MOT S6 Y^U T 6 N G U Y CO C O A SUY DINH DU'&NG T H A P C 6 | 6f T R i Dl>ai 5 TU6l TAI 3 HUYEN, T I N H N G H E AN NAM 2011
Ho Thu Mai'". Pham Thi Thuy Hoi', Nguyen Thi Htfong Lien', Nguyen Hong TrinViin
' (ien Dinh dudng, Hd Npi - .So-Y le Hd Npi l O M TA I
NghiSn CU'U b&nh chu-ng n h d m xdc d|nh mOt s6 y4u l 6 nguy c c cua s u y d.nh d y a n g t h l p coi tren 400 tr6 12-59 thdng dy(?c thu'c hi§n lgi Nghe An n d m 2 0 1 1 . K^t qud cho t h l y c 6 moi lien q u a n chgt che n h i t giya mirc ddp y n g nhu c l u khuydn ngh| vk ndng l y g n g {OR=4,4, p<0,01). ddp i>ng nhu c l u s i t (OR=3,7; p<0.01) va t h y c h d n h nuoi d y c n g c h d m s6c tre ciia bd me ( O R = 3 . 3 , p < 0 , 0 1 ) v d i t i n h trgng s u y d m h d u & n g t h l p COI cua trd. De cdi thien linh irgng d m h d u o n g t h l p cibi cOa tr6 lgi dia b a n n g h i g n c d u d^r d n phong chong suy dmh d u ' c n g tre em can d u a ra giai phSp can thiep ddc hieu n h d m giup cai Ihien c h l d p d m h d y o n g cila tre cung v d i viec nang cao thij'c h^nh nu6i d y o n g v& c h a m s6c tre d u n g c u a ba me.
TLI- k h o a : suy dmh d y o n g t h l p coi, yeu to iien q u a n , tre 12-59 thdng, Nghe A n , 2011
I. DAT VAN DE
Suy dinh duong thap cdi va thieu vi chat dinh dudng la nhirng van de cd y nghia sue khoe cpng ddng dang quan tam d nhieu nudc dang phat tnen. Ty lfi suy dinh dudng the thap cdi cua tre em Viet Nam nam 2011 cdn d miic cao (27,5%). Dac biet d mpt so viing ty lfi nay cdn d muc rat cao nhu Tay Nguyen (37,3%), vimg nui phia B4C (33.6%), Bac Trung Bd va duyen hai mien Trung (32%). Trong dd ly lfi thap cdi cua tinh nghe An la 31,8% [I]. Kfit qua Tdng difiu tra vi chat dinh dudng nam 2008 cho thay ty Ie thieu mau chung la 28,8%) [2]; Ty 16 thieu vita- min A tien lam sang o khu vuc Bac midn Trung cao hem so vdi toan qudc (16.4" b so vdi 14.2"i)}.
Mdt sd nghien ciru gan day cho lhay ty lfi ihicu vi chat d tre <5 tudi d mirc rat cao [3], [4]. Kel qua nghien ciru bd sung kem d tic 4-36 thang tudl bl suy dinh dudng ctia Nguyen Xuan Ninh va cpng su [5] cho thay tre duoc bd sung kem cd mirc tang trong luang, ehieu cao cao han va
ty le mac tieu chay thap hem so vdi nhdm chung mdt each cd y nghTa thdng ke.
Nghe An la mdt tinh nam d Bac mifin Tmng cd ty le suy dinh dudng ihap cdi cdn d muc rat cao [1] so vdl mirc trung binh cua loan qudc.
Tir thyc tfi tren ehiing tdi da ihyc hien nghien cuu nay vdi muc dieh nham xac dinh mdt so yeu td nguy ea cua suy dinh dudng thap cdi d tre dudi 5 tudi tai 3 huyen, tmh Nghfi An.
