斯里兰卡五岁以下儿童死亡率的决定因素:2016年斯里兰卡国土安全部数据的多层次分析
Kaludura Anupama Seuwandi Thabrew1, Marina Roshini Sooriyarachchi2, Dushantha Nalin K Jayakody3,4
1Faculty of Arts & Science, Sri Lanka Technological Campus, Padukka, Sri Lanka.
PloS one
|September 8, 2023
概括
斯里兰卡的五岁以下儿童死亡率 (U5M) 受到非母乳养,多胎和母亲病史等因素的显著影响. 一个多层次模型准确地预测了U5M,强调了针对性母亲教育和干预的需要.
科学领域:
- 公共卫生 公共卫生
- 生物统计学 生物统计学
- 流行病学 流行病学
背景情况:
- 五岁以下儿童死亡率 (U5M) 是一个国家的发展和公共健康的关键指标.
- 确定U5M的预后因素对于实施有效的公共卫生干预至关重要.
- 斯里兰卡的人口和健康调查 (DHS) 为分析儿童死亡率趋势提供了有价值的数据.
研究的目的:
- 分析与斯里兰卡五岁以下死亡率 (U5M) 相关的预后因素.
- 为了比较二元物流回归模型 (BLRM) 和二元物流随机拦截多层模型 (BLRIMM) 的预测精度.
- 在斯里兰卡背景下,确定影响U5M的关键风险和保护因素.
主要方法:
- 利用了2016年斯里兰卡人口和健康调查 (DHS) 的数据,其中包括8123名儿童.
- 采用了二进制逻辑回归模型 (BLRM) 和二进制逻辑随机截取多层模型 (BLRIMM).
- 对比了两个统计模型的预测百分比,以评估它们的准确性.
主要成果:
- 二元物流随机拦截多层模型 (BLRIMM) 显示出比BLRM (98.31%) 更高的预测准确度 (98.67%).
- 对于U5M的显著风险因素包括没有母乳养 (OR = 116.74),多胎 (OR = 3.73),非正常分娩 (OR = 1.86),母体流产/婴儿丧失史 (OR = 2.27) 和较高的母体BMI (OR = 1.05).
- 来自佛教,印度教和罗马天主教家庭的孩子与其他宗教团体相比,U5M的几率明显较低. 在U5M中观察到显著的未观察到的集群水平变化 (p=0.0405).
结论:
- BLRIMM是一个更准确的模型,用于预测斯里兰卡的U5M.
- 对健康的生活方式,母乳养,安全分娩和照顾孩子的母亲教育至关重要.
- 解决与宗教有关的差异和改善孕产妇健康指标对于减少U5M至关重要.
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