大连市2005年集居儿童健康状况监测分析

目的:通过对影响我市集居儿童健康状况因素的分析,探讨并改进集居儿童卫生保健管理模式,提高管理水平。方法:对2005年大连市74368名儿童的体检结果进行监测分析。结果:我市集居儿童营养不良患病率为1.50%,城乡差异显著;单纯性肥胖患病率为6.06%,呈逐年上升趋势;VD缺乏性佝偻病、缺铁性贫血患病率呈逐年下降趋势。结论:大连市集居儿童健康状况良好,今后要重点加强肥胖儿童的管理,降低农村集居儿童营养不良患病率,重点开展小年龄组儿童佝偻病、贫血的预防工作。     

辽阳市2003～2007年集体儿童健康状况纵向分析

目的:掌握近5年辽阳市集体儿童健康状况及变化趋势,为改善集体儿童健康水平提供科学依据。方法:采用2003～2007年全市托幼园所儿童健康统计报表资料,对0～6岁儿童健康状况进行分析。结果:近5年儿童营养不良状况呈下降趋势,肥胖患病率呈逐年上升趋势,儿童贫血患病率在2.52%～3.23%之间波动;口腔龋齿患病率在39.24%～40.57%之间波动;视力低下呈逐年上升趋势。结论:近5年间辽阳市集体儿童营养状况有所改善,今后应加强贫血、口腔龋齿、视力低下等预防保健和肥胖儿童干预工作。     

北京市西城区2003至2012年集体儿童健康状况分析

目的了解北京市西城区集体儿童健康状况变化趋势,为儿童保健管理决策提供依据。方法采用时间序列比较法对北京市西城区2003至2012年集体儿童保健年报资料进行分析。结果10年间儿童低体重、生长迟缓和消瘦患病率均低于0．25％;儿童贫血率逐年下降;儿童肥胖检出率有逐年下降趋势（χ2＝30．11,P＜0．05）,但其检出率仍较高（5．49％）,5～6岁儿童明显高于3～4岁儿童;儿童龋患率高于30％,4～6岁集体儿童视力低常检出率呈逐年下降趋势,儿童弱视患病率也有下降趋势（χ2值分别为31．51、15．43,均P＜0．05）。结论北京市西城区托幼园所3～6岁儿童健康状况良好,预防和干预儿童肥胖、口腔龋齿和视力低常仍是今后工作重点。     

滨州市集体儿童9年健康发育变化趋势分析

目的:探讨滨州市幼儿园集体儿童生长发育健康状况的变化趋势,为儿童保健提供依据。方法:采用时间序列比较方法对滨州市属幼儿园1998年~2006年儿童健康查体资料进行整理、比较、分析。结果:9年间营养不良连续处于较低水平(1%左右);肥胖呈明显上升趋势;龋病患病率下降明显;贫血患病率有波动,总体呈下降趋势。结论:9年间滨州市集体儿童营养不良发病率一直处于较低水平;儿童肥胖率增长明显;儿童龋病、儿童贫血分别得到有效控制。     

2007～2009年新余市城区集体儿童健康体检结果分析

目的:掌握新余市城区集体儿童的健康状况及变化趋势,为行政部门决策提供科学依据。方法:收集、整理、分析2007～2009年新余市城区集体儿童健康体检资料及健康状况统计表。结果:2007～2009年新余市城区集体儿童低体重发病率分别为2.01%、1.56%、1.29%,生长发育迟缓分别为3.53%、1.80%、1.40%,贫血患病率分别为11.42%、9.47%、8.35%,均有逐年下降的趋势;肥胖患病率分别为1.17%、1.65%、1.85%,龋齿患病率分别为16.05%、20.00%、22.65%,有上升趋势。结论:新余市城区集体儿童健康水平逐年提高,营养不良、贫血患病率呈逐年下降趋势,肥胖、龋齿患病率呈上升趋势。提示预防肥胖、龋齿是城区托幼机构儿童保健工作的重点。     

仪征市托幼集体儿童2000-2009年健康状况分析

目的 了解10 a间托幼集体儿童健康状况变化趋势,为制定幼儿园保健管理措施提供依据.方法 对仪征市16所幼儿园集体儿童2000-2009年健康检查结果进行统计分析.结果 儿童体重达标率、身高达标率、肥胖检出率逐年提高,营养不良患病率呈下降趋势;贫血检出率在1.25%～5.23%之间,波动中有下降趋势;龋齿患病率呈下降趋势,但仍处在较高水平.2000年与2009年各项指标比较,差异均有统计学意义(P值均＜0.01).结论 仪征市集体儿童营养状况良好.应加强肥胖、营养不良、贫血儿童专案管理以及口腔保健管理工作.     

