Atalell Kendalem Asmare, Dessie Melkamu Tilahun, Wubneh Chalachew Adugna
Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Nutrition. 2023 Apr;108:111940. doi: 10.1016/j.nut.2022.111940. Epub 2022 Dec 14.
Undernutrition, particularly wasting, is continuing to be a major challenge in developing countries like Ethiopia. However, data on the geographic variations over time are limited. We aimed to investigate the spatiotemporal variation of wasting in Ethiopia using two decades of Ethiopia Demographic and Health Surveys data, from 2000 to 2019.
Trend and geospatial regression analysis using a bayesian framework were used to predict wasting in Ethiopia among children aged <5 y. The primary outcomes (wasting) were obtained from the Ethiopia Demographic and Health Surveys conducted between 2000 and 2019. Covariates were accessed from different publicly available credible sources at a high resolution. The spatial binomial regression model through the bayesian framework was fitted to identify drivers of wasting among children in Ethiopia.
The overall national prevalence of wasting among children aged <5 y in Ethiopia was 11.9% in 2000, 11.1% in 2005, 10.2% in 2011, 12.3% in 2016, and 9.4% in 2019, with substantial spatial variation across subnational and local levels over time. Spatial clustering of wasting was observed in eastern Ethiopia (Afar and Somali regions). Altitude (mean regression coefficient = -0.38; 95% credible interval, -0.69 to -0.07) and population density (mean regression coefficient = -0.02; 95% credible interval, -0.03 to -0.01) were negatively associated with wasting, whereas distance to health facilities (mean regression coefficient = 0.13; 95% credible interval, 0.03-0.23) was positively associated with wasting.
The reduction in the national prevalence of wasting among children was not as expected. Spatial clustering of wasting was observed in the northern, northeastern, eastern, and western parts of Ethiopia. Spatial clustering of wasting was associated with altitude, precipitation, population density, distance to health facilities, travel time to the nearest cities, and distance to a water body. Early screening and treatment of wasted children should be strengthened. Furthermore, outreach community awareness, especially in rural parts of the country, should be recommended through community health extension workers.
营养不良，尤其是消瘦，在埃塞俄比亚等发展中国家仍然是一项重大挑战。然而，关于随时间变化的地理差异的数据有限。我们旨在利用2000年至2019年期间二十年的埃塞俄比亚人口与健康调查数据，调查埃塞俄比亚消瘦情况的时空变化。
使用贝叶斯框架进行趋势和地理空间回归分析，以预测埃塞俄比亚5岁以下儿童的消瘦情况。主要结果（消瘦）来自2000年至2019年期间进行的埃塞俄比亚人口与健康调查。协变量从不同的高分辨率公开可靠来源获取。通过贝叶斯框架拟合空间二项回归模型，以确定埃塞俄比亚儿童消瘦的驱动因素。
2000年埃塞俄比亚5岁以下儿童消瘦的全国总体患病率为11.9%，2005年为11.1%，2011年为10.2%，2016年为12.3%，2019年为9.4%，随着时间推移，各次国家级和地方级别的空间差异很大。在埃塞俄比亚东部（阿法尔和索马里地区）观察到消瘦的空间聚集现象。海拔（平均回归系数=-0.38；95%可信区间，-0.69至-0.
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