印度东北部6-59个月儿童贫血危险因素的多水平多项逻辑斯谛回归模型
A multilevel multinomial logistic regression model for identifying risk factors of anemia in children aged 6-59 months in northeastern states of India
摘要：
在这篇文章中，我们使用多级多项逻辑斯谛回归模型，以确定印度东北部各邦儿童贫血的危险因素。数据包括10，136名6-59个月年龄组的儿童。根据WHO指南，我们将贫血水平作为结局变量，根据血液中的血红蛋白浓度分为四个顺序类别（重度、中度、轻度和非贫血）。以居住地为二水平变量，建立了两水平随机截距模型。各州之间的类内相关性（ICC）为0.0577，表明居住州占响应变量总变化的约6%。对多水平模型进行了比较，并根据离差检验确定了最终模型。我们观察到，处于或低于严重贫血水平的预测概率为0.1247，中度贫血水平为0.3578，轻度贫血水平为0.0698，非贫血为0.4477。我们发现，结婚年龄（OR=1.13，95%CI：1.05，1.21）和孩子的数量（OR=1.09，95%CI：1.03，1.15）对处于或低于较低血红蛋白水平（严重贫血）有显着影响。此外，儿童年龄（OR=0.92，95%CI：0.86-1.00）是一个重要的预测因素，表明如果儿童年龄为48个月或更大，严重贫血的几率会降低。
英文摘要：
In this article, we use multilevel multinomial logistic regression model to identify the risk factors of anemia in children of northeastern States of India. The data consisted of 10,136 children of age group 6-59 months. We considered the level of anemia as the outcome variable with four ordinal categories (severe, moderate, mild, and non-anemic) based on hemoglobin concentration in blood as per WHO guidelines. A two-level random intercept model was considered with state of residence as the level-2 variable. The intra-class correlation (ICC) between states is 0.0577 indicating approximately 6% of the total variation in the response variable accounted for by the state of residence. Several multilevel models have been compared, and a final model was decided based on deviance test. We observed that predicted probability of being at or below severely anemic level to be 0.1247, at moderately anemic level: 0.3578, at mildly anemic level: 0.0698, and being non-anemic to be 0.4477. We found that age at marriage (OR=1.13, 95% CI: 1.05, 1.21) and the number of children even born (OR=1.09, 95% CI: 1.03, 1.15) have significant effect on being at or below lower hemoglobin level (severely anemic). Furthermore, age of child (OR=0.92, 95% CI: 0.86-1.00) was a significant predictor, indicating that odds of severe anemia decreases if the child is 48 months or older.
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