北京市1990～1996年0～6岁儿童健康状况分析

目的 为分析北京市1990～1996年0～6岁儿童健康状况.方法 采用纵向比较方法对北京市1990～1996年儿童保健年报资料进行了分析.结果 (1)北京市4个月内婴儿母乳喂养率逐年提高,按NPA定义,1996年达88.96%;儿童中重度营养不良患病率由1990年的2.44%下降到1995年的1.11%;儿童贫血、佝偻病患病率逐年下降,分别由1990年的7.23%、3.50%下降到1996年的3.09%、0.97%;(2)同一时期农村儿童中重度营养不良、贫血、佝偻病患病率高于城市儿童;3岁以下儿童中重度营养不良及贫血患病率高于3岁以上儿童.结论 提示儿童保健工作的重点是婴幼儿和农村儿童.     

郑州市2009年—2011年城市、农村儿童保健情况分析

目的了解郑州市2009年10月1日—2011年9月30日城市、农村儿童保健指标变化和儿童保健工作情况,分析郑州市儿童健康状况。方法根据郑州市2009年—2011年妇幼卫生年报表,对年报表的部分儿童保健指标进行回顾性分析。结果比较2009—2011年的儿童保健指标,5岁以下儿童死亡率、婴儿死亡率农村均高于城市,且呈逐年下降趋势;3岁以下儿童系统管理率、7岁以下儿童保健管理率城市均高于农村,呈逐年上升趋势。结论提高儿童保健工作质量,不单要重视儿童保健水平,还要加强围产期保健管理。该市要继续加强各级妇幼保健人员的专业知识、技能培训,不断提高郑州市儿童保健工作水平。     

北京市0～6岁儿童健康状况10年变化趋势分析

目的 为分析北京市０～６岁儿童健康状况１０年变化趋势。方法 采用纵向比较方法对北京市１９９０～１９９９年儿童保健年报资料进行了分析。结果 ①北京市４个月内婴儿母乳喂养率逐年提高,按ＮＰＡ定义,１９９９年达９０．９９％;儿童中重度营养不良患病率由１９９０年的２．４４％下降到１９９９年的０．６０％;儿童贫血、佝楼病患病率分别由１９９０年的７．２３％、３．５０％下降到１９９９年的２．６７％、０．７６％;②同期农村儿童中重度营养不良、贫血、佝楼病患病率高于城市儿童;３岁以下儿童中重度营养不良及贫血患病率高于３岁以上儿童。结论 提示儿童保健工作的重点是婴幼儿和农村儿童。     

2004年大连市0~6岁儿童健康状况分析

目的:探讨2004年大连市0～6岁儿童健康状况。方法:采用分层整群抽样方法,对大连市0～6岁儿童健康情况进行调查。结果:2004年大连市母乳喂养率92 .38%,佝偻病发生率8. 08%,上呼吸道感染发生率62 .22%,腹泻发生率22 .40%,贫血患病率3 .11%,肥胖发生率3 .33%。结论:大连市儿童营养状况良好,儿童保健的工作重点是婴幼儿保健和农村儿童保健,肥胖儿童的预防和干预也将成为今后工作的重点。     

2007—2011年厦门市海沧区集体儿童健康状况分析

目的了解2007—2011年海沧区3~6岁集体儿童5年来体格发育变化情况及常见病患病率变化趋势,为儿童保健管理决策提供科学依据。方法采用纵向比较方法,对2007—2011年海沧区3~6岁集体儿童体格检查资料进行整理分析。结果 2007—2011年海沧区3~6岁集体儿童身高(身长)体质量达标率呈上升趋势(P<0.05);营养不良(低体质量、发育迟缓、消瘦)、龋齿、贫血患病率呈现下降趋势(P<0.05);但肥胖检出率逐年上升(P<0.05)。结论海沧区集体儿童健康状况良好,但肥胖儿的增多应引起重视,预防和干预肥胖是下一步工作重点。     

