以下是The Lancet（《柳葉刀》）雜志中文版網站于2010年3月第 4 卷 - 第 3 期“本月文章精選”中給出的免費全文的摘要
Child disability screening, nutrition, and early learning in 18 countries with low and middle incomes: data from the third round of UNICEF’s Multiple Indicator Cluster Survey (2005–06)
18個中低收入國家兒童殘疾篩查、營養和早期教育狀況分析：UNICEF第3輪多指標類集調查結果（2005—2006年）
作者：Carissa A Gottlieb, Matthew J Maenner, Claudia Cappa, Maureen S Durkin
【英文摘要】
Background
Child disability is an emerging global health priority. To address the need for internationally comparable information about the frequency and situation of children with disabilities, UNICEF has recommended that countries include the Ten Questions screen for disability in the Multiple Indicator Cluster Survey (MICS) programme. We examined child disability screening and its association with nutrition and early learning in countries with low and middle incomes.
Methods
Cross-sectional data for the percentage of children screening positive for or at risk of disability were obtained for 191 199 children aged 2–9 years in 18 countries participating in the third round of MICS in 2005–06. Screening results were descriptively analysed according to sociodemographic, nutritional, early-learning, and schooling variables. We constructed a weighted analysis to account for the sampling design in every country and tested for differences within countries using χ2 analyses.
Findings
A median 23% (range 3–48) of children aged 2–9 years screened positive for disability in the 18 participating countries. For children aged 2–4 years, screening positive for disability was significantly more likely in children who were not breastfed versus those who were (median 36% [9–56] vs 26% [4–51]) in eight of 18 countries, in children who had not received vitamin A supplementation versus those who had (36% [7–53] vs 29% [4–50]) in five of ten countries assessed, in children who met criteria for stunting (26% [6–54]) or being underweight (36% [3–61]) versus those who did not (25% [3–42] and 26% [4–43], respectively) in five of 15 countries assessed for stunting and in seven of 15 countries assessed for being underweight, and in those who participated in few early-learning activities versus others (31% [7–54] vs 24% [4–51]) in eight of 18 countries. Children aged 6–9 years who did not attend school screened positive for disability more often than did children attending school (29% [2–83] vs 22% [3–47]) in eight of 18 countries.
Interpretation
Our results draw attention to the need for improved global capacity to assess and provide services for children at risk of disability. Further research is needed in countries with low and middle incomes to understand and address the role of nutritional deficiencies and restricted access to learning opportunities as both potential antecedents of childhood disability and consequences of discrimination.
Funding
UNICEF; Department of Population Health Sciences,
【中文摘要】
背 景 兒童殘疾是一項全球日益受關注的健康問題。為了滿足獲得兒童殘疾發生率及其狀況的國際可比性信息的需要，聯合國兒童基金會（UNICEF）建議各國在多指標類集調查（MICS）中納入殘疾10項問題篩查問卷。我們對中低收入國家的兒童殘疾篩查結果及其與營養和早期教育的相關性進行了分析。
方 法 采集UNICEF 2005—2006年第3輪多指標類集調查（MICS3）的18個參與國的橫斷面研究數據，分析191 199名2～9歲兒童殘疾篩查陽性或有殘疾風險的百分比結果。依據社會狀況、營養、早期教育和入學情況，對篩查結果進行描述性分析，并對每個國家的采樣設計進行加權分析，用χ2分析檢測國家之間的差異。
結 果 在18個參與國中，2～9歲兒童殘疾篩查陽性率的中位數為23%（極差 3～48）。18個國家中有8個國家的結果顯示，2～4歲兒童中，非母乳喂養兒童的殘疾篩查陽性率[36%（極差 9～56）]明顯高于母乳喂養兒童[26%（極差 4～51）]；在10個補充維生素A喂養調查的國家中，5個國家的結果顯示，未補充維生素A的兒童殘疾陽性率高于補充的兒童[36%（極差 7～53）vs 29%（極差 4～50）]；在15個進行發育遲緩調查和15個進行體重過輕調查的國家中，分別有5個和7個國家的結果顯示，有發育遲緩或體重過輕的兒童，篩查陽性率分別為26%（極差 6～54）和36%（極差 3～61），而發育正常或非體重過輕者則為25%（極差 3～42）和26%（極差 4～43）；18個國家中有8個國家的結果顯示，很少參與早期教育活動的兒童篩查陽性率高于其他兒童[31%（極差 7～54）vs 24%（極差 4～51）]。18個國家中有8個國家的結果顯示，6～9歲兒童中未入學者的殘疾篩查陽性率高于入學者[29%（極差 2～83）vs 22%（極差 3～47）]。
結 論 研究結果使人們注意到，必須提高兒童殘疾風險評估和提供服務的整體能力。需要在中低收入國家進行進一步的研究，以說明和確定營養不良和學習機會受限是兒童殘疾并導致歧視的兩個潛在因素。
基 金 UNICEF和美國威斯康星大學麥迪遜分校人口健康科學系。
（編輯：劉鵬達）
