Background
Methods
Study design
Human subjects and data collection
Definitions of indicators
Statistical analysis
Explanatory variables
Two-level logistic regression
Results
Baseline characteristics
Characteristicsb
| Gansu | Guangxi | Guizhou | Jiangxi | Inner Mongolia | Ningxia | Qinghai | Sichuan | Xinjiang | Chongqing |
---|---|---|---|---|---|---|---|---|---|---|
Parity† | 1.6 ± 0.8 | 1.4 ± 0.6 | 1.5 ± 0.7 | 1.5 ± 0.6 | 1.2 ± 0.4 | 1.5 ± 0.7 | 1.4 ± 0.6 | 1.5 ± 0.5 | 1.6 ± 0.8 | 1.3 ± 0.5 |
Gender* | ||||||||||
Girl | 138(44.8) | 660(41.8) | 480(38.2) | 483(31.0) | 550(45.3) | 505(40.2) | 742(47.0) | 668(42.7) | 1008(47.1) | 516(47.8) |
Boy | 170(55.2) | 919(58.2) | 776(61.8) | 1073(69.0) | 663(54.7) | 752(59.8) | 837(53.0) | 895(57.3) | 1133(52.9) | 564(52.2) |
Ethnicity* | ||||||||||
Minority | 3(1.0) | 999(63.3) | 896(71.3) | 11(0.7) | 66(5.4) | 232(18.5) | 586(37.1) | 529(33.8) | 1727(80.7) | 24(2.2) |
Han | 305(99.0) | 580(36.7) | 360(28.7) | 1545(99.3) | 1147(94.6) | 1025(81.5) | 993(62.9) | 1034(66.2) | 414(19.3) | 1056(97.8) |
Currently breast-feeding* | ||||||||||
No | 13(4.2) | 32(2.0) | 64(5.1) | 84(5.4) | 70(5.8) | 61(4.9) | 46(2.9) | 84(5.4) | 106(5.0) | 29(2.7) |
Yes | 295(95.8) | 1538(98.0) | 1188(94.9) | 1471(94.6) | 1143(94.2) | 1193(95.1) | 1532(97.1) | 1479(94.6) | 2034(95.0) | 1050(97.3) |
Children' age (months)‡ | ||||||||||
0 ~ 6 | 23(7.5) | 283(17.9) | 143(11.4) | 274(17.6) | 191(15.7) | 148(11.8) | 145(9.2) | 191(12.2) | 331(15.5) | 120(11.1) |
7 ~ 12 | 51(16.6) | 408(25.8) | 270(21.5) | 366(23.5) | 336(27.7) | 286(22.8) | 378(23.9) | 314(20.1) | 471(22.0) | 216(20.0) |
13 ~ 18 | 52(16.9) | 326(20.6) | 220(17.5) | 302(19.4) | 236(19.5) | 235(18.7) | 294(18.6) | 293(18.7) | 389(18.2) | 192(17.8) |
19 ~ 24 | 64(20.8) | 271(17.2) | 262(20.9) | 303(19.5) | 178(14.7) | 220(17.5) | 278(17.6) | 283(18.1) | 343(16.0) | 192(17.8) |
25 ~ 30 | 47(15.3) | 150(9.5) | 175(13.9) | 168(10.8) | 99(8.2) | 168(13.4) | 234(14.8) | 229(14.7) | 311(14.5) | 161(14.9) |
31 ~ 36 | 71(23.1) | 141(8.9) | 186(14.8) | 143(9.2) | 173(14.3) | 200(15.9) | 250(15.8) | 253(16.2) | 296(13.8) | 199(18.4) |
Mothers’ age‡ | ||||||||||
<20 | 2(0.7) | 17(1.1) | 23(1.9) | 23(1.5) | 12(1.0) | 26(2.1) | 79(5.0) | 29(1.9) | 113(5.3) | 12(1.2) |
