PDF(Pubmed)
Abstract：
UNASSIGNED: Identifying the critical modifiable risk factors for acute respiratory tract infections (ARIs) and diarrhoea is crucial to reduce the burden of disease and mortality among children under 5 years of age in sub-Saharan Africa (SSA) and ultimately achieving the Sustainable Development Goals (SDGs). We investigated the modifiable risk factors of ARI and diarrhoea among children under five using nationally representative surveys.
UNASSIGNED: We used the most recent demographic and health survey (DHS) data (2014-2021) from 25 SSA countries, encompassing a total of 253,167 children. Countries were selected based on the availability of recent datasets (e.g., DHS-VII or DHS-VIII) that represent the current socioeconomic situations. Generalised linear latent mixed models were used to compute odds ratios (ORs). Population attributable fractions (PAFs) were calculated using adjusted ORs and prevalence estimates for key modifiable risk factors among ARI and diarrhoeal cases.
UNASSIGNED: This study involved 253,167 children, with a mean age of 28.7 (±17.3) months, and 50.5% were male. The highest PAFs for ARI were attributed to unclean cooking fuel (PAF = 15.7%; 95% CI: 8.1, 23.1), poor maternal education (PAF = 13.4%; 95% CI: 8.7, 18.5), delayed initiation of breastfeeding (PAF = 12.4%; 95% CI: 9.0, 15.3), and poor toilets (PAF = 8.5%; 95% CI: 4.7, 11.9). These four modifiable risk factors contributed to 41.5% (95% CI: 27.2, 52.9) of ARI cases in SSA. The largest PAFs of diarrhoea were observed for unclean cooking fuel (PAF = 17.3%; 95% CI: 13.5, 22.3), delayed initiation of breastfeeding (PAF = 9.2%; 95% CI: 7.5, 10.5), household poverty (PAF = 7.0%; 95% CI: 5.0, 9.1) and poor maternal education (PAF = 5.6%; 95% CI: 2.9, 8.8). These four modifiable risk factors contributed to 34.0% (95% CI: 26.2, 42.3) of cases of diarrhoea in SSA.
UNASSIGNED: This cross-sectional study identified four modifiable risk factors for ARI and diarrhoea that should be a priority for policymakers in SSA. Enhancing home-based care and leveraging female community health workers is crucial for accelerating the reduction in under-5 mortality linked to ARI and diarrhoea in SSA.
UNASSIGNED: None.
UNASSIGNED: We used the most recent demographic and health survey (DHS) data (2014-2021) from 25 SSA countries, encompassing a total of 253,167 children. Countries were selected based on the availability of recent datasets (e.g., DHS-VII or DHS-VIII) that represent the current socioeconomic situations. Generalised linear latent mixed models were used to compute odds ratios (ORs). Population attributable fractions (PAFs) were calculated using adjusted ORs and prevalence estimates for key modifiable risk factors among ARI and diarrhoeal cases.
UNASSIGNED: This study involved 253,167 children, with a mean age of 28.7 (±17.3) months, and 50.5% were male. The highest PAFs for ARI were attributed to unclean cooking fuel (PAF = 15.7%; 95% CI: 8.1, 23.1), poor maternal education (PAF = 13.4%; 95% CI: 8.7, 18.5), delayed initiation of breastfeeding (PAF = 12.4%; 95% CI: 9.0, 15.3), and poor toilets (PAF = 8.5%; 95% CI: 4.7, 11.9). These four modifiable risk factors contributed to 41.5% (95% CI: 27.2, 52.9) of ARI cases in SSA. The largest PAFs of diarrhoea were observed for unclean cooking fuel (PAF = 17.3%; 95% CI: 13.5, 22.3), delayed initiation of breastfeeding (PAF = 9.2%; 95% CI: 7.5, 10.5), household poverty (PAF = 7.0%; 95% CI: 5.0, 9.1) and poor maternal education (PAF = 5.6%; 95% CI: 2.9, 8.8). These four modifiable risk factors contributed to 34.0% (95% CI: 26.2, 42.3) of cases of diarrhoea in SSA.
