Risk factors and regional variations of malnutrition among children under 5 in Myanmar: cross-sectional analyses at national and subnational levels
Risk factors and regional variations of malnutrition among children under 5 in Myanmar: cross-sectional analyses at national and subnational levels
复制标题
缅甸 5 岁以下儿童营养不良的风险因素和地区差异：国家和国家以下各级的横断面分析
DOI：
10.1136/bmjopen-2019-030894
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发表时间：
2019-09-01
期刊：
影响因子：
2.9
通讯作者：
Shibuya, Kenji
中科院分区：
文献类型：
--
作者：
Khaing, Hnin Thiri;Nomura, Shuhei;Shibuya, Kenji
目的缅甸儿童营养不良的水平、分布及其潜在危险因素尚不十分清楚。这项研究的目的是：估计目前全国和国家以下各级四种营养不良的流行率（发育迟缓、消瘦、体重不足和超重）;确定与每种类型的营养不良相关的潜在风险因素，并调查已确定的风险因素的分布如何解释营养不良患病率的地区差异。设计/2015-2016年缅甸人口与健康调查的数据被用来估计国家和国家以下各级（15个地区）四种类型营养不良的患病率。应用Logistic回归模型分析每种类型的营养不良与其危险因素之间的关系，包括儿童因素、父母社会地位和家庭条件。结果全国5岁以下儿童发育迟缓、消瘦、体重过轻和超重的患病率为29.1%（95% CI 27.7%至30.6%）、6.8%（6.0%至7.6%）、18.3%（17.0%至19.5%）和1.5%（1.1%至1.9%）。观察到每种营养不良的发生率存在很大的区域差异。每种类型的营养不良的几个风险因素，包括低出生体重（LBW）和产妇营养状况不佳。除了超重，区域差异很大程度上仍然存在，即使调整后的风险因素investigated.Conclusion 5岁以下儿童营养不良的患病率仍然很高，在缅甸，最常见的发育迟缓。应紧急鼓励采取有针对性的干预措施，以预防出生体重不足，改善产妇营养状况以及其他社会人口状况。有必要开展进一步的研究，调查该国5岁以下儿童营养不良发生率区域差异的潜在来源。
Objective The levels, distributions of child malnutrition and its potential risk factors are not very well known in Myanmar. The objectives included in this study were: to estimate the current national and subnational prevalence of four types of malnutrition (stunting, wasting, underweight and overweight) among children under 5 in Myanmar; to identify potential risk factors associated with each type of malnutrition and to investigate how the identified risk factors' distributions explained the regional disparities in malnutrition prevalence.Design/methods Data from the Myanmar Demographic and Health Survey 2015-2016 were used to estimate the prevalence of four types of malnutrition at both national and subnational levels (15 regions). Logistic regression models were applied to examine the association between each type of malnutrition and its risk factors, including child's factors, parental social status and household conditions. The risk factor-adjusted prevalence of the malnutrition was estimated at the subnational level based on the estimated parameters from the regression models.Results The national prevalence of stunting, wasting, underweight and overweight in children under 5 was estimated to be 29.1% (95% CI 27.7% to 30.6%), 6.8% (6.0% to 7.6%), 18.3% (17.0% to 19.5%) and 1.5% (1.1% to 1.9%), respectively. Substantial regional variations in the prevalence of each type of malnutrition were observed. Several risk factors of each type of malnutrition were identified, including low birth weight (LBW) and inadequate maternal nutritional status. Except for overweight, regional variations largely persisted even after adjustment for the risk factors investigated.Conclusion The prevalence of malnutrition among children under 5 is still high in Myanmar, most commonly stunting. Targeted interventions aimed at prevention of LBW, improving the maternal nutritional status, in addition to other sociodemographic conditions should be encouraged urgently. Further research is necessary to investigate the potential sources of regional variation in prevalence of malnutrition among children under 5 in the country.