Chronic Child Malnutrition in Ecuador and Associated Risk Factors

Zoila Moreira-Moreira, Denise Guevara-Cando, Gabriela Paredes-Oñate, Ángel Cabezas-Lucio, Yimy Nazareno-Valencia, Marlon Villacis-Aveiga, Génesis Avellán-Cevallos, Emma Prieto-Cuesta, María Valle-Hidalgo, Hector Guerrero-Maila, Zoila Moreira Moreira
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Abstract

Chronic child malnutrition worldwide is responsible for 45% of deaths in children under 5 years of age. In Ecuador, 27.2% of children suffer from any type of malnutrition. This problem has alarming consequences since it affects the country's productivity and has an impact throughout the individual's life, since at this stage the greatest impact is suffered by the child's brain, in which irreversible metabolic and structural alterations occur. However, child malnutrition is not only a problem of lack of food, it is a deeper social conflict that must be considered when providing solutions. A nationally representative sample of children under 5 years of age from the National Health and Nutrition Survey 2018 (ENSANUT) was used. A binary logistic linear regression model was used where Odds Ratio (OR) with their 95% confidence intervals (95% CI) were estimated for each of the independent variables. Our results reveal that family income reduces the probability of child malnutrition by 2.03 times. In addition, micronutrient intake during 6 months to 2 years of age reduces the probability of child malnutrition by 2.32 times (OR= -1.91 ; -3.02). This result is statistically significant (p<0.05). On the other hand, unemployment, being out of the labor force (in the mother) having a greater number of children at home, working more hours and being a migrant mother also positively predicts the probability of suffering from chronic child malnutrition.  Malnutrition is one of the main health problems in Ecuador. It affects a significant percentage of the population and, associated with other factors, is responsible for most of the avoidable mortality and considerable damage to children's health. For this reason, strategies should include epidemiological surveillance, promotion.
厄瓜多尔儿童慢性营养不良及相关风险因素
全世界 45% 的 5 岁以下儿童死于长期营养不良。在厄瓜多尔,27.2%的儿童患有任何类型的营养不良。这一问题造成了令人担忧的后果,因为它影响了国家的生产力,并对个人的一生产生影响,因为在这一阶段,儿童的大脑受到的影响最大,会发生不可逆转的新陈代谢和结构改变。然而,儿童营养不良不仅是一个缺乏食物的问题,它还是一个更深层次的社会矛盾,在提供解决方案时必须加以考虑。研究采用了 2018 年全国健康与营养调查(ENSANUT)中具有全国代表性的 5 岁以下儿童样本。我们使用了二元逻辑线性回归模型,对每个自变量的比值比(OR)及其 95% 置信区间(95% CI)进行了估计。结果显示,家庭收入可将儿童营养不良的概率降低 2.03 倍。此外,6 个月至 2 岁期间的微量营养素摄入量可将儿童营养不良的概率降低 2.32 倍(OR=-1.91;-3.02)。这一结果具有统计学意义(P<0.05)。另一方面,失业、脱离劳动力队伍(母亲)、家中子女较多、工作时间较长和流动人口母亲也会对儿童患慢性营养不良的概率产生积极的预测作用。 营养不良是厄瓜多尔的主要健康问题之一。营养不良影响着相当大比例的人口,与其他因素一起,造成了大部分可避免的死亡和对儿童健康的严重损害。因此,相关战略应包括流行病学监测、宣传、教育和培训。
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