Malnutrition is a determining factor in diarrheal duration, but not incidence, among young children in a longitudinal study in rural Bangladesh

Diarrhea and malnutrition are common in young children in developing countries and a reciprocal relationship has been postulated with diarrhea leading to malnutrition and malnutrition predisposing to diarrhea. To investigate the importance of malnutrition as a determining factor in diarrheal illnesses, data were analyzed from a longitudinal community-based study done in rural Bangladesh. Children classified by nutritional status according to a variety of anthropometric indicators were prospectively evaluated for incidence, duration, and etiology of diarrhea. Children with low weight for length had longer durations of diarrhea than better nourished children; however, children of differing nutritional status had similar diarrheal incidences. The duration of diarrhea, including that associated with enterotoxigenic Escherichia coli and Shigella, increased progressively as nutritional status indicators worsened. These results suggest that nutritional interventions alone are unlikely to reduce the high incidence of diarrhea, but that efforts to improve nutritional status may have a beneficial effect on the duration of diarrhea and its unfavorable nutritional consequences.     

沈阳市城区儿童营养与健康状况调查及影响因素分析

目的 了解沈阳市城区儿童营养与健康状况,掌握儿童常见营养性疾病的发病率、发病原因及影响因素。方法 采用整群分层抽样方法随机抽取沈阳市2个城区8个街道共6 477名5岁以下儿童开展流行病学调查。结果 不同月龄、不同性别婴儿体重和身高均值均高于WHO(2006)标准,男婴高于女婴,差异有统计学意义(P均＜0.01);5岁以下儿童低体重、生长迟缓、消瘦、超重、肥胖患病率分别为0.12%、0.35%、0.75%、22.59%、8.17%;6~8个月和5岁以下儿童贫血发生率分别为12.35%、8.12%;5岁以下儿童呼吸道感染与腹泻两周患病率分别为8.65%、14.40%。结论 应加强5岁以下儿童健康管理,开展儿童体格及营养发育监测;对辖区内儿童家长进行科学喂养指导,提高母乳喂养率,以降低5岁以下儿童尤其是6个月儿童营养性缺铁性贫血的发生,提高5岁以下儿童营养健康水平。     

Association between household solid waste disposal and health, Belo Horizonte (MG), Brasil]

There are few published studies about the effects of inadequate solid waste collection on the health of the population exposed to this situation. The objective of the present work was to describe this association in a sample of children under 5 years of age living in seven low-income neighborhoods and favelas in the city of Belo Horizonte, state of Minas Gerais, Brazil. We defined as "exposed" those children whose families were not served by waste collection; "not-exposed" were children who lived in areas with waste collection. The study employed data collected in 1994 and organized as a database by the municipal department of health. We employed a cross-sectional design, in which a "case" was defined as a child whose outpatient clinic record indicated a diagnosis of diarrheal, parasitic, or dermatological disease. Other diagnoses for the same age group composed the control group. Our epidemiological study revealed an association between the absence of domestic solid waste collection and public health. Our results suggest that the children exposed to the absence of solid waste collection have a 40% higher odds (OR = 1.40) of presenting diarrheal, parasitic, and dermatological diseases than not-exposed children. In addition, the calculation of attributable risk revealed that the presence of waste collection could prevent (based on the 1995 situation) 512 cases in the neighborhoods studied and (based on the 1994 conditions) 2316 cases among children in the entire city of Belo Horizonte.     

