•j TAP CHi NGHIEN CCPU Y HQC | Summary
K N O W L E D G E , P R A C T I C E O F U S I N G W A T E R A M O N G P O P U L A T I O N L I V I N G IN 4 H O T S P O T S O F A C U T E D I A R R H E A IN
HA T A Y P R O V I N C E IN 2 0 0 9
The study aims to describe knowlegde, practice and their relationship in some hot spots In fomier Hatay province. Study subjects and methodology: 4000 heads of the households were interviewed about knowledge on safe water's criteria, health consequences of not using safe water and practice in using safe water Results: Knowledge on safe water's criteria was not good.
73.0 - 83.3% listed the transparency, 41.5 - 59.6% listed the colour and taste; 66.7 - 77.6%
pointed out that using unsafe water causes dlanliea; 28.6 - 33.7% mentioned dermatitis and sore eyes; 12.5 - 13.9% listed gyneaeology disease. Urban people had better knowledge than rural people Practice in using safe water was different across study sites. Practice of water filter among households using drill well water was 38.7 - 96.3%. Practice of using lap water for food processing was low at 27.3 - 38.3% Prevalence of using boil water for drinking was gopd at 83.9 - 91.5%. Relationship between: knowledge on criterias of safe water with practice of drinking boilt water and use safe water for food processing; knowledge on health consequences of using not safe water with practice of using safe water, knowledge on using unboilt water makes diarrhea With food processing.
Key words: knowledge, practice, safe water
TiNH HiNH THIJA CAN VA BEG PHJ 6 TR^ EM DU-ai 5 TU6l NAM 2009 TAI VIET NAM
Trin Thanh Od\ Nguyin Phuvng Hoa^
' Vi$n Dinh dw&ng, ^Tn/dng Dai hgc Y Hi NOi Nghiin cuv dugc thwc hiin nhim khio sit ty 1$ thira cin va bdo phi b trd em dudi 5 tuii Kit qui: &iu tra trin tdng sd 96626 trd (50268 trd trai vi 46358 tre gii) cho thiy ty li tre thim cin li 4,1% (95% CI3,9- 4.4). ty Id bio phi li 1,2% (95% CI1,1 -1.3). Ty Id thua cin vi bio phi & trd trai cao hon so vdri nhdm trd gii {p<0,05). Tfli thira cin vi bio phi cao nhit d nhdm trd tir 0 - 5 thing tuoi (5.8% va 2,1%). Kit luin: ty Id tri thira cin d tri em Vidt Nam dang ting din. Cin sdm triin khai dc chuong trinh ean thipp.
Tir khda: thi^a d n , b i o phi, tre em du^i S t u l i
I. DAT V A N O £ "^y- ^y '^ ^^° P^' ^^^^ ^^^ ^^^^ ^^^ *^®°
chuln qudc t l cua Oy ban Bdo phi QuIc t l Hi|n nay, trd thda cdn vd bdo phi dang Id (lOTF) Id khoang 22% Ire trei vd 27% tre gdi d mdl vin d l sdc khde todn d u vd dd trd thdnh 35 tuoi td 2 - 15 tuli duyc xdc djnh Id thua vin d l sdc khde phi biln d cdc nudc dd phdt cdn vd td 5,5% tre trai vd 7,2% tre gdi Id bj tnin vd dang hinh thdnh d cdc nudc phdt bdo phi. Theo udc luyng cua T l chde Y t l triln. Of Vuang quIc Anh cung nhu phan Idn T h l gidi (WHO) thl it nhit 20 lri|u tre em dudi cdc nude phdt ttiln khdc, ty Ifi tre bdo phi 5 tijii ttfin todn t h l gidi cd tinh trgng ttidg cdn dd tdng ddt biln td nhdng ndm 1970 cho din h d c bfio phi [2]. Sy thgy d i i eua nin kinh t l TCNCYH 75 (4)-2011
I TAP CHl NGHigN CCrU Y HOC | vd lli song ddn din sy ttiay doi v l Unh ti^ng dinh dudng duyc diln ra d nhilu nudc trfin the gidi vd duyc gpi Id "dinh dudng chuyin dii" [7. 8], Vln de bfio phi vd thda cdn dudng nhu mflt "phan dng smh hda" doi vdi "mdi ti"udng gdy bdo phi" nhu thye phim cao ndng luyng. nguin ttiyc phim dii ddo, mdi tnjdng kich thich dn uing kfim theo giam vfin dfing cathe.
