西部45县3岁以下儿童感冒与腹泻两周患病率及其影响因素分析
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摘要
背景与目的
儿童健康问题是发展中国家面临的重要公共卫生问题,尤其是小年龄组儿童的健康易受社会经济以及医疗卫生水平的影响。全球每年有近1300万儿童因感染性疾病死亡,其中近1000万是5岁以下儿童,感染性疾病死亡人数中99%死亡病例发生在经济落后的发展中国家。造成这种现象的原因是多方面的、综合的,但主要影响因素尚不十分清楚。婴幼儿感冒和腹泻是发展中国家儿童的常见病和多发病,特别是在广大农村地区,严重地影响着儿童的生长发育和健康成长。因此,了解农村婴幼儿的感冒和腹泻患病情况,探讨其影响因素,对提高儿童的健康水平起非常重要的作用。
2005年卫生部与联合国儿童基金会合作,在我国西部10个省(直辖市、自治区)开展了《农村初级卫生保健项目(2001～2005)》,本文系该项目中基础调查部分的儿童患病相关研究内容与结果。目的是分析2005年中国西部农村3岁以下儿童感冒与腹泻的患病状况和分布特征,发现两病两周患病率的发展趋势和主要影响因素,为针对性指导西部农村儿童合理预防感冒及腹泻提供科学建议,以期改善儿童营养状况并促进生长发育。
方法
本文采用横断面调查的方法。研究对象为3岁以下儿童,其母亲也被纳入研究。在卫生部与联合国儿童基金会确定调查县(45个县)的基础上,采用多阶段随机抽样法在各调查县中随机抽取5个乡,从抽中乡中随机抽取4个村,再从样本村中随机抽取16户有3岁以下儿童的家庭,调查儿童及其母亲。资料收集采用入户问卷调查和测查方式。通过母亲回忆获得儿童在调查时点前两周内感冒和腹泻患病情况。采用Epidata3.02软件建立数据库,运用两次录入法进行数据录入,进行逻辑检错和极值检错等方法检查数据错误。统计推断采用x~2检验,因素分析采用非条件多因素logistic回归模型,统计描述、统计推断和因素分析应用SPSS13.0统计软件包完成,相关图表用Excel完成。
结果
(1)西部45县农村3岁以下儿童感冒和腹泻的两周患病率分别为19.1%和7.4%,显著低于2001年西部46县3岁以下儿童感冒和腹泻两周患病率(28.2%和18.2%)。儿童感冒两周患病率男童(19.8%)显著高于女童(18.1%),儿童腹泻两周患病率男童(7.6%)略高于女童(7.1%),儿童感冒和腹泻两周患病率随着儿童年龄的增加呈下降趋势。
(2)按各县经济状况分组(农村类型)后,西部45县3岁以下儿童感冒两周患病率分别为:一类农村15.4%、二类农村21.2%、三类农村21.3%和四类农村14.9%;儿童腹泻两周患病率依次为:5.7%、5.9%、6.6%和13.4%。
(3)研究发现影响儿童感冒两周患病的因素有:农村类型(OR=1.058)、儿童年龄(OR=0.915)、产后访视次数(OR=0.889)、在儿童成长过程中母亲接受儿童疾病预防的宣传(OR=0.797)和母亲民族(OR=0.724)。影响儿童腹泻两周患病的因素有:母亲民族(OR=1.299)、农村类型(OR=1.178)、产后访视次数(OR=0.926)、母亲住院分娩(OR=0.798)、6个月以下纯母乳喂养(OR=0.730)、家庭食用碘盐(OR=0.722)、儿童年龄(OR=0.683)、母亲单独给儿童做饭(OR=0.670)和儿童服用过维生素A(OR=0.455)。
结论
(1)2005年西部农村3岁以下儿童感冒和腹泻两周患病率总体较2001年有较大幅度的下降;而且随着儿童年龄的增加呈下降趋势。
(2)影响西部农村3岁以下儿童感冒和腹泻患病的主要因素包括社会经济发展水平、孕产期保健状况、儿童喂养方式和母亲的疾病预防知识等。
(3)降低西部农村3岁以下儿童感冒患病的主要措施包括:加强母亲孕产期保健、普及儿童疾病预防知识和适时添加蛋白类辅食;降低儿童腹泻患病的主要措施包括:加强母亲孕产期保健、提高母亲单独给儿童做饭的比例和6个月以下纯母乳喂养率,特别关注经济落后地区。
Background and Objective
Children health is a very important public health issue in developing countries, especially in young children whose health situation is closely related with social-economic and health care develepment medical application factors. Common cold(Acute Respiratory Infection) and diarrhoea are common diseases for children in developing countries, especially in rural areas. These diseases impeded the growth or development of children to a great extent. There are 13,000,000 children died of infectious deseases and 10,000,000 of them are under 5. Infectious diseases contribute to 70% of all causes for children mortality and 99% of them are from developing countries. The reasons for the above phenomena are not very clear. It is very important for improving children health to explore the prevalence of common cold and diarrhoea and their correlations in china.
