中国1996-2006年5岁以下儿童腹泻死亡及诊治情况分析

Analysis on the diarrhea mortality rate, pre-death diagnosis and treatment of children under-5 in China, 1996-2006

目的 了解1996-2006年中国5岁以下儿童腹泻死亡率的变化趋势及其死前诊治情况.方法 采用全国5岁以下儿童死亡监测网收集的1996-2006年以人群为基础的监测资料,计算不同地区5岁以下儿童腹泻死亡率并探讨死亡儿童的死前诊治情况.结果 全国、城市和农村5岁以下儿童腹泻死亡率分别由1996年的249.8/10万、11.6/10万、304.7/10万下降至2006年的75.6/10万、6.1/10万、94.3/10万,分别下降了69.7%、47.4%、69.1%.沿海、内地和边远地区5岁以下儿童腹泻死亡率分别由1996年的48.9/10万、178.9/10万、566.9/10万下降至2006年的6.2/10万、30.4/10万、199.2/10万,分别下降了87.3%、83.0%、64.9%.农村地区5岁以下腹泻死亡儿童就诊比例,在乡卫生院约为23.7%,在村卫生室约37.9%;15.1%腹泻死亡儿童未就医;腹泻儿童中约20%未治疗,50%～60%门诊治疗,仅约20%住院治疗.结论 1996-2006年中国5岁以下儿童腹泻死亡率呈明显下降趋势,但各类地区间的差距在加大.

Objective To understand the trends of diarrhea mortality rate, pre-death diagnosis and treatment of children under-5 in China, from1996 to 2006. Methods We used data obtained from the 1996 to 2006 national child mortality surveillance network, including 116 counties （cities） throughout China, to evaluate the under 5 mortality rate （U5MR） due to diarrhea in different geographical areas, and related factors of under 5 children mortality due to diarrhea. Results Data from the national U5MR due to diarrhea fell from 249.8 in 1996 to 75.6 per 100 000 live births, in 2006. The U5MR due to diarrhea in urban reduces from 11.6 in 1996 to 6.1 per 100 000 live births in 2006, with a reduction of 47.4%. The U5MR due to diarrhea in rural decreased from 304.7 in 1996 to 94.3 per 100 000 live births in 2006, with a reduction of 69.1%. The U5MR due to diarrhea in coastal,inland and remote areas fell from 48.9, 178.9 and 566.9 in 1996 to 6.2,30.4 and 199.2 per 100 000live births in 2006, with a reduction of 87.3%, 83.0% and 64.9%, respectively. Among the rural children died of diarrhea, about 37.9% were diagnosed in a village clinic, 15.1% never received any diagnostic procedure. Nearly 20% of the patients had not been treated, with 50%-60% of them had only been treated in an outpatient department. Conclusion During 1996-2006, the U5MR due to diarrhea showed a substantially downward trend in China but the disparities between urban and rural,remote and coastal, areas were increasing.