2021年江苏省0～6岁儿童出生队列DTaP-IPV/Hib五联疫苗接种率评价

目的 分析2021年江苏省0～6岁儿童吸附无细胞百白破、灭活脊髓灰质炎和b型流感嗜血杆菌（结合）联合疫苗（DTaP -IPV/Hib五联疫苗,以下简称五联疫苗）接种率。方法 通过江苏省预防接种综合服务管理信息系统管理儿童建立2015—2021年出生队列,计算各年度出生队列五联疫苗接种率。结果 截至2021年底,江苏省0～6岁儿童出生队列五联疫苗1～4剂累计分别接种47.39、44.19、40.27 和21.71万剂,累计接种率分别为7.65%、7.14%、6.50%和3.51%。苏南地区五联疫苗接种率高于其他地区,常住儿童接种率高于流动儿童,但地区间分布不平衡。结论 2021年江苏省0～6岁儿童出生队列五联疫苗接种率呈上升趋势,需通过健康宣教和扩大供应等方式进一步提升全程接种率。     

潮阳市1990～2002年0～9岁儿童乙型肝炎发病率分析

乙型肝炎(简称乙肝)是一种严重危害人群健康的传染病。潮阳市疾病监测显示,近年来病毒性肝炎发病率呈明显上升趋势,其中乙肝占总发病数的62．06％^[1]。通过对人群乙肝的流行病学分析,找出流行规律及其影响因素,对于指导乙肝防治有重要意义。     

Persistent diarrhoea in a rural area of Bangladesh: a community-based longitudinal study

As part of a health impact evaluation of a water supply and sanitation project in a rural area of Bangladesh, diarrhoeal morbidity was recorded in children 0-4 years of age using weekly recall in household interviews, during the period March 1984 to December 1987. During the baseline year, 1984, the incidence rate of all diarrhoea episodes (3.8 episodes per child per year), and those defined as persistent, duration greater than 14 days (0.6 episodes per child per year), showed a similar age distribution, peaking in the 12-23 month age group. Sixteen per cent of all episodes were classified as persistent, and this proportion was greatest in the 0-5 month age group (25%). Children suffering at least one episode of persistent diarrhoea in 1984 also experienced a higher incidence of acute diarrhoea (less than = 14 days duration) than those suffering acute diarrhoea only (4.2 versus 3.7 episodes per child per year). Persistent diarrhoea showed a similar seasonal pattern to that of all episodes. Rates of abdominal pain, isolation of Shigella spp and a diagnosis of dysentery were significantly higher in persistent episodes than in acute episodes. Closer follow-up of children during 1986 and 1987, through the recording of all periods of absence of the child from the home, showed that overall diarrhoea incidence rates were little affected when absence was taken into account, but that the incidence of persistent diarrhoea and the proportion of episodes classified as persistent were significantly reduced. The implications of this methodological problem are discussed.     

Contamination of weaning foods and transmission of enterotoxigenic Escherichia coli diarrhoea in children in rural Bangladesh

In longitudinal studies of infectious diseases and nutrition in Bangladesh, we determined the degree of bacterial contamination of traditional weaning foods and evaluated the role of these foods in the transmission of diarrhoeal diseases. 41% of samples of food items fed to weaning aged children contained Escherichia coli; these organisms were used as indicators of faecal contamination. Milk and foods prepared particularly for infants were more frequently and heavily contaminated with E. coli than was boiled rice, and E. coli levels were found to be related to the storage of cooked foods at high environmental temperatures. 50% of drinking water specimens also contained E. coli, but colony counts were approximately 10-fold lower than in food specimens. The proportion of a child's food samples that contained E. coli was significantly related to the child's annual incidence of diarrhoea associated with enterotoxigenic E. coli. This observation underscores the importance of seeking locally available foods that are hygienic as well as nutritious to supplement the diets of breastfeeding children in developing countries.     

