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目的:分析2003~2012年兰州市5岁以下儿童死亡率及变化趋势,预测近3年死亡率。方法:对兰州市5岁以下儿童死亡年报资料进行整理分析,采用曲线拟合方法建立预测模型,经统计学检验和评价后根据拟合优度选择最佳模型进行预测。结果:2012年早期新生儿、新生儿、婴儿及5岁以下儿童死亡率分别为4.09‰、5.23‰、6.74‰、7.47‰,较2003年分别下降了71.54%、66.54%、63.19%、62.44%;2003~2012年10年间郊县与城区早期新生儿、新生儿、婴儿及5岁以下儿童死亡率均呈下降趋势,郊县的降幅更大且两者差距逐渐缩小;2015年4项指标预计分别为2.53‰(95%CI:1.94‰~3.32‰)、3.17‰(95%CI:2.21‰~4.53‰)、4.21‰(95%CI:3.14‰~5.65‰)和4.73‰(95%CI:3.67‰~6.10‰)。结论:减少新生儿死亡,特别是早期新生儿死亡是降低5岁以下儿童死亡的关键;未来工作的重点依旧是郊县保健工作质量的提高。
Objective: To analyze the mortality rate and change trend of children under 5 years of age in Lanzhou City from 2003 to 2012, and predict the mortality rate in recent 3 years. Methods: The data of annual deaths of children under 5 years of age in Lanzhou were collected and analyzed. The prediction model was established by curve fitting method. The best model was selected according to the goodness of fit by the statistical test and evaluation. Results: The mortality rates of neonates, newborns, infants and children under 5 years old in early 2012 were 4.09 ‰, 5.23 ‰, 6.74 ‰ and 7.47 ‰, respectively, down 71.54%, 66.54%, 63.19% and 62.44% In the 10-year period from 2003 to 2012, the mortality rate of newborns, newborns, infants and children under 5 years of age in suburban and urban areas showed a downward trend, while that in suburban and rural areas decreased more and the gap between the two was gradually reduced. In 2015, four indicators are expected (95% CI: 3.14 ‰ ~ 5.65 ‰) and 4.73 ‰ (95% CI: 2.94 ‰ ~ 3.32 ‰), 3.17 ‰ (95% CI: 2.21 ‰ ~ 4.53 ‰) : 3.67 ‰ ~ 6.10 ‰). CONCLUSIONS: Reducing neonatal deaths, particularly early neonatal deaths, is the key to reducing the deaths of children under five years of age; the focus of future work is still on improving the quality of care in suburban settings.