| ObjectiveTo investigate the prevalence of common diseases among middle school students in Linxia Hui Autonomous Prefecture of Gansu Province,such as poor vision,permanent tooth caries,malnutrition and high blood pressure,to understand the prevalence of common diseases among middle school students in Linxia Hui Autonomous Prefecture of Gansu Province.To analyze and explore the correlation between common diseases and health behaviors of local middle school students.To provide a basis for further optimizing prevention and control programs,taking targeted intervention measures,ensuring and promoting the health of local children and adolescents.MethodsThe multi-stage stratified cluster sampling method was used to select students from 7 schools in Linxia City(2 junior high schools and 2 senior high schools)and Yongjing County(2 junior high schools and 1 senior high school)in Linxia Hui Autonomous Prefecture from 2019 to 2021.A 3-year survey on common diseases and influencing factors of health was carried out to collect monitoring data and carry out the following work:(1)Chi-square test or rank sum test(Mann-Whitney and Kruskal-Wallis)was used to analyze the disease status of poor vision,permanent dental caries,nutritional status and high blood pressure of local middle school students in different years,ages,genders,ethnicities and school years.Spearman rank correlation coefficient was used to analyze the correlation between different degrees of poor vision and nutritional status with year and age.(2)Chi-square test was used to analyze the basic characteristics,diet and exercise of poor vision,dental caries of permanent teeth and high blood pressure,respectively,and the specific influencing factors of poor vision were analyzed by chi-square test.The statistically significant results of single factor analysis were included in binary Logistic regression model for multivariate analysis,and the nutritional status was analyzed by disordered multi-classification Logistic regression model.Correlation statistical test levelα=0.05.Results1.Analysis on the prevalence of common diseases(1)From 2019 to 2021,1,979,1,993 and 1,900 students were monitored respectively,with a total of 5,872.They ranged in age from 12 to 21,with an average age of 14.68 years.Among them,3,432(58.4%)students from urban areas and 2,440(41.6%)students from suburban counties.There were 2,864 boys(48.8%)and 3,008 girls(51.2%),with a sex ratio of 1:1.05.There were 3,304 middle school students(56.3%)and 2,568 high school students(43.7%).There were 3,229 Han students(55.0%)and 2,643 ethnic minority students(45.0%).(2)From 2019 to 2021,the overall prevalence rates of common diseases among students from high to low were poor eyesight,caries of permanent teeth,high blood pressure,malnutrition and obesity,and the detection rates were 78.4%,60.8%,14.3%,8.7%and 6.2%,respectively.The prevalence rate of common diseases is consistent in each year.The longitudinal comparison showed that there was significant difference in the prevalence rate of high blood pressure between years(χ~2=12.561,P=0.002).There was a linear trend that the proportion of patients increased with the increase of year(trendχ~2=12.229,P<0.001).There was no linear trend or correlation between poor visual acuity,caries of permanent teeth and nutritional status(all P>0.05).(3)From 2019 to 2021,the overall prevalence rates of mild,moderate and severe poor vision were 6.4%,16.2%and 55.8%respectively,and the prevalence rates of different degrees of poor vision showed the characteristics of severe poor vision>moderate poor vision>mild poor vision(all P<0.05).There was a negative correlation between year and the degree of poor vision,that is,the proportion of severe poor vision decreased with the increase of year(r_s=-0.033,P=0.011),and there was a positive correlation between age and the degree of poor vision,that is,the proportion of severe poor vision increased with the increase of age(r_s=0.147,P<0.001).There were significant differences in the prevalence of poor vision among different ages,monitoring sites,genders,nationalities and school sections(all P<0.001).(4)There were significant differences in the distribution of students’nutritional status among different ages,monitoring sites,genders,nationalities and school segments(all P<0.001).There was a negative correlation between age and nutritional status of students,that is,the proportion of obesity in children and adolescents decreased with the increase of age(r_s=-0.055,P<0.001).