2006～2010年北京市通州区永顺镇0～6岁婴幼儿健康体检分析

目的了解北京市通州区永顺镇0～6岁婴幼儿健康状况,为提高婴幼儿健康水平制定相应预防控制措施提供依据。方法采用纵向比较法,对2006～2010年永顺镇0～6岁婴幼儿每年参加健康体检者数据进行统计分析,评估婴幼儿健康状况,分析逐年变化规律。结果永顺镇0～6岁婴幼儿各类营养不良患病率处于较低水平;肥胖婴幼儿患病率由2006年的1.90%上升到2010年的3.42%;辖区内0～2岁婴幼儿贫血患病率明显高于3～6岁幼儿;视力低常幼儿检出率由2006年的1.08%上升到2010年的5.02%。结论婴幼儿贫血、肥胖预防控制工作是今后的工作重点,视力低常已成为影响幼儿健康的新问题。     

顺义区城区学龄前儿童营养与健康状况评价

目的研究顺义区部分学龄前儿童的生长发育及营养健康状况,制定干预措施。方法采用整群抽样法,随机抽取5所幼儿园999名1～7岁学龄前儿童,进行医学体检、实验室检测。采用WHO和卫生部标准评估学龄前儿童营养与健康状况。结果999名学龄前儿童营养状况正常的占77．8％,营养不良和超重肥胖分别占总调查儿童的5．71％和16．51％。平均血红蛋白125．86g/L,贫血16人．检冉率为1．60％,铁不足者占19．52％。结论要提高学龄前儿童的健康水平,教育和卫生行政部门要进一步加强个体幼儿园管理．加强对幼教人员的培训．提高其业务素质,监督幼儿园落实各项卫生保健制度。     

乌鲁木齐市学龄前集体儿童健康状况调查

目的:通过对乌鲁木齐市学龄前集体儿童健康状况调查,了解和评定乌鲁木齐市学龄前集体儿童生长发育状况,探讨存在的问题并提出干预措施,以提高儿童健康水平。方法:采用分层整群抽样方法从乌鲁木齐市所属9个区中随机抽取3个区的9所幼儿园中1483名3～6岁儿童,测量体重和身高,检测龋齿患病情况及血红蛋白含量,并采用统计学方法分析乌鲁木齐市学龄前儿童体重、身高的均值与2005年我国9城市比较。结果:乌鲁木齐市学龄前儿童中所有年龄组男、女童体重、身高测定值均为男童大于女童,且均高于2005年9城市标准。营养不良、贫血、肥胖及龋齿的患病率分别为0.9%、6.1%、9.6%及40.6%,不同年龄龋齿患病率差异有统计学意义(P<0.05)。结论:乌鲁木齐市学龄前集体儿童体格发育良好,肥胖患病率高于其他城市,应加强健康教育,严格按照疾病的防治常规制订防范措施,做到早期预防和早期发现,综合防范,群防群治,减少疾病的患病率,提高儿童健康水平。     

Using routine growth monitoring data in tracking overweight prevalence in young children

BACKGROUND: Childhood obesity is a public health concern in Canada. Few anthropometrical data are available to monitor the obesity trend in young Canadian children. This study explored the feasibility of using routine growth monitoring data from physicians' offices for tracking the prevalence of obesity in children from two to six years of age in County of Middlesex and the City of London, Ontario. METHOD: Data on body weight and height were retrieved from the growth chart at each immunization visit and routine checkup in five medical centres in the Middlesex-London area. Postal code data were also collected as a proxy measure for socio-economic status. The BMI-for-age references by the Centers for Disease Control and Prevention (CDC) of the United States were used to classify the weight status of the children. RESULTS: In total, 1,370 growth charts of children from two to six years of age were reviewed. Approximately 30% of young children were either at risk of being overweight or were overweight, with an onset as early as age two. CONCLUSION: Overweight is prevalent in young children. Data from routine growth monitoring in primary health care settings have great potential to be used as a population-based data source to track the prevalence of obesity in young children.     