20 ~ 29 | 223(72.6) | 1017(64.5) | 900(73.5) | 1122(73.4) | 950(78.6) | 962(78.7) | 1153(73.6) | 976(63.2) | 1439(67.7) | 635(65.4) |
30 ~ 39 | 80(26.1) | 514(32.6) | 286(23.4) | 378(24.7) | 242(20.0) | 229(18.7) | 328(20.9) | 505(32.7) | 548(25.8) | 298(30.7) |
40~ | 2(0.7) | 28(1.8) | 15(1.2) | 6(0.4) | 5(0.4) | 5(0.4) | 6(0.4) | 35(2.3) | 26(1.2) | 26(2.7) |
Mothers’ educations years‡ | ||||||||||
no education | 83(27.1) | 46(2.9) | 197(15.7) | 74(4.8) | 76(6.3) | 155(12.5) | 428(27.3) | 83(5.3) | 72(3.4) | 20(1.9) |
1 ~ 5 | 106(34.6) | 484(30.7) | 364(29.1) | 662(43.1) | 186(15.3) | 245(19.8) | 400(25.5) | 269(17.3) | 713(33.3) | 50(4.7) |
6 ~ 9 | 94(30.7) | 941(59.6) | 644(51.4) | 729(47.4) | 772(63.6) | 731(59.1) | 563(36.0) | 1103(70.8) | 1182(55.3) | 848(80.5) |
10 ~ 12 | 15(4.9) | 80(5.1) | 40(3.2) | 58(3.8) | 134(11.0) | 86(7.0) | 120(7.7) | 79(5.1) | 143(6.7) | 80(7.6) |
>12 | 8(2.6) | 28(1.8) | 8(0.6) | 14(0.9) | 45(3.7) | 19(1.5) | 55(3.5) | 25(1.6) | 29(1.4) | 55(5.2) |
Wealth index‡ | ||||||||||
Poor | 79(25.6) | 336(21.3) | 559(44.5) | 222(14.3) | 161(13.3) | 100(8.0) | 683(43.3) | 282(18.0) | 1281(59.8) | 130(12.0) |
Middle | 53(17.2) | 639(40.5) | 353(28.1) | 512(32.9) | 430(35.4) | 418(33.3) | 587(37.2) | 823(52.7) | 658(30.7) | 564(52.2) |
Rich | 176(57.1) | 604(38.3) | 344(27.4) | 822(52.8) | 622(51.3) | 739(58.8) | 309(19.6) | 458(29.3) | 202(9.4) | 386(35.7) |
Total | 308 | 1579 | 1256 | 1556 | 1213 | 1257 | 1579 | 1563 | 2141 | 1080 |
Prevalence of undernutrition
Characteristics | CIAF | No failure | Wasting only | Wasting and underweight | Wasting,stunting and underweight | Underweight and stunting | Stunting only | Underweight only |
---|---|---|---|---|---|---|---|---|
NO. (%) | NO. (%) | NO. (%) | NO. (%) | NO. (%) | NO. (%) | NO. (%) | NO. (%) | |
Province | ||||||||
Gansu | 74(24.0)* | 234(76.0)* | 6(1.9)* | 4(1.3)* | 2(0.6)* | 13(4.2)* | 49(15.9)* | 0(0.0)* |
Guangxi | 395(25.0) | 1184(75.0) | 43(2.7) | 48(3.0) | 28(1.8) | 77(4.9) | 175(11.1) | 21(1.3) |
Guizhou | 494(39.3) | 762(60.7) | 34(2.7) | 54(4.3) | 28(2.2) | 135(10.7) | 210(16.7) | 28(2.2) |
Jiangxi | 298(19.2) | 1258(80.8) | 37(2.4) | 41(2.6) | 15(1.0) | 46(3.0) | 142(9.1) | 17(1.1) |
Inner Mongolia | 95(7.8) | 1118(92.2) | 15(1.2) | 5(0.4) | 2(0.2) | 12(1.0) | 56(4.6) | 5(0.4) |
Ningxia | 135(10.7) | 1122(89.3) | 26(2.1) | 18(1.4) | 6(0.5) | 20(1.6) | 60(4.8) | 5(0.4) |
