卫生研究

目的评价营养包对山西、湖北和云南三省六县6～23月龄婴幼儿生长发育和贫血改善效果。方法在山西、湖北和云南3省6个县采用概率比例规模抽样方法抽取乡/镇和村,采用随机等距离抽取6～23月龄婴幼儿为监测对象。2012年完成基线调查,2013年发放营养包,2014和2015年分别完成干预效果监测。通过聚类分组为营养包服用组和未服用组,比较分析婴幼儿身长、体重、血红蛋白(Hb)等指标变化,采用多元线性回归分析影响婴幼儿身长、体重、Hb等指标并探究营养包干预的效果。结果共纳入4809名婴幼儿,其中营养包服用组2536名、未服用组2273名。营养包服用组和未服用组婴幼儿身长分别为77.6和75.9 cm,生长迟缓率分别为6.8%和10.3%,Hb含量分别为121.3和117.1 g/L,贫血率分别为21.2%和32.1%,差异有统计学意义(P<0.05);两组婴幼儿体重差异无统计学意义。多元线性回归结果显示,月龄、性别、出生体重、营养包服用包数、辅食添加食物种类、看护人受教育程度等因素影响婴幼儿身长、体重、血红蛋白等营养指标。在均衡食用的情况下,营养包食用数量与婴幼儿身长、血红蛋白含量和年龄别身高得分显著相关。结论营养包干预促进婴幼儿身长发育,增加血红蛋白含量,降低生长迟缓率和贫血率。

OBJECTIVE To evaluate the effect of Yingyangbao(YYB) intervention in 6-23 months infants in six poor counties from Shanxi, Hubei and Yunnan Provinces. METHODS Probability proportionate to size sampling method was used to extract townships and villages, and random isometric sampling was used to select monitored infants.A baseline survey was completed in 2012. Yingyangbao was delivered to all the infants in the counties through a registration system started in 2013 and then the delivering has been continuously conducted to the infants according to their age. The cross sectional sampled infants were monitored and evaluated of the effect in 2014 and 2015 respectively. Using synthetic clustering grouping method, the infants were divided into quasi-control group(YYB-NG), YYB intervention group(YYB-FG)for comparative analysis to eliminate the effect of YYB intervention. Multiple linear regression analysis were used to establish the dose-effect relationship between YYB intervention, other factors and main nutrition indices. RESULTS A total of 4809 individuals were included in this study, among which data of 2273 individuals were included in the YYB-NG and 2536 data were included in the YYB-FG. The body length of YYB-FG and YYB-NG was 77.6 cm and 75.9 cm, respectively. Stunting rates of YYB-FG and YYB-NG were 6.8% and 10.3%, respectively. Hb levels and anemia rates of YYB-FG and YYB-NG were 121.3 g/L, 117.1 g/L and 21.2%, 32.1% respectively, with statistically significant difference(P<0.05). However, there was no significant difference in body weight between the groups. Multiple linear regression showed that YYB intervention has a significant quantitative relationship with body length, Hb, HAZ. The regression also implied that the influencing factor including month-age, gender, birth-height, birth-weight, minimum dietary diversity, caregiver educational background have a significant relationship with nutrition improvement. CONCLUSION YYB intervention can effectively improve the body length, Hb and HAZ, while reduce stunting rate and anemia rate of IYC in the intervention area.