An epidemiological study of health and nutritional status of under five children in semi-urban community of Gujarat

In developing countries, children of 0-5 years of age form a large as well as "high risk" group. Malnutrition poses a grave risk to the health of these children. The main objectives of this study were to assess the health & nutritional status of children of 0-5 years of age group & to study the influence of various epidemiological factors on health & nutritional status of children on 0-5 years of age group. It is a community based cross sectional study done in randomly selected three wards of Petlad town, district Anand in Gujarat state. 300 children of age group 0-5 years selected by systematic sampling method. Mother of each child included in the study was subjected to personal interview in her own house followed by clinical examination & anthropometric measurements of the child. The three indices of nutritional status namely, weight for age, height for age, & weight for height were expressed in standard deviation units from the median for the international reference populations as per WHONCHS standards & were compared with WHONCHS growth reference data. The prevalence of under weight (wt. for age below 2SD) was 43.67%. 50.3% children were found stunted (ht. 1br age below -2 SID) with higher prevalence in 2nd and 5th year of life. Prevalence of wasting (wt. for ht. below 2SD) was comparatively low (23.2% with a peak in 3rd year of life). These nutritional parameters showed a significant association with parental education, socio-economic status, family size, environmental conditions (safe drink water, sanitary waste disposal & overcrowding), & episodes of common diseases.     

Intra-household correlations in maternal-child nutritional status in rural Guinea: implications for programme-screening strategies.

It is commonly assumed in public health practice that households in developing country settings are relatively homogeneous with respect to nutritional status. To the extent that this assumption is valid, nutritional assessments of mothers or individual children would provide an effective screening mechanism for household-level maternal-child nutritional risk. However, there has been no confirmation of the strength of intra-household correlations in nutritional status among women and children. Using data from a cross-sectional survey undertaken in 1990 in rural central Guinea, the present study investigates the nature of within-household relationships in maternal and child nutritional status and considers the implications for programme screening strategies. Mothers and their surviving children under 5 years of age are the focus of the analysis. Correlations between maternal and child nutritional levels are assessed and the performance of maternal-child nutritional indicators as screening tools for household nutritional risk are formally evaluated by analysing the sensitivity, specificity, and positive-negative predictive values of various indicators.     

Mild vitamin A deficiency and risk of respiratory tract diseases and diarrhea in preschool and school children in northeastern Thailand

A cross-sectional study, a follow-up study, and an intervention trial were carried out to investigate the association between mild vitamin A deficiency and the occurrence of diarrhea and respiratory diseases. Cross-sectional analysis was performed among 1,772 children, aged 1-8 years, in the Sakon Nakhon province of northeastern Thailand. Children with a history of diarrhea or respiratory disease had lower levels of serum retinol and retinol-binding protein. Adjusted for age, sex, nutritional status, and level of urbanization, logistic regression using data for 877 children showed a negative association between serum retinol and both diarrhea and respiratory diseases. A follow-up three months later (n = 146 children) showed that children with deficient serum retinol (less than 0.35 mumol/liter) had a fourfold greater risk of respiratory disease (p less than 0.01). No relation was found for diarrhea. An intervention trial (n = 166 children aged 1-5 years) showed that, during 2 months of follow-up after administration of oral vitamin A (200,000 IU), the control group (aged 3-5 years) had a higher incidence of respiratory disease (2.9 times) as well as diarrhea (3.1 times). Between 2 and 4 months, a significantly (p less than 0.025) higher incidence of respiratory diseases (2.5 times) could be observed in children aged 1-2 years. This study supports earlier reports on a greater risk of respiratory diseases and of diarrhea in mild vitamin A deficiency. Supplementation reduced the incidence of both diarrhea and respiratory disease for a period of at least 2 months.     