UNASSIGNED: This cross-sectional study identified four modifiable risk factors for ARI and diarrhoea that should be a priority for policymakers in SSA. Enhancing home-based care and leveraging female community health workers is crucial for accelerating the reduction in under-5 mortality linked to ARI and diarrhoea in SSA.
UNASSIGNED: None.
摘要：
确定急性呼吸道感染（ARIs）和腹泻的关键可改变危险因素对于降低撒哈拉以南非洲（SSA）5岁以下儿童的疾病负担和死亡率至关重要，并最终实现可持续发展目标（SDGs）。我们使用全国代表性调查调查了5岁以下儿童ARI和腹泻的可改变危险因素。
■我们使用了来自25个SSA国家的最新人口和健康调查（DHS）数据（2014-2021年），共有253,167名儿童。根据最新数据集的可用性选择了国家(例如，DHS-VII或DHS-VIII）代表当前的社会经济状况。使用广义线性潜在混合模型来计算优势比(OR)。人群归因分数（PAF）使用调整后的OR和患病率估计值计算ARI和腹泻病例中的关键可改变的危险因素。
■这项研究涉及253,167名儿童，平均年龄28.7(±17.3)个月，50.5%为男性。ARI的最高PAF归因于不清洁的烹饪燃料（PAF=15.7％；95％CI：8.1，23.1），产妇教育水平差（PAF=13.4%；95%CI：8.7，18.5），母乳喂养延迟开始（PAF=12.4%；95%CI：9.0，15.3），厕所差（PAF=8.5%；95%CI：4.7，11.9）。这四个可改变的危险因素导致SSA中ARI病例的41.5%(95%CI:27.2,52.9)。观察到腹泻的最大PAF是不清洁的烹饪燃料（PAF=17.3％；95％CI：13.5，22.3），母乳喂养开始延迟（PAF=9.2％；95％CI：7.5，10.5），家庭贫困（PAF=7.0％；95％CI：5.0，9.1）和产妇教育程度低（PAF=5.6％；95％CI：2.9，8.8）。这四个可改变的危险因素导致了34.0%(95%CI:26.2,42.3)的SSA腹泻病例。
这项横断面研究确定了ARI和腹泻的四个可改变的风险因素，这应该是SSA政策制定者的优先事项。加强家庭护理和利用女性社区卫生工作者对于加快降低SSA与急性呼吸道感染和腹泻相关的5岁以下儿童死亡率至关重要。
■无。
■我们使用了来自25个SSA国家的最新人口和健康调查（DHS）数据（2014-2021年），共有253,167名儿童。根据最新数据集的可用性选择了国家(例如，DHS-VII或DHS-VIII）代表当前的社会经济状况。使用广义线性潜在混合模型来计算优势比(OR)。人群归因分数（PAF）使用调整后的OR和患病率估计值计算ARI和腹泻病例中的关键可改变的危险因素。
■这项研究涉及253,167名儿童，平均年龄28.7(±17.3)个月，50.5%为男性。ARI的最高PAF归因于不清洁的烹饪燃料（PAF=15.7％；95％CI：8.1，23.1），产妇教育水平差（PAF=13.4%；95%CI：8.7，18.5），母乳喂养延迟开始（PAF=12.4%；95%CI：9.0，15.3），厕所差（PAF=8.5%；95%CI：4.7，11.9）。这四个可改变的危险因素导致SSA中ARI病例的41.5%(95%CI:27.2,52.9)。观察到腹泻的最大PAF是不清洁的烹饪燃料（PAF=17.3％；95％CI：13.5，22.3），母乳喂养开始延迟（PAF=9.2％；95％CI：7.5，10.5），家庭贫困（PAF=7.0％；95％CI：5.0，9.1）和产妇教育程度低（PAF=5.6％；95％CI：2.9，8.8）。这四个可改变的危险因素导致了34.0%(95%CI:26.2,42.3)的SSA腹泻病例。
这项横断面研究确定了ARI和腹泻的四个可改变的风险因素，这应该是SSA政策制定者的优先事项。加强家庭护理和利用女性社区卫生工作者对于加快降低SSA与急性呼吸道感染和腹泻相关的5岁以下儿童死亡率至关重要。
■无。
