埃塞俄比亚五岁以下儿童维生素A补充剂覆盖率及相关因素：一项系统评价与荟萃分析

Vitamin A supplementation coverage and associated factors among Ethiopian children under five years: a systematic review and meta-analysis.

作者信息

Yirdaw Berhanu Wale, Moges Abrham Maru, Awoke Setargew Kebie, Agmas Maritu Ayalew, Mekonen Asmare Yimer, Abebe Abusew Yehuala, Gebiru Ashebir Mamay, Beyene Jember Ayelgne, Yimer Bimrew Bayuh

机构信息

Department of Pediatrics and Child Health Nursing, Teda Health Science College, P.O.BOX: 790, Gondar, Amhara, Ethiopia.

Department of Psychiatry, Teda Health Science College, Gondar, Amhara, Ethiopia.

出版信息

BMC Pediatr. 2025 Sep 24;25(1):693. doi: 10.1186/s12887-025-06030-8.

DOI:10.1186/s12887-025-06030-8

PMID:40993632

Abstract

BACKGROUND

Vitamin A deficiency remains a critical public health issue in Ethiopian children under five years, significantly contributing to increased morbidity and mortality. Despite national supplementation programs, coverage is low and regionally varied. This systematic review and meta-analysis aimed to synthesize existing evidence on vitamin A supplementation coverage and associated factors in Ethiopian children under five, crucial for enhancing child health interventions.

METHODS

A comprehensive literature search was conducted across PubMed, Medline, HINARI, EMBASE, Web of Science, Scopus, and Google Scholar from March 25 to April 17, 2025, adhering to PRISMA guidelines. Additional studies were identified through reference checking. Eligibility criteria guided article selection, and study quality was assessed using the Newcastle-Ottawa Scale. Publication bias was evaluated via Funnel plot inspection and Egger's test, while heterogeneity was assessed using Cochrane Q and I² tests. A random effects meta-analysis in STATA 17 computed the pooled estimate of vitamin A supplementation practice.

RESULTS

Our review included a total of 11 studies, encompassing 32,361 study participants. The meta-analysis revealed that the overall coverage of vitamin A supplementation among children under the age of five years in Ethiopia was 53.43% (95% CI: 42.81-64.05). Key factors significantly associated with vitamin A supplementation coverage included family wealth status, maternal antenatal care (ANC) visits, mothers' access to vitamin A information, and mothers' educational status.

CONCLUSION

This systematic review and meta-analysis confirmed that vitamin A supplementation coverage in Ethiopia is critically low, standing at just 53.43%. This falls well below the 95% national target and the 80% WHO and UNICEF threshold, highlighting an urgent need for intensified interventions. Our findings offer clear guidance for policymakers and public health implementers: focus on empowering mothers through education and information, promoting consistent antenatal care (ANC) attendance, and addressing socioeconomic disparities to significantly boost national vitamin A supplementation coverage.

TRIAL REGISTRATION

PROSPERO registration number: CRD420251017115.

摘要

背景

维生素A缺乏仍然是埃塞俄比亚5岁以下儿童面临的一个关键公共卫生问题，对发病率和死亡率的上升有重大影响。尽管有国家补充计划，但覆盖率较低且存在地区差异。本系统评价和荟萃分析旨在综合关于埃塞俄比亚5岁以下儿童维生素A补充覆盖率及相关因素的现有证据，这对于加强儿童健康干预措施至关重要。

方法

2025年3月25日至4月17日，按照PRISMA指南，在PubMed、Medline、HINARI、EMBASE、Web of Science、Scopus和谷歌学术上进行了全面的文献检索。通过参考文献检查确定了其他研究。入选标准指导文章选择，使用纽卡斯尔-渥太华量表评估研究质量。通过漏斗图检查和埃格检验评估发表偏倚，使用Cochrane Q和I²检验评估异质性。在STATA 17中进行随机效应荟萃分析，计算维生素A补充实践的合并估计值。

结果

我们的综述共纳入11项研究，涉及32361名研究参与者。荟萃分析显示，埃塞俄比亚5岁以下儿童维生素A补充的总体覆盖率为53.43%（95%CI：42.81-64.05）。与维生素A补充覆盖率显著相关的关键因素包括家庭财富状况、孕产妇产前检查（ANC）次数、母亲获取维生素A信息的情况以及母亲的教育程度。

结论

本系统评价和荟萃分析证实，埃塞俄比亚维生素A补充的覆盖率极低，仅为53.43%。这远低于95%的国家目标以及世界卫生组织和联合国儿童基金会80%的阈值，凸显了加强干预措施的迫切需求。我们的研究结果为政策制定者和公共卫生实施者提供了明确指导：专注于通过教育和信息增强母亲的能力，促进持续进行产前检查（ANC），并解决社会经济差距，以显著提高国家维生素A补充的覆盖率。