中国循证医学杂志

中国循证医学杂志

基于《世界卫生统计 2015》资料全球 5 岁以下儿童死亡率的现状分析

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目的 评价 WHO 194 个会员国 5 岁以下儿童死亡率(U5MR)千年发展目标完成情况,分析全球 U5MR 现状。 方法 以《世界卫生统计 2015》U5MR、主要死因构成比为基础,采用 1990~2013 年 U5MR 下降幅度评估千年发展目标完成情况,通过 2000 年与 2013 年阶段性比较分析 U5MR 变化规律,采用双变量 Pearson 相关分析判断 U5MR 与“感染非感染性疾病比值”、人均 GDP 的相关性。 结果 截至 2013 年,在 194 个 WHO 会员国中,46 个(23.71%)国家 U5MR 实现了千年发展目标。2000 年与 2013 年比较,六大洲、低和高死亡率组 U5MR 差异有统计学意义(P<0.05),中等死亡率组差异无统计学意义(P>0.05);中、低死亡率组“感染非感染性疾病比值”差异无统计学意义(P>0.05),高死亡率组差异有统计学意义(P<0.05)。低与中、中与高死亡率组 U5MR、“感染非感染性疾病比值”及平均下降量比较差异有统计学意义(P<0.05)。全球 U5MR 地区性差异明显,非洲 U5MR 均值最高,欧洲最小,大洋洲、南美洲、北美洲居中,亚洲渐趋中等水平。各国 U5MR 与“感染非感染性疾病比值”呈高度正相关关系(r2000年=0.934,r2013年=0.911,P<0.05),与人均 GDP 呈低度负相关关系(r2000年=–0.443,r2013年=–0.433,P<0.05)。 结论 降低全球 U5MR 任重而道远,防控重点应放在非洲和亚洲。防控感染性疾病是中、高死亡率国家的有效措施之一,防控非感染性疾病是低死亡率国家的重要措施之一。加大卫生投入是进一步降低全球 U5MR 的重要途径。

Objective To assess the completion of the under 5 mortality rate (U5MR) of Millennium Development Goals in 194 member countries of WHO, and to analyze the present situation of the global U5MR. Methods Based on the U5MR and the proportion of main causes of death in the "World Health Statistics 2015", the Millennium Development Goals of the decline of U5MR from 1990 to 2013 was assessed, the U5MR was analyzed by comparison between 2000 and 2013. Bivariate Pearson correlation analysis was used to determine the correlation between mortality and the ratio of infection to non infectious diseases and GDP per person in U5MR. Results By 2013, in 194 WHO member states, the U5MR in 46 (23.71%) countries achieved the millennium development goals. Comparison between 2000 and 2013, there was significant difference between low and high mortality groups in six continents (P<0.05), there was no significant difference between the moderate death groups (P>0.05), there was no significant difference in the ratio of infection to non infectious diseases between the middle and low mortality groups (P>0.05), however there was significant difference between the high mortality groups (P<0.05). There was significant difference in the average decline of U5MR and the ratio of non infectious diseases between low and medium, middle and high mortality groups (P<0.05). The Global U5MR had significant regional differences, the highest U5MR was in Africa, the lowest U5MR was in Europe, the medium U5MR was in North America, Oceania, South America, Asia was becoming the middle level. The U5MR was highly correlated with the ratio of infection to non-infectious diseases in every country (r2000y=0.934,r2013y=0.911,P<0.05), and it was low negatively correlated with GDP per capita (r2000y=–0.443,r2013y=–0.433,P<0.05). Conclusions There is a long way to reduce global child mortality. Prevention and control should focus on Africa and Asia. Prevention and control of infectious diseases is an effective measure for middle and high mortality countries. Prevention and control of non-infectious diseases is an important measure for low mortality countries. Increasing health investment is an important means to further reduce global U5MR.

关键词: 5 岁以下儿童死亡率; 世界卫生统计; 感染性疾病; 人均 GDP

Key words: Under 5 mortality rate; World health statistics; Infectious diseases; GDP per capita

引用本文: 李鸿斌. 基于《世界卫生统计 2015》资料全球 5 岁以下儿童死亡率的现状分析. 中国循证医学杂志, 2017, 17(3): 269-275. doi: 10.7507/1672-2531.201701051 复制

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