H. RHL O N G P H A P N G H I E N C L L 2.1. Thdi gian: Thang 6 nam 2011 2.2. Dia diem: 1 Oxa ciia 3 huyen Tuong Duong, NghTa Dan \ ii Dien Chau, tinh Nghe An.
2.3. Doi tupng: Tre 12-59 thang va me cua tre 2.4. Thi^t ke nghien cuu: Nghien cuu benh chirng
2.5. Cd mau nghien ciru: Nghifin ciiu duoc thyc hien tren 400 tre 12-59 thang tuoi (200 tre thkp cdi va 200 tre khdng th5p cdi) va 400 ba me cua tre.
*Tac gia. Hd Thu Mai
Dia chi: Vien Dinh Dudng qudc gia Dien thoai: 0904.437.872 Email: [email protected]
102 Tap ehi Y hpc du phdng. Tap XXlll, sd 2 (138) PHU BAN Ngay nhan bai: 20/2/2013 Ngay giri phan bien: 22/2/2013 Ngay dang bai: 5/5/2013
2.6. Phmmg phap danh gia ket qua - Danh gia tinh trang dinh dudng: Tinh trang dinh dudng eua trfi dugc danh gia dya vao sd do nhan trac (can nang va chifiu cao). Tre duac danh gia la suy dinh duang khi cac chi sd can nang/tudi, chieu cao/tudi, can n^ng/chieu cao <
-2 SD va thira can khi can nang/chieu cao > +2 SD [6]. Ba me duac coi la thifiu nang Iupng trudng dien khi chi sd khdi co the (BMI) <I8.5 va thira can-beo phi khi BMI>29,9 [7].
- Danh gia tinh trang vi chat dinh dudng:
Thifiu kem khi ndng dp kcm huyet thanh < 10,7
|imol/L [8]; thieu vitamin A khi ndng dp retinol
huyet thanh < 0,7 mmol/l va thieu mau khi ndng d d H b < l l g/dl [8].
- Xac djnh yeu td nguy ea: Khau phan cua tre (ap dung phuang phap hdi ghi 24 gid qua) [9]; Kifin thirc, thye hanh nudi dudng cham sdc tre eua ba mp dupc phdng van bang eau hdi ve kien thuc, thyc hanh va dp bao phii (Knowl- edge. Practice, Coverage-KPC) duge thifit kfi san. Danh gia dugc dua vao cac chi sd danh gia cua WHO va hudng dan phan tich sd lieu difiu ira KPC [10],
III.KETQUA
Bang 1. Tinh tr^ng dinh du^ng vd thieu vi chat dinh du'&ng o* tre 12-59 thang bj thap coi
Chi tieu Tinh tr^ng dinh du'O'ng
Binh thu'O'ng {%) Thap coi (%) Suy dmh dudng the nhe can
Suy dinh dudng t h i giy cdm Thllu mau
Retinol huyet thanh thap Kem huylt Ihanh thlp
77,5*
9,5"
21,5- 19,0*
33,0-
*.p<0,noi;" p<0.05:
Kfit qua nghifin ciru d Bang 1 cho thay, phan Idn nhihig tre hi suy dinh dudng (SDD) the thap cdi dfiu bi SDD the nhe can (77,5%) Trong khi dd d nhdm tre khdng bi suy dinh dudng the thap cdi, ty le tre bj suy dinh dudng thfi nhe can rat thap (l,5';u). Su khac biet giira 2 nhdm cd y nghia thdng kfi (p<0,001). Ty Ifi thieu mau d nhdm tre bi suy dinh dudng thap cdi la 21,5%) Bang 2. Gid trj dinh du'ong
cao hon cd y nghTa thdng kfi so vdi nhdm khdng thap edi (16,5%) vdi p<0,001. Tre bi thap cdi cd ty ie thieu retinol huyfit thanh cao hem 2 Ian so vdi nhdm khdng thap cdi (19% so vdi 8%).
