腹泻死亡率高的撒哈拉以南非洲国家的婴儿喂养方式与腹泻
Infant feeding practices and diarrhoea in sub-Saharan African countries with high diarrhoea mortality.
作者信息
Ogbo Felix A, Agho Kingsley, Ogeleka Pascal, Woolfenden Sue, Page Andrew, Eastwood John
机构信息
Centre for Health Research, School of Medicine, Western Sydney University, Campbelltown Campus, New South Wales, Australia.
Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia.
出版信息
PLoS One. 2017 Feb 13;12(2):e0171792. doi: 10.1371/journal.pone.0171792. eCollection 2017.
BACKGROUND
The impacts of optimal infant feeding practices on diarrhoea have been documented in some developing countries, but not in countries with high diarrhoea mortality as reported by the World Health Organisation/United Nations Children's Fund. We aimed to investigate the association between infant feeding practices and diarrhoea in sub-Saharan African countries with high diarrhoea mortality.
METHOD
The study used the most recent Demographic and Health Survey datasets collected in nine sub-Saharan African countries with high diarrhoea mortality, namely: Burkina Faso (2010, N = 9,733); Demographic Republic of Congo (2013; N = 10,458); Ethiopia (2013, N = 7,251); Kenya (2014, N = 14,034); Mali (2013, N = 6,365); Niger (2013, N = 7,235); Nigeria (2013, N = 18,539); Tanzania (2010, N = 5,013); and Uganda (2010, N = 4,472). Multilevel logistic regression models that adjusted for cluster and sampling weights were used to investigate the association between infant feeding practices and diarrhoea in these nine African countries.
RESULTS
Diarrhoea prevalence was lower among children whose mothers practiced early initiation of breastfeeding, exclusive and predominant breastfeeding. Early initiation of breastfeeding and exclusive breastfeeding were significantly associated with lower risk of diarrhoea (OR = 0.81; 95% confidence interval (CI): 0.77-0.85, P<0.001 and OR = 0.50; 95%CI: 0.43-0.57, respectively). In contrast, introduction of complementary foods (OR = 1.31; 95%CI: 1.14-1.50) and continued breastfeeding at one year (OR = 1.27; 95%CI: 1.05-1.55) were significantly associated with a higher risk of diarrhoea.
CONCLUSION
Early initiation of breastfeeding and exclusive breastfeeding are protective of diarrhoea in sub-Saharan African countries with high diarrhoea mortality. To reduce diarrhoea mortality and also achieve the health-related sustainable development goals in sub-Saharan African, an integrated, multi-agency strategic partnership within each country is needed to improve optimal infant feeding practices.
背景
在一些发展中国家，已记录了最佳婴儿喂养方式对腹泻的影响，但世界卫生组织/联合国儿童基金会报告显示，在腹泻死亡率高的国家尚未有相关记录。我们旨在调查腹泻死亡率高的撒哈拉以南非洲国家中婴儿喂养方式与腹泻之间的关联。
方法
该研究使用了在九个腹泻死亡率高的撒哈拉以南非洲国家收集的最新人口与健康调查数据集，即：布基纳法索（2010年，N = 9733）；刚果民主共和国（2013年；N = 10458）；埃塞俄比亚（2013年，N = 7251）；肯尼亚（2014年，N = 14034）；马里（2013年，N = 6365）；尼日尔（2013年，N = 7235）；尼日利亚（2013年，N = 18539）；坦桑尼亚（2010年，N = 5013）；以及乌干达（2010年，N = 4472）。使用针对聚类和抽样权重进行调整的多水平逻辑回归模型，来调查这九个非洲国家中婴儿喂养方式与腹泻之间的关联。
结果
母亲进行早开奶、纯母乳喂养和主要母乳喂养的儿童腹泻患病率较低。早开奶和纯母乳喂养与较低的腹泻风险显著相关（比值比（OR）= 0.81；95%置信区间（CI）：0.77 - 0.85，P < 0.001以及OR = 0.50；95%CI：0.43 - 0.57）。相比之下，添加辅食（OR = 1.31；95%CI：1.14 - 1.50）和一岁时继续母乳喂养（OR = 1.27；95%CI：1.05 - 1.55）与较高的腹泻风险显著相关。
结论
在腹泻死亡率高的撒哈拉以南非洲国家，早开奶和纯母乳喂养对腹泻有预防作用。为降低腹泻死亡率并实现撒哈拉以南非洲与健康相关的可持续发展目标，每个国家都需要建立一个综合的多机构战略伙伴关系，以改善最佳婴儿喂养方式。
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