河北省赵县6～23个月儿童贫血患病率及影响因素分析

Prevalence and associated factors of anemia for children aged 6～23 months in Zhao county,Hebei province

目的了解河北省赵县6-23个月儿童贫血患病率现状及影响因素,为制定干预措施提供依据。方法研究对象为赵县农村6-23个月儿童。16个乡镇全部纳入,根据各村的人口总数,采用与规模成比例的概率抽样,共抽取160个行政村,每村随机抽取7名儿童。问卷调查采用经过改编的世界卫生组织标准化的妇幼卫生家庭调查工具,应用智能手机调查系统进行数据收集。应用HemoCue HB201＋血红蛋白仪检测末梢血血红蛋白,取静脉血应用化学发光法检测血清铁蛋白,免疫透射比浊法检测C反应蛋白。结果 1 109名儿童的血红蛋白值平均值为（106.0±14.0）g/L,贫血患病率为55.9%,不同年龄组差异有统计学意义,9-11个月组最高（72.7%）,18-20个月组最低（41.4%）。轻度贫血占78.4%,其次是中度贫血,占20.0%,重度贫血仅占1.6%。290名儿童的血清铁蛋白中位数为7.35g/L,铁缺乏率为93.5%。贫血患儿肯定有铁缺乏。男童、9-11月龄、剖腹产、未断奶、昨天未吃含铁丰富的食物或补铁药物、未达到推荐的膳食频率更容易发生贫血。结论赵县6-23个月儿童贫血患病率很高,绝大多数为轻度贫血和缺铁性贫血。不合理的喂养是贫血的重要相关因素,需要采取有效措施改善家长不正确的喂养行为,降低儿童贫血患病率。

Objective To determine the prevalence and associated factors of anemia for children aged 6-23months in Zhao county and provide evidence for intervention. Methods Participants were children aged 6-23months in rural Zhao county.All 16 townships were included and 160 villages were randomly selected using Proportional to Population Size（PPS）method according to villages＇ population.In each village,7children were randomly selected.The questionnaires were adapted from Maternal,Newborn and Child Health Household Survey tool by the World Health Organization and a smartphone software was used for data collection.Hemoglobin,serum ferritin and C-reaction protein were measured. Results The concentration of hemoglobin for 1 109 children averaged（106.0±14.0）g/L,and anemia prevalence was 55.9%.The anemia prevalence was significantly different among age groups,with 9-11months being the highest（72.7%）and 18-20months being the lowest（41.4%）.Mild,moderate and severe anemia accounted for 78.4%,20.0% and 1.6%respectively.The median of serum ferritin for 290 children was 7.35g/L,and the prevalence of iron deficiency was 93.5%.Male,9-11months,cesarean section,not weaning,not eating iron-rich food or iron medication and lass than recommended dietary frequency were more likely to be anemic. Conclusions The prevalence of children age 6-23months is very high and most of them are mild anemia and iron deficiency anemia.Inappropriate feeding is an important factors associated with anemia,therefore,effective measures are needed to improve the feeding practice of caregivers and hence to reduce the prevalence of anemia.