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31999名坦桑尼亚婴儿出生后第一年住院的预测因素

Predictors of Hospitalization During the First Year of Life among 31999 Tanzanian Infants.

作者信息

Briegleb Christina, Sudfeld Christopher R, Smith Emily R, Ruben Julia, Muhihi Alfa, Mshamu Salum, Noor Ramadhani Abdallah, Masanja Honorati, Fawzi Wafaie W

机构信息

Harvard School of Public Health, Department of Global Health and Population, 655 Huntington Avenue, Boston, MA 02115, USA

Harvard School of Public Health, Department of Global Health and Population, 655 Huntington Avenue, Boston, MA 02115, USA.

出版信息

J Trop Pediatr. 2015 Oct;61(5):317-28. doi: 10.1093/tropej/fmv030. Epub 2015 May 14.

Abstract

OBJECTIVE

This study explored the risk factors for infant hospitalization in urban and peri-urban/rural Tanzania.

METHODS

We conducted a prospective cohort study examining predictors of hospitalization during the first year of life among infants enrolled at birth in a large randomized controlled trial of neonatal vitamin A supplementation conducted in urban Dar es Salaam (n = 11,895) and peri-urban/rural Morogoro region (n = 20,104) in Tanzania. Demographic, socioeconomic, environmental and birth outcome predictors of hospitalization were assessed using proportional hazard models.

RESULTS

The rate of hospitalization was highest during the neonatal period in both Dar es Salaam (102/10,000 neonatal-months) and Morogoro region (78/10,000 neonatal-months). Hospitalization declined with increased age and was lowest for infants 6-12 months of age in both Dar es Salaam (11/10,000 infant-months) and Morogoro region (16/10,000 infant-months). In both Dar es Salaam and Morogoro region, older maternal age, male sex, low birth weight and being small for gestational age were significant predictors of higher risk of hospitalization (p < 0.05). Increased wealth and having a flush toilet were significantly associated with an increased risk of hospitalization in Morogoro region only (p < 0.05).

CONCLUSIONS

This study determined high rates of neonatal hospitalization in Tanzania. Interventions to increase birth size may decrease risk of hospitalization. Equity in access to hospitals for poor rural families in Tanzania requires attention.

摘要

目的

本研究探讨了坦桑尼亚城市及城市周边/农村地区婴儿住院的风险因素。

方法

我们开展了一项前瞻性队列研究,调查在坦桑尼亚达累斯萨拉姆市(n = 11895)和莫罗戈罗地区城市周边/农村(n = 20104)进行的一项大型新生儿维生素A补充随机对照试验中,出生时登记入组的婴儿在出生后第一年住院的预测因素。使用比例风险模型评估住院的人口统计学、社会经济、环境和出生结局预测因素。

结果

达累斯萨拉姆市(102/10000新生儿月)和莫罗戈罗地区(78/10000新生儿月)新生儿期的住院率最高。住院率随年龄增长而下降,在达累斯萨拉姆市(11/10000婴儿月)和莫罗戈罗地区(16/10000婴儿月),6 - 12月龄婴儿的住院率最低。在达累斯萨拉姆市和莫罗戈罗地区,母亲年龄较大、男性、低出生体重和小于胎龄均是住院风险较高的显著预测因素(p < 0.05)。仅在莫罗戈罗地区,财富增加和有冲水马桶与住院风险增加显著相关(p < 0.05)。

结论

本研究确定了坦桑尼亚新生儿的高住院率。增加出生体重的干预措施可能会降低住院风险。坦桑尼亚贫困农村家庭就医公平问题需要关注。

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