VIETNAM MEDICAL JOURNAL N°2 - OCTOBER - 2017 yeu trong nghien eiru ciia chiing toi la the ton
thu'dng xu'dng ddn thuan (78,6%). [2]
Ket qua dieu tri trong bang 4 chd thay ti le dap dng tot sau 6 tuan va 12 tuan tan cdng deu la 83,3% nhu'ng ti le hoan toan lui benh co sd khac biet sau 6 tuan tan cong la 26,2% va sau 12 tuan tan cong la 47,6%.JTi le dap iing trung binh va kem khdng thay doi sau 6 tuan va 12 tuan tan cong.
Ket qua tu'dng t d theo nghien cu'u ciia Vd Thi Phddng Mai sau 6 tuan tan cdng dau tien dieu tri theo phac do LCH I I , ehi ed 57,8% tre nghien ciru dap irng tdt vdi dieu trj, sau ddt tan cdng thd 2 cd 82,3% dap irng tdt. [2] Theo nghien eiru eiia Marela trong 16 nam nghien ciru dieu tri theo phac do LCH 1, LCH 2 va DAL HX 83/90, sau 6 tuan tan cdng dau tien, ed 75,8% tre nghien eiru dap irng tot vdi dieu tri, cd 9 , 1 % dap irng trung binh va cd 15,2% tre khdng dap u'ng vdi dieu tri. Doi vdi nhdm ton thu'dng da cd quan khdng ed ed quan nguy cd thi ti le dap iTng tdt dieu tri trong cac nghien eiru dddc ghi nhan la 86% [5].
Sau 6 tuan tan cdng thir 2, dap irng dieu tri trung binh va kem khdng thay ddi nhu'ng ton thu'dng xu'dng giam han. Dieu nay tu'dng u'ng vdi ket qua la sd lu'dng benh nhan d eac nhdm khdng thay ddi nhu'ng trong nhdm dap irng tdt, mot sd benh nhan t d thoai lui chuyen sang lui benh hoan toan.
Ton thu'dng xu'dng trong nghien cdu eua Titgemeyer da phan la tdn thu'dng xu'dng mdt vj trf (68%) va dieu tri trong nghien ciru nay la ket hdp ca phau thuat triet de, xa tr; va hda trj khac vdi nghien cii'u cua chiing tdi sir dung phac dd
LCH I I I . Tuy nhien ket qua eung tu'dng tir nhi/
trong nghien ciru ciia Titgemeyer (2001), ton thu'dng mot ed quan trong do da phan ton thu'dng xu'dng cd t i ie khdi benh sau dieu tri ban dau theo phac do DAL-HX 83/90 la 8 1 % . [6]
V. KET LU&N
Benh LCH tai Benh vien Nhi trung u'dng gap nhieu nhat la the u bach eau u^ acid va nhom ton thu'dng xu'dng ddn thuan. Trieu chimg hay gap nhat la khuyet xu'dng, trong do chii yeu la mot vi tri, hay gap nhat d xu'dng so. Dap irhg tdt sau 6 tuan va 12 tuan tan cong nhd nhau nhuhg lui benh hoan toan sau 12 tuan eao hdn sau 6 tuan.
TAI LIEU T H A M KHAO
1. Nguyen Cong Khanh, (2008). Huyet hoc Mm sang Nhi khoa. Hpi chimg tang mo bao, Nha xuS ban Y hoc. Ha Noi.
2. Vo Thj Phu'dng Mai, Quach Vinh Phuc, Doan Minh Trong va cong sy (2011). Chan ffoan va di'eu tri benh mo bao Langerhans 6 tre em. Yijgc thanh phd Ho Chi Minh, 15(4): 215.
3. Gadn«- H., Grois N., Ark» M et al (2001), A ran±)mized tnal of treatment ftx" mulBsystEm Langerhans' cell hisHocytosis. J Pediatr, 138(5): 728-734.
4. Ladisch S., Gadner H., Arico M et al (1994).
LCH-I: a randomized trial of etoposide vs.
vinblastine in disseminated Langerhans cell hisbocytosis. The Histiocyte Society. I^ed Pediatr Oncol, 23{2): 107-110.