2012-2016年河北省5岁以下腹泻患儿轮状病毒感染情况及流行特征分析

目的 了解2012-2016年河北省5岁以下腹泻患儿轮状病毒流行病学特点和基因型别。方法 收集河北省病毒性腹泻监测哨点医院2012年1月-2016年12月0~59月龄腹泻患儿粪便标本1 614份。采用ELISA方法检测轮状病毒抗原,阳性标本采用RT-PCR法进行分型鉴定。采用SPSS 20.0软件对腹泻患儿轮状病毒的感染情况及流行特征进行分析。结果 1 614份标本轮状病毒抗原阳性率为45.23%(730/1 614),男女阳性率分别为42.96%(412/959)、48.55%(318/655),男女患儿差异有统计学意义(χ²=4.906,P=0.027)。轮状病毒感染呈现明显的季节性分布,秋冬季(11月-次年3月)检出率最高。轮状病毒感染在0~59月龄均有发生,集中在3~35月龄,占全部的96.44%,且随月龄增长呈现先升高后降低趋势,不同年龄组患儿中轮状病毒阳性率差异有统计学意义(χ² =94.369,P=0.000)。730例轮状病毒阳性标本在2012-2016年均以G9血清型为主,所占比例呈逐年上升趋势,P分型以P[8]为主。G/P组合以G9P[8]为主,占70.14%,其次为G2P[4],占7.53%。结论 2012-2016年,轮状病毒是河北地区5岁以下儿童病毒性腹泻的主要病原,秋冬季高发,G9P[8]为该地区的流行株。     

2005—2018年中国5岁以下轮状病毒腹泻报告病例流行特征分析

目的分析2005—2018年中国(不含中国香港、澳门和台湾数据,下同)5岁以下轮状病毒腹泻病例的流行特征及变化趋势。方法从传染病报告信息管理系统中下载2005—2018年中国其他感染性腹泻报告病例数据,提取、建立5岁以下轮状病毒腹泻报告病例数据库,用描述性流行病学方法分析其流行特征及变化趋势。结果2005—2018年共报告5岁以下儿童轮状病毒腹泻报告病例820588例,男性为500944例;年均报告发病率为63.7/10万,报告发病率从2005年的8.4/10万波动上升至2018年的178.1/10万;报告省份由17个增加到30个;发病高峰季节为11月至次年2月;<5月龄的儿童占13.1%(107845例),6月龄至2岁占70.3%(576874例),报告发病数高峰为11~13月龄儿童(163947例)。年均报告发病率前3位的省份分别为(535.2/10万)、广东(334.3/10万)和北京(317.3/10万);除西藏地区无报告外,报告发病率最低3个省份分别为山西(0.9/10万)、黑龙江(1.6/10万)和辽宁(2.5/10万);南方地区报告发病数(745526例)是北方(74935例)的9.9倍。检出轮状病毒与其他腹泻病原两种及以上同时感染的病例占1.8%(15030例),其中90.1%(13544例)是轮状病毒与腺病毒同时感染。结论我国5岁以下儿童自6月龄起轮状病毒感染率迅速上升,84.4%的报告病例为<2岁婴幼儿。     

Nutritional status and factors associated with stunting in children attending public daycare centers in the Municipality of São Paulo, Brazil

This study reports the nutritional status of children attending daycare centers in the Municipality of S?o Paulo, Brazil. A representative sample of 827 children under 84 months of age was evaluated. Anthropometric measurements and information on socioeconomic characteristics and morbidity were collected. The most prevalent nutritional deficit was stunting (7.0%; 95%CI: 3.60-10.40). Univariate analysis showed a significant association between stunting and age (< 24 months), OR = 2.10 (95%CI: 1.11-3.98); diarrhea one month prior to the data collection, OR = 2.84 (95%CI: 1.42-5.66); mother's or caregiver's schooling (< 3 years), OR = 3.87 (95%CI: 1.10-13.68); number of household members (> 7), OR = 3.02(95%CI: 1.46-6.22); and number of siblings (> 2) OR = 4.81 (95%CI: 1.72-13.44). In the multivariate analysis, only diarrhea one month prior to the data collection, OR = 2.54 (95%CI: 1.20-5.38) and > 2 siblings, OR = 7.40 (95%CI: 2.20-24.93), remained associated with stunting.     

