Determinants of childhood stunting in the Democratic Republic of Congo: further analysis of Demographic and Health Survey 2013-14
Determinants of childhood stunting in the Democratic Republic of Congo: further analysis of Demographic and Health Survey 2013-14
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DOI：
10.1186/s12889-017-4621-0
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发表时间：
2017-08-01
影响因子：
4.5
通讯作者：
Hatloy, Anne
中科院分区：
文献类型：
--
作者：
Kismul, Hallgeir;Acharya, Pawan;Hatloy, Anne
背景：刚果民主共和国（DRC）的儿童发育迟缓患病率是世界上最高的。有必要系统地调查发育迟缓如何在不同的决心水平上发生作用，并查明造成发育迟缓的主要因素。本研究的目的是寻找发育迟缓的关键决定因素在DRCA.Methods：本研究使用的数据从刚果民主共和国人口健康调查2013-14，其中包括人体测量9030 5岁以下儿童。根据WHO指南计算年龄别身高Z评分并分类。发育迟缓和生物人口学特征之间的关联进行了评估，采用logistic回归。在发育迟缓的发生率方面，城乡差距很大，农村地区发育迟缓儿童的比例高于城市。年龄大于6个月、前一次生育间隔小于24个月、来自较低财富五分位数的男婴发育迟缓的几率最高。有几个省份发育迟缓的几率特别高。早期开始母乳喂养，母亲分娩时年龄超过20岁，发育迟缓的几率较低。母亲越高，孩子发育不良的可能性就越小。同样，母亲的体重指数，获得安全饮用水，获得卫生厕所，母亲的受教育程度与儿童发育迟缓的双变量Logistic回归呈负相关，但他们失去了统计学意义的多变量分析与儿童在家庭和居住地的数量。结论：儿童发育迟缓是普遍存在的刚果民主共和国和日益增加的患病率是令人担忧的。这项研究确定了决定刚果民主共和国发育迟缓高患病率的可改变因素。政策实施应特别针对发育迟缓高发省份，并解决可改变的决定因素，如减少社会经济差距。促进营养的干预措施，包括尽早开始母乳喂养，应成为当务之急。
Background: Prevalence of child stunting in the Democratic Republic of Congo (DRC) is among the highest in the world. There is a need to systematically investigate how stunting operates at different levels of determination and identify major factors contributing to the development of stunting. The aim of this study was to look for key determinants of stunting in the DRC.Methods: This study used data from the DRC Demographic Health Survey 2013-14 which included anthropometric measurement for 9030 under 5 year children. Height-for-Age Z score was calculated and classified according to the WHO guideline. The association between stunting and bio-demographic characteristics was assessed using logistic regression.Results: Prevalence of stunting was much higher in boys than girls. There was a significant rural urban gap in the prevalence of stunting with rural areas having a larger proportion of children living with stunting than urban. Male children, older than 6 months, preceding birth interval less than 24 months, being from lower wealth quintiles had the highest odds of stunting. Several provinces had in particular high odds of stunting. Early initiation of breastfeeding, mother's age more than 20 years at the time of delivery had lower odds of stunting. The taller the mother the less likely the child was to be stunted. Similarly, mother's BMI, access to safe water, access to hygienic toilet, mother's education were found negatively correlated with child stunting in the bivariate logistic regression, but they lost statistical significance in multivariate analysis together with numbers of children in the family and place of residence.Conclusions: Child stunting is widespread in the DRC and increasing prevalence is worrisome. This study has identified modifiable factors determining high prevalence of stunting in the DRC. Policy implementation should in particular target provinces with high prevalence of stunting and address modifiable determinants such as reducing socioeconomic disparity. Nutrition promotion intervention, including early initiation of breastfeeding should be an immediate priority.