Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.
Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
BMC Oral Health. 2020 Jun 5;20(1):166. doi: 10.1186/s12903-020-01149-9.
This study assessed the direct, indirect and total effect of distal - political - risk indicators (affecting populations), and proximal risk indicators (affecting women) on the global prevalence of early childhood caries (ECC) in 3-5 year old children.
Data on global ECC prevalence were obtained from a prior study. Data for distal risk indicators (voice and accountability; political stability/absence of terrorism; control of corruption) were obtained from the World Bank Governance indicators, 2016. Data for proximal risk indicators (women's opportunity for leadership; percentage of female legislators, top officials and managers; basic employability status of women; ability of women to afford time off work to care for newborns; gross national income (GNI) per capita for females) were derived from the Human Development Index, 2016. Associations between variables were assessed with path analysis.
Voice and accountability (β = - 0.60) and GNI per capita for females (β = - 0.33) were directly associated with a lower ECC prevalence. Political stability/absence of terrorism (β =0.40) and higher percentage of female legislators, senior officials and managers (β = 0.18) were directly associated with a higher ECC prevalence. Control of corruption (β = - 0.23) was indirectly associated with a lower ECC prevalence. Voice and accountability (β = 0.12) was indirectly associated with a higher ECC prevalence. Overall, voice and accountability (β = - 0.49), political stability/absence of terrorism (β = 0.34) and higher female GNI (β = - 0.33) had the greatest effects on ECC prevalence.
Distal risk indicators may have a stronger impact on ECC prevalence than do proximal risk indicators.. Approaches to control ECC may need to include political reforms.
本研究评估了影响儿童人口的远端政治风险指标（影响人群）和影响妇女的近端风险指标对 3-5 岁儿童早期儿童龋（ECC）全球患病率的直接、间接和总影响。
从先前的研究中获得了关于全球 ECC 患病率的数据。从世界银行治理指标（2016 年）获得了影响人群的远端风险指标（声音和问责制；政治稳定/无恐怖主义；腐败控制）的数据。从人类发展指数（2016 年）获得了近端风险指标（妇女担任领导的机会；女立法者、高级官员和经理的百分比；妇女的基本就业状况；妇女负担得起照顾新生儿的休假时间的能力；女性人均国民总收入（GNI））的数据。使用路径分析评估变量之间的关联。
声音和问责制（β=-0.60）和女性人均 GNI（β=-0.33）与较低的 ECC 患病率直接相关。政治稳定/无恐怖主义（β=0.40）和更高比例的女立法者、高级官员和经理（β=0.18）与较高的 ECC 患病率直接相关。腐败控制（β=-0.23）与较低的 ECC 患病率间接相关。声音和问责制（β=0.12）与较高的 ECC 患病率间接相关。总体而言，声音和问责制（β=-0.49）、政治稳定/无恐怖主义（β=0.34）和女性较高的 GNI（β=-0.33）对 ECC 患病率的影响最大。
远端风险指标对 ECC 患病率的影响可能大于近端风险指标。控制 ECC 的方法可能需要包括政治改革。
