Department of Statistics, College of Natural and Computational Science, Mekelle University, Mekelle, Ethiopia.
Department of Statistics, College of Natural and Computational Science, Adigrat University, Adigrat, Ethiopia.
PLoS One. 2024 Jul 31;19(7):e0304662. doi: 10.1371/journal.pone.0304662. eCollection 2024.
In Ethiopia, the mortality rate for children under five is a public health concern. Regretfully, the problem is notably underestimated and underreported, making it impossible to fully recognize how serious the situation is in the nation's developing regions. Unfortunately, no single study has been conducted to reveal the rates and predictor factors of under-five child death in Ethiopia's pastoral regions. Therefore, the purpose of this study was to determine the critical variables that led to a shorter survival time to death for children in Ethiopia's pastoral regions under the age of five.
Between January 18 and June 27, 2016, a retrospective follow-up study was done among under-five children in pastoral areas of Ethiopia. The statistically significant difference between categorical predictors was shown using the log-rank test, and the Kaplan-Meier survival curve was used to determine the survival time. In order to identify the time-to-death predictor factors in children under five, Cox proportional hazards (PH) model analyses of bivariable and multivariable variables were fitted.
A total 7,677 children were included in the study. The overall incidence rate of under-five mortality was 8.4% (95% CI 7.77%, 9.0%). In the multivariable Cox PH model analysis, children vaccinated (AHR: 0.72, 95% CI: 0.59, 0.88), mothers aged 35-40 (AHR: 1.27; 95% CI: 1.06, 1.52), and above 41 (AHR: 2.18, 95% CI: 1.59, 2.98), not initiating exclusively breastfeeding (AHR: 1.26, 95% CI: 1.02, 1.55), the agriculture sector of the mother's occupation (AHR: 2.57, 95% CI: 1.74, 3.31), the male sex of the household head (AHR: 0.67, 95% CI: 0.56, 0.81), non-anemic child (AHR: 0.67, 95% CI: 0.55, 0.83), and rural residence (AHR: 3.27, 95% CI: 1.45, 7.38) were identified as main predictors of time to death among under-five children.
In this study, the authors found a higher rate of under-five deaths than the national figure. A child vaccinated, exclusively breastfeeding, mother's occupation, sex of household head, anemic child, mother's age, and residence were found to be the most influential predictors for time-to-death. Therefore, to lower the high incidence of under-five mortality, the government should focus on the pastoral regional states of Ethiopia.
在埃塞俄比亚，五岁以下儿童的死亡率是一个公共卫生关注点。遗憾的是，这个问题被明显低估和少报，使得人们无法全面了解该国发展中地区的情况有多严重。不幸的是，没有任何单一的研究能够揭示埃塞俄比亚牧区五岁以下儿童死亡的发生率和预测因素。因此，本研究旨在确定导致埃塞俄比亚牧区五岁以下儿童生存时间缩短的关键变量。
2016 年 1 月 18 日至 6 月 27 日，对埃塞俄比亚牧区五岁以下儿童进行了回顾性随访研究。使用对数秩检验显示分类预测因子之间的统计学显著差异，并使用 Kaplan-Meier 生存曲线确定生存时间。为了确定五岁以下儿童死亡时间的预测因素，对单变量和多变量变量进行了 Cox 比例风险 (PH) 模型分析。
共有 7677 名儿童纳入研究。五岁以下儿童总死亡率为 8.4%（95%CI 7.77%，9.0%）。在多变量 Cox PH 模型分析中，接种疫苗的儿童（AHR：0.72，95%CI：0.59，0.88）、母亲年龄 35-40 岁（AHR：1.27；95%CI：1.06，1.52）和 41 岁以上（AHR：2.18，95%CI：1.59，2.98）、未开始纯母乳喂养（AHR：1.26，95%CI：1.02，1.55）、母亲职业为农业（AHR：2.57，95%CI：1.74，3.31）、户主为男性（AHR：0.67，95%CI：0.56，0.81）、非贫血儿童（AHR：0.67，95%CI：0.55，0.83）和农村居住（AHR：3.27，95%CI：1.45，7.38）被确定为五岁以下儿童死亡时间的主要预测因素。
在这项研究中，作者发现五岁以下儿童的死亡率高于全国水平。接种疫苗、纯母乳喂养、母亲职业、户主性别、儿童贫血、母亲年龄和居住地是与死亡时间最相关的预测因素。因此，为了降低五岁以下儿童死亡率的高发生率，政府应重点关注埃塞俄比亚的牧区州。