Association between clinical type of diarrhoea and growth of children under 5 years in rural Bangladesh

BACKGROUND: The role of diarrhoea in the aetiology of growth retardation in young children remains controversial. To evaluate this, a population-based, longitudinal study of young children aged 6-48 months was conducted in Matlab, a rural area of Bangladesh, between May 1988 and April 1989. METHODS: Data obtained from 584 children were examined by one-year (n = 412) and 3-month (n = 1220) growth periods. Each growth period was analysed based on clinical types of diarrhoea, namely, non-diarrhoea, non-dysentery diarrhoea (diarrhoea without blood), and dysentery (diarrhoea with blood). Weight and height gains were compared among the study groups initially by one-way analysis of variance followed by multivariate analysis adjusting for potential confounding variables. RESULTS: Compared to non-diarrhoea and non-dysentery diarrhoea, dysentery was associated with significantly lower annual weight gain (1866 g [P < 0.01] and 1550 g [P < 0.05] versus 1350 g, respectively) and height gain (6.51 cm and 5.87 cm versus 5.27 cm [P < 0.01], respectively). Both 3-month dysentery and non-dysentery intervals were significantly associated with less weight gain compared to non-diarrhoea intervals (490 g and 522 g versus 637 g [P: < 0.05], respectively). Dysentery intervals were also associated with significantly poorer height gain compared to other intervals (2.19 cm versus 2.42 cm [P < 0.05] and 2.46 cm [P < 0.01], respectively). CONCLUSIONS: The growth of young children is strongly influenced by the clinical type of diarrhoea and the impact is dependent on the proportion of dysentery episodes in the total diarrhoeal burden.     

Spatial distribution of watery diarrhoea in children: identification of "risk areas" in a rural community in Bangladesh

To assess the geographic variation of acute watery diarrhoea in children 0 to 5 years old in rural Bangladesh, all cases of "cholera-like" diarrhoea were plotted on the map. A clustering pattern was noticed, and validated by a nonparametric clustering test for in-homogeneous population. Several risk areas for the disease were identified. In these areas, the point prevalence (8.7/1000) was notably higher than outside the areas (0.41/1000), (95% confidence interval, 15.55-29.30). Parents' education, population density and use of sanitary latrines were significantly related to the risk areas (p < or = 0.001). The results of this study indicate that computer-assisted mapping may be useful in defining and monitoring risk areas for watery diarrhoea in children.     

中国农村0～6岁儿童忽视现状

目的 了解我国农村0～6岁儿童的忽视状况.方法 采用多阶段分层整群随机抽样方法,于2010年11月在全国共抽取10个省(直辖市)中84个乡镇的7411名0～6岁儿童,其中0 ～2岁儿童3315名,3～6岁组4096名.应用“中国农村0～2岁儿童忽视评价常模”、“中国农村3～6岁儿童忽视评价常模”进行问卷调查.采用SPSS 13.0软件对不同年龄、性别、忽视层面(身体、情感、教育、安全、医疗及社会忽视6个层面)的忽视率与忽视度等进行统计学描述、x2检验及方差分析等.结果 中国农村0～2岁组儿童忽视度为45.01±7.56,忽视率为54.9％(1819/3315);3～6岁组儿童忽视度为44.42 ±7.57,忽视率为53.8％(2203/4096).0、1、2岁儿童忽视率分别为58.5％(654/1117)、52.2％(597/1144)、53.9％ (568/1054) (P ＜0.05).3～6岁组中,男性情感、安全忽视层面忽视度(44.60±7.86,36.82±9.03)高于女性(44.03±7.72,36.25±9.05)(P值均＜0.05),情感、社会层面忽视率[16.8％(349/2072),28.3％ (586/2072)]也高于女性[14.1％ (286/2024),24.8％(503/2024)](P值均＜0.05).0～2和3～6岁组儿童均以受到单项忽视为主,发生率分别为20.6％(683/3315)和22.7％(931/4096).0～2岁组以单亲家庭和再婚家庭中儿童忽视率较高[62.5％(15/24)和63.2％ (12/19)],3～6岁组以单亲家庭中儿童忽视率最高(60.0％,27/45).结论 中国农村0～6岁儿童忽视状况严重,有待于进一步探讨其影响因素,从而采取有效干预措施.     

