Child disability screening, nutrition, and early learning in 18 countries with low and middle incomes: data from the third round of UNICEF's Multiple Indicator Cluster Survey (2005-06)
Child disability screening, nutrition, and early learning in 18 countries with low and middle incomes: data from the third round of UNICEF's Multiple Indicator Cluster Survey (2005-06)
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DOI：
10.1016/s0140-6736(09)61871-7
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发表时间：
2009-11-01
期刊：
影响因子：
168.9
通讯作者：
Durkin, Maureen S.
中科院分区：
文献类型：
--
作者：
Gottlieb, Carissa A.;Maenner, Matthew J.;Durkin, Maureen S.
儿童残疾是一个正在出现的全球卫生优先事项。为了满足对关于残疾儿童的频率和情况的国际可比资料的需要，儿童基金会建议各国在多指标类集调查（多指标类集调查）方案中列入残疾问题的十个问题筛选。我们研究了低收入和中等收入国家的儿童残疾筛查及其与营养和早期学习的关系。方法对2005- 2006年参加第三轮多指标类集调查的18个国家的191199名2-9岁儿童进行残疾筛查阳性或有残疾风险的儿童百分比进行横断面数据分析。根据社会人口学、营养、早期学习和学校教育变量对筛查结果进行描述性分析。我们构建了一个加权分析来解释每个国家的抽样设计，并使用chi(2)分析来检验国家内部的差异。在18个参与国中，2-9岁儿童中有23%（范围3- 48%）的残疾筛查呈阳性。2 - 4岁儿童,残疾是筛查阳性非母乳喂养的儿童更有可能与那些(中值36% [9-56]vs 26%[4-51])在18个国家八,在孩子尚未收到补充维生素A和那些(36% vs 29%[4-50][7-53])在10个国家的五个评估,在孩子遇到发育不良(26%[6-54])或标准体重不足(3 - 61)(36%)和那些没有(25%(3-42)和26% (4-43),在被评估为发育迟缓的15个国家中有5个，在被评估为体重不足的15个国家中有7个，在18个国家中有8个国家中参与早期学习活动较少的国家中（31%[7-54]对24%[4-51]）。在18个国家中的8个国家中，6-9岁未上学儿童的残疾筛查呈阳性的比例高于上学儿童（29%[2-83]对22%[3-47]）。我们的研究结果让人们注意到，需要提高全球评估残疾风险儿童的能力，并为他们提供服务。低收入和中等收入国家需要进一步研究，以了解和解决营养缺乏和学习机会受限作为儿童残疾的潜在先兆和歧视后果的作用。
Background Child disability is an emerging global health priority. To address the need for internationally comparable information about the frequency and situation of children with disabilities, UNICEF has recommended that countries include the Ten Questions screen for disability in the Multiple indicator Cluster Survey (MICS) programme. We examined child disability screening and its association with nutrition and early learning in countries with low and middle incomes.Methods Cross-sectional data for the percentage of children screening positive for or at risk of disability were obtained for 191199 children aged 2-9 years in 18 countries participating in the third round of MICS in 2005-06. Screening results were descriptively analysed according to sociodemographic, nutritional, early-learning, and schooling variables. We constructed a weighted analysis to account for the sampling design in every country and tested for differences within countries using chi(2) analyses.Findings A median 23% (range 3-48) of children aged 2-9 years screened positive for disability in the 18 participating countries. For children aged 2-4 years, screening positive for disability was significantly more likely in children who were not breastfed versus those who were (median 36% [9-56] vs 26% [4-51]) in eight of 18 countries, in children who had not received vitamin A supplementation versus those who had (36% [7-53] vs 29% [4-50]) in five of ten countries assessed, in children who met criteria for stunting (26% [6-54]) or being underweight (36% [3-61]) versus those who did not (25% [3-42] and 26% [4-43], respectively) in five of 15 countries assessed for stunting and in seven of 15 countries assessed for being underweight, and in those who participated in few early-learning activities versus others (31% [7-54] vs 24% [4-51]) in eight of 18 countries. Children aged 6-9 years who did not attend school screened positive for disability more often than did children attending school (29% [2-83] vs 22% [3-47]) in eight of 18 countries.Interpretation Our results draw attention to the need for improved global capacity to assess and provide services for children at risk of disability. Further research is needed in countries with low and middle incomes to understand and address the role of nutritional deficiencies and restricted access to learning opportunities as both potential antecedents of childhood disability and consequences of discrimination.