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对布隆迪五岁以下儿童疟疾、贫血和发育迟缓潜在风险因素与儿童期合并症之间的相互关系进行建模。

Modelling the interrelationships between potential risk factors and childhood Co-morbidity of Malaria, Anaemia, and stunting in children less than five years in Burundi.

作者信息

Gaston Rugiranka Tony, Ramroop Shaun, Habyarimana Faustin

机构信息

School of Mathematics, Statistics and Computer Sciences, University of KwaZulu-Natal, Pietermaritzburg Campus, Private Bag X01, Scottsville, 3209, South Africa.

出版信息

Heliyon. 2024 Sep 26;10(19):e38525. doi: 10.1016/j.heliyon.2024.e38525. eCollection 2024 Oct 15.

Abstract

BACKGROUND

Anaemia, malaria, and stunting remain health problems, especially in children younger than five years, and those conditions are linked to morbidity and mortality. The main objective was to assess the relationships between anaemia, malaria, and stunting. Also, the current study aimed to understand the complex interrelationships between explanatory factors, and their direct or indirect relationship with childhood malaria, anaemia, and stunting in Burundi.

METHODS

The study used secondary data from the Demographic and Health Survey in Burundi (BDHS) conducted on the March 7, 2017, with a weighted sample size of 13611 children younger than five years. A multivariate structural equation model (SEM) was used to evaluate the interrelationships between dependent variables and their direct or indirect relationship with childhood malaria, anaemia, and stunting. SEMs diverge from other techniques, as they look at the effects on hypothesised relationships from both direct and indirect perspectives (Takele et al., 2023) [1]. The variables with statistical significance were set at a p-value <0.05.

RESULTS

The findings from this study indicated an association between anaemia, malaria, and stunting (p < 0.001). The environmental and household factors were statistically significant (p < 0.038 and p < 0.001 respectively) and positively impacted childhood malaria, anaemia, and stunting. The results also indicated that the household factors were statistically significant (p < 0.001) predictors of childhood malaria, anaemia, and stunting. Furthermore, the findings from this study revealed that geophysical factors have a positive significant (p < 0.001) impact on childhood malaria, anaemia, and stunting via the mediating of the household factors. Contrastingly, with the environmental factors as a mediator, we observe a negative significant (p < 0.001) impact on childhood malaria, anaemia, and stunting. Lastly, the results showed that demographic factors had a negative significant (p = 0.004) effect on childhood anaemia, malaria, and stunting via the mediating of household factors.

CONCLUSION

The findings from this study revealed an association between malaria, anaemia, and stunting, which imply that these conditions could contribute to collaborative improvements in child well-being. In addition, child demographic, household, environmental, and geographic factors were direct and indirect important drivers of childhood malaria, anaemia, and stunting. Therefore, improving sanitation, access to clean water, nutrition practices, and health care, especially for children from rural areas, and uneducated mothers with poor backgrounds could help to control and eliminate stunting, anemia, and malaria in children younger than five years in Burundi.

摘要

背景

贫血、疟疾和发育迟缓仍是健康问题,尤其是在五岁以下儿童中,这些状况与发病率和死亡率相关。主要目标是评估贫血、疟疾和发育迟缓之间的关系。此外,本研究旨在了解布隆迪解释性因素之间的复杂相互关系,以及它们与儿童疟疾、贫血和发育迟缓的直接或间接关系。

方法

本研究使用了2017年3月7日进行的布隆迪人口与健康调查(BDHS)的二手数据,加权样本量为13611名五岁以下儿童。采用多元结构方程模型(SEM)来评估因变量之间的相互关系,以及它们与儿童疟疾、贫血和发育迟缓的直接或间接关系。结构方程模型与其他技术不同,因为它们从直接和间接两个角度研究对假设关系的影响(Takele等人,2023年)[1]。具有统计学意义的变量设定为p值<0.05。

结果

本研究结果表明贫血、疟疾和发育迟缓之间存在关联(p<0.001)。环境和家庭因素具有统计学意义(分别为p<0.038和p<0.001),并对儿童疟疾、贫血和发育迟缓产生积极影响。结果还表明,家庭因素是儿童疟疾、贫血和发育迟缓的统计学显著(p<0.001)预测因素。此外,本研究结果显示,地球物理因素通过家庭因素的中介作用对儿童疟疾、贫血和发育迟缓有显著的正向影响(p<0.001)。相反,以环境因素为中介,我们观察到对儿童疟疾、贫血和发育迟缓有显著的负向影响(p<0.001)。最后,结果表明,人口因素通过家庭因素的中介作用对儿童贫血、疟疾和发育迟缓有显著的负向影响(p = 0.004)。

结论

本研究结果揭示了疟疾、贫血和发育迟缓之间的关联,这意味着这些状况可能有助于共同改善儿童福祉。此外,儿童人口、家庭、环境和地理因素是儿童疟疾、贫血和发育迟缓的直接和间接重要驱动因素。因此,改善卫生条件、获得清洁水、营养习惯和医疗保健,特别是针对农村地区儿童以及背景不佳的未受过教育的母亲,有助于控制和消除布隆迪五岁以下儿童的发育迟缓、贫血和疟疾。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eafc/11490769/922f5cdaff36/gr1.jpg

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