遵义地区1岁以下农村留守儿童蛋白质-能量营养不良状况调查及影响因素分析

背景　蛋白质-能量营养不仅在认知发育，还在神经系统、生长发育、心血管系统等方面发挥重要作用，并且蛋白质-能量营养对0~1岁儿童体格、智力发育的影响可能是长期的、不可恢复的。因此，研究分析儿童蛋白质-能量营养不良（PEM）的状况及相关影响因素，对预防留守儿童的PEM及相关疾病具有重要意义。但是，遵义市农村留守儿童（≤1岁）的具体蛋白质-能量营养状况与健康问题还没有详细的资料。目的　分析遵义地区1岁以下农村留守儿童PEM状况及相关影响因素。方法　2017年8月-2019年9月采用分层随机抽样法选取遵义地区1岁以下农村留守儿童进行PEM筛查，采用问卷调查的方法收集儿童性别、月龄、看护人文化程度、吸收情况、饮食结构、父母平均身高、家庭人均年收入等情况，并测量儿童身高、体质量，采用多因素Logistic回归分析探讨1岁以下农村留守儿童PEM的影响因素。结果　共发放问卷700份，回收有效问卷650份，问卷有效回收率为92.9%。650例遵义地区1岁以下农村留守儿童PEM患病率为32.5%（211/650）。不同月龄、看护人文化程度、吸收情况、饮食结构、父母平均身高、家庭人均年收入的遵义地区1岁以下农村留守儿童PEM患病率比较，差异均有统计学意义（P<0.05）。多因素Logistic回归分析结果显示，月龄〔OR=9.562，95%CI（4.737，19.299）〕、看护人文化程度〔OR=0.482，95%CI（0.330，0.704）〕、吸收情况〔OR=2.508，95%CI（1.678，3.747）〕、饮食结构〔OR=0.298，95%CI（0.196，0.453）〕、父母平均身高〔OR=0.317，95%CI（0.208，0.481）〕、家庭人均年收入〔OR=0.367，95%CI（0.240，0.561）〕是PEM的影响因素（P<0.05）。结论　遵义地区1岁以下农村留守儿童PEM患病率较高，月龄、看护人文化程度、吸收情况、饮食结构、父母平均身高、家庭人均年收入是遵义地区1岁以下农村留守儿童PEM的影响因素。

Protein-energy Malnutrition Prevalence and Influencing Factors in Rural Left-behind Children under 1 Year Old in Zunyi Area

Background Protein-energy nutrition plays an important role not only in cognitive development,but also in the nervous system,growth and development,cardiovascular system,and its influence on physical and intellectual development of 0-1-year-old children may be long-term,unrecoverable.Therefore,research and analysis of children’s proteinenergy malnutrition(PEM)status and influencing factors are of great significance for preventing PEM and related diseases in left-behind children.However,there is no detailed information on the PEM and health problems of left-behind children(≤1 year old)in rural Zunyi City.Objective To investigate the PEM prevalence and influencing factors in rural left-behind children under 1 year old in Zunyi area.Methods From August 2017 to September 2019,a random stratified sampling method was used to select rural left-behind children under 1 year old in Zunyi area for PEM screening.An interview-based or telephone-based questionnaire survey was conducted with the caregivers of the children to collect the sex,age in months,absorption status,diet structure,measured height and weight of the children,and average height of their parents,annual household income per capita,as well as their caregivers’education level.Multivariate Logistic regression analysis was used to explore the influencing factors of PEM in these children.Results A total of 700 questionnaires were distributed and 650(92.9%)responsive ones were returned.The prevalence of PEM in the children was 32.5%(211/650).PEM prevalence differed obviously in the children by their age in months,absorption status,diet structure,and their parents’average height,annual household income per capita,as well as their caregivers’education level(P<0.05).The results of multivariate Logistic regression analysis showed that children’s age in monthsOR=9.562,95%CI(4.737,19.299)],absorption statusOR=2.508,95%CI(1.678,3.747)],diet structureOR=0.298,95%CI(0.196,0.453)],average height of children’s parentsOR=0.317,95%CI(0.208,0.481)],annual household income per capitaOR=0.367,95%CI(0.240,0.561)]and education level of their caregiversOR=0.482,95%CI(0.330,0.704)]were associated with PEM(P<0.05).Conclusion The prevalence of PEM in rural left-behind children under 1 year old in Zunyi area was relatively high.Children’s age in months,absorption status,diet structure,average height of children’s parents,annual household income per capitaand education level of their caregivers may be associated with PEM.