Ty le thieu kem huyet thanh d nhdm tre bi SDD thfi thap cdl cao han cd y nghTa thdng ke so vdi nhdm khdng bi suy dinh dudng chieu cao theo tudi vdi p<0,05.
khau phan cua tre duoi 5 tuoi Gia trj dinh du'd'ng
Nang lugng TB (Kcal) Protein (g) Lipid KP (g) Vitamin C (mg) Vilamin A KP (meg) Kem (mg) Sat (mg)
Binh thuong (n=200) 977,1 ±363,0
38,0 ± 16,3 28,4 ±21.4 43,2 ± 43,7 243,8 ±197,5
4,36 ± 2.0 5,8 ± 2,8
Thlp coi (n=200) 757,0 ±277,7
29,0 ±12,1 19,5 ± 10,6 31,8 ±36,2 197,0 ±188,7
3,6 ±1,8 4,4 ±2,4
P
<0,05
<0,05
<0,05
<0,05
<0,05
<0,05
<0,05 Tap chi y hoc du phong. Tap XXIII, so 2 (138) PHU BAN
Gia tri dinh dudng kli5u phkn ciia nhimg tre bj SDD thfi thdp cdi thip hom ed >' nghia thong kg so vdl nhdm tre khdng bi SDD thfi thkp cdi (p<0,05).
Bang 3. Kien thiJc ciia bk m? vk nudi duwng vA cham s6c tre
Kien thirc
Binh thud'ng (n=200)
Thlp c6i (n=200) S6 lu'P'ng Ty I9 % S6 lu^ng T^ li Kiln thirc nudi duong vA chSm sdc lr6 khde m$nh
Bilt cho Ird bu trong vdng 1 gid d^u sau sinh Bilt it nhit 2 Ipi ich cua silra me Biet cho tr6 an bo sung sau 6 th^ng Ve diing 6 vuong thirc an
Bill dimg ve thoi gian cai si>a (sau 24 thcing) Bilt su' di^ng bieu do tang trudng
Kiln thirc nudi dudng va cham soc tre l<hi m i c benh Biet > 2 bieu hien tre mac tieu chay nang Biet nuoi duong tre tieu chay
Biet > 2 bieu hien tre mic nhiim khuan ho hap (NKHH) nang
Biet nuoi dudng tre mac NKHH
164 30 46 4 186
53
46 105 37 91
82.0 15,0 23,0 2,0 93,0' 26,5
24.0 52.5 18.5 45.5'
176 27 37 4 111 63
52 104 51 110
88.0 13,5 18,5 2,0 55,5 31,5
26,0 52,0 25.5 55.0 p<o.ni, -. p<o,05
Ket qua d Bang 3 cho thay, kien thirc vfi nudi dudng va cham sde tre khoe manh cua eae ba me d 2 nhdm tre thap cdi va binh thudng la tuang tu nhau. Rieng kien thuc vfi biet diing thdi diem cai sira eho tre thi ty le ba me cd con khdng hi suy dinh dudng thap cdi tra Idi dimg la 93,0%. eao han cd y nghia thdng ke so vdi ba me cd con bi suy dinh dudng thap cdi (55,5%)
vdi p<0,01.
Kifin thuc \ c nudi duong va cham sdc tre khi mac bfinh ciia cic ba me d ca 2 nhdm dfiu tuong tu nhau. Ty Ifi ba m? cd kien thuc dung vfi nuoi dudng va cham sde tre khi bj mac NKHH d nhdm tre binh thudtig (45,5%) thap hen cd y nghTa thdng kfi so vdi nhdm tre bi thap cdi (55,0%)\dip<0,05.
