Department of Public health, College of Medicine and Health sciences, Wollo University, Dessie, Ethiopia.
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
PLoS One. 2019 Apr 22;14(4):e0215572. doi: 10.1371/journal.pone.0215572. eCollection 2019.
Childhood acute respiratory infection remains the commonest global cause of morbidity and mortality among under-five children. In Ethiopia, it remains the highest burden of the health care system. The problem varies in space and time, and exploring its spatial distribution has supreme importance for monitoring and designing effective intervention programs.
A two stage stratified cluster sampling technique was utilized along with the 2016 Ethiopian Demographic and Health Survey (EDHS) data. About 10,006 under-five children were included in this study. Bernoulli model was used to investigate the presence of purely spatial clusters of under-five acute respiratory infection using SaTScan.ArcGIS version 10.1 was used to visualize the distribution of pneumonia cases across the country. Mixed-effect logistic regression model was used to identify the determinants of acute respiratory infection.
In this study, acute respiratory infection among under-five children had spatial variations across the country (Moran's I: 0.34, p < 0.001). Acute respiratory infection among under-five children in Tigray (p < 0.001) and Oromia (p < 0.001) National Regional States clustered spatially. History of diarrhoea (Adjusted Odds Ratio (AOR) = 4.71, 95% CI: (3.89-5.71))), 45-59 months of age (AOR = 0.63, 95% CI: (0.45-0.89)), working mothers (AOR = 1.27, 95% CI: (1.06-1.52)), mothers' secondary school education (AOR = 0.65; 95% CI: (0.43-0.99)), and stunting (AOR = 1.24, 95% CI: (1.00-1.54)) were predictors of under-five acute respiratory infection.
In Ethiopia, acute respiratory infection had spatial variations across the country. Areas with excess acute respiratory infection need high priority in allocation of resources including: mobilizing resources, skilled human power, and improved access to health facilities.
儿童急性呼吸道感染仍然是五岁以下儿童全球发病率和死亡率最高的原因。在埃塞俄比亚，它仍然是医疗保健系统负担最重的疾病。该问题在空间和时间上存在差异，因此探索其空间分布对于监测和制定有效的干预计划至关重要。
利用两阶段分层聚类抽样技术以及 2016 年埃塞俄比亚人口与健康调查（EDHS）数据，对 10006 名五岁以下儿童进行了研究。使用 Bernoulli 模型，通过 SaTScan 来研究五岁以下急性呼吸道感染的纯空间集群的存在情况。ArcGIS 版本 10.1 用于可视化全国范围内肺炎病例的分布情况。使用混合效应逻辑回归模型来确定急性呼吸道感染的决定因素。
本研究表明，五岁以下儿童的急性呼吸道感染在全国范围内存在空间差异（Moran's I：0.34，p<0.001）。提格雷（Tigray）和奥罗莫（Oromia）地区的五岁以下儿童急性呼吸道感染呈空间聚集性（p<0.001）。腹泻史（调整后的优势比（AOR）=4.71，95%置信区间（CI）：（3.89-5.71）））、45-59 个月龄（AOR=0.63，95%CI：（0.45-0.89））、母亲就业（AOR=1.27，95%CI：（1.06-1.52））、母亲中学教育（AOR=0.65；95%CI：（0.43-0.99））和发育迟缓（AOR=1.24，95%CI：（1.00-1.54））是五岁以下儿童急性呼吸道感染的预测因素。
在埃塞俄比亚，急性呼吸道感染在全国范围内存在空间差异。急性呼吸道感染高发地区需要高度优先考虑资源分配，包括：调动资源、配备熟练人力以及改善获得卫生设施的机会。
