中低收入国家儿童发育迟缓的患病率及其决定因素：系统评价和荟萃分析。
Prevalence and determinants of developmental delay among children in low- and middle-income countries: a systematic review and meta-analysis.
机构信息
School of Medicine, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia.
Department of Nursing, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia.
出版信息
Front Public Health. 2024 Apr 2;12:1301524. doi: 10.3389/fpubh.2024.1301524. eCollection 2024.
BACKGROUND
Developmental delay is a public health problem in low- and middle-income countries. However, there is no summarized evidence in low- and middle-income countries on developmental delay, and primary studies on this issue show varied and inconclusive results. This systematic review and meta-analysis aimed to assess the pooled magnitude of confirmed developmental delay and its determinants among children in low- and middle-income countries.
METHODS
We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to write this systematic review and meta-analysis. Primary studies were searched from PubMed, PsycINFO, Hinari, Science Direct, African Journal of Online, Web of Science, and Google Scholar databases. The Newcastle-Ottawa Scale, adapted for the cross-sectional studies, was used to assess the quality of the included studies. Heterogeneity and publication bias were assessed by the I and Eggers tests, respectively. Due to the high heterogeneity, the random effects model was used for analysis. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to show the association between developmental delay and its determinants.
RESULTS
The pooled prevalence of confirmed developmental delay was 18.83, 95% CI (15.53-22.12). In the subgroup analysis, a high prevalence of developmental delay [26.69% (95% CI, 15.78-37.60)] was observed in studies performed in Africa. Maternal education [3.04; 95% CI (2.05, 4.52)] and low birth weight [3.61; 95% CI (1.72, 7.57)] were significant determinants of developmental delay.
CONCLUSION
The pooled prevalence of developmental delay in low- and middle-income countries was high as compared to that in high-income countries. Maternal education level and weight at birth were significantly associated with developmental delays. Therefore, strategies should be designed to decrease the rate of low birth weight and the number of illiterate mothers living in low- and middle-income countries.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO, CRD42024513060.
背景
发育迟缓是中低收入国家的一个公共卫生问题。然而，中低收入国家关于发育迟缓的综合证据并不多，而且关于这个问题的初步研究结果各不相同，没有定论。本系统评价和荟萃分析旨在评估中低收入国家儿童发育迟缓的综合发生率及其决定因素。
方法
我们遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南来撰写本系统评价和荟萃分析。从 PubMed、PsycINFO、Hinari、Science Direct、African Journal of Online、Web of Science 和 Google Scholar 数据库中搜索原始研究。使用经过改编的适用于横断面研究的纽卡斯尔-渥太华量表来评估纳入研究的质量。通过 I ² 和 Eggers 检验分别评估异质性和发表偏倚。由于高度异质性，使用随机效应模型进行分析。使用比值比（OR）及其 95%置信区间（CI）来显示发育迟缓及其决定因素之间的关联。
结果
确认的发育迟缓的总患病率为 18.83%，95%CI（15.53-22.12）。在亚组分析中，在非洲进行的研究中观察到发育迟缓的高患病率[26.69%（95%CI，15.78-37.60）]。母亲的教育程度[3.04；95%CI（2.05，4.52）]和低出生体重[3.61；95%CI（1.72，7.57）]是发育迟缓的显著决定因素。
结论
与高收入国家相比，中低收入国家发育迟缓的总患病率较高。母亲的教育水平和出生体重与发育迟缓显著相关。因此，应制定策略降低中低收入国家低出生体重率和文盲母亲的数量。
系统评价注册
PROSPERO，CRD42024513060。
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