中西部不同民族地区家庭卫生与儿童腹泻关系

Association of household sanitation with diarrhea among small children in ethnic minority regions of central and western China

目的了解中西部不同民族地区农村家庭卫生情况与儿童腹泻现状,分析儿童腹泻的主要影响因素,为儿童腹泻病防治提供科学依据。方法于2016年8—10月,采用按容量比概率抽样法(PPS),对河南省、四川彝族自治州、西藏自治区6个县的1348名5岁以下儿童及其看护人进行问卷调查。结果儿童腹泻两周患病率为17.58%,其中河南为6.63%,四川为25.42%,西藏为15.17%,差异有统计学意义(χ2=71.096,P<0.001)。不同地区和民族腹泻儿童护理情况、家庭卫生情况比较差异均有统计学意义(P<0.05)。多因素logistic回归分析显示,月龄<24个月(0个月~:OR=4.096,95%CI=1.140~14.721;6个月~:OR=4.875,95%CI=1.389~17.110;12个月~:OR=6.969,95%CI=2.059~23.583)、饮用水未煮沸(OR=1.678,95%CI=1.024~2.749)和水源未受保护(OR=1.786,95%CI=1.067~2.991)是儿童腹泻的主要危险因素。结论中西部农村地区儿童腹泻情况严重,家庭卫生有待改善,不同民族、地区差异较大。应将<2岁儿童作为重点关注对象,积极对饮用水等家庭卫生情况采取干预措施,促进儿童腹泻病的防治。

Objective To examine the status of household sanitation,prevalence and impact factors of diarrhea in small children in rural ethnic minority regions of central and western China for providing evidences to child diarrhea prevention.Methods Using probability-proportional-to-size sampling,we recruited 1355 children aged≤5 years in 90 villages in Henan province(Henan),Sichuan Yi Autonomous Prefecture(Sichuan)and Tibet Autonomous Region(Tibet)and conducted a face-to-face questionnaire survey among the caregivers of the children during August-October 2016.Results Valid information were collected from caregivers of 1348 children averagely aged 22.34±15.56 months.The overall two-week prevalence rate of diarrhea was 17.58%for all the children and the two-week prevalence rate for the children in Henan,Sichuan,and Tibet were 6.63%,25.42%,and 15.17%,respectively,with a significant difference(χ2=71.096,P<0.001).The diarrhea prevalence rate differed significantly by daily care and household sanitation among the children of different nationalities and living in various regions(P<0.05).Multivariate logistic regression analysis revealed following main risk factors for child diarrhea prevalence:aged<24 months(0-5 months:odds ratio[OR]=4.096,95%confidence interval[95%CI]:1.140-14.721;6-12 months:OR=4.875,95%CI:1.389-17.110;12-23 months:OR=6.969,95%CI:2.059-23.583);consuming unboiled drinking water(OR=1.678,95%CI=1.024-2.749);and consuming domestic water from an unprotected water source(OR=1.786,95%CI:1.067-2.991).Conclusion Among the small children in rural regions of central and western China,diarrhea is prevalent and there are obvious disparities in diarrhea prevalence among the children of different nationalities and living in various regions.Household hygienic condition of drinking water and domestic water need to be improved for the prevention of diarrhea in the children,especially in those less than two years old.