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尼日利亚儿童发病率的相关因素:来自横断面数据有序分析的证据。

Correlates of childhood morbidity in Nigeria: Evidence from ordinal analysis of cross-sectional data.

机构信息

Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria.

出版信息

PLoS One. 2020 May 14;15(5):e0233259. doi: 10.1371/journal.pone.0233259. eCollection 2020.

Abstract

BACKGROUND

Child mortality records show that 1 in every 13 children dies before age five in sub-Saharan Africa with diseases such as pneumonia, diarrhoea and malaria considered to be the leading causes of such deaths. In Nigeria where 50% of all under-five deaths are attributed to morbidity, much attention has been directed to single health conditions. This study aims at examining the factors that are associated with single health conditions and comorbidity among children in Nigeria.

MATERIALS AND METHODS

This study was based on data from 2013 Nigeria Demographic and Health Survey (DHS) which involved 27,571 under-five children who suffered from acute respiratory infection, diarrhoea or fever within two weeks of data collection exercise. Descriptive statistics and generalized ordinal logistic regression model were used for the analysis.

RESULTS

About 14% of children suffered from a single health condition and 9% suffered from comorbidity. The likelihood of suffering from a single health condition and comorbidity is higher for children who are of third order birth or more (OR = 1.24, 95% CI = 1.11-1.39 & OR = 1.31, 95% CI = 1.12-1.55) compared to those who are of first order birth. The likelihood also increased for children whose mothers live in Northeast (OR = 3.19, 95% CI = 2.86-3.55 & OR = 3.88, 95% CI = 3.30-4.57) compared to children whose mothers live in North Central. The odds of suffering from a single health condition and comorbidity reduced for children who are from richest households, aged 3 years and above and were of average size at birth. Children of women who obtained water from improved source are less likely to experience any morbidity (OR = 0.93, 95% CI = 0.87-0.99) compared to children whose mothers obtained water from non-improved source.

CONCLUSIONS

The study has demonstrated that children in Nigeria are not only exposed to the risk of single health conditions but they are also exposed to the risk of comorbidity. Efforts should be made to design appropriate health care models that would facilitate a considerable reduction in childhood morbidity in the country.

摘要

背景

儿童死亡率记录显示,撒哈拉以南非洲地区每 13 名儿童中就有 1 名在五岁前死亡,肺炎、腹泻和疟疾等疾病被认为是导致此类死亡的主要原因。在尼日利亚,50%的五岁以下儿童死亡归因于发病,因此人们对单一疾病状况给予了更多关注。本研究旨在探讨尼日利亚儿童单一疾病状况和共病的相关因素。

材料与方法

本研究基于 2013 年尼日利亚人口与健康调查(DHS)的数据,该调查涉及 27571 名在数据收集活动两周内患有急性呼吸道感染、腹泻或发热的五岁以下儿童。采用描述性统计和广义有序逻辑回归模型进行分析。

结果

约 14%的儿童患有单一疾病状况,9%的儿童患有共病。与第一胎出生的儿童相比,第三胎或以上出生的儿童(OR=1.24,95%CI=1.11-1.39;OR=1.31,95%CI=1.12-1.55)和母亲居住在东北部(OR=3.19,95%CI=2.86-3.55;OR=3.88,95%CI=3.30-4.57)的儿童患有单一疾病状况和共病的可能性更高。来自最富裕家庭、年龄在 3 岁及以上且出生时体重处于平均水平的儿童,患有单一疾病状况和共病的可能性降低。从改良水源获得水的妇女所生的儿童,其患病的可能性较小(OR=0.93,95%CI=0.87-0.99),而从非改良水源获得水的儿童则不然。

结论

本研究表明,尼日利亚儿童不仅面临单一疾病状况的风险,而且还面临共病的风险。应努力设计适当的医疗保健模式,以显著降低该国儿童的发病风险。

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