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2013—2024年安徽省18岁以下儿童伤害死亡变化趋势及健康指标达标分析

Temporal trend of injury deaths in children aged <18 years and compliance analysis of health indicators in Anhui, 2013−2024

    摘要
  • 摘要:
    目的 分析安徽省2013—2024年18岁以下儿童伤害死亡特征及变化趋势，为完善儿童伤害防控相关措施提供依据。
    方法  资料来源于全省24个省级代表性死因监测点数据，采用R4.5.1软件描述伤害死亡的分布特征，采用Joinpoint 4.9.1.0软件计算平均年度变化百分比（AAPC）并对伤害死亡率进行趋势分析。
    结果  安徽省18岁以下儿童伤害标化死亡率由2013年的17.77/10万下降到2024年的9.75/10万（AAPC=−5.59%，P<0.001）。2013—2024年安徽省男童与女童伤害标化死亡率均呈下降趋势（AAPC分别为−7.09%、−3.07%，均P＜0.05），＜1岁、1～<5岁、5～<10岁、10～<15岁年龄组儿童伤害粗死亡率均呈下降趋势（AAPC分别为−7.41%、−9.49%、−7.92%、−4.05%，均P＜0.05）。总体来说，男童伤害粗死亡率高于女童（χ2=273.303，P<0.001），农村儿童伤害粗死亡率高于城市（χ2=57.501，P<0.001），皖南、皖中和皖北不同地区儿童伤害粗死亡率不同（χ2=52.844，P<0.001），差异均有统计学意义。18岁以下儿童伤害前5位死因依次为溺水（占36.64%）、道路交通伤害（占26.39%）、跌倒（占8.45%）、窒息（占6.96%）和自杀（占6.87%）。窒息、道路交通伤害、溺水标化死亡率均呈下降趋势（AAPC分别为−9.98%、−8.83%、−8.09%，均P＜0.001），自杀标化死亡率呈上升趋势（AAPC=10.79%，P<0.001）。伤害为18岁以下儿童第一位死因。10～<18岁儿童伤害死亡占比呈上升趋势。<1岁组的首位伤害死因为窒息，1～<18岁组的首位伤害死因为溺水；自杀为10～<18岁组的第三位伤害死因。按2013—2024年儿童伤害死亡率平均增长速度，预计2030年可实现《中国儿童发展纲要（2021—2030 年）》目标。
    结论  安徽省18岁以下儿童伤害死亡率呈下降趋势，尽管预测2030年可达标，但伤害仍然是儿童第一位死因，且存在性别、年龄、城乡和地区差异。应重点关注男性、农村、皖北地区儿童，根据不同年龄组的主要伤害类型采取针对性防控措施。

     

    Abstract:
    Objective To analyze the characteristics and changing trends of injury deaths among children under 18 years old in Anhui province from 2013 to 2024, and provide evidence for the improvement of injury prevention and control in children.
    Methods The data were collected from 24 provincial-level death surveillance points in Anhui. Software R4.5.1 was used to describe the distribution of injury deaths, and software Joinpoint 4.9.1.0 was used to calculate the average annual percentage change (AAPC) for analyzing the trend of injury mortality.
    Results The standardized mortality rate (SMR) of injury decreased from 17.77/100 000 in 2013 to 9.75/100 000 in 2024 in children aged <18 years in Anhui (AAPC=−5.59%, P < 0.001). From 2013 to 2024, the SMRs of injury showed downward trends in both boys and girls in Anhui (AAPC: −7.09% for boys and −3.07% for girls, both P < 0.05). The crude mortality rates (CMRs) of injury in children in age groups <1 year, 1−<5 years, 5−<10 years, and 10−<15 years all exhibited decreasing trends (AAPC: −7.41%, −9.49%, −7.92%, and −4.05%, all P < 0.05). Overall, the CMR of injury in boys was higher than that in girls (χ2=273.303, P < 0.001), and the CMR of injury in rural children was higher than that in urban children (χ2=57.501, P < 0.001). The CMR of injury in children in southern, central, and northern Anhui differed (χ2=52.844, P < 0.001), with significant differences. The top five causes of injury death in children aged <18 years old were drowning (36.64%), road traffic accident (26.39%), fall (8.45%), suffocation (6.96%), and suicide (6.87%). The SMRs of suffocation, road traffic injury, and drowning all showed decreasing trends (AAPC; −9.98%, −8.83%, and −8.09%, all P < 0.001), while the SMR of suicide showed an increasing trend (AAPC=10.79%, P < 0.001). Injury was the leading cause of death in children age <18 years. The proportion of injury deaths in children aged 10−<18 years showed an increasing trend. The leading cause of injury death in those aged <1 year was suffocation, while it was drowning in those aged 1−<18 years. Suicide was the third leading cause of injury death in children aged 10−<18 years.
    Conclusion The mortality rate of injury in children under 18 years old showed a downward trend in Anhui. Although it is expected to meet the standards by 2030, injury remains the leading cause of death in children, with gender, age, urban−rural status, and area specific differences. Special attention should be paid to boys, children in rural areas, and those living in northern Anhui. Targeted prevention and control measures should be taken according to the main types of injury in children in different age groups.

     

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