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1、目的:描述安徽省兒童維生素A營(yíng)養(yǎng)現(xiàn)狀,分析了兒童維生素A水平和亞臨床維生素A缺乏影響因素,為安徽省制定維生素A缺乏預(yù)防控制措施提供科學(xué)依據(jù).結(jié)論:從全省的SAVD患病的平均水平來(lái)看,SVAD是尚不足成為安徽省的公共營(yíng)養(yǎng)問(wèn)題.但SVAD分布并不平衡,部分農(nóng)村地區(qū)存在維生素A缺乏的公共衛(wèi)生問(wèn)題的假設(shè)尚不能排除.改善兒童喂養(yǎng),補(bǔ)充維生素A制劑和健康狀況對(duì)預(yù)防和控制SVAD可能有積極意義.預(yù)防控制的重點(diǎn)應(yīng)放在社會(huì)經(jīng)濟(jì)狀況較差,采取混合母乳喂養(yǎng)2
2、歲以?xún)?nèi)的兒童,強(qiáng)調(diào)給及時(shí)兒童添加富含維生素A輔助食品的重要性.從長(zhǎng)遠(yuǎn)來(lái)看,應(yīng)該通過(guò)健康教育的手段提高母親及時(shí)給兒童添加維生素A制劑和富含維生素A的食品知識(shí)和技能,并鼓勵(lì)婦女在妊娠和哺乳期間多食富含維生素A豐富的食品,以提高機(jī)體和乳汁中維生素A的含量.關(guān)鍵詞 維生素A營(yíng)養(yǎng)狀況 危險(xiǎn)因素 膳食調(diào)查Objectives This study was performed to reveal the nutritonal status of vi
3、tamin A and determine its related factors among children aged 0 to 5 years in Anhui Province, and,therefore, to provide the scientific evidences for interventions to prevent and control the vitamin A deficiency.Methods A
4、 total of 1052 children aged 0 to 5 years were randomly selected from four counties and one city in Anhui Provinces. Venous blood samples were collected from all subjects and the fluorescence method was used to measure t
5、he serum level of vitamin A to evaluate the nutritional status of vitamin A of children. Socio-economic factors, family backgrounds, breast-feeding, dietary frequencies, history of diseases within two weeks, KAP on child
6、 feeding-up and other related factors were also gathered through the questionnaire by interview. The cut-off point for sub-clinical vitamin A deficiency was defined as less and equal to 20 μg/dl of serum retinol level.Va
7、riance analysis, chi-square test, multiple linear regressions, Logistic regressions and other statistic methods are applied to analyse the data.Results The average SROL among children aged 0 to 5 years old was (30.36±7.9
8、4) μg/dl, which was comparable to that of a survey conducted at national scale in China in 2000. Prevalence of SVAD and suspected SVAD were 6.8% and 45.3% in all subjects respectively. The prevalence of SVAD is higher in
9、 rural areas(8.0%) than in urban areas(2.0%). The average SROL is significantly different between rural areas and urban areas, as well as among the sampling rural areas.The average SROL increased with the increment of av
10、erage annual family income,parents' schooling, parents' wages and children's age and decreased with the increment of the size of family, numbers and the order of siblings.The SROL in children with mixed milk breast-feedi
11、ng was lower compared to that of children with pure milk breast-feeding and non-breast-feeding respectively. The SROL increased in child administrated with vitamin A preparation or fed with high frequencies of vitamin A
12、rich foods. The SROL showed no difference in children suffering from fever and diarrhea two weeks before their blood collection compared to those without those diseases. Multiple liner regression analysis showed that chi
13、ldren living in rural areas,younger siblings or those with a peasant mother, younger age, mixed milk breast-feeding tend to have a low SROL.The prevalence of SVAD decreased with the increase of average annual family inco
14、me,parents' schooling and children's age and increased with the increase of the size of family, numbers and sequences of siblings. The prevalence of SVAD is higher in children with mixed milk breast-feeding than that of
15、children with pure milk breast-feeding and non-breast-feeding respectively. SVAD is lower in child administrated with vitamin A preparations or fed with high frequencies of vitamin A rich foods than that of children with
16、out vitamin A preparations or with low frequencies of such foods. The prevalence of SVAD is higher in children suffering from fever and diarrhea two weeks before their blood collection (10.5% andl2.5) than in those witho
17、ut those diseases (6.2% and 6.1%). Factor analysis uncovered 3 distinct patterns in children's feeding. Only the 'animal flesh' feeding pattern (factor), proved to be significantly protective from SVAD. Non-conditional L
18、ogistic regression analysis showed that children living in rural areas, younger siblings or those with a peasant mother, younger age, mixed milk breast-feeding and history of diarrhea were prone to suffer from SVAD.A1 to
19、 4 case-control study was conducted by applying the conditional Logistic regressions to reveal the risk factors of SVAD within this study. Cases and controls were matched by age within eight months, sex and locale. Condi
20、tional Logistic regression analysis showed that cases tended to have more siblings (OR= 1.947,95%CI: 1.071~3.540), be younger among their siblings(OR=2.242, 95%CI:1.209~4.167) and more likely to live in family with 4 to
21、5 members(OR=2.291,95%CI: 1.224~4.290) compared to that of controls. And the cases were more likely to have mixed breast-feeding compared with controls(OR= 2.849, 95%CI: 1.311~6.191 ).Mothers of case children tended to h
22、ave more experiences of gestations and parturitions than that of controls. Multiple conditional Logistic regressions showed younger siblings or children with mixed breast-feeding were risk factors of SVAD.Conclusions In
23、light of the provincial average level of SVAD among children, SVAD is not regarded as a public nutrition problem in Anhui Province. As the distribution of SVAD is unbalance, the hypothesis that SVAD is the public nutriti
24、on problem in some parts of this province especially in rural areas can not be refused. Measurements to promote vitamin A rich diet, supplement synthetic vitamin A and improve health conditions might be positive ways to
25、improve the SROL and prevent the occurrencesof SVAD among children. Prevention and control measurements should be focused onchildren within 2 years old with low socio-economic status, especially with mixedbreast-feeding.
26、 The importance of timely introducing vitamin A-rich foods duringweaning to reduce the risk of SVAD should be emphasized. On a long-term basisparents should be educated on the importance of the timingly feeding and consu
27、mptionof locally available sources of provitamin A and pre-formed vitamin A rich foods, andthe avoidance of overcooking. Mothers should also be encouraged to eat more vitaminA containing foods to improve the level of bre
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