Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
BMC Pediatr. 2024 Jul 5;24(1):433. doi: 10.1186/s12887-024-04900-1.
Under-five children's diarrhea is a significant public health threat and the World Health Organization (WHO) reported it as the second leading cause of children's death worldwide. In this study area, little is known about the spatiotemporal distribution of under-5 diarrhea incidence. This study was therefore, conducted among all districts in the Central Gondar zone to assess the spatial, temporal, and spatiotemporal variation in diarrhea incidence among under-five children in the Central Gondar zone. The data for children under 5 years of age with diarrhea was obtained from Central Gondar Zone Health Department diarrhea reports from January 2019 to December 2022. All districts were included and geo-coded. The spatial data were created in ArcGIS 10.8.1. Global and local spatial autocorrelation were used to detect hot spots and cold spots. The Poisson model was generated by applying the Kulldorff method in SaTScan™9.6 to analyse the the purely temporal, spatial, and space-time clusters. The study revealed spatial variation of under-5 diarrhea where Gondar City, Gondar Zuria, East Dembia, and Lay Armacho districts were the high-rate spatial clusters during the study period. A year search window for temporal scan statistic identified 01 January 2020-30 December 2021 as risk periods across all districts. Spatiotemporal scan statistics detected high-rate clusters at Gondar City, Gondar Zuria, East Dembia, Lay Armacho, and Alefa between 2019 and 2022. In conclusion, there has been a spatial, temporal, and spatiotemporal variability of under-5 children's diarrhea in the Central Gondar Zone. Interventional and preventive strategies should be developed and given priority to the areas that has been detected as a hotspot in this study to reduce the mortality and morbidity of under 5 children.
5 岁以下儿童腹泻是一个重大的公共卫生威胁，世界卫生组织（WHO）报告称，它是全球儿童死亡的第二大主要原因。在这个研究区域，人们对 5 岁以下儿童腹泻的时空分布知之甚少。因此，本研究在中央贡德尔地区的所有区进行，以评估中央贡德尔地区 5 岁以下儿童腹泻的空间、时间和时空变化。2019 年 1 月至 2022 年 12 月，从中央贡德尔区卫生部门的腹泻报告中获取了 5 岁以下腹泻儿童的数据。所有地区都被包括在内并进行了地理编码。空间数据是在 ArcGIS 10.8.1 中创建的。全局和局部空间自相关用于检测热点和冷点。Poisson 模型通过在 SaTScan™9.6 中应用 Kulldorff 方法生成，用于分析纯粹的时间、空间和时空聚类。研究表明，5 岁以下儿童腹泻存在空间变化，贡德尔市、贡德尔 Zuria、东德姆比亚和莱阿姆拉乔等区是研究期间高发病率的空间集群。对时间扫描统计的一年搜索窗口确定了 2020 年 1 月 1 日至 2021 年 12 月 30 日是所有区的风险期。时空扫描统计检测到 2019 年至 2022 年期间贡德尔市、贡德尔 Zuria、东德姆比亚、莱阿姆拉乔和阿莱法等区的高发病率集群。总之，中央贡德尔地区 5 岁以下儿童腹泻存在空间、时间和时空变化。应制定干预和预防策略，并优先考虑本研究中检测到的热点地区，以降低 5 岁以下儿童的死亡率和发病率。
