Kitaw Tegene Atamenta, Zemariam Alemu Birara, Azmeraw Molla, Haile Ribka Nigatu
Department of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia.
Sci Rep. 2025 Apr 7;15(1):11903. doi: 10.1038/s41598-025-91694-6.
Despite significant efforts, undernutrition remains a critical public health issue, particularly in developing countries like Ethiopia. Anthropometric failure, which indicates inadequate child growth and development, has severe consequences. Analyzing the spatial distribution and determinants of anthropometric failure is crucial for evaluating and improving nutritional programs. Understanding these spatial patterns can enhance targeted resource allocation, thereby accelerating progress toward optimal child growth. This study utilized a spatial analysis of anthropometric failure using data from the EMDHS 2019, focusing on a weighted sample of 3,659 children under five. The survey was conducted from March 21, 2019, to June 28, 2019, following a two-stage stratified sampling. Non-spatial analysis was conducted using STATA version 17, while ArcGIS Pro and SatScan version 9.6 were used for spatial visualization. Multiscale geographically weighted regression analysis identified significant determinants, with statistical significance set at a p-value of less than 0.05. The prevalence of anthropometric failure among the sampled children was 36.79% (95% CI 35.22%-38.37%). A clustered distribution was observed (Moran's I = 0.249, p < 0.001), with significant clustering in the Amhara, Tigray, Afar, and Somali regions. Children in these clusters were twice as likely to experience anthropometric failure (RR = 2.01, p < 0.001). Key determinants of spatial variation included mothers with no formal education (Mean = 0.1402, p < 0.001), low household wealth (Mean = 0.1651, p = 0.002), short birth intervals (Mean = 0.1165, p = 0.014), and insufficient postnatal care (Mean = 0.0589, p = 0.004). With a prevalence of 36.79%, anthropometric failure among children under five in Ethiopia is a major concern. The observed clustering highlights the need for targeted interventions, including improving maternal education, increasing household wealth, and enhancing access to family planning and postnatal care. Special emphasis should be placed on hotspot areas to effectively address and reduce undernutrition.
尽管付出了巨大努力，但营养不良仍然是一个关键的公共卫生问题，在埃塞俄比亚等发展中国家尤为如此。人体测量指标不达标的情况表明儿童生长发育不足，会产生严重后果。分析人体测量指标不达标的空间分布及其决定因素对于评估和改进营养项目至关重要。了解这些空间模式可以加强有针对性的资源分配，从而加快实现儿童最佳生长发育的进程。本研究利用2019年埃塞俄比亚微型人口与健康调查（EMDHS）的数据，对人体测量指标不达标的情况进行了空间分析，重点关注3659名五岁以下儿童的加权样本。该调查于2019年3月21日至2019年6月28日进行，采用两阶段分层抽样。非空间分析使用STATA 17版本进行，而ArcGIS Pro和SatScan 9.6版本用于空间可视化。多尺度地理加权回归分析确定了显著的决定因素，统计学显著性设定为p值小于0.05。抽样儿童中人体测量指标不达标的患病率为36.79%（95%置信区间35.22%-38.37%）。观察到存在聚集分布（莫兰指数I = 0.249，p < 0.001），阿姆哈拉、提格雷、阿法尔和索马里地区存在显著聚集。这些聚集地区的儿童出现人体测量指标不达标的可能性是其他地区儿童的两倍（相对风险RR = 2.01，p < 0.001）。空间差异的关键决定因素包括未接受过正规教育的母亲（均值= 0.1402，p < 0.001）、家庭财富水平低（均值= 0.1651，p = 0.002）、生育间隔短（均值= 0.1165，p = 0.014）以及产后护理不足（均值= 0.0589，p = 0.004）。埃塞俄比亚五岁以下儿童人体测量指标不达标的患病率为36.79%，这是一个主要问题。观察到的聚集现象凸显了进行有针对性干预的必要性，包括提高母亲教育水平、增加家庭财富以及改善计划生育和产后护理服务的可及性。应特别关注热点地区，以有效应对和减少营养不良问题。
