苏州市5岁以下社区儿童腹泻发病及就诊情况调查

沈思; 代子瑞; 陈立凌; 邵雪君; 张钧; 张涛; 薛建; 赵根明

doi:10.16462/j.cnki.zhjbkz.2023.02.011

苏州市5岁以下社区儿童腹泻发病及就诊情况调查

doi: 10.16462/j.cnki.zhjbkz.2023.02.011

沈思¹,
代子瑞¹,
陈立凌²,
邵雪君³,
张钧²,
张涛¹,
薛建³,
赵根明^1, ,

1.
200032 上海，复旦大学公共卫生学院流行病学教研室，公共卫生安全教育部重点实验室，上海市重大传染病和生物安全研究院
2.
215004 苏州，苏州市疾病预防控制中心传染病预防控制科
3.
215003 苏州，苏州大学附属儿童医院检验科

基金项目:

上海市公共卫生体系建设三年行动计划(2020-2022年)重点学科 GWV-10.1-XK16

默沙东研究者发起项目 MIISP59169

详细信息

通讯作者:
赵根明，E-mail：gmzhao@shmu.edu.cn

中图分类号: R183
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- 被引次数: 0
出版历程
- 收稿日期: 2022-01-12
- 修回日期: 2022-03-27
- 网络出版日期: 2023-02-20
- 刊出日期: 2023-02-10

Investigation on the incidence and health-seeking behavior of diarrhea among children aged under 5 years in Suzhou

1.
Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai Institute of Infectious Disease and Biosecurity, Shanghai 200032, China
2.
Department of Prevention and Control, Suzhou Center for Disease Control and Prevention, Suzhou 215004, China
3.
Department of Clinical Laboratory, Suzhou University Affiliated Children's Hospital, Suzhou 215003, China

Funds:

Three-year Action Plan (2020-2022) and Key Discipline Program on Public Health System Construction of Shanghai GWV-10.1-XK16

Investigator-Initiated Studies Program of Merck Sharp & Dohme Corp Grant MIISP59169

More Information

Corresponding author: ZHAO Gen-ming, E-mail: gmzhao@shmu.edu.cn

摘要

摘要: 目的了解苏州市5岁以下社区儿童腹泻病的发生及就诊情况，为相关卫生政策的制定提供参考。方法采用重复横断面调查的设计和分层随机抽样的方法，了解儿童过去1月内的腹泻病发生及就诊情况。结果苏州市5岁以下儿童过去1月内腹泻病发生率为3.39%，平均每人每年腹泻0.41次；腹泻后的就诊率为72.50%。其中6月龄~1岁组儿童腹泻发生率最高为5.97%(χ² =126.52, P < 0.001)。不同季节儿童腹泻的就诊率差异无统计学意义，就诊行为模式相对固定，未就诊首要原因是家长认为病情不重，未就诊腹泻儿童首选自行服药治疗。结论苏州市5岁以下社区儿童腹泻疾病负担值得重视，特别是低年龄婴幼儿；应加强对儿童家长相关宣教，进一步完善医疗卫生建设，加强儿童腹泻病监测。
- 儿童腹泻 /
- 腹泻病 /
- 社区调查 /
- 就诊行为
Abstract: Objective This paper aims to investigate the incidence and health-seeking behavior of diarrhea among children under 5 years old in Suzhou City, and to inform the development of relevant health policies. Methods A repeated cross-sectional survey design and a stratified random sampling method was conducted to investigate the occurrence and health-seeking practices of childhood diarrhea in the past 1 month. Results The occurrence rate of diarrhea among children under 5 years old in Suzhou last month was 3.39%, with an average of 0.41 episodes of diarrhea per child per year. The consultation rate was 72.50%. The peak rate of diarrhea was 5.97% among children aged 6-12 months (χ² =126.52, P < 0.001). The different consultation rates of childhood diarrhea in different seasons were not statistically significant, and the health-seeking pattern was relatively fixed. The primary reason for children not seeking medical care was that parents did not think the disease was serious, and they preferred self-treatment through self-medication. Conclusions Attention should be paid to diarrhea among children under 5 years old in Suzhou City, especially among younger infants. Relevant education of parents should be strengthened, medical and health care should be further improved, and surveillance of childhood diarrhea should be enhanced.
- Childhood diarrhea /
- Diarrhea /
- Community survey /
- Health-seeking behavior

