A multilevel analysis of lifestyle variations in symptoms of acute respiratory infection among young children under five in Nigeria
A multilevel analysis of lifestyle variations in symptoms of acute respiratory infection among young children under five in Nigeria
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DOI：
10.1186/s12889-016-3565-0
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发表时间：
2016-08-25
影响因子：
4.5
通讯作者：
Chiao, Chi
中科院分区：
文献类型：
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作者：
Adesanya, Oluwafunmilade A.;Chiao, Chi
背景：尼日利亚五岁以下儿童因急性呼吸道感染 (ARI) 死亡的估计人数位居世界第二。一个常见的假设是，社会经济资源的不公平分配塑造了个人的生活方式和健康行为，从而导致健康状况恶化，包括急性呼吸道感染的症状。本研究考察了生活方式因素是否与尼日利亚 5 岁以下儿童的 ARI 风险相关，同时考虑了个人层面和背景层面的风险因素。方法：数据来自具有全国代表性的 2013 年尼日利亚人口和健康调查。对居住在 896 个社区的 28,596 名 5 岁或以下幸存儿童进行了分析。我们采用两级多级逻辑回归来模拟生活方式因素与 ARI 症状之间的关系。 结果：多级回归的多变量结果表明，许多生活方式因素（例如室内生物质烹饪（OR = 2.30；p < 0.01）和不洗手（OR = 1.66；p < 0.001））会增加出现 ARI 症状的几率。急性呼吸道感染症状的风险增加也与居住在西北地区和孤儿/弱势儿童比例较高的社区显着相关（OR = 1.74；p < 0.001）。 结论：我们的研究结果强调了尼日利亚儿童在其居住社区内的生活方式高于其个人特征的重要性。旨在减少急性呼吸道感染症状的基于计划的战略应考虑包括提供基本住房标准、提供改进的炉灶和增强健康行为的政策。
Background: Nigeria has the second highest estimated number of deaths due to acute respiratory infection (ARI) among children under five in the world. A common hypothesis is that the inequitable distribution of socioeconomic resources shapes individual lifestyles and health behaviors, which leads to poorer health, including symptoms of ARI. This study examined whether lifestyle factors are associated with ARI risk among Nigerian children aged less than 5 years, taking individual-level and contextual-level risk factors into consideration.Methods: Data were obtained from the nationally representative 2013 Nigeria Demographic and Health Survey. A total of 28,596 surviving children aged 5 years or younger living in 896 communities were analyzed. We employed two-level multilevel logistic regressions to model the relationship between lifestyle factors and ARI symptoms.Results: The multivariate results from multilevel regressions indicated that the odds of having ARI symptoms were increased by a number of lifestyle factors such as in-house biomass cooking (OR = 2.30; p < 0.01) and no hand-washing (OR = 1.66; p < 0.001). An increased risk of ARI symptoms was also significantly associated with living in the North West region and the community with a high proportion of orphaned/vulnerable children (OR = 1.74; p < 0.001).Conclusions: Our findings underscore the importance of Nigerian children's lifestyle within the neighborhoods where they reside above their individual characteristics. Program-based strategies that are aimed at reducing ARI symptoms should consider policies that embrace making available basic housing standards, providing improved cooking stoves and enhancing healthy behaviors.