Haroon Saloojee, Tim De Maayer, Michel L Garenne, Kathleen Kahn
{"title":"有什么新发现？调查南非艾滋病高发地区儿童严重营养不良的风险因素。","authors":"Haroon Saloojee, Tim De Maayer, Michel L Garenne, Kathleen Kahn","doi":"10.1080/14034950701356435","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>To identify risk factors for severe childhood malnutrition in a rural South African district with a high HIV/AIDS prevalence.</p><p><strong>Design: </strong>Case-control study.</p><p><strong>Setting: </strong>Bushbuckridge District, Limpopo Province, South Africa.</p><p><strong>Participants: </strong>100 children with severe malnutrition (marasmus, kwashiorkor, and marasmic kwashiorkor) were compared with 200 better nourished (>-2 SD weight-for-age) controls, matched by age and village of residence. Bivariate and multivariate analyses were conducted on a variety of biological and social risk factors.</p><p><strong>Results: </strong>HIV status was known only for a minority of cases (39%), of whom 87% were HIV positive, while 45% of controls were stunted. In multivariate analysis, risk factors for severe malnutrition included suspicion of HIV in the family (parents or children) (OR 217.7, 95% CI 22.7-2091.3), poor weaning practices (OR 3.0, 95% CI 2.0-4.6), parental death (OR 38.0, 95% CI 3.8-385.3), male sex (OR 2.7, 95% CI 1.2-6.0), and higher birth order (third child or higher) (OR 2.3, 95% CI 1.0-5.1). Protective factors included a diverse food intake (OR 0.53, 95% CI 0.41-0.67) and receipt of a state child support grant (OR 0.44, 95% CI 0.20-0.97). A borderline association existed for family wealth (OR 0.9 per unit, 95% CI 0.83-1.0), father smoking marijuana (OR 3.9, 95% CI 1.1-14.5), and history of a pulmonary tuberculosis contact (OR 3.2, 95% CI 0.9-11.0).</p><p><strong>Conclusions: </strong>Despite the increasing contribution of HIV to the development of severe malnutrition, traditional risk factors such as poor nutrition, parental disadvantage and illness, poverty, and social inequity remain important contributors to the prevalence of severe malnutrition. Interventions aiming to prevent and reduce severe childhood malnutrition in high HIV prevalence settings need to encompass the various dimensions of the disease: nutritional, economic, and social, and address the prevention and treatment of HIV/AIDS.</p>","PeriodicalId":82655,"journal":{"name":"Scandinavian journal of public health. Supplement","volume":"69 ","pages":"96-106"},"PeriodicalIF":0.0000,"publicationDate":"2007-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2830109/pdf/ukmss-28816.pdf","citationCount":"0","resultStr":"{\"title\":\"What's new? Investigating risk factors for severe childhood malnutrition in a high HIV prevalence South African setting.\",\"authors\":\"Haroon Saloojee, Tim De Maayer, Michel L Garenne, Kathleen Kahn\",\"doi\":\"10.1080/14034950701356435\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>To identify risk factors for severe childhood malnutrition in a rural South African district with a high HIV/AIDS prevalence.</p><p><strong>Design: </strong>Case-control study.</p><p><strong>Setting: </strong>Bushbuckridge District, Limpopo Province, South Africa.</p><p><strong>Participants: </strong>100 children with severe malnutrition (marasmus, kwashiorkor, and marasmic kwashiorkor) were compared with 200 better nourished (>-2 SD weight-for-age) controls, matched by age and village of residence. Bivariate and multivariate analyses were conducted on a variety of biological and social risk factors.</p><p><strong>Results: </strong>HIV status was known only for a minority of cases (39%), of whom 87% were HIV positive, while 45% of controls were stunted. In multivariate analysis, risk factors for severe malnutrition included suspicion of HIV in the family (parents or children) (OR 217.7, 95% CI 22.7-2091.3), poor weaning practices (OR 3.0, 95% CI 2.0-4.6), parental death (OR 38.0, 95% CI 3.8-385.3), male sex (OR 2.7, 95% CI 1.2-6.0), and higher birth order (third child or higher) (OR 2.3, 95% CI 1.0-5.1). Protective factors included a diverse food intake (OR 0.53, 95% CI 0.41-0.67) and receipt of a state child support grant (OR 0.44, 95% CI 0.20-0.97). A borderline association existed for family wealth (OR 0.9 per unit, 95% CI 0.83-1.0), father smoking marijuana (OR 3.9, 95% CI 1.1-14.5), and history of a pulmonary tuberculosis contact (OR 3.2, 95% CI 0.9-11.0).