{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T18:31:31Z","timestamp":1777314691713,"version":"3.51.4"},"reference-count":41,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T00:00:00Z","timestamp":1728864000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\nBackground<\/jats:title>\nOverweight\/ obesity among under-five children is an emerging public health issue of the twenty-first century. Due to the quick nutritional and epidemiological change, non-communicable diseases, premature death, disability, and reproductive disorders have grown in low-income countries. Besides, little attention has been given. Therefore, we aimed to explore spatial variations and predictors of overweight\/obesity among under-five children in Ethiopia using a geospatial technique.<\/jats:p>\n<\/jats:sec>\n\nMethods<\/jats:title>\nA total weighted sample of 3,609 under-five children was included in the study. A cross-sectional study was conducted using a nationally representative sample of the 2019 Ethiopia Mini Demographic and Health Survey data set. ArcGIS version 10.8 was used to explore the spatial variation of obesity. SaTScan version 9.6 software was used to analyze the spatial cluster detection of overweight\/obesity. Ordinary least square and geographically weighted regression analysis were employed to assess the association between an outcome variable and explanatory variables. A p-value of less than 0.05 was used to declare it statistically significant.<\/jats:p>\n<\/jats:sec>\n\nResults<\/jats:title>\nThe spatial distribution of overweight\/obesity among under-five children in Ethiopia was clustered (Global Moran\u2019s I = 0.27, p-value<0.001). The significant hot spot areas or higher rates of childhood obesity, were found in Southern Amhara, Northwest Somalia, Border of Harari, central Addis Ababa, Eastern SNNPR, and Northwestern Oromia region. In spatial SaT Scan analysis, 79 significant clusters of overweight\/obesity were detected. The primary clusters were located in SNNPR, Oromia, and Addis Ababa (RR = 1.48, LLR = 31.40, P-value < 0.001). In the geographically weighted regression analysis, urban residence, cesarean section, rich households, and female children were statistically significant predictors.<\/jats:p>\n<\/jats:sec>\n\nConclusions<\/jats:title>\nOverweight or obesity among under-five children show spatial variations across Ethiopian regions. GWR analysis identifies cesarean section, wealth index, urban residence, and child sex as significant predictors. The Ministry of Health and Ethiopian Public Health Institute should target regions with these contributing predictors, promoting localized physical education, health education campaigns, and ongoing community monitoring to encourage active lifestyles and reduce sedentary behaviors among children.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0312025","type":"journal-article","created":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T17:28:46Z","timestamp":1728926926000},"page":"e0312025","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Spatial variations and predictors of overweight\/obesity among under-five children in Ethiopia: A geographically weighted regression analysis of the 2019 Ethiopian Mini Demographic and Health Survey"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9583-5876","authenticated-orcid":true,"given":"Agmasie Damtew","family":"Walle","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5416-616X","authenticated-orcid":true,"given":"Shimels Derso","family":"Kebede","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1026-0626","authenticated-orcid":true,"given":"Jibril Bashir","family":"Adem","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ermias Bekele","family":"Enyew","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Habtamu Alganeh","family":"Guadie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teshome","family":"Bekana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Habtamu Setegn","family":"Ngusie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sisay Maru","family":"Wubante","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sisay Yitayih","family":"Kassie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Addisalem Workie","family":"Demsash","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wabi Temesgen","family":"Atinafu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tigist Andargie","family":"Ferede","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,10,14]]},"reference":[{"key":"pone.0312025.ref001","doi-asserted-by":"crossref","first-page":"881296","DOI":"10.3389\/fpubh.2022.881296","article-title":"Prevalence of overweight\/obesity and associated factors among under-five children in Ethiopia: a multilevel analysis of nationally representative sample","volume":"10","author":"M.A. Gebremichael","year":"2022","journal-title":"Frontiers in Public Health"},{"key":"pone.0312025.ref002","author":"Organization, W.H.","year":"2024","journal-title":"Obesity and overweight"},{"issue":"1","key":"pone.0312025.ref003","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13104-019-4752-8","article-title":"Overweight and obesity among children under five in Ethiopia: further analysis of 2016 national demographic health survey: a case control study","volume":"12","author":"H.G. 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Krivoruchko","year":"2012"},{"key":"pone.0312025.ref026","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1007\/s11802-018-3380-6","article-title":"Evaluation of ordinary least square (OLS) and geographically weighted regression (GWR) for water quality monitoring: A case study for the estimation of salinity","volume":"17","author":"M. Nazeer","year":"2018","journal-title":"Journal of Ocean University of China"},{"key":"pone.0312025.ref027","first-page":"1","article-title":"A modification to geographically weighted regression","volume":"16","author":"Y.-Y. Leong","year":"2017","journal-title":"International journal of health geographics"},{"issue":"12","key":"pone.0312025.ref028","doi-asserted-by":"crossref","first-page":"e0143215","DOI":"10.1371\/journal.pone.0143215","article-title":"Prevalence and risk factors of overweight and obesity among children aged 6\u201359 months in Cameroon: a multistage, stratified cluster sampling nationwide survey","volume":"10","author":"S. Tchoubi","year":"2015","journal-title":"PloS one"},{"issue":"5","key":"pone.0312025.ref029","first-page":"2057","article-title":"Prevalence of and factors associated with overweight and obesity among nursery school children aged 3\u20136 years in Eldoret Municipality.","volume":"14","author":"F.B. Wandia","year":"2014","journal-title":"African Journal of Food, Agriculture, Nutrition and Development"},{"issue":"3","key":"pone.0312025.ref030","doi-asserted-by":"crossref","first-page":"176","DOI":"10.3109\/09540261.2012.688195","article-title":"The global childhood obesity epidemic and the association between socio-economic status and childhood obesity","volume":"24","author":"Y. 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Lee","year":"2019","journal-title":"Endotext [Internet]"},{"issue":"4","key":"pone.0312025.ref037","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1515\/anre-2017-0027","article-title":"The frequency of overweight and obesity occurrence among Polish children (age 6\u20137 years) in relation to the place of residence, the education level of parents and the number children in the family","volume":"80","author":"M. Markowska","year":"2017","journal-title":"Anthropological Review"},{"key":"pone.0312025.ref038","first-page":"e1","article-title":"Prevalence of Childhood Obesity by Sex and Regions in Peru, 2015","volume":"90","author":"A. Hern\u00e1ndez-V\u00e1squez","year":"2016","journal-title":"Revista espanola de salud publica"},{"key":"pone.0312025.ref039","first-page":"1","article-title":"Prevalence and predictors of overweight and obesity among school-aged children in urban Ghana.","author":"R. 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