5. Marcia Kanadani Campos Marcos Borato Viana et al (2004). Langerhans cell histocytosis: a 16-year experience. Jomal de pedlab7c83{i): 79-86.
6. Titgemeyer C , Grois N., Minkov M et al (2001). Pattern and course of single-system disease in Langerhans cell histiocytosis data from the DAL-HX 83- and 90-study. Med Pediatr On'coli 37(2): 108-114.
GANH NANG KEP VE SUY DINH D I T C N G VA YEU TO LIEN QUAN TREN TR^ TIEN HOC DU'O'NG TAI MOT SO XA
THUOC HUYEN QUYNH PHU, TINH T H A I BINH
Nguyin Diic Diu', Nguyen Quang Dung
T O M TATGanh nang kep ve suy dinh dudng tren tre tien hoc du'dng gan day ehua du'Oe nghien ciili tai huySn Quynh Phu, tinh Thai Binh. Nghien ciru cat ngang mo ta tren 505 tre 3-5 tuoi tai 3 xa, thj tran ciia huyen 'Vl^ £H: Yhoc ddphong va yte cong cdng, Bai hoc YHN Chju trach nhiem chi'nh: Nguyen Quang Dung Email: [email protected]
Ngay nhan bai: 18.8.2017 Ngay phan bien khoa hoc: 4.10.2017 Ngay duyet bai: 11.10.2017
Quynh Phu nham mo ta ganh nang kep ve suy dinh duQng va yeu to lien quan. Doi tu'dng dddc can, do chieu cao, danh gia tinh trang dinh du6ng bang chi so WAZ, HAZ, WHZ va BAZ ciia WHO 2006. Yeu to liin quan du'dc thu thap bang each yeu cBu bo va me hoc sinh dien phieu dieu tra. Tv- le suy dinh duQng (SDD) the nhe can la 6,7%, thap coi la 6,9%, gay com la 6,5%, thira can/beo phi la 4,7%. Nguy cd SDD the nhe can ciia tre eo can nang sd sinh (CNSS) < 2SO0 gram cao gap 3,56 lan so vdi tre co CNSS > 2500 gram (P = 0,045). Nguy cO SDD thi thap coi cf tre cp bo v6i chieu cao < 164,4 cm eao gap 4,02 lan so vol tre CO bo vdi chieu cao > 164,4 cm (P < 0,001). Nguy
156
TAP CHi Y HOC VIET NAM TAP 459 - THANG 10 • SO 2 - 2017
"cd thira can/beo phi ciia tre trai cao hdn tre gai 2,96 Bn (P = 0,021). Ganh nang kep ve suy dinh duQng da xuat hien tren tre tien hoc du'dng tai huyen Quynh Phu.
QiSS CO moi hen quan vdi SDD the nhe c^n; chieu cao ciia bo va me CO moi lien quan tdi SDD the thap coi; gio^
t'nh CO moi lien quan vdi thift can/beo phi.
TO'khoa: Ginh nang kep ve suy dinh duSng, yeu to lien quan, thap coi, thira can, beo phi.
SUMMARY
DOUBLf BURDEN OF MALMHRinON AND ASSOOAim FACTORS AMONG PRESCHOOL CHILDREN IN SOME COMMUNES OF QUYNH PHU
Disrmcr, THAI BINH PROVINCE Double burden of malnutrition among preschool children has not been investigated recently in Quynh Phu disp-ict. Thai Binh pnavince. The cross-sectional dudy on 505 children 3-5 years old from 3 communes (rf Quynh Phu district aims to describe this problem and assodated factors. V\/eight, height were collected and nutritional status was assessed using WAZ, HAZ, WHZ and BAZ according to the 2006 WHO child growth standard. Associated factors were collected by asking die parents to fill in the questionnaire. The prevalence of underweight was 6.7%, stunting was 6.9%, wasting was 6.5%, overweight/obesity was 4.7%. Children with birth weight less than 2500 gram were 3.56 times more likely to be undenweight compared to those with birth weight higher than 2500 gram (P = 0.045). Children born to fathers who were less than 164.4 cm in height were 4.02 times more likely to be stunted compared with fethers who were at least 164.4 cm in height (P < 0.001). Boys are 2.96 times more likely to be overweight/obesity than girls (P = 0.021). The double burden of malnutrition occurs in preschool children in Quynh Phu district. Birth weight is associated with underweight; height of father and mother is associated with stunting; sex is associated with ovenweight/obesity.
