Prevalence of undernutrition among children in the Garhwal Himalayas
Prevalence of undernutrition among children in the Garhwal Himalayas
复制标题
DOI：
10.1177/156482650903000108
复制
发表时间：
2009-03-01
影响因子：
1.9
通讯作者：
Sah, Archana
中科院分区：
文献类型：
--
作者：
Dutta, Anuradha;Pant, Kiran;Sah, Archana
背景资料。营养状况是衡量全球儿童福祉的最佳指标。在印度，每三个孩子中就有一个体重不足，而在加尔瓦尔喜马拉雅山脉，只有五分之一的孩子营养正常。关于加赫瓦尔地区儿童营养状况如此之低的原因，目前缺乏相关信息。目的：本研究旨在找出可能影响加赫瓦尔喜马拉雅地区儿童营养状况的因素。发育迟缓，意味着长期不可逆转的慢性营养不良，以及消瘦，意味着儿童严重营养不良。随机抽取三大农业气候条件(高、中、低丘陵)各一镇、一村的40户家庭，共计240户。通过营养人体测量法评估了353名儿童(0至12岁)的营养状况，并与分别识别消瘦和发育迟缓的年龄体重和年龄身高z分数表(WAZ和HAZ)进行了比较，并与世界卫生组织(WHO)2007年生长参考图进行了比较。采用卡方检验分析年龄、性别、海拔高度、地区等因素对儿童营养状况的影响。在研究的353名儿童中，38.2%属于学龄儿童，女孩比男孩多7%。仅有11.3%的儿童HAZ正常，10.3%的儿童WAZ正常。最大比例的儿童(31.8%的HAZ和29.1%的WAZ)聚集在SDI组，即严重发育迟缓或虚弱的组。除9至12岁组外，所有年龄组中，大多数儿童都属于WAZ SDI类别。性别似乎对SDI类别有很大影响。严重发育迟缓(SDI)女孩占17.0%，男孩占14.8%；WAZ女孩占16.1%，男孩占13%。城市地区的情况稍好一些：6.4%的样本HAZ正常，7.1%的样本WAZ正常，而农村儿童的这一比例分别为4.4%和4.6%。在所有三种农业气候情况下，HAZ SDI(发育迟缓)类别的儿童比例最大(15.3%在高山，7.3%在中山，9.5%在低山)。地区(农村和城市)对儿童发育迟缓和消瘦有显著影响。儿童性别只影响发育迟缓。另外两个变量，海拔高度和年龄，与发育迟缓或消瘦没有显著关系。加赫瓦尔地区的儿童营养不良率非常高。大多数人严重发育迟缓和消瘦，这表明慢性和急性营养不良的发病率很高。只有居住地(农村或城市)对儿童的营养状况有影响。
Background. Nutritional status is the best indicator of the global well-being of children. In India every third child is underweight, whereas in the Garhwal Himalayas only one-fifth of the children are nutritionally normal. Information regarding the causes of such low nutritional status in children of Garhwal is lacking.Objective, The present study was designed to identify factor.; that may influence the nutritional status of the children of the Garhwal Himalayas. Stunting, signifying long-term irreversible chronic undernutrition, was studied, along with wasting, which signifies acute undernutrition among children.Methods. Forty families from one town and one village in each of the three major agroclimatic situations (high, middle, and low hills) were selected at random (total 240 families). The nutritional status of 353 children (0 to 12 years of age) was assessed by nutritional anthropometry and compared with tables of weight-for-age and height for-age z-scores (WAZ and HAZ) identifying wasting and Stunting, respectively, and compared with the World Health Organization (WHO) Growth Reference charts 2007. Chi-square test was applied to analyze the effects of age, sex, altitude, and area on the nutritional status of children.Results. Of the 353 children studied, 38.2% belonged to the school-aged group, with 7% more girls than boys. Only 11.3% of the children had normal HAZ while 10.3% had normal WAZ. The largest percentages of children (31.8% HAZ and 29.1%, WAZ) were clustered in the SDI group, that is the severely stunted or wasted group. In every age group except the 9- to 12-year group, most of the children were found in the WAZ SDI category. Gender appeared to influence the SDI category significantly. There were 17.0% severely stunted girls (SDI), as compared to 14.8% boys; while the percentages of WAZ girls was 16.1% and boys was 13%. The situation in the urban areas was slightly better: 6.4% of the sample had normal HAZ and 7.1% had normal WAZ compared with 4.4% and 4.6% of the rural children. In all three agroclimatic situations, the largest percentage of children fell in the HAZ SDI (stunted) category (15.3% in the high hills, 7.3% in the middle hills, and 9.5% in the low hills). There is a significant effect of area (rural vs. urban) on stunting and wasting among children. The child sex affects stunting only. The other two variables, altitude and age, do not show a significant relationship with stunting or wasting.Conclusions. The rate of malnutrition among children in the Garhwal is very high. The majority are severely stunted and wasted, indicating a high prevalence of both chronic and acute malnutrition. Only the area of residence (rural or urban) had an influence on a child nutritional status.