湖南省贫困地区营养包干预与婴幼儿营养和健康状况关系

Association between Yingyangbao intervention and nutritional and health status among infants and young children in poverty-stricken areas of Hunan province

目的分析营养包干预对6~23月龄婴幼儿营养和健康状况的影响。方法于2020年8—10月,采用多阶段抽样和随机等距抽样相结合的方法在湖南省贫困地区42个县随机抽取12619名6~23月龄婴幼儿为研究对象,进行问卷调查并测量其身长、体重和血红蛋白等指标;根据营养包干预情况将婴幼儿分为未食用组(3438人)、非有效食用组(3119人)和有效食用组(6062人),比较婴幼儿蛋白质-能量营养不良患病率、贫血率和发热、腹泻2周患病率,并采用logistic回归模型分析营养包有效食用和非有效食用对婴幼儿营养与健康状况的影响。结果营养包未食用组、非有效食用组和有效食用组婴幼儿生长迟缓率分别为4.5%、5.4%和4.3%,低体重率分别为3.4%、3.9%和3.0%,消瘦率分别为3.1%、3.6%和2.7%,贫血率分别为29.6%、20.8%和15.3%,发热2周患病率分别为14.3%、14.5%和11.5%,腹泻2周患病率分别为12.0%、12.1%和9.2%。多因素logistic回归分析显示,有效食用营养包是婴幼儿贫血(aOR=0.43,95%CI=0.39~0.48)、过去2周发热(aOR=0.79,95%CI=0.70~0.90)和过去2周腹泻(aOR=0.75,95%CI=0.65~0.86)的保护因素;非有效食用营养包也是婴幼儿贫血的保护因素(aOR=0.61,95%CI=0.54~0.58)。未发现营养包食用与婴幼儿生长迟缓(aOR=0.95,95%CI=0.77~1.17)、低体重(aOR=0.89,95%CI=0.70~1.13)、消瘦(aOR=0.91,95%CI=0.71~1.17)存在关联。结论有效食用营养包可有效改善婴幼儿贫血状况,降低发热和腹泻2周患病率;非有效食用营养包虽可降低婴幼儿贫血率,但效果远不及有效食用。

Objective To analyze effects of Yingyangbao(YYB)intervention-a community-based complementary food supplement program on nutritional and health status of infants and young children aged 6-23 months in poverty-stricken regions.Methods A combination of multistage sampling and random isometric sampling was used to recruit 12619 infants and young children aged 6-23 months in 42 poverty-stricken counties of Hunan province.Questionnaire survey,body length and weight measurement,and hemoglobin detection were conducted among the participants between August and October 2020.According to the consumption of YYB,all participants were divided into three groups of non-consumption(n=3438),non-effective consumption(n=3119)and effective consumption(n=6062).The prevalence rate of protein-energy malnutrition,anemia,two-week fever and diarrhea among the three groups were compared.Multivariate logistic regression was used to analyze effects of effective and non-effective consumption of YYB on nutritional and health status of participants.Results Among the participants with non-consumption,non-effective consumption,and effective consumption of YYB,the prevalence rates were 4.5%,5.4%,and 4.3%for stunting,3.4%,3.9%,and 3.0%for underweight,3.1%,3.6%,and 2.7%for wasting,29.6%,20.8%,and 15.3%for anemia,14.3%,14.5%,and 11.5%for having fever in the two weeks,and 12.0%,12.1%,and 9.2%for having diarrhea in the two weeks,respectively.Multivariate logistic regression analysis showed that among the participants,effective consumption of YYB was a protective factor against anemia(adjusted odds ratio[aOR]=0.43,95%confidence interval[95%CI]:0.39-0.48),two-week fever(aOR=0.79,95%CI:0.70-0.90),and two-week diarrhea(aOR=0.75,95%CI:0.65-0.86);non-effective consumption of YYB also was also a protective factor against anemia(aOR=0.61,95%CI=0.54-0.58).There was no significant association of YYB consumption with stunting(aOR=0.95,95%CI=0.77-1.17),underweight(aOR=0.89,95%CI=0.70-1.13),and wasting(aOR=0.91,95%CI=0.71-1.17)among the participants.Conclusion For the infants and young children in in poverty-stricken regions,effective consumption of Yingyangbao could improve anemia and reduce the two-week prevalence rate of fever and diarrhea;but noneffective consumption of Yingyangbao is less effective than effective consumption in reducing anemia.