2013年中国居民家庭安全饮用水和卫生厕所状况与0~5岁儿童生长迟缓的相关性

Relationship between household safe drinking water,hygienic toilet and prevalence of stunting for Chinese children aged 0 to 5 years old in 2013

目的了解2013年中国居民家庭饮用水主要来源、日常使用厕所类型,并探索其与0~5岁儿童生长迟缓之间的关系。方法资料来源于"2010—2013年中国居民营养与健康状况监测"项目,采用多阶段分层整群抽样的方法,共纳入中国30个省(自治区、直辖市)55个调查县(市/区)165个乡镇(街道)中0~5岁儿童32861名。采用面对面询问看护人的方式收集儿童、母亲和家庭的基本情况、家庭饮用水的主要来源、日常使用的厕所类型等信息;使用标准化的身长板或身高计测量儿童身长(身高),并计算年龄别身高(身长)Z评分[height(length)for age Z score,HAZ(LAZ)],将HAZ(LAZ)<-2定义为生长迟缓。采用SAS 9.4软件进行统计描述和分析,通过SURVEYFREQ计算安全饮用水和卫生厕所覆盖率、生长迟缓率,通过多因素Logistic回归中SURVEYLOGISTIC探索家庭饮用水的主要来源、日常使用的厕所类型与0~5岁儿童生长迟缓的关系。结果32861名儿童中男童占51.4%,0~岁组、1~岁组、2~岁组、3~岁组、4~岁组和5~岁组所占比例分别为26.5%、16.4%、14.4%、15.2%、15.1%和12.4%。安全饮用水覆盖率为86.9%,其中净化处理过的自来水占49.4%,公共水管占15.9%,受保护的井水或泉水占15.6%。卫生厕所覆盖率为56.8%,其中,水冲式卫生厕所占52.1%,卫生旱厕占4.7%。0~5岁儿童生长迟缓率为8.1%。以安全饮用水和非安全饮用水为家庭饮用水主要来源的家庭中,0~5岁儿童生长迟缓率分别为8.1%和7.8%,差异无统计学意义(P=0.882)。以卫生厕所和非卫生厕所为日常家庭使用厕所类型的家庭中,0~5岁儿童生长迟缓率分别为6.6%和10.0%,差异无统计学意义(P=0.069)。多因素Logistic分析结果显示,调整性别、年龄、城市/农村类别、家庭人均年收入、母亲文化程度、近2周内是否腹泻、膳食是否合理等因素后,未发现卫生状况与0~5岁儿童生长迟缓之间存在相关性。结论2013年中国家庭饮用水源、日常使用厕所类型与0~5岁儿童生长迟缓之间的关联不显著。

OBJECTIVE To investigate the relationship between household drinking water,toilet status and the prevalence of stunting for Chinese children aged 0 to 5 years old in 2013.METHODS Data was extracted from the Chinese National Nutrition and Health Surveillance in 2013.A total of 32861 children aged 0 to 5 years old were selected from 165 townships(streets)of 55 counties(cities/districts)in 30 provinces.Caregivers were face to face interviewed to collect data,including demographic characteristics of children,mothers and household,main source of household drinking water and main type of household toilet.Height/Length of children was measured using a standard procedure.Height(Length)for age Z score(HAZ(LAZ))was calculated using WHO Anthro Survey Analyser software(online version),and stunting was defined as HAZ(LAZ)<-2.SAS 9.4 was used to analyze.SURVEYFREQ procedure was used to calculate the coverage rate of safe drinking water,hygienic toilet,and the prevalence of stunting.SURVEYLOGISTIC procedure was used to analyze the relationship between household safe drinking water,hygienic toilet and prevalence of stunting for Chinese children aged 0 to 5 years old in 2013.RESULTS A total of 32861 children completed the study.The coverage rate of safe drinking water was 86.9%.The proportion of water piped into household,a public tab and water from a protected spring or well was 49.4%,15.9% and 15.6%,respectively.The coverage rate of hygienic toilet was 56.8%.The proportion of pour-flush toilet and pit latrine were 52.1% and 4.7%.The prevalence of stunting for 0 to 5 years old children was 8.1% in China.The prevalence of stunting were 8.1%for children aged 0-5 years old with safe household drinking water and 7.8% for those without safe household drinking water.The difference was not significant(P=0.882).The prevalence of stunting was 6.6% for children aged 0-5 years old with hygienic household toilet and 10.0% for those without hygienic household toilet.The difference was not significant(P=0.069).There was no significant relationship between household sanitary condition and stunting for children aged 0 to 5 years old.CONCLUSION Household sanitary conditions,including main source of household drinking water and the main type of household toilet may not be associated with the prevalence of stunting for children aged 0 to 5 years old in this settings.