Department of Monitoring and Evaluation, West Gondar Zonal Health Department, Gondar, Ethiopia.
BMC Public Health. 2022 Apr 9;22(1):698. doi: 10.1186/s12889-022-13156-2.
Intestinal parasitic infection is one of the neglected tropical diseases (NTD) which is mainly concentrated in developing countries. Gastrointestinal parasitic infections are diseases of poverty, which mainly affects children living in tropical and subtropical regions like Ethiopia. Deworming to children aged 24-59 months of age is one of the strategic initiatives to halt the global burden of intestinal parasitosis among under-five children. The information generated at local levels like hotspot areas (clusters with a high proportion of poor deworming uptake) that were identified in this study could help decision-makers to develop location-based interventional strategies.
This study was aimed to assess the spatial variation and factors associated with poor deworming uptake among children aged 24-59 months in Ethiopia using evidence from the 2016 Ethiopian Demographic Health Survey (EDHS).
To explore, create, visualize and edit the spatial information of poor uptake of deworming medication, ArcGIS version 10.8 software was used. The spatial pattern of poor deworming uptake was determined using global spatial autocorrelation. Purely spatial scan statistic was used to identify statistically significant hotspot areas using SaTScan™ version 9.7 software. Multilevel logistic regression analysis was fitted to identify factors associated with poor deworming uptake in Ethiopia. Variables with a p-value< 0.2 in the bivariable regression were considered for multivariable regression analysis. Adjusted odds ratio with a 95% confidence interval (CI) and p-value < 0.05 were used to declare the statistical significance of each factor.
The spatial pattern of poor deworming uptake in Ethiopia was non-random, i.e. clustered. The most likely cluster was found concentrated in most parts of Somali and East Oromia. Variables like being born from an uneducated mother ((Adjusted Odds Ratio (AOR) = 1.65; 95% CI: 1.16-2.36)), being born from an unemployed mother (AOR = 1. 1.43; 95% CI: 1.19-1.74), being delivered at home (AOR = 1.60 95% CI: 1.27, 2.02), diarrhea in the last 2 weeks (AOR = 0.68, 95%CI: 0.51, 0.90), and region of residency were the significant variables associated with poor deworming medication uptake among children aged to 24 to 59 months in Ethiopia.
The spatial pattern of poor deworming uptake was non-random in Ethiopia. Variables like educational status, employment, distance, place of delivery, diarrhea and region of living were found associated with poor deworming uptake. Tailoring interventional programs based on identified clusters is recommended to minimize this unfavorable deworming uptake.
肠道寄生虫感染是被忽视的热带病（NTD）之一，主要集中在发展中国家。肠道寄生虫感染是一种贫困病，主要影响生活在埃塞俄比亚等热带和亚热带地区的儿童。对 24-59 月龄儿童进行驱虫是阻止五岁以下儿童肠道寄生虫病全球负担的战略举措之一。本研究在热点地区（驱虫吸收率高的集群）确定的本地信息可以帮助决策者制定基于位置的干预策略。
本研究旨在利用 2016 年埃塞俄比亚人口与健康调查（EDHS）的数据，评估埃塞俄比亚 24-59 月龄儿童驱虫药服用不足的空间变化和相关因素。
使用 ArcGIS 版本 10.8 软件探索、创建、可视化和编辑驱虫药服用不足的空间信息。使用全局空间自相关确定驱虫药服用不足的空间模式。使用 SaTScan™ 版本 9.7 软件的纯空间扫描统计确定具有统计学意义的热点地区。使用多水平逻辑回归分析确定与埃塞俄比亚驱虫药服用不足相关的因素。单变量回归中 p 值<0.2 的变量被认为与多变量回归分析相关。调整后的优势比（OR）和 95%置信区间（CI）以及 p 值<0.05 用于表示每个因素的统计学意义。
埃塞俄比亚驱虫药服用不足的空间模式是非随机的，即聚类。最有可能的集群集中在索马里和东奥罗莫的大部分地区。一些变量，如母亲未受过教育（调整后的优势比（AOR）=1.65；95%置信区间（CI）：1.16-2.36））、母亲失业（AOR=1.14；95%CI：1.19-1.74）、在家分娩（AOR=1.60；95%CI：1.27-2.02）、过去两周腹泻（AOR=0.68；95%CI：0.51-0.90）以及居住地区是与埃塞俄比亚 24-59 月龄儿童驱虫药服用不足相关的显著变量。
埃塞俄比亚驱虫药服用不足的空间模式是非随机的。教育程度、就业、距离、分娩地点、腹泻和居住地区等变量与驱虫药服用不足有关。建议根据确定的集群制定干预计划，以最大限度地减少这种不利的驱虫药服用不足情况。
