Guangdong Centre for Disease Control and Prevention, Institute of Chronic Noncommunicable Disease Prevention and Control, 160 Qunxian Road, Panyu district, Guangzhou 511430, China.
Qingyuan City Centre for Disease Control and Prevention,Institute of Chronic Noncommunicable Disease Prevention and Control, 6 Kangle Road, Qingcheng district, Qingyuan 511518, China.
J Trop Pediatr. 2023 Apr 5;69(3). doi: 10.1093/tropej/fmad012.
Drowning is the leading cause of death for children under the age of 15 years in Guangdong Province, China. This serious public health issue also exists in low- and middle-income countries (LMICs), which have few value-integrated intervention programs. The current study presents an integrated intervention project that aims to explore an effective pattern of prevention for child drowning in rural areas and feasibility to perform in other LMICs.
We conducted a cluster randomized controlled trial by comparing the incidence of non-fatal drowning among children in two groups in rural areas of southern China. We recruited the participants in two phases and reached a total of 10 687 students from 23 schools at two towns in Guangdong Province, China. At the first and second phases, 8966 and 1721 students were recruited, respectively.
The final evaluation questionnaires were collected after 18 months of integrated intervention, where we obtained 9791 data from Grades 3-9. The incidence of non-fatal drowning between the intervention and control groups after intervention did not differ significantly from the baseline according to the total number of students, male students, female students and Grades 6-9 [0.81; 95% confidence interval (CI): [0.66, 1.00]; p = 0.05, 1.17; 95% CI: [0.90, 1.51]; p = 0.25, 1.40; 95% CI: [0.97, 2.02]; p = 0.07 and 0.97; 95% CI: [0.70, 1.34]; p = 0.86], except for Grades 3-5 (1.36; 95% CI: [1.02, 1.82]; p = 0.037). The study observed a significantly positive benefit of awareness and risk behaviours of non-fatal drowning between the intervention and control groups (0.27, 95% CI: [0.21, 0.33]; p = 0.00, -0.16; 95% CI: [-0.24, -0.08]; p = 0.00).
The integrated intervention exerted a significant impact on the prevention and management of child non-fatal drowning, especially in rural areas.
在中国广东省，溺水是 15 岁以下儿童死亡的主要原因。这一严重的公共卫生问题也存在于中低收入国家（LMICs），这些国家几乎没有综合干预项目。本研究提出了一个综合干预项目，旨在探索农村地区预防儿童溺水的有效模式，并探讨在其他 LMICs 实施的可行性。
我们通过比较中国南方两个农村地区两组儿童的非致命性溺水发生率，进行了一项整群随机对照试验。我们分两个阶段招募参与者，共招募了来自广东省两个城镇的 23 所学校的 10687 名学生。在第一和第二阶段，分别招募了 8966 名和 1721 名学生。
经过 18 个月的综合干预后，我们共收集了 9791 名 3-9 年级学生的最终评估问卷。根据学生总数、男生、女生和 6-9 年级学生的数据，干预组和对照组在干预后的非致命性溺水发生率与基线相比没有显著差异[0.81；95%置信区间（CI）：[0.66，1.00]；p=0.05，1.17；95%CI：[0.90，1.51]；p=0.25，1.40；95%CI：[0.97，2.02]；p=0.07，0.97；95%CI：[0.70，1.34]；p=0.86]，但 3-5 年级学生除外（1.36；95%CI：[1.02，1.82]；p=0.037）。研究发现，干预组和对照组对非致命性溺水的意识和风险行为有显著的积极益处（0.27，95%CI：[0.21，0.33]；p=0.00，-0.16；95%CI：[-0.24，-0.08]；p=0.00）。
综合干预对预防和管理儿童非致命性溺水，特别是在农村地区，产生了显著影响。
