PDF(Pubmed)
Abstract：
BACKGROUND: The Joint Monitoring Program (JMP) for water supply and sanitation developed by the WHO and UNICEF defines safe child feces disposal practices as either burial or defecation into a toilet. Children become exposed to fecal-oral illnesses when their stools are not disposed of appropriately, and this vulnerability persists until all children\'s stools are properly disposed of. Data on the elements influencing child feces disposal in East Africa is scarce. Hence, this study aimed to assess the prevalence and associated factors of safe child feces disposal in East Africa.
METHODS: Data from the Demographic and Health Surveys, which were collected between 2015 and 2022 in 10 East African nations, were used in this analysis. For a weighted 44,821 children under the age of two, we examined additional features as well as how child feces were disposed of. Both bivariable and multivariable multilevel logistic regression were carried out to choose potential components and identify important explanatory variables connected to the outcome variable. With 95% confidence intervals, adjusted odd ratios (AORs) were used to present the results. P values of ≤ 0.2 and < 0.05 were used to investigate significant factors in the binary and multivariable multilevel logistic regression models respectively.
RESULTS: Approximately 65.54% (95% CI: 65.10, 65.98) of children\'s waste was disposed of properly. Women age from 35 to 49 years (AOR = 1.12, 95% CI: 1.05-1.19) 15-24 years old, primary (AOR = 1.62, 95% CI, 1.53,1.72), and secondary/higher education (AOR = 1.22, 95% CI, 1.14,1.31), women from highly educated community (AOR = 1.33, 95% CI, 1.22,1.46), employed (AOR = 1.29, 95% CI, 1.24,1.35), poorer(AOR = 1.51,95% CI, 1.42,1.61), middle(AOR = 1.67, 95% CI, 1.56,1.78), richer(AOR = 1.96,95% CI, 1.82,2.11), and richest(AOR = 2.08, 95% CI, 1.91,2.27), mass media exposure (AOR = 1.37,95% CI,1.31,1.44), community level mass media exposure (AOR = 1.23, 95% CI, 1.34,1.34), had ANC visit(AOR = 1.71, 95% CI, 1.55,1.88), modern contraceptive(AOR = 1.17, 95% CI, 1.12,1.23), health institution delivery (AOR = 2.22, 95% CI, 2.09,2.34), had an improved toilet facility (AOR = 1.12, 95% CI, 1.07,1.17), children who\'s their age group from 6 to 11 months old, (AOR = 2.12, 95% CI, 2.01,2.25) and 12-23 months old (AOR = 3.10,95% CI, 2.94,3.27) were the factors associated with higher odds of safe child feces disposal as compared to less than six months old children respectively. Finally, women from high community poverty level (AOR = 0.87, 95% CI, 0.79,0.95), and rural women were the factors associated with lower odds of safe child feces disposal (AOR = 0.91, 95% CI 0.85-0.98) compared to their counterparts respectively.
CONCLUSIONS: East Africa has a Slightly lower proportion of properly disposing of child feces. There was a strong correlation between characteristics such as residence, mother\'s age, education level, work status, place of delivery, ANC visit, child\'s age, wealth index, media exposure, and poverty. Acting on these factors and strengthening and using links between mother and child health care is, thus, strongly advocated.
METHODS: Data from the Demographic and Health Surveys, which were collected between 2015 and 2022 in 10 East African nations, were used in this analysis. For a weighted 44,821 children under the age of two, we examined additional features as well as how child feces were disposed of. Both bivariable and multivariable multilevel logistic regression were carried out to choose potential components and identify important explanatory variables connected to the outcome variable. With 95% confidence intervals, adjusted odd ratios (AORs) were used to present the results. P values of ≤ 0.2 and < 0.05 were used to investigate significant factors in the binary and multivariable multilevel logistic regression models respectively.
RESULTS: Approximately 65.54% (95% CI: 65.10, 65.98) of children\'s waste was disposed of properly. Women age from 35 to 49 years (AOR = 1.12, 95% CI: 1.05-1.19) 15-24 years old, primary (AOR = 1.62, 95% CI, 1.53,1.72), and secondary/higher education (AOR = 1.22, 95% CI, 1.14,1.31), women from highly educated community (AOR = 1.33, 95% CI, 1.22,1.46), employed (AOR = 1.29, 95% CI, 1.24,1.35), poorer(AOR = 1.51,95% CI, 1.42,1.61), middle(AOR = 1.67, 95% CI, 1.56,1.78), richer(AOR = 1.96,95% CI, 1.82,2.11), and richest(AOR = 2.08, 95% CI, 1.91,2.27), mass media exposure (AOR = 1.37,95% CI,1.31,1.44), community level mass media exposure (AOR = 1.23, 95% CI, 1.34,1.34), had ANC visit(AOR = 1.71, 95% CI, 1.55,1.88), modern contraceptive(AOR = 1.17, 95% CI, 1.12,1.23), health institution delivery (AOR = 2.22, 95% CI, 2.09,2.34), had an improved toilet facility (AOR = 1.12, 95% CI, 1.07,1.17), children who\'s their age group from 6 to 11 months old, (AOR = 2.12, 95% CI, 2.01,2.25) and 12-23 months old (AOR = 3.10,95% CI, 2.94,3.27) were the factors associated with higher odds of safe child feces disposal as compared to less than six months old children respectively. Finally, women from high community poverty level (AOR = 0.87, 95% CI, 0.79,0.95), and rural women were the factors associated with lower odds of safe child feces disposal (AOR = 0.91, 95% CI 0.85-0.98) compared to their counterparts respectively.
