西藏自治区山南市0~6岁儿童贫血现状及影响因素研究

Anemia incidence and influencing factors among children aged 0-6 years in Shannan city,Xizang Autonomous Region

目的调查西藏自治区山南市0~6岁儿童贫血现状并分析儿童贫血的影响因素。方法采用横断面研究方法, 对2020至2022年西藏自治区山南市所辖十二县(区)12 405名0~6岁儿童血红蛋白进行检测, 并收集其基本信息, 包括性别、年龄、民族、住址、当地海拔等。根据被调查儿童居住地海拔, 报告平原标准下的儿童贫血情况及校正海拔后贫血患病情况, 并比较不同组间儿童血红蛋白状况, 采用多因素Logistic回归法分析儿童贫血影响因素。结果 12 405名儿童中男6 383名(51.46%)、女6 022名(48.54%);新生儿462名(3.72%)、1~<4月龄68名(0.55%)、4~<6月龄153名(1.23%)、6月龄至6岁11 722名(94.49%)。海拔校正前山南市0~6岁儿童贫血患病率为15.50%(1 923/12 405), 海拔校正后总的贫血率为57.84%(7 175/12 405)。12 405名儿童血红蛋白水平为(130±21)g/L。男童贫血率明显高于女童[59.17%(3 777/6 383)比56.43%(3 398/6 022)], 藏族儿童贫血率明显高于其他民族儿童[58.21%(6 992/12 011)比46.45%(183/394)], 农牧区儿童贫血率明显高于城镇儿童[58.75%(6 212/10 574)比52.59%(963/1 831)], 更高海拔地区儿童贫血率明显高于高海拔地区儿童[67.98%(2 773/4 079)比52.87%(4 402/8 326)], 差异均有统计学意义(均P<0.05)。多因素Logistic回归分析显示, 女童(OR=0.89, 95%CI 0.83~0.96)、其他民族(OR=0.72, 95%CI 0.58~0.89)、4~<6月龄(OR=0.40, 95%CI 0.24~0.67)和6月龄至6岁(OR=0.59, 95%CI 0.43~0.82)是贫血发生的保护因素, 农牧区(OR=1.15, 95%CI 1.04~1.28)、居住海拔≥4 000 m地区(OR=1.88, 95%CI 1.73~2.04)是贫血发生的独立危险因素。结论山南市0~6岁儿童贫血患病状况仍较为严重, 且受性别、城乡、儿童年龄、海拔等因素影响。

Objective:To investigate the prevalence and influencing factors of anemia children aged 0-6 years in Shannan city,Xizang Autonomous Region.Methods:A cross-sectional study was performed to measure hemoglobin of 12405 children aged 0-6 years in 12 counties(districts)of Shannan city,Xizang Autonomous Region and basic information including gender,age,ethnicity,address,local altitude,urban area,agricultural and pastoral areas,etc were collected.According to the altitude of the surveyed children′s place of residence,anemia in children under the plain standard and the prevalence of anemia after adjusting for altitude were reported,and the influencing factors of anemia in these children were analyzed by Logistic regression methods.Results:Among the 12405 children,6383(51.46%)were males,6022(48.54%)were females,462(3.72%)were newborns,68(0.55%)were 1 month old children,153(1.23%)were 4-<6 months old children,and 11722(94.49%)were 6 months to 6 years old children.The prevalence of anemia in children aged 0-6 years in Shannan city before altitude correction was 15.50%(1923/12405),and it was 57.84%(7175/12405)after altitude correction.The hemoglobin level in the children was(131±20)g/L.Univariate analysis showed that the anemia rate of males was higher than that of females(59.17%(3777/6383)vs.56.43%(3398/6022),P<0.05),the anemia rate of Tibetan children was higher than that of children of other ethnic groups(58.21%(6992/12011)vs.46.45%(183/394),P<0.05),the anemia rate of children in agricultural and pastoral areas was higher than that of urban children(58.75%(6212/10574)vs.(52.59%963/1831),P<0.05),and the anemia rate of children in higher-altitude areas was higher than that of children in high-altitude areas(67.98%(2773/4079)vs.52.87%(4402/8326),P<0.05).Logistic regression analysis revealed that girls(OR=0.89,95%CI 0.83-0.96),children of other ethnic groups(OR=0.72,95%CI 0.58-0.89),children aged 4-<6 months(OR=0.40,95%CI 0.24-0.67)and children aged 6 months to 6 years(OR=0.59,95%CI 0.43-0.82)were protective factors,and children who lived in agricultural and pastoral areas(OR=1.15,95%CI 1.04-1.28)and children living at altitudes higher than 4000 m areas(OR=1.88,95%CI 1.73-2.04)were independent risk factors for the occurrence of anemia.Conclusions:The prevalence of anemia in children aged 0-6 years in Shannan city was still relatively high.It might be affected by factors such as sex,ethnicity,age of the children,place of residence and altitude where the children lived.