The importance of public health, poverty reduction programs and women's empowerment in the reduction of child stunting in rural areas of Moramanga and Morondava, Madagascar.
The importance of public health, poverty reduction programs and women's empowerment in the reduction of child stunting in rural areas of Moramanga and Morondava, Madagascar.
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DOI：
10.1371/journal.pone.0186493
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Randremanana RV
中科院分区：
文献类型：
--
作者：
Remonja CR;Rakotoarison R;Rakotonirainy NH;Mangahasimbola RT;Randrianarisoa AB;Jambou R;Vigan-Womas I;Piola P;Randremanana RV
营养不良占五岁以下儿童死亡率的45%，尽管全球正在动员起来抗击慢性营养不良。在马达加斯加，最新数据显示，5岁以下儿童发育迟缓的患病率仍在47.4%左右。这项研究旨在确定Moramanga和Morondava地区农村地区儿童发育迟缓的决定因素，以针对主要干预地区。2014-2015年间，一项病例对照研究在6至59.9个月大的儿童中进行。我们测量了母亲和儿童的身高和体重，并收集了儿童、母亲和家庭特征的数据。从每个儿童身上采集一份粪便样本，用于肠道寄生虫鉴定。我们使用多变量Logistic回归模型，使用反向逐步方法来确定发育迟缓的决定因素。我们在Moramanga和Morondava分别包括894名和932名儿童。发育迟缓在两个地区都很普遍，Moramanga和Morondava分别为52.8%和40.0%。在这两个研究地点，发育迟缓与特定的年龄阶段(12mo至35mo)最相关。感染鞭虫(AOR：2.4，95%CI：1.1-5.3)和贫困家庭(AOR：2.3，95%CI：1.6-3.4)是Moramanga的主要危险因素。在莫伦达瓦，母亲在家庭外活动(AOR：1.7，95%CI：1.2-2.5)和出生时体型较小(AOR：1.6，95%CI：1.1-2.1)的儿童更有可能发育迟缓，而适当的生育间隔(≥24个月)似乎具有保护性(AOR：0.4，95%CI：0.3-0.7)。可在这两个领域改善儿童成长的干预措施包括减贫、赋予妇女权力、侧重于清洁卫生和提高可接受性的公共卫生方案以及提高儿童/产妇保健服务的覆盖面和质量。
Malnutrition accounts for 45% of mortality in children under five years old, despite a global mobilization against chronic malnutrition. In Madagascar, the most recent data show that the prevalence of stunting in children under five years old is still around 47.4%. This study aimed to identify the determinants of stunting in children in rural areas of Moramanga and Morondava districts to target the main areas for intervention. A case-control study was conducted in children aged from 6 to 59.9 months, in 2014–2015. We measured the height and weight of mothers and children and collected data on child, mother and household characteristics. One stool specimen was collected from each child for intestinal parasite identification. We used a multivariate logistic regression model to identify the determinants of stunting using backwards stepwise methods. We included 894 and 932 children in Moramanga and in Morondava respectively. Stunting was highly prevalent in both areas, being 52.8% and 40.0% for Moramanga and Morondava, respectively. Stunting was most associated with a specific age period (12mo to 35mo) in the two study sites. Infection with Trichuris trichiura (aOR: 2.4, 95% CI: 1.1–5.3) and those belonging to poorer households (aOR: 2.3, 95% CI: 1.6–3.4) were the major risk factors in Moramanga. In Morondava, children whose mother had activities outside the household (aOR: 1.7, 95% CI: 1.2–2.5) and those perceived to be small at birth (aOR: 1.6, 95% CI: 1.1–2.1) were more likely to be stunted, whereas adequate birth spacing (≥24months) appeared protective (aOR: 0.4, 95% CI: 0.3–0.7). Interventions that could improve children’s growth in these two areas include poverty reduction, women’s empowerment, public health programmes focusing on WASH and increasing acceptability, and increased coverage and quality of child/maternal health services.
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影响因子：
2.8
作者：
Gibbs CM;Wendt A;Peters S;Hogue CJ
通讯作者：
Hogue CJ
影响因子：
7.7
作者：
Fuller, James A.;Villamor, Eduardo;Eisenberg, Joseph N. S.
通讯作者：
Eisenberg, Joseph N. S.
影响因子：
3.4
作者：
CASEMORE, DP
通讯作者：
CASEMORE, DP
影响因子：
7.7
作者：
Christian P;Lee SE;Donahue Angel M;Adair LS;Arifeen SE;Ashorn P;Barros FC;Fall CH;Fawzi WW;Hao W;Hu G;Humphrey JH;Huybregts L;Joglekar CV;Kariuki SK;Kolsteren P;Krishnaveni GV;Liu E;Martorell R;Osrin D;Persson LA;Ramakrishnan U;Richter L;Roberfroid D;Sania A;Ter Kuile FO;Tielsch J;Victora CG;Yajnik CS;Yan H;Zeng L;Black RE
通讯作者：
Black RE
影响因子：
3.9
作者：
Branca, F;Ferrari, M
通讯作者：
Ferrari, M