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采用贝叶斯多层次分析方法预测埃塞俄比亚 6-59 个月儿童发育迟缓的因素。

Predictors of stunting among children age 6-59 months in Ethiopia using Bayesian multi-level analysis.

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, College of Medical and Health Sciences, Wollo University, Dessie, Ethiopia.

Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

Sci Rep. 2021 Feb 12;11(1):3759. doi: 10.1038/s41598-021-82755-7.

Abstract

In developing countries including Ethiopia stunting remained a major public health burden. It is associated with adverse health consequences, thus, investigating predictors of childhood stunting is crucial to design appropriate strategies to intervene the problem stunting. The study uses data from the Ethiopian Demographic and Health Survey (EDHS) conducted from January 18 to June 27, 2016 in Ethiopia. A total of 8117 children aged 6-59 months were included in the study with a stratified two stage cluster sampling technique. A Bayesian multilevel logistic regression was fitted using Win BUGS version 1.4.3 software to identify predictors of stunting among children age 6-59 months. Adjusted odds ratio (AOR) with 95% credible intervals was used to ascertain the strength and direction of association. In this study, increasing child's age (AOR = 1.022; 95% CrI 1.018-1.026), being a male child (AOR = 1.16; 95%CrI 1.05-1.29), a twin (AOR = 2.55; 95% CrI 1.78-3.56), having fever (AOR = 1.23; 95%CrI 1.02-1.46), having no formal education (AOR = 1.99; 95%CrI 1.28-2.96) and primary education (AOR = 83; 95%CrI 1.19-2.73), birth interval less than 24 months (AOR = 1.40; 95% CrI 1.20-1.61), increasing maternal BMI (AOR = 0.95; 95% CrI 0.93-0.97), and poorest household wealth status (AOR = 1.78; 95% CrI 1.35-2.30) were predictors of childhood stunting at individual level. Similarly, region and type of toilet facility were predictors of childhood stunting at community level. The current study revealed that both individual and community level factors were predictors of childhood stunting in Ethiopia. Thus, more emphasize should be given by the concerned bodies to intervene the problem stunting by improving maternal education, promotion of girl education, improving the economic status of households, promotion of context-specific child feeding practices, improving maternal nutrition education and counseling, and improving sanitation and hygiene practices.

摘要

在包括埃塞俄比亚在内的发展中国家,发育迟缓仍然是一个主要的公共卫生负担。它与不良健康后果有关,因此,调查儿童发育迟缓的预测因素对于设计干预发育迟缓问题的适当策略至关重要。本研究使用了 2016 年 1 月 18 日至 6 月 27 日在埃塞俄比亚进行的埃塞俄比亚人口与健康调查(EDHS)的数据。共有 8117 名 6-59 个月大的儿童参与了这项研究,采用分层两阶段聚类抽样技术。使用 WinBUGS 版本 1.4.3 软件拟合贝叶斯多水平逻辑回归,以确定 6-59 个月儿童发育迟缓的预测因素。使用调整后的优势比(AOR)和 95%可信区间来确定关联的强度和方向。在这项研究中,儿童年龄的增加(AOR=1.022;95%CrI 1.018-1.026)、男童(AOR=1.16;95%CrI 1.05-1.29)、双胞胎(AOR=2.55;95%CrI 1.78-3.56)、发热(AOR=1.23;95%CrI 1.02-1.46)、无正规教育(AOR=1.99;95%CrI 1.28-2.96)和小学教育(AOR=83;95%CrI 1.19-2.73)、出生间隔小于 24 个月(AOR=1.40;95%CrI 1.20-1.61)、母亲 BMI 的增加(AOR=0.95;95%CrI 0.93-0.97)和最贫穷的家庭财富状况(AOR=1.78;95%CrI 1.35-2.30)是个体层面儿童发育迟缓的预测因素。同样,地区和厕所设施类型是社区层面儿童发育迟缓的预测因素。本研究表明,个体和社区层面的因素都是埃塞俄比亚儿童发育迟缓的预测因素。因此,有关机构应更加重视通过改善孕产妇教育、促进女童教育、改善家庭经济状况、促进具体情况的儿童喂养做法、改善孕产妇营养教育和咨询、以及改善环境卫生和个人卫生做法,来干预发育迟缓问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8cc/7881183/0ac9a86b324b/41598_2021_82755_Fig1_HTML.jpg

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