社区的除虫和微量营养状况 露天排便的流行率:使用印度2016-2018年全国代表性数据的观察性研究
Suman Chakrabarti1, Sitara S R Ajjampur2, Hugh Sharma Waddington3
1International Food Policy Research Institute, Washington DC, and India.
PLoS medicine
|May 10, 2024
概括
在印度,除有效地改善了微量营养素的状况,但仅在露天排便 (OD) 较低的地区. 高的OD率降低了除虫效益,需要综合的卫生和除虫策略,以获得更好的公共卫生结果.
科学领域:
- 公共卫生 公共卫生
- 营养科学 营养科学
- 传染病流行病学 传染病流行病学
背景情况:
- 微量营养素缺乏是印度的主要公共卫生问题.
- 土壤传播的虫感染 (STH) 导致微量营养素状况不佳.
- 印度各州的露天排便 (OD) 患病率差异很大,影响了STH传播和除虫疗效.
研究的目的:
- 在印度不同卫生环境中调查除虫剂对微量营养素状况的有效性.
- 确定露天排便 (OD) 水平对除虫和微量营养素缺乏之间的关联的影响.
- 确定OD的潜在值,超出这些值后,除虫干预变得不那么有效.
主要方法:
- 利用了来自全国综合营养调查 (2016-2018) 的105,060名年龄在1-19岁的个体的横截面数据.
- 采用后勤回归模型来分析除虫,社区OD水平和缺铁,,维生素A,叶酸和维生素B12之间的关系.
- 通过将社区分为无OD,中度OD和高OD类别进行了敏感性分析.
主要成果:
- 较高的OD水平与较低的除虫覆盖率和较高的贫血和,维生素A和B12缺乏的患病率有关.
- 在没有OD的社区中,除的个体对贫血,铁和叶酸缺乏的几率显著降低.
- 除虫对贫血和叶酸缺乏的保护作用在中度至高OD (30% - 60%值) 的社区下降.
结论:
- 在印度,中度至高的露天排便率显著改变了除虫干预措施对微量营养素状况的有效性.
- 公共卫生政策应该考虑对干预措施进行排序:改善低OD地区的除虫覆盖率,并在除虫活动之前优先考虑高OD地区的卫生改善.
- 需要进一步研究微量营养素补充作为除和OD消除之外的补充策略.
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