and Bangladesh Breastfeeding Foundation (BBF) showed a rate of exclusive breastfeeding to be around 32-52%, which have actually remained same or declined over time. The NNP baseline survey using a strict definition of exclusive breastfeeding showed a rate of exclusive breastfeeding (12.8%) until six months of age. Another study from the Abhoynagar field site of ICDDR,B reported the prevalence of exclusive breastfeeding to be 15% only. Considerable efforts have been made to improve the rates of exclusive breastfeeding. Nationally, initiation of breastfeeding within one hour of birth, feeding colostrum, and exclusive breastfeeding have been promoted through the Baby-Friendly Hospital Initiative (BFHI) implemented and supported by BBF and UNICEF respectively. Since most (87-91%) deliveries take place in home, the BFHI has a limited impact on the breastfeeding practices. Results of a few studies done at ICDDR,B and elsewhere in developing countries showed that the breastfeeding peer-counselling method could substantially increase the rates of exclusive breastfeeding. Results of a study in urban Dhaka showed that the rate of exclusive breastfeeding was 70% among mothers who were counselled compared to only 6% who were not counselled. Results of another study in rural Bangladesh showed that peer-counselling given either individually or in a group improved the rate of exclusive breastfeeding from 89% to 81% compared to those mothers who received regular health messages only. This implies that scaling up peer-counselling methods and incorporation of breastfeeding counselling in the existing maternal and child heath programme is needed to achieve the Millennium Development Goal of improving child survival. The recent data showed that the prevalence of starting complementary food among infants aged 6-9 months had increased substantially with 76% in the current dataset. However, the adequacy, frequency, and energy density of the complementary food are in question. Remarkable advances have been made in the hospital management of severely-malnourished children. The protocolized management of severe protein-energy malnutrition at the Dhaka hospital of ICDDR,B has reduced the rate of hospital mortality by 50%. A recent study at ICDDR,B has also documented that home-based management of severe protein-energy malnutrition without follow-up was comparable with a hospital-based protocolized management. Although the community nutrition centres of the NNP have been providing food supplementation and performing growth monitoring of children with protein-energy malnutrition, the referral system and management of complicated severely-malnourished children are still not in place.     

2009年陕西省农村6岁以下儿童生长发育与营养状况调查

目的调查分析陕西省农村地区6岁以下儿童生长发育与营养状况,了解陕西省农村儿童生长发育与营养状况存在的主要问题,为进一步制定营养改进措施提供依据。方法按中国CDC＂6岁以下儿童状况调查＂方案,对陕西省蓝田县、白水县共计636名6岁以下农村儿童进行身高、体重的测量和血红蛋白检测,并以问卷的形式对以上儿童的家长进行了喂养方式及辅食添加状况进行调查。结果 6岁以下儿童低体重率为3.30%,生长迟缓率为5.03%,消瘦率为1.10%,贫血率14.78%。结论婴幼儿辅食添加的时间、质量和数量上尚存在不科学之处。原因与经济贫困有关外,还与当地的婴幼儿家长缺乏婴幼儿喂养知识有关。     

Relationship between child feeding practices and malnutrition in 7 remote and poor counties, P R China

The World Health Organization reported that inappropriate feeding in children is responsible for one-third of the cases of malnutrition. This cross-sectional study aimed to determine the prevalence of malnutrition and identify the relationship between feeding practices and malnutrition in children below 5 years, in 7 remote and poor counties of China. A sample of 2201 children and 1978 caregivers were obtained with multistage cluster random sampling. A survey about feeding practices among the caregivers was implemented using a structured questionnaire, and the health status of children was evaluated using anthropometric measurements. We found 5 problems: first, high prevalence of stunting, underweight and wasting in children below 5 years old (19.3%, 13.1% and 5.5%); second, short duration of breastfeeding for children below 36 months; third, low prevalence of exclusive breastfeeding among children below 6 months of age and continued breastfeeding to 1 year (17.5% and 32.2%). Fourth, although most of the infants (81.1%) between 6 and 8 months of age were given complementary foods, some of the 6- to 8-month-old infants did not receive any complementary foods. Last, a higher prevalence of stunting among Chinese children who had never been breastfed, who had been breastfed for less than 1 year, or had been fed with semi-solid foods of poor quality. Therefore, we suggest that more programs to increase caregivers' feeding knowledge and practices be conducted, to improve the health of children in remote and poor areas in China.     

Feeding practices in 105 counties of rural China

BACKGROUND: China has the largest population in the world with more than 70% of the people living in rural areas. Over 34% of children under the age of 5 years are responded to show moderate or severe growth stunting, so United Nations International Children's Emergency Fund and Chinese Ministry of Health conducted this large-scale survey in China. This study aimed to learn the feeding practice, to find the problems in child-feeding practice and to provide evidence for the government to develop an approach to child malnutrition in rural China. METHODS: A structured questionnaire was used to survey 21,036 mothers of children with age of 0-24 months. RESULTS: Of the 20,915 children, 98.22% were breastfeeding and 24.36% were exclusively breastfeeding. The proportion of children with weekly protein intake was 78.47%. Among the infants under 4 months, the risk of pneumonia in the group of exclusive breastfeeding was 1.69%, while in the group of non-exclusive breastfeeding was 3.63%, showing a statistically significant difference between the two groups. The risk of diarrhoea in the group of exclusive breastfeeding and in the group of non-exclusive breastfeeding among the infants under 4 months was 24.37% and 40.86%, respectively, also showing a statistically significant difference between the two groups. For children with age 4-6 months, the complementary feeding contributed to a higher prevalence of diarrhoea, but not pneumonia. CONCLUSIONS: The breastfeeding was very common, but the exclusive breastfeeding was quite low and the exclusive breastfeeding for children under the age of 4 months decreased the risks of pneumonia and diarrhoea. For children with age 4-6 months, the exclusive breastfeeding could decrease the risk of diarrhoea, too. Protein intake was insufficient for children in rural China. The rural people lacked health knowledge and were greatly influenced by traditional feeding practices.     

1998～2003年中国母乳喂养与婴儿过渡期食物添加状况分析

[目的]从第三次国家卫生服务调查资料中了解我国婴儿喂养现状,从而发现问题、提出建议.[方法]利用第三次国家卫生服务调查的资料,对婴儿喂养情况进行描述性分析.[结果]1998～2003年间我国产妇早开奶率为19%～26%,且在县（区）级以上医院或妇幼保健院住院分娩的产妇早开奶情况并不好于不在上述医院住院分娩的产妇;城乡的母乳喂养情况较好;农村地区儿童辅食添加存在问题,普遍存在辅食添加过晚的现象,而四类农村地区存在过早添加辅食现象,在四类农村,有约50%的婴儿在4个月内添加了辅食.[结论]近年我国儿童母乳喂养率高,但产妇早开奶情况无明显改善;在农村地区,儿童辅食添加过早和过晚现象同时存在.     

Ecological factors underlying protein-calorie malnutrition in an irrigated area of the Sudan

A community survey was undertaken in 14 villages in the Gezira farming region of the Sudan to determine the causes of malnutrition which is prevalent in the area. Low expenditure on food, poor housing conditions, and poor hygiene were found to result from low income. While the ultimate goal should be improvement of income, quicker results will accrue from tackling the equally important dietary causes which result from ignorance about child feeding. In the Sudan, the decline of breastfeeding, the rise in bottlefeeding, the lack of supplementary feeding, and inequitable intrafamily distribution of food are particularly important causative factors. The low levels of immunization against communicable diseases is a contributory factor which could be corrected immediately. Family size and birth rank were not important in the etiology of malnutrition.