ORIGINAL RESEARCH article
Front. Public Health
Sec. Children and Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1456068
Neighborhood-Level Heterogeneity in Childhood Morbidity through Generalized Linear Mixed Models
Provisionally accepted
- 1Department of Economics, University of Messina, Messina, Italy
- 2Department of Statistics, College of Natural and Computational Sciences, University of Gondar, Gondar, Ethiopia
- 3Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara Region, Ethiopia
- 4Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara Region, Ethiopia
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Objective: Childhood morbidities are crucial for improving long-term public health outcomes. This study aimed to examine the existence of child-specific and regional variation in childhood morbidity based on the cross-cutting study of the Performance Monitoring for Action Ethiopia community survey (PMA-ET), and its relationship to socioeconomic and demographic variables in families.Methods: We enrolled 2581 children suffering from different illnesses from 6 regions of the country of the survey at six weeks postpartum. Generalized linear mixed models (GLMMs) with maximum likelihood estimation were used to assess children's comorbidity status, and the DHARMa package in R to provide readily interpretable scaled residuals and test functions for typical model misspecification problems for the fitted GLMMs.Results: GLMMs with two random intercept models show the presence of child morbidity variations. Cough, fever, and diarrhea were found to be the most frequent types of children's illnesses among the main illness categories that were recorded. Cooking fuel, wealth quartiles, mothers' marital status, mother age, parity, residence, mother's education status, and availability of electricity were significantly associated with children's morbidity.Conclusions: These data show that variations in children's comorbidity were associated with both regional and child-specific characteristics. Thus, general principles for designing policies and interventions are required to reduce child comorbidity.
Keywords: AIC, Children Comorbidity, dharma, GLMMs, Laplace approximation, Random effect
Received: 27 Jun 2024; Accepted: 15 May 2025.
Copyright: © 2025 Derso, Gelaye, Campolo, Woldemariam and Alibrandi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Endeshaw Assefa Derso, Department of Economics, University of Messina, Messina, Italy
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