卫生研究

目的研究2009年中国贫困地区5岁以下儿童营养不良状况及其影响因素。方法采用多阶段分层整群随机抽样方法,共调查贫困地区5岁以下儿童7818名。内容包括询问调查、体格测量、生化检测和膳食调查。以2006年WHO生长发育标准计算Z评分,5岁以下儿童营养不良率的计算采用WHO Anthro V3.2.2软件。多因素分析采用非条件logistic回归。数据清理和分析均采用SAS 9.12统计软件。结果 2009年中国贫困地区5岁以下儿童生长迟缓率为15.9%,低体重率为7.8%,消瘦率为3.7%。排除了其他变量的影响后显示,那些低出生体重(OR=1.975,95%CI=1.515～2.575)、家庭年人均收入2000元以下(OR=1.813,95%CI=1.364～2.409)、看护人为非父亲/母亲(OR=1.190,95%CI=1.022～1.387)、家庭饮水不卫生(OR=1.282,95%CI=1.120～1.466)的儿童更容易发生营养不良;与母亲职业为技术、干部、军人等的儿童相比,母亲是纯农民、农民工、农村手工业/个体工商户以及从事家务等职业的儿童发生营养不良的危险分别是前者的5.384倍(OR=5.384,95%CI=2.490～11.642)、4.244倍(OR=4.244,95%CI=1.953～9.222)、4.872倍(OR=4.872,95%CI=2.169～10.947)和5.331倍(OR=5.331,95%CI=2.438～11.654);距离住所1公里以内有医疗点是儿童营养不良的保护因素(OR=1.246,95%CI=1.100～1.411);出生后9个月才开始添加辅食可增加儿童营养不良危险(OR=1.194,95%CI=1.016～1.403)。结论贫困地区5岁以下儿童营养不良状况不容忽视,影响贫困地区5岁以下儿童营养状况的不良因素依然存在和变化。综合改善将是有效措施。

Objective To study the status of malnutrition and its influencing factors in children less than 5 years of age in poor areas of China in 2009.Methods Multistage stratified random cluster sampling method used in the national survey was performed.The subjects of the study were 7818 children less than 5 years of age in poor areas.The contents of the investigation included questionnaire survey,anthropometric measurement,biochemical tests and dietary survey.Z-scores were calculated according to WHO growth standards.The prevalence of malnutrition was calculated by WHO Anthro V 3.2.2 software.Data processing and multiple factors analysis were finished by non condition logistic regression in software SAS 9.12.Results The prevalence of stunting,underweight and wasting in children under 5 year-old in poor areas of China were 15.9%,7.8% and 3.7%,respectively.Excluding other influencing factors,the results suggested that the low birth weight(OR=1.975,95%CI=1.515-2.575),household income less than 2000 Yuan per capita per year(OR=1.813,95%CI=1.364-2.409),not cared by father/mother(OR=1.190,95%CI=1.022-1.387)and no sanitary drinking water(OR=1.282,95%CI=1.120-1.466) are the most important factors making the child more likely to become malnutrition.Compared to the child whose mother was professional personnel,cadre or army-woman,the child whose mother was farmer(OR=5.384,95%CI=2.490-11.642),migrant worker(OR=4.244,95%CI=1.953-9.222),rural handicraft worker or individual-owned businesswoman(OR=4.872,95%CI=2.169-10.947)and household wife(OR=5.331,95%CI=2.438-11.654)was easy to become malnutrition.The nearest medical institution at a distance of not more than 1 km is a protective factor for malnutrition(OR=1.246,95%CI=1.100-1.411).The risk of malnutrition would be increased when food supplements were started from the 9th month after birth(OR=1.194,95%CI=1.016-1.403).Conclusion Malnutrition in children under 5 year-old in poor areas of China should not be ignored.Influencing factors are still existing and changing.Comprehensive improvement will be the effective measure for changing the nutritional status of children.