| OBJECTIVETo study on the nutritional status of vitamin A and influencing factors of children aged 3-18 in Hainan Province,so as to provide a scientific basis for the Hainan Provincial Government to formulate intervention strategies related to vitamin A nutritional problems and physical health promotion of children aged 3-18.METHODSSubjectsThis study was funded by a major science and technology project of Hainan Province"Research on growth and development monitoring and influencing factors of children(0-18 years old)in Hainan Province,ZDKJ2019010".The cities and counties in Hainan Province were divided into urban and rural areas.Using the method of multi-stage cluster random sampling,in the first stage,all urban districts were included in the study,and one township was randomly selected in each rural city and county;in the second stage,one kindergarten,elementary school and secondary school were randomly selected in each district/township;in the third stage,one to two classes of students were randomly selected in each grade in the selected schools,and children who met the inclusion criteria were selected as the subjects..MethodsA field survey was conducted from January 2021 to June 2022 to obtain data on the demographic characteristics,family situation,diet and vitamin A nutritional status of children aged 3-18 years in Hainan Province by means of questionnaires and laboratory tests.The SPSS 26.0 software was used to statistically describe and analyze the collected data.Theχ~2test was used to compare the differences in vitamin A nutritional status among different characteristics of children,and two-level logistic regression model and binary logistic regression were used to analyze the factors affecting the vitamin A nutritional status of children aged 3-18 years in Hainan Province.The differences were statistically significant with P<0.05.RESULTS1.A total of 11732 children aged 3-18 years in Hainan Province were investigated in this study,and 6894 and 4838 children were included in urban and rural areas,respectively.2.The incidence of serum vitamin A marginal deficiency in children aged 3-18years in Hainan Province was 11.67%,and in urban and rural children were 8.95%and 15.54%,respectively;the incidence of serum vitamin A marginal deficiency in children aged 3-5 year,6-11 year and 12-18 years groups were 15.76%,10.98%and8.48%,respectively.The incidence of serum vitamin A deficiency rate was 0.85%,and in urban and rural children were 0.36%and 1.55%,respectively;the incidence of serum vitamin A deficiency in children aged 3-5 year,6-11 year and 12-18 years groups were 2.01%,0.40%and 0.33%,respectively,with 0.54%and 2.90%in urban and rural children in the 3-5 years group,respectively.3.By comparing between different regions,it was found that the incidence of insufficient vitamin A in urban children was lower than rural children(9.31%VS.17.09%,P<0.05).By comparison between different age groups,3-5 years old children had the highest incidence of insufficient vitamin A(17.77%),and the deficiency rate showed a decreasing trend with age(P<0.05).By comparing between different ethnic groups,it was found that the incidence of insufficient vitamin A in Han children was lowest,and the difference between Han and Li children’s incidence of insufficient vitamin A was statistically significant by two-by-two comparison(P<0.05).4.Two-level logistic regression models showed that there was no aggregation of vitamin A nutritional status among children aged 3-18 years in Hainan Province at the city and county levels.The results of binary logistic regression showed that children aged 6-11 years(OR=0.341,95%CI:0.300-0.389),12-18 years(OR=0.234,95%CI:0.199-0.275),only child(OR=0.753,95%CI:0.649-0.873),mother’s education level was high school/secondary school(OR=0.790,95%CI:0.664-0.941),mother’s education level was college/bachelor’s degree and above(OR=0.738,95%CI:0.587-0.929),father’s education level was high school/secondary school(OR=0.676,95%CI:0.574-0.796),father’s education level was college/bachelor’s degree and above(OR=0.648,95%CI:0.522-0.804),annual household income>100,000(OR=0.733,95%CI:0.584-0.920),intake of vegetables and fruits 3-6 days in the last 1week(OR=0.595,95%CI:0.500-0.709),intake of vegetables and fruits>6 days in the last 1 week(OR=0.506,95%CI:0.445-0.574),and weekly intake of vitamin A supple-ments within the last 1 month(OR=0.842,95%CI:0.740-0.957)were protective factors for normal vitamin A in children,and father’s ethnicity of Li(OR=1.389,95%CI:1.016-1.897)was a risk factor.CONCLUSION1.The overall vitamin A nutritional status of children aged 3-18 years in Hainan Province is good,and still attention should be paid to the marginal vitamin A deficiency in children.The vitamin A deficiency status of children aged 3-5 years in rural areas is a mild public health problem.2.The vitamin A nutritional status of children aged 3-18 years in Hainan Province was related to region,age,ethnicity,only children,parental ethnicity,parental education,annual family income,family type and diet(frequency of vegetable and fruit food intake in the last 1 week,whether they were picky eaters,and whether they took weekly vitamin A supplements in the last 1 month).In this study,age,only child,parental education,annual family income,intake of vegetable and fruit foods,and intake of vitamin A supplements were found to be protective factors for normal vitamin A.The father’s ethnicity of Li was a risk factor for vitamin A insufficiency. |
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