四川省2001-2013年5岁以下儿童死亡率及死因构成的变化趋势

Trend analysis on mortality and the mortal causes among children under 5 in Sichuan province,from 2001 to 2013

目的 分析2001-2013年四川省＜5岁儿童死亡率（U5MR）和死因构成变化趋势.方法 从四川省＜5岁儿童死亡监测网收集2001-2013年基础监测资料,采用描述统计和x2检验分析四川省城市和农村儿童死亡率、新生儿死亡率、死因别死亡率.结果 四川省U5MR从2001年的35.30‰降至2013年的11.77‰.2013年四川省农村U5MR为城市2.37倍,新生儿死亡占U5MR比例的44.72％.2013年四川省U5MR死因前3位：肺炎、先天性心脏病、早产或低出生体重.其中,城市前3位：先天性心脏病、溺水和早产或低出生体重（出生窒息并列）,农村前3位：肺炎、早产或低出生体重与出生窒息.出生窒息、肺炎和低出生体重死亡率均逐年下降,而溺水、腹泻和交通意外死亡率呈现反复.结论 2013年四川省U5MR已达到国家2020年l3‰目标;降低农村U5MR,缩小城乡差异仍然是今后工作重点;基于死因构成变化,防治重点需要相应调整.

Objective To study the mortality of children under five and the causes of death together with related trend of dynamics,from 2001 to 2013 in Sichuan province.Methods Using the Children Death Monitoring Network under five in Sichuan province to obtain basic data.Descriptive statistics and chi-square were used to describe the mortalities in children and infants as well as the causes of death,in both rural and urban areas of Sichuan province.Results In Sichuan province,the mortality of children under five decreased from 35.30‰ in 2001 to 11.77‰o in 2013.In 2013,mortality in the rural areas was 2.37 times more than that in the urban area.The proportion of neonatal deaths among the mortality in children under five was 44.72%.Pneumonia,congenital heart diseases and premature or low birth weigh were the top three causes of death for children under five.Among them,the top three causes of death for urban area were congenital heart disease,drowning,and premature or low birth weight/birth asphyxia.Meanwhile,the top three causes of death in rural areas were pneumonia,premature birth/low birth weight and birth asphyxia.Overall,the mortality rates of birth asphyxia,pneumonia and low birth weight gradually decreasd but drowning,diarrhea and traffic accidents fluctuated.Conclusion The mortality of children under five in Sichuan province was 13%,which had already met the goal set for the year 2020.However,reducing the mortality in rural areas,narrowing the gap between urban and rural areas seemed the main part of the future endeavor while focus of prevention should be adjusted according to the causes of death.