(5)The prevalence rate of permanent dental caries was the highest in 17-year-old students(65.8%)and the lowest in 12-year-old students(55.9%).There was significant difference among different age groups(χ~2=38.677,P<0.001),and showed an increasing trend with age(trend χ~2=27.035,P<0.001).The prevalence rate of permanent dental caries in urban students(63.4%)was higher than that in suburban students(57.2%).The prevalence of permanent dental caries in girls(69.8%)was higher than that in boys(51.4%).The prevalence rate of permanent dental caries in minority students(63.8%)was higher than that in Han students(58.4%).The prevalence of permanent dental caries in senior high school students(65.5%)was higher than that in junior high school students(57.2%),and the above differences were statistically significant(all P<0.001).(6)The prevalence rate of high blood pressure was the highest in 14-year-old students(18.2%)and the lowest in 18-year-old to 20-year-old students(3.7%).There was significant difference among different age groups(χ~2=64.609,P<0.001).And the overall trend decreased with the increase of age(trend χ~2=22.936,P<0.001).The prevalence rate of high blood pressure in girls(16.5%)was higher than that in boys(12.0%),the prevalence rate of Han students(15.6%)was higher than that of minority students(12.8%),and the prevalence rate of junior high school students(15.9%)was higher than that of senior high school students(12.4%).The differences were statistically significant(all P<0.05).The prevalence rate of high blood pressure in urban students(13.9%)was lower than that in suburban students(15.0%),and there was no statistical difference between them(χ~2=1.306,P=0.253).2.Analysis of influencing factors(1)The results of multivariate analysis of poor vision showed that monitoring point,gender,school section,nationality,using electronic equipment to surf the Internet,average time of doing homework every day after school in the past week,attending English and other cultural cram classes in the past week,starting to participate in extracurricular classes,eyes more than one foot away from the book and parents’myopia were the influencing factors of poor eyesight(all P<0.05).Among them,the risk of poor eyesight in suburban counties is higher than that in urban areas(OR=1.74,95%CI:1.47～2.05),girls is higher than boys(OR=1.55,95%CI:1.36～1.78),senior high school students are higher than junior high school students(OR=2.39,95%CI:2.06～2.76),using electronic equipment to surf the Internet is higher than not(OR=1.32,95%CI:1.14～1.53),and the time of writing homework more than 2 hours after school is higher than that of<2 hours(OR=1.30,95%CI:1.13～1.50),attending cram school for more than 2 hours than<2 hours(OR=1.48,95%CI:1.12～1.94),attending extracurricular classes at the age of≥6 is higher than never attending cram classes(OR=1.21,95%CI:1.04～1.41),only fathers are more myopic than their parents(OR=1.83,95%CI:1.45～2.30),only mothers are more myopic than their parents(OR=2.67,95%CI:2.02～3.53),the myopia of parents is higher than that of parents(OR=3.93,95%CI:2.58～6.00).All of them were statistically significant(all P<0.05).The risk of poor vision in ethnic minorities was lower than that in Han nationality(OR=0.78,95%CI:0.67～0.91),and the eyes often/always more than one foot from the book were lower than the eyes never/occasionally more than one foot from the book(OR=0.74,95%CI:0.644～0.85).All of them were statistically significant(all P<0.05).(2)The results of multivariate analysis of nutritional status showed that there were differences in the effects of age,sex,school stage,fried food,eating fresh vegetables and the number of PE classes on malnutrition and normal weight(all P<0.05).Compared with normal body weight,the risk of malnutrition was lower at the age of 12 and 13 years old than that at≥17 years old(OR=0.39,95%CI:0.26～0.57),at the age of 14-16 years old was lower than that at≥17 years old(OR=0.67,95%CI:0.49～0.91),and the number of PE classes at 0 times per week was lower than that at more than 3 times per week(OR=0.46,95%CI:0.22～0.97).All of them were statistically significant(all P<0.05).Compared to normal weight.Boys have a higher risk of malnutrition than girls(OR=2.77,95%CI:2.26～3.40),junior high school students are higher than senior high school students(OR=2.37,95%CI:1.78～3.16),never eating fried food is higher than eating fried food more than once a day(OR=2.14,95%CI:1.28～3.58),eating vegetables less than once a day is higher than eating vegetables twice a day or more(OR=1.63,95%CI:1.23～2.16),eating vegetables once a day is higher than eating vegetables twice a day or more(OR=1.28,95%CI:1.01～1.61).All of them were statistically significant(all P<0.05).