Tap chi Y hgc du phdng. Tap XXIII, sd 2 (138) PHU BAN
Bang 4. ThiPc hanh cua bk m$ ve cho tre an bo sung
C h i s d
Binh thud'ng (n=200) Thlp cbi (n=200)
So luo'ng Ty 1^ % S6 lup'ng Ty If % So \kn an bo sung theo khuyin nghi
Tre 12-23 thang an bo sung (I n h l l 3 biia/ngay
Trg 24-59 thSng an bo sung (t nhll 4 bira/ng^y
Ty l§ Chung
Thdnh phan bua an bo sung DO 4 nhom thi^c phim Khong du 4 nhom thuc pham
61
150 50
40,7*
75,0 25,0
13 53
73,5 26,5
*p<0.05
Ket qua ve thue hanh eho tre an bd sung giam nhanh theo tudi, nhdm 12-23 thang cao ciia ba me ed con 12-59 thang tai Nghe An d ban nhifiu so vdi nhdm >23 thang va nhdm tre Bang 4 cho thay, ty le tre 12-59 thang dugc an thap cdi thap hon so vdi nhdm khdng bi thap bo sung du sd bira tdi thieu/ngay theo khuyfin cdi (8,7%. va 11,1%). Sd tre an bd sung du 4 nghj d nhdm tre khdng bi thap cdi cao hon so nhdm thuc pham ehi chiem ty le 73,5%) va vdi nhdm tre hi thap edi (40,7% so vdi 35,3%) 75% d nhdm thap edi va nhdm khdng thap cd y nghTa thdng ke vdi p<0,05. Ty Ie nay edi.
Bang 5. Mot so yeu to lien quan vd'i suy dinh duong the thap coi d tre < 5 tuoi
Chi sd OR 95 % Cl p Me bl Ihilu nang lugng trudng diln 1,1
Retinol huylt thanh thlp 2.9 Kem huylt thanh thap 1,8 Khflng dap irng nhu c l u nang lup'ng 4,4 Khong 6Ap ung nhu cau kem 2,2 Khong dap i>ng nhu c l u vitamin A 2,5 Khflng d^p ung nhu c l u s i l 3,7 Thyc hanh nudi dudng cua me chua dung 3,3 Tinh trang m i c bgnh cua tre 1,9
0,8-1.7 1.5-5.4 1.2-2.8 2.5-7.7 1.4-3.3 1.2-5.1 1.9-7.3 1.3-12,0 1,2-3,1
>0,05
<0,01
<0,01
<0,01
<0,01
<0,05
<0,01
<001
<0,01
Tap chi Y hpc dir phong, Tap XXIII, so 2 (138) PHU BAN
Kfit qua d Bang 5 eho thay_ khdng cd mdi lien quan giua tinh trang thieu nang lygng trudng difin eua mc vdi suy dinh dudng the thap cdi d con (OR=I,I; p>0,05). Ndng dp retinol huyfit thanh Ihap cung anh hudng ddn tinh trang suy dinh duang the thip cdi d tre dudi 5 tudi.
Nhirng tre cd ndng dp retinol huyel thanh thap cd nguy ca suy dinh dudng thap cdi eao ban 2,9 lan so vdi nhu'ng tre cd ndng dg retinol huyel thanh binh thudng (p<0,01). Nguy ca suy dinh dudng thfi thSp edi cao han 1,8 Ian d nhdm tre cd ndng dd kcm huyet thanh thap so vdi nhdm tre cd ndng do kem huyfit thanh binh thudng (p<0,01). Nang lugng khau phan thap lam tang nguy cd bi suy dinh dudng thfi thap cdi d irc Icn 4,4 ikn (p<0,001). Cd mdi lien qua giua mirc dap irng nhu cau khuyfin nghi kem khau phan thap vdl tinh trang suy dinh duang thap cdi.
Nhihig tre cd kem khau phan thap ban nhu cau khuyfin nghi thi cd nguy cd bi mac suy dinh dirdng the thap cdi cao han 2,2 lan so vdi nhung tre cd kem khau phan dap ung nhu cau khuyen nglii(p<0,01).
