Department of Geography, Faculty of the Social Sciences, University of Ibadan, Ibadan, Nigeria.
Int J Public Health. 2019 Nov;64(8):1183-1192. doi: 10.1007/s00038-019-01285-2. Epub 2019 Jul 30.
This study (1) examines spatio-temporal variation in diarrhoea prevalence and (2) for 2013 identifies and maps the factors associated with diarrhoea prevalence at district level.
Data were drawn from Demographic Health Surveys (1990, 1999, 2003, 2008 and 2013). Moran index was used to analyse spatial dependence and clustering of diarrhoea prevalence in 2008 and 2013. Geographical Weighted Poisson Regression analysis was used to identify factors associated with diarrhoea prevalence for 2013.
Diarrhoea prevalence was higher in rural than in urban areas. Prevalence exhibited statistically significant spatial variation, but temporal variation and spatial dependence were not significant. Locally, diarrhoea prevalence hot spots clustered among five states in the North East zone. Non-improved sanitation, children 6-23 months not breastfed, dung floor, relative poverty, unemployed mothers and Gini coefficient were main predictors of diarrhoea prevalence.
Results of spatial analysis improved understanding of local spatio-temporal variation in diarrhoea prevalence and underlying factors. Intervention strategies should emphasize behaviour change regarding washing of hands and feeding utensils before and after feeding children, exclusive breastfeeding, safe water, improved sanitation and hygiene, particularly in hot spot states.
本研究（1）考察腹泻发病率的时空变化，（2）确定并绘制 2013 年与地区腹泻发病率相关的因素。
数据来自人口健康调查（1990、1999、2003、2008 和 2013 年）。使用 Moran 指数分析 2008 年和 2013 年腹泻发病率的空间依赖性和聚类。使用地理加权泊松回归分析确定 2013 年与腹泻发病率相关的因素。
农村地区的腹泻发病率高于城市地区。发病率表现出统计学上显著的空间差异，但时间变化和空间依赖性不显著。在局部地区，腹泻发病率热点集中在东北部五个州。未改善的卫生条件、6-23 个月未母乳喂养的儿童、粪地板、相对贫困、失业母亲和基尼系数是腹泻发病率的主要预测因素。
空间分析的结果提高了对腹泻发病率和潜在因素的局部时空变化的理解。干预策略应强调在喂养儿童前后洗手和喂养器具、纯母乳喂养、安全用水、改善卫生和卫生条件方面的行为改变，特别是在热点州。
