Nadia Koyratty, Robert Ntozini, Mduduzi Nn Mbuya, Andrew D Jones, Roseanne C Schuster, Katarzyna Kordas, Chin-Shang Li, Naume V Tavengwa, Florence D Majo, Jean Humphrey, Laura E Smith
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However, the contributions of household resource insecurities, such as food and water, to growth and growth trajectory are understudied.</p><p><strong>Methods: </strong>We used the cluster-randomised Sanitation Hygiene and Infant Nutrition Efficacy trial to determine the association of household-level food insecurity (FI) and water insecurity (WI) on LAZ and LAZ trajectory among infants during early life. Dimensions of FI (poor access, household shocks, low availability and quality) and WI (poor access, poor quality, low reliability) were assessed with the multidimensional household food insecurity and the multidimensional household water insecurity measures. Infant length was converted to LAZ based on the 2006 WHO Child Growth Standards. We report the FI and WI fixed effects from multivariable growth curve models with repeated measures of LAZ at 1, 3, 6, 12 and 18 months (M1-M18).</p><p><strong>Results: </strong>A total of 714 and 710 infants were included in our analyses of LAZ from M1 to M18 and M6 to M18, respectively. Mean LAZ values at each time indicated worsening linear growth. From M1 to M18, low food availability and quality was associated with lower LAZ (β=-0.09; 95% -0.19 to -0.13). From M6 to M18, poor food access was associated with lower LAZ (β=-0.11; 95% -0.20 to -0.03). None of the WI dimensions were associated with LAZ, nor with LAZ trajectory over time.</p><p><strong>Conclusion: </strong>FI, but not WI, was associated with poor linear growth among rural Zimbabwean infants. Specifically, low food availability and quality and poor food access was associated with lower LAZ. 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引用次数: 0
摘要
导言:发育迟缓或线性生长迟缓(以身长-年龄 Z 值(LAZ)衡量)仍然是一项重大的公共卫生挑战,尤其是在中低收入国家的农村地区。它是婴儿出生和成长环境不足的标志。然而,人们对食物和水等家庭资源不安全对婴儿成长和成长轨迹的影响研究不足:我们采用分组随机的环境卫生和婴儿营养有效性试验来确定家庭层面的食物不安全(FI)和水不安全(WI)对婴儿早期生命周期的LAZ和LAZ轨迹的影响。通过多维度家庭粮食不安全和多维度家庭水不安全测量方法评估了粮食不安全(获取渠道不畅、家庭冲击、可用性低和质量差)和水不安全(获取渠道不畅、质量差、可靠性低)。婴儿身长根据 2006 年世界卫生组织儿童生长标准转换为 LAZ。我们报告了重复测量 1、3、6、12 和 18 个月 (M1-M18) LAZ 的多变量生长曲线模型中的 FI 和 WI 固定效应:共有714名和710名婴儿分别在M1至M18和M6至M18期间参与了LAZ分析。每个时间段的LAZ平均值均显示线性生长恶化。从M1到M18,食物可获得性和质量低与LAZ较低有关(β=-0.09;95% -0.19至-0.13)。从M6到M18,食物可获得性差与LAZ较低有关(β=-0.11;95% -0.20至-0.03)。WI的任何一个维度都与LAZ无关,也与LAZ随时间变化的轨迹无关:结论:FI(而非 WI)与津巴布韦农村婴儿线性生长不良有关。具体而言,食物可获得性低、质量差以及食物可获得性差与 LAZ 较低有关。没有证据表明FI或WI对LAZ轨迹有影响。
Growth and growth trajectory among infants in early life: contributions of food insecurity and water insecurity in rural Zimbabwe.
Introduction: Stunting or linear growth faltering, measured by length-for-age Z-score (LAZ), remains a significant public health challenge, particularly in rural low-income and middle-income countries. It is a marker of inadequate environments in which infants are born and raised. However, the contributions of household resource insecurities, such as food and water, to growth and growth trajectory are understudied.
Methods: We used the cluster-randomised Sanitation Hygiene and Infant Nutrition Efficacy trial to determine the association of household-level food insecurity (FI) and water insecurity (WI) on LAZ and LAZ trajectory among infants during early life. Dimensions of FI (poor access, household shocks, low availability and quality) and WI (poor access, poor quality, low reliability) were assessed with the multidimensional household food insecurity and the multidimensional household water insecurity measures. Infant length was converted to LAZ based on the 2006 WHO Child Growth Standards. We report the FI and WI fixed effects from multivariable growth curve models with repeated measures of LAZ at 1, 3, 6, 12 and 18 months (M1-M18).
Results: A total of 714 and 710 infants were included in our analyses of LAZ from M1 to M18 and M6 to M18, respectively. Mean LAZ values at each time indicated worsening linear growth. From M1 to M18, low food availability and quality was associated with lower LAZ (β=-0.09; 95% -0.19 to -0.13). From M6 to M18, poor food access was associated with lower LAZ (β=-0.11; 95% -0.20 to -0.03). None of the WI dimensions were associated with LAZ, nor with LAZ trajectory over time.
Conclusion: FI, but not WI, was associated with poor linear growth among rural Zimbabwean infants. Specifically, low food availability and quality and poor food access was associated with lower LAZ. There is no evidence of an effect of FI or WI on LAZ trajectory.