利用 2000 年至 2019 年期间二十年的数据绘制埃塞俄比亚发育迟缓儿童分布图。通过贝叶斯方法进行地理空间分析。
Mapping stunted children in Ethiopia using two decades of data between 2000 and 2019. A geospatial analysis through the Bayesian approach.
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.
Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
出版信息
J Health Popul Nutr. 2023 Oct 26;42(1):113. doi: 10.1186/s41043-023-00412-3.
BACKGROUND
Childhood stunting is a major public health problem globally, resulting in poor cognition and educational performance, low adult wages, low productivity, and an increased risk of nutrition-related chronic diseases in adulthood life. Accurate and reliable data on the prevalence of stunting over time with a sub-national estimate are scarce in Ethiopia.
OBJECTIVE
Our objective was to investigate the spatiotemporal distributions and ecological level drivers of stunting among under-five children over time in Ethiopia.
METHODS
A geospatial analysis using the Bayesian framework was employed to map the spatial variations of stunting among children aged less than five years. The data for the primary outcome were obtained from the Ethiopian Demographic and Health Surveys (2000-2019) and covariates data were accessed from different publicly available credible sources. The spatial binomial regression model was fitted to identify drivers of child stunting using the Bayesian approach.
RESULT
The national prevalence of stunting was 47.9 in 2000, 43.3 in 2005, 37.3 in 2011, 36.6 in 2016, and 35.9 in 2019, with a total reduction rate of 25%. Substantial spatial clustering of stunting was observed in the Northern (Tigray), Northcentral (Amhara), and Northwestern (Amhara) parts of Ethiopia. Temperature (mean regression coefficient (β): -0.19; 95% credible interval (95% CrI): -0.25, -0.12) and population density (β: -0.012; 95% CrI: -0.016, -0.009) were negatively associated with stunting, whereas travel time to the nearest cities (β: 0.12; 95% CrI: 0.064, 0.17) was positively associated with child stunting in Ethiopia.
CONCLUSION
The prevalence of stunting varied substantially at subnational and local levels over time. Clustering of stunted children were observed in the Northern parts of Ethiopia. Temperature, population density and travel time to the nearest cities were identified as the drivers of stunting in children. Improving community awareness of child nutrition through community health extension programs should be strengthened.
背景
儿童发育迟缓是全球一个主要的公共卫生问题，会导致认知和教育表现不佳、成年后工资较低、生产力低下以及成年后患与营养相关的慢性病的风险增加。在埃塞俄比亚，关于随时间推移的发育迟缓患病率的准确和可靠数据以及省级估计数据都很缺乏。
目的
我们的目的是调查随时间推移，埃塞俄比亚五岁以下儿童发育迟缓的时空分布和生态水平驱动因素。
方法
使用贝叶斯框架进行地理空间分析，以绘制五岁以下儿童发育迟缓的空间变化图。主要结局数据来自埃塞俄比亚人口与健康调查（2000-2019 年），协变量数据来自不同的公开可信来源。使用贝叶斯方法拟合空间二项式回归模型，以确定儿童发育迟缓的驱动因素。
结果
2000 年、2005 年、2011 年、2016 年和 2019 年全国发育迟缓患病率分别为 47.9%、43.3%、37.3%、36.6%和 35.9%，总降幅为 25%。在埃塞俄比亚北部（提格雷）、中北部（阿姆哈拉）和西北部（阿姆哈拉）地区观察到发育迟缓的显著空间聚类。温度（平均回归系数（β）：-0.19；95%可信区间（95%CrI）：-0.25，-0.12）和人口密度（β：-0.012；95%CrI：-0.016，-0.009）与发育迟缓呈负相关，而到达最近城市的旅行时间（β：0.12；95%CrI：0.064，0.17）与埃塞俄比亚儿童发育迟缓呈正相关。
结论
随时间推移，发育迟缓的患病率在次国家和地方层面有很大差异。在埃塞俄比亚北部地区观察到发育迟缓儿童的聚类。温度、人口密度和到达最近城市的旅行时间被确定为儿童发育迟缓的驱动因素。应加强通过社区卫生推广计划提高社区对儿童营养的认识。
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