Rahman Asif Md Rezaur, Islam Md Ridwan, Bashar Syed Jayedul, Al Fidah Md Fuad, Amin Rukaeya, Rahman Md Mushfiqur, Faruque Asg, Chisti Mohammod Jobayer, Ahmed Tahmeed, Nuzhat Sharika
Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, Bangladesh.
Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, Bangladesh
BMJ Paediatr Open. 2025 Apr 8;9(1):e003259. doi: 10.1136/bmjpo-2024-003259.
The burden of childhood diarrhoea remains one of the most important public health problems in countries like Bangladesh, which can be reduced by effective preventive measures. We aimed to investigate the trends in preventive measures practised among under five children with diarrhoea over the last 12 years.
Data was extracted from the Diarrhoeal Disease Surveillance System at Dhaka Hospital for the period 2012-2023. STATA 15 was used for analysis. We used the Joncheere-Terpstra trend test to examine the trend in preventive measures against diarrhoea and the slope index of inequality (SII) to determine their association with the wealth index.
Among 20 373 participants, 61.0% were male, with a median (IQR) age of 11 months (8.0-16.0). Most (88.3%) had access to sanitary latrines, and 40.3% of households consumed boiled or filtered water. We found that 50.3% children aged 6-59 months received vitamin A, and 88.4% of children >9 months had measles vaccination. Breastfeeding practices were observed in 17.8% of the children. Significant upward trends were observed for sanitary latrine use and measles vaccination (p<0.001). Receiving vitamin A supplementation and boiled/filtered water consumption showed a declining trend (p<0.001). Parental education and maternal media exposure were found to be significantly associated with the preventive measures (p<0.05). The wealth index showed a significant association with vitamin A supplementation (p<0.01). However, SII does not indicate inequality between the groups. We found that children from wealthier quintile families had a significantly higher rate of measles immunisation, as indicated by the SII (p value=0.039).
Improving practices of preventive measures can significantly reduce diarrhoeal diseases among children under five. Emphasis should be placed on vitamin A supplementation and the consumption of boiled or filtered water. A targeted approach is essential, including promoting health education, enhancing health awareness, and increasing media exposure for mothers.
在孟加拉国等国家，儿童腹泻负担仍然是最重要的公共卫生问题之一，有效的预防措施可减轻这一负担。我们旨在调查过去12年中5岁以下腹泻儿童所采取预防措施的趋势。
从达卡医院腹泻病监测系统中提取2012年至2023年期间的数据。使用STATA 15进行分析。我们采用琼奇尔-特普斯特拉趋势检验来研究腹泻预防措施的趋势，并使用不平等斜率指数（SII）来确定其与财富指数的关联。
在20373名参与者中，61.0%为男性，中位（IQR）年龄为11个月（8.0 - 16.0）。大多数（88.3%）可使用卫生厕所，40.3%的家庭饮用煮沸或过滤后的水。我们发现，6至59个月大的儿童中有50.3%接受了维生素A补充，9个月以上儿童中有88.4%接种了麻疹疫苗。17.8%的儿童有母乳喂养习惯。卫生厕所使用和麻疹疫苗接种呈显著上升趋势（p<0.001）。接受维生素A补充和饮用煮沸/过滤后的水呈下降趋势（p<0.001）。发现父母教育程度和母亲的媒体接触与预防措施显著相关（p<0.05）。财富指数与维生素A补充显著相关（p<0.01）。然而，SII并未表明各群体之间存在不平等。我们发现，如SII所示，来自较富裕五分位数家庭的儿童麻疹免疫接种率显著更高（p值 = 0.039）。
改善预防措施的实施可显著减少5岁以下儿童的腹泻疾病。应重点关注维生素A补充以及饮用煮沸或过滤后的水。采取有针对性的方法至关重要，包括促进健康教育、提高健康意识以及增加母亲的媒体接触。
