BACKGROUND:Diarrhea and acute respiratory infection (ARI) are major causes of child mortality. We aimed to identify risk factors associated with diarrhea and ARI among children under 2 years of age in rural northern Bangladesh.
METHOD:We collected information on diarrhea and ARI in the previous 14 days and the previous 6 months at 6, 12, 18 and 24 months of age as part of a longitudinal, cluster randomized effectiveness trial, the Rang-Din Nutrition Study which enrolled 4011 pregnant women at ≤20 gestational weeks. Women and their children were followed up until 2 years postpartum. Information on household socioeconomic status, type of toilet, garbage disposal system, food insecurity, number of under-five children in the household, type of family, maternal characteristics and child characteristics was collected at baseline and/or at 6, 12, 18 and 24 months postpartum. Data on newborn health and feeding behaviors were collected within 72 h of delivery. Associations between potential risk factors and morbidity prevalence outcomes were assessed using logistic regression controlling for potential confounders.
RESULTS:Out of 3664 live born children, we collected information from ~ 3350 children at 6, 12, 18 and 24 months of age. Diarrhea in the previous 14 days, and in the previous 6 months, was associated with maternal depression score and food insecurity; diarrhea in the previous 6 months was also associated with family type (nuclear vs. joint). ARI in the previous 14 days was associated with maternal depression score, type of toilet and garbage disposal, household food insecurity and sex. Cough or nasal discharge in the past 6 months was associated with maternal depression score, type of toilet and garbage disposal, household food insecurity, sex and perceived overall physical condition of the infant after birth.
CONCLUSION:Maternal depression and food insecurity appear to be important risk factors for diarrhea and respiratory infection among children under 2 years of age in this setting. These findings suggest that policies and programs that include strategies to address maternal mental health and household food insecurity may contribute to improved child health.
TRIAL REGISTRATION:The trial was registered with the US National Institutes of Health at ClinicalTrials.gov, # NCT01715038 , with registration completed October 26, 2012.
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【Factors associated with diarrhea and acute respiratory infection in children under two years of age in rural Bangladesh.].
【孟加拉国农村地区两岁以下儿童的腹泻和急性呼吸道感染相关因素。】
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DOI：10.1186/s12887-019-1738-6文章类型：杂志文章
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背景：腹泻和急性呼吸道感染（ARI）是儿童死亡的主要原因。我们旨在确定孟加拉国北部农村地区2岁以下儿童与腹泻和ARI相关的危险因素。
方法：我们进行了纵向，整群随机有效性试验（Rang-Din营养研究，纳入4011），收集了前14天和前6个月（分别在6、12、18和24个月时）的腹泻和ARI信息。 ≤20个孕周的孕妇。对妇女及其子女进行随访，直到产后2年。有关家庭社会经济状况，厕所类型，垃圾处理系统，粮食不安全状况，家庭中五岁以下儿童数量，家庭类型，孕产妇特征和儿童特征的信息是在基线和/或在6、12、18和产后24个月。在分娩后72h之内收集了有关新生儿健康和喂养行为的数据。潜在危险因素与发病率结果之间的关联使用对潜在混杂因素的逻辑回归控制进行了评估。
结果：在3664名活产儿中，我们从6、12、18和24月龄的〜3350名儿童中收集了信息。前14天和前6个月的腹泻与孕产妇抑郁评分和食物不安全相关；前6个月的腹泻也与家庭类型（核与关节）有关。前14天的ARI与孕产妇抑郁评分，厕所和垃圾处理类型，家庭粮食不安全状况以及性别有关。在过去的六个月中，咳嗽或鼻涕与母体抑郁评分，厕所和垃圾处理类型，家庭食物不安全状况，性别以及出生后婴儿的整体身体状况有关。
结论：在这种情况下，母亲抑郁和食物不安全似乎是2岁以下儿童腹泻和呼吸道感染的重要危险因素。这些发现表明，包括解决孕产妇精神健康和家庭粮食不安全问题的战略在内的政策和计划可能有助于改善儿童健康。
试验注册：该试验已在美国国立卫生研究院的ClinicalTrials.gov上注册，编号为NCT01715038，注册于2012年10月26日完成。
方法：我们进行了纵向，整群随机有效性试验（Rang-Din营养研究，纳入4011），收集了前14天和前6个月（分别在6、12、18和24个月时）的腹泻和ARI信息。 ≤20个孕周的孕妇。对妇女及其子女进行随访，直到产后2年。有关家庭社会经济状况，厕所类型，垃圾处理系统，粮食不安全状况，家庭中五岁以下儿童数量，家庭类型，孕产妇特征和儿童特征的信息是在基线和/或在6、12、18和产后24个月。在分娩后72h之内收集了有关新生儿健康和喂养行为的数据。潜在危险因素与发病率结果之间的关联使用对潜在混杂因素的逻辑回归控制进行了评估。
结果：在3664名活产儿中，我们从6、12、18和24月龄的〜3350名儿童中收集了信息。前14天和前6个月的腹泻与孕产妇抑郁评分和食物不安全相关；前6个月的腹泻也与家庭类型（核与关节）有关。前14天的ARI与孕产妇抑郁评分，厕所和垃圾处理类型，家庭粮食不安全状况以及性别有关。在过去的六个月中，咳嗽或鼻涕与母体抑郁评分，厕所和垃圾处理类型，家庭食物不安全状况，性别以及出生后婴儿的整体身体状况有关。
结论：在这种情况下，母亲抑郁和食物不安全似乎是2岁以下儿童腹泻和呼吸道感染的重要危险因素。这些发现表明，包括解决孕产妇精神健康和家庭粮食不安全问题的战略在内的政策和计划可能有助于改善儿童健康。
试验注册：该试验已在美国国立卫生研究院的ClinicalTrials.gov上注册，编号为NCT01715038，注册于2012年10月26日完成。