Cde ylu t l nguy ca bfio phi cua tre cQng dd duyc nhilu tdc gia nghifin edu. M$t nghifin edu y Trung QuIe dd xdc djnh Id b l mg bj bfio phi (OR 2,43; 95% Cl 0,78-6,59). trlnh dfi hpc van cua mg ttilp (OR 2,22; 95% Cl 1,39 - 3.55), chl dd dn (OR 2,68; 95% Cl 1,64 - 4?29), vd xem ti vi nhilu hyn hai gid/ngdy (OR 1,56;
95% Cl 1,17-2,09) Id cdc ylu t i nguy ca ddn din ttnh trgng thdg d n vd bdp phi [4]
Trong nhdng ndm gin ddy, Vifit Nam dd dgt duyc nhdng thdnh lyu ddng k l trong kinh l l nhd sy md cug trong qugn hfi kinh t l dd thu ht^t duyc nhilu nguin diu tu phdt triln.
ddc bi|t d cdc tmng tdm kinh t l Idn Id d c thdnh phi Idn nhu thdnh phi H i Chl Minh. Hd Nfii,... Cd mfit bd phdn khdng nhd tre em se bj thda cdn, bdo phi - chO ylu d khu vyc thdnh Thj [3]. o l tdi ndy tiln hdnh vdi mgc t i i u : xdc djnh ty Ifi ttida cdn vd bfio phi d tre em dudi 5 tuii ndm 2009.
II. D 6 I TifCfUG VA PHU'aNG P H A P o i l tuyng: tre em dudi 5 lull tai khu vyc duyc ehpn vdo dilu tra.
Cd mlu: Oilu tra duyc tiln hdnh tgi 63 tinh, mli ti'nh ehpn nglu nhidn dan 30 cym vd mli cym ehpn nglu nhifin dan 50 tre em dudi 5 tuli
Cdn bd thu ttilp s l lifiu Id cde cdn bfi cua trgm y t l xd dd duyc tdp huln ky v l phuang phdp cdn, do vd hodn thdnh philu phdng vln.
Phdn tich s l li$u: sd dyng phin m i m . EpIDatg d l nhdp s l lifiu, phdn tich s l lifiu
blng phin mem Stata phifin ban 10.0.
Tre em duyc xdc djnh Id thda cdn khi BMI- theo-tuii-2-score (BAZ) > 2 SD; vd trd duyc su dung quan t h l tham chilu cua WHO 2005.
Ty Ifi ti-e em dudi 5 tuoi bj thda cdn vd bdo phi duac phdn tich thee gidi tinh vd nhfim tuli,
Thudt todn Khi binh phuang {x^) duyc sif dyng nhdm so sdnh sy khdc bi|t gida cdc nhdm, Nghifin cdu su dgng mire)/ nghTg a = 0,05.
III.
K£T QUAOilu trg duyc tiln hdnh td thdng 6 - 12/2009. trdn ting s l 96626 tre (50268 ttl trgi vd 46358 tre gdi) tgi 63 tinh/ thdnh trong ca nudc.
