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基于埃塞俄比亚 EDHS2016 数据的混合效应和多水平逻辑回归分析:探究与儿童急性呼吸道感染症状相关的邻里环境风险因素。

Investigating neighbourhood environmental risk factors associated with childhood acute respiratory infection symptoms in Ethiopia mixed effect and multilevel logistic regression analysis based on EDHS 2016.

机构信息

Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

Front Public Health. 2024 Aug 1;12:1391682. doi: 10.3389/fpubh.2024.1391682. eCollection 2024.

Abstract

BACKGROUND

Acute respiratory infection is an infectious illness caused by acute viral or bacterial infection. According to a 2018 WHO report, exposures to indoor and ambient air environmental pollution were contributing factors to a higher risk of respiratory problems following 7 million deaths of children under five globally. Housing conditions such as wall material, roof type, kitchen location, sanitation condition, and cooking fuel type are household-level predictors of acute respiratory disease among children under five years of age.

METHOD

This research used EDHS-2016 secondary data, which are nationally representative. The data collection period was from January 18, 2016, to June 27, 2016. Among the 16,650 total surveys, 10,006 households that had children below 5 years of age. The outcome variable for this study was acute respiratory infection symptoms. Analyses were performed using STATA Version 17.1. The data were weighted before performing analysis to reinstate the representativeness of the sample. In the bivariable analysis, a value <0.2 was used to screen for multivariable. Multicollinearity was checked using the variance inflation factor. Then, a multilevel multivariable regression model was used in this study for the analysis of acute respiratory infection symptoms and possible predictor variables. Variables with a value <0.05 in multivariable regression analysis were considered statistically significant predictors.

RESULTS

Most (95.00%) households commonly used solid fuel for cooking, and household main construction materials: 81.44 and 91.03% of floors and walls of households were constructed with unprocessed natural materials, respectively. The prevalence of acute respiratory infection symptoms among children under five years of age was 7.955% (7.397, 8.551%). The findings indicated that acute respiratory infection symptoms among children under five years of age were significantly linked with the age of the children, diarrhea status, residence, region, fuel type, stool disposal, wall material, and floor material.

CONCLUSION

Interventions should target modifiable factors such as proper stool disposal of the youngest child, informing the health effects of poor housing conditions such as improving wall and floor construction material to reduce acute respiratory infection symptoms among children under five years of age.

摘要

背景

急性呼吸道感染是一种由急性病毒或细菌感染引起的传染病。根据世界卫生组织 2018 年的报告,室内和环境空气污染暴露是导致全球 700 万 5 岁以下儿童死亡后呼吸问题风险更高的因素之一。住房条件,如墙壁材料、屋顶类型、厨房位置、卫生条件和烹饪燃料类型,是 5 岁以下儿童急性呼吸道疾病的家庭预测因素。

方法

本研究使用 EDHS-2016 二级数据,该数据具有全国代表性。数据收集时间为 2016 年 1 月 18 日至 6 月 27 日。在总共 16650 项调查中,有 10006 户家庭有 5 岁以下的儿童。本研究的结果变量为急性呼吸道感染症状。使用 STATA 版本 17.1 进行分析。在进行分析之前,对数据进行了加权,以恢复样本的代表性。在单变量分析中,使用 值<0.2 来筛选多变量。使用方差膨胀因子检查多重共线性。然后,本研究使用多水平多变量回归模型分析急性呼吸道感染症状和可能的预测变量。多变量回归分析中 值<0.05 的变量被认为是具有统计学意义的预测变量。

结果

大多数(95.00%)家庭常用固体燃料做饭,家庭主要建筑材料:81.44%和 91.03%的家庭地板和墙壁分别由未经加工的天然材料建造。5 岁以下儿童急性呼吸道感染症状的患病率为 7.955%(7.397,8.551%)。研究结果表明,5 岁以下儿童急性呼吸道感染症状与儿童年龄、腹泻状况、住所、地区、燃料类型、粪便处理、墙壁材料和地板材料显著相关。

结论

干预措施应针对可改变的因素,如妥善处理最小的孩子的粪便,告知不良住房条件对健康的影响,如改善墙壁和地板建筑材料,以减少 5 岁以下儿童的急性呼吸道感染症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70a3/11328150/5b9e594d5032/fpubh-12-1391682-g001.jpg

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