Lugng vitamin A khau phan cua tre dudi 5 tudl thap hon nhu cau khuyfin nghi Iam tang nguy ca bl suy dinh dudng thap cdi len 2,5 lan (<0,05). Nhirng tre cd Iuang sat khau phan thap hon nhu cau khuyen nghi se co nguy ca bi suy dinh dudng the thap edi cao han 3,7 lan so vdi nhung tre cd lupng sat khau phan dap ung nhu cau khuyfin nghi vfi sat cho tre < 5 Uidi (p<0,01).
Nhirng tre la con ciia ba me ed thuc hanh nudi dudng va eham sdc tre ehua diing cd nguy ca bi suy dinh dudng thap cdi cao hon 3,3 lan so vdl nhirng tre la con eiia ba me ed thuc hanh dmh duong diing (p<0,0I).Tinh trang mac cac benh nhiem triing ciia tre lam tang nguy ca hi suy dinh dudng thap cdi Ifin 1,9 lan so vdi nhirng tre khdng bi mac benh nhidm triing (p<0,01)
IV. BAN LUAN
Ket qua danh gia yeu td nguy ea ciia suy dinh dudng thfi thap cdi tren 400 tre 12-59 thang tai 3 huyen cua tinh Nghe An nam 2011 cho thay che do dinh dudng kem, thue hanh nudi duang va cham sdc tre kem cung nhu tinh
trang m5c b?nh ciia trd la nhirng nguyen nhan chinh dkn den ty Ie suy dinh duong thap cdi eao ciia tre dudi 5 tudi tai cae huyen khd khan cua Nghe An. Kh^u phkn bd sung cua tre khdng hgp ly (thieu ca sd luong va chSt lugng). Nhung tre bi Ihap cdi cd gia tri dinh dudng khau phan fhap han so vdi nhirng tre binh thudng (Bang 2).
Mdt nguyen nhan khac cd the din den ty le suy dinh dudng thap cdi cao la do hau hfit cac ba me cd trinh do hpe van thap, chii yfiu lam ndng nghiep nfin kha nang tifip can vdi thdng tin cdn nhifiu han chd do dd dan den viee cham sde tre chua tdt Tinh trang thifiu vi chat dinh dudng nhu skt, kcm, vitamin A d tre cung la mpt trong nhirng nguyfin nhan quan irpng dan den tinh trang thap cdi cao. Nhirng tre bi suy dinh duang thkp edi cd ndng do vitamin A, kem huyet thanh va Hemoglobin trung binh thap hon cd y nghia thong kfi so vdi nhdm tre khdng hi suy dinh dudng the thap cdi vdi p<0,05 va ty lfi tre bj thifiu nhirng vi chat nay cung cao han so vdi nhdm tre binh thudng (p<0,01) (Bang 4). Nghifin cuu eiia Nguyfin Thanh Ha cho thay ehieu cao ciia tre lifin quan chat vdi ndng do Hb (r=0,168;
p<0,05) [II] va ndng dp retinol huyet thanh (r-=0,l30; p<0,05), ndng do kem huyfit thanh (1^0,186; p<0,01) va long so ngay mac nhifim khuSn hd hkp (r=0.121; p<0,05).
Mgt trong nhihig yeu td anh hudng den tinh trang suy dinh dudng the thap cdi la tre dugc gia dinh cho an hoac udng cac thuc an khac trudc khi duac bii sira me lan dau tifin (Bang 5).