Keywords: The double burden of malnutrition, associated factors, stunting, overweight, obesity.
I.OATVXNOE
Tinh trang dinh duSng (TTDD) la ket qua eua sd tu'dng tac giiJa tieu thu thdc pham, sir dyng cac diat dinh duQng va tinh trang sire khde, thdc hanh cham sde sire khde. Qua trinh tang trddng ciia tre em chju anh hu'dng bdi nhieu yeu td nhd di tmyen, benh tat, dinh dudng, mdi tru'dng sdng.
Nghien cirii trong nddc eho thay, da^ xuat hien ganh nang kep ve suy dinh du'dng tren tre em dddi 5 tuoi: tinh trang thieu va thira dinh dddng ciing mot liic ton tai [ 1 ] . Suy dinh dddng la mot trong nhii'ng nguyen nhan hang dau lam gia tang ty le mac benh va td vong d tre em dddi 5 tudi tai cac nddc dang phat trien [2, 3]. Sd lieu ve TTDD tre em dddi 5 tudi la birc tranh mp ta thdc trang dinh ddSng, la can cir ed sd de d d bao tinh hinh sii'c khoe, dinh duSng, phan anh mure song ciia ngu'di dan trong cong dong [4].
Ket qua nghien ciru gdp phan giiip dda ra cac chi'nh sach dinh dddng, can thiep dinh du'dng thich hdp nham cai thien TTDD, nang cao sire khde cua tre em. Do do, tim hieu thdc trang dinh dddng va xac dinh cac yeu to lien quan tren tre dddi 5 tuoi la het su'c can thiet.
Quynh Phu la mot huyen dong bang thupe tinh Thai Binh. Mac dii da cd nhu'ng thay dol dang ke ve dieu kien kinh te xa hdi d Thai Binh ndi chung va Quynh Phu ndi rieng, nhdng ehu^
cd mdt nghien cdu nao danh gia TTDD va yeu to lien quan trong thdi gian gan day. Do do, nghien cdu nay nham muc tieu xae dmh ty le SDD, thira can, beo phi va tinn hieu mot sd yeu to lien quan tren tre em liTa tuoi tien hoe dddng tai mot sd xa va thi tran ciia huyen Quynh Phu, tinh Thai Binh.
IL OOI TU'pNG VA PHLfaWG PHAP NGHIEN COU 2 . 1 . Dol tu'dng: Tre trai va gai trong do tuoi tir 3 tcfl 5 tuo'i, khde manh, khdng bi di tat gay gii, veo cot sdng, bo me dong y cho tham gia nghien cdu.
2.2. Dja diem: Xa An My, An Thanh, va thj tran An Bai, huyen Quynh Phu, tinh Thai Binh.
2.3. Thdi gian thu thap so lieu: Thang 9- 10 nam 2016.
2.4. Thiet ke nghiin cu\i: Cat ngang md ta.
2.5. Cd mau, chpn m l u
Sd dung cdng thirc ddc tinh mot ty le quan the vdi dp chi'nh xac tuyet doi:
Trong do, P la ty le SDD the nhe can d tre dddi 5 tuoi tai Thai Binh [ 4 ] : 13,7%, Zi.„/2 = 1,96 la gia tri dng vdi dp tin cay 95%, d la sai so ve ty le SDD the nhe can so vdi ty le thdc trong epng dong. Cd mau toi thieu tinh dddc la 505 ngu'di.
Lap danh sach tre tai eac trddng mam non ciia 3 xa, sd dung phu'dng phap chpn mau ngau nhien ddn de chpn tre vao nghien cdu.
2.6. Thu thap so lieu
- Can nang: Tre dddc can bang can dien tir Tanita, dp ehinh xac 0,1 kg. Khi can, tre mac quan ao tdi thieu, ket qua dddc ghi bang ddn vj kg vdi 1 sd le.
