埃塞俄比亚家庭碘盐利用的空间分布及决定因素：基于埃塞俄比亚人口与健康调查的空间和多水平分析
Spatial distribution and determinants of household iodized salt utilization in Ethiopia: a spatial and multilevel analysis of Ethiopian demographic and Health survey.
机构信息
Department of Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia.
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia.
出版信息
BMC Public Health. 2020 Sep 17;20(1):1421. doi: 10.1186/s12889-020-09538-z.
BACKGROUND
Iodine deficiency disorder is a significant public health problem, affecting both developed and developing nations worldwide. It is associated with poor body growth and irreversible mental retardation. However, little is known about the spatial distribution and determinants of household iodized salt utilization in Ethiopia. Therefore, this study aimed to explore the spatial distribution and determinants of iodized salt utilization at national level.
METHODS
Ethiopian Demographic and Health Survey 2016 data was used to investigate the spatial distribution and determinants of household iodized salt utilization in Ethiopia. ArcGIS 10.6 and SaTScan™ version 9.6 software were used to explore the spatial distribution and detect significant clusters, respectively. The odds ratio with its 95% confidence interval (CI) was determined for potential determinants included in the multivariable multilevel logistic regression model.
RESULTS
Household iodized salt utilization was spatially clustered in Ethiopia (Moran's Index = 0.076, p-value = 0.01). The significant hotspot areas with high iodized salt utilization were located in Benishangul, Amhara, Gambella, Tigray and Northwest Oromia regions. Significant cold spot areas (areas with low iodized salt utilization) were found in Somali, and East Afar regions. Those households with higher education level ((Adjusted Odds Ratio [AOR] =1.49, 95% CI =1.14-1.93), high community level education (AOR = 1.51, 95% CI = 1.03-2.20), middle wealth index (AOR = 1.31, 95% CI = 1.04-1.65) and high community media exposure (AOR = 1.52, 95% CI = 1.07-2.17) had higher odds of iodized salt utilization.
CONCLUSIONS
Household iodized salt utilization had significant spatial variation across the country. Both household and community level variables were found to be associated with household iodized salt utilization in Ethiopia. Therefore, increasing the education level, wealth status and community media exposure is recommended to improve iodized salt utilization in a country. A targeted intervention is also needed for those regions with low household iodized salt utilization.
背景
碘缺乏症是一个严重的公共卫生问题，影响着全球的发达国家和发展中国家。它与身体发育不良和不可逆转的智力迟钝有关。然而，人们对埃塞俄比亚家庭碘化盐利用的空间分布和决定因素知之甚少。因此，本研究旨在探讨国家一级家庭碘化盐利用的空间分布和决定因素。
方法
使用埃塞俄比亚 2016 年人口与健康调查数据，研究埃塞俄比亚家庭碘化盐利用的空间分布和决定因素。使用 ArcGIS 10.6 和 SaTScan™ 版本 9.6 软件分别探索空间分布和检测显著聚类。确定多变量多层逻辑回归模型中包含的潜在决定因素的优势比及其 95%置信区间（CI）。
结果
家庭碘化盐利用在埃塞俄比亚呈现空间聚集（莫兰指数=0.076，p 值=0.01）。高碘化盐利用率的显著热点地区位于本尚古勒-古马兹、阿姆哈拉、甘贝拉、提格雷和西北奥罗米亚地区。低碘化盐利用率的显著冷点地区位于索马里和东非 尔地区。那些受教育程度较高的家庭（调整后的优势比[AOR]=1.49，95%置信区间[CI]=1.14-1.93）、社区教育水平较高的家庭（AOR=1.51，95%CI=1.03-2.20）、中等财富指数的家庭（AOR=1.31，95%CI=1.04-1.65）和高社区媒体曝光率的家庭（AOR=1.52，95%CI=1.07-2.17），更有可能使用碘化盐。
结论
家庭碘化盐利用在全国范围内存在显著的空间差异。家庭和社区层面的变量都与埃塞俄比亚家庭碘化盐利用有关。因此，建议提高教育水平、财富状况和社区媒体曝光率，以改善一个国家的碘化盐利用。还需要针对碘化盐利用率低的地区进行有针对性的干预。
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