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埃塞俄比亚育龄妇女贫血的空间分布及决定因素:多水平和空间分析。

Spatial distribution and determinant factors of anaemia among women of reproductive age in Ethiopia: a multilevel and spatial analysis.

机构信息

Priority Research Center for Generational Health and Aging, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.

Western New South Wales, Local Health District, Dubbo, New South Wales, Australia.

出版信息

BMJ Open. 2019 Apr 4;9(4):e027276. doi: 10.1136/bmjopen-2018-027276.

Abstract

OBJECTIVE

The aim of this study was to assess the spatial distribution and determinant factors of anaemia among reproductive age women in Ethiopia.

METHODS

An in-depth analysis of the 2016 Ethiopian Demographic and Health Survey data was undertaken. Getis-Ord Gi* statistics were used to identify the hot and cold spot areas for anaemia among women of reproductive age. A multilevel logistic regression model was used to identify independent predictors of anaemia among women of reproductive age.

RESULTS

Older age (adjusted OR [AOR]=0.75; 95% CI 0.64 to 0.96), no education (AOR=1.37; 95% CI 1.102 to 1.72), lowest wealth quantile (AOR=1.29; 95% CI 1.014 to 1.60), currently pregnant (AOR=1.28; 95% CI 1.10 to 1.51, currently breast feeding (AOR=1.09; 95% CI 1.025 to 1.28), high gravidity (AOR=1.39; 95% CI 1.13 to 1.69) and HIV positive (AOR=2.11; 95% CI 1.59 to 2.79) are individual factors associated with the occurrence of anaemia. Likewise, living in a rural area (AOR=1.29; 95% CI 1.02 to 1.63) and availability of unimproved latrine facilities (AOR=1.18; 95% CI 1.01 to 1.39) are community-level factors associated with higher odds of anaemia. The spatial analysis indicated that statistically high hotspots of anaemia were observed in the eastern (Somali, Dire Dawa and Harari regions) and north-eastern (Afar) parts of the country.

CONCLUSION

The prevalence rate of anaemia among women of reproductive age varied across the country. Significant hotspots/high prevalence of anaemia was observed in the eastern and north-eastern parts of Ethiopia. Anaemia prevention strategies need to be targeted on rural residents, women with limited to no education, women who are breast feeding, areas with poor latrine facilities and women who are HIV positive.

摘要

目的

本研究旨在评估埃塞俄比亚育龄妇女贫血的空间分布和决定因素。

方法

对 2016 年埃塞俄比亚人口与健康调查数据进行深入分析。使用 Getis-Ord Gi*统计量识别育龄妇女贫血的热点和冷点地区。采用多水平逻辑回归模型确定育龄妇女贫血的独立预测因素。

结果

年龄较大(调整后的比值比 [AOR]=0.75;95%置信区间 0.64 至 0.96)、未受教育(AOR=1.37;95%置信区间 1.102 至 1.72)、最贫穷的财富阶层(AOR=1.29;95%置信区间 1.014 至 1.60)、当前怀孕(AOR=1.28;95%置信区间 1.10 至 1.51)、当前哺乳(AOR=1.09;95%置信区间 1.025 至 1.28)、高孕次(AOR=1.39;95%置信区间 1.13 至 1.69)和 HIV 阳性(AOR=2.11;95%置信区间 1.59 至 2.79)是与贫血发生相关的个体因素。同样,居住在农村地区(AOR=1.29;95%置信区间 1.02 至 1.63)和缺乏改良的厕所设施(AOR=1.18;95%置信区间 1.01 至 1.39)是与贫血发生几率较高相关的社区因素。空间分析表明,该国东部(索马里、德雷达瓦和哈拉里地区)和东北部(阿法尔地区)存在统计学意义上的贫血高度热点地区。

结论

育龄妇女贫血的患病率在全国范围内存在差异。在埃塞俄比亚的东部和东北部地区观察到显著的贫血热点/高患病率。贫血预防策略需要针对农村居民、受教育程度有限或无教育的妇女、正在哺乳的妇女、卫生设施差的地区以及 HIV 阳性妇女。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59cb/6500301/f8889d25c9fd/bmjopen-2018-027276f01.jpg

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