- Chieu eao: Chieu cao cua tre dddc do bang thdde go 3 manh ciia UNICEF, dp chinh xac Oj^l cm. Khi do chieu cao, tre bo giay hoac dep, mat nhin thang, hai tay buong thong 2 ben, dam bao 2 got chan, 2 bap chan, 2 mong, hai ba vai va eham dau cham vao thdde do. Ket qua dddc ghi vdi bang ddn vi la cm va 1 so le.
- Tuoi; Tudi eiia tre dddc thu thap bang each hdi ngay sinh dddng Ijch, sau do lay ngay dieu tra t r d di ngay sinh de tinh ra tuoi.
VIETNAM MEDICAL JOURNAL H°2 - OCTOBER • 2017 - Cac yeu to lien quan nhd can nang sd^sinh
eiia tre, gidi tinh, thdi diem an dam, trinh dp hpc van ciia me, can nang, chieu eao eua bo va me dddc thu thap bang each yeu a u phu huynh dien phieu dieu tra.
2.7. Cac yeu to Hen quan
- Can nang sd sinh thap khi can nang cua tre liie sinh < 2500 gram.
- Gidi tinh chia thanh 2 gidi nam va nu".
- Thdi diem an dam dung dddc dinh nghTa la khi tre dddc trdn 6 tliang tuoi.
- Trinh dd hoc van ciia me dddc chia thanh 2 mdc: T d cap 1 tdi cap 3 va tir trung cap trd len.
- Chieu cao trung binh ciia nam va nD" trddng thanh Viet Nam dddc diing de phan TTDD ciia bova me eiia tre thanh 2 nhdm: eao hdn va thap hdn gia trj trung binh. Ddi vdi bo ciia tre, chia thanh 2 nhdm cao hdn va thap hdn 164,4 cm.
Doi vdi me ciia tre, chia thanh 2 nhdm eao hdn vathaphcjn 153,4 em [1].
- BMI ciia bo hoac me dddc phan thanh 2 nhom thieu va khdng thieu nang Iddng trddng dien vdi nguSng BMI la 18,5. De danh gia tinh trang thira can/beo phi eiia bd va me, ngddng BMI la 25 dddc sd dung, trong dd < 25 la khdng
thda can/beo phi va > 25 la thiTa can/beo phi.
2.8. Xiyiy so'lieu: So lieu thong tin chung dddc nhap bang phan mem Epidata 3.1. So lieu nhan trac dddc nhap va tinh toan bang ph^n mem WHO Anthro, WHO Anthoplus, sau do di/dc ehuyen sang lam sach va phan tich bang phin mem SPSS 22. Ket qua tfnh dddc tinh ra cac so trung binh va ty le phan tram. Yeu td lien quan dddc xac djnh thong qua ty suat chenh OR, moi lien quan eo y nghTa thdng ke khi P < 0,05.
III. KET QUA
Bang 1. Ty Ii suy dinh du&ig, thu^
cin/beo phi cua ddi tu'dng nghien ahi
SDD nhe can SDD thap coi SDD gay com Thu^ can/beo phi
So lu'dng ( N = 505)
34 35 33 24
Tyle (Vol 6,7 6,9 6,5 47 Ty le SDD, thii^ can/beo phi eiia doi tudng nghien eiru dddc trinh bay trong Bang 1, Ty le SDD nhe can la 6,7%, SDD thap coi la 6,9%, SDD gay edm la 6,5%, thu^ can/beo phi la 4,7%.
