在城市几内亚比绍发现高死亡率的儿童子组:探索和验证队列研究
Andreas Rieckmann1, Sebastian Nielsen2,3, Piotr Dworzynski4
1Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
JMIR public health and surveillance
|April 9, 2024
概括
几内亚比绍的儿童死亡率仍然很高,特定的子组面临着更高的风险. 针对某些城市地区的儿童,那些没有预订母亲的儿童,以及那些在干旱季节来自多妻制家庭的儿童的有针对性的干预措施对于减少儿童死亡至关重要.
科学领域:
- 全球健康 全球健康
- 儿科公共卫生 儿科公共卫生
- 流行病学 流行病学
背景情况:
- 全球儿童死亡率有所下降,但在几内亚比绍等低收入国家仍然很高.
- 持续高的儿童死亡率需要确定针对性干预的脆弱子组.
研究的目的:
- 为了确定城市比绍,几内亚比绍的儿童死亡风险较高的子组.
- 为开发有针对性的健康干预提供证据,并为公共卫生政策提供信息.
主要方法:
- 利用了来自比绍,几内亚比绍的班迪姆健康项目 (2003-2019) 的数据.
- 采用空间分析,因果调整回归和机器学习来识别风险因素和子组.
- 应用目标最大概率估计 (TMLE) 来进行可靠的因果模型,对高达3岁的死亡风险进行分析.
主要成果:
- 分析了21,005名儿童的数据;死亡风险从5.2% (2003-2011) 降至2.9% (2012-2016).
- 确定了三个高风险子组:特定城市地区的儿童,没有产前护理的母亲生下的儿童,以及在干旱季节出生的多妻家庭的儿童.
- 这些子组的死亡风险始终较高,社会和经济因素对整体儿童死亡造成了重大影响.
结论:
- 结果强调了针对特定高风险子组的特定风险的有针对性的干预措施的必要性.
- 干预措施应补充一般公共卫生战略,以实现减少儿童死亡率的综合方法.
- 未来的研究应该专注于开发,测试和比较有针对性的干预策略,以优化儿童健康结果.
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