Low birth weight is associated with altered immune function in rural Bangladeshi children: a birth cohort study

BACKGROUND: Low birth weight is generally an outcome of a fetal insult or nutritional insufficiency. Recent studies have shown that such exposure early in life may have long-term implications for later immunocompetence and susceptibility to infectious diseases. OBJECTIVE: We aimed to investigate the effect of birth weight on immune function in preschool-age children. DESIGN: A birth cohort cross-sectional study was conducted in children (n = 132) aged 60.8 +/- 0.32 mo who were born in Matlab, a rural area of Bangladesh, and whose weight and length were measured within 72 h of birth. The outcome measures were thymopoiesis, T cell turnover, acute phase response, and percentage of lymphocytes. RESULTS: Children born with low birth weight (<2500 g; LBW group, n = 66) had significantly higher concentrations of T cell receptor excision circles in peripheral blood mononuclear cells-a biomarker for thymopoiesis-and significantly higher serum bactericidal activity and C-reactive protein concentrations than did children born with normal birth weight (>or=2500 g; NBW group, n = 66) (P < 0.05 for both). The LBW group children had significantly lower concentrations of interleukin 7 in plasma (P = 0.02), shorter telomere length in peripheral blood mononuclear cells (P = 0.02), and a lower percentage of CD3 T cells (P = 0.06) than did the NBW group children. CONCLUSIONS: Greater peripheral T cell turnover (shorter telomeres and lower CD3 concentrations) due to immune activation (elevated C-reactive protein concentrations and bactericidal activity) may have resulted in a greater need for replenishment from the thymus (higher T cell receptor excision circles); these events may cause lower immune functional reserve in preschool-age children born with LBW. Thus, LBW has implications for immunocompetence and increased vulnerability to infectious diseases in later life.     

陕西省0～12岁农村儿童意外伤害影响因素分析

探讨陕西省农村地区0～ 12岁儿童意外伤害发生的影响因素,对今后开展儿童意外伤害健康教育,做好预防工作提供依据. 1.资料与方法:2010年5-6月,在陕西省蒲城、淳化、西乡、佳县、榆阳5个区县开展农村儿童意外伤害调查.以儿童是否发生意外伤害为结局变量,以村庄为2水平,个体为1水平建立两水平logistic回归模型.将家庭住房特征和耐用消费品等因素做主成分分析,构造综合财富指数.数值越大,说明家庭经济状况越好.分析时将其划分为3个等级,即贫困、中等、富裕.使用SPSS 20.0软件和SAS 9.1软件对数据进行整理和分析.     

Epidemiology of rotavirus and cholera in children aged less than five years in rural Bangladesh

Despite the known presence of rotavirus-associated diarrhoea in Bangladesh, its prevalence, including records of hospitalization in rural health facilities, is largely unknown. In a systematic surveillance undertaken in two government-run rural health facilities, 457 children, aged less than five years, having acute watery diarrhoea, were studied between August 2005 and July 2007 to determine the prevalence of rotavirus. Due to limited financial support, the surveillance of rotavirus was included as an addendum to an ongoing study for cholera in the same area. Rotavirus infection was detected in 114 (25%) and Vibrio cholerae in 63 (14%) children. Neither rotavirus nor V cholerae was detected in 280 (61%) samples; these were termed 'non-rotavirus and non-cholera' diarrhoea. Both rotavirus and cholera were detected in all groups of patients (<5 years). The highest proportion (41%; 47/114) of rotavirus was in the age-group of 6-11 months. In children aged less than 18 months, the proportion (67%; 76/114) of rotavirus was significantly (p < 0.001) higher than that of cholera (16%; 10/63). By contrast, the proportion (84%; 53/63) of cholera was significantly (p < 0.001) higher than that of rotavirus (33%; 38/114) in the age-group of 18-59 months. During the study period, 528 children were hospitalized for various illnesses. Thirty-eight percent (202/528) of the hospitalizations were due to acute watery diarrhoea, and 62% were due to non-diarrhoeal illnesses. Rotavirus accounted for 34% of hospitalizations due to diarrhoea. Severe dehydration was detected in 16% (74/457) of the children. The proportion (51%; 32/63) of severe dehydration among V cholerae-infected children was significantly higher (p < 0.001) compared to the proportion (16%; 18/114) of rotavirus-infected children. The study revealed that 12-14% of the hospitalizations in rural Bangladesh in this age-group were due to rotavirus infection, which has not been previously documented.     

