Woldekidan Mesfin Agachew, Arja Asrat, Worku Getaye, Walker Ally, Kassebaum Nicholas J, Hailemariam Alemnesh, Naghavi Mohsen, Hay Simon, Misganaw Awoke
National Data Management and Analytics Center, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America.
PLOS Glob Public Health. 2024 Jul 16;4(7):e0002640. doi: 10.1371/journal.pgph.0002640. eCollection 2024.
Child malnutrition is the main contributor to the disease burden in Ethiopia. The objective of this study was to determine the prevalence and trends of child malnutrition and maternal anemia in Ethiopia at the national and regional state levels between 1990 and 2019.
We used all accessible data sources and analyzed prevalence, death, and years of life lost (YLL) due to child malnutrition and maternal anemia across nine regions and two chartered cities in Ethiopia, as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. The burden and trends of child and maternal malnutrition and anemia at the national level, across the regions, and in cities were assessed. Point estimates with 95% uncertainty intervals (UI) are presented.
Of the 190,173 total under-5 deaths in Ethiopia in 2019, 108,864 (95% UI: 83,544-141,718; 57·2%, 51·3-62·7) were attributed to malnutrition. The prevalence of stunting, underweight, and wasting was 37·0%, 27·0%, and 7·0%, respectively, in 2019. The YLL rate attributable to child malnutrition declined from 251,964 per 100,000 population (95% UI: 218,720-287,559) in 1990 to 57,615 (95% UI: 44,190-75,015) in 2019. The YLL rate of wasting, stunting, and underweight in Ethiopia was 18,566 per 100,000 population (95% UI: 12,950-26,123), 3,290 (95% UI: 1,443-5,856), and 5,240 (95% UI: 3,608-7,312) in 2019, respectively. Gambella showed the highest YLL rate reduction among regions, with a 98·2% change for stunting, 95·9% for wasting, and 97·9% for underweight between 1990 and 2019. The prevalence of anemia among under-5 children in Ethiopia was 62·0% (95% UI: 59·1%-65·1%) in 2019. Somali has the highest child anemia prevalence, 84·4% (95% UI: 79·8%-88·8%), compared to others in 2019. The prevalence of anemia in women of reproductive age (15-49 years) in Ethiopia was 20·4% (95% UI: 19·0%-21·8%) in 2019.
The prevalence of child malnutrition and maternal anemia in Ethiopia remains high compared to national, WHO, and UNICEF 2030 targets in all indicators of child malnutrition and anemia despite several interventions in the last three decades. The YLL rate due to child malnutrition was high, with regional variations. In conjunction with other sectors, especially agriculture, the National Nutrition Program and other nutrition initiatives must make greater efforts with short-term and long-term interventions to improve access and better nutrition.
儿童营养不良是埃塞俄比亚疾病负担的主要促成因素。本研究的目的是确定1990年至2019年期间埃塞俄比亚全国和各地区州儿童营养不良和孕产妇贫血的患病率及趋势。
作为《2019年全球疾病、伤害及风险因素负担研究》（GBD 2019）的一部分，我们使用了所有可获取的数据源，并分析了埃塞俄比亚九个地区和两个特许城市因儿童营养不良和孕产妇贫血导致的患病率、死亡人数及寿命损失年数（YLL）。评估了国家层面、各地区以及城市中儿童和孕产妇营养不良及贫血的负担和趋势。呈现了带有95%不确定性区间（UI）的点估计值。
2019年埃塞俄比亚5岁以下儿童死亡总数为190,173例，其中108,864例（95% UI：83,544 - 141,718；57.2%，51.3 - 62.7）归因于营养不良。2019年，发育迟缓、体重不足和消瘦的患病率分别为37.0%、27.0%和7.0%。因儿童营养不良导致的YLL率从1990年的每10万人251,964例（95% UI：218,720 - 287,559）降至2019年的57,615例（95% UI：44,190 - 75,015）。2019年埃塞俄比亚消瘦、发育迟缓及体重不足的YLL率分别为每10万人18,566例（95% UI：12,950 - 26,123）、3,290例（95% UI：1,443 - 5,856）和5,240例（95% UI：3,608 - 7,312）。甘贝拉地区在各地区中YLL率下降幅度最大，1990年至2019年间，发育迟缓下降了98.2%，消瘦下降了95.9%，体重不足下降了97.9%。2019年埃塞俄比亚5岁以下儿童贫血患病率为62.0%（95% UI：59.1% - 65.1%）。2019年，索马里儿童贫血患病率最高，为84.4%（95% UI：79.8% - 88.8%）。2019年埃塞俄比亚育龄妇女（15 - 49岁）贫血患病率为20.4%（95% UI：19.0% - 21.8%）。
尽管在过去三十年中采取了多项干预措施，但与国家、世界卫生组织及联合国儿童基金会的2030年目标相比，埃塞俄比亚儿童营养不良和孕产妇贫血的患病率在儿童营养不良和贫血的所有指标上仍然很高。因儿童营养不良导致的YLL率很高，且存在地区差异。国家营养计划和其他营养举措必须与其他部门，尤其是农业部门共同努力，通过短期和长期干预措施，加大力度改善营养获取情况并提高营养水平。
