Bolarinwa Obasanjo Afolabi, Tadesse Tessema Zemenu, Frimpong James Boadu, Seidu Abdul-Aziz, Opoku Ahinkorah Bright
Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
Obaxlove Consult, Lagos, Nigeria.
Environ Health Insights. 2021 Oct 19;15:11786302211045286. doi: 10.1177/11786302211045286. eCollection 2021.
Diarrhea is one of the health problems contributing to Nigeria's under-5 mortality rate, ranked as the eighth highest globally. As our search is concerned, there is limited evidence on the spatial distribution of childhood diarrhea in Nigeria. Therefore, this study aimed to examine the spatial distribution and predictors of diarrhea among under-5 children in Nigeria.
Using data from the child's recode file of the 2018 Nigeria Demographic and Health Survey, a sample of 28 583 children of women of reproductive age was considered as the sample size for this study. The outcome variable used in this study was childhood diarrhea. We employed both multilevel and spatial analyses to ascertain the factors associated with childhood diarrhea as well as its spatial clustering.
The regional distribution of the prevalence of diarrhea among children in Nigeria ranged from 0% to 62%. The hotspots for childhood diarrhea were in Yobe, Bauchi, Gombe, Kano, Sokoto, Imo, and Taraba. The likelihood of a child having diarrhea in Nigeria was higher among women whose partners have secondary education and above [aOR = 1.18; 95%CI = 1.05-1.33], women currently working [aOR = 1.24; 95%CI = 1.13-1.35], women practicing Islam [aOR = 1.24; 95%CI = 1.04-1.46], and women who were exposed to mass media [aOR = 1.29; 95%CI = 1.18-1.42], compared to women whose partners had no formal education, women not currently working, women practicing Christianity, and those who were not exposed to mass media. Children born to mothers who reside in North East [aOR = 2.55; 95%CI = 2.10-3.10], and communities with medium socioeconomic status [aOR = 1.44; 95%CI = 1.09-1.91] were more likely to experience diarrhea compared to those born to mothers residing in the North Central and in communities with low socioeconomic status.
High proportions of childhood diarrhea among under-5 children in Nigeria were located in Yobe, Bauchi, Gombe, Kano, Sokoto, Imo, and Taraba. Policies and interventions that seek to reduce or eliminate diarrhea diseases among under-5 children in Nigeria should take a keen interest in the factors identified as predictors of childhood diarrhea in this study as this will help in achieving the aims of WASH, ORT corners, and SDG 3 by the year 2030.
腹泻是导致尼日利亚五岁以下儿童死亡率的健康问题之一，在全球排名第八。就我们的研究而言，关于尼日利亚儿童腹泻空间分布的证据有限。因此，本研究旨在调查尼日利亚五岁以下儿童腹泻的空间分布及其预测因素。
利用2018年尼日利亚人口与健康调查中儿童记录文件的数据，选取28583名育龄妇女的子女作为本研究的样本量。本研究中使用的结果变量是儿童腹泻。我们采用多层次和空间分析来确定与儿童腹泻相关的因素及其空间聚集情况。
尼日利亚儿童腹泻患病率的区域分布范围为0%至62%。儿童腹泻的热点地区包括约贝州、包奇州、贡贝州、卡诺州、索科托州、伊莫州和塔拉巴州。与伴侣未接受过正规教育、目前未工作、信奉基督教且未接触大众媒体的女性相比，伴侣接受过中等及以上教育的女性 [调整后比值比（aOR）=1.18；95%置信区间（CI）=1.05 - 1.33]、目前正在工作的女性 [aOR = 1.24；95%CI = 1.13 - 1.35]、信奉伊斯兰教的女性 [aOR = 1.24；95%CI = 1.04 - 1.46] 以及接触过大众媒体的女性 [aOR = 1.29；95%CI = 从1.1至]，其子女患腹泻的可能性更高。与居住在中北部地区且母亲所在社区社会经济地位较低的儿童相比，居住在东北部地区 [aOR = 2.55；95%CI = 2.10 - 3.10] 以及母亲所在社区社会经济地位中等的儿童 [aOR = 1.44；95%CI = 1.09 - 1.91] 患腹泻的可能性更大。
尼日利亚五岁以下儿童中，腹泻高发地区集中在约贝州、包奇州、贡贝州、卡诺州、索科托州、伊莫州和塔拉巴州。旨在减少或消除尼日利亚五岁以下儿童腹泻疾病的政策和干预措施应密切关注本研究中确定为儿童腹泻预测因素的那些因素，因为这将有助于在2030年前实现水、环境卫生和个人卫生（WASH）目标、口服补液盐（ORT）推广点目标以及可持续发展目标3。