北京市儿童肥胖的生活行为因素和家庭聚集性

目的 探讨儿童肥胖与其生活行为因素、父母肥胖的关系,为制定儿童肥胖的防治政策提供依据.方法 整群随机选取北京市城郊21 198名2～18岁儿童进行横断面研究.问卷调查包括儿童肥胖的家庭环境因素及其父母的肥胖情况;体格测量主要为儿童的身高、体重.采用SPSS13.0软件进行统计学分析,包括一般性描述、趋势卡方检验和非条件logistic回归分析.结果采用国际肥胖工作组推荐的儿童肥胖参考值(IOTF参考值),21 198名2～18岁儿童肥胖率为5.6%.儿童吸烟、饮酒等行为因素及其肥胖状况存在家庭聚集性.父母均不吸烟、一方吸烟、双亲均吸烟的子女吸烟率分别为1.50%、2.93%和6.01%(χ2趋势=45.422,P<0.01);父母均不饮酒、一方饮酒、双亲均饮酒的子女饮酒率分别为5.85%、9.12%和13.96%(χ2趋势=107.009,P<0.01).根据双亲BMI状态分组,"父母正常"、"父亲肥胖"、"母亲肥胖"、"双亲肥胖"各组中儿童肥胖率分别为3.29%、11.48%、9.12%和27.01%(χ2趋势=293.404,P<0.01).控制性别、年龄后,体育锻炼、睡眠、吃禽类食物、看电视、饮酒可能是儿童肥胖的影响因素.控制年龄、性别、青春期等协变量,与父母体重正常相比,母亲肥胖对女儿肥胖的影响较大(OR=5.93,95% CI:3.57～9.84),而父亲肥胖对儿子肥胖的影响较大(OR=4.29,95% CI:3.21～5.72).父母同时肥胖对女儿肥胖产生的影响(OR=28.51,95%CI:15.13～53.72),远远大于其对儿子肥胖的影响(OR=7.21,95% CI:4.07～12.75);其对2～5岁、10～12岁儿童的影响(OR=18.67,95% CI.49～234.46;OR=22.25,95% CI:10.62～46.59),大于其对其他年龄组肥胖的影响.结论 父母肥胖可能是儿童肥胖的独立危险因素,且关联存在性别、年龄差异.父母生活行为对儿童具有重要影响,对儿童肥胖的预防或干预应重视家庭环境因素.     

Inclusion team science improves participation of children with disabilities in pediatric obesity programs

BackgroundChildren with disabilities have higher prevalence rates of obesity compared to children without disabilities. Evidence supports the importance of early interventions in preventing pediatric obesity from progressing to adulthood obesity but there are limited opportunities for children with disabilities to participate in these early life programs.ObjectiveThe aim of this study was to examine multiple frameworks of disability inclusion that progressively reshaped an existing pediatric obesity intervention program toward improving participation for children with disabilities.MethodsA qualitative narrative analysis approach involving semi-structured interviews, focus groups and participant observations was used to describe the experiences of eight obese children with disabilities, twelve obese children without disabilities, ten parents and ten volunteer healthcare student trainers who participated in an obesity intervention program, Fit Kids for Life (FKFL).ResultsFKFL participants' positive worldviews of disability inclusion, active involvement of parents and family members, diverse team of health professionals and volunteers, and improved health outcomes facilitated children with disabilities’ participation in the program. Disability and obesity stigma and lack of local inclusive sites hindered access and participation for children with disabilities.ConclusionsResults support using inclusion team science to improve participation and outcomes of a pediatric obesity intervention program for children with disabilities.     

