| Objective1.To investigate the death age,sex and regional distribution of children under 5 years old,infants,and neonates from 2007 to 2016 in Zibo,as well as their mortality trends.2.To analyze the major causes.of death,the acquisition of treatment and health service in children under 5 years old,infants,and neonates in Zibo before they died from 2007 to 2016,and to provide evidence for targeted measures to improve the quality of medical care service in children.3.To make regression analysis of dead children' s cases that could be avoided or would have been avoided if some conditions had been created.So that to provide reference for decreasing children's mortality.MethodsThe study applies descriptive studies of epidemiology.Children under 5 years old,infants,and neonates in Zibo were retrospective analyzed and recruited in the study from 2007 to 2016.The distribution in death year,age,sex and regions were analyzed,and the trend in the changes of mortality rate,the ratio of infant mortality rate to under-five mortality rate(IMR/U5MR),the ratio of neonatal mortality rate to infant mortality rate(NMR/IMR)from 2007 to 2016 were analyzed.Meanwhile,the main death causes,the situation of acquiring medical care service were analyzed in constituent ratio.All the data collected in the study was analyzed by IBM SPSS 24.0(network edition).Chi-square test was used for analysis of difference and trend in mortality rate.To make regression analysis of dead children's cases that could be avoided or would have been avoided if some conditions had been created.Results1.The mortality rates of children under 5 years old from 2007 to 2016 in Zibo.?There were 356755 live children in Zibo from 2007 to 2016,but 4127 of them died under 5 years old,the mortality rate accounted for 1.16‰..?The average mortality rate of newborns,infants,and children under 5 years old were 2.86‰,3.95‰,4.77‰ respectively,decreasing by 36.68%,35.97%and 30.10%compared with the year of 2017.?The mortality rates of children under 5 years old,infants and newborns from 2007 to 2016 in Zibo decreased(P trend = 0.017;P trend=0.016;Ptrend =0.038).2.Distribution characteristics of the mortality rate of children under 5 years old?The characteristics of age composition:the ratio of 0 days,1 days,7 days,28 days,1 years to death was 16.63%,27.08%,15.89%,23.09%and 17.30%,respectively.?Gender distribution characteristics:the mortality rate of children under 5 years old,infants and newborns is significantly higher than that of women.The difference is statistically significant(x2=15.07,P=0.000;?2=14.16,P=0.000;?2=10.O01,P=0.002);The linear trend of Chi-square test results showed that the mortality of male children under 5 years old and infants decreased from 2007 to 2016 in Zibo.(P trend = 0.019;P trend =0.022).The mortality of female children under 5 years old,infants and neonates decreased(P trend =0.041;P trend =0.016;P trend =0.025).?Urban and rural distribution:The mortality of children under 5 years old,infants,neonates in urban and rural areas were no significant differences;the liner trend of Chi-square test shows that the downward trend of infant mortality rate(P trend =0.050),rural children under 5 years old,infant and neonatal death rate decreased(P trend =0.010;P trend =0.021;P trend =0.017).3.The mortality rates of children under 5 years old in different districts The mortality rates of children under five years old,infants and neonates were declined in three counties and five districts in Zibo from 2007 to 2016,and significant differences were found in the mortality rates among districts and counties,and the highest mortality rates occurred in Zichuan region in children under 5 years old(5.72‰?4.87‰),and Gaoqing County in both infants and neonates(3.48‰).4.The correlation between ratio of neonatal mortality rate to infant mortality rate(NMR/IMR),and ratio of infant mortality rate to under-five mortality rate(IMR/U5MR)?The ratios of IMR/U5MR from 2007 to 2016 fluctuated from 79.32%to 88.62%.?The ratios of neonatal mortality from 2007 to 2016 fluctuated from 60.37%to 78.00%.5.Deaths causes sequence ?The five leading deaths of causes in newborns,infants and children under the age of 5 years were preterm birth,low birth weight,birth asphyxia,congenital heart disease,pneumonia,accidental asphyxia,respectively in Zibo from 2007 to 2016.?Meanwhile,traffic accidents in other deaths causes were in a climbing trend in children under the age of 5 years.?The top three death categories of children under the age of 5 years were neonatal diseases.congenital abnormalities,accidents and poisoning from 2007 to 2016.6.The acquisition of treatment and health care services in children under 5 years old ?The death rate of children under 5 years old in Zibo from 2007 to 2016 accounted for 70.40 to 88.52%,and no treatment before death accounted for 14.76%.?The hospitalization before death of children in city was significantly higher than the proportion of rural children under 5 years old(?2=29.04,P=0.000);the proportion of outpatient treatment of death in children under 5 years old in rural areas was significantly higher than that of city(?2=13.73,P = 0.000);before treatment was significantly higher than the proportion of deaths in children under 5 years old rural city(?2=12.17,P = 0.000).?The provincial(city)level hospital of children under 5 years of age accounted for 53.48%of the diagnosis and treatment institutions,ranking first in the diagnosis and treatment institutions.7.The review of inevitable death for children under 5 years old.?For children under 5 years of age,the inevitable death assessment is 47.27%,and the rate of children's death that could be avoided or would have been avoided if some conditions had been created is 46.88%.?The rate of evitable death is 1.56%.2007-2016 years in Zibo city can avoid death factors logistics regression analysis indicated that the Zichuan area can avoid the risk of death increased 2.722 times(95%CI 1.094-6.778),birth weight of children in the normal range of avoidable mortality risk than birth weight in the normal range of children increased 1.875 times(95%CI1.035-3.379).Conclusions1.In the past 2007-2016 years,the mortality rate of children under 5 years of age in Zibo was declining year by year.Neonatal death is the first of children under 5 years of age,and reducing the mortality of newborn is the key to reduce the mortality of children under 5 years of age.2.In 2007-2016,the main causes of death in children under 5 years old,infants and newborn was preterm birth,low birth weight and birth asphyxia.Health care institutions should strengthen health care during pregnancy and childbirth,do wellin transporting critical neonates,improve midwifery and neonatal first aid skills,and reduce premature birth,low birth weight and birth asphyxia.3.The death rate of Zichuan district and Gaoqing County in all districts and counties of Zibo is highest.The government departments should focus on the supervision and policy support and capital investment in these two regions.4.In medical treatment,the medical institutions,consciousness,treatment methods of rural children under 5 years old were lower than those of the same situation of city children before death,thus it's important to improve rural children's health care facilities,medical and health personnel allocation and education services etc.5.The review of children under 5 years old mainly concludes the inevitable death and the death that could be avoided or would have been avoided if some conditions had been created;by reducing the birth and death of children in Zichuan district children of normal weight can significantly reduce the death of children in Zibo city under 5 years old can prevent the occurrence of death. |
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