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表 1 研究对象的一般人口学特征

Table 1. Basic demographic characteristics of the study subjects

人口学特征	姑苏区		新城区		县级市		χ²值	P值
人口学特征	例数(n)	比率(%)	例数(n)	比率(%)	例数(n)	比率(%)	χ²值	P值
性别							1.20	0.550
男	1 107	52.54	3 220	53.54	4 426	52.70
女	1 000	47.46	2 794	46.46	3 973	47.30
年龄(月)							68.16	< 0.001
0~＜6	202	9.59	578	9.61	758	9.02
6~＜12	297	14.10	939	15.61	1 143	13.61
12~＜24	413	19.60	1 517	25.22	1 863	22.18
24~＜36	407	19.32	1 110	18.46	1 660	19.76
36~＜48	412	19.55	1 004	16.70	1 566	18.65
48~＜60	376	17.84	886	14.40	1 409	16.78
医疗保险							142.30	< 0.001
有	1 350	64.07	3 785	62.94	4 545	54.11
无	757	35.93	2 229	37.06	3 854	45.89

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表 2 不同年龄组儿童腹泻发生率和腹泻病例就诊率[n(%)]

Table 2. The incidence of diarrhea and visiting rate of diarrhea cases in children of different age groups [n(%)]

年龄(月)	调查人数	腹泻发生	腹泻就诊
0~＜6	1 538	61(3.97)	45(73.77)
6~＜12	2 379	142(5.97)	111(78.17)
12~＜24	3 793	181(4.77)	128(70.72)
24~＜36	3 177	76(2.39)	51(67.11)
36~＜48	2 982	52(1.74)	41(78.85)
48~＜60	2 651	48(1.81)	30(62.50)
合计	16 520	560(3.39)	406(72.50)
χ²值		126.52	6.55
P值		< 0.001	0.256

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表 3 不同地区儿童1月内腹泻病例就诊情况[n(%)]

Table 3. The medical institutions selection of diarrhea children within 1 month in different regions [n(%)]

地区	腹泻例数(n)	就诊例数	就诊例次									χ²值	P值
地区	腹泻例数(n)	就诊例数	苏州儿童医院	市立医院本部	市中医院	县级人民医院	三级综合医院	社区卫生服务中心	妇幼保健院/所	私人诊所	其他	χ²值	P值
姑苏区	77	57(74.03)	22(33.33)	20(30.30)	2(3.03)	9(13.64)	5(7.58)	3(4.55)	0(0.00)	2(3.03)	3(4.55)	72.55	< 0.001
新城区	230	167(71.94)	71(39.89)	27(15.17)	1(0.56)	27(15.17)	15(8.43)	19(10.67)	5(2.81)	8(4.49)	5(2.81)	186.04	< 0.001
县级市	253	182(72.61)	17(8.81)	13(6.74)	16(8.29)	78(40.41)	24(12.44)	16(8.29)	9(4.66)	4(2.07)	16(8.29)	179.26	< 0.001
合计	560	406(72.50)	110(25.17)	60(13.73)	19(4.35)	114(26.09)	44(10.07)	38(8.70)	14(3.20)	14(3.20)	24(5.49)	250.97	< 0.001

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表 4 不同地区儿童1月内腹泻病例未就诊处理情况及原因[n(%)]

Table 4. The treatment and reasons of diarrhea children within 1 month without visiting hospital in different regions [n(%)]

地区	未就诊例数	处理方式的例次			未就诊原因的例次
地区	未就诊例数	自行服药治疗	居家休息	照常上学(园)	离家太远不方便	看病人太多	没时间	病情不重	其他
姑苏区	20(25.97)	9(45.00)	11(55.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	18(85.71)	3(14.29)
新城区	63(28.06)	40(63.49)	22(34.92)	1(1.59)	3(4.35)	3(4.35)	1(1.45)	54(78.26)	8(11.59)
县级市	71(27.39)	45(63.38)	24(33.80)	2(2.82)	1(1.39)	0(0.00)	4(5.56)	58(80.55)	9(12.50)
合计	154(27.50)	94(61.04)	57(37.01)	3(1.95)	4(2.47)	3(1.85)	5(3.09)	130(80.25)	20(12.34)

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表 5 不同季节儿童腹泻发病及就诊情况[n(%)]

Table 5. The incidence and visiting rate of diarrhea children in different seasons [n(%)]

季节	调查人数	腹泻发生	腹泻就诊
春季	1 715	29(1.69)	21(72.41)
夏季	5 561	185(3.33)	125(67.57)
秋季	1 739	77(4.43)	60(77.92)
冬季	7 505	269(3.58)	200(74.35)
合计	16 520	560(3.39)	406(72.50)
χ²值		21.77	0.66
P值		< 0.001	0.885

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