School of Public Health, Taipei Medical University, 250 Wu-Hsing St, Taipei 11031, Taiwan.
Department of Molecular Parasitology and Tropical Diseases, School of Medicine, Taipei Medical University, 250 Wu-Hsing St, Taipei 11031, Taiwan.
J Trop Pediatr. 2020 Feb 1;66(1):66-74. doi: 10.1093/tropej/fmz031.
Approximately 45% of all children's deaths are associated with malnutrition, and sub-Saharan Africa is hardest hit by this phenomenon. However, information on geographical variations of malnutrition in developing countries is limited. This study examined the geographical distribution and community characteristics associated with child malnutrition in Burkina Faso.
Data from the 2011 Burkina Faso Demographic Health Survey were analyzed. A general Kriging interpolation method was used to generate spatial malnutrition patterns. The global Moran's I test was used to identify significant malnutrition spatial patterns. Generalized estimating equations (GEEs) were fitted to examine the association between community level factors and malnutrition.
Average rates of stunting and wasting in the communities were 32.48% and 15.05%, respectively. Stunting hotspots were observed in the eastern and northeastern parts of Burkina Faso (i.e. Oudolan, Séno and Yagha, among others), while high rates of wasting were observed in the north-central part. The GEE results revealed lower stunting rates in communities with a higher percentage of households with improved sanitation. Communities with higher rates of professionally assisted births were associated with low wasting rates, while communities with higher rates of households with a low wealth index reported higher rates of wasting.
Spatial statistical models of malnutrition prevalence are useful for indicating hotspots over wide areas and hence, for guiding intervention strategies. This study revealed significant geographical patterns and community factors associated with childhood malnutrition. These factors should be considered in future programs aimed at reducing malnutrition in Burkina Faso.
约 45%的儿童死亡与营养不良有关，而撒哈拉以南非洲地区受此现象影响最为严重。然而，发展中国家有关营养不良的地理差异信息有限。本研究调查了布基纳法索儿童营养不良的地理分布和社区特征。
分析了 2011 年布基纳法索人口健康调查的数据。采用一般克立金插值法生成空间营养不良模式。使用全局 Moran's I 检验来识别显著的营养不良空间模式。拟合广义估计方程（GEE）以检验社区水平因素与营养不良之间的关联。
社区中发育迟缓率和消瘦率分别为 32.48%和 15.05%。布基纳法索东部和东北部地区（如 Oudolan、Séno 和 Yagha 等）存在发育迟缓热点，而中北部地区消瘦率较高。GEE 结果显示，卫生条件改善程度较高的家庭比例较高的社区发育迟缓率较低。专业助产率较高的社区消瘦率较低，而贫困指数较低的家庭比例较高的社区消瘦率较高。
营养不良流行的空间统计模型有助于指出广泛地区的热点地区，从而指导干预策略。本研究揭示了与儿童营养不良相关的显著地理模式和社区因素。这些因素应在未来旨在减少布基纳法索营养不良的项目中加以考虑。
