Statistics Department, Under Natural Science College, Wollo University, Wollo, Ethiopia.
Statistics Department, Under Natural and Computational Science College, University of Gondar, Gondar, Ethiopia.
PLoS One. 2021 May 13;16(5):e0251239. doi: 10.1371/journal.pone.0251239. eCollection 2021.
Childhood under-nutrition is a major global health problem. Although the rate of under-nutrition in Ethiopia has declined in the last decade, but it still remains being the major causes of morbidity and mortality of children under-five years. The problem is even worse in rural areas. The prevalence of underweight among rural children was 25% compared with 13% among urban children. To alleviate this problem, it is necessary to determine the magnitude and determinants of underweight. The study models non-Gaussian data analysis to identify risk factors associated with underweight among under-five children in rural Ethiopia.
The data source for this study was secondary data, which was retrieved from EDHS 2016 database. It was analyzed using two model families; one with marginal models (GEE and ALR) in which responses are modeled and marginalized overall other responses, and the other is random effects model (GLMM) which is useful when the interest of the analyst lies in the individual's response profiles as well as to evaluate within and between regional variations of underweight.
From fitting non-Gaussian data analysis to identify risk factors associated with underweight among under five children in rural Ethiopia, the independent variable which have significant effect on underweight were:-Age of child, birth interval, mothers education, fathers education, wealth index, diarrhea in last two weeks, fever in last two weeks are significant and also father's work status shows that difference in significance among the category.
Child age, preceding birth interval, mother's education, household's wealth index, fever, diarrhea, father's education and father's work status were associated with child underweight. Furthermore, there is both within and between regional heterogeneity of underweight among children in rural Ethiopia. Therefore, rigorous community-based interventions (such as uplifting mother's education by providing formal education and preventing infectious diseases that cause diarrhea and fever) should be developed and executed throughout the country to improve this grave situation of underweight prevalence in rural areas of Ethiopia.
儿童营养不足是一个全球性的主要健康问题。尽管在过去十年中，埃塞俄比亚的营养不足率有所下降，但它仍然是五岁以下儿童发病率和死亡率的主要原因。在农村地区，这个问题更加严重。农村儿童体重不足的患病率为 25%，而城市儿童为 13%。为了解决这个问题，有必要确定体重不足的程度和决定因素。本研究采用非正态数据分析模型，以确定与埃塞俄比亚农村地区五岁以下儿童体重不足相关的风险因素。
本研究的数据来源是二手资料，从 EDHS 2016 数据库中检索。使用两种模型家族进行分析；一种是边缘模型（GEE 和 ALR），其中对响应进行建模并边缘化其他所有响应，另一种是随机效应模型（GLMM），当分析师的兴趣在于个体的响应分布以及评估体重不足的个体和区域内的差异时，这种模型很有用。
通过对识别与埃塞俄比亚农村地区五岁以下儿童体重不足相关的风险因素的非正态数据分析，对体重不足有显著影响的自变量是：-儿童年龄、出生间隔、母亲教育程度、父亲教育程度、财富指数、过去两周内腹泻、过去两周内发烧，这些都是显著的，父亲的工作状况也表明了这些类别之间的显著差异。
儿童年龄、前次出生间隔、母亲教育程度、家庭财富指数、发烧、腹泻、父亲教育程度和父亲工作状况与儿童体重不足有关。此外，埃塞俄比亚农村地区儿童的体重不足存在个体和区域内的异质性。因此，应在全国范围内制定和实施严格的基于社区的干预措施（如通过提供正规教育提高母亲的教育水平，预防导致腹泻和发烧的传染病），以改善埃塞俄比亚农村地区体重不足流行的严重状况。
