Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box: 196, Gondar, Ethiopia.
Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
BMC Pediatr. 2022 May 23;22(1):301. doi: 10.1186/s12887-022-03370-7.
BACKGROUND: Diarrhea is the second most common cause of death in under-five children. Fluid and food replacement during diarrheal episodes have a paramount effect to avert morbidity and mortality. However, there is limited information about feeding practices. This study aimed to assess the prevalence of drinking or eating more and associated factors during diarrhea among under-five children in East Africa using demographic and health surveys (DHSs). METHODS: Secondary data analysis was done on DHSs 2008 to 2018 in 12 East African Countries. Total weighted samples of 20,559 mothers with their under-five children were included. Data cleaning, coding, and analysis were performed using Stata 16. Multilevel binary logistic regression were performed to identify factors associated with drinking or eating more during diarrheal episodes. Adjusted Odds Ratio (AOR) with a 95% CI, and p-value < 0.05 were used to declare statistical significance. RESULTS: Prevalence of drinking or eating more than usual during diarrhea disease in East Africa was 26.27%(95% CI: 25.68-26.88). Mothers age > 35 years (AOR: 1.14, 95% CI: (1.03, 1.26), mothers primary education (AOR: 1.17, 95% CI: 1.06,1.28), secondary education (AOR: 1.43,95% CI: 1.27,1.61), and higher education (AOR: 1.42,95% CI: 1.11,1.81), occupation of mothers (agriculture, AOR: 2.2, 95% CI: 1.3-3.6), sales and services, AOR = 1.20, CI:1.07,1.34), manual, AOR =1.28,95% CI: 1.11,1.44), children age 1-2 years (AOR =1.34,95% CI: 1.22,1.46) and 3-4 years (AOR =1.36,95% CI: 1.20,1.55), four and more antenatal visits (AOR: 1.14,95% CI: 1.03,1.27), rich wealth status (AOR:1.27,95% CI: 1.16,1.40), birth in health facility (AOR = 1.19, 95%CI: 1.10, 1.30) and visit health facility (AOR = 1.12, 95%CI: 1.03, 1.22) were associated with drinking or eating more. CONCLUSION: The prevalence of drinking or eating more is low in East Africa. Maternal age, occupation, antenatal care visit, marital status, educational status, wealth status, place of delivery, visiting health facility, and child age were significantly associated with drinking or eating more during diarrheal episodes. Health policy and programs should focus on educating mothers, improving the household wealth status, encouraging women to contact health facilities for better feeding practices of children during diarrheal episodes.
背景：腹泻是五岁以下儿童死亡的第二大主要原因。在腹泻发作期间，进行液体和食物替代对于避免发病和死亡至关重要。然而，关于喂养实践的信息有限。本研究旨在使用人口与健康调查（ DHS）评估东非地区五岁以下儿童腹泻时多喝或多吃的流行情况及其相关因素。
方法：对 12 个东非国家 2008 年至 2018 年的 DHS 进行二次数据分析。共纳入了 20559 名携带五岁以下儿童的母亲的总加权样本。使用 Stata 16 进行数据清理、编码和分析。采用多水平二项逻辑回归分析与腹泻时多喝或多吃相关的因素。使用调整后的优势比（AOR）及其 95%置信区间（CI）和 p 值<0.05 来判断统计学意义。
结果：东非地区腹泻时多喝或多吃的流行率为 26.27%（95%CI：25.68-26.88）。母亲年龄>35 岁（AOR：1.14，95%CI：1.03，1.26）、母亲接受过小学教育（AOR：1.17，95%CI：1.06，1.28）、中学教育（AOR：1.43，95%CI：1.27，1.61）和高等教育（AOR：1.42，95%CI：1.11，1.81）、母亲职业（农业，AOR：2.2，95%CI：1.3-3.6）、销售和服务（AOR=1.20，CI：1.07，1.34）、体力劳动（AOR=1.28，95%CI：1.11，1.44）、儿童年龄 1-2 岁（AOR=1.34，95%CI：1.22，1.46）和 3-4 岁（AOR=1.36，95%CI：1.20，1.55）、接受过 4 次或以上产前检查（AOR：1.14，95%CI：1.03，1.27）、较富裕的财富状况（AOR：1.27，95%CI：1.16，1.40）、在医疗机构分娩（AOR=1.19，95%CI：1.10，1.30）和去医疗机构就诊（AOR=1.12，95%CI：1.03，1.22）与多喝或多吃相关。
结论：东非地区多喝或多吃的流行率较低。母亲年龄、职业、产前保健就诊、婚姻状况、教育程度、财富状况、分娩地点、去医疗机构就诊以及儿童年龄与腹泻时多喝或多吃显著相关。卫生政策和项目应重点教育母亲，改善家庭财富状况，鼓励妇女在腹泻发作期间联系卫生机构，以改善儿童的喂养实践。
BMC Pregnancy Childbirth. 2021-6-2
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