Novignon Jacob, Nonvignon Justice
Department of Economics, University of Ibadan, Ibadan, Nigeria.
BMC Res Notes. 2012 Jul 27;5:380. doi: 10.1186/1756-0500-5-380.
The burden of fevers remains enormous in sub-Saharan Africa. While several efforts at reducing the burden of fevers have been made at the macro level, the relationship between socioeconomic status and fever prevalence has been inconclusive at the household and individual levels. The purpose of this study was to examine how individual and household socioeconomic status influences the prevalence of fever among children under age five in four sub-Saharan African countries.
The study used data from the 2008 Demographic and Health Survey (DHS) from Ghana, Nigeria, Kenya and Sierra Leone with a total of 38,990 children below age five. A multi-level random effects logistic model was fitted to examine the socioeconomic factors that influence the prevalence of fever in the two weeks preceding the survey. Data from the four countries were also combined to estimate this relationship, after country-specific analysis.
The results show that children from wealthier households reported lower prevalence of fever in Ghana, Nigeria and Kenya. Result from the combined dataset shows that children from wealthier households were less likely to report fever. In general, vaccination against fever-related diseases and the use of improved toilet facility reduces fever prevalence. The use of bed nets by children and mothers did not show consistent relationship across the countries.
Poverty does not only influence prevalence of fever at the macro level as shown in other studies but also the individual and household levels. Policies directed towards preventing childhood fevers should take a close account of issues of poverty alleviation. There is also the need to ensure that prevention and treatment mechanisms directed towards fever related diseases (such as malaria, pneumonia, measles, diarrhoea, polio, tuberculosis etc.) are accessible and effectively used.
在撒哈拉以南非洲，发热负担依然巨大。虽然在宏观层面已经做出了多项减轻发热负担的努力，但在家庭和个人层面，社会经济地位与发热患病率之间的关系尚无定论。本研究的目的是探讨个人和家庭社会经济地位如何影响撒哈拉以南非洲四个国家五岁以下儿童的发热患病率。
该研究使用了来自加纳、尼日利亚、肯尼亚和塞拉利昂2008年人口与健康调查（DHS）的数据，共有38990名五岁以下儿童。采用多层次随机效应逻辑模型来研究在调查前两周影响发热患病率的社会经济因素。在进行国别分析后，还将四个国家的数据合并起来估计这种关系。
结果显示，在加纳、尼日利亚和肯尼亚，来自较富裕家庭的儿童报告的发热患病率较低。合并数据集的结果表明，来自较富裕家庭的儿童报告发热的可能性较小。总体而言，接种与发热相关的疾病疫苗以及使用改良的卫生设施可降低发热患病率。儿童和母亲使用蚊帐在各国之间并未显示出一致的关系。
正如其他研究所示，贫困不仅在宏观层面影响发热患病率，在个人和家庭层面也是如此。针对预防儿童发热的政策应密切考虑扶贫问题。还需要确保针对与发热相关疾病（如疟疾、肺炎、麻疹、腹泻、脊髓灰质炎、结核病等）的预防和治疗机制易于获得并得到有效利用。