Kit qui nghifin cdu cho thiy tJ Id trd thifa cdn Chung Id 4.1% (95% Cl 3,9 - 4,4) vd tJ Ifi tre bdo phi Id 1.2% (95% Cl 1,1 - 1.3). T^ 1$
t r l trai bj thda cdn vd bdo phi cao han d trl gdi (4,7% vd 1.5% so vdi 3,5% vd 0.9%;
p < 0,05). Cdc nhdm tuli khdc nhau ed ty 1$
t r l bj thda cdn vd bdo phi khdc nhau, nhdm t r l tif 24 thdng tuli trd Ifin cd ty 1$ thda cdn vd bdo phi thip han cdc t^ 1$ ndy d nhdm trl bfi. Xu hudng ndy tuang dli gilng nhau d d hai gidi. trd ty ifi bfio phi dfihdm.trl trai chua ed sy khdc bifit cd y nghTa thing kfi d nhdm t r l bfi vd nhdm t r l Idn (p > 0,05). (Bdng 1).
Kit qud nghifin cdu cho thiy.ty Ifi thda cdn d nhdm ttl td 0 - 5 thdng lull Id cao nhit vd t^
II ndy gilm din theo thdng tuii cua ttl. Tuy nhifin, ty Ifi giam d tre gdi theo thdng tuli diu ddn han d tte nam. Khdng thiy sy khde bifit ty Id ttida cdn d t r l trai so vdi t r l gdi td 0 - 41 thdng hill (p > 0.05). 0" nhdm trd td 42 thdng 'tuii ti-d Ifin. ty Ifi thda cdn d t r l trai cao han
tre gdi (p< 0,05).
Kit qud nghidn cdu eua bdng 2 eho ttily ty ifi thda d n vd bdo phi d khu vye d c tinh thufic miln Ddng Nam bd cao han d c tinh thufickhu vyc sinh thdi khdc (thda cdn: 7.2%
vd bfio phi: 2.3%; p < 0,05). Cdc ty Ifi ndyl nhit d khu vyc cdc tinh Oing blng ; Hlng (ttiira cdn: 3.1% vd bdo phi: 0.7%).
1
-20111
112 TCNCYfl 75 (4)
I T » P SHl WBMIEN CCKJ Y HOC I
Bdng 1 . T^ 1$ thi^a c i n vd lido phi i> t r i em dvi>i 5 t u i i , n i m 2009
BMI4ieo-tuii Z.scoie (BAZ)
Trd trai Tre gai Ting Nhim ~ ' ^
tuii % t r e > % t i « %trt> %tri> %tri> %bi>
(thdng) +2SD > + 3 S D g^ + 2 S D + 3 S D g^ + 2 S D + 3 S D trd tre
6-11
1S-23
24-29
36-41
42-47
46-53
54-59
Ting
[ 9 5 % Cl]
6,2 5,3 - 7,2
5,2 4,6 - 6,9
4,9
4,3 - 5,7 5,6 4,8 - 6,5
4,2 3,5-5,0
4,5
3,7 - 5,7 3,7 3,0 - 4,5
4,2 3 ,4 - 5,0
3,8 2,9 - 4,6
3,9 3,1-5,1
4,7 4,4 • 5,0
[ 9 5 % CIJ 2,3
1,8-3,0 1,6 1,2-2,0
1,3
1,1-1,7 1,6 1,2-2,1
1.4 1,1-2,0
1,2
0,9-1,7 1,1 0.8-1,5
1,5 t,1-2,1
1,0 0,7-1,6
1,6 1,1 -2,2
1,5 1,3-1,6
• 3718
7243
6083
• 7013
5483
5226
4632
4145
3602
3123
5026
e
[9S%CI]
5,3
4,4- 6.3 4,3 3,7- 5,0
4,5
3,9 - 5,3 4,1 3,5 - 4,7
3,6 3,0 - 4,3
3,1
2,3,4,1 3,7 3,0-4,7
2,2 1,7-2,9
2,1 1,3-3,2
1,2 0,8-1,8
3,5 2,9 - 4,3
[95%
1,8
1,3-2.5 1,1 0,9-1,5
