Abstract：
BACKGROUND: Childhood malnutrition in India remains among the highest in the world. Adult alcohol consumption and severe malnutrition have increased among indigenous people in South India. However, the association between them is poorly understood.
OBJECTIVE: We aimed to evaluate this association, which could help design better intervention strategies.
METHODS: This case-control observational study was conducted in the Nilgiri district in South India. Cases included children aged 1-5 years with moderate malnutrition. Controls were defined as children in the same age group with normal weight-for-age. A questionnaire was used to collect data on demographics, socioeconomic status (SES), and parental education. The WHO Alcohol Use Disorders Identification Test (AUDIT) questionnaire was used to estimate parental alcohol use. Health-care workers collected data from within the community.
RESULTS: The baseline demographics of the children in the control (n = 250) and case groups (n = 177) were similar. Paternal age and AUDIT scores were not different in the two groups. SES was lower in the malnourished group, while maternal education among cases was significantly lower. Maternal and paternal education were associated with childhood malnutrition (odds ratio [OR]: 0.728 [95% confidence interval (CI): 0.583-0.903] and OR: 0.753 [95% CI: 0.589-0.957], respectively). After adjustment for covariates, paternal alcohol use was associated with a higher risk of malnutrition (OR: 1.56 [95% CI: 1.00-2.47]), which SES partly mediated.
CONCLUSIONS: Paternal alcohol consumption is associated with childhood malnutrition, partially mediated by lower SES. Furthermore, lower SES appeared to be strongly associated with paternal alcohol consumption.
OBJECTIVE: We aimed to evaluate this association, which could help design better intervention strategies.
METHODS: This case-control observational study was conducted in the Nilgiri district in South India. Cases included children aged 1-5 years with moderate malnutrition. Controls were defined as children in the same age group with normal weight-for-age. A questionnaire was used to collect data on demographics, socioeconomic status (SES), and parental education. The WHO Alcohol Use Disorders Identification Test (AUDIT) questionnaire was used to estimate parental alcohol use. Health-care workers collected data from within the community.
RESULTS: The baseline demographics of the children in the control (n = 250) and case groups (n = 177) were similar. Paternal age and AUDIT scores were not different in the two groups. SES was lower in the malnourished group, while maternal education among cases was significantly lower. Maternal and paternal education were associated with childhood malnutrition (odds ratio [OR]: 0.728 [95% confidence interval (CI): 0.583-0.903] and OR: 0.753 [95% CI: 0.589-0.957], respectively). After adjustment for covariates, paternal alcohol use was associated with a higher risk of malnutrition (OR: 1.56 [95% CI: 1.00-2.47]), which SES partly mediated.
CONCLUSIONS: Paternal alcohol consumption is associated with childhood malnutrition, partially mediated by lower SES. Furthermore, lower SES appeared to be strongly associated with paternal alcohol consumption.
摘要：
背景：印度的儿童营养不良仍然是世界上最高的。印度南部土著人民的成人饮酒和严重营养不良有所增加。然而,人们对它们之间的联系知之甚少。
目的：我们旨在评估这种关联，这可以帮助设计更好的干预策略。
方法：本病例对照观察性研究在印度南部的Nilgiri区进行。病例包括1-5岁中度营养不良的儿童。对照组被定义为相同年龄段的儿童，体重正常。问卷被用来收集人口统计数据，社会经济地位(SES)，和父母教育。使用WHO酒精使用障碍鉴定测试（AUDIT）问卷来评估父母的酒精使用情况。卫生保健工作者从社区内部收集数据。
结果：对照组（n=250）和病例组（n=177）儿童的基线人口统计学相似。两组的父亲年龄和AUDIT评分没有差异。营养不良组的SES较低，而病例中的母亲教育程度明显较低。母亲和父亲的教育与儿童营养不良有关（比值比[OR]：0.728[95％置信区间（CI）：0.583-0.903]和OR：0.753[95％CI：0.589-0.957]，分别)。在调整协变量后，父亲饮酒与较高的营养不良风险相关(OR:1.56[95%CI:1.00-2.47]),其中SES部分介导。
结论：父亲饮酒与儿童营养不良有关，部分由较低的SES介导。此外，较低的SES似乎与父亲饮酒密切相关。
目的：我们旨在评估这种关联，这可以帮助设计更好的干预策略。
方法：本病例对照观察性研究在印度南部的Nilgiri区进行。病例包括1-5岁中度营养不良的儿童。对照组被定义为相同年龄段的儿童，体重正常。问卷被用来收集人口统计数据，社会经济地位(SES)，和父母教育。使用WHO酒精使用障碍鉴定测试（AUDIT）问卷来评估父母的酒精使用情况。卫生保健工作者从社区内部收集数据。
结果：对照组（n=250）和病例组（n=177）儿童的基线人口统计学相似。两组的父亲年龄和AUDIT评分没有差异。营养不良组的SES较低，而病例中的母亲教育程度明显较低。母亲和父亲的教育与儿童营养不良有关（比值比[OR]：0.728[95％置信区间（CI）：0.583-0.903]和OR：0.753[95％CI：0.589-0.957]，分别)。在调整协变量后，父亲饮酒与较高的营养不良风险相关(OR:1.56[95%CI:1.00-2.47]),其中SES部分介导。
结论：父亲饮酒与儿童营养不良有关，部分由较低的SES介导。此外，较低的SES似乎与父亲饮酒密切相关。