Nutritional status of preschool Senegalese children: long-term effects of early severe malnutrition

The prevalence of malnutrition remains high in many developing countries. However, data relating to the long-term effects of severe malnutrition, specifically, serum levels of biochemical indicators of nutritional status, are still scarce in the literature. Hence the present study aimed to investigate the nutritional, biological and growth status of Senegalese preschool children previously hospitalised for severe malnutrition. The study involved twenty-four 7-year-old children who had suffered from marasmus 5 years earlier, twenty-four siblings living in the same household, and nineteen age-matched children living in the centre of Dakar. The siblings were of similar age to the post-marasmic children. Anthropometry, serum biochemical indicators of nutritional status, growth factors, and haematological and mineral parameters were measured. The prevalence of stunting and wasting was the same in the post-marasmic children as in the siblings. Body-fat and fat-free-mass (FFM) deficits in both groups were corroborated by abnormally low concentrations of transthyretin, osteocalcin, insulin-like growth factor (IGF)-1, and insulin-like growth factor-binding protein (IGFBP)-3. FFM was positively and significantly correlated with concentrations of IGF-1 and IGFBP-3. In the post-marasmic children, height for age was also correlated with IGF-1. Of the post-marasmic children, 53 % had Fe-deficiency anaemia, as did 35 % of the siblings and 29 % of the controls. No significant associations were found between the serum concentrations of Ca, Cu, K, Mg, Na, P, Se, Zn and growth retardation. At 5 years after nutritional rehabilitation, the post-marasmic children remained stunted with nutritional indices significantly lower than the control children. However, these children were doing as well as their siblings except for minor infections.     

2012年深圳市光明新区儿童感染性腹泻流行病学特征及相关因素分析

目的了解深圳市光明新区儿童感染性腹泻流行特征及因素,为有效控制该类疾病提供科学依据。方法对深圳市光明新区疾病监测信息报告管理系统中上报的儿童感染性腹泻病例进行描述性流行病学分析,并采用病例对照研究,选取100例儿童感染性腹泻患者作为病例组,并进行1:1条件匹配作为对照;制作调查表进行调查;采用单因素和多因素条件Logistic回归分析筛选危险因素。结果 2012年深圳市光明新区共报告感染性腹泻病例2 558例,其中儿童病例(0~14岁)2 373例,年发病率为0.48%。5岁儿童占15岁儿童报告病例的95.7%,感染性腹泻发病时间主要在秋冬季。单因素分析差异有统计学意义(P0.05)的变量为户籍、居住环境、家庭收入、剪手指甲、奶瓶(餐具)消毒、剩饭菜加热、剩饭菜处置、室内有苍蝇;多因素分析进入模型有统计学意义(P0.05)的变量为奶瓶(餐具)消毒和室内有苍蝇,其OR值分别为9.790和24.355。结论深圳市光明新区2012年感染性腹泻报告病例主要集中在0~5岁的散居儿童,秋冬季是感染性腹泻的发病高峰,奶瓶(餐具)消毒和室内有苍蝇是儿童感染性腹泻发生的危险因素。     

2009-2014年许昌市0～6岁儿童传染病流行病学分析

摘要:目的　分析2009-2014年许昌市0～6岁儿童法定报告传染病流行特征,为预防控制传染病提供科学依据。方法　采用描述流行病学方法进行数据分析。结果　2009-2014年共报告许昌市0～6岁儿童法定传染病28种42229例,年均发病率为1683.96/10万。前5位的病种为手足口病、流行性腮腺炎、其它感染性腹泻、细菌性痢疾和麻疹。不同年龄发病情况和疾病谱构成不同,手足口病、细菌性痢疾、其它感染性腹泻、麻疹发病率随年龄增长下降,流行性腮腺炎发病率随年龄增长上升;0～岁组儿童新生儿破伤风、梅毒、丙肝、肺结核发病率高于其他年龄组。肠道传染病发病最高峰出现在4-5月（占45.28%）,呼吸道传染病发病最高峰出现在4-6月（占42.52%）,虫媒及自然疫源性疾病发病高峰期为7-9月（占87.50%）,血源及性传播疾病无明显发病高峰。结论　许昌市0～6岁儿童传染病发病率高,是传染病预防控制工作的重点针对人群,应根据疾病谱、流行特征采取有效措施减少疫情发生。     

