背景:尽管在降低5岁以下儿童死亡率方面取得了重大进展,四分之三的五岁以下儿童死亡仍然是由肺炎等可预防的疾病造成的,腹泻,疟疾,新生儿问题。儿童疾病的社区综合病例管理(ICCM)可以作为降低低收入和中等收入国家可预防儿童死亡率的一种手段。我们的目的是评估埃塞俄比亚ICCM利用的总体水平及其相关因素。
方法:纳入本综述的候选研究是通过对各种数据库的搜索确定的。包括PubMed,EMBASE,谷歌学者,和大学存储库在线数据库,从2024年2月1日到2024年3月18日。使用纽卡斯尔-渥太华质量评估量表(NOS)对纳入本系统评价和荟萃分析的研究进行质量评估。使用MicrosoftExcel和Stata17软件进行数据提取和分析。分别。使用Cochran的Q检验和I2统计来评估研究之间的异质性,而发表偏倚的存在是通过漏斗图和Egger回归不对称检验来评估的。根据样本量和研究地点进行亚组分析。
结果:在这项研究中,ICCM利用率的汇总水平为42.73(95%,CI27.65%,57.80%)基于从十项主要研究中获得的证据。在这次审查中,父母对疾病的认识(OR=2.77,95%,CI2.06、3.74),对ICCM服务的认识(OR=3.64,95%,CI2.16、6.14),感知到的疾病严重程度(OR=3.14,95%,CI2.33、4.23),中等/以上教育水平(OR=2.57,95%,CI1.39、4.77),并住在距卫生站30分钟以内(OR=3.93,95%,CI2.30,6.74)是与埃塞俄比亚ICCM利用率显着相关的变量。
结论:发现埃塞俄比亚的ICCM利用率较低。诸如父母对疾病的认识等因素,ICCM服务知识,感知疾病的严重程度,参加中等教育或更高水平的教育,和生活在距离卫生站30分钟内与ICCM的利用显着相关。因此,至关重要的是,要注重提高认识和改善获得高质量ICCM服务的机会,以减少可预防原因造成的儿童发病率和死亡率。
BACKGROUND: Despite significant progress being made in reducing under-five mortality, three-fourths of under-five deaths are still caused by preventable conditions such as pneumonia, diarrhea, malaria, and newborn issues. Integrated community case management of childhood illnesses (ICCM) could serve as a means to reduce preventable child mortality in Low- and Middle-Income countries. Our aim was to assess the overall level of ICCM utilization and its associated factors in Ethiopia.
METHODS: Candidate studies for inclusion in this review were identified through searches across various databases, including PubMed, EMBASE, Google Scholar, and university repositories online databases, spanning from February 1, 2024, to March 18, 2024. The quality assessment of the studies included in this systematic review and meta-analysis was conducted using the Newcastle-Ottawa Quality Assessment Scale (NOS). Data extraction and analysis were carried out using Microsoft Excel and Stata 17 software, respectively. Heterogeneity among the studies was assessed using Cochran\'s Q test and I2 statistics, while the presence of publication bias was evaluated through funnel plots and Egger\'s regression asymmetry test. Subgroup analysis was performed based on sample size and study site.
RESULTS: In this study, the pooled level of ICCM utilization was found to be 42.73 (95%, CI 27.65%, 57.80%) based on the evidence obtained from ten primary studies. In this review, parents\' awareness about illness (OR = 2.77, 95%, CI 2.06, 3.74), awareness about ICCM service (OR = 3.64, 95%, CI 2.16, 6.14), perceived severity of the disease (OR = 3.14, 95%, CI 2.33, 4.23), secondary/above level of education (OR = 2.57, 95%, CI 1.39, 4.77), and live within 30 min distance to the health post (OR = 3.93, 95%, CI 2.30, 6.74) were variables significantly associated with utilization of ICCM in Ethiopia.
CONCLUSIONS: The utilization of ICCM was found to be low in Ethiopia. Factors such as parents\' awareness about the illness, knowledge of ICCM services, perceived severity of the disease, attending a secondary or more level of education, and living within 30 min distance to the health post were significantly associated with the utilization of ICCM. Therefore, it is crucial to focus on creating awareness and improving access to high-quality ICCM services to reduce child morbidity and mortality from preventable causes.