Ngoda Octavian Aron, Renju Jenny, Mahande Michael Johnson, Kagoye Sophia Adam, Mboya Innocent Baltazar, Msuya Sia Emmanueli
Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi Tanzania.
Tanzania Medicine and Medical Devices Authority, Dodoma, Tanzania.
East Afr Health Res J. 2023;7(1):40-48. doi: 10.24248/eahrj.v7i1.707. Epub 2023 Jul 12.
Adolescent pregnancy increases the risk of maternal and child morbidity and mortality. We aimed to determine trends and factors associated with adolescent pregnancy in Tanzania from 2004 to 2016 using the Tanzania Demographic and Health surveys (TDHS).
We carried out an analytical cross-sectional study using the TDHS data for the years 2004 to 2005, 2010 and 2015 to 2016 among adolescent girls aged 15 to 19 years. Data analysis was performed using STATA version 15. Data analysis considered the complex survey design inherent in the demographic and health survey (DHS) data. The Poisson regression model was used to estimate Prevalence Ratios (PR) and 95% confidence intervals for factors associated with adolescent pregnancy.
We analysed data for a total of 10,972 adolescents for the three TDHS rounds. The proportion of adolescent pregnancy significantly decreased from 26% to 22.8% from the year 2004/05 to 2010 and then increased again to 26.7% in 2015/16. Adolescents who were aged 18 to 19 years (APR 1.52; 95% CI, 1.38 to 1.68) married or cohabiting with their partners (APR 2.15; 95% CI, 1.93 to 2.40; ), widowed/divorced/separated (APR 2.32; 95% CI, 2.03 to 2.66; ), and among those who started sexual activity before 15 years of age (APR 1.20; 95% CI, 1.11 to 1.31; ) were more likely to become pregnant during adolescence. In contrast, adolescents with secondary school education level and above were the least likely to become pregnant (APR 0.62; 95% CI, 0.51 to 0.75; ) compared to those with no formal education.
One in four adolescent girls aged 15 to 19 in Tanzania have already started childbearing and despite fluctuation, high rate of adolescent pregnancy persists. Preventive interventions should focus on adolescents with low education level, married/cohabiting with their partners, and who have started sex before 15 years of age. We advocate for the increase of school attendance until high school level to reduce the risk of early pregnancy in adolescents. Furthermore, qualitative studies are crucial to explore reasons for the rising trend of adolescent pregnancy in most zones of Tanzania, particularly between 2010 and 2015/16.
青少年怀孕会增加母婴发病和死亡风险。我们旨在利用坦桑尼亚人口与健康调查（TDHS）确定2004年至2016年坦桑尼亚青少年怀孕的趋势及相关因素。
我们使用2004年至2005年、2010年以及2015年至2016年的TDHS数据，对15至19岁的青少年女孩开展了一项分析性横断面研究。使用STATA 15版进行数据分析。数据分析考虑了人口与健康调查（DHS）数据中固有的复杂调查设计。采用泊松回归模型估计与青少年怀孕相关因素的患病率比（PR）及95%置信区间。
我们对三轮TDHS的总共10972名青少年的数据进行了分析。青少年怀孕比例从2004/05年的26%显著降至2010年的22.8%，随后在2015/16年又升至26.7%。18至19岁的青少年（PR 1.52；95%置信区间为1.38至1.68）、与伴侣结婚或同居的青少年（PR 2.15；95%置信区间为1.93至2.40）、丧偶/离婚/分居的青少年（PR 2.32；95%置信区间为2.03至2.66）以及15岁前开始性行为的青少年（PR 1.20；95%置信区间为1.11至1.31）在青春期更易怀孕。相比之下，与未接受正规教育的青少年相比，接受过中学及以上教育的青少年怀孕可能性最小（PR 0.62；95%置信区间为0.51至0.75）。
坦桑尼亚15至19岁的青少年女孩中，四分之一已开始生育，尽管有波动，但青少年怀孕率依然居高不下。预防性干预应侧重于教育水平低、与伴侣结婚/同居以及15岁前开始性行为的青少年。我们主张增加高中学龄段的入学率，以降低青少年早孕风险。此外，开展定性研究对于探究坦桑尼亚多数地区青少年怀孕上升趋势的原因至关重要，尤其是在2010年至2015/16年期间。
