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加纳6至59个月儿童贫血患病率及其严重程度相关因素:多层次有序逻辑回归分析

The prevalence of anemia and the factors associated with its severity among children aged 6-59 months in Ghana: A multi-level ordinal logistic regression.

作者信息

Asgedom Yordanos Sisay, Habte Aklilu, Woldegeorgis Beshada Zerfu, Koyira Mengistu Meske, Kedida Beimnet Desalegn, Fente Bezawit Melak, Gebrekidan Amanuel Yosef, Kassie Gizachew Ambaw

机构信息

Department of Epidemiology, College of Health Sciences and Medicine, Wolaita Sodo University, Soddo, Ethiopia.

School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia.

出版信息

PLoS One. 2024 Dec 23;19(12):e0315232. doi: 10.1371/journal.pone.0315232. eCollection 2024.

Abstract

INTRODUCTION

Anemia is a significant health problem that has a profound impact on young children under the age of five. It can result in severe consequences, such as stunted growth, impaired cognitive and motor development, increased illness, and even death. In Ghana, anemia is the leading cause of child mortality, yet there is a lack of information available on the prevalence of anemia and the factors associated with its severity in children under five in the country. To fill this gap, this study was conducted to investigate the prevalence and determinants of anemia severity among children aged 6-59 months in Ghana.

METHODS

This study used data from the 2022 Ghana Demographic and Health Survey (GDHS) and included a weighted total sample of 3585 children aged 6-59 months. Given the hierarchical nature of the DHS data and the ordinal nature of anemia, a multilevel ordinal logistic regression model was employed. The Brant test was used to determine whether the proportional odds assumption was met (P ≥0.05). Deviance was used for model comparison. For the multivariable analysis, variables with a p-value ≤0.2 in the bi-variable analysis were considered. The Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI) was reported as a factor associated with anemia severity in the multivariable multilevel proportional odds model.

RESULTS

A study conducted in Ghanaian children aged 6-59 months found that 49.1% of them had anemia (95% CI: 47.4%-50.7%). The results indicated that 27.6% of patients had mild anemia, while 21.4% had moderate to severe anemia. Factors that were significantly associated with higher odds of childhood anemia included being 6-23 months old, male, having a maternal age of 15-24 or 25-34 years, belonging to poorer or wealthier households, having a higher birth order, being stunted, having maternal anemia, no media exposure, and living in the Northern, Upper East, or Upper West regions.

CONCLUSION

Anemia among children aged 6-59 months in Ghana is a major public health concern. It is recommended to improve access to the media, address maternal anemia through targeted interventions, and strengthen the wealth status of families. Furthermore, preconception care for mothers during pregnancy should be supported to reduce anemia in the long-term. Additionally, the early detection and management of stunted children should be strengthened to decrease childhood anemia.

摘要

引言

贫血是一个严重的健康问题,对五岁以下幼儿有深远影响。它可能导致严重后果,如生长发育迟缓、认知和运动发育受损、疾病增加,甚至死亡。在加纳,贫血是儿童死亡的主要原因,但该国缺乏关于五岁以下儿童贫血患病率及其严重程度相关因素的信息。为填补这一空白,本研究旨在调查加纳6至59个月儿童贫血严重程度的患病率及其决定因素。

方法

本研究使用了2022年加纳人口与健康调查(GDHS)的数据,包括3585名6至59个月儿童的加权总样本。鉴于DHS数据的分层性质和贫血的有序性质,采用了多水平有序逻辑回归模型。使用布兰特检验来确定是否满足比例优势假设(P≥0.05)。偏差用于模型比较。对于多变量分析,考虑双变量分析中p值≤0.2的变量。在多变量多水平比例优势模型中,报告了具有95%置信区间(CI)的调整优势比(AOR)作为与贫血严重程度相关的因素。

结果

一项针对加纳6至59个月儿童的研究发现,其中49.1%患有贫血(95%CI:47.4%-50.7%)。结果表明,27.6%的患者患有轻度贫血,而21.4%患有中度至重度贫血。与儿童贫血几率较高显著相关的因素包括年龄在6至23个月、男性、母亲年龄在15至24岁或25至34岁、属于较贫困或较富裕家庭、出生顺序较高、发育迟缓、母亲贫血、无媒体接触以及居住在北部、上东部或上西部地区。

结论

加纳6至59个月儿童的贫血是一个主要的公共卫生问题。建议改善媒体接触机会,通过有针对性的干预措施解决母亲贫血问题,并加强家庭的财富状况。此外,应支持孕期母亲的孕前护理,以长期减少贫血。此外,应加强对发育迟缓儿童的早期检测和管理,以减少儿童贫血。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6180/11666026/a23afa67a824/pone.0315232.g001.jpg

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