Ty lfi tre bi suy dinh dudng thfi thap cdi dugc an hoac udng thuc an khac ngoai siia me trudc khi bii me lan dau tien eao han so vdi nhdm tte khdng bl thdp cdi (15,7% va 8%). Ben canh do ty le tre thap cdi duac an du sd biia toi thifiu/ngay theo kliuyen nghi cua Td chuc Y te thfi gldi thap han so vdi nhdm tre khdng bi thap edi (35,3%o so vdi 40,7%o). Khdng nhimg tre khdng an dii sd bua theo khuyen nghi ma ed tdi 26,5%o tre bi thap cdi khdng an dii 4 nhdm thuc pham. Day chinh la nguyfin nhan dan den miic nang luang khau phan ciia tre thap va khdng dap img nhu cau khuyfin nghi dinh dudng cua Vifin Dinh dudng [12] vaddng gdp vao ty lfi suy dinh dudng thap cdi cua tre. Cd mdi lifin quan giiia thieu nang lugng khau phan vdi tlnh trang Tap ehi Y hgc du phdng, Tap XXIII, s6 2 (138) PHU BAN
suy dinh dudng thap cdl d trfi. Ty lfi tre cd nang lugng khau phan dap ung nhu cau khuyen nghi dinh duong cua Vifin Dinh dudng nam 2007 d nhdm bi suy dinh dudng thap cdi la 90,5%
trong khi do d nhdm tre khdng hi suy dinh duang thap cdi ik 68,5%) va su khac bifit cd y nghia thdng ke vdi p'<0,01. Va nhfrng tre cd nang lugng khau phan khdng dap ung nhu cau khuyfin nghi ed nguy ca bj suy dinh dudng thap cdi cao gap 4,4 lan so vdi nhdm tre ed nang lugng khau phan dap img nhu cau khuyen nghi.
Nghien cuu ciia Hd Thu Mai tai Ddng Nai cung ed chung mgt nhan dinh la cd mdi lien quan giira nang lugng khau phan ciia tre vdi chieu eao cua tre [13]. Dieu nay eiing ly giai ve ty lfi suy dinh dudng man tinh eiia tre tai dja ban nghien cim cdn cao do tre bj thieu nang Iugng khau phan keo dai.
Tinh trang mac benli nhiem triing cung la mdt trong nhiing yeu td lien quan tdi suy dinh dudng thfi thap cdi d tre dudi 5 tudi tai dia ban nghifin ciiu. Nhimg tre bi mac benh nhiem triing trong 2 tuan qua ciing cd nguy ea hi thap cdi cao han 1,9 lan so vdi nhiing tre khdng bi mac bfinh (p<D,01). Bfin eanh tinh trang tre bi mac bfinh ciing anh hudng khdng tdt dfin hnh trang dinh dudng cua tre thi viec cham sdc chua tdt ciia ba me ciing gdp phan lam cho tinh trang dinh dudng cua tre kem han. Day la mdt thuc te ve nhan thuc va thuc hanh cua ba me trong viec nudi dudng tre dm. Nhirng tre la con cua ba me cd thuc hanh nudi dudng va cham sdc tre chua dung cd nguy cd bi Ihap cdi cao hem 3,3 Ian so vdl nhiing tre la con cua ba me ed thue hanh dung.
V. KET LUAN
Nghien cim ve tim hieu mdt sd yfiu td lien quan dfin suy dlnh dudng thap cdi tai 3 huyfin cua Nghfi An thuc hifin nam 2011. Ket qua cho thay cd mdi lifin quan chat che giira mure dap ling nhu cau khuyfin nghi ve nang Iugng (OR=4,4; p<0,OI), dap iing nhu cliu sat {OR=3,7; p<0,01) va thuc hanh nudi duang cham sdc tre cua ba me (OR=3,3; p<0,01) vdi tinh trang suy dinh dudng thip cdi ciia tre.
VL KHUYEN NGHI
Tir nhiing kfit qua dat dugc ciia nghien ciru, chiing tdi dua ra khuyen nghj nhu sau:
De eai thifin tinh trang dinh dudng thap cdi eiia tre tai dia ban nghifin ciru thi dir an phdng chdng suy dinh dudng tre em can dua ra giai phip can thifip dac hifiu nham giiip cai thien chfi dg dinh dudng ciia tre ciing vdi viec nang cao thuc hanh nudi dudng va eham sde tre diing cua ba m?.
TAI LIEU THAM KHAO
1 Vien Dinh duang (2012), Kfit qua difiu tra ve tinh trang dinh dudng va khau phan tre em Viel Nam 2-5 tudi nam 2011, bao cao cua Vien Dinh dudng.
