贵州1991—2015年<5岁儿童死亡率和死亡原因分析  

Mortality rate and causes of death among children under 5 years old in Guizhou province,1991-2015

作　　者：冯海哲[1] 王菲[2] 张谊[1] 韩燕[1] 李艳萍 FENG Hai-zhe WANG Fei ZHANG Yi et al(Department of Child Health Care, Institute for Maternal and Child Health, Center for Disease Control and Prevention of Guizhou Province, Guiyang , Guizhou Province 550004, Chin)

机构地区：[1]贵州省疾病预防控制中心妇幼保健所儿童保健科,贵阳550004 [2]贵阳市妇幼保健院儿童医院 [3]贵州省卫生计生委妇幼处

出　　处：《中国公共卫生》2017年第10期1469-1473,共5页Chinese Journal of Public Health

基　　金：贵州省卫生计生委科学技术基金(gzw jkj2015-1-005)

摘　　要：目的分析1991—2015年贵州省<5岁儿童年龄别死亡率(U5MR)和主要死因别死亡率,评价贵州省《千年发展目标4(MDG 4)》指标的进展情况。方法采用贵州省<5岁儿童死亡监测网1991—2015年监测资料,计算城市、农村新生儿、婴儿及<5岁儿童死亡率和<5岁儿童主要死因死亡专率。结果 2015年贵州省新生儿死亡率(NMR)、婴儿死亡率(IMR)和U5MR分别为3.5‰、8.7‰和12.2‰,比1991年分别下降92.9%、86.8%和87.6%,城市、乡村儿童死亡率均呈下降趋势,其中,NMR、IMR和U5MR分别由1991年的25.0‰(城市)和55.3‰(农村)、39.9‰和93.0‰、42.1‰和112.4‰下降至2015年的3.2‰和3.6‰、7.6‰和9.2‰、10.3‰和13.2‰(均P<0.01)。2015年贵州省农村NM R、IM R、U5M R分别为城市的1.13、2.63、1.28倍,而1991年分别为2.21、2.33、2.67倍。贵州省<5岁儿童死亡主要死因中,肺炎、腹泻、出生窒息、早产或低出生体重和脑膜炎死亡专率均呈下降趋势,分别从1991年的3276.1/10万、1501.7/10万、1416.7/10万、689.4/10万和689.4/10万下降到2015年的215.3/10万、61.6/10万、154.4/10万、153.7/10万和4.7/10万(P<0.01)。2015年全省U5M R前4位死因分别为肺炎、出生窒息、早产或低出生体重和先天性心脏病。其中,城市前4位为肺炎、早产或低出生体重、先天性心脏病、出生窒息,农村前4位为肺炎、早产或低出生体重、出生窒息、先天性心脏病。肺炎、出生窒息、早产低出生体重死亡率均逐年下降,而先天性心脏病、溺水和交通意外死亡率呈现反复。结论 2015年贵州省U5MR为12.2‰,已达到国家2020年目标,降低农村U5M R、缩小城乡差距仍是今后工作的重点,但是,基于死因别构成变化,防治重点要进行相应调整。Objective To examine age-specific mortality rate and the main cause-specific mortality rate among chil- dren under 5 years old in Guizhou province from 1991 to 2015 for evaluating the improvement in indicators of ＂the Fourth Millennium Development Goal （ 1991 - 2015 ） ＂. Methods Neonatal mortality rate （ NMR）, infant mortality rate （IMR） ,under 5 years old children mortality rate （U5MR）, and the main cause of death of under 5 years old children in rural and urban areas of Guizhou province from 1991 to 2015 were analyzed statistically using data extracted from Mortal- ity Surveillance Network for Children under 5 Years Old. Results The NMR,IMR and U5MR were 3.5‰,8.7‰,and 12. 2‰ in Guizhou province in 2015 and the rates were reduced by 92. 9 %, 86. 8 %, and 87.6 %, respectively, compared to those in the year of 1991. The mortality rate among the children were declined yearly both in rural and urban areas. From 1991 to 2015 in both rural and urban areas, the NMR was decreased from 25.0‰ to 3.2‰ and from 55.3‰ to 3. 6‰; the IMR was decreased from 39. 9‰to 7. 6‰ and 93. 0‰ to 9. 2‰ and the U5MR was decreased from 42. 1%o and 112.4‰ to 10. 3‰ and 13.2%o,with significant differences （P 〈0. 01 for all）. The NMR,IMR,and U5MR in the rural areas were 1.28,2. 63 ,and 1.13 times higher than in the urban areas in 2015 ,while those rates were 2. 67,2. 33 ,and 2. 21 times higher than those in 1991. During the 25 years in Guizhou province, significant decreases in specific mortality rate for the main causes of death among the children under 5 years old were observed, with the decreases of pneumonia （ from 3 276. 1 to 215.3 per 100 000 ）, diarrhea （ 1501.7 to 61.6 ）, asphyxia （ 1416. 7 to 154.4 ）, premature or low birth weight （689.4 to 153.7）, and meningitis （689.4 to 4. 7 ）, respectively （ P 〈 0. 01 for all）. In 2015, the top four major causes of death were pneumonia, asphyxia, premature or low birth weight and congenital heart disease for all the chil

关 键 词：儿童 新生儿 死亡率 死因构成 

分 类 号：R195[医药卫生—卫生统计学]