背景:营养不良,包括发育迟缓,浪费,体重不足,是一个全球性的问题,特别是低收入和中等收入国家的儿童。据我们所知,这项研究首次来自阿富汗。其主要目标是估计发育迟缓的患病率和相关风险因素,浪费/瘦身,阿富汗坎大哈市城市小学生体重不足。
方法:这项基于学校的横断面研究是在6个月(2022年10月至2023年3月)期间对1205名6-12岁的小学生进行的。从所有参与者收集人体测量和其他数据。数据采用描述性统计分析,卡方检验(使用粗比值比或COR),和多变量逻辑回归(使用调整后的比值比或AOR)。
结果:在1205名注册的政府学校学生中,47.4%,19.5%,25.6%发育迟缓,浪费/瘦身,体重不足,分别。与发育迟缓相关的统计学显著因素是6-9岁年龄组(AOR1.3,95%CI1.1-1.7),作为女孩(AOR2.3,95%CI1.8-3.0),贫困(AOR2.2,95%CI1.5-3.2),大家族(AOR3.0,95%CI2.4-3.9),文盲母亲(AOR1.6,95%CI1.0-2.6),失业的家庭户主(AOR3.3,95%CI2.3-4.8),和不吃早餐(AOR1.7,95%CI1.2-2.3)。与消瘦相关的主要因素是6-9岁年龄组(AOR30.5,95%CI11.8-78.7),跳过早餐(AOR22.9,95%CI13.9-37.8),过去两周的病史(AOR17.0,95%CI6.6-43.8)。此外,与体重不足相关的主要因素是6-9岁年龄组(AOR2.6,95%CI1.6-4.1),跳过早餐(AOR2.6,95%CI1.8-3.6),卫生条件差(AOR1.9,95%CI1.1-3.2)。
结论:发育迟缓,浪费/瘦身,和体重不足在坎大哈市的小学生(包括男孩和女孩)中非常普遍。建议地方政府(阿富汗教育部和公共卫生部)在国际组织和捐助机构的帮助下,实施全面的学校供餐方案,特别是针对女孩的方案。应开展健康和营养教育计划,重点是6-9岁儿童的营养,以及健康早餐和良好卫生条件的重要性。
BACKGROUND: Undernutrition, which includes stunting, wasting, and underweight, is a global problem, especially among children of low- and middle-income countries. To our knowledge, this study is first of its type from Afghanistan. Its main objectives were to estimate the prevalence and associated risk factors of stunting, wasting/thinness, and underweight among urban primary school children in Kandahar city of Afghanistan.
METHODS: This school-based cross-sectional study was conducted among 1205 primary school children aged 6-12 years during a period of six months (October 2022-March 2023). Anthropometric measurements and other data were collected from all the participants. Data were analyzed by using descriptive statistics, Chi square test (using crude odds ratio or COR), and multivariate logistic regression (using adjusted odds ratio or AOR).
RESULTS: Among the 1205 enrolled government school students, 47.4%, 19.5%, and 25.6% had stunting, wasting/thinness, and underweight, respectively. Statistically significant factors associated with stunting were age group 6-9 years (AOR 1.3, 95% CI 1.1-1.7), being girl (AOR 2.3, 95% CI 1.8-3.0), poverty (AOR 2.2, 95% CI 1.5-3.2), large family (AOR 3.0, 95% CI 2.4-3.9), illiterate mother (AOR 1.6, 95% CI 1.0-2.6), jobless head of the family (AOR 3.3, 95% CI 2.3-4.8), and skipping breakfasts (AOR 1.7, 95% CI 1.2-2.3). Main factor associated with wasting/thinness were age group 6-9 years (AOR 30.5, 95% CI 11.8-78.7), skipping breakfasts (AOR 22.9, 95% CI 13.9-37.8), and history of sickness during the past two weeks (AOR 17.0, 95% CI 6.6-43.8). Also, main factors associated with underweight were age group 6-9 years (AOR 2.6, 95% CI 1.6-4.1), skipping breakfasts (AOR 2.6, 95% CI 1.8-3.6), and poor sanitation (AOR 1.9, 95% CI 1.1-3.2).
CONCLUSIONS: Stunting, wasting/thinness, and underweight are highly prevalent among primary school children (both girls and boys) in Kandahar city. It is recommended that local government (Afghanistan Ministry of Education and Ministry of Public Health) with the help of international organizations and donor agencies should implement comprehensive school-based feeding programs especially for girls. Health and nutrition education programs should be conducted with emphasis on nutrition of children aged 6-9 years as well as importance of healthy breakfast and good sanitation.