Banff 2. Cac ySu to lien guan tell SDD the nhe can
Dac diem So tre SDD nhe can | T v l e ( % ) OR ( 9 5 % C I ) P Can nanq sd sinh
< 2500 q
> 2500 q
4 30
19,0
6,1 3,56 (1,13-11,25 f^icfitinh
Trai Gal
18 16
ThSi Khong dunq
Dunq
10 24
6,9
6,5 1,07 (0,53-2,14) Jiem an dam
1 5,6
1
7,4 0,75 (0,35-1,59) Hoc van meCap 1 tdi 3 Trunq cap trd ien
24
10
1
6,96,3 1,10 (0,51-2,36) BMI cua me
<18,5
> 18,5
12 22
1 14,8
5,2 3,18 (1,50-7,72) BMI cua bd
< 18,5
> 18,5
3 31
I 10,7
1
6,5 1,73 (0,49-6,04) 0,045 1,0001,000
1,000 0,006
0,290 Cac yeu to iien quan tdi SDD the nhe can cua tre du'dc tnnh bay trong Bang 2. Tre co can nang sd sinii
< 2500 g CO nguy cd SDD nhe can gap 3,56 lan tre cd can nang sd sinh > 2500 g (OR = 3,560, 95% a = 1,13 -11,25, P = 0,045). Ty ie SDD the nhe can d tre co me co BMI < 18,5 ia 14,8% va co me o5 BMI >
18,5 la 5,2%; nguy cd SDD tlie nhe can d tre co me co BMI < 18,5 cao gap 3,18 Bn so vdi me m BMI >
18,5 (OR = 3,180; 95% Q : 1,50-7,72; P = 0,006). Khong tim thay moi iien quan giua SDD the nlie can vdi cac yeu to khac: gidi tfnh, thdi diem an dam, trinh do hoc van ngu'di me, BMI cua bo.
Bang 3. Cac yeu to lien guan tdi SDD thethSp coi
Dac diem | So tre SDD thap coi | Ty le ( ° / 0 I OR ( 9 5 % C I ) I "
Can nanq sd sinh
< 2500 q
; 2500 q
14,3
2,35 (0,66-8,41)0,172
TAP CHi Y HOC VlgT NAM T/tP 459 - T H A H G 10 - SO 2 - 2017
Gidi tinh Trai 1
Gai 1 17 18
6,5
7,3 i 0,88(0,44-1,75) Thdi diem an dam
Khdnq dunq 1 Dunq 1 Cap 1 tdi 3 1 Trunq cap trd len 1
14 21 25 10
1 7,8 1 6,4 Trinh dd hoc van nqu'di
1 ^'2 1 6,3
J 1,23(0,61-2,49)
•ne
-1 1,15 (0,54-2,54) Chieu cao me
< 153,4 cm 1
> 153,4 cm 1 15 20
Ch
< 164,4 cm 1
> 164,4 cm 1 18 17
13,0
5,1 -1 2,78(1,37-5,62) eu cac bd
1 15,5
1 4,4 ] 4,02(2,00-8,09) BMI cua me
< 18,5 1
> 18,5 1 5 30
1 6,2
1 7,1 -1 0,86(0,33-2,30) BMI cua bd
< 18,5 1 i 18,5 1
3 32
I 10,7
1 6,7 A 1,67 (0,48- 5,82) 0,730
0,585 0,851
0,006
0,000
1,000 0,305 Cac yeu to lien quan tdi SDD the thap coi ciia tre du'dc trinh bay trdng Bang 3. Co moi lien quan giua chieu cao bo, chieu cao me vdi ty le SDD the thap coi. Nguy cd SDD the thap coi d tre co bd vdi chieu cao < 164,4 cm cao gap 4,02 ^ n so vdi tre cd bo vdi chieu cao > 164,4 cm (OR = 4,02, 9 5 % a : 2,00-8,09; P = 0,000). Nguy cd SDD the thap coi d tre cd me vdi chieu cad < 153,4 cm cao gap 2,78 lan so vdi tre co me vdi chieu cao > 153,4 cm (OR = 2,78, 95%CI: 1,37-5,62; P = 0,006).
Khong tim thay moi lien quan giua SDD the nhe can vdi cac yeu to ichac: can nang sd sinh, gidi tinh, thdi diem an dam, trinh do hpc van ngu'di me, BMI cua bo va me.