An interval scale for development of children aged 0-2 years

Measurement of development is often less precise than that of height and weight. Developmental scores are typically based on passing one or more developmental markers, but do not have interval scale so calculating differences between scores can be nonsensical. Age-specific standardized scores are sometimes used, but fail to have a common metric that allows comparison of developmental scores across age. The goal of this study is to develop a quantitative developmental score (D-score) with improved measurement characteristics. The basic assumption of the D-score is the existence of a common continuous scale for the development. Scores of 2151 children between 0 and 2 years on a Dutch developmental instrument were analysed. Application of the Rasch Model resulted in excellent reliability and satisfactory fit. This indicates that the new quantitative D-score succeeds in representing outcomes of the instrument on a common interval scale. Age-conditional reference values for the D-score were derived by means of the LMS method. The definition of the D-scores is not specific to age, so the D-score of a measured person can be compared to the D-score of another person of a different age. Difference scores between sessions can be used to evaluate developmental velocity on the individual level. To our knowledge this is the first developmental scale for children with such properties.     

重庆市农村0～6岁儿童忽视现状及影响因素

目的 了解重庆市农村0～6岁儿童忽视状况及影响因素.方法 采用“中国农村儿童忽视评价常模”中制定的量表和评价方法及分层多级整群抽样方法,于2010年12月在重庆市3个区抽取822名0～6岁农村儿童作为调查对象,用忽视率和忽视度描述其受忽视状况,采用logistic多因素回归分析方法分析影响忽视的相关因素.结果 调查对象忽视率和忽视度分别为35.64％(293/822)、49.69±6.45.男童忽视度(50.23±6.40)高于女童(49.09±6.47)(P＜0.05);留守儿童忽视率[40.48％(202/499)]与忽视度(50.64±6.29)均高于非留守儿童[28.17％(91/323),48.23±6.44](P ＜0.05).多因素非条件logistic回归分析结果显示,留守儿童(OR=1.61,95％ CI:1.17 ～2.21)、单亲和再婚家庭(OR=1.39,95％CI:1.10～1.76)、在家务农和外出务工的母亲职业(OR=0.81,95％CI:0.73 ～0.90)、冷淡疏远的母子关系(OR=1.42,95％ CI:1.02～ 1.97)等情况的儿童更容易受到忽视.结论 重庆市农村0～6岁儿童受忽视程度比较严重,影响儿童受忽视的主要因素为留守儿童、单亲和再婚家庭、在家务农和外出务工的母亲职业、冷淡疏远的母子关系.     

2013年中国0～2岁儿童血红蛋白值空间分布特征

目的获取中国不同地区的儿童血红蛋白值对于制定各地区儿童贫血判断标准具有重要的指导意义。方法利用2010—2013年中国居民营养与健康状况监测中13 951名0～2岁儿童数据(男童7192人,女童6759人;城市6866人,农村7085人),利用SAS统计分析儿童血红蛋白值特征,基于地理信息系统(GIS)空间分析方法进行血红蛋白反距离权重空间插值,获得中国儿童血红蛋白空间分布,并进行儿童血红蛋白值与海拔高度的相关性分析。结果 2013年中国0～2岁儿童血红蛋白值为112. 02～139. 03 g/L,黑龙江伊安县[(139. 04±1. 22) g/L]和甘肃康乐县[(132. 43±0. 82) g/L)儿童平均血红蛋白值最高,其次山西、云南、安徽、青海、福建等省份监测点儿童也具有较高的血红蛋白平均值(124. 03～128. 72 g/L)。血红蛋白空间插值结果表明,中国0～2岁儿童血红蛋白呈现出空间差异性特征,分别形成以黑龙江、甘肃-青海、山西、云南为核心的内陆高值区,安徽-江苏-浙江-福建的临海高值区,四川东部-重庆-湖北西部-陕西南部、内蒙古-山西-陕西交界处、北京-河北、吉林-辽宁交界、广东南部、海南等血红蛋白低值区。血红蛋白与海拔高度的相关性分析发现,2013年中国0～2岁儿童血红蛋白平均值与海拔高度无显著相关关系(r=0. 18,P=0. 19)。结论 2013年中国0～2岁儿童血红蛋白空间分布具有显著的地区差异,形成局部血红蛋白高值区和低值区,而这种特征与海拔高度无显著的相关关系。     