0,9
0,6-1,3 0,8 0,6-1,2
1,0 0,7-1,6
0,9
0,5-1,6 1,1 0,7-1,7
0,7 0,4-1,1
0,6 0,4-1,1
0,3 0,1 - 0,6
0,9 0,8-1,1
3215
6661
5804
6120
5083
4862
4142
3927
3440
3104
46358 [ 9 5 % -
Cl]
5,8
5,1 - 6,5 4,8 4,3 - 5,3
4,7
4,3-5,3 4,9 4,3 - 5,6
3.9 3,4 - 4,5
3,8
3,2 - 4,5 .3.7 3,1 - 4,4
3,2 2,8 - 3,8
2.9 2,3 - 3,7
2.6 2,1 - 3,2
4,1 3,9-4,4
[95%
cn 2,1 1,7-2,5
1,4
1,1-1,7 1.1
0.9-1.4 1.2 0,9-1,5
1,2 0,9'- 1,6
1,1
0,8-1,4 1,1 0,8-1,4
1,1 0,8-1,4
0,8 0,6-1,2
0.9 0,7-1,3
1,2 1.1-1,3
13133
10566
8774
8072
7042
6227
96626
TCNCYH 75 (4)-2011
I TAP CHi NGHIEN C t K j Y HOC [•
Bang 2. Ty l# thCFa c a n vd bdo phi o tre em < 5 t u i i t h e o v u n g s i n h t h d i , n d m 2009 BMI theo tudi Z-scoie
Tre gdi T6ng
% tre > % tre >
vang sinh 1 2 SD • 3 SD [95%
Cl]
[95%
Ci]
% t r e > % t r c > % t r * >
35 +2 SD + 3 SD s d * 2 SD tre
% t r * >
+ 3SD [95% [95%
01] Cl] [95% Ci] [95%
Cl]
S i t r i
D6ng bang 3 5 o,9 song H6ng
(11 tinh) 3.1-4.1 07-1,2 2,1-3.0 0,4-0,7 2,7- 3,5 0,6- 0,9 Viing nui vd
Cao nguyen phia Bdc (14 linh)
4,3 1.4 3.7-5.1 1,1-1.!
6556 6035 3,0-4,0 0,8-1,3 3.4-4.5 Bdc mien 4.7
tmng vd Ven bien
mi^n trung 4.1-5.3 1.^
(14 linh)
11606 10709 2.7- 3,5 0,6- 0,9 3.5- 4,3
Tdy Nguy&n (5 tinh) Dfing Nam B$
(6 linh) 3,7 2.9- 4.6
8,1 6,8- 9,6
0,7 0,3-1,4
2,7 2,0- 3,6
2887
7194 2,5 1,9-3,3
6,4 5,3- 7,6
0.5 0,3- 0,9
1.8 1,3- 2,6
2742
6903 3,1 2,5-3,9
7,2 6,2- 8,4
0,6 0,3-1,1
2,3 1.8- 2.9
6629
14097 Ddng bSng
sfing CCFU Long (13 tinh)
3.7-4,8 1,0-1,7
10226 9577 3,1-4,2 0,8-1,3 3,5-4,4
BMI-theo-Tudi Z-Ecoie
Biiu d i 1. Phdn b6 BMI theo tuil-Z-score a'lriemdirdn5tuilndm2009 TCNCYH 75 (4)-2011
i TAP CHi NGHIEN Cl L P U Y t ^ f ^ Bilu d l 1 cho Oily dudng BMI theo tuoi-Z-score d tre em dudi 5 tuoi trong ndm 2009 Id phdn b l chuln. Tf Ifi thda cdn cOa ttl em dudi 5 tijii tgi Vi|t Nam dd cgp han dudng phdn bo chuln cua T l chde Y t l The gidi ndm 2005.
IV. BAN LUAN
Nlu nhu trang nhdng ndm 80 thl cdc vln de dinh dudng cOa tre em Id ty Ifi suy dinh dudng khd eao th) din nay t^ l | ndy dd giam.
nhung di kfim theo dd Id ty Ifi tre thua edn vd bdo phi dd tdng Ifin mfit cdc nhanh chdng, nhit Id tgi khu vyc thdnh thj, Ty ifi ndy tgi Thdnh phi H i Chi Minh vdo ndm 2000 Id khdng 6% thl din ndm 2002 dd Id 9% [5].