Disparities in Obesity and Overweight Prevalence Among US Immigrant Children and Adolescents by Generational Status

We examined the prevalence and socio-behavioral correlates of obesity and overweight among 46,707 immigrant and US-born children and adolescents aged 10–17 years. The 2003 National Survey of Children’s Health was used to estimate obesity and overweight prevalence among children in 12 immigrant groups, stratified by race/ethnicity and generational status. Logistic regression was used to examine immigrant differentials in the prevalence and odds of obesity and overweight. Obesity and overweight prevalence varied from a low of 6 and 18% for second-generation Asian immigrants to a high of 24 and 42% for native-born black children (US-born black children with US-born parents), respectively. After adjusting for age, gender, ethnicity, socioeconomic status, perceived neighborhood safety, television viewing, computer use, and physical activity, first-generation immigrant children, overall, had 26% lower odds of obesity than native-born children. Obesity and overweight prevalence was lower for immigrant black and white children than their native-born counterparts, while obesity and overweight prevalence among Hispanic children did not vary significantly by generational status. Compared with native-born white children, the adjusted odds of obesity were 64% higher for native-born blacks, 55% higher for second-generation Hispanic immigrants, and 63% lower for first-generation Asian immigrants. Adjusted immigrant differentials in overweight risks were also marked. Socioeconomic, demographic, and behavioral factors accounted for 61 and 35% of ethnic-immigrant disparities in obesity and overweight prevalence, respectively. Immigrant patterns in childhood obesity and overweight vary substantially by ethnicity and generational status. To reduce disparities, obesity prevention programs must target at-risk children of both immigrant and US-born parents.     

Nutritional status of urban schoolchildren of high and low socioeconomic status in Quetzaltenango, Guatemala.

OBJECTIVE: The prevalence of overweight and obesity is growing in children in many developing countries, increasing chronic disease risk. Our objective was to assess the prevalence of stunting, underweight, overweight, and obesity in schoolchildren 8 to 10 years old who were of high or low socioeconomic status (SES) in Quetzaltenango, which is the second largest city in Guatemala. METHODS: Between April and June 2005 we conducted a cross-sectional survey among 583 children in private and public elementary schools, in which we measured height and weight. The Centers for Disease Control and Prevention (CDC) 2000 height-for-age z-scores, weight-for-age z-scores, and body mass index-for-age centiles were used to define stunting, underweight, overweight, and obesity. RESULTS: Mean height, weight, and body mass index were significantly higher in the 327 children of high SES than in the 256 children of low SES, across sexes and age groups. The prevalence of stunting was significantly higher in low-SES children than in high-SES ones (27.0% vs. 7.3%, P < 0.01) , and this was also true for underweight (14.1% versus 4.6%, P < 0.01). In contrast, the prevalence of overweight (17.7% versus 10.5%, P < 0.01) was higher in high-SES children than in low-SES ones; the same was true for obesity (14.4% versus 2.3%, P < 0.01). The prevalence of stunting among children of low SES, and the prevalence of overweight and obesity among children of high SES far exceeded the CDC 2000 reference ranges. CONCLUSIONS: A high prevalence of both stunting and excess body weight was found in this urban Guatemalan population, with notable contrasts between social classes. The obesity among high-income children indicates that the city is undergoing the nutrition transition, with further implications for future risks related to chronic disease. Nutrition and health interventions are needed to reduce these risks.     

沈阳市城区0～18岁儿童单纯性肥胖症流行病学研究

目的:了解沈阳市0～18岁儿童、青少年单纯性肥胖症在人群中的分布特点,分析发展趋势,为制定正确的防治对策提供科学依据。方法:采用美国卫生统计中心/疾病控制中心(NCHS/CDC)制定的身高标准体重法,按照整群分层抽样的方法调查沈阳市5个城区0～18岁儿童17332人,其中0～5岁10555人,6～18岁6777人。结果:沈阳市0～18岁儿童青少年总肥胖检出率为11.48%,总超重检出率为12.48%。学龄前儿童肥胖检出率为6.13%,超重检出率为13.22%,肥胖超重比为2.2,脂肪重聚年龄为3岁。学龄儿童肥胖检出率为19.80%,超重检出率为11.33%,肥胖超重比为0.6。与1996年相比,10年动态趋势为学龄前儿童肥胖检出率年增长值为21.5%,学龄儿童为21.1%。结论:沈阳市城区有近1/4的儿童青少年超重和肥胖,10年增长率处于失控的奇高速度。儿童青少年肥胖已经成为沈阳市一个重要公共卫生问题,需引起社会的高度关注。