CONCLUSIONS: East Africa has a Slightly lower proportion of properly disposing of child feces. There was a strong correlation between characteristics such as residence, mother\'s age, education level, work status, place of delivery, ANC visit, child\'s age, wealth index, media exposure, and poverty. Acting on these factors and strengthening and using links between mother and child health care is, thus, strongly advocated.
摘要：
背景：世卫组织和联合国儿童基金会制定的供水和卫生联合监测计划（JMP）将安全的儿童粪便处理方法定义为埋葬或排便到厕所。当孩子的粪便没有得到适当的处理时，他们就会面临粪便-口腔疾病，这个漏洞一直存在，直到所有儿童的凳子都得到妥善处理。关于影响东非儿童粪便处理的因素的数据很少。因此，本研究旨在评估东非儿童粪便安全处理的患病率和相关因素.
方法：来自人口和健康调查的数据，2015年至2022年在10个东非国家收集，在此分析中使用。对于加权的44,821名两岁以下儿童，我们检查了其他特征以及儿童粪便的处理方式。进行了双变量和多变量多水平逻辑回归，以选择潜在成分并确定与结果变量相关的重要解释变量。95%的置信区间，调整后的奇数比率(AORs)用于呈现结果。P值≤0.2和<0.05分别用于调查二元和多变量多水平logistic回归模型中的重要因素。
结果：大约65.54%（95%CI：65.10，65.98）的儿童废物得到了妥善处理。女性年龄从35到49岁（AOR=1.12，95％CI：1.05-1.19）15-24岁，主要(AOR=1.62，95%CI，1.53，1.72)，和中等/高等教育(AOR=1.22，95%CI，1.14，1.31)，来自高学历社区的女性(AOR=1.33，95%CI，1.22，1.46)，受雇(AOR=1.29，95%CI，1.24，1.35)，较差（AOR=1.51,95%CI，1.42,1.61），中等(AOR=1.67，95%CI，1.56,1.78)，更丰富(AOR=1.96,95%CI，1.82,2.11)，和最富有(AOR=2.08，95%CI，1.91，2.27)，大众媒体暴露(AOR=1.37,95%CI，1.31,1.44)，社区层面的大众媒体暴露(AOR=1.23，95%CI，1.34，1.34)，进行了ANC访问(AOR=1.71，95%CI，1.55,1.88)，现代避孕药(AOR=1.17，95%CI，1.12，1.23)，医疗机构分娩(AOR=2.22，95%CI，2.09，2.34)，厕所设施有所改善(AOR=1.12，95%CI，1.07,1.17)，他们的年龄组从6到11个月大的儿童，（AOR=2.12，95％CI，2.01，2.25）和12-23月龄（AOR=3.10，95％CI，2.94，3.27）是与小于6个月儿童相比，安全处理儿童粪便的几率较高的相关因素。最后,来自高社区贫困水平的妇女(AOR=0.87，95%CI，0.79，0.95)，和农村妇女是与儿童粪便安全处理几率较低的相关因素(AOR=0.91,95%CI0.85-0.98).
结论：东非对儿童粪便的妥善处理比例略低。居住等特征之间存在很强的相关性，母亲的年龄，教育水平,工作状态,交货地点,ANC访问，孩子的年龄，财富指数，媒体曝光,和贫困。根据这些因素采取行动，加强和利用母亲和儿童保健之间的联系，因此，大力提倡。
方法：来自人口和健康调查的数据，2015年至2022年在10个东非国家收集，在此分析中使用。对于加权的44,821名两岁以下儿童，我们检查了其他特征以及儿童粪便的处理方式。进行了双变量和多变量多水平逻辑回归，以选择潜在成分并确定与结果变量相关的重要解释变量。95%的置信区间，调整后的奇数比率(AORs)用于呈现结果。P值≤0.2和<0.05分别用于调查二元和多变量多水平logistic回归模型中的重要因素。
结果：大约65.54%（95%CI：65.10，65.98）的儿童废物得到了妥善处理。女性年龄从35到49岁（AOR=1.12，95％CI：1.05-1.19）15-24岁，主要(AOR=1.62，95%CI，1.53，1.72)，和中等/高等教育(AOR=1.22，95%CI，1.14，1.31)，来自高学历社区的女性(AOR=1.33，95%CI，1.22，1.46)，受雇(AOR=1.29，95%CI，1.24，1.35)，较差（AOR=1.51,95%CI，1.42,1.61），中等(AOR=1.67，95%CI，1.56,1.78)，更丰富(AOR=1.96,95%CI，1.82,2.11)，和最富有(AOR=2.08，95%CI，1.91，2.27)，大众媒体暴露(AOR=1.37,95%CI，1.31,1.44)，社区层面的大众媒体暴露(AOR=1.23，95%CI，1.34，1.34)，进行了ANC访问(AOR=1.71，95%CI，1.55,1.88)，现代避孕药(AOR=1.17，95%CI，1.12，1.23)，医疗机构分娩(AOR=2.22，95%CI，2.09，2.34)，厕所设施有所改善(AOR=1.12，95%CI，1.07,1.17)，他们的年龄组从6到11个月大的儿童，（AOR=2.12，95％CI，2.01，2.25）和12-23月龄（AOR=3.10，95％CI，2.94，3.27）是与小于6个月儿童相比，安全处理儿童粪便的几率较高的相关因素。最后,来自高社区贫困水平的妇女(AOR=0.87，95%CI，0.79，0.95)，和农村妇女是与儿童粪便安全处理几率较低的相关因素(AOR=0.91,95%CI0.85-0.98).
结论：东非对儿童粪便的妥善处理比例略低。居住等特征之间存在很强的相关性，母亲的年龄，教育水平,工作状态,交货地点,ANC访问，孩子的年龄，财富指数，媒体曝光,和贫困。根据这些因素采取行动，加强和利用母亲和儿童保健之间的联系，因此，大力提倡。
