Department of Health Informatics, School of public health, Asrat Woldeyes Health Sciences Campus, Debre Berhan University, Debre Birhan, Ethiopia.
Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
PLoS One. 2024 Oct 14;19(10):e0312025. doi: 10.1371/journal.pone.0312025. eCollection 2024.
Overweight/ obesity among under-five children is an emerging public health issue of the twenty-first century. Due to the quick nutritional and epidemiological change, non-communicable diseases, premature death, disability, and reproductive disorders have grown in low-income countries. Besides, little attention has been given. Therefore, we aimed to explore spatial variations and predictors of overweight/obesity among under-five children in Ethiopia using a geospatial technique.
A total weighted sample of 3,609 under-five children was included in the study. A cross-sectional study was conducted using a nationally representative sample of the 2019 Ethiopia Mini Demographic and Health Survey data set. ArcGIS version 10.8 was used to explore the spatial variation of obesity. SaTScan version 9.6 software was used to analyze the spatial cluster detection of overweight/obesity. Ordinary least square and geographically weighted regression analysis were employed to assess the association between an outcome variable and explanatory variables. A p-value of less than 0.05 was used to declare it statistically significant.
The spatial distribution of overweight/obesity among under-five children in Ethiopia was clustered (Global Moran's I = 0.27, p-value<0.001). The significant hot spot areas or higher rates of childhood obesity, were found in Southern Amhara, Northwest Somalia, Border of Harari, central Addis Ababa, Eastern SNNPR, and Northwestern Oromia region. In spatial SaT Scan analysis, 79 significant clusters of overweight/obesity were detected. The primary clusters were located in SNNPR, Oromia, and Addis Ababa (RR = 1.48, LLR = 31.40, P-value < 0.001). In the geographically weighted regression analysis, urban residence, cesarean section, rich households, and female children were statistically significant predictors.
Overweight or obesity among under-five children show spatial variations across Ethiopian regions. GWR analysis identifies cesarean section, wealth index, urban residence, and child sex as significant predictors. The Ministry of Health and Ethiopian Public Health Institute should target regions with these contributing predictors, promoting localized physical education, health education campaigns, and ongoing community monitoring to encourage active lifestyles and reduce sedentary behaviors among children.
21 世纪，五岁以下儿童超重/肥胖是一个新兴的公共卫生问题。由于营养和流行病学的快速变化，在低收入国家，非传染性疾病、早逝、残疾和生殖障碍的发病率不断上升。此外，对此关注甚少。因此，我们旨在使用地理空间技术探索埃塞俄比亚五岁以下儿童超重/肥胖的空间变化及其预测因素。
本研究纳入了 3609 名五岁以下儿童的总加权样本。这是一项使用 2019 年埃塞俄比亚迷你人口与健康调查数据集的全国代表性样本进行的横断面研究。ArcGIS 版本 10.8 用于探索肥胖的空间变化。SaTScan 版本 9.6 软件用于分析超重/肥胖的空间聚类检测。普通最小二乘法和地理加权回归分析用于评估因变量和解释变量之间的关系。p 值小于 0.05 被认为具有统计学意义。
埃塞俄比亚五岁以下儿童超重/肥胖的空间分布呈聚集性（全局 Moran's I = 0.27，p 值<0.001）。在阿姆哈拉南部、索马里西北部、哈拉里边境、亚的斯亚贝巴中部、东索马里和奥罗米亚西北部地区发现了儿童肥胖率较高的显著热点地区。在空间 SaT Scan 分析中，检测到 79 个超重/肥胖的显著聚类。主要聚类位于南方的 SNNPR、奥罗米亚和亚的斯亚贝巴（RR = 1.48，LLR = 31.40，P 值 < 0.001）。在地理加权回归分析中，城市居住、剖腹产、富裕家庭和女孩是统计学上的显著预测因素。
五岁以下儿童超重或肥胖存在跨埃塞俄比亚地区的空间差异。GWR 分析确定剖腹产、财富指数、城市居住和儿童性别是重要的预测因素。卫生健康部和埃塞俄比亚公共卫生研究所应针对具有这些影响因素的地区，开展有针对性的体育教育、健康教育活动和持续的社区监测，鼓励儿童积极生活方式，减少久坐行为。
