| 【Background】With the reform of the economy and the acceleration of urbanization in China,millions of rural residents have migrated to urban areas with their families for seeking job opportunites,the result of which is the rapid increase of migrant children.“Migrant Children”was defined as children under 18 years of age who followed their parents or guardian to live in a town/sub-district(non-registered household city)for more than six months and whose household register(hukou)is in another town/sub-district.Based on the data from Chinese sixth census in 2010,the numbers of migrant children nationwide had reached 35.81millions.And in Beijing,which holds the fifth largest internal trans-provincial migrant children in China,there were more than 0.64 million migran children aged 0-17 years in 2010.In addition,the ratio of migrant children to local children in Beijing was 32.78%,which was second in China.Based on the data from government,there are 767.8 million in Beijing,of which 404.07 million lived in migtants densely populated communities.The process of migration and particularity of migrants themselves may have a complicated influence on nutritional status of migrant children.One side,Scoial factors such as the fundamental changes in living environment and a lack of community support may result in nutritional anemia due to changes in feeding practices.On the other side,parents’low education level may result in the lack of active learning feeding and health knowledge,which contributed to nutritonal anemia of migrant children.Nutritional anemia is defined as any anemia resulting from a dietary deficiency of materials essential to red blood cell formation,iron,zinc,viamins(esprcially folic acid),protein.Anemia in young children may have a long-term effect on their neurological development and behavior,some of which is irreversible.Based on the data from Nutrition Development Report of Children Aged 0-6 years(2012),28 percent of rural children between 6-12 months old and 21 percent between 13-24 months still suffered from anaemia in 2010.Recent surveys from China that a high prevalence of nutritional anemia among children aged 6~23 months in rural area ranges from 30%-60%,which indicated anemia is a moderate or severe public health problem in China according to the World Health Organization’s classification of public health significance of anemia.Although rural to urban migrants have opportunities for better access to health care services and a more diversified dietary,the disparity of anemia prevalence among migrant children and local children has been reported.However,there has been no study to explore the prevalence of nutritional anemia and its risk factors among migrant children in migrants densely populated communities of Beijing,in China.This study aimed to investigate the status of complementary feeding and nutritional anemia among migrant children aged 6~23 months from migrant densely populated communities of Beijing,and to explore the risk factors of complementary feeding and nutritional anemia.【Objectives】This study aimed to investigate the status of complementary feeding and nutritional anemia among migrant children aged 6~23 months from migrant densely populated communities of Beijing,and to explore the risk factors of nutritional anemia.【Methods】Design A cross-sectional survey was conducted among migrant children in the migrants densely populated communities from November 2016 to April 2017 in Beijing,China.3 migrants densely populated communities were selected from Chaoyang district,Haidian district and Changping district by non-probability sampling.305 children aged6~23 months were recruited by cluster sampling from 3 random migrant densely populated communities of Beijing.Date collection The nutritional status questionnaire of 6~23 months children was used as the survey instrument,which was adapted from the maternal,newborn and child health household survey tool by World Health Organization.The questionnaire included socio-demographic information on children and families,children’s health and feeding practices,24-hour diet review and dietary review over the past week.The content of socio-demographic information on children and families was a self-designed questionnaire,and children’s health and feeding practices,24-hour diet review and dietary review over the past week were adapted from the maternal,newborn and child health household survey tool by the World Health Organization.The children’s hemoglobin was measured using HemoCue HB201+hemoglobinometer([HemoCue,Angelholm,Sweden],precision of 1 g/L).About 10μ/l blood sample of each child was collected from the left ring or middle finger by HemoCue Microcuvettes.WHO indicators for assessing infant and young child complementary feeding practices and anemia standards.The World Health Organization(WHO)and the United Nations Children’s Fund(UNICEF)have released feeding assessment indicators for infants and young children in 2007.The migrant children complementary feeding practices were evaluated by four complementary feeding indicators in this study.The World Health Organization(WHO)and the United Nations Children’s Fund(UNICEF),defines hemoglobin≤110 g/L as anemia.Statistical analyses The data were analyzed using Statistical Product and Service Solutions(SPSS20.0.).Chi?square test was completed to determine significantly factors before analyzing the data(only the factors with P or trend P<0.05 were used to developed the regression model).Logistic regression(with the method of backwards Walds)was used to obtain odds ratio(ORs)and 95%confidence intervals(95%CIs)to analyze the associations between anemia and the potential risk factors.Non-significant variables were removed from the final model.P value<0.05 is considered as statistically significantly different.【Results】A total of 305 migrant children aged 6~23 months were investigated,of which54.1%were male and 45.9%were female.Among 305 children surveyed,30.8%(94)were aged 6-11 months,34.4%(105)were aged 12-17 months and 34.8%(106)were aged 18-23 months.The primary caregivers of migrant children are mother(maternal parenting 83.3%,254).The education level of parents is mainly junior high and high school:46.2%(141)fathers had junior high school education,and 27.9%(85)fathers had high school;50.5%(154)mothers had junior high school education,and 35.1%(107)mothers had high school education.Father’s occupation is mainly based on work,accounting for 73.4%(224).And housework is the migrant mother’s main occupation(66.2%,202).The prevalence of stunning,wasting,underweight and were 1.3%,0.65%and0.65%.The rates of minimum dietary diversity,minimum meal frequency,minimum acceptable diet,and the consumption of iron-rich or iron fortified foods among children in the previous day aged 6~23 months were 84.6%(258/305),64.9%(198/305),58.4%(178/305)and 55.7%(170/305).The rate of minimum dietary diversity,minimum meal frequency,minimum acceptable diet,and the consumption of iron-rich or iron fortified foods in infant 6~11months,12~17months,18~23months was different,which was significant(χ~2 were 10.725,10.189,7.093 and37.098,respectively,P<0.05).The rate of minimum dietary diversity and the consumption of iron-rich or iron-fortified foods between 6~17 months continued breastfed infant and weaning infant was different,which was also significant(χ~2 were21.2 and 25.844,respectively,P<0.05).The average of hemoglobin in 305 migrant children was 113.68±13.77 g/L.The prevalence of nutritional anemia was 39.3%,with mild,moderate and severe accounted for 83.2%,13%and 3.8%,respectively.And significantly difference among age groups(P<0.05)with 6~11 months being the highest(50%)and 18~23 months being lowest(26.4%).Logistic regression analysis showed that family with fridge(OR=0.327;95%CI:0.1661-0.642),continued breastfeeding(OR=2.838;95%CI:1.652-4.874)and consumption of iron-rich or fortified foods in the past 24 hours(OR=0.265;95%CI:0.157-0.448)were significantly risk factors of nutritional anemia.【Conclusions】Future interventions targeting the improvement of complementary feeding and reduction of nutritional anemia in children from migrants densely populated community in developed city should consider developing strategies of appropriate complementary feeding practices,especially for those children aged 6~11 months in poverty,and those with continued breastfeeding. |
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