Trong cudc dilu tra gin day nhat cda Trung tdm Dinh dudng d n g ding thl ty t r l thua cdn tgi thdnh phi Ho Chl Minh ndm 2006 Id 20,5%
(95% Cl 17,5 - 24,3) vd bdo phi id 16.3%
(95% Cl 13.2 - 20,4) dya theo tifiu chl cua Oy ban bdo phi QuIc t l [3], Ty i$ bfio phi ndy cdn cao gin gip ddi so vdi tJ tfi thda edn vd bfio phi d B I C Kinh, Trung QuIc [4].
Trong nghifin cdu ndy, ty Ifi thua cdn d nhdm trl tuli 0 - 5 thdng tuoi eao han hin so vdl cdc nhdm tuli khdc cd the Id do sy by sda d tre sy sinh vd mdt phin cCIng cd thl do vific tudn thu d i hit quin do khi d n cho t r l sa sinh chua duyc dly du.
Qua phdn tich 19 II thda cdn bdo phi theo nhdm tuli cho thiy ty Id ndy giam din td lue sinh ra eho din khi trd trdn 5 tuli.
Cdc kit qud nghifin cdu trfin t h l gidi dd cho ttily. trang 10 ndm qua, xu hudng tJ l | tre dudi 5 lull bj bfio phi tilp tgc gia tdng d cdc nude dd phdt triln [1. 3] cQng nhu d cde nude dang phdt triln [8j.
Oli vdi cdc nude dang phdt then thi ton tgi d hai vln d l . (1) trd suy dinh dudng nhg d n vln dang Id vln d l cfing ddng vd (2) tre thda cdn, bdo phi dd hinh thdnh vd dang phdt triln 12. 7]. Sy phdt triln v l kinh t l , sy chuyin dli din l l i sing cdng nghifip d nhdng viing cdng nghilp hda dd kfio theo sy ttiay dli trong mdi trudng cQng nhu d c vln d l sue khde mdi.
V. K t T LUAN
Ty Ifi thda cdn d tre dudi 5 tuoi Id 4.1 %. ty Ifi beo phi Id 1,2 %. & nhdm tre tuli td 42 thdng trd Idn, cdc ty Id ndy d tre trai cao hyn tte gdi.
Qua phdn tich ty Ifi thua cdn thep nhdm tuoi cho thay ty Ifi ndy giam din tu liic sinh ra cho den khi tre duyc 5 tuii. Cde tinh thufic khu vyc mien Odng Nam bfi cd ty Ifi t r l bj thda cdn vd bfio phi cao han so vdi cdc tinh thudc cdc khu vue sinh thdi khdc.
T A I L I E U THAM K H A O 1. Khoi HH (2006). Mdt s i vln d l dinh dudng d n g ding d Vifit Nam. Hd Nfii, 2006.
2. Cole TJ, Bellizzl MC (2000).
Establishing a standard detinition for child overweight and obesity worldwide:
international survey. 7(3): 35-41
3. Dieu H, Dibley M (2007). Prevalence of overweight and obesity in preschool children and associated socio-demographie factors in Ho Chi Minh City, Vietnam. Int J Pediatt Obes.
2(1): 40-50
4. Jiang J, Rosenqvist U (2006). Risk factors for oveniveight in 2- to 6-year-old children, in Beijing, China. Int J PediatrObes 1(2): 103-108
5. Loan T, Oanh NP, Hanh TMT, Hung KTN (2003). Nutritional status of primary school children in Ho Chi Minh City, 2002, Nutrition Centre of Ho Chi Minh City.
6. NIN-GSO (2003). Result of nutrition status for children and mother from nutrition survey in 2002.
7. Popkin B, Norton S, Kim S, Mahal M, Shuigao J (2001). Trends in diet, nutritional status, and diet-related non-eommunicdble disease in China and India' the economic costs of the nutrition transition. Nutrition Reviews 59: 379 - 390.
