Abstract
徐培培,张倩,杨媞媞,许娟,甘倩,曹薇,李荔,潘慧,赵文华.2019年 “农村义务教育学生营养改善计划”覆盖地区中小学生贫血状况及影响因素分析[J].Chinese journal of Epidemiology,2022,43(4):496-502
2019年 “农村义务教育学生营养改善计划”覆盖地区中小学生贫血状况及影响因素分析
Anemia prevalence and its influencing factors among students involved in the Nutrition Improvement Program for Rural Compulsory Education Students in 2019
Received:August 10, 2021  
DOI:10.3760/cma.j.cn112338-20210810-00627
KeyWord: 血红蛋白|贫血|中小学生
English Key Word: Hemoglobin|Anemia|Primary and middle school student
FundProject:公共卫生专项任务经费(131031107000180004)
Author NameAffiliationE-mail
Xu Peipei National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention/Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing 100050, China  
Zhang Qian National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention/Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing 100050, China  
Yang Titi National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention/Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing 100050, China  
Xu Juan National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention/Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing 100050, China  
Gan Qian National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention/Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing 100050, China  
Cao Wei National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention/Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing 100050, China  
Li Li National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention/Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing 100050, China
National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China 
 
Pan Hui National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention/Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing 100050, China  
Zhao Wenhua National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention/Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing 100050, China zhaowh@chinacdc.cn 
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Abstract:
      目的 分析2019年“农村义务教育学生营养改善计划”覆盖地区中小学生贫血状况及其影响因素。方法 研究对象为2019年“农村义务教育学生营养改善计划”覆盖地区47 297名6~17岁中小学生。依据2011年WHO贫血诊断标准,分析比较不同性别、年龄、地区中小学生的血红蛋白水平和贫血率,并采用多因素logistic回归模型分析贫血的影响因素。结果 2019年我国“农村义务教育学生营养改善计划”覆盖地区中小学生血红蛋白均值为135.19 g/L,贫血率为8.7%;女生贫血率(10.0%)高于男生(7.4%),西部地区贫血率(9.8%)高于中部地区(7.1%);西北、西南、中南、华东、华北及东北地区贫血率分别为10.2%、9.7%、8.3%、7.5%、5.7%和3.5%;6~、11~、14~17岁年龄组贫血率分别为8.0%、8.3%和10.9%。多因素logistic回归分析显示,不使用营养配餐软件的学校(OR=1.482,95%CI:1.296~1.694,P<0.001)、午餐不供应肉类食物的学校(OR=1.241,95%CI:1.103~1.395,P<0.001)以及低收入家庭(OR=1.297,95%CI:1.211~1.389,P<0.001)的学生贫血发生风险更高;模型增加学生饮食相关因素后显示,每周吃≥3次肉类食物的学生贫血发生风险较低(OR=0.907,95%CI:0.832~0.989,P=0.026)。结论 “农村义务教育学生营养改善计划”对我国中小学生贫血改善已产生重要影响,但“农村义务教育学生营养改善计划”覆盖地区学生贫血率仍高于全国平均水平,学生家庭收入、学校所在地、学校配餐能力及食物供应种类等是中小学生贫血发生率的主要影响因素,需要各方给予进一步关注和重视。
English Abstract:
      Objective To analyze anemia prevalence and its influencing factors of students involved in the Nutritional Improvement Program for Rural Compulsory Education Students in 2019. Methods From the 2019 surveillance system of the Nutrition Improvement Program for Rural Compulsory Education Students, 47 297 primary and middle school students aged 6-17 were included in the study. Hemoglobin level was tested according to the criteria of WHO 2011. Anemia prevalence of different genders, ages, and regions was analyzed. Results The average hemoglobin level was 135.19 g/L, with the prevalence of anemia as 8.7% in the children aged 6-17. The prevalence of anemia was 10.0% in girls, higher than that in boys (7.4%). The prevalence rates in western and central areas were 9.8% and 7.1%, respectively. From northwest, southwest, central and south, east, north to northeast areas of China, the anemia rate appeared gradually decreasing (10.2%, 9.7%, 8.3%, 7.5%, 5.7% and 3.5%). The anemia prevalence rates were 8.0%, 8.3%, and 10.9% in children from the 6-, 11-, and 14-17 years age groups, respectively. Logistic regression models revealed that students from schools not using catering software (OR=1.482, 95%CI:1.296-1.694,P<0.001), schools not serving lunch (OR=1.241, 95%CI:1.103-1.395,P<0.001), and from relatively low-income families (OR=1.297, 95%CI:1.211-1.389,P<0.001) showed as risk factors for anemia. After supplementing students' dietary factors, the results showed that students who ate meat three or more times a week had a lower risk of anemia (OR=0.907, 95%CI:0.832-0.989,P=0.026). Conclusions The Nutritional Improvement Program for Rural Compulsory Education Students had an essential impact on improving the anemia prevalence of primary and middle school students. Family income, school location, economic factors, school feeding, and students' diet programs all impacted the prevalence of anemia.
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