Qinghai | 295(18.7) | 1284(81.3) | 20(1.3) | 25(1.6) | 4(0.3) | 39(2.5) | 199(12.6) | 4(0.3) |
Sichuan | 472(30.2) | 1091(69.8) | 53(3.4) | 51(3.3) | 16(1.0) | 77(4.9) | 265(17.0) | 8(0.5) |
Xinjiang | 429(20.3) | 1712(80.0) | 32(1.5) | 33(1.5) | 21(1.0) | 76(3.5) | 244(11.4) | 21(1.0) |
Chongqing | 247(22.9) | 833(77.1) | 12(1.1) | 12(1.1) | 5(0.5) | 40(3.7) | 170(15.7) | 3(0.3) |
Gender | ||||||||
Girl | 1119(19.5)* | 4631(80.5) | 106(1.8) | 117(2.0) | 35(0.6)* | 223(3.9) | 591(10.3)* | 39(0.7) |
Boy | 1815(23.3) | 5967(76.7) | 172(2.2) | 174(2.2) | 92(1.2) | 312(4.0) | 979(12.6) | 73(0.9) |
Ethnicity | ||||||||
Minority | 1410(27.8)* | 3663(72.2) | 106(2.1) | 129(2.5)* | 70(1.4)* | 300(5.9)* | 734(14.5)* | 61(1.2)* |
Han | 1524(18.0) | 6935(82.0) | 172(2.0) | 162(1.9) | 57(0.7) | 235(2.8) | 836(9.9) | 51(0.6) |
Currently breast-feeding | ||||||||
No | 129(21.9) | 460(78.1) | 6(1.0) | 13(2.2) | 7(1.2) | 27(4.6) | 72(12.2) | 3(0.5) |
Yes | 2799(21.7) | 10124(78.3) | 272(2.1) | 278(2.2) | 120(0.9) | 507(3.9) | 1493(11.6) | 109(0.8) |
Children’ age (months) | ||||||||
0 ~ 6 | 245(13.3) | 1604(86.7) | 71(3.8)* | 28(1.5)* | 2(0.1)* | 23(1.2)* | 112(6.1)* | 8(0.4)* |
7 ~ 12 | 490(15.8) | 2606(84.2) | 72(2.3) | 82(2.6) | 23(0.7) | 68(2.2) | 209(6.8) | 33(1.1) |
13 ~ 18 | 544(21.4) | 1995(78.6) | 47(1.9) | 69(2.7) | 43(1.7) | 84(3.3) | 277(10.9) | 19(0.7) |
19 ~ 24 | 639(26.7) | 1755(73.3) | 33(1.4) | 40(1.7) | 32(1.3) | 117(4.9) | 390(16.3) | 22(0.9) |
25 ~ 30 | 467(26.8) | 1275(73.2) | 25(1.4) | 32(1.8) | 14(0.8) | 120(6.9) | 259(14.9) | 16(0.9) |
31 ~ 36 | 549(28.7) | 1363(71.3) | 30(1.6) | 40(2.1) | 13(0.7) | 123(6.4) | 323(16.9) | 14(0.7) |
Mothers’ age | ||||||||
<20 | 69(20.5) | 267(79.5) | 8(2.4) | 6(1.8) | 2(0.6) | 14(4.2) | 35(10.4) | 4(1.2) |
20 ~ 29 | 2007(21.4) | 7370(78.6) | 194(2.1) | 212(2.3) | 80(0.9) | 349(3.7) | 1077(11.5) | 81(0.9) |
30 ~ 39 | 776(22.8) | 2632(77.2) | 66(1.9) | 68(2.0) | 40(1.2) | 150(4.4) | 420(12.3) | 25(0.7) |
40~ | 33(21.4) | 121(78.6) | 6(3.9) | 3(1.9) | 1(0.6) | 9(5.8) | 12(7.8) | 2(1.3) |
Mothers’ educations years | ||||||||
no education | 340(27.6)* | 894(72.4) | 19(1.5) | 28(2.3) | 21(1.7)* | 81(6.6)* | 176(14.3)* | 11(0.9) |
1 ~ 5 | 904(26.0) | 2575(74.0) | 61(1.8) | 86(2.5) | 46(1.3) | 184(5.3) | 489(14.1) | 33(0.9) |