Data were collected from National Primary Health Care Program (2001-2005), which was sponsored by Chinese MOH and UNICEF. The aim of this study is to explore the distribution of the prevalence of common cold and diarrhoea in children under 3 and their correlations. The findings of the study are expected to have important policy implications for recommendations on the rational prevention of common cold and diarrhoea and improve the growth or development of children in China.
Methods
In this cross-sectional study, children under 3 and their mothers across 45 counties in Western China were included. A 3-stage sampling method was used in the study. 5 twonships were drawn from each county, and 4 villages were drawn from each selected twomship. Total16 families with children under 3 were drawn from each selected village. A questionnaire was prepared for children and their mothers. The study subjects were interviewed at home. EpiData 3. 02 was used to record questionnaire information, and SPSS13.0 software and excel were used to analyze the data. x~2 test and logistic regression model were used for statistical analysis.
Results
1. The two-week prevalence rates of common cold and diarrhoea for children under 3 across 45 counties of western China in 2005 were 19.1% and 7.4%, respectively. The prevalence rates in 2005 were dramatically lower than those (28.2% and 18.2% respectively) in 2001. The prevalence rate of common cold for boys (19.8%) was significantly higher than those for girls (18.1%). And the prevalence rate of diarrhoea for boys (7.6%) was slightly higher than those for girls (7.1 %). The prevalence rates of common cold and diarrhoea for children decreased with ages.
2. The two-week prevalence rates of common cold for children under 3 across 45 counties of Western China in 2005 were 15.4%, 21.2%, 21.3%, 14.9% respectively for the first class villages, the second class villages, the third class villages and the forth class villages. The two-week prevalence rates of diarrhoea for children under 3 across 45 counties of western China in 2005 were 5.7%, 5.9%, 6.6%, 13.4% respectively for first class villages, second class villages, third class villages and forth class villages.
3. The influence factors of two-week prevalence rate of common cold for children were village classes (OR=1.058), children ages (OR=0.915), times of postnatal visiting (OR=0.889), mothers' educated by disease prevention for children (OR=0.797) and mothers' ethnics (OR=0.724). The influence factors of two-week prevalence rate of diarrhoea for children were mothers' ethnic group (OR=1.299), village classes (OR=1.178), times of postnatal visiting (OR=0.926), hospital delivery (OR=0.798), exclusive breast feeding under 6 months (OR=0.730), iodized salt (OR=0.722), children ages (OR=0.683), special cooking for children (OR=0.670) and vitamin A intake (OR=0.455).
Conclusions
1. The two-week prevalence rates of common cold and diarrhoea for children under 3 across 45 counties of western China in 2005 were higher than the national average level, and the rates were lower than 2001. The two-week prevalence rates of common cold and diarrhea for children decreased along with ages.
2. The influence factors of two-week prevalence rate of common cold for children under 3 were social-economic developing levels, health situation in rinatal period, feeding styles and mothers' knowledge of prevention of diseases.
3. Strategies to reduce the prevalence rate of common cold for children under 3 were improving antenatal and postnatal care, popularizing knowledge of prevention of children diseases, timely adding protein food for children. Strategies to reduce the prevalence rate of diarrhoea for children under 3 were improving antenatal and postnatal care, increasing special cooking for children and increasing pure breast feeding under 6 months.