Bang 4. Cac yeu to lien guan tdi thii'a can/beo phi
Oac diem i So t r e thira can/beo phi I Tv l e ( % ) I OR (95°/iiCI) n ~ Can nanq sd sinh
< 2500 q
> 2500 q
Trai
2,96 (1,16-7,59)
Thdi diem an dam Khonq diinq
Dunq 2,8
2,15 (0,79-5,87) 0,188
Trinh dd hoc van nqu'di me
Cap 1 tdi 3 4,3
Trunq cap trd len I 5,7
0,75 (0,32-1,75)
0,504Chieu cao me
< 153,4 cm
> 153,4 cm
0,47 (0,14-1,61)
Chieu cap bd
< 164,4 cm
> 164,4 cm
5,2
4,6 1,12 (0,44-2,90)
BMI cua bd
4,6 3,44 (0,40-29,79) 0,290
> 2 5
20
10,8
4,3
2,72 (0,88-8,41) 0,090
Cac yeu t d lien quan tdi thus can/bed phi cuatre du'dc trinh bay trpng Bang 4. Ty le thua can/bed phi d tre trai la 6,9% va tre gai la 2,4%.
Nguy cd thCra can/bed phi cua tre trai cao hdn tre gai 2,96 lan (OR = 2,96, 9 5 % a : 1,16-7,59, P
= 0,021). Khong tim thay moi lien quan giua thiTa can/beo phi vdi cac yeu td khac; can nang sd sinh, gidi tfnh, thdi diem an dam, trinh dp hoc van ngu'di me, chieu cao bd va me, BMI ciia bo va me. T"/ le thira can/beo phi ciia tre cp me vdi
VIETNAM MEDICAL JOURNAL N°2 - OCTOBER - 2017 BMI > 25 ia 14,3%, cao hdn so vdi me vdi BMI
< 25 (P = 0,290). Ty le thda can/beo phi eua tre cd bo vdi BMI > 25 la 10,8%, eao hdn so vdi bd vdi BMI < 25 (P = 0,090).
IV. BAN LUAN
Bai bao nay da eho thay ganh nang kep ve suy dinh dddng da xuat hien d tre 3-5 tuoi va chi rd mot vai yeu to lien quan. Cae yeu t d lien quan tdi SDD the nhe can bao gom can nang sd sinh, tinh trang BMI ciia ngddi me. Cac yeu td lien quan tdi SDD the thap edi bao gom chieu cao cua bo va me. Yeu td lien quan tdi thda can/beo phi ehi CO duy nhat mdt yeu to la gidi tinh eiia tre.
Nguy cd thda can/beo phi eiia tre trai eao hdn tre gai 2,96 lan, phii hdp vdi ket qua eiia mot sd nghien ciru trdde day tren tre tien hoc dddng [5]. Che do an, hoat dong the lire la hai yeu to chinh anh hddng tdi TTDD. Ket qua nghien cdu gdi y cac nghien cdu tddng lai can tap trung mo ta 2 yeu to nay de gdp phan giai thich sd khac biet ve ty le thira can/beo phi giii'a 2 gidi. Van de thda can/beo phi d tre trai nhieu hdn tre gai la mot dac diem djch te ve TTDD dang chu y. Can thiep dinh du'dng can chii trong tren tre trai thira can/beo phi nham han che cae hau qua sau nay d tuoi trddng thanh.
Nghien ciru eiia chiing tdi phat hien thay ty le SDD the nhe can, thap coi ciia tre cd can nang sd sinh dddi 2500 gram cao hdn tre cd can nang sd sinh tren 2500 gram. Tuy nhien, ehi ed mdi lien quan giii^ can nang sd sinh thap va SDD the nhe can la co y nghTa thong ke: OR = 3,56 (P = 0,045). Ket qua nay phii hdp vdi nghien ciru trdde day tren tre dddi 5 tuoi ta[S6c Sdn, Ha Noi [6]. Suy dinh dddng bao thai dan tdi tre sinh ra ed can nang sd sinh thap, phan anh tinh trang thieu an, an uong khong hdp ly ciia phu nu' mang thai. Dieu dd gdi y, viec cham sdc dinh du8ng, hddng dan phu nd mang thai each an uong hdp ly la rat quan trpng, gdp phan giam ty le tre cd can nang sd sinh thap, gian tiep cai thien TTDD ciia tre va ha thap ty le SDD the nhe can.