2006-2010四川地区婴幼儿腹泻轮状病毒监测

目的了解四川地区哨点医院轮状病毒腹泻流行状况和特点,为疫苗研制和疫情控制提供科学依据。方法四川监测点(成都市儿童医院)监测对象为5岁以下腹泻的门诊和住院患儿,收集2006-2010年患儿的粪便标本进行轮状病毒检测和分型,使用ELISA进行病毒检测,RT-PCR进行病毒分型。结果 972例腹泻患儿送检标本中检测到353株轮状病毒抗原阳性,阳性率为36.3%,6月龄-2岁幼儿是轮状病毒感染的高发年龄段,轮状病毒腹泻发病的高峰季节是10-12月份。结论轮状病毒是四川地区哨点医院婴幼儿腹泻的重要病原,毒株流行型别显示一定的规律性和多样性。     

Anthropometry and subsequent mortality in groups of children aged 6-59 months in Guinea-Bissau

To assess the importance of nutritional status for subsequent survival, 2228 children aged 6-59 mo were followed for 8-12 mo in four different areas of Guinea-Bissau. The overall death rate was 0.62/100 child-months of follow-up (126 deaths) and 0.63 for the 1756 children who were examined on entering the study (109 deaths). Mortality was twice as high in the periurban as in the rural areas due to an outbreak of measles. In a bivariate analysis the relationship between nutritional status indicators and mortality was confounded by the age dependence of both. Using Cox's regression technique, height-for-age but not weight-for-height was positively correlated with survival. The number of children in the household was a better discriminator for death from measles than was nutritional status. Long-term factors, probably of multiple social origin, are likely causes of both relatively short stature and high mortality.     

本溪市垃圾转运站发展的实践与探讨

本溪市自１９９４年起建设了约１００座垃圾房。通过对几种垃圾收运方式的比较，结合本溪市的实际情况确定以建设垃圾屋为主，逐渐开展居民生活垃圾袋化收集的方式，在新建小区的环卫验收时，要验收是否建设了配套的垃圾房，从而解决了垃圾房的建设资金问题，使环境卫工作得到发展。     

云南德宏州傣族、景颇族、阿昌族、德昂族0～6岁儿童营养不良等常见病的调查

目的:了解云南德宏州傣族、景颇族、阿昌族、德昂族0～6岁儿童营养不良现状,为防治疾病提供科学依据。方法:采用典型调查对云南德宏州傣族、景颇族、阿昌族、德昂族0～6岁儿童进行体格发育测量;调查急性呼吸道感染(ARI)、反复呼吸道感染(RRI)、腹泻(CDD)、贫血、营养不良等情况;血红蛋白Hb测定运用血细胞分析仪(迈瑞BC-2008),6月～6岁Hb<110 g/L为贫血;体格发育形态指标按全国九市儿童体格发育调查方案;统计处理和分析采用SPSS 15.0软件进行。结果:消瘦率、ARI、急性腹泻、慢性腹泻及贫血随年龄增加而降低;低体重率和发育迟缓率与年龄之间差异无统计学意义;RRI随年龄增加而增加;呼吸道感染(ARI、RRI)、慢性腹泻、贫血民族之间差异有统计学意义,其中景颇族贫血发病居4个民族之首,阿昌族以RRI、急性腹泻、慢性腹泻居4个民族之首;结论:营养不良有明显下降趋势;贫血发生率还很高,主要原因是地中海贫血占的比例大。     

Household income and health status in children and adolescents in Britain

BACKGROUND: Mortality, health, and well-being across the lifespan are associated with socioeconomic position (typically operationalised as occupational status). There is some evidence that adolescence represents a period of 'relative equalisation' of health inequalities. Our aim was to examine the association between inequalities in household income and health in childhood and adolescence. METHODS: Cross-sectional survey using multistage stratified random sample of households in Britain. Information was collected on 10438 children aged 5-15 years. RESULTS: Low levels of equivalised household income was associated with poorer health for 13 out of the 22 indicators examined (odds ratio P < 0.05 for > or =1 income quintile). Multivariate analyses controlling for child characteristics, parental socioeconomic status and household composition indicated that low levels of equivalised household income increased the odds of poor health for 9 out of the 22 indicators examined. There was little evidence of any systematic differences in the extent of health inequalities across age groups (5-10 and 11-15 years). CONCLUSION: Household income is related to a range of health outcomes for children and adolescents, even when other indicators of socioeconomic status are taken into account. We found little evidence that adolescence represents a period of relative equalisation of health inequalities.     

