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非洲孕产妇死亡率的趋势、预测及地区差异(1990 - 2030年):一种自回归积分滑动平均(ARIMA)预测方法

Trends, Projections, and Regional Disparities of Maternal Mortality in Africa (1990-2030): An ARIMA Forecasting Approach.

作者信息

Onambele Luc, Guillen-Aguinaga Sara, Guillen-Aguinaga Laura, Ortega-Leon Wilfrido, Montejo Rocio, Alas-Brun Rosa, Aguinaga-Ontoso Enrique, Aguinaga-Ontoso Ines, Guillen-Grima Francisco

机构信息

School of Health Sciences, Catholic University of Central Africa, Yaoundé 1110, Cameroon.

Department of Health Sciences, Public University of Navarra, 31008 Pamplona, Spain.

出版信息

Epidemiologia (Basel). 2023 Aug 29;4(3):322-351. doi: 10.3390/epidemiologia4030032.

Abstract

With the United Nations Sustainable Development Goals (SDG) (2015-2030) focused on the reduction in maternal mortality, monitoring and forecasting maternal mortality rates (MMRs) in regions like Africa is crucial for health strategy planning by policymakers, international organizations, and NGOs. We collected maternal mortality rates per 100,000 births from the World Bank database between 1990 and 2015. Joinpoint regression was applied to assess trends, and the autoregressive integrated moving average (ARIMA) model was used on 1990-2015 data to forecast the MMRs for the next 15 years. We also used the Holt method and the machine-learning Prophet Forecasting Model. The study found a decline in MMRs in Africa with an average annual percentage change (APC) of -2.6% (95% CI -2.7; -2.5). North Africa reported the lowest MMR, while East Africa experienced the sharpest decline. The region-specific ARIMA models predict that the maternal mortality rate (MMR) in 2030 will vary across regions, ranging from 161 deaths per 100,000 births in North Africa to 302 deaths per 100,000 births in Central Africa, averaging 182 per 100,000 births for the continent. Despite the observed decreasing trend in maternal mortality rate (MMR), the MMR in Africa remains relatively high. The results indicate that MMR in Africa will continue to decrease by 2030. However, no region of Africa will likely reach the SDG target.

摘要

联合国可持续发展目标(2015 - 2030年)聚焦于降低孕产妇死亡率,因此监测和预测非洲等地区的孕产妇死亡率对于政策制定者、国际组织和非政府组织制定卫生战略至关重要。我们从世界银行数据库收集了1990年至2015年每10万例分娩的孕产妇死亡率。采用连接点回归评估趋势,并使用自回归积分滑动平均(ARIMA)模型对1990 - 2015年的数据进行分析,以预测未来15年的孕产妇死亡率。我们还使用了霍尔特方法和机器学习先知预测模型。研究发现非洲的孕产妇死亡率呈下降趋势,平均年百分比变化(APC)为-2.6%(95%置信区间-2.7;-2.5)。北非的孕产妇死亡率最低,而东非的下降幅度最大。特定区域的ARIMA模型预测,2030年各地区的孕产妇死亡率会有所不同,从北非每10万例分娩中有161例死亡到中非每10万例分娩中有302例死亡,整个非洲大陆平均每10万例分娩中有182例死亡。尽管观察到孕产妇死亡率呈下降趋势,但非洲的孕产妇死亡率仍然相对较高。结果表明,到2030年非洲的孕产妇死亡率将继续下降。然而,非洲没有一个地区可能实现可持续发展目标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecea/10528291/eec9d0bfbe5c/epidemiologia-04-00032-g001.jpg

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