Department of Epidemiology and Health Statistics, School of Public Health, College of Medicine, Xi'an Jiaotong University, PO Box 46, Xi'an, Shaanxi 710061, PR China.
BMC Public Health. 2013 Mar 19;13:238. doi: 10.1186/1471-2458-13-238.
Since 2000, there has been a decline in the proportion of oral rehydration salts (ORS) therapy in childhood diarrhea. How to sustain and achieve a high level of ORS therapy continues to be a challenge.
The data of 14112 households and 894 villages in 45 counties across 10 provinces of Western China were collected in 2005. Generalized estimated equation logistic regression models were used to identify the determinants of ORS use in home-based and village-level care.
The therapy rate of ORS was 34.62%. This rate in home-based care (HBC) was significantly lower than that in village-level care (VLC), township-level care or county-level-or-above care. The children in the families with several pre-school-aged children (OR = 0.29 95% CI: 0.10, 0.86) or of the smaller age (12 vs 36 months: OR = 0.10 95% CI 0.02, 0.41; 24 vs 36 months: OR = 0.26 95% CI 0.09, 0.77) were less likely to receive ORS therapy against diarrhea in HBC. The children whose family had the habit of drinking boiled water (OR = 2.77 95% CI 1.30-5.91), or whose caretakers received educational materials about childhood diseases (OR = 3.08 95% CI 1.54, 6.16), or who were living in the villages in which village clinics had the available ORS packages (OR = 3.94 95% CI 2.25, 6.90) were more likely to receive ORS therapy against diarrhea in VLC.
There thus, ORS promoting program should give the highest priority to home care. ORS promoting strategies for low-level care could be strengthened based on children characteristics, the habit of drinking water and the situation of receiving educational material in the families and on the availability of ORS packages in village clinics in rural Western China.
自 2000 年以来,儿童腹泻中口服补液盐(ORS)疗法的比例有所下降。如何维持和实现高水平的 ORS 疗法仍然是一个挑战。
2005 年,在我国西部 10 个省的 45 个县的 894 个村庄和 14112 户家庭中收集了数据。使用广义估计方程逻辑回归模型来确定家庭和村级护理中使用 ORS 的决定因素。
ORS 的治疗率为 34.62%。家庭护理(HBC)中的这一比例明显低于村级护理(VLC)、乡镇级护理或县级及以上护理。家中有多个学龄前儿童的儿童(OR=0.29,95%CI:0.10,0.86)或年龄较小的儿童(12 个月与 36 个月:OR=0.10,95%CI:0.02,0.41;24 个月与 36 个月:OR=0.26,95%CI:0.09,0.77)不太可能接受 HBC 中针对腹泻的 ORS 治疗。家中有喝开水习惯的儿童(OR=2.77,95%CI:1.30-5.91)、接受过儿童疾病教育材料的照顾者(OR=3.08,95%CI:1.54,6.16)、或生活在村级诊所提供 ORS 包的村庄中的儿童(OR=3.94,95%CI:2.25,6.90)更有可能在 VLC 中接受针对腹泻的 ORS 治疗。
因此,ORS 推广计划应优先考虑家庭护理。可以根据儿童特征、家庭饮水习惯和接受教育材料的情况以及村级诊所 ORS 包的供应情况,加强针对低级别护理的 ORS 推广策略。