Environmental and health impacts of household solid waste handling and disposal practices in third world cities: the case of the Accra Metropolitan Area, Ghana

Inadequate provision of solid waste management facilities in Third World cities results in indiscriminate disposal and unsanitary environments, which threatens the health of urban residents. The study reported here examined household-level waste management and disposal practices in the Accra Metropolitan Area, Ghana. The residents of Accra currently generate large amounts of solid waste, beyond the management capabilities of the existing waste management system. Because the solid waste infrastructure is inadequate, over 80 percent of the population do not have home collection services. Only 13.5 percent of respondents are served with door-to-door collection of solid waste, while the rest dispose of their waste at communal collection points, in open spaces, and in waterways. The majority of households store their waste in open containers and plastic bags in the home. Waste storage in the home is associated with the presence of houseflies in the kitchen (r = .17, p < .0001). The presence of houseflies in the kitchen during cooking is correlated with the incidence of childhood diarrhea (r = .36, p < .0001). Inadequate solid waste facilities result in indiscriminate burning and burying of solid waste. There is an association between waste burning and the incidence of respiratory health symptoms among adults (r = .25, p < .0001) and children (r = .22, p < .05). Poor handling and disposal of waste are major causes of environmental pollution, which creates breeding grounds for pathogenic organisms, and the spread of infectious diseases. Improving access to solid waste collection facilities and services will help achieve sound environmental health in Accra.     

Lack of impact of a water and sanitation intervention on the nutritional status of children in rural Bangladesh

The nutritional impact of a water and sanitation intervention in a rural community of Bangladesh, comprising the provision of handpumps, construction of latrines and hygiene education was assessed. During 3 years, the quarterly anthropometric measures of about 200 children aged 12-35 months from the intervention community were compared with those of a similar number of children from a control area. The interventions reduced the incidence of diarrhoea by 25 per cent among the children less than 5 years of age. There was no significant difference in nutritional status, however, between the two groups of children. Moreover, within the intervention area, indicators of water and latrine use were not significantly related to the children's nutritional status. This suggests that either the obtained reduction of diarrhoea was not large enough to have an impact on nutritional status or that diarrhoea is not an important cause of malnutrition in this community.     

Global Burden of Nutritional Deficiencies among Children under 5 Years of Age from 2010 to 2019

Under-five years of age is a critical period for children’s growth and development. Nutritional deficiency during this period is associated with wasting, underweight and stunting. We aimed to conduct an epidemiological study using data derived from the GBD2019 to found the global distribution and changing trends of nutritional deficiencies among children under 5 years old, as well as the correlation between social development status and nutritional deficiencies. Nutritional deficiencies in children under 5 years has been substantially improved in the past decade; however, the progress has been unevenly distributed globally. The incidence and DALY rate decreased with the increase of socio-demographic index. In 2019, the incidence (51,872.0 per 100,000) was highest in Central Sub-Saharan Africa and the DALY rate (5597.1 per 100,000) was the highest in Western Sub-Saharan Africa. Among five subcategories of nutritional deficiencies in children under 5 years, vitamin A deficiency accounted for the largest proportion of incident cases (100,511,850, 62.1% in 2019), while the proportion of DALYs caused by protein–energy malnutrition was the highest (9,925,276, 62.0%). Nutritional deficiency in some countries remains worrisome, for whom policies guarantees and sustained efforts to control nutritional deficiencies are urgently needed.