森林覆盖变化对五岁以下儿童急性呼吸道感染、腹泻和发热患病率的影响：采用生态系统方法促进儿童健康。
Effect of forest cover change on the prevalence of acute respiratory tract infections, diarrhoea, and fever among children under five: Using an ecosystem approach to child health.
作者信息
Timilsina Amit, Chalise Binaya, Ahmed Kedir Y, Thapa Subash
机构信息
Research and Community Development Center, Kathmandu, Nepal.
Network for Education and Research on Peace and Sustainability, Hiroshima University, Hiroshima, Japan.
出版信息
PLoS One. 2025 Aug 12;20(8):e0330101. doi: 10.1371/journal.pone.0330101. eCollection 2025.
INTRODUCTION
An ecosystem approach to child health emphasizes the interconnectedness of environmental, social, and biological factors in shaping children's health and well-being. However, it is not known whether changes in forest cover have an effect on common childhood illnesses. This study investigated the associations between forest cover and acute respiratory infections (ARI), diarrhoea, and fever among children under five in Nepal.
METHOD
This was a cross-sectional study based on the analysis of the Nepal Demographic and Health Surveys (NDHS) datasets of 2011 (N = 5054) and 2016 (N = 4861). Forest cover data for the years 2011 and 2016 were extracted from high-resolution raster images from NASA Earthdata (30m resolution). We employed a logit model on the geo-linked NDHS datasets to compute the marginal effect of forest cover on ARI, diarrhoea, and fever.
RESULTS
From 2011 to 2016, the prevalence of fever increased from 18% to 20%, while the prevalence of diarrhoea decreased from 14% to 7%, and ARI prevalence decreased from 5% to 3%. The mean tree cover percentage also decreased from 21% in 2011 to 19% in 2016. Forest cover was significantly associated with reduced likelihood of diarrhoea symptoms among children in both 2011 and 2016. Change in forest cover between 2011 and 2016 was significantly associated with a reduced probability of diarrhoea by 3.39% (Δy/Δx: -0.0339, 95% CI: -0.0141, -0.0535; p-value: 0.001), after adjusting for all other variables. No significant associations were found between forest cover change and changes in ARI and fever prevalence among children under five.
CONCLUSION
The present results should be interpreted cautiously, as they may not accurately reflect individual-level dynamics regarding the effect of forest cover on child health outcomes. The effect of forest cover in reducing childhood diarrhoea underscores the need for comprehensive child health programs that also incorporate environmental components.
引言
儿童健康的生态系统方法强调环境、社会和生物因素在塑造儿童健康和福祉方面的相互关联性。然而，森林覆盖率的变化是否会对常见的儿童疾病产生影响尚不清楚。本研究调查了尼泊尔五岁以下儿童的森林覆盖率与急性呼吸道感染（ARI）、腹泻和发烧之间的关联。
方法
这是一项横断面研究，基于对2011年（N = 5054）和2016年（N = 4861）尼泊尔人口与健康调查（NDHS）数据集的分析。2011年和2016年的森林覆盖数据是从美国国家航空航天局地球数据（30米分辨率）的高分辨率栅格图像中提取的。我们在地理链接的NDHS数据集上采用逻辑模型来计算森林覆盖率对ARI、腹泻和发烧的边际效应。
结果
从2011年到2016年，发烧患病率从18%上升到20%，而腹泻患病率从14%下降到7%，ARI患病率从5%下降到3%。平均树木覆盖率也从2011年的21%下降到2016年的19%。在2011年和2016年，森林覆盖率与儿童腹泻症状发生可能性的降低均显著相关。在对所有其他变量进行调整后，2011年至2016年森林覆盖率的变化与腹泻概率降低3.39%显著相关（Δy/Δx：-0.0339，95%置信区间：-0.0141，-0.0535；p值：0.001）。未发现五岁以下儿童的森林覆盖率变化与ARI和发烧患病率变化之间存在显著关联。
结论
本研究结果应谨慎解读，因为它们可能无法准确反映森林覆盖率对儿童健康结果影响的个体层面动态。森林覆盖率对减少儿童腹泻的作用凸显了制定全面的儿童健康计划的必要性，这些计划还应纳入环境因素。
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