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中国青海农村6至23个月儿童贫血的患病率及病因:一项横断面研究的结果

Prevalence and causes of anaemia in children aged 6-23 months in rural Qinghai, China: findings from a cross-sectional study.

作者信息

Huang Yiwen, Wang Lijuan, Huo Junsheng, Wu Qiong, Wang Wei, Chang Suying, Zhang Yanfeng

机构信息

Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing, China.

Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China.

出版信息

BMJ Open. 2019 Sep 8;9(9):e031021. doi: 10.1136/bmjopen-2019-031021.

Abstract

OBJECTIVE

To investigate the current situation of anaemia among children aged 6-23 months in a rural county in China, and to explore the influencing factors and the main causes of anaemia.

DESIGN

A cross-sectional study.

SETTING

Huzhu County in Qinghai Province, China PARTICIPANTS: We selected 38 sampled villages using Proportional to Population Size sampling method. We obtained the name list of children aged 6-23 months in each sampled village and planned to survey all the eligible children aged 6-23 months and their caregivers.

PRIMARY AND SECONDARY OUTCOMES MEASURES

The prevalence of anaemia, the influencing factors of anaemia, the laboratory tests for biological causes of anaemia, including serum ferritin, soluble transferrin receptor, folic acid, homocysteine and vitamin B12.

RESULTS

A total of 754 children aged 6-23 months and their caregivers were surveyed, and 183 anaemic children aged 12-23 months were collected venous blood sample. The anaemia prevalence of children aged 6-23 months in Huzhu County was 59.1%. Children of younger age (OR=0.968, 95% CI 0.940 to 0.998), Tibetan nationality (OR=3.123, 95% CI 1.473 to 6.623) and not introducing meat (OR=0.698, 95% CI 0.499 to 0.976) were more likely to be anaemic. More than 80% of children with anaemia were due to iron deficiency (ID), and 20.2% of them had both iron and folic acid deficiencies.

CONCLUSIONS

The anaemia prevalence of children aged 6-23 months in Huzhu County was high and children of younger age, Tibetan nationality and not introducing meat were more likely to be anaemic. The main cause of anaemia was nutritional anaemia, with the vast majority being ID. Interventions of feeding counselling and nutrients supplements are appropriate and should be further strengthened.

TRIAL REGISTRATION NUMBER

ChiCTRPRC12002444.

摘要

目的

调查中国一个乡村县6至23个月儿童的贫血现状,探讨贫血的影响因素及主要病因。

设计

横断面研究。

地点

中国青海省互助县

研究对象

采用按人口规模成比例抽样方法选取38个抽样村。获取每个抽样村6至23个月儿童的名单,计划对所有符合条件的6至23个月儿童及其照料者进行调查。

主要和次要观察指标

贫血患病率、贫血的影响因素、贫血生物学病因的实验室检测,包括血清铁蛋白、可溶性转铁蛋白受体、叶酸、同型半胱氨酸和维生素B12。

结果

共调查了754名6至23个月儿童及其照料者,收集了183名12至23个月贫血儿童的静脉血样本。互助县6至23个月儿童的贫血患病率为59.1%。年龄较小的儿童(比值比=0.968,95%置信区间0.940至0.998)、藏族儿童(比值比=3.123,95%置信区间1.473至6.623)以及未添加肉类(比值比=0.698,95%置信区间0.499至0.976)的儿童更易患贫血。超过80%的贫血儿童是由于缺铁,其中20.2%同时存在铁和叶酸缺乏。

结论

互助县6至23个月儿童贫血患病率较高,年龄较小、藏族儿童以及未添加肉类的儿童更易患贫血。贫血的主要原因是营养性贫血,绝大多数为缺铁性贫血。喂养咨询和营养补充干预措施是合适的,应进一步加强。

试验注册号

ChiCTRPRC12002444。

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