Altare Chiara, Delbiso Tefera Darge, Guha-Sapir Debarati
Centre for Research on the Epidemiology of Disasters, Institute of Health and Society, Université catholique de Louvain, Clos Chapelle-aux-Champs, 30.94, 1200 Brussels, Belgium.
Int J Environ Res Public Health. 2016 Jan 28;13(2):178. doi: 10.3390/ijerph13020178.
Child undernutrition is a major public health concern in Ethiopia (stunting national prevalence: 44%; wasting: 10%), despite the overall improvement in child health status during the last decade. Hundreds of small-scale surveys are conducted in Ethiopia's emergency pockets under ENCU's supervision. We reviewed the evidence from small-scale surveys conducted between 2008 and 2013 with two objectives: to provide a summary estimate of wasting prevalence from emergency pockets and to examine reasons for variation in prevalence estimates. We created a dataset by combining data from the Complex Emergency Database, the Famine Early Warning System Network and the Armed Conflict Location Event Data. We conducted a meta-analysis of small-scale surveys using a random effects model with known within-study heterogeneity. The influence of survey covariates on estimated prevalence was investigated with meta-regression techniques. We included 158 surveys in the analysis. A high degree of heterogeneity among surveys was observed. The overall estimate of wasting prevalence was 10.6% (95% CI 9.8-11.4), with differences among regions and between residents and refugees. Meta-regression results showed that vaccination coverage, child mortality, diarrhea prevalence and food insecurity are significantly associated with wasting prevalence. Child care and displacement status were not. Aggregated analysis of small-scale surveys provides insights into the prevalence of wasting and factors explaining its variation. It can also guide survey planning towards areas with limited data availability.
尽管过去十年埃塞俄比亚儿童健康状况总体有所改善，但儿童营养不良仍是该国主要的公共卫生问题（发育迟缓全国患病率：44%；消瘦：10%）。在埃塞俄比亚紧急状况地区，在埃塞俄比亚营养状况紧急情况调查（ENCU）的监督下开展了数百次小规模调查。我们回顾了2008年至2013年间进行的小规模调查的证据，目的有两个：提供紧急状况地区消瘦患病率的汇总估计，并研究患病率估计值差异的原因。我们通过合并来自复杂紧急情况数据库、饥荒早期预警系统网络和武装冲突地点事件数据的数据创建了一个数据集。我们使用具有已知研究内异质性的随机效应模型对小规模调查进行了荟萃分析。采用荟萃回归技术研究了调查协变量对估计患病率的影响。我们纳入了158项调查进行分析。观察到调查之间存在高度异质性。消瘦患病率的总体估计为10.6%（95%置信区间9.8 - 11.4），各地区以及居民和难民之间存在差异。荟萃回归结果表明，疫苗接种覆盖率、儿童死亡率、腹泻患病率和粮食不安全状况与消瘦患病率显著相关。儿童照料和流离失所状况则不然。小规模调查的汇总分析为消瘦患病率及其变化的影响因素提供了见解。它还可以指导在数据可用性有限的地区进行调查规划。
