Department of Child Health Care, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008, Hunan Province, China.
Hunan Provincial Clinical Research Center for Newborn Diseases Of Maternal Origins, Changsha, 410008, Hunan Province, China.
Sci Rep. 2024 Jun 15;14(1):13867. doi: 10.1038/s41598-024-64967-9.
Fever and diarrhea are key causes of malnutrition, growth and development disorders, and death among children. At present, most studies on the associated factors of fever and diarrhea in children are concentrated in African and South Asian countries, but relevant research in China is very limited. This study was aimed to analyze the two-week prevalence of fever, diarrhea, and coexisting fever and diarrhea among children aged 6-23 months in rural areas of Hunan Province and to explore the associated factors. The survey data of the Nutrition Improvement Program for Children in Poor Areas (NIPCPA) from 2016 to 2023 was used here. NIPCPA is a cross-sectional survey completed annually in Hunan to collect children's nutrition and health indicators. The two-week prevalence rates of fever, diarrhea, and coexisting fever and diarrhea among children aged 6-23 months were 12.2% (2066/16,985), 9.6% (1634/16,985), and 3.2% (542/16,985), respectively. Multivariate logistic regression analysis showed the risks of fever, diarrhea, and coexisting fever and diarrhea were higher among younger children. The high educational level of caregivers, effective consumption of Yingyangbao (a complementary food supplement containing iron, zinc, calcium, vitamins A, D, B1, B2, B12, folic acid, and other micronutrients), and complementary feeding meeting minimum dietary diversity and meeting minimum acceptable diet were protective factors against fever in children, with adjusted odds ratios (aORs) of 0.87 (95%CI: 0.78-0.98), 0.78 (0.69-0.87), 0.73 (0.65-0.82), and 0.74 (0.66-0.84), respectively. Effective consumption of Yingyangbao, and complementary feeding meeting the minimum dietary diversity and meeting minimum acceptable diet were protective factors against diarrhea in children, with aORs of 0.72 (95%CI: 0.63-0.83), 0.79 (0.70-0.91), and 0.80 (0.70-0.92), respectively. Effective consumption of Yingyangbao, and complementary feeding meeting the minimum dietary diversity and meeting minimum acceptable diet were protective factors against coexisting fever and diarrhea among children, with aORs of 0.53 (95%CI: 0.43-0.66), 0.71 (0.58-0.89), and 0.70 (0.56-0.88), respectively. Fever, diarrhea, and the coexisting fever and diarrhea affect one in eight, one in ten, and one in thirty children respectively in rural areas of Hunan. Effective interventions should be actively taken, such as improving the education level of caregivers, enhancing their scientific feeding skills for children, and promoting children's compliance with Yingyangbao consumption, to further reduce the prevalence of fever and diarrhea in children.
发热和腹泻是导致儿童营养不良、生长发育障碍和死亡的主要原因。目前，大多数关于儿童发热和腹泻相关因素的研究集中在非洲和南亚国家，但中国的相关研究非常有限。本研究旨在分析湖南省农村地区 6-23 月龄儿童发热、腹泻和发热腹泻并存的两周患病率，并探讨其相关因素。本研究使用了 2016 年至 2023 年贫困地区儿童营养改善项目（NIPCPA）的调查数据。NIPCPA 是一项在湖南省每年进行的横断面调查，旨在收集儿童营养和健康指标。6-23 月龄儿童发热、腹泻和发热腹泻并存的两周患病率分别为 12.2%（2066/16985）、9.6%（1634/16985）和 3.2%（542/16985）。多因素 logistic 回归分析显示，年龄较小的儿童发热、腹泻和发热腹泻并存的风险较高。看护人文化程度较高、有效食用营养包（一种含有铁、锌、钙、维生素 A、D、B1、B2、B12、叶酸等微量营养素的补充食品）、以及满足最低饮食多样性和最低可接受饮食的补充喂养是儿童发热的保护因素，调整后的比值比（aOR）分别为 0.87（95%CI：0.78-0.98）、0.78（0.69-0.87）、0.73（0.65-0.82）和 0.74（0.66-0.84）。有效食用营养包和满足最低饮食多样性和最低可接受饮食的补充喂养是儿童腹泻的保护因素，调整后的比值比（aOR）分别为 0.72（95%CI：0.63-0.83）、0.79（0.70-0.91）和 0.80（0.70-0.92）。有效食用营养包和满足最低饮食多样性和最低可接受饮食的补充喂养是儿童发热腹泻并存的保护因素，调整后的比值比（aOR）分别为 0.53（95%CI：0.43-0.66）、0.71（0.58-0.89）和 0.70（0.56-0.88）。发热、腹泻和发热腹泻并存分别影响湖南省农村地区八分之一、十分之一和三十分之一的儿童。应积极采取有效干预措施，如提高看护人文化程度，增强其科学喂养儿童的技能，并促进儿童服用营养包，以进一步降低儿童发热和腹泻的患病率。
