Nottingham Biomedical Research Unit, Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK.
J Epidemiol Community Health. 2013 Apr;67(4):327-31. doi: 10.1136/jech-2011-200744. Epub 2012 Aug 25.
A reduction in sex ratio at live birth has been proposed as a sentinel health indicator that can be used to monitor the health of populations.
To test the hypothesis that a lower sex ratio is associated with adverse national population health using the prevalences of HIV and tuberculosis as measures of societal well-being.
An ecological study design using routinely collected data and adjusting for potential confounding factors.
The mean global sex ratio was 1.05. There was marked heterogeneity in the sex ratio between different global regions (p<0.0001). Those regions with the highest prevalences of HIV infection had lower sex ratios, with the value for the highest quartile being 0.022 (95% CIs CI 0.013 to 0.031) lower than the lowest quartile. Similarly, those areas with the highest quartile of tuberculosis infection had a sex ratio of 0.016 (95% CI 0.004 to 0.028) lower than those in the lowest quartile. Similar results were observed in a subgroup analysis limited to countries from the African continent.
The data are consistent with the hypothesis that a reduced sex ratio at live birth is a potential sentinel health indicator of lower population health. However, these data do not demonstrate either a casual relationship or reveal any biological mechanisms that may account for these observations.
有人提出，出生时性别比例降低可作为监测人群健康的预警健康指标。
采用艾滋病毒和结核病的流行率作为社会福利的衡量标准，检验出生时性别比例降低与国家人口健康状况不佳相关的假设。
采用常规收集数据并对潜在混杂因素进行调整的生态研究设计。
全球平均性别比为 1.05。不同全球区域之间的性别比存在明显差异（p<0.0001）。艾滋病毒感染流行率最高的区域性别比例较低，最高四分位数的数值比最低四分位数低 0.022（95%CI 0.013 至 0.031）。同样，结核感染最高四分位数的区域性别比比最低四分位数低 0.016（95%CI 0.004 至 0.028）。在仅限于非洲国家的亚组分析中也观察到了类似的结果。
数据与出生时性别比例降低是人口健康状况不佳的潜在预警健康指标的假设一致。但是，这些数据既不能证明两者之间存在因果关系，也不能揭示可能导致这些观察结果的任何生物学机制。
