Effects of a community-based approach of food and psychosocial stimulation on growth and development of severely malnourished children in Bangladesh: a randomised trial
Effects of a community-based approach of food and psychosocial stimulation on growth and development of severely malnourished children in Bangladesh: a randomised trial
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DOI：
10.1038/ejcn.2012.13
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发表时间：
2012-06-01
影响因子：
4.7
通讯作者：
Persson, L. A.
中科院分区：
文献类型：
--
作者：
Nahar, B.;Hossain, M. I.;Persson, L. A.
背景/目标：社会心理刺激（PS）和食品补充剂（FS）可改善营养不良儿童的发育。本研究评估了以社区为基础的 PS 和 FS 对严重营养不良儿童生长发育的影响。 对象/方法：6-24 个月的严重体重不足住院儿童 (n = 507) 在出院时被随机分配到五组：(i) PS、(ii) FS、(iii) PS_FS、(iv) 诊所对照和 (v) 医院对照。 PS 包括游戏课程和有关儿童发展的家长咨询。社区诊所每两周（即每两周）进行一次随访，持续 6 个月。 FS 包括分发 3 个月的谷物食品包（150-300 kcal/天）。所有组均接受医疗护理、微量营养素补充、健康教育和生长监测。在基线和干预 3 个月和 6 个月后，使用修订版贝利婴儿发育量表评估儿童的发育。使用标准程序测量人体测量结果：将有任何刺激的组与没有刺激的组进行比较，发现刺激对儿童的心理发展指数（组*会话相互作用 P = 0.037，效应大小 = 0.37 s.d.）和年龄体重 Z 分数（组 * 会话相互作用 P = 0.02，效应大小 0.26 s.d.）有显着影响。然而，由于最初非常严重的营养不良，发育和营养状况持续不佳。对运动发育和线性生长没有影响。结论：接受任何刺激的儿童对智力发育和体重增长都有显着的益处。需要更深入、更长时间的干预来纠正他们较差的发育水平和营养状况。欧洲临床营养杂志 (2012) 66, 701-709; doi：10.1038/ejcn.2012.13； 2012 年 2 月 22 日在线发布
Background/Objective: Psychosocial stimulation (PS) and food supplementation (FS) improve development of malnourished children. This study evaluates the effects of a community-based approach of PS and FS on growth and development of severely malnourished children.Subjects/Methods: Severely underweight hospitalised children aged 6-24 months (n = 507) were randomly allocated on discharge to five groups: (i) PS, (ii) FS, (iii) PS_FS, (iv) clinic-control and (v) hospital-control. PS included play sessions and parental counselling on child development. This was done at each fortnightly follow-up visit, that is, every second week, for 6 months at community clinics. FS included distribution of cereal-based food packets (150-300 kcal/day) for 3 months. All groups received medical care, micronutrient supplementation, health-education and growth monitoring. Children's development was assessed using revised version of Bayley Scales of Infant Development at baseline and after 3 and 6 months of intervention. Anthropometry was measured using standard procedure.Results: Comparing groups with any stimulation with those with no stimulation there was a significant effect of stimulation on children's mental development index (group*session interaction P = 0.037, effect size = 0.37 s.d.) and weight-for-age Z-score (group*session interaction P = 0.02, effect size 0.26 s.d.). Poor levels of development and nutritional status were sustained, however, due to their initial very severe malnutrition. There was no effect on motor development and linear growth.Conclusion: Children receiving any stimulation showed a significant benefit to mental development and growth in weight. More intensive intervention with longer duration is needed to correct their poor developmental levels and nutritional status. European Journal of Clinical Nutrition (2012) 66, 701-709; doi: 10.1038/ejcn.2012.13; published online 22 February 2012