儿童健康问题是发展中国家面临的重要公共卫生问题,尤其是小年龄组儿童的健康易受社会经济以及医疗卫生水平的影响。全球每年有近1300万儿童因感染性疾病死亡,其中近1000万是5岁以下儿童,感染性疾病死亡人数中99%死亡病例发生在经济落后的发展中国家。造成这种现象的原因是多方面的、综合的,但主要影响因素尚不十分清楚。婴幼儿感冒和腹泻是发展中国家儿童的常见病和多发病,特别是在广大农村地区,严重地影响着儿童的生长发育和健康成长。因此,了解农村婴幼儿的感冒和腹泻患病情况,探讨其影响因素,对提高儿童的健康水平起非常重要的作用。
2005年卫生部与联合国儿童基金会合作,在我国西部10个省(直辖市、自治区)开展了《农村初级卫生保健项目(2001～2005)》,本文系该项目中基础调查部分的儿童患病相关研究内容与结果。目的是分析2005年中国西部农村3岁以下儿童感冒与腹泻的患病状况和分布特征,发现两病两周患病率的发展趋势和主要影响因素,为针对性指导西部农村儿童合理预防感冒及腹泻提供科学建议,以期改善儿童营养状况并促进生长发育。
方法
本文采用横断面调查的方法。研究对象为3岁以下儿童,其母亲也被纳入研究。在卫生部与联合国儿童基金会确定调查县(45个县)的基础上,采用多阶段随机抽样法在各调查县中随机抽取5个乡,从抽中乡中随机抽取4个村,再从样本村中随机抽取16户有3岁以下儿童的家庭,调查儿童及其母亲。资料收集采用入户问卷调查和测查方式。通过母亲回忆获得儿童在调查时点前两周内感冒和腹泻患病情况。采用Epidata3.02软件建立数据库,运用两次录入法进行数据录入,进行逻辑检错和极值检错等方法检查数据错误。统计推断采用x~2检验,因素分析采用非条件多因素logistic回归模型,统计描述、统计推断和因素分析应用SPSS13.0统计软件包完成,相关图表用Excel完成。
结果
(1)西部45县农村3岁以下儿童感冒和腹泻的两周患病率分别为19.1%和7.4%,显著低于2001年西部46县3岁以下儿童感冒和腹泻两周患病率(28.2%和18.2%)。儿童感冒两周患病率男童(19.8%)显著高于女童(18.1%),儿童腹泻两周患病率男童(7.6%)略高于女童(7.1%),儿童感冒和腹泻两周患病率随着儿童年龄的增加呈下降趋势。
(2)按各县经济状况分组(农村类型)后,西部45县3岁以下儿童感冒两周患病率分别为:一类农村15.4%、二类农村21.2%、三类农村21.3%和四类农村14.9%;儿童腹泻两周患病率依次为:5.7%、5.9%、6.6%和13.4%。
(3)研究发现影响儿童感冒两周患病的因素有:农村类型(OR=1.058)、儿童年龄(OR=0.915)、产后访视次数(OR=0.889)、在儿童成长过程中母亲接受儿童疾病预防的宣传(OR=0.797)和母亲民族(OR=0.724)。影响儿童腹泻两周患病的因素有:母亲民族(OR=1.299)、农村类型(OR=1.178)、产后访视次数(OR=0.926)、母亲住院分娩(OR=0.798)、6个月以下纯母乳喂养(OR=0.730)、家庭食用碘盐(OR=0.722)、儿童年龄(OR=0.683)、母亲单独给儿童做饭(OR=0.670)和儿童服用过维生素A(OR=0.455)。
结论
(1)2005年西部农村3岁以下儿童感冒和腹泻两周患病率总体较2001年有较大幅度的下降;而且随着儿童年龄的增加呈下降趋势。
(2)影响西部农村3岁以下儿童感冒和腹泻患病的主要因素包括社会经济发展水平、孕产期保健状况、儿童喂养方式和母亲的疾病预防知识等。
(3)降低西部农村3岁以下儿童感冒患病的主要措施包括:加强母亲孕产期保健、普及儿童疾病预防知识和适时添加蛋白类辅食;降低儿童腹泻患病的主要措施包括:加强母亲孕产期保健、提高母亲单独给儿童做饭的比例和6个月以下纯母乳喂养率,特别关注经济落后地区。
Background and Objective
Children health is a very important public health issue in developing countries, especially in young children whose health situation is closely related with social-economic and health care develepment medical application factors. Common cold(Acute Respiratory Infection) and diarrhoea are common diseases for children in developing countries, especially in rural areas. These diseases impeded the growth or development of children to a great extent. There are 13,000,000 children died of infectious deseases and 10,000,000 of them are under 5. Infectious diseases contribute to 70% of all causes for children mortality and 99% of them are from developing countries. The reasons for the above phenomena are not very clear. It is very important for improving children health to explore the prevalence of common cold and diarrhoea and their correlations in china.