(3)The results of multivariate analysis of nutritional status showed that monitoring point,age,sex,school section,living in school or not,eating fresh vegetables,the number of days of medium-and high-intensity exercise and the number of PE classes had influence on the changes between obesity and normal weight(all P<0.05).Among them,compared with normal weight.The risk of obesity in urban areas is lower than that in suburban counties(OR=0.55,95%CI:0.41～0.73),junior high school students are lower than senior high school students(OR=0.64,95%CI:0.50～0.96),residential students are lower than non-resident students(OR=0.47,95%CI:0.36～0.62),never eating vegetables is lower than eating vegetables twice or more times a day(OR=0.35,95%CI:0.14～0.83),1-3 PE classes per week are lower than more than 3 PE classes per week(OR=0.40,95%CI:0.22～0.71).All of them were statistically significant(all P<0.05).Compared with normal body weight,the risk of obesity at the age of 13 was higher than that of≥17(OR=1.79,95%CI:1.12～2.86),that of 14-year-old was higher than that of 17(OR=1.63,95%CI:1.13～2.35),that of boys was higher than that of girls(OR=1.76,95%CI:1.40～2.20),and that the risk of obesity in boys was higher than that in girls(OR=1.51,95%CI:1.17～1.96).All of them were statistically significant(all P<0.05).(4)The results of multivariate analysis of permanent dental caries showed that economic area,sex,school level and nutritional status were the influencing factors of permanent dental caries(all P<0.05).The risk of permanent tooth caries in girls was higher than that in boys(OR=2.26,95%CI:2.03～2.53),high school students were higher than junior high school students(OR=1.34,95%CI:1.20～1.49),malnutrition was higher than normal weight(OR=1.56,95%CI:1.28～1.92),all had statistical significance(all P<0.05).The risk of permanent dental caries in areas with poor economic development was lower than that in areas with good economic development(OR=0.52,95%CI:0.45～0.61),and that of overweight was lower than that of normal weight(OR=0.75,95%CI:0.64～0.88).All of them were statistically significant(all P<0.05).(5)The results of multivariate analysis of high blood pressure showed that sex,school age and nutritional status were the influencing factors of high blood pressure(all P<0.05).The risk of high blood pressure in girls was higher than that in boys(OR=1.52,95%CI:1.30～1.77),overweight was higher than normal weight(OR=1.48,95%CI:1.20～1.84),obesity was higher than normal weight(OR=3.90,95%CI:3.07～4.95),all had statistical significance(all P<0.05).The risk of high blood pressure in senior high school students was lower than that in junior high school students(OR=0.79,95%CI:0.64～0.97),malnutrition was lower than normal weight(OR=0.70,95%CI:0.51～0.97),and that of≥17-year-old students was lower than that of 12-year-old students(OR=0.72,95%CI:0.52～0.97).All of them were statistically significant(all P<0.05).Conclusion(1)The overall detection rate of common diseases among middle school students in Linxia Prefecture from 2019 to 2021 is poor vision,permanent tooth caries,high blood pressure,malnutrition and obesity.(2)The prevalence rate of poor vision in different degrees was severe poor vision>moderate poor vision>mild poor vision,and there was a positive correlation between age and the degree of poor vision.Urban and rural areas,gender,school section,nationality,whether or not to use electronic devices to surf the Internet,average time to do homework after school,time to attend cultural cram classes,age to start extracurricular classes,eyes more than one foot away from books and parents’myopia are the influencing factors of poor eyesight.(3)There is a negative correlation between age and nutritional status.There were differences in the effects of age,sex,school period,fried food,fresh vegetables and the number of PE classes on malnutrition and normal weight.There were differences in the effects of urban and rural areas,age,sex,school section,living in school or not,eating fresh vegetables,medium and high intensity exercise days and PE class times on obesity and normal weight.(4)The detection rate of permanent dental caries increased with age,which showed that the incidence of permanent dental caries in urban areas was higher than that in suburban counties,that of girls was higher than that of boys,that of ethnic minorities was higher than that of Han nationality,and that of senior high school students was higher than that of junior high school students.The incidence of permanent dental caries is related to economic area,sex,school level and nutritional status.(5)The detection rate of high blood pressure increases year by year,which shows that girls are higher than boys,Han nationality is higher than ethnic minorities,and junior high school students are higher than senior high school students.The occurrence of high blood pressure is related to sex,school grade,age and nutritional status. |
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