6 ~ 9 | 1543(20.3) | 6064(79.7) | 180(2.4) | 162(2.1) | 55(0.7) | 244(3.2) | 829(10.9) | 61(0.8) |
10 ~ 12 | 97(11.6) | 738(88.4) | 14(1.7) | 11(1.3) | 5(0.6) | 15(1.8) | 48(5.7) | 4(0.5) |
>12 | 36(12.6) | 250(87.4) | 4(1.4) | 2(0.7) | 0(0.0) | 5(1.7) | 22(7.7) | 3(1.0) |
Wealth index | ||||||||
poor | 1054(27.5)* | 2779(72.5) | 83(2.2) | 97(2.5) | 59(1.5)* | 205(5.3)* | 557(14.5)* | 41(1.1) |
middle | 1046(20.8) | 3991(79.2) | 108(2.1) | 106(2.1) | 35(0.7) | 190(3.8) | 572(11.4) | 32(0.6) |
rich | 834(17.9) | 3828(82.1) | 87(1.9) | 88(1.9) | 33(0.7) | 140(3.0) | 441(9.5) | 39(0.8) |
Total | 2934(21.7) | 10598(78.3) | 278(2.1) | 291(2.2) | 127(0.9) | 535(4.0) | 1570(11.6) | 112(2.1) |
Predictor of undernutrition
Characteristics | Null model | Random intercept model with individual variables |
---|---|---|
Fixed effects (OR, 95% CI)
| ||
Individual level variables | ||
Province | ||
Gansu | 1.18 (0.70, 1.99) | |
Guangxi | 1.25 (0.90, 1.74) | |
Guizhou | 2.15 (1.50, 3.08) | |
Jiangxi | 0.99 (0.71, 1.38) | |
Inner Mongolia | 0.41 (0.28, 0.60) | |
Ningxia | 0.49 (0.34, 0.72) | |
Qinghai | 0.82 (0.59, 1.14) | |
Sichuan | 1.77 (1.28, 2.45) | |
Xinjiang | 0.79 (0.58, 1.06) | |
Chongqing | 1.40 (0.97, 2.02) | |
Children’ age (months) | ||
0 ~ 6 | 1.00 (Reference) | |
7 ~ 12 | 1.27 (1.07, 1.50) | |
13 ~ 18 | 1.84 (1.55, 2.18) | |
19 ~ 24 | 2.41 (2.03, 2.86) | |
25 ~ 30 | 2.47 (2.06, 2.96) | |
31 ~ 36 | 2.86 (2.39, 3.41) | |
Parity | 1.05 (0.97, 1.13) | |
Gender | ||
girl | 1.00 (Reference) | |
boy | 1.27 (1.16, 1.39) | |
Currently breastfeeding | ||
no | 1.00 (Reference) | |
yes | 0.94 (0.76, 1.17) | |
Ethnicity | ||
Minority | 1.00 (Reference) | |
Han | 0.77 (0.65, 0.90) | |
Wealth index | ||
poor | 1.00 (Reference) | |
middle | 0.86 (0.76, 0.97) | |
rich | 0.79 (0.69, 0.90) | |
Mothers’ educations years | ||
no education | 1.00 (Reference) | |
1 ~ 5 | 0.89 (0.76, 1.05) | |
6 ~ 9 | 0.75 (0.64, 0.89) | |
10 ~ 12 | 0.47 (0.36, 0.61) | |
>12 | 0.52 (0.34, 0.79) | |
Mothers’ age (years) | ||
<20 | 1.00 (Reference) | |
20 ~ 29 | 0.88 (0.66, 1.17) | |
30 ~ 39 | 0.81 (0.60, 1.10) | |
40~ | 0.65 (0.39, 1.07) | |
Random effects
| ||
County level variance (SE) | 0.67 (0.08) | 0.36 (0.05) |
VPC (latent variable method) | 17.0% | 9.8% |
PCV | Reference | 46.3% |
MOR (95% CI) | 2.18 (2.01,2.39) | 1.76 (1.65, 1.90) |