Lili Xiong, Jian He, Liping Li, Zhiyu Liu, Hua Wang
Maternal and Children Health Care Hospital of Hunan Province, Changsha, China.
Injury Prevention Research Center, Shantou University Medical College, Guangdong Province, China.
PLoS One. 2017 Jan 11;12(1):e0168524. doi: 10.1371/journal.pone.0168524. eCollection 2017.
Injury is an important cause of childhood mortality in China. We described the epidemiology and trends of injury-related deaths of children <5 years of age in Hunan province, and discussed several policy implications.
Injury-related deaths of children <5 years of age in 2009-2014 were identified from surveillance data. All specific injury mortality and mortality rates in urban and rural area were calculated from census data; Cochran-armitage trend test was used to assess the time trends.
Injury was the leading cause of death in children <5 years of age. Overall injury mortality was 48.96 per 100,000 persons, gradually declined with the year (Z = -18.75, P<0.001), and accounted for 27.14% of all deaths. Injury mortality in rural areas was 64.66 per 100,000 persons, which was more than 3.73 times higher than the rate in urban areas. The three leading causes of injury-related death were drowning (43.63%), suffocation (27.57%), and traffic accidents (14.34%). Suffocation was the leading cause in children <1 year of age (79.49%). Suffocation has high incidence in the winter and spring, and drowning has high incidence in the summer season. Drowning was the leading cause in children 1-4 years of age (62.80%). Drowning and suffocation accounted for 67.74% and 65.11%, of injury-related deaths that occurred at home; while the traffic injury deaths (54.12%) occurred mainly in transit.
Injury-related fatalities in children <5 years of age followed time trends that were different in rural and urban areas. Effective childhood injury prevention may require different prevention policies combination depending on epidemiological characteristics such as development of injury surveillance and public education on injury knowledge. There is a need for evidence-based surveillance of risk factors for development of effective injury prevention programs.
伤害是中国儿童死亡的重要原因。我们描述了湖南省5岁以下儿童伤害相关死亡的流行病学特征和趋势，并讨论了若干政策启示。
从监测数据中识别出2009 - 2014年5岁以下儿童伤害相关死亡情况。根据人口普查数据计算城乡所有特定伤害死亡率和死亡率；采用 Cochr an - Armitage趋势检验评估时间趋势。
伤害是5岁以下儿童的主要死因。总体伤害死亡率为每10万人48.96例，随年份逐渐下降（Z = -18.75，P < 0.001），占所有死亡的27.14%。农村地区伤害死亡率为每10万人64.66例，是城市地区的3.73倍多。伤害相关死亡的三大主要原因是溺水（43.63%）、窒息（27.57%）和交通事故（14.34%）。窒息是1岁以下儿童的主要死因（79.49%）。窒息在冬春季节高发，溺水在夏季高发。溺水是1 - 4岁儿童的主要死因（62.80%）。溺水和窒息分别占在家中发生的伤害相关死亡的67.74%和65.11%；而交通伤害死亡（54.12%）主要发生在途中。
5岁以下儿童伤害相关死亡呈现出城乡不同的时间趋势。有效的儿童伤害预防可能需要根据伤害监测发展和伤害知识公众教育等流行病学特征制定不同的预防政策组合。需要基于证据的危险因素监测以制定有效的伤害预防计划。
