Status of anemia of school-age children in Aheqi Countyof Xinjiang and its influencing factors
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摘要:目的 观察新疆维吾尔自治区（简称新疆）阿合奇县地区学龄期儿童缺铁性贫血（IDA）发生情况并分析其影响因素。方法 采用多阶段随机抽样方法于2021年2—12月在新疆阿合奇县地区1个镇（3个社区）、5乡2场（共23个行政村委会）中抽取1 258名学龄期儿童作为调查对象，统计学龄期儿童的相关资料；调查新疆阿合奇县地区学龄期儿童IDA患病现状，并采用Logistic回归分析探讨新疆阿合奇县地区学龄期儿童IDA的影响因素。结果 1 258名新疆阿合奇县地区学龄期儿童中，442名儿童（患病组）患有不同程度IDA，IDA患病率为35.14%（442/1 258），816名儿童（未患病组）未患IDA；患病组居住地为乡村者、婴儿期母乳喂养者、饮食以囊或抓饭为主者、经常或每日喝奶茶者、幽门螺杆菌（Hp）感染阳性者占比均高于未患病组，添加辅食时间晚于未患病组，差异有统计学意义（P < 0.05）；2组儿童其他资料比较，差异无统计学意义（P>0.05）。Logistics回归分析结果显示，居住地为乡村、婴儿期母乳喂养、添加辅食时间较晚、饮食以囊或抓饭为主、经常或每日喝奶茶、Hp感染阳性是新疆阿合奇县学龄期儿童发生IDA的危险因素（OR>1，P < 0.05）。结论 新疆阿合奇县地区学龄期儿童IDA患病率较高，可能受儿童的居住地、婴儿期喂养方式、添加辅食时间、饮食结构、喝奶茶情况和Hp感染情况的影响。Abstract:Objective To observe the occurrence of iron deficiency anemia (IDA) in school-age children in Aheqi County of Xinjiang Uygur Autonomous Region (Xinjiang), and to analyze its influencing factors.Methods Multistage random sampling was used to collect 1 258 school-age children in two investigations from one town (3 communities) and 5 townships (23 administrative village committees) in Aheqi County of Xinjiang from February to December 2021, relevant data of school-age children were counted. The prevalence of IDA in school-age children in Aheqi County of Xinjiang was investigated, and Logistic regression was used to analyze the influencing factors of IDA of school-age children in Aheqi County of Xinjiang.Results There were 442 cases(illness group) with different degrees of IDA in 1 258 school-age children in Aheqi County of Xinjiang, the prevalence of IDA was 35.14% (442/1 258), and 816 children (non-diseased group) did not develop IDA. The proportions of children living in rural areas, given breastfeeding in infancy, mainly intake of flatbread and pilaf in Xinjiang, drinking milk tea frequently or every day, and positive for Helicobacter pylori (Hp) infection in the illness group were higher than those in the non-diseased group, and the time of adding supplementary food was later than that of children in the non-diseased group, the differences were statistically significant (P < 0.05). There was no statistical significant difference in other data between two groups (P>0.05). Logistic regression analysis showed that living in rural areas, breastfeeding in infancy, addition of supplementary food in late period, diet based on flatbread and pilaf, regular or daily drinking milk tea and positive for Hp infection were the risk factors of IDA among school-age children in Aheqi County of Xinjiang (OR>1, P < 0.05).Conclusion The prevalence of IDA in school-age children in Aheqi County of Xinjiang is high, which may be affected by children's place of residence, feeding mode in infancy, time of supplementary feeding, dietary structure, drinking milk tea and Hp infection.
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表 1 2组儿童一般资料比较[M(P25, P75)](x±s)[n(%)]
指标 患病组(n=442) 未患病组(n=816) Z/χ2/t P 年龄/岁 10.00(9.00, 11.00) 10.00(9.00, 11.00) 1.259 0.208 性别 男 228(51.58) 395(48.41) 1.158 0.282 女 214(48.42) 421(51.59) 体质量/kg 31.88±6.76 32.07±6.85 0.472 0.637 民族 汉族 34(7.69) 51(6.25) 2.672 0.445 柯尔克孜族 381(86.20) 698(85.54) 维吾尔族 13(2.94) 30(3.68) 回族 14(3.17) 37(4.53) 居住地 城镇 58(13.12) 152(18.63) 6.248 0.012 乡村 384(86.88) 664(81.37) 家庭类型 直系家庭 296(66.97) 558(68.38) 0.507 0.776 单亲家庭 108(24.43) 185(22.67) 其他 38(8.60) 73(8.95) 主要看护人受教育程度 初中及以下 217(49.10) 413(50.61) 0.268 0.875 高中 198(44.80) 354(43.38) 大专及以上 27(6.11) 49(6.00) 婴儿期喂养方式 母乳喂养 296(66.97) 478(58.58) 8.526 0.004 非母乳喂养 146(33.03) 338(41.42) 添加辅食时间/月 12.00(10.00, 14.00) 12.00(10.00, 13.00) 3.471 0.001 食物种类 肉类为主 176(39.82) 395(48.41) 8.530 0.003 囊或抓饭为主 266(60.18) 421(51.59) 喝奶茶情况 不喝或偶尔 54(12.22) 153(18.75) 8.901 0.003 经常或每日 388(87.78) 663(81.25) 幽门螺杆菌感染 阴性 347(78.51) 701(85.91) 11.290 0.001 阳性 95(21.49) 115(14.09) 
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表 2 主要自变量赋值情况
自变量 变量类型 赋值 居住地 分类变量 0=城镇, 1=乡村 喂养方式 分类变量 0=非母乳喂养, 1=母乳喂养 添加辅食时间 连续变量 — 食物种类 分类变量 0=肉类为主, 1=囊或抓饭为主 喝奶茶情况 分类变量 0=不喝或偶尔喝, 1=经常或每日喝 幽门螺杆菌感染 分类变量 0=阴性, 1=阳性
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表 3 新疆阿合奇县学龄期儿童IDA影响因素的Logistics回归分析
相关因素 β 标准误 Wald P OR 95%CI 居住地 1.607 0.300 28.650 < 0.001 4.987 2.769~8.982 喂养方式 1.079 0.183 34.974 < 0.001 2.943 2.058~4.209 添加辅食时间 0.071 0.021 11.796 0.001 1.074 1.031~1.118 食物种类 1.460 0.193 56.990 < 0.001 4.307 2.948~6.292 喝奶茶情况 0.416 0.190 4.808 0.028 1.151 1.045~2.197 Hp感染 2.223 0.293 57.428 < 0.001 9.239 5.198~16.419 常量 -5.048 0.459 120.723 < 0.001 — — IDA: 缺铁性贫血; Hp: 幽门螺杆菌。
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