Adesanya Oluwafunmilade A, Chiao Chi
Ogun State Government and UPLIFT Development Foundation, Abeokuta 110001, Nigeria.
Institute of Health and Welfare Policy, College of Medicine, National Yang-Ming University, No. 155, Sec. 2, Li-Nong St., Taipei 112, Taiwan.
Int J Environ Res Public Health. 2017 Nov 16;14(11):1396. doi: 10.3390/ijerph14111396.
The exposure-disease-stress model places young children in their physical and social contexts and considers the extent and intensity of associational links to symptoms of acute respiratory infection (ARI), taking in to account a range of biological, social, and environment components. This study uses the 2013 Nigeria Demographic and Health Survey to assess the individual and environmental risks present in the North-Western and South-Southern Nigerian communities and examines their associations with ARI symptoms. The descriptive findings show that the prevalence of ARI symptoms is significantly higher among preschool children in the North-Western province (5.7%) than in the South-Southern province (1.4%) ( < 0.001). In addition to regional differences, multilevel logistic models further indicate that the increased likelihood of a child suffering from ARI symptoms is significantly associated with the dry season (aOR 1.42; 95% CI: 1.02-1.97) and household poverty (aOR 1.42; 95% CI: 1.01-1.99), even after adjusting for the cooking fuel used and various other characteristics of the children, households, and communities. These findings underscore the importance of taking into account environmental risks when addressing specific regional variations in ARI symptoms, because these determinants differ between communities in Nigeria. As it is imperative to achieve minimum levels of child health, in order to improve economic development across regions, future health policies aiming to promote child health will benefit from taking a region-specific perspective into consideration.
暴露-疾病-压力模型将幼儿置于其身体和社会环境中,并考虑与急性呼吸道感染(ARI)症状的关联程度和强度,同时考虑一系列生物、社会和环境因素。本研究利用2013年尼日利亚人口与健康调查评估尼日利亚西北部和南部社区存在的个人和环境风险,并研究它们与ARI症状的关联。描述性结果表明,西北部省份学龄前儿童的ARI症状患病率(5.7%)显著高于南部省份(1.4%)(<0.001)。除了地区差异外,多水平逻辑模型进一步表明,即使在调整了所使用的烹饪燃料以及儿童、家庭和社区的各种其他特征后,儿童患ARI症状可能性的增加仍与旱季(调整后比值比1.42;95%置信区间:1.02-1.97)和家庭贫困(调整后比值比1.42;95%置信区间:1.01-1.99)显著相关。这些发现强调了在应对ARI症状的特定地区差异时考虑环境风险的重要性,因为这些决定因素在尼日利亚不同社区之间存在差异。由于实现儿童健康的最低水平对于促进各地区的经济发展至关重要,未来旨在促进儿童健康的卫生政策将受益于考虑特定地区的视角。