Comparison of the Nutritional Status of Overseas Refugee Children with Low Income Children in Washington State

Introduction
The extent that the dual burden of undernutrition and overnutrition affects refugee children before resettlement in the US is not well described.
Objective
To describe the prevalence of wasting, stunting, overweight, and obesity among refugee children ages 0–10 years at their overseas medical screening examination prior to resettlement in Washington State (WA), and to compare the nutritional status of refugee children with that of low-income children in WA.
Methods
We analyzed anthropometric measurements of 1047 refugee children ages 0–10 years old to assess their nutritional status at the overseas medical screening examination prior to resettlement in WA from July 2012—June 2014. The prevalence estimates of the nutritional status categories were compared by country of origin. In addition, the nutritional status of refugee children age 0–5 years old were compared to that of low-income children in WA from the Center for Disease Control and Prevention’s Pediatric Nutrition Surveillance System.
Results
A total of 982 children were eligible for the study, with the majority (65%) from Somalia, Iraq and Burma. Overall, nearly one-half of all refugee children had at least one form of malnutrition (44.9%). Refugee children ages 0–10 years were affected by wasting (17.3%), stunting (20.1%), overweight (7.6%) and obesity (5.9%). Among children 0–5 years old, refugee children had a significantly higher prevalence of wasting (14.3% versus 1.9%, p<0.001) and stunting (21.3% versus 5.5%, p<0.001), and a lower prevalence of obesity (6.2% versus 12.9%, p<0.001) than low-income children in WA.
Conclusion
The dual burden of under- and over-nutrition among incoming refugee children as well as their overall difference in prevalence of nutritional status categories compared to low-income children in WA provides evidence for the importance of tailored interventions to address the nutritional needs of refugee children.

引言
目前针对安置至美国前的难民儿童所受营养不足与营养过剩双重负担的影响程度，尚未得到充分阐明。

研究目的
本研究旨在描述华盛顿州（Washington State, WA）安置前海外医学筛查中，0~10岁难民儿童的消瘦（wasting）、生长迟缓（stunting）、超重及肥胖患病率，并对比该群体与华盛顿州低收入儿童的营养状况。

研究方法
本研究对2012年7月至2014年6月期间，在华盛顿州安置前接受海外医学筛查的1047名0~10岁难民儿童的人体测量学指标（anthropometric measurements）进行了分析，以评估其营养状况。研究按儿童原籍国，对各类营养状况的患病率估算值进行了对比；此外，还将0~5岁难民儿童的营养状况，与美国疾病控制与预防中心（Center for Disease Control and Prevention）儿科营养监测系统收录的华盛顿州低收入儿童的营养状况进行了对比。

研究结果
最终共有982名儿童符合本研究入组标准，其中多数（65%）来自索马里、伊拉克与缅甸。整体而言，近半数（44.9%）难民儿童存在至少一种营养不良问题。0~10岁难民儿童中，消瘦患病率为17.3%、生长迟缓为20.1%、超重为7.6%、肥胖为5.9%。在0~5岁儿童群体中，难民儿童的消瘦患病率（14.3% vs 1.9%，p<0.001）与生长迟缓患病率（21.3% vs 5.5%，p<0.001）均显著高于华盛顿州低收入儿童，而肥胖患病率（6.2% vs 12.9%，p<0.001）则显著低于后者。

研究结论
即将安置至华盛顿州的难民儿童所面临的营养不足与营养过剩双重负担，以及其与该州低收入儿童在各类营养状况患病率上的整体差异，均证明了针对难民儿童制定个性化营养干预措施的重要性。