Fenta Setegn Muche, Nigussie Teshager Zerihun
Department of statistics, Faculty of Natural and Computational Sciences, Debre Tabor University, Debra Tabor, Ethiopia.
Arch Public Health. 2021 Jul 6;79(1):123. doi: 10.1186/s13690-021-00566-8.
Diarrhea is the second cause of child deaths globally. According to World Health Organization reports, in each year it kills more than 525,000 children under-5 years. More than half of these deaths occur in five countries including Ethiopia. This study aimed to identify both individual and community-level risk factors of childhood diarrheal in Ethiopia.
Ethiopian demography and health survey of 2016 data were used for the analysis. A total of 10,641 children aged 0-59 months were included in the analysis. A multi-level mixed-effect logistic regression model was used to identify both individual and community-level risk factors associated with childhood diarrheal.
The incidence of childhood diarrheal was 12% (95%CI: 11.39, 12.63). The random effect model revealed that 67% of the variability of childhood diarrhea explained by individual and community level factors. From the individual-level factors, children aged 36-59 month (AOR = 3.166; 95% CI: 2.569, 3.900), twin child (AOR = 1.871; 95% CI: 1.390, 2.527), birth order 5 and above (AOR = 2.210, 95% CI: 1.721, 2.839), not received any vaccination (AOR = 1.197; 95% CI: 1.190,1.527), smaller size of child at birth (AOR = 1.303;95% CI: 1.130,1.504) and never breastfed children (AOR = 2.91;95%CI:2.380,3.567) associated with the higher incidence of childhood diarrhea. From the community-level factors, living in a rural area ((AOR = 1.505; 95%CI: 1.233, 1.836)), unprotected source of drinking water (AOR: 1.289; 95% CI: 1.060, 1.567) and availability of unimproved latrine facilities (OR: 1.289; 95% CI: 1.239, 1.759) associated with the higher incidence of childhood diarrhea. Besides, Children live in Afar, Amhara, Benishangul-Gumuz, Gambella, SNNPR and Dire Dawa regions had higher incidence of childhood diarrhea.
The incidence of childhood diarrhea was different from cluster to clusters in Ethiopia. Therefore, integrated child health intervention programs including provisions of toilet facility, access to a clean source of drinking water, educate parents about the importance of breastfeeding and vaccination have to be strongly implemented in order to reduce the high incidence of childhood diarrhea among children in Ethiopia.
腹泻是全球儿童死亡的第二大原因。根据世界卫生组织的报告，每年有超过52.5万名5岁以下儿童死于腹泻。其中一半以上的死亡发生在包括埃塞俄比亚在内的五个国家。本研究旨在确定埃塞俄比亚儿童腹泻的个体和社区层面风险因素。
分析使用了2016年埃塞俄比亚人口与健康调查数据。共有10641名年龄在0至59个月的儿童纳入分析。采用多层次混合效应逻辑回归模型确定与儿童腹泻相关的个体和社区层面风险因素。
儿童腹泻发病率为12%（95%置信区间：11.39，12.63）。随机效应模型显示，个体和社区层面因素解释了67%的儿童腹泻变异性。个体层面因素中，36至59个月龄儿童（比值比=3.166；95%置信区间：2.569，3.900）、双胞胎儿童（比值比=1.871；95%置信区间：1.390，2.527）、出生顺序为5及以上（比值比=2.210，95%置信区间：1.721，2.839）、未接种任何疫苗（比值比=1.197；95%置信区间：1.190，1.527）、出生时体型较小（比值比=1.303；95%置信区间：1.130，1.504）以及从未母乳喂养的儿童（比值比=2.91；95%置信区间：2.380，3.567）与儿童腹泻较高发病率相关。社区层面因素中，生活在农村地区（比值比=1.505；95%置信区间：1.233，1.836）、饮用水源无保护（比值比：1.289；95%置信区间：1.060，1.567）以及存在未改善的厕所设施（比值比：1.289；95%置信区间：1.239，1.759）与儿童腹泻较高发病率相关。此外，生活在阿法尔、阿姆哈拉、本尚古勒-古穆兹、甘贝拉、南方各族州人民区域和迪雷达瓦地区的儿童腹泻发病率较高。
埃塞俄比亚儿童腹泻发病率在不同群组间存在差异。因此，必须大力实施综合儿童健康干预项目，包括提供厕所设施、获取清洁饮用水源、向家长宣传母乳喂养和疫苗接种的重要性，以降低埃塞俄比亚儿童中儿童腹泻的高发病率。
