Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
BMC Pediatr. 2024 Jan 6;24(1):23. doi: 10.1186/s12887-023-04480-6.
BACKGROUND: Diarrhea is the second leading cause of morbidity and mortality for under-five children which cause about 525,000 deaths annually. Even though diarrheal diseases have decreased substantially at the global level, low-income countries are still faced with a huge number of diarrheal diseases. Thus, our aim was to assess the child feeding practices during diarrheal diseases and associated factors among children aged 6 to 23 months in Sub-Saharan African countries using the recent demographic and health survey. METHODS: The appended and most recent demographic and health survey (DHS) dataset of 19 Sub-Saharan African countries from 2015 to 2020 was used for data analysis. A total of 64,628 living children aged 6-23 months with diarrhea were used as a weighted sample. The determinants of appropriate feeding practice were determined using a multilevel mixed-effects logistic regression model. Significant factors associated with appropriate feeding practice in the multilevel mixed-effect logistic regression model were declared significant at p-values < 0.05. The adjusted odds ratio (AOR) and confidence interval (CI) were used to interpret the results. RESULT: The overall prevalence of appropriate child feeding practice during diarrhea in this study was 6.24% (95% CI: 6.06, 6.43). Maternal age (15 to 19 years and 20 to 35 years) (AOR = 1.32, 95%CI: 1.12, 1.55 and AOR = 1.14, 95%CI: 1.03, 1.27), mothers education (primary and secondary level) (AOR = 1.23, 95%CI: 1.12, 1.35 and AOR = 1.28, 95%CI: 1.15, 1.43), having media exposure(AOR = 1.36, 95%CI: 1.26, 1.46), being married (AOR = 1.18, 95%CI: 1.01, 1.38), currently working (AOR = 1.08, 95%CI:1.00, 1.15), vaccinated for Rotavirus (AOR = 1.30, 95%CI:1.19, 1.43) and living in Central and eastern African countries (AOR = 1.82, 95%CI: 1.12, 2.97) and (AOR = 2.23, 95%CI: 1.37, 3.61) respectively were significantly associated with appropriate feeding practice. CONCLUSION: The prevalence of appropriate feeding practice during child diarrheal disease aged 6-23 months of age was strictly low which implies that child diarrhea and appropriate feeding practice is still a great issue in in Sub-Saharan African countries. Enhancing maternal education, strengthening media exposure and vaccination for rotavirus, and designing interventions that address the mother's marital status, mother's work status, and country category are recommended to enhance appropriate feeding practices. Furthermore, special consideration should be given to older mothers to increase appropriate feeding practices during diarrheal disease.
背景：腹泻是导致五岁以下儿童发病率和死亡率第二高的疾病，每年导致约 52.5 万人死亡。尽管全球腹泻病发病率已大幅下降，但低收入国家仍面临大量腹泻病。因此，我们的目的是使用最近的人口与健康调查评估撒哈拉以南非洲国家 6 至 23 个月儿童腹泻期间的喂养方式以及相关因素。
方法：使用来自 2015 年至 2020 年的 19 个撒哈拉以南非洲国家的最新附加人口与健康调查（DHS）数据集进行数据分析。共有 64628 名 6-23 个月龄患有腹泻的活产儿童作为加权样本。使用多级混合效应逻辑回归模型确定适当喂养方式的决定因素。在多级混合效应逻辑回归模型中与适当喂养实践相关的显著因素被宣布为 p 值 < 0.05。使用调整后的优势比（AOR）和置信区间（CI）来解释结果。
结果：本研究中腹泻期间适当儿童喂养实践的总体流行率为 6.24%（95%CI：6.06，6.43）。母亲年龄（15 至 19 岁和 20 至 35 岁）（AOR=1.32，95%CI：1.12，1.55 和 AOR=1.14，95%CI：1.03，1.27），母亲教育（小学和中学水平）（AOR=1.23，95%CI：1.12，1.35 和 AOR=1.28，95%CI：1.15，1.43），媒体接触（AOR=1.36，95%CI：1.26，1.46），已婚（AOR=1.18，95%CI：1.01，1.38），目前正在工作（AOR=1.08，95%CI：1.00，1.15），接种轮状病毒疫苗（AOR=1.30，95%CI：1.19，1.43）和居住在中非和东非国家（AOR=1.82，95%CI：1.12，2.97）和（AOR=2.23，95%CI：1.37，3.61）与适当的喂养实践显著相关。
结论：6-23 个月龄儿童腹泻期间适当喂养实践的流行率严格较低，这意味着儿童腹泻和适当喂养实践仍然是撒哈拉以南非洲国家的一个重大问题。建议加强母亲教育、加强媒体接触和轮状病毒疫苗接种，并设计解决母亲婚姻状况、母亲工作状况和国家类别的干预措施，以提高适当的喂养实践。此外，应特别关注年龄较大的母亲，以增加腹泻期间的适当喂养实践。
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