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埃塞俄比亚五岁以下儿童腹泻的趋势及决定因素:横断面研究:基于2000 - 2016年埃塞俄比亚人口与健康调查(EDHS)数据的贝叶斯方法多元分解及多层次分析

Trends and determinants of diarrhea among under-five children in Ethiopia: cross-sectional study: multivariate decomposition and multilevel analysis based on Bayesian approach evidenced by EDHS 2000-2016 data.

作者信息

Negesse Yilkal, Taddese Asefa Adimasu, Negesse Ayenew, Ayele Tadesse Awoke

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, College of Health Science, Mizan-Teferi, Ethiopia.

Department of Epidemiology and Biostatistic, Institute of public health, College of Medicine and Health Science, Gondar, Ethiopia.

出版信息

BMC Public Health. 2021 Jan 22;21(1):193. doi: 10.1186/s12889-021-10191-3.


DOI:10.1186/s12889-021-10191-3
PMID:33482778
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7821641/
Abstract

BACKGROUND: Despite significant progress in the reduction of under-five child deaths over the last decades in Ethiopia, still diarrhea remains the second cause of morbidity and mortality among under five children next to pneumonia. OBJECTIVE: To show trends and determinants of diarrhea among under five children in Ethiopia based on the four Ethiopian Demographic and health surveys data (2000-2016). METHODS: A total of 10,753 in 2000, 10,039 in 2005, 10,946 in 2011 and 10,337 in 2016 under five age children were involved in this study. Multivariate decomposition and multilevel analysis based on Bayesian approach was performed. RESULTS: Ninety seven percent of the change in diarrhea prevalence over time was attributable to difference in behavior. Being twin (AOR = 1.3; 95% CrI 1.1-1.5), big weight (AOR = 1.63; 95% CrI 1.62-2.02), not vaccinated for rotavirus (AOR = 1.44; 95% CrI 1.12-1.9) and for measles (AOR = 1.2; 95% CrI 1.1-1.33), poor wealth status (AOR 2.6; 95% CrI 1.7-4.06), having more than three under-five children (AOR 1.3; 95% CrI 1.1-1.61), member of health insurance (AOR 2.2; 95% CrI 1.3-3.8) and long distance from the health facility (AOR 2.7; 95% CrI 2.2-3.5) were more likely to experience diarrhea. CONCLUSION: The prevalence of diarrhea was significantly declined over the last sixteen years and the decline was due to difference in behavior between the surveys. Being twin, weight of child at birth, vaccinated for measles and rotavirus, number of under-five children, wealth status, distance to health facility, health insurance and child waste disposal method were significantly associated with diarrhea among under five children in Ethiopia. Therefore Ethiopian government should focus on the strengthening and scaling up of behavioral change packages of the community regarding to keeping hygiene and sanitation of the community and their environment, vaccinating their children, accessing health care services to prevent diarrheal disease.

摘要

背景:尽管过去几十年来埃塞俄比亚在降低五岁以下儿童死亡率方面取得了重大进展,但腹泻仍然是仅次于肺炎的五岁以下儿童发病和死亡的第二大原因。 目的:基于埃塞俄比亚四次人口与健康调查数据(2000 - 2016年),展示埃塞俄比亚五岁以下儿童腹泻的趋势和决定因素。 方法:本研究纳入了2000年的10753名、2005年的10039名、2011年的10946名和2016年的10337名五岁以下儿童。采用基于贝叶斯方法的多变量分解和多层次分析。 结果:腹泻患病率随时间的变化中,97%可归因于行为差异。双胞胎(调整后比值比[AOR]=1.3;95%可信区间[CrI] 1.1 - 1.5)、出生体重较大(AOR = 1.63;95% CrI 1.62 - 2.02)、未接种轮状病毒疫苗(AOR = 1.44;95% CrI 1.12 - 1.9)和麻疹疫苗(AOR = 1.2;95% CrI 1.1 - 1.33)、财富状况差(AOR 2.6;95% CrI 1.7 - 4.06)、五岁以下儿童数量超过三个(AOR 1.3;95% CrI 1.1 - 1.61)、参加健康保险(AOR 2.2;95% CrI 1.3 - 3.8)以及距离医疗机构较远(AOR 2.7;95% CrI 2.2 - 3.5)的儿童更易患腹泻。 结论:过去十六年腹泻患病率显著下降,且下降归因于各次调查间的行为差异。双胞胎、出生时体重、麻疹和轮状病毒疫苗接种情况、五岁以下儿童数量、财富状况、距离医疗机构的远近、健康保险以及儿童排泄物处理方式与埃塞俄比亚五岁以下儿童腹泻显著相关。因此,埃塞俄比亚政府应着重加强和扩大社区行为改变计划,包括保持社区及其环境的卫生、为儿童接种疫苗、获得医疗服务以预防腹泻疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2382/7821641/96e9396416f8/12889_2021_10191_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2382/7821641/cf0aa2d369fa/12889_2021_10191_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2382/7821641/96e9396416f8/12889_2021_10191_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2382/7821641/cf0aa2d369fa/12889_2021_10191_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2382/7821641/96e9396416f8/12889_2021_10191_Fig2_HTML.jpg

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本文引用的文献

[1]
Prevalence of diarrheal diseases and associated factors among under-five children in Dale District, Sidama zone, Southern Ethiopia: a cross-sectional study.

BMC Public Health. 2019-9-6

[2]
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