Children with access to improved sanitation but not improved water are at lower risk of stunting compared to children without access: a cohort study in Ethiopia, India, Peru, and Vietnam.
Children with access to improved sanitation but not improved water are at lower risk of stunting compared to children without access: a cohort study in Ethiopia, India, Peru, and Vietnam.
复制标题
与无障碍儿童相比，有改善卫生但没有改善水的儿童患有阻碍：在埃塞俄比亚，印度，秘鲁和越南进行的同类研究。
DOI：
10.1186/s12889-017-4033-1
复制
发表时间：
2017-01-23
影响因子：
4.5
通讯作者：
Young Lives Determinants and Consequences of Child Growth Project Team
中科院分区：
文献类型：
--
作者：
Dearden KA;Schott W;Crookston BT;Humphries DL;Penny ME;Behrman JR;Young Lives Determinants and Consequences of Child Growth Project Team
这项研究的目的是了解水，卫生设施和儿童成长之间的联系。我们使用来自Young Lives研究的7，715名埃塞俄比亚、印度、秘鲁和越南儿童的数据估计了发育迟缓（年龄别身高Z评分<-2 SD）和消瘦（BMI-Z <-2 SD）的风险比。 在未经调整的模型中，家庭获得改善的水和厕所往往与降低发育迟缓的风险，调整后的儿童，家庭，父母，和社区变量，获得改善的水通常与发育迟缓，也不瘦，除了在埃塞俄比亚，获得改善的水与1岁和5岁时减少发育迟缓和瘦。相比之下，在未调整和调整的模型中，1岁时发育迟缓在厕所使用方便的儿童中比在没有厕所的儿童中更不常见，并且这种差异在儿童5岁和8岁时持续存在。例如，在调整后的估计中，越南5岁的儿童在8岁时获得改善厕所的相对发育迟缓风险为0.62 - 0.68，而5岁的儿童没有获得改善厕所。水和厕所很少与瘦联系在一起。我们的研究结果表明，获得改善的卫生设施比获得改善的水更容易降低发育迟缓的风险。然而，在就厕所相对于水的影响得出明确结论之前，还需要进行更多的研究。据我们所知，这项研究首次证明了婴儿期获得改善厕所的强大和持久的重要性，不仅在第一年，而且持续到童年。需要进行更多的纵向调查，以确定WASH与发育迟缓和消瘦的同时和长期关系。本文的在线版本（doi：10.1186/s12889 - 017 - 4033 - 1）包含补充材料，可供授权用户使用。
This study’s purpose was to understand associations between water, sanitation, and child growth. We estimated stunting (height-for-age Z score <−2 SD) and thinness (BMI-Z <−2 SD) risk ratios using data from 7,715 Ethiopian, Indian, Peruvian, and Vietnamese children from the Young Lives study. In unadjusted models, household access to improved water and toilets was often associated with reduced stunting risk. After adjusting for child, household, parent, and community variables, access to improved water was usually not associated with stunting nor thinness except in Ethiopia where access to improved water was associated with reduced stunting and thinness at 1y and 5y. In contrast, in both unadjusted and adjusted models, stunting at 1y was less common among children with good toilet access than among those without access and this difference persisted when children were 5y and 8y. For example, in adjusted estimates, Vietnamese 5y olds with access to improved toilets had relative stunting risk at 8y 0.62-0.68 that of 5y olds with no access to improved toilets. Water and toilets were rarely associated with thinness. Results from our study indicate that access to improved sanitation is more frequently associated with reduced stunting risk than access to improved water. However, additional studies are needed before drawing definitive conclusions about the impact of toilets relative to water. This study is the first to our knowledge to demonstrate the robust and persistent importance of access to improved toilets in infancy, not only during the first year but continuing into childhood. Additional longitudinal investigations are needed to determine concurrent and long-term associations of WASH with stunting and thinness. The online version of this article (doi:10.1186/s12889-017-4033-1) contains supplementary material, which is available to authorized users.