Data were collected from National Primary Health Care Program (2001-2005), which was sponsored by Chinese MOH and UNICEF. The aim of this study is to explore the distribution of the prevalence of common cold and diarrhoea in children under 3 and their correlations. The findings of the study are expected to have important policy implications for recommendations on the rational prevention of common cold and diarrhoea and improve the growth or development of children in China.
Methods
In this cross-sectional study, children under 3 and their mothers across 45 counties in Western China were included. A 3-stage sampling method was used in the study. 5 twonships were drawn from each county, and 4 villages were drawn from each selected twomship. Total16 families with children under 3 were drawn from each selected village. A questionnaire was prepared for children and their mothers. The study subjects were interviewed at home. EpiData 3. 02 was used to record questionnaire information, and SPSS13.0 software and excel were used to analyze the data. x~2 test and logistic regression model were used for statistical analysis.
Results
1. The two-week prevalence rates of common cold and diarrhoea for children under 3 across 45 counties of western China in 2005 were 19.1% and 7.4%, respectively. The prevalence rates in 2005 were dramatically lower than those (28.2% and 18.2% respectively) in 2001. The prevalence rate of common cold for boys (19.8%) was significantly higher than those for girls (18.1%). And the prevalence rate of diarrhoea for boys (7.6%) was slightly higher than those for girls (7.1 %). The prevalence rates of common cold and diarrhoea for children decreased with ages.
2. The two-week prevalence rates of common cold for children under 3 across 45 counties of Western China in 2005 were 15.4%, 21.2%, 21.3%, 14.9% respectively for the first class villages, the second class villages, the third class villages and the forth class villages. The two-week prevalence rates of diarrhoea for children under 3 across 45 counties of western China in 2005 were 5.7%, 5.9%, 6.6%, 13.4% respectively for first class villages, second class villages, third class villages and forth class villages.
3. The influence factors of two-week prevalence rate of common cold for children were village classes (OR=1.058), children ages (OR=0.915), times of postnatal visiting (OR=0.889), mothers' educated by disease prevention for children (OR=0.797) and mothers' ethnics (OR=0.724). The influence factors of two-week prevalence rate of diarrhoea for children were mothers' ethnic group (OR=1.299), village classes (OR=1.178), times of postnatal visiting (OR=0.926), hospital delivery (OR=0.798), exclusive breast feeding under 6 months (OR=0.730), iodized salt (OR=0.722), children ages (OR=0.683), special cooking for children (OR=0.670) and vitamin A intake (OR=0.455).
Conclusions
1. The two-week prevalence rates of common cold and diarrhoea for children under 3 across 45 counties of western China in 2005 were higher than the national average level, and the rates were lower than 2001. The two-week prevalence rates of common cold and diarrhea for children decreased along with ages.
2. The influence factors of two-week prevalence rate of common cold for children under 3 were social-economic developing levels, health situation in rinatal period, feeding styles and mothers' knowledge of prevention of diseases.
3. Strategies to reduce the prevalence rate of common cold for children under 3 were improving antenatal and postnatal care, popularizing knowledge of prevention of children diseases, timely adding protein food for children. Strategies to reduce the prevalence rate of diarrhoea for children under 3 were improving antenatal and postnatal care, increasing special cooking for children and increasing pure breast feeding under 6 months.
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