印度儿童发育迟缓和体重不足双重负担的空间变化和风险因素:共轭地理加成建模方法。

IF 2.4 Q3 NUTRITION & DIETETICS Journal of Nutritional Science Pub Date : 2024-09-26 eCollection Date: 2024-01-01 DOI:10.1017/jns.2024.49
Dhiman Bhadra
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引用次数: 0

摘要

印度是世界上儿童营养不良负担最重的国家之一。儿童营养不良的两个主要方面,即发育迟缓和体重不足,在特定人群中可能存在显著关联,而现有文献很少探讨这一事实。在本研究中,我们对从第五次全国家庭健康调查(National Family Health Survey 5)中获得的具有全国代表性的 104,021 名儿童数据采用了共轭地理加成模型框架,以评估印度儿童发育迟缓和体重不足双重负担的空间分布和关键驱动因素,同时考虑到这种相关性。在 5 岁以下儿童中,发育迟缓、体重不足及其并发症的发生率分别为 35.37%、28.63% 和 19.45%,两者之间存在显著的正相关关系(Pearsonian Chi Square = 19346,P 值 = 0)。与发育迟缓和体重不足明显相关的一些因素包括儿童性别(发育迟缓(体重不足)的调整比值(AOR)=1.13(1.12))、出生体重(发育迟缓(体重不足)的调整比值(AOR)=1.46(1.64))、分娩类型(发育迟缓(体重不足)的 AOR = 1.12 (1.19))、产前检查(发育迟缓(体重不足)的 AOR = 0.94 (0.96))和母亲身材矮小(发育迟缓(体重不足)的 AOR = 2.19 (1.85))。发育迟缓和体重不足的双重负担具有明显的空间异质性,东部和西部各州的发病率最高,而北部和南部各州的发病率相对较低。总之,这些结果表明,"一刀切 "的战略是不适当的,并强调有必要制定一个干预框架,以解决该国最易受影响的地区和人口亚群的营养缺乏问题。
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Spatial variation and risk factors of the dual burden of childhood stunting and underweight in India: a copula geoadditive modelling approach.

India has one of the highest burdens of childhood undernutrition in the world. The two principal dimensions of childhood undernutrition, namely stunting and underweight can be significantly associated in a particular population, a fact that is rarely explored in the extant literature. In this study, we apply a copula geoadditive modelling framework on nationally representative data of 104,021 children obtained from the National Family Health Survey 5 to assess the spatial distribution and critical drivers of the dual burden of childhood stunting and underweight in India while accounting for this correlation. Prevalence of stunting, underweight and their co-occurrence among under 5 children were 35.37%, 28.63% and 19.45% respectively with significant positive association between the two (Pearsonian Chi square = 19346, P-value = 0). Some of the factors which were significantly associated with stunting and underweight were child gender (Adjusted Odds Ratio (AOR) = 1.13 (1.12) for stunting (underweight)), birthweight (AOR = 1.46 (1.64) for stunting (underweight)), type of delivery (AOR = 1.12 (1.19) for stunting (underweight)), prenatal checkup (AOR = 0.94 (0.96) for stunting (underweight)) and maternal short-stature (AOR = 2.19 (1.85) for stunting (underweight)). There was significant spatial heterogeneity in the dual burden of stunting and underweight with highest prevalence being observed in eastern and western states while northern and southern states having relatively lower prevalence. Overall, the results are indicative of the inadequacy of a "one-size-fits-all" strategy and underscore the necessity of an interventional framework that addresses the nutritional deficiency of the most susceptible regions and population subgroups of the country.

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来源期刊
Journal of Nutritional Science
Journal of Nutritional Science NUTRITION & DIETETICS-
CiteScore
3.00
自引率
0.00%
发文量
91
审稿时长
7 weeks
期刊介绍: Journal of Nutritional Science is an international, peer-reviewed, online only, open access journal that welcomes high-quality research articles in all aspects of nutrition. The underlying aim of all work should be, as far as possible, to develop nutritional concepts. JNS encompasses the full spectrum of nutritional science including public health nutrition, epidemiology, dietary surveys, nutritional requirements, metabolic studies, body composition, energetics, appetite, obesity, ageing, endocrinology, immunology, neuroscience, microbiology, genetics, molecular and cellular biology and nutrigenomics. JNS welcomes Primary Research Papers, Brief Reports, Review Articles, Systematic Reviews, Workshop Reports, Letters to the Editor and Obituaries.
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