Birhan Tilahun Yemanu, Birhan Nigussie Adam, Alene Muluneh
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
Department of Statistics, College of Natural and Computational Science, Mekdela Amba University, Mekdela, Ethiopia.
Risk Manag Healthc Policy. 2021 Mar 15;14:1085-1095. doi: 10.2147/RMHP.S297564. eCollection 2021.
Despite the benefits of breast milk and colostrum for the health and survival of children, early prelacteal feeding is commonly practiced worldwide, particularly in low- and middle-income countries. The aim of this study was to evaluate the pooled prevalence and determinants of prelacteal feeding in Eastern Africa.
This study was carried out within 11 East African countries from 2010 to 2018, a pooled study of prelacteal feeding was performed. For assessing model fitness and contrast, intra-class correlation coefficient, median odds ratio, proportional change in variance, and deviance were used. In order to identify possible covariates associated with prelacteal feeding in the study area, the multilevel multivariable logistic regression model was adapted. Adjusted Odds Ratio was used with 95% confidence interval to declare major prelacteal factors.
The pooled prevalence of prelacteal feeding in Eastern Africa was 12% (95% CI: 11.42-12.53%), with the highest prevalence of prelacteal feeding in the Comoros (39%) and the lowest in Malawi (3%). Multilevel multivariable logistic regression model; wealth index (AOR = 1.22; 95% CI 1.03-1.34), ANC visit (AOR = 1.42; 95% CI: 1.12-1.79), institutional delivery (AOR = 0.58; 95% CI: 0.58-0.64), small birth size (AOR = 1.14; 95% CI: 1.30-1.26), delivery type (AOR = 2.61; 95% CI: 2.30-2.96), and high community ANC visit (AOR = 0.90; 95% CI: 0.84-0.97) were significantly associated with prelacteal feeding in Eastern Africa.
In East Africa, the magnitude of prelacteal feeding was still high. The possible determinants of prelacteal feeding in Eastern Africa were wealth index, birth interval, delivery mode, place of delivery, ANC visit, and community ANC visit. Structural improvements are required for women with caesarean births to achieve optimal breastfeeding practice in Eastern Africa.
尽管母乳和初乳对儿童健康和生存有益，但全球普遍存在早期开奶前喂养现象，尤其是在低收入和中等收入国家。本研究旨在评估东非早期开奶前喂养的合并患病率及其决定因素。
本研究于2010年至2018年在11个东非国家开展，进行了一项早期开奶前喂养的汇总研究。为评估模型拟合度和对比情况，使用了组内相关系数、中位数优势比、方差比例变化和偏差。为确定研究区域内与早期开奶前喂养相关的可能协变量，采用了多水平多变量逻辑回归模型。使用调整后的优势比及95%置信区间来确定主要的早期开奶前喂养因素。
东非早期开奶前喂养的合并患病率为12%（95%CI：11.42 - 12.53%），科摩罗的早期开奶前喂养患病率最高（39%），马拉维最低（3%）。多水平多变量逻辑回归模型显示，财富指数（调整后优势比[AOR]=1.22；95%CI：1.03 - 1.34）、产前检查（AOR = 1.42；95%CI：1.12 - 1.79）、机构分娩（AOR = 0.58；95%CI：0.58 - 0.64）、出生体重小（AOR = 1.14；95%CI：1.30 - 1.26）、分娩类型（AOR = 2.61；95%CI：2.30 - 2.96）以及社区产前检查率高（AOR = 0.90；95%CI：0.84 - 0.97）与东非早期开奶前喂养显著相关。
在东非，早期开奶前喂养的比例仍然很高。东非早期开奶前喂养的可能决定因素包括财富指数、生育间隔、分娩方式、分娩地点、产前检查以及社区产前检查率。在东非，剖腹产妇女需要进行结构改善以实现最佳母乳喂养实践。
