目的 探索宁夏中小学生贫血患病的民族差异及其影响因素,为改善宁夏学生贫血的干预政策、措施提供依据。方法 采用分层随机整群抽样,选择宁夏回、汉族7、9、12、14岁四个年龄段3 747名学生作为研究对象进行贫血及其相关因素的研究。结果 宁夏中小学生总体贫血患病率为8.1%,回族学生贫血患病率为8.7%(140/1 615),略高于汉族学生的7.7%(165/2 132),差异有统计学意义(χ2=1.06,P=0.01)。回族学生轻度贫血检出率为7.2%,中重度贫血检出率为1.4%,汉族学生分别为6.4%、1.3%。在低年龄组中,回、汉族学生的贫血患病率较高。Logistic回归分析发现,汉族学生中,年龄(9岁OR=0.53,95%CI:0.33~0.85,P<0.05;12岁OR=0.51, 95%CI:0.32~0.82,P<0.05)、营养不良(OR=0.63,95%CI:0.45~0.87,P<0.05)与贫血患病有关;回族学生中,性别(OR=1.65,95%CI:1.15~2.36,P<0.05)、年龄(9岁OR=0.35,95%CI:0.21~0.58,P<0.05;12岁OR=0.54, 95%CI:0.32~0.92,P<0.05)与贫血患病有关。交互作用分析发现,民族与女生、乡村、12岁、14岁学生之间存在交互作用(P<0.05)。结论 针对回、汉族的不同民族差异制定贫血防治措施,建议增加回族学生饮食中含铁食物的摄入,关注贫血间的性别、城乡差异,进而提高宁夏回、汉族学生的健康状况。
Abstract
Objective To explore the ethnic differences and influencing factors of anemia in primary and middle school students in Ningxia,in order to provide a straightforward basis for improving the intervention policies and measures for anemia in Ningxia students. Method A stratified random cluster sampling method was used to select 3 747 students from the four age groups(7,9,12 and 14 years old) of Ningxia Hui and Han nationality as participants. Results The prevalence of total anemia among primary and middle school students in Ningxia was 8.1%. And the prevalence of anemia among Hui was 8.7%(140/1 615),slightly higher than that of Han(7.7%,165/2 132)(χ2=1.06,P=0.01). The detection rates of mild and moderate/severe anemia among Hui students were 7.2% and 1.4%,respectively,while 6.4% and 1.3% in Han students. The prevalence of anemia was higher in Han students at younger age group. Logistic regression analysis demonstrated that age(9 years old OR=0.53,95%CI:0.33-0.85;12 years old OR=0.51,95%CI:0.32-0.82),malnutrition(OR=0.63,95%CI=0.45-0.87) were related to anemia in Han students. While gender(OR=1.65,95%CI:1.15-2.36) and age(9 years old OR=0.35,95%CI:0.21-0.58;12 years old OR=0.54,95%CI:0.32-0.92) were correlated with anemia in Hui students(P<0.05). Interaction analysis found that there were interaction effects between ethnicity and gender,areas,as well as age(P<0.05). Conclusions To formulate measures for prevention and treatment of anemia according to different ethnic differences between Hui and Han,it is recommended to increase the iron-rich foods intake in the diet of Hui students. Moreover,more attention should be paid to gender and urban-rural differences on anemia, so as to improve the health status of Ningxia Hui and Han students.
关键词
宁夏 /
回族 /
汉族 /
贫血 /
学生
Key words
Ningxia /
Huiethnic /
Hanethnic /
anemia /
students
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参考文献
[1] Cardoso M,Augusto A,Bortolini G,et al.Effect of providing multiple micronutrients in powder through primary healthcare on anemia in young brazilian children:a multicentre pragmatic controlled trial[J].PLoS One,2016,11(3):e0151097.
[2] Luo RK-WM,Rozelle S,Zhang L,et al.Anemia in rural China′s elementary schools-prevalence and correlates in Shaanxi province′s poor counties [J].Ecology of Food & Nutrition,2010,49(5):357-372.
[3] Song Y,Wang HJ,Dong B,et al.National trends in hemoglobin concentration and prevalence of anemia among chinese school-aged children,1995-2010 [J].J Pediatr,2017,183(4):164-169.
[4] Nkrumah B,Nguah SB,Sarpong N,et al.Hemoglobin estimation by the HemoCue(R) portable hemoglobin photometer in a resource poor setting [J].BMC Clin Pathol,2011,11(4):1-6.
[5] 中国学生体质健康研究组.2014年全国学生体质与健康调研报告[R].北京:高等教育出版社,2016:15-49.
[6] World Health Organization(WHO).Iron Deficiency anaemia assessment,prevention,and control,a guide for programme managers [R].Geneva:World Health Organization,2001.
[7] Chan M.Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity [R].World Health Organization,2011:1-6.
[8] 季成叶,张琳,马军,等.学龄儿童青少年营养不良筛查(WS/T456-2014) [S].北京:北京大学儿童青少年卫生研究所,2014.
[9] 李菁菁,程茅伟,戴诗玙,等.湖北省贫困农村地区中小学生贫血及饮食行为状况 [J].中国学校卫生,2017,38(10):1546-1552.
[10] 杨招庚,王政和,马军.中国2014年7~14岁学生血红蛋白水平及贫血状况分析 [J].中华流行病学杂志,2017,38(5):588-591.
[11] Telangana TKMPJ.Impact of change in dietary behavior and iron supplemention for reduction of iron deficiency anemia in rural adolescent girls [J].Int J Agric,2017,7(4):525-528.
[12] World Health Organization(WHO).Global nutrition targ-ets 2025- Anaemia policy brief [R].2001:1-114.
[13] Adamu U,Crampin A,Kayuni N,et al.Prevalence and risk factors for anemia severity and type in Malawian men and women:urban and rural differences [J].Popul Health Metr,2017,15(1):1-15.
[14] Luo RK-WM,Kleiman-Weiner M,Rozelle S,et al.Anemia in rural China′s elementary schools- prevalence and correlates in Shaanxi province′s poor counties [J].Eclo Food Nutr,2010,49(5):357-372.
[15] 周潇潇,王子睿,陈庚,等.台州市中小学生贫血监测结果分析 [J].预防医学,2018,30(2):208-210.
[16] 杜雪莹,谈蔚清,杨帆,等.广州市义务教育阶段学生贫血及相关因素研究 [J].中国学校卫生,2016,37(12):1845-1847.
[17] 季成叶,陶芳标,武丽杰,等.儿童少年卫生学[M].7版.北京:人民卫生出版社,2014:140-145.
[18] World Health Organization(WHO).Guidelines on food fortification with micronutrients[R/OL].2006.http://www.who.int/nutrition/publications/guide_food_fortification_micronutrients.pdf.
[19] World Health Organization(WHO).United Nations Children′s Fund,Global Alliance for Improved Nutrition,the Micronutrient Initiative,and Flour Fortification Initiative.Recommendations on Wheat and Maize Flour Fortification.Meeting Report:Interim Consensus Statement [R/OL].2009.http://www.who.int/nutrition/publications/micronutrients/wheat_maize_fort.pdf.
[20] 武连富.营养干预对儿童缺铁性贫血的效果研究 [J].继续医学教育,2017,31(5):97-98.
[21] 宋逸,张冰,胡佩瑾,等.中国少数民族学生贫血现况及其与营养状况的关联研究 [J].北京大学学报:医学版,2016,48(3):429-435.