College of Medicine and Health Sciences, Samara University, Samara, Ethiopia.
Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia.
PLoS One. 2020 Apr 1;15(4):e0230978. doi: 10.1371/journal.pone.0230978. eCollection 2020.
Acute respiratory infection (ARI) and diarrhoea are the leading causes of childhood morbidity and mortality in Ethiopia. Understanding the associations between infant and young child feeding (IYCF) and ARI and diarrhoea can inform IYCF policy interventions and advocacy in Ethiopia. This study aimed to investigate the relationship between IYCF practices and ARI and diarrhoea in Ethiopian children.
This study used the Ethiopia Demographic and Health Survey (EDHS) data for the years 2000 (n = 3680), 2005 (n = 3528), 2011 (n = 4037), and 2016 (n = 3861). The association between IYCF practices and (i) ARI and (ii) diarrhoea were investigated using propensity score matching and multivariable logistic regression models. The IYCF practices include early initiation of breastfeeding, exclusive breastfeeding (EBF), predominant breastfeeding, introduction of complementary foods, continued breastfeeding at two years and bottle feeding.
Infants and young children who were breastfed within 1-hour of birth and those who were exclusively breastfed had a lower prevalence of ARI. Infants who were exclusively and predominantly breastfed had a lower prevalence of diarrhoea. Early initiation of breastfeeding (Odds ratio [OR]: 0.81; 95% confidence interval [CI]: 0.72, 0.92) and EBF (OR: 0.65; 95% CI: 0.51, 0.83) were associated with lower risk of ARI. Bottle-fed children had higher odds of ARI (OR: 1.36; 95% CI: 1.10, 1.68). Early initiation of breastfeeding and EBF were associated with lower odds of diarrhoea (OR: 0.88; 95% CI: 0.79, 0.94 for Early initiation of breastfeeding and OR: 0.51; 95% CI: 0.39, 0.65 for EBF). Infants who were predominantly breastfed were less likely to experience diarrhoea (OR: 0.69; 95% CI: 0.53, 0.89).
The recommended best practices for preventing ARI and diarrhoeal diseases in infants and young children namely: the early initiation of breastfeeding, EBF and avoidance of bottle feeding should be institutionalized and scale-up in Ethiopia as part of implementation science approach to cover the know-do-gaps.
急性呼吸道感染（ARI）和腹泻是埃塞俄比亚儿童发病率和死亡率的主要原因。了解婴儿和幼儿喂养（IYCF）与 ARI 和腹泻之间的关联，可以为埃塞俄比亚的 IYCF 政策干预和宣传提供信息。本研究旨在调查埃塞俄比亚儿童的 IYCF 实践与 ARI 和腹泻之间的关系。
本研究使用了 2000 年（n=3680）、2005 年（n=3528）、2011 年（n=4037）和 2016 年（n=3861）的埃塞俄比亚人口与健康调查（EDHS）数据。使用倾向评分匹配和多变量逻辑回归模型研究了 IYCF 实践与（i）ARI 和（ii）腹泻之间的关系。IYCF 实践包括早开奶、纯母乳喂养（EBF）、主要母乳喂养、添加补充食品、两岁时继续母乳喂养和奶瓶喂养。
出生后 1 小时内进行母乳喂养的婴儿和幼儿以及纯母乳喂养的婴儿患 ARI 的比例较低。纯母乳喂养和主要母乳喂养的婴儿腹泻的发生率较低。早开奶（比值比[OR]：0.81；95%置信区间[CI]：0.72，0.92）和 EBF（OR：0.65；95% CI：0.51，0.83）与较低的 ARI 风险相关。奶瓶喂养的儿童患 ARI 的几率更高（OR：1.36；95% CI：1.10，1.68）。早开奶和 EBF 与腹泻的几率较低相关（早开奶的 OR：0.88；95% CI：0.79，0.94，和 EBF 的 OR：0.51；95% CI：0.39，0.65）。主要母乳喂养的婴儿腹泻的可能性较小（OR：0.69；95% CI：0.53，0.89）。
为预防婴儿和幼儿的 ARI 和腹泻病而推荐的最佳做法，即早期开奶、纯母乳喂养和避免奶瓶喂养，应在埃塞俄比亚作为实施科学方法的一部分得到制度化和扩大规模，以弥补知识-实践差距。
