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目的了解川渝农村项目县5岁以下儿童生长及保健现状,为制定科学、有效的儿童保健政策及干预措施提供参考依据。方法采用不等概率抽样选取川渝地区6个项目县的54个自然村中5岁以下儿童及其看护人为研究对象,对儿童看护人进行问卷调查并测量家中5岁以下儿童身高(长)和体质量、检测6～35个月龄儿童血红蛋白。对5岁以下儿童生长情况影响因素进行多因素logistic回归分析。结果 5岁以下儿童看护人1 089人,文化程度小学或初中者占82.1%(894/1 089),2009年家庭人均纯收入中位数为2 500元。家中最小孩子住院分娩率为86.6%(933/1 077),初乳喂养率为96.4%(1 050/1 089),平均断奶月龄(11.6±5.6)个月,过去2周儿童腹泻患病率为19.6%(213/1 089),咳嗽过的儿童有264人(24.2%)。5岁以下儿童1 197人,生长迟缓率、低体质量率和消瘦率分别为17.4%(200/1 152)、4.7%(55/1 173)和2.2%(25/1 148),6～35个月龄儿童低血红蛋白(<110g/L)检出率为38.4%(272/709),其中男童低体质量率高于女童[5.9%(38/645)vs 3.2%(17/528);χ2=4.638,P=0.031]、男童消瘦率高于女童[3.0%(19/634)vs 1.2%(6/514);χ2=4.460,P=0.035],差异均有统计学意义。多因素logistic回归分析结果显示:儿童性别为男、母亲在家分娩和低出生体质量可能是儿童生长水平低下的影响因素。结论川渝农村地区5岁以下儿童看护人的儿童保健认知水平普遍较低,儿童生长发育存在不同程度的滞后和营养不良,应加强儿童保健知识宣传和健康教育工作,提高保健机构服务能力。
Objective To understand the status of growth and health care of children under 5 years old in rural project counties in Sichuan and Chongqing, and provide reference for formulating scientific and effective child health policies and interventions. Methods By unequal probability sampling, children under 5 years of age and their caregivers were selected from 54 villages in 6 project counties in Sichuan and Chongqing as subjects. Questionnaires were made on the children’s caregivers to measure the height (length) and body length of children under 5 years of age Quality, detection of 6 to 35 months old children hemoglobin. Multivariate logistic regression analysis of the influencing factors on the growth of children under 5 years of age. Results The number of caregivers of children under 5 years of age was 1 089, with 82.1% (894/1 089) having primary education or junior high school education. In 2009, the median per capita net income of the family was 2 500 yuan. The hospitalization rate of the youngest children in hospital was 86.6% (933/1 077), the rate of colostrum feeding was 96.4% (1050/1 089), the average weaning age (11.6 ± 5.6) months, the prevalence of diarrhea in the past two weeks The rate was 19.6% (213/1 089) and 264 (24.2%) were coughing children. The number of children under 5 years of age was 1,197. The rates of growth retardation, low body weight and wasting rates were 17.4% (200/1 152), 4.7% (55/1 173) and 2.2% (25/1 148), respectively, The detection rate of low hemoglobin (<110g / L) in 35-month-old children was 38.4% (272/709), of which the prevalence of low body weight was higher in boys than in girls [5.9% (38/645) vs 3.2% ); χ2 = 4.638, P = 0.031], the wasting rate of boys was higher than that of girls [3.0% (19/634) vs 1.2% (6/514); χ2 = 4.460, P = 0.035] . Multivariate logistic regression analysis showed that children’s sex as male, mother’s delivery at birth and low birth weight may be the influencing factors of children’s low level of growth. Conclusion The cognition level of child care among children under 5 years of age in rural areas in Sichuan and Chongqing is generally low. Children’s growth and development have lag and malnutrition in varying degrees. Publicity and health education should be strengthened to improve the service ability of health institutions.