2. Vifin Dinh dudng (2012), cap nhat tinh hinh thieu mau d Viet Nam, Hdi thao vfi bd sung sat/folic va vi chat dinh dirdng trong phdng chdng thieu mau. Ha Ndi.
3. Nguyen Van Nhien et al (2008), Micronutri- ent deficiencies and anemia among pre- school children in rural Vietnam, Asia Pac J Clin Nutr, 17(1), p. 48-55.
4. NguyenThanhHa(2010), Hifiu qua bd sung kem va sprinkles va da vi chat tren tre 6-36 thang tudi suy dinh duong thap cdi tai huyfin Gia Binh, tinh Bac Ninh.
5. Ninh X.N.,Thissen J.R, Collete L., Gerard., Khoi HH., Ketelsleger J.M., (1996), Zinc supplimentation increase growth and circu- lating insulin-like growth gaclor (IGF-I) in growth retarded Vietnamese children. Am J ClinNutr, 63, p. 514-519.
6. WHO (2005), Global Database on Child Growth and Malnutrition: methodology and applications, WHO press.
7. WHO (2000), Obesity: preventing and man- aging the global epidemic. Technical report series 894. Geneva.
8. Global Allliance for Improve Nutrition (2006), Vitamin and mineral deficiencies technical situattion analysis. Global Alliance for nutrition, Geneva press.
9. Gibson R.S (1990), Principles of nutritional assessment, Oxford, London, New Delhi:
Tap chi Y hpc du phdng, Tap XXlll, sd 2(138) PHU BAN
Oxford, No. 37, pp.155-165.
10. WHO (2008), Indicators for assessing infant and young child feeding practices. Conclu- sions of a consensus meeting held 6-8 No- vember 2007 in Wasinhinglon D.C, USA, pp. 5-11
11.Nguyfin Thanh Ha (2011), Hifiu qua ciia bd sung kcm va sprinkles da vi chai Iron tre 6- 36 thang tudi suy dinh dudng thap cdi tai huyfin (iia Binh, Bac Ninh, Luan an ticn sT
dinh dudng cpng ddng, Vi?n Dinh dudng.
12.Bp Y tfi, Vien Dinh dudng (2007), Bang nhu cau dinh dudng khuyfin nghj cho ngudi Vifit Nam, Nha xuat ban Y hgc. Ha Ndi.
13.Ho Thu Mai, Phan Van Huan, Pham Thi Thiiy Hda (2011), Tinh trang dinh dudng, thieu mau va mpt sd yfiu td lien quan ciia tre dudi 5 tudi lai khu cdng nghiep Bifin Hda, Dong Nai nam 2010. Tap chi Y hgc Thuc hanh-Ha Npi, so 10 (788), p 133-136.
RISK FACTORS OF STUNTING OF CHILDREN UNDER FIVE YEARS OLD IN THREE DISTRICTS, NGHE AN PROVINCE
Ho Thu Mai', Pham Thj Thuy Hoa', Nguyen Thj Huong Lien^ Nguyen Hong Trudng'
'National Institute of Nutrititm, Hanoi Hanoi Department of Health The case-control study on 400 children from 12-59 months of age in Nghe An was carried out aims to identyfy risk factors of stunting. The re- sults showed that, there is a closed relationship between RDA on dietary energy (OR=4,4, p<0,0l), Dietary iron (OR=3,7; p<0,01) and practice on take care of children of mother (OR=3,3; p<0,01) with stunting of children. The
Protein Energy Malnutrition Control Project need to provide specific interventions to help im- prove children's diets along with improving feed- ing practices and proper health care of the mother aim to improve the nutritional status of children stunted in the study area.
Key words: Stunting, risk factors, children 12-59 monlhs, Nghe An. 2011.
Tap chi Y hgc du phdng. Tap XXlll, sd 2 (138) PHV BAN
