苏州市5岁以下儿童死亡现状与预测分析

An analysis on mortality and prediction among children under-5 in Suzhou

目的分析2008-2017年苏州市5岁以下儿童死亡流行病学特征及预测未来3年死亡率,为制定预防控制措施提供参考依据。方法收集2008-2017年苏州市户籍5岁以下儿童死亡资料,采用描述流行病学方法对死亡率及主要死因顺位进行统计分析,进一步进行检验了解死亡率变化趋势。利用自回归滑动平均混合模型(ARIMA),预测2018-2020年苏州市5岁以下儿童死亡率(U5MR)。结果 2008-2017年苏州市平均U5MR为6. 21‰、婴儿死亡率(IMR)为4. 66‰、新生儿死亡率(NMR)为2. 82‰,随着年份的增加均呈现下降趋势,差异有统计学意义(χ2=354. 71,χ2=244. 14,χ2=122. 35,均P<0. 001)。近10年,5岁以下儿童前5位死因依次为起源于围生期情况、先天异常、伤害、神经系统疾病和呼吸系统疾病。2018-2020年苏州市U5MR预测结果分别为3. 61‰、2. 74‰和1. 88‰。结论苏州市U5MR显著下降,2020年预期降至1. 88‰,目前起源于围生期情况、先天异常和伤害是造成5岁以下儿童死亡的主要死因。

Objective To analyze the epidemiological characteristics from 2008 to 2017 and predict the mortality of the next 3 years among children under-5 in Suzhou,in rank to provide a reference for formulating the preventive and control measures.Methods To collect the death data of children under-5 in Suzhou,2008-2017.The mortality and the rand of death causes were analyzed by descriptive epidemiological methods,the mortality trend of children aged 0~5 years were analyzed by trend Chi-square test.The autoregressive integrated moving average(ARIMA)was used to predict the children under-5 mortality rate(U5 MR)in 2018-2020.Results The average U5 MR in Suzhou was 6.21‰,the infant mortality rate(IMR)was 4.66‰and the neonatal mortality rate,(NMR)was 2.82‰during the period of 2008-2017,which all showed a descending tendency(χ~2=354.71,χ~2=244.14,χ~2=122.35,all P<0.001).In the recent 10 years,the top 5 causes of death in children under-5 were perinatal period diseases,congenital anomaly,injury,nervous and respiratory system diseases.The forecast results of U5 MR in Suzhou were 3.61‰,2.74‰and 1.88‰for 2018 to 2020,respectively.Conclusion The U5 MR decreased significantly in Suzhou,which was expected to fall to 1.88‰in 2020.The perinatal period diseases,congenital anomaly and injury were the main causes of death for children under-5 years old.