四川省〓川大地震の被災地における約1年後の妊婦・授乳婦および小児の栄養状態と改善方法(<緊急特集>災害栄養-ビタミン・ミネラルから食事と健康まで-III)
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Objective To evaluate the effects of Wenchuan Earthquake on the nutritional status of reproductive women (15-44 years old) and the infants and young children (0-60 months old) and the efficacy of intervention way on improving the nutritional status of the infants and young children (6-23 months old). Methods This paper reviews the study on nutritional status of maternal and children, and the related intervention trial purposed for improving the infants and young children (6-23 months old) which was carried out in the poorly affected areas after the serious Earthquake. Results 1) The nutrition status of vulnerable populations living in the areas affected by "Wenchuan" earthquake in 2008: For infants and young children under 36 months of age, malnutrition prevalence was severe, growth retardation accounted for about 14% and anemia prevalence was up to 40%. Both growth retardation and anemia prevalence were remarkably higher than the national averaged level in rural areas with the same living conditions; the percentages of infants and young children suffered from the respiratory-infected disease and diarrhea within recent two weeks were up to 40.4% and 30.2%, respectively. The anemia prevalence of pregnant women and lactating mothers was rather serious and the anemic rates of the two groups were 54.0% and 24.0%, respectively. A shortage of calcium, vitamin C and vitamin B group was very common in the diets of these women. After three months of the earthquake, some clinical signs related to micronutrient deficiencies occurred in vulnerable populations, such as glossitis, angular stomatitis, gingival bleeding, and leg cramps and other symptoms. 2) The nutritional status of reproductive women and children aged less than 60 months in the disaster rural area at one year after the Wenchuan Earthquake: The intakes of meat and poultry intakes of the pregnant, lactating and non-pregnant-non-lactating women were only (58.1±67.7) g/d, (76.3±218.7) g/d, and (23.9±29.6) g/d, respectively; the intakes of aquatic products were even as low as (10.0±20.7) g/d, (3.6±10.2) g/d, and (4.3±13.3) g/d, respectively. The prevalence rates of vitamin A deficiency and marginal deficiency were 6.9% and 18.2%, respectively. The total prevalence rate of deficiency and insufficiency of vitamin D was 93.9%. The prevalence rate for anemia was 32.6%, that for iron deficiency in reproductive women was 51.0%, and that for zinc deficiency in women was about 61.6%. The exclusive breast milk feeding rate in infants aged less than 6 months was 58.8%. Among children aged 0-23 months, only 10.7% got breast feeding within 1 hour after delivery. Ninety two percent of children aged 0-23 months never received any nutritional supplements. The average intakes of vegetables, aquatic products, meat and poultries of children aged 24-59 months were (63.6±56.7) g/d, (2.6±7.9) g/d, (19.4±24.0) g/d, respectively; fruits, dairy products and legumes intakes were (102.2±110.8) g/d, (65.2±123.8) g/d and (20.5±29.0) g/d, respectively. The prevalence rates of vitamin A deficiency and marginal deficiency were 15.4% and 30.3%, respectively. The total prevalence rate of vitamin D deficiency and insufficiency was 92.0%. The prevalence rates of anemia in children aged 0-month and 24-59 months were 47.5% and 21.5%, respectively. The iron deficiency rate in the infants and children was 45.7%, and serum zinc was insufficient in 65.5% (127/197) of them. The prevalence rate of stunt was 13.6% (38/279) of children aged 24-59 months. 3) Nutrition effectiveness of Yingyangbao in infants and young children aged 6-23 months who suffered Wenchuan earthquake in Sichuan Province in Lixian County: The HAZ scores of the infants and young children aged 6-11 and 18-23 months were increased to the levels of 0.51 and 0.44 compared to the baseline, respectively. They were significantly higher than those of the baseline (P<0.05). The stunting rate in young children aged 18-23 months was significantly lower than the baseline (P<0.05). The hemoglobin concentrations in the 4 age groups were increased to the levels of 12.7, 11.4, 16.7 and 15.7 g/L compared to the baseline, respectively. The total anemic prevalence rate in each age group was significantly lower than the baseline χ^=15.863, 24.302, 37.365, and 25.990, respectively, P<0.001). Conclusion The results indicated that the dietary structure was seriously affected by the Earthquake. The diet sources from animal and legume products were relatively little. The nutritional status of micronutrients was poor. The deficiencies of vitamin A, vitamin D, and iron, and zinc were highly prevalent in the disaster area. Yingyangbao, which contains quality protein, multivitamins and minerals, was supplemented to infants and young children aged 6-23 months for 15 months and this supplementation was found to be effective in improving growth and decreasing anemia.
- 2011-10-25