浙江省0～2岁儿童先天性心脏病患病率研究

目的　了解０ ～２ 岁儿童先天性心脏病（ 先心病） 患病情况。方法　利用心脏听诊和超声检查相结合的方法，对浙江省嘉兴等１３ 个市县０ ～２ 岁儿童进行了先心病患病率调查和病因分析。结果　发现０ ～２ 岁儿童先心病患病率为３．７２ ‰。不同年龄组间先心病患病率存在差异，０岁组最高，为５ ．５４‰；１ 岁组次之，为３ ．３６ ‰；２ 岁组最低，为２ ．６６ ‰。男女间先心病患病率没有差异。室间隔缺损比例最高，占５９ ．４ ％ 。结论　表明先心病属我国重要的公共卫生问题之一，开展出生儿先心病监测和病因研究，减少先心病发生，对提高儿童生命质量有重要的意义。     

河北省0～6岁儿童出生缺陷基本情况调查与分析

目的:调查河北省0～6岁出生缺陷儿童基本情况和发生现状。方法:采用个人访谈、整群回顾性调查方法,由调查员入户,根据调查表内容对0～6岁儿童经医院确诊及肉眼可见出生缺陷情况逐一填写。结果:调查河北省辖区2003～2008年出生的儿童总数为4611808例,出生缺陷儿童总数29564例,出生缺陷发生率64.1/万;前6类出生缺陷顺位为:脑瘫、先天性心脏病、先天性四肢畸形、唇腭裂、先天性智力低下、先天性聋哑;各市间出生缺陷发生率明显不同,其中出生缺陷发生率最高的地区为承德市,其次为邯郸市,廊坊市发生率最低。山区出生缺陷发生率高于丘陵和平原,乡村出生缺陷发生率高于城市;不同年度、性别和孩次儿童出生缺陷发生率不同;男性和女性出生缺陷发生例数和发生率分别为18039例(79.9/万)和11526例(55.6/万);一孩、二孩和多孩出生缺陷发生例数和发生率分别为18646例(21.6/万)、10173例(74.5/万)和706例(139.6/万)。结论:河北省0～6岁儿童出生缺陷发生状况在不同年度、地域、地势、城乡之间有明显不同,且男性高于女性,并随孩次的增加而明显增加。     

城乡婴幼儿维生素B_1、维生素B_2和烟酸机体营养状况分析

目的了解城市和农村地区婴幼儿维生素B1(VB1)、维生素B2(VB2)和烟酸的机体营养状况及其差异,为制定婴幼儿营养干预措施提供依据。方法抽取山东省某市0～3岁婴幼儿106名,农村0～3岁婴幼儿290名。取婴幼儿晨尿40ml,采用荧光法测定尿液中VB1、VB2和烟酸的含量。结果城市婴幼儿VB1、VB2和烟酸偏低和不足的百分比分别为1.9%、8.0%和9.1%,农村分别为4.5%、56.7%和27.1%。城乡婴幼儿机体VB1含量的中位数分别是495.00和420.56μg/g,其中12月～和24月～组城市高于农村(P<0.05)。城乡婴幼儿机体VB2含量的中位数为303.07和70.88μg/g,各年龄组婴幼儿VB2城市均高于农村(P<0.05)。城市及农村婴幼儿机体烟酸含量的中位数分别为6.31和4.22mg/g,其中6月～组、12月～组、18月～、24月～组婴幼儿烟酸含量存在城乡差异,城市高于农村(P<0.05)。结论城市和农村地区婴幼儿VB1、VB2和烟酸机体营养状况城乡差异显著,且城市均好于农村,农村地区VB2和烟酸缺乏比例较高。     

