利用2000年至2019年期间进行的五次埃塞俄比亚人口与健康调查数据绘制儿童体重不足情况地图：基于贝叶斯框架的地理空间分析
Mapping underweight in children using data from the five Ethiopia Demographic and Health Survey data conducted between 2000 and 2019: A geospatial analysis using the Bayesian framework.
作者信息
Atalell Kendalem Asmare, Alemu Tewodros Getaneh, Wubneh Chalachew Adugna
机构信息
Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
出版信息
Front Nutr. 2022 Sep 29;9:988417. doi: 10.3389/fnut.2022.988417. eCollection 2022.
BACKGROUND AND AIMS
The Sustainable Development Goal is targeted to end all types of malnutrition including underweight by 2030. However, the reduction rate is not as expected to meet the target. Thus, we aimed to investigate the spatiotemporal distributions and drivers of underweight among children aged below 5 years in Ethiopia.
METHODS
Geostatistical analysis using the Bayesian framework was conducted to map the spatial and Spatiotemporal distributions of underweight. Data for the primary outcome was obtained from the Ethiopian Demographic and Health Survey 2000-2019. Covariate data were accessed from different credible online sources at high resolutions. Spatial binomial regression was fitted to identify drivers of underweight using the Bayesian approach.
RESULTS
The overall national prevalence of underweight was 44.7, 37.7, 35.4, 25.5, and 23.8% in 2000, 2005, 2011, 2016, and 2019, respectively, with a total reduction rate of 46.8%. Significant spatial clustering of underweight was observed in Northern, Northwestern, Southeastern, Eastern borders, and the border between Oromia and SNNPR regions. Mean annual temperature (mean regression coefficient (β): -0.39; 95% credible interval (95% CrI): -0.63, -0.14), altitude (β:-0.30; 95% CrI: 0.57, -0.05), population density (β:-0.03; 95% CrI: -0.03, -0.02), and distance to water bodies (β:-0.03; 95% CrI: -0.05, -0.004) were negatively associated with being underweight. However, travel time to the nearest cities in minutes (β: 0.09; 95% CrI: 0.03, 0.14) was positively associated with being underweight.
CONCLUSION
The national prevalence of underweight is reduced slower than expected in Ethiopia, with significant spatial variations across subnational and local levels. Temperature, altitude, population density, and distance to water bodies were negatively associated with underweight, whereas travel time to the nearest cities was positively associated with underweight in Ethiopia. Improving child nutrition through creating awareness and providing clean water should be strengthened.
背景与目的
可持续发展目标旨在到2030年消除包括体重不足在内的所有类型的营养不良。然而，减少率未达预期目标。因此，我们旨在调查埃塞俄比亚5岁以下儿童体重不足的时空分布及其驱动因素。
方法
采用贝叶斯框架进行地统计分析，以绘制体重不足的空间和时空分布图。主要结果的数据来自2000 - 2019年埃塞俄比亚人口与健康调查。协变量数据从不同可靠的在线来源以高分辨率获取。使用贝叶斯方法拟合空间二项回归以确定体重不足的驱动因素。
结果
2000年、2005年、2011年、2016年和2019年全国体重不足的总体患病率分别为44.7%、37.7%、35.4%、25.5%和23.8%，总减少率为46.8%。在北部、西北部、东南部、东部边境以及奥罗米亚和南方各族州地区之间的边境观察到体重不足存在显著的空间聚集。年平均温度（平均回归系数（β）：-0.39；95%可信区间（95% CrI）：-0.63，-0.14）、海拔（β：-0.30；95% CrI：-0.57，-0.05）、人口密度（β：-0.03；95% CrI：-0.03，-0.02）以及到水体的距离（β：-0.03；95% CrI：-0.05，-0.004）与体重不足呈负相关。然而，到最近城市的出行时间（分钟）（β：0.09；95% CrI：0.03，0.14）与体重不足呈正相关。
结论
埃塞俄比亚全国体重不足患病率的降低速度比预期慢，在国家以下和地方层面存在显著的空间差异。在埃塞俄比亚，温度、海拔、人口密度和到水体的距离与体重不足呈负相关，而到最近城市的出行时间与体重不足呈正相关。应通过提高认识和提供清洁水来加强儿童营养改善工作。
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