分析营养包干预下婴幼儿贫血的影响因素,以期为贫困地区婴幼儿贫血问题的进一步改善提供科学依据。方法 2015年采用多阶段抽样、按规模大小成比例概率抽样和随机等距抽样相结合的方法抽取我国营养包覆盖地区19 552名6~23月龄婴幼儿为调查对象。通过血红蛋白检测判断婴幼儿是否贫血,通过问卷调查了解婴幼儿看护人基本情况、营养知识掌握情况,营养包服用情况及过去24 h喂养情况,并计算辅食喂养指标合格率。采用多因素非条件Logistic回归模型分析调查人群贫血的相关因素。结果 被调查儿童总贫血率为30.0%(5 883/19 552)。非贫血组婴幼儿看护人有81.9%为初中及以上学历,营养知识回答正确率为42.4%,均高于贫血组看护人。非贫血组婴幼儿营养包服用时长为(7.37±4.76)个月,长于贫血组婴幼儿。非贫血组婴幼儿最小膳食种类合格率、最低膳食频次合格率及最低可接受膳食合格率分别为69.2%、68.0%和41.9%,同样高于贫血组婴幼儿,以上差异均具有统计学意义(P<0.05)。Logistic回归分析结果显示,婴幼儿性别(OR=0.918,95%CI:0.856~0.985,P=0.017)、年龄(OR=0.947,95%CI:0.936~0.958,P<0.001)、看护人学历(OR=0.772,95%CI:0.742~0.804,P<0.001)、营养知识掌握正确率(OR=0.995,95%CI:0.993~0.997,P<0.001)、辅食种类合格情况(OR=1.128,95%CI:1.044~1.219,P=0.002)及辅食频次合格情况(OR=0.678,95%CI:0.629~0.730,P<0.001)及营养包服用时长(OR=0.984,95%CI:0.973~0.995,P=0.005)均为贫血的相关影响因素。结论 持续有效的营养包服用,提高贫困地区教育水平,普及营养健康知识及改善婴幼儿辅食喂养情况将有利于控制贫困地区婴幼儿贫血患病率。

Objective To analyze the influencing factors of anemia among infants and young children in complementary food supplement(Yingyangbao,YYB) intervention areas,so as to provide scientific reference for the improvement of anemia. Methods A total of 19 522 infants and young children aged 6 to 23 months were selected in this study in 2015 by multistage sampling,probability proportional to size sampling and random equidistant sampling methods from the YYB intervention areas. Anemia was determined by hemoglobin measurement. Information about caregivers,nutrition knowledge,YYB intake situation and feeding during the last 24 hours were investigated by questionnaire. The indicators to assess feeding practice were calculated. Multi non-conditional Logistic regression model was used to analyze factors associated with anemia. Results The anemia rate of surveyed children was 30.0%(5 883/19 552). In the non-anemic group,about 81.9% of the infant caregivers received junior high school education or above,and the nutritional knowledge accuracy rate was 42.4%,which were both significantly higher than those of the anemic group(P<0.05). For the non-anemic infants and young children,the duration of YYB intake was approximately(7.37±4.76) months,which was significantly longer than that of the anemic group. Besides,the minimum dietary diversity rate,the minimum meal frequency rate and the minimum acceptable diet rate were 69.2%,68.0% and 41.9%,respectively,significantly better than those of the anemic children. Logistic regression analysis showed that infants′ gender(OR= 0.918,95% CI:0.856-0.985,P=0.017),age(OR=0.947,95%CI:0.936-0.958,P＜0.001),education level of caregivers(OR=0.772,95%CI:0.742-0.804,P＜0.001),correct nutrition knowledge(OR=0.995,95%CI:0.993-0.997,P＜0.001),minimum dietary diversity(OR=1.128,95%CI:1.044-1.219,P=0.002),minimum dietary frequency(OR=0.984,95%CI:0.973-0.995,P＜0.005),and YYB intake duration(OR=0.984,95%CI:0.973-0.995,P＜0.001) were all associated factors with anemia. Conclusion Continuous and effective YYB intake,popularization of nutrition knowledge and improvement of education and feeding practice would contribute to control the prevalence of anemia among infants and young children in poor areas of China.