</p><p><strong>Conclusions: </strong>Despite the increasing contribution of HIV to the development of severe malnutrition, traditional risk factors such as poor nutrition, parental disadvantage and illness, poverty, and social inequity remain important contributors to the prevalence of severe malnutrition. Interventions aiming to prevent and reduce severe childhood malnutrition in high HIV prevalence settings need to encompass the various dimensions of the disease: nutritional, economic, and social, and address the prevention and treatment of HIV/AIDS.</p>\",\"PeriodicalId\":82655,\"journal\":{\"name\":\"Scandinavian journal of public health. Supplement\",\"volume\":\"69 \",\"pages\":\"96-106\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2007-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2830109/pdf/ukmss-28816.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Scandinavian journal of public health. Supplement\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1080/14034950701356435\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Scandinavian journal of public health. Supplement","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/14034950701356435","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
目的：在艾滋病毒/艾滋病高发的南非农村地区，确定导致儿童严重营养不良的风险因素：设计：病例对照研究：地点：南非林波波省布什布克里奇区：将 100 名患有严重营养不良（马拉氏症、卡瓦氏症和马拉氏症卡瓦氏症）的儿童与 200 名营养状况较好（与年龄相比体重大于 2 SD）的对照组儿童进行比较，对照组儿童的年龄与居住村庄相匹配。对各种生物和社会风险因素进行了二元和多元分析：只有少数病例（39%）的艾滋病毒感染状况是已知的，其中 87% 的病例艾滋病毒感染呈阳性，而 45% 的对照组病例发育迟缓。在多变量分析中，导致严重营养不良的风险因素包括：怀疑家人（父母或子女）感染艾滋病毒（OR 217.7，95% CI 22.7-2091.3）、断奶方法不当（OR 3.0，95% CI 2.0-4.6）、父母死亡（OR 38.0，95% CI 3.8-385.3）、男性（OR 2.7，95% CI 1.2-6.0）和出生顺序较高（第三个孩子或以上）（OR 2.3，95% CI 1.0-5.1）。保护因素包括食物摄入多样化（OR 0.53，95% CI 0.41-0.67）和获得州儿童抚养补助金（OR 0.44，95% CI 0.20-0.97）。与家庭财富（OR 0.9/单位，95% CI 0.83-1.0）、父亲吸食大麻（OR 3.9，95% CI 1.1-14.5）和肺结核接触史（OR 3.2，95% CI 0.9-11.0）存在边缘关联：尽管艾滋病毒对严重营养不良的发生有越来越大的影响，但营养不良、父母弱势和疾病、贫困和社会不平等等传统风险因素仍然是导致严重营养不良发生的重要原因。在艾滋病毒高发地区，旨在预防和减少儿童严重营养不良的干预措施需要涵盖疾病的各个层面：营养、经济和社会，并解决艾滋病毒/艾滋病的预防和治疗问题。
What's new? Investigating risk factors for severe childhood malnutrition in a high HIV prevalence South African setting.
Aim: To identify risk factors for severe childhood malnutrition in a rural South African district with a high HIV/AIDS prevalence.
Design: Case-control study.
Setting: Bushbuckridge District, Limpopo Province, South Africa.
Participants: 100 children with severe malnutrition (marasmus, kwashiorkor, and marasmic kwashiorkor) were compared with 200 better nourished (>-2 SD weight-for-age) controls, matched by age and village of residence. Bivariate and multivariate analyses were conducted on a variety of biological and social risk factors.
Results: HIV status was known only for a minority of cases (39%), of whom 87% were HIV positive, while 45% of controls were stunted. In multivariate analysis, risk factors for severe malnutrition included suspicion of HIV in the family (parents or children) (OR 217.7, 95% CI 22.7-2091.3), poor weaning practices (OR 3.0, 95% CI 2.0-4.6), parental death (OR 38.0, 95% CI 3.8-385.3), male sex (OR 2.7, 95% CI 1.2-6.0), and higher birth order (third child or higher) (OR 2.3, 95% CI 1.0-5.1). Protective factors included a diverse food intake (OR 0.53, 95% CI 0.41-0.67) and receipt of a state child support grant (OR 0.44, 95% CI 0.20-0.97). A borderline association existed for family wealth (OR 0.9 per unit, 95% CI 0.83-1.0), father smoking marijuana (OR 3.9, 95% CI 1.1-14.5), and history of a pulmonary tuberculosis contact (OR 3.2, 95% CI 0.9-11.0).
Conclusions: Despite the increasing contribution of HIV to the development of severe malnutrition, traditional risk factors such as poor nutrition, parental disadvantage and illness, poverty, and social inequity remain important contributors to the prevalence of severe malnutrition. Interventions aiming to prevent and reduce severe childhood malnutrition in high HIV prevalence settings need to encompass the various dimensions of the disease: nutritional, economic, and social, and address the prevention and treatment of HIV/AIDS.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
