基于DHS数据库探究尼泊尔5岁以下儿童腹泻流行趋势及其影响因素

The epidemic trend and influencing factors of diarrhea in children under 5 years old in Nepal based on the demographic and health survey data

目的描述尼泊尔5岁以下儿童腹泻现状,并探讨其影响因素。方法数据来源于尼泊尔人口与健康调查公共数据库中2006年、2011年和2016年尼泊尔全国调查问卷。描述尼泊尔各地区三年的儿童腹泻情况。通过χ~2检验、秩和检验和Logistic回归分析模型进行分析,探讨尼泊尔5岁以下儿童腹泻发病影响因素。结果2006年、2011年和2016年尼泊尔5岁以下儿童腹泻总体发病率分别是12.3%、13.3%和6.8%,呈下降趋势,各地区发病率的变化略有不同。单因素分析结果显示儿童性别、年龄、母亲生育该儿童年龄、母亲受教育年限、水源、厕所设施和燃料类型等因素在腹泻儿童与未腹泻儿童中差异有统计学意义(均有P<0.05)。多因素Logistic回归分析模型分析显示改良厕所设施(OR=0.874,95%CI:0.769~0.994,P=0.041)和儿童年龄(OR=0.613,95%CI:0.580~0.648,P<0.001)是尼泊尔5岁以下儿童腹泻的保护因素,而男性儿童发病风险高于女性(OR=1.277,95%CI:1.147~1.422,P<0.001)。结论2006-2016年尼泊尔5岁以下儿童腹泻发病率呈下降趋势,厕所设施、儿童年龄和儿童性别是儿童腹泻的影响因素。

Objective To describe the current situation of diarrhea in children under five years old in Nepal and to explore its influencing factors.Methods Data were collected from the open-access database,Nepal Demographic and Health Surveys in 2006,2011 and 2016.Chi-square(χ~2)and Wilcoxon rank sum test were used to compare difference of potential risk factors between groups with and without diarrhea.Multiple Logistic regression model was adopted to identify significant influencing factors on diarrhea in children under five years old in Nepal.Results In 2006,2011 and 2016,the incidence of diarrhea children under five in Nepal was 12.3%,13.3%and 6.8%,respectively.Univariate analysis of the potential influencing factors showed that there were significant differences in the gender,water source,toilet facilities and fuel type,age of children,age of mother when she gave birth to the child and education years of mother and children with and without diarrhea(all P<0.05).Multiple analysis revealed that improved toilet facilities(OR=0.874,95%CI:0.769-0.994,P=0.041)and the age of children(OR=0.613,95%CI:0.580-0.645,P<0.001)were protective factors of childhood diarrhea,and the risk of boys was higher than that of girls(OR=1.277,95%CI:1.147-1.423,P<0.001).Conclusions From 2006 to 2016,the incidence of diarrhea in children under five years old in Nepal was decreasing.Toilet facilities,age of children and gender of children were identified as the influencing factors of childhood diarrhea.