| BackgroundAnemia in our country and even around the world is an important public health problem. Anemia in children and adolescents incorporated into the student common disease category is one of the important contents of students’common diseases prevention. Anemia more obviously impact on children than adults, leading to stunted growth, the decline of body resistance and cognitive function, etc. So to understand the situation of children’s anemia disease and influenced factors of anemia in children has important significance in the field of public health and social economics.ObjectiveThrough analysising the monitoring data of "Nutrition Improvement Programme for Rural Compulsory Education Students (NNIPRCS)" from 2012 to 2014, this study to explore epidemic regularity of students’anemia and its influencing factors. To Analysis the occurrence and development regularity of primary and middle school students’hemoglobin concentration and the frequency of anemia disease; And collect information of the countys, the schools and students, to explore the possible factors that affect the anemia condition of students. This study want to provide basic data and suggestions for student nutrition improvement.MethodsIn 2012, from fifty key monitoring counties of NNIPRCS ", in accordance with multi-stage stratified random cluster sampling principles, two primary schools and two junior schools were selected by three food supply modes (school-, company-, and mix-). Then, about 40 students in a class of each grade were randomly extracted from grade 1 to grade 4 in primary school and grade 7 in middle school. From 2012 to 2014, every September to survey the researching object. We should collecting the related information with the "countys investigation questionnaire", "schools investigation questionnaire" and "students investigation questionnaire", as well as determinating the hemoglobin concentration of students. To describe the hemoglobin concentration using the mean and standard deviation, and to describe anemia disease using cases and prevalence. Using multi level model (the response variable is hemoglobin concentration) and generalized linear mixed models (response variable is anemia) for single factor and multiple factors analysis.ResultsThe longitudinal monitoring data of 21882 students were investigated, Each student has more than twice and monitoring data, so the data is unbalanced. From 2012 to 2014, the percent of male was 51.66%,50.69% and 50.99% respectively, and the percent of female was 48.34%、49.01%、49.31% respectively. The percent of middle school students was 18.38%,18.32% and 18.17% respectively. And the percent of primary school students was 81.62%,81.68% and 81.83% respectively.From 2012 to 2014, the survey area’average hemoglobin concentrations were 133.02 g/L,135.76 g/L,137.91 g/L respectively, rising along with the change of time (estimation=2.7937, t=6.18, P=<.0001), with the cumulative increase of 4.89 g/L. The anemia prevalence were 16.87%、14.39%、11.35% respectively, falling along with the change of time (estimation=-0.1916,t=-2.65, P=0.0080), with the cumulative decrease of 5.52%. There were big differences among groups in the changing with time of anemia condition. Such as several provinces’anemia prevalence rised along with the change of time; In high age group, increasing of hemoglobin concentration of boy was significantly higher than girls’; Adolescent girls had the highest anaemia.Through the multiple factors analysis, the study found that insect repellent has a promoting effect on the improvement of the anemia condition of students; High income levels, the intake of meat hinder the improvement of the anemia condition of students;This study didn’t find the relationship of nutrition knowledge score and anemia.ConclutionAfter the implementation of NNIPRCS, student’s hemoglobin concentration increased year by year, anemia prevalence decline year by year. But the change over time of different people differences. Student anemia status is affected by gender, age and region. So we should give the children of vulnerable groups more concern, such as young children, adolescent girls and students in areas prone to anemia. Health education and insect repellent has a promoting effect on the improvement of the anemia condition of students. |
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