背景:在埃塞俄比亚,五岁以下儿童的死亡率是一个公共卫生问题。遗憾的是,这个问题被明显低估和低估,这使得人们无法充分认识到国家发展中地区的局势有多严重。不幸的是,没有一项研究揭示埃塞俄比亚牧区5岁以下儿童死亡率和预测因素。因此,本研究的目的是确定导致埃塞俄比亚牧区5岁以下儿童生存至死亡时间缩短的关键变量。
方法:2016年1月18日至6月27日,对埃塞俄比亚牧区5岁以下儿童进行了回顾性随访研究。使用对数秩检验显示了分类预测因子之间的统计显着差异,采用Kaplan-Meier生存曲线确定生存时间。为了确定五岁以下儿童的死亡时间预测因素,拟合双变量和多变量的Cox比例风险(PH)模型分析。
结果:总共7,677名儿童被纳入研究。5岁以下儿童死亡率总发生率为8.4%(95%CI7.77%,9.0%)。在多变量CoxPH模型分析中,接种疫苗的儿童(AHR:0.72,95%CI:0.59,0.88),35-40岁的母亲(AHR:1.27;95%CI:1.06,1.52),高于41(AHR:2.18,95%CI:1.59,2.98),不开始纯母乳喂养(AHR:1.26,95%CI:1.02,1.55),母亲职业的农业部门(AHR:2.57,95%CI:1.74,3.31),户主的男性性别(AHR:0.67,95%CI:0.56,0.81),非贫血儿童(AHR:0.67,95%CI:0.55,0.83),和农村居住地(AHR:3.27,95%CI:1.45,7.38)被确定为5岁以下儿童死亡时间的主要预测因子。
结论:在这项研究中,作者发现五岁以下儿童的死亡率高于全国数字。一名儿童接种了疫苗,纯母乳喂养,母亲的职业,户主的性别,贫血的孩子,母亲的年龄,和居住地被认为是死亡时间最有影响力的预测因素。因此,为了降低五岁以下儿童死亡率的高发生率,政府应该把重点放在埃塞俄比亚的牧区州。
BACKGROUND: In Ethiopia, the mortality rate for children under five is a public health concern. Regretfully, the problem is notably underestimated and underreported, making it impossible to fully recognize how serious the situation is in the nation\'s developing regions. Unfortunately, no single study has been conducted to reveal the rates and predictor factors of under-five child death in Ethiopia\'s pastoral regions. Therefore, the purpose of this study was to determine the critical variables that led to a shorter survival time to death for children in Ethiopia\'s pastoral regions under the age of five.
METHODS: Between January 18 and June 27, 2016, a retrospective follow-up study was done among under-five children in pastoral areas of Ethiopia. The statistically significant difference between categorical predictors was shown using the log-rank test, and the Kaplan-Meier survival curve was used to determine the survival time. In order to identify the time-to-death predictor factors in children under five, Cox proportional hazards (PH) model analyses of bivariable and multivariable variables were fitted.
RESULTS: A total 7,677 children were included in the study. The overall incidence rate of under-five mortality was 8.4% (95% CI 7.77%, 9.0%). In the multivariable Cox PH model analysis, children vaccinated (AHR: 0.72, 95% CI: 0.59, 0.88), mothers aged 35-40 (AHR: 1.27; 95% CI: 1.06, 1.52), and above 41 (AHR: 2.18, 95% CI: 1.59, 2.98), not initiating exclusively breastfeeding (AHR: 1.26, 95% CI: 1.02, 1.55), the agriculture sector of the mother\'s occupation (AHR: 2.57, 95% CI: 1.74, 3.31), the male sex of the household head (AHR: 0.67, 95% CI: 0.56, 0.81), non-anemic child (AHR: 0.67, 95% CI: 0.55, 0.83), and rural residence (AHR: 3.27, 95% CI: 1.45, 7.38) were identified as main predictors of time to death among under-five children.
CONCLUSIONS: In this study, the authors found a higher rate of under-five deaths than the national figure. A child vaccinated, exclusively breastfeeding, mother\'s occupation, sex of household head, anemic child, mother\'s age, and residence were found to be the most influential predictors for time-to-death. Therefore, to lower the high incidence of under-five mortality, the government should focus on the pastoral regional states of Ethiopia.