TCNCYH 75 (4)-2011 115
I TAP CHl NGHIEN CUm Y HOC h
8. Wang Y , Monteiro C, Popkin MB (2002). cMdcen » i d adcdescents in ttie United States, Braal, Trends of obesity and underweight in older China,aidRusaaAmJClinNufr75:971-977.
S u m m a r y
OVERWEIGHT AND OBESITY AMONG CHILDREN UNDER 5 YEARS IN VIETNAM, 2009
The study aims to investigate the prevalence of overweight and obesity among children under 5 years. Results: 96626 children (50268 boys and 46358 girls). The prevalence of ovenA^eight and obesity were 4 . 1 % (95% Cl 3.9 - 4.4) and 1.2% (95% Cl 1.1 - 1 . 3 ) respectively. The prevalence of overweight and obesity among boys were significantiy higher ttian among girls (p < 0.05). The prevalence of overweight and obesity among children who was 0-5 months were the highest (5.8% and 2.1%). Conclusions: overweight and obesity is increasing among children less than 5 years in Viejnam, Intervention programs to central the problem are needed to implement soon.
Key w o r d s : over w e i g h t , obesity, c h i l d r e n under 5 years
GIA TR! DINH DU'DNG, DAC TiNH C A M QUAN CCiA MY TOM
S A N X U A T TU' B Q T M Y TANG CUaNG VI C H A TN g u y i n TO A n h , N g u y i n Xudn Ninh Vi$n Dinh dudng Nghidn cdu^joc thwc hiin nhim theo ddi gii tq dinh dudng. vi sinh vit cue my tdm chi biin tir bdt myr ting cudng vi chit theo thdi gian bio quin vi dinh gii die tinh dm quan vi khi ning chip nhin cua mjf tdm trdn php nO tu& sinh di 20 - 35 tu&. Kit qui: Bpt my ting cudng vl chit cd cic gii tii dinh dudng.dn xuit khdng bj d nhiim vi sinh vit. 4 trong 5 ch/ s l dinh dudng (pmtein. lipid. Fe, Zn khdng bi suy glim trong qui trinh chi biin vi bio quin; chi sd acid folic bj glim manh sau chi biin. edn khdng ding ki tir sau 3 thing sin xuit Die tinh cim quan chung cOa my tdm dat mdc khi (17.5 - 17.7 diim/iSim 20).
dUyc cic ddi tuong chip nhin tdt trong 7 ngiy sir dpng sin phim. Kit luin. khuyin nghj: My tdm sin xuit tir bdt my ting cudng vi chit, da sd cic chi tidu 6n djnh tmng thdi gian 3-6 thing bio quin. ridng add folic bi glim mpnh sau 3 sin xuit. Mf tdm cd <Sim dm quan cao vi dt^w cdng ddng chip nhin tdt. Cin tfln hinh nghiin ciru vi tinh 6n tfnh cua dc vi chit vdi cic sin phim khic chi biin tir bit mf. cQng nhu dinh gii hiiu qui eua su dpng sin phim trin ngudi.
Tir khda: b $ t m y , m y t d m , t d n g cwimg v i c h i t , d^c tfnh c d m q u a n
I. D A T V A N O E k l h-fin,. d l i t u y n g cd nguy c a n h i t Id phy n d T h i l u mdu do ttiilu sdt. I h i l u folic, tiiilu * " ^ ' ^ ' " ^ ^^ "^ ^ r l em T h i l u vi c h i t gdy nfin kem dang Id v l n d l sdc khde d n g d i n g d " ^ ^ " 9 ^ " ^ ^ ^ * " 9 ^h.dng t i t lifin quan vdi kfim n h i l u n u d c ttfin ttil gidi. trong dd d V i | t P^^t tiiln ttil c h i t , ti-i t u | , m i l n djch... I n h Nam l / d c tinh tiling binh khoang 30 - 50% hudng d i n s d c khoe d nhdn. cOng n h u s y ddn s l V i l t Nam d v l n d l t h i l u d c vi chdt phdt t r i l n cua xd hdi [3. 5].
116 TCNCYH 75 (4)-201^