Ket qua nghien cuii nay cho thay BMI ciia me cd lien quan vdi SDD the nhe can d con. Tre c6 me vdi BMI < 18,5 cd nguy cd SDD nhe can eao gap 3,18 lan so vdi tre ed me vdi BMI > 18,5.
Phat hien nay phu hdp vdi nghien ciru eua Subramanian va cong sd [ 2 ] . SDD the nhe can la he qua ciia SDD thap coi va SDD gay com lam cho tre cd can nang thap so vdi tuoi. Mdi lien quan giii'a BMI eua me va SDD the nhe can 6 eon phan anh che dp an chda day du d c^ me va tre, lam eho can nang ciia tre va me deu thap.
Cd nhieu yeu^td gay anh hu'dng tdi chieu cao eiia mot ca the nhu" di truyen, gidi tinh, tinh trang sde khde, dinh du'dng... Nghien cdu ciia chiing tdi eho thay, nhudg tre cd bo hoac me thap hdn chieu cao trung binh ngu'di tru'dng thanh Viet Nam co nguy cd SDD thap coi cao hdn so vdi tre ed bd me cao hdn chieu cao trung binh. Mot nghien ciTu tai Iran cho thay, tre vfl bo thap hdn 160em cd it nguy ed SDD thip c6i hdn tre vdi bo thap hdn 160 cm [7], Cae phat hien khoa hoe nay khang djnh, muon cai tliien chieu eao hay giam ty le SDD thap col, can co che dp dinh du'dng hdp ly cho ca the trong chu ky vdng ddi t d khi con la bao thai tdi khi tru'dng thanh. Nhutig tre trai, tre gai vi thanh nien du'dc cham soc dinh dudng tot se trd thanh nhifhg ngufli trddng thanh co chieu eao tdt hdn, sinh ra nhijhg dda eon khoe manh, it nguy ed SDD thap coi!
V. KET L U A N
Da xuat hien ganh nang kep ve suy dinh dudng tren tre tien hoc du'dng 3-5 tuoi tai mfit so xa/thi tran ciia huyen Quynh Phu. Cae yeu to lien quan tdi SDD the nhe can la can nang sd sinh eua tre, BMI eiia ngu'di me. Cae yeu to lien quan tdi SDD the thap edi la chieu cao eiia bo va me. Yeu td lien quan tdi thda can/beo phi la gidi tinh ciia tre. Chda tim thay mdi lien quan gliiti TTDD ciia tre vdi thdi diem tre dddc an dam, trinh dp hpc van ciia me.
TAI LIEU T H A M KHAO
1. Bo Y te- Vien Dinh du'dng, Unlcef (2010). long dieu tra dinh dddng nam 2009-2010. Nha xucit ban V hoc. Ha Noi.
2. Subramanian SV, Ackerson LK, Davey Smith G, et al (2009). Association of maternal height with chiid mortality, anthropometric failure, and anemia in India. JAMA;301(16): 1691-701.
3. United Nation System Standing Committee On Nutrition (2010). Report on the World Nutrition Situation, 2010.
4. Vien Dinh Du'dnp (2015). Ty le suy dinh dirdng tre em du'di 5 tuoi theo cac mdc do, theo yung sinh thai. So lieu thong ke suy dinh dd9ng tre em nam 2015.
5. Do LM, Tran TK, Eriksson B, Petzold M, etal (2017). Prevalence and incidence of ovenveighl and obesity among Vietnamese preschool children:
a lonaitudinal cohort study. BMC Pediatr 17(1):
150. doi: 10.1186/sl2887-017-0904-y.
6. Vu Thi Thanh Hu'dng, Pham Van Hoan^(2007).
Tinh trang dinh duQng ciia tre em dudi 5 tuoi huyen Soc son- Ha Noi nam 2001- 2006 va mot so yeu to hen Quan. Tao ifhi Y hoc thu'c hanh: 3:89-90.
7. Esfariani F, Roustaee R, Mohammadi F. et al (20131. Determinants of stunting in school-aged children of tehran, Iran. Int J Prev Med;4(2): 173-9.
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