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

李瑞雪; 赖颖斯; 冯晨阳; 郝元涛

doi:10.16462/j.cnki.zhjbkz.2020.01.008

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

doi: 10.16462/j.cnki.zhjbkz.2020.01.008

李瑞雪¹,
赖颖斯^{1, 2},
冯晨阳¹,
郝元涛^{1, 2, ,}

1.
510080 广州, 中山大学公共卫生学院医学统计学系
2.
510275 广州, 中山大学全球卫生研究中心

基金项目: 国家自然科学基金(81703320);广东省自然科学基金(2017A030313704);中华医学基金会公开竞争科研资助项目(17-274)

详细信息

通讯作者:
郝元涛, E-mail:haoyt@mail.sysu.edu.cn

中图分类号: R181
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出版历程
- 收稿日期: 2019-09-08
- 修回日期: 2019-10-25
- 刊出日期: 2020-01-10

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

1.
Department of Medical Statistic, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
2.
Sun Yat-sen Global Health Institute, Sun Yat-sen Universityy Guangzhou 510275, China

Funds: National Natural Science Foundation of China(81703320); Natural Science Foundation of Guangdong Province(2017A030313704); CMB Open Competition program(17-274)

More Information

Corresponding author: HAO Yuan-tao, E-mail:haoyt@mail.sysu.edu.cn

摘要

摘要: 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χ²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。
- Logistic回归分析模型 /
- 儿童腹泻 /
- 影响因素
Abstract: 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(χ²) 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.
- Logistic regression analysis model /
- Diarrhea in children /
- Risk factors

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表 1 尼泊尔各分区2006年、2011年及2016年5岁以下儿童的腹泻情况

Table 1. Diarrhea among children under 5 years of age in 2006, 2011 and 2016 in various regions of Nepal

尼泊尔分区	2006年			2011年			2016年
尼泊尔分区	调查人数 (人)	发病人数 (人)	发病率 (%)	调查人数 (人)	发病人数 (人)	发病率 (%)	调查人数 (人)	发病人数 (人)	发病率 (%)
东部	1 132	154	13.60	979	120	12.26	833	55	6.60
中部	1 251	153	12.23	987	142	14.39	1 144	94	8.22
西部	912	114	12.50	693	110	15.87	853	42	4.92
中西部	885	92	10.40	1 084	158	14.58	1 011	70	6.92
远西部	939	117	12.46	912	104	11.40	637	44	6.91
合计	5 119	630	12.31	4 655	634	13.62	4 478	305	6.81

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表 2 5岁以下儿童腹泻组与非腹泻组特征比较[n(%)]

Table 2. Comparison of characteristics between diarrhea group and non-diarrhea group in children under 5 years old [n(%)]

特征指标	腹泻组 (n=1 569)	非腹泻组 (n=12 780)	χ²/W值	P值
性别			17.88	0.016
男	894(56.98)	6 555(51.29)
女	675(43.02)	6 225(48.71)
水源			3.90	0.048
改良	1 334(85.02)	11 100(86.85)
未改良	235(14.98)	1 680(13.15)
厕所设施			47.79	< 0.001
改良	676(43.08)	6 692(52.36)
未改良	893(56.92)	6 088(47.64)
燃料使用			7.45	0.006
固体	1 362(86.81)	10 751(84.12)
非固体	207(13.19)	2 029(15.88)
与母亲共同生活			3.70	0.055
是	1 567(99.87)	12 714(99.48)
否	2(0.13)	66(0.52)
年龄(岁)^a	1(1, 2)	2(1, 3)	11 418 335	< 0.001
母亲生育该儿童年龄(岁)^a	25(22, 30)	26(23, 30)	8 740 535	< 0.001
母亲受教育年限(年)^a	0(0, 7)	1(0, 8)	9 267 335	0.001
家庭财富指数^ab	-53 521 (-82 933, 8404)	-48 617 (-83 864, 21 580)	9 081 335	0.064
家庭5岁以下儿童数目(人)^a	2(1, 2)	2(1, 2)	8 740 535	0.707
注：^a表示为中位数(四分位间距)；^b家庭财富指数为：DHS通过主成分分析利用家庭资产数据构建的衡量家庭财富水平的指标。

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表 3 尼泊尔5岁以下儿童腹泻Logistic回归分析模型结果

Table 3. Logistic regression analysis model results of diarrhea in children under 5 years old in Nepal

变量	β值	s_x	Z值	OR(95% CI)值	P值
母亲受教育年限	-0.056	0.032	-1.760	0.946(0.888~1.006)	0.078
儿童年龄	-0.489	0.029	-17.141	0.613(0.580~0.648)	< 0.001^a
厕所设施
未改良				1.000
改良	-0.134	0.065	-2.048	0.874(0.769~0.994)	0.041^a
儿童性别
女性				1.000
男性	0.245	0.055	4.458	1.277(1.147~1.422)	< 0.001^a
年份(年)
2006				1.000
2011	0.114	0.062	1.840	1.129(0.999~1.275)	0.066
2016	-0.584	0.080	-7.261	0.560(0.478~0.655)	< 0.001^a
注:^a表示P < 0.05, 差异有统计学意义。

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