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埃塞俄比亚西南部谢科地区农村社区健康推广模式与非模式家庭中五岁以下儿童腹泻病的危险因素:比较横断面研究

Risk factors of diarrhoeal disease in under-five children among health extension model and non-model families in Sheko district rural community, Southwest Ethiopia: comparative cross-sectional study.

作者信息

Gebru Teklemichael, Taha Mohammed, Kassahun Wondwosen

机构信息

Department of Public Health, Aman Health Science College, Mizan Teferi, Ethiopia.

出版信息

BMC Public Health. 2014 Apr 23;14:395. doi: 10.1186/1471-2458-14-395.

Abstract

BACKGROUND

Worldwide diarrheal disease is the second leading cause of death in under-five year's children. In Ethiopia diarrhoea kills half million under-five children every year second to pneumonia. Poor sanitation, unsafe water supply and inadequate personal hygiene are responsible for 90% of diarrhoea occurrence; these can be easily improved by health promotion and education. The Ethiopian government introduced a new initiative health extension programme in 2002/03 as a means of providing a comprehensive, universal, equitable and affordable health service. As a strategy of the programme; households have been graduated as model families after training and implementing the intervention packages. Therefore the aim of the study was to assess risk factor of diarrheal disease in under-five children among health extension model and non-model families.

METHOD

A community based comparative cross-sectional study design was employed in 2012 at Sheko district. Multi-stage sampling technique was employed to select 275 model and 550 non-model households that had at least one under-five children. Data was collected using structured questioner and/or checklist by trained data collectors. A summery descriptive, binary and multivariate logistic regression was computed to describe the functional independent predictors of childhood diarrhoea.

RESULT

The two weeks diarrhoea prevalence in under-five children among health extension model and non-model households were 6.4% and 25.5%, respectively. The independent predictors of childhood diarrhoea revealed in the study were being mothers can't read and write [OR: 1.74, 95% CI: (1.03, 2.91)], monthly family income earn less than 650 Birr [OR: 1.75, 95% CI: (1.06, 2.88)], mothers hand washing not practice at critical time [OR: 2.21, 95% CI: (1.41, 3.46)], not soap use for hand washing [OR: 7.40, 95% CI: (2.61, 20.96)], improper refuse disposal [OR: 3.19, 95% CI: (1.89, 5.38)] and being non-model families for the health extension programme [OR: 4.50, 95% CI: (2.52, 8.03].

CONCLUSION

The level of diarrheal disease variation was well explained by maternal education, income, personal hygiene, waste disposal system and the effect of health extension programme. Thus encouraging families to being model families for the programme and enhancing community based behavioural change communication that emphasize on personal hygiene and sanitation should be strengthening to reduce childhood diarrhoea.

摘要

背景

全球范围内,腹泻病是五岁以下儿童的第二大死因。在埃塞俄比亚,腹泻病每年导致五十万五岁以下儿童死亡,仅次于肺炎。卫生条件差、不安全的供水和个人卫生习惯不良导致了90%的腹泻病例;通过健康促进和教育,这些情况可以很容易得到改善。埃塞俄比亚政府在2002/03年推出了一项新的倡议——健康推广计划,作为提供全面、普及、公平且负担得起的医疗服务的一种方式。作为该计划的一项策略;家庭在接受培训并实施干预措施后被评为模范家庭。因此,本研究的目的是评估健康推广模范家庭和非模范家庭中五岁以下儿童腹泻病的风险因素。

方法

2012年在谢科地区采用了基于社区的比较横断面研究设计。采用多阶段抽样技术,选取了至少有一名五岁以下儿童的275个模范家庭和550个非模范家庭。由经过培训的数据收集员使用结构化问卷和/或清单收集数据。计算了汇总描述性、二元和多变量逻辑回归,以描述儿童腹泻的功能独立预测因素。

结果

健康推广模范家庭和非模范家庭中五岁以下儿童的两周腹泻患病率分别为6.4%和25.5%。该研究中揭示的儿童腹泻的独立预测因素包括母亲不识字[比值比:1.74,95%置信区间:(1.03, 2.91)]、家庭月收入低于650比尔[比值比:1.75,95%置信区间:(1.06, 2.88)]、母亲在关键时间不洗手[比值比:2.21,95%置信区间:(1.41, 3.46)]、洗手不用肥皂[比值比:7.40,95%置信区间:(2.61, 20.96)]、垃圾处理不当[比值比:3.19,95%置信区间:(1.89, 5.38)]以及不是健康推广计划的模范家庭[比值比:4.50,95%置信区间:(2.52, 8.03)]。

结论

腹泻病的变化水平可以通过母亲的教育程度、收入、个人卫生、垃圾处理系统以及健康推广计划的影响得到很好的解释。因此,应鼓励家庭成为该计划的模范家庭,并加强以社区为基础的行为改变沟通,强调个人卫生和环境卫生,以减少儿童腹泻。

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