Adverse pregnancy outcomes in rural Maharashtra, India (2008-09): a retrospective cohort study

ABSTRACT: BACKGROUND: The study was carried out to record adverse pregnancy outcomes and to obtain information about sex ratio at birth in rural especially tribal areas in the State of Maharashtra, India. About 10% population of the state is tribal. Although the tribal population is considered vulnerable to innumerable adversities, regretfully information about pregnancy wastage among them is not available. The study of sex ratio at birth was planned as the overall sex ratio and child sex ratio had declined in the state. METHODS: The cohort of antenatal cases registered in rural areas of Maharashtra in the calendar year 2008 was followed up to study the pregnancy outcomes. A retrospective study was carried out from October 2009 to August 2010. The outcomes of all the registered antenatal cases were recorded by the Auxiliary Nurse Midwives. The summary sheets were obtained by Block Medical Officers. The data was entered at the block level by trained data entry operators in specially designed web-based software. Adverse pregnancy outcome was categorized in two groups abortion and stillbirth. RESULTS: About 1.1 million registered pregnancies were followed up. In the state 5.34% registered pregnancies ended in abortions. In tribal PHCs the relative risk of spontaneous abortion and induced abortion was 0.91and 0.38 respectively. It was also revealed that about 1.55% pregnancies culminated in stillbirth. The relative risk of stillbirths in tribal PHCs was 1.33. The sex ratio at birth in the state was 850. The ratio was 883 in the tribal PHCs. Correlation was observed between sex ratio at birth and induced abortion rate. CONCLUSIONS: The study indicates that women from tribal PHCs are exposed to higher risk of adverse pregnancy outcome in the form of stillbirths. In non-tribal PHCs high induced abortion rate and poor sex ratio at birth is observed. These two indicators are correlated. The correlation may be explained by the unscrupulous practice of sex selective abortion.     

上海市7岁以下儿童头胸围发育的调查

[目的 ]　了解上海市 7岁以下儿童头胸围发育现状 ,1985～ 1995年头胸围相互变化的规律。 [方法 ]　选取同年龄、同性别、同城乡的 0～ 6岁儿童分 2 2个年龄组 ,每组 2 0 0例 ,分析头胸围的均数及标准差。 [结果 ]　1995年现状 :0～ 4个月龄的婴儿 ,胸围增长的速度大于头围 ,4～ 12月龄婴儿 ,胸围增长速度小于头围 ,1岁以后胸围增长速度又大于头围。头胸围交叉相对早的婴儿 ,体格发育优越。 1985年与 1995年比较 :头胸围交叉时间无明显提前 ,个别年龄组有延迟。 10年均值比较发现 ,胸围发育落后于头围发育。 [结论 ]　头胸围增长速度因年龄增长而变化。 10年比较 ,胸围发育落后于头围发育。     

辽宁省0～14岁儿童格林-巴利综合征流行病学分析

目的 分析辽宁省儿童格林－巴利综合征（GBS）的发病率、分布特征及可能的危险因素。方法 对辽宁省1997－2001年上报的218例0－14岁GBS病例进行个案调查，并进行统计分析。结果 辽宁省0－14岁GBS报告发率为0.65/10万，病死率为4.1%。残留麻痹率为55.4%。肠道病毒分离阳性率为7.3%。发病率存在季节差异，夏季发病率较高为0.93/10万，冬季发病率较低为0.4/10万，夏季、冬季发病率有显著性差异（P＜0.05）。结论 肠道病毒感染及口服脊髓灰质炎疫苗可能是该病的一个诱因。辽宁省儿童GBS有很高的残留麻痹率。为55.4%，与应当引起临床医生、防疫工作者和儿童家长的高度重视。