Population attributable risk of key modifiable risk factors associated with non-exclusive breastfeeding in Nigeria

被引:27
作者
Ogbo, Felix Akpojene [1 ,3 ]
Page, Andrew [1 ]
Idoko, John [2 ]
Agho, Kingsley E. [1 ,4 ]
机构
[1] Western Sydney Univ, Sch Med, Translat Hlth Res Inst, Campbelltown Campus,Locked Bag 1797, Penrith, NSW 2571, Australia
[2] Univ Jos, Fac Med Sci, Dept Med, PMB 2084, Jos, Plateau State, Nigeria
[3] Prescot Specialist Med Ctr, Makurdi, Benue State, Nigeria
[4] Western Sydney Univ, Sch Sci & Hlth, Campbelltown Campus,Locked Bag 1797, Penrith, NSW 2571, Australia
关键词
Infant; Nigeria; Non-exclusive breastfeeding; Population attributable risk; GLOBAL BURDEN; SYSTEMATIC ANALYSIS; LIFE-STYLE; DISEASE; CANCER; DETERMINANTS; PROPORTION; STATE;
D O I
10.1186/s12889-018-5145-y
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: Non-exclusive breastfeeding (non-EBF) is a risk factor for many of the 2300 under-five deaths occurring daily in Nigeria -a developing country with approximately 40 million children. This study aimed to quantify and compare the attributable burden of key modifiable risk factors associated with non-EBF in Nigeria to inform strategic policy responses and initiatives. Methods: Relative risk and exposure prevalence for selected modifiable risk factors were used to calculate population attributable fractions based on Nigeria Demographic and Health Surveys data for the period (1999-2013). Scenarios based on feasible impact of community-based interventions in reducing exposure prevalence were also considered to calculate comparative potential impact fractions. Results: In Nigeria, an estimated 22.8% (95% Confidence Interval, CI: 9.2-37.0%) of non-EBF was attributable to primary and no maternal education; 24.7% (95% CI: 9.5-39.5%) to middle and poor household wealth, 9.7% (1.7-18.1%) to lower number (1-3) and no antenatal care visits; 18.8% (95% CI: 6.9-30.8%) to home delivery and 16.6% (95% CI: 3.0-31.3%) to delivery assisted by a non-health professional. In combination, more than half of all cases of non-EBF (64.5%; 95% CI: 50.0-76.4%) could be attributed to those modifiable risk factors. Scenarios based on feasible impacts of community-based approaches to improve health service access and human capacity suggest that an avoidable burden of non-EBF practice of approximately 11% (95% CI: -5.4; 24.7) is achievable. Conclusion: Key modifiable risk factors contribute significantly to non-EBF in Nigerian women. Community-based initiatives and appropriate socio-economic government policies that specifically consider those modifiable risk factors could substantially reduce non-EBF practice in Nigeria.
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页数:9
相关论文
共 58 条
[11]  
[Anonymous], ROUX PRIZ ACT DAT SE
[12]  
[Anonymous], MILL DEV GOALS PERF
[13]  
[Anonymous], 2010, CONS REP 6 COUNTR RE
[14]  
Barendregt J J., 2009, Ersatz User Guide
[15]   Categorical versus continuous risk factors and the calculation of potential impact fractions [J].
Barendregt, Jan J. ;
Veerman, J. Lennert .
JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, 2010, 64 (03) :209-212
[16]  
Benichou J., 1998, Attributable risk, P216
[17]   Population attributable risk of breast cancer in white women associated with immediately modifiable risk factors [J].
Clarke, Christina A. ;
Purdie, David M. ;
Glaser, Sally L. .
BMC CANCER, 2006, 6 (1)
[18]   The Preventable Causes of Death in the United States: Comparative Risk Assessment of Dietary, Lifestyle, and Metabolic Risk Factors [J].
Danaei, Goodarz ;
Ding, Eric L. ;
Mozaffarian, Dariush ;
Taylor, Ben ;
Rehm, Juergen ;
Murray, Christopher J. L. ;
Ezzati, Majid .
PLOS MEDICINE, 2009, 6 (04)
[19]   Sociocultural factors and the promotion of exclusive breastfeeding in rural yoruba communities of Osun state, Nigeria [J].
DaviesAdetugbo, AA .
SOCIAL SCIENCE & MEDICINE, 1997, 45 (01) :113-125
[20]  
Ekure E N., 2003, Nigeria Journal of Clinical Practice, V6, P92