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首页> 外文学位 >Child growth in developing countries: Wasting and diarrhea impair linear growth in early childhood.
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Child growth in developing countries: Wasting and diarrhea impair linear growth in early childhood.

机译：发展中国家的儿童成长：浪费和腹泻会损害幼儿的线性成长。

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摘要

Background: The effects of weight faltering and diarrhea on linear growth have been inconsistently reported in the literature. Some studies have identified long-term effects on linear growth faltering, whereas others have not.;Objectives: In this thesis, we sought to explore the relationships between weight faltering, diarrhea, and linear growth in early childhood using data from up to eight cohort studies performed in South America, Africa, and Asia.;Methods: We identified the effect of weight faltering and weight-for-length Z-score variability on length-for-age Z-score at 18-24 months through linear mixed effects models. Then, using the entire history of diarrhea in the first two years of life, in 30-day periods, we determined the effect of diarrhea in each of those periods on length and weight at different ages. Finally, we calculated the effect of diarrhea during three- to six-month periods on linear and ponderal growth velocity using linear mixed effects models incorporating linear spline terms, and determined how that translates to linear growth faltering at 24 months of age.;Results: We found that instances of wasting and highly variable weight-for-length Z-scores were associated with lower length-for-age Z-scores at 18-24 months. Using the life history of diarrhea in 30-day periods approach, we found that there was a short-term effect of diarrhea on weight, but no discernable effect of diarrhea in any single 30-day period on length, either over the short- or long-term. It was only when we calculated the cumulative effect of diarrhea over multiple periods that we observed a statistically significant effect of diarrhea on linear growth faltering at 24 months of age. Diarrhea had small, but measurable, long-term effects on linear growth and was responsible for ∼7% of linear growth retardation in these populations. This finding supports the idea of environmental enteropathy, the idea that recurrent enteric insults result in long-term linear growth faltering. In addition, we confirmed that diarrhea during the current period negatively effected length and weight velocity, and that catch-up growth occurs in the subsequent period if no further diarrhea occurs. If there is diarrhea during the subsequent period, linear growth faltering continues or worsens.;Conclusions: The overall message of this thesis is that weight faltering and diarrhea can have long-term effects on linear growth faltering, but given adequate time between insults, catch-up growth can occur. Integrated nutrition promotion and diarrhea prevention interventions are needed to decrease the burden of weight faltering and diarrhea in resource-poor settings with the goal of increasing the time between insults. Integrated interventions will also result in lower child mortality due to these risk factors.
机译：背景：文献中不一致地报道了体重下降和腹泻对线性生长的影响。一些研究已经确定了对线性增长步履蹒跚的长期影响，而其他研究则没有。目的：在本文中，我们试图利用多达8个队列的数据来探索幼儿体重下降，腹泻和线性增长之间的关系。方法：通过线性混合效应模型，我们确定了18-24个月体重下降和体重Z值变异对年龄长Z值的影响。然后，使用生命的头两年的整个腹泻史，在30天的时间内，我们确定了在每个时期中腹泻对不同年龄段的身长和体重的影响。最后，我们使用结合了线性样条项的线性混合效应模型计算了三到六个月期间腹泻对线性和垂体生长速度的影响，并确定了如何将其转化为24个月大时的线性生长步履蹒跚。结果：我们发现，在18-24个月时，浪费和高度可变的Z值分数与较低的Z值长度相关。使用30天腹泻的生活史方法，我们发现腹泻对体重有短期影响，但在短短或30天的任何单个30天期间内，腹泻对体重的持续时间都没有明显的影响长期。只有当我们计算了多个时期的腹泻累积效应时，我们才观察到腹泻对24个月大的线性生长步履蹒跚具有统计学意义。腹泻对线性增长的影响很小，但是可测量的长期影响是这些人群中线性增长迟缓的约7％。这一发现支持了环境性肠病的想法，即肠内反复发作会导致长期线性生长动摇的想法。另外，我们证实了当前时期的腹泻会对身长和体重速度产生负面影响，并且如果没有进一步的腹泻发生，那么在随后的时期中会出现追赶性生长。如果在随后的时期出现腹泻，则线性增长步履蹒跚继续或恶化。;结论：本论文的总体信息是体重波动和腹泻可对线性增长步履蹒跚产生长期影响，但在两次侮辱，捕获之间有足够的时间会发生增长。需要综合营养促进和腹泻预防干预措施，以减少资源贫乏地区体重减轻和腹泻的负担，目的是增加两次侮辱之间的时间。由于这些危险因素，综合干预措施还将降低儿童死亡率。

著录项

  • 作者

    Richard, Stephanie Ann.;

  • 作者单位

    The Johns Hopkins University.;

  • 授予单位 The Johns Hopkins University.;
  • 学科 Health Sciences Nutrition.;Health Sciences Public Health.;Health Sciences Epidemiology.
  • 学位 Ph.D.
  • 年度 2012
  • 页码 122 p.
  • 总页数 122
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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