Abstract: Objective To explore the the epidemiological status,characteristics and the major causes of accidental mortality in children under five years old in Chengdu,China and provide scientific basis for policy setting to reduce the under-5 mortality. Methods A retrospective analysis was conducted through a province-based surveillance networkin in Chengdu from 2005 to 2014.The accidental mortality and the major causes in children under 5 years old were analyzed by trend chi-square test and rank test with SPSS 19.0 software. Results The decline trends of the total mortality in children under 5 years old were found in Chengdu from 2005 to 2014,especially in neonatal and the infant above 28 days.The mortality of children aged 1 to 4 years old and the accidental mortality of all ages did not show the significant decline trends.However,the proportion of accidental death in total mortality increased in children under 5 years old (χ²=4.50,P=0.03).Accidental suffocation was the leading cause of accidental deaths among the newborns and infants,making up 88.37% and 83.85% of the total accidental deaths,respectively.Drowning and traffic accident were the top two causes of accidental death in children aged 1 to 4 years old,making up 58.16% and 16.51%,respectively.The accidental mortality in urban areas did not decline (P＞0.05),while the accidental mortality in rural areas decline (P＜0.05).The causes of death were different between the urban and rural areas.The three leading causes of death in urban areas were accidental asphyxia (38.48%),drowning (22.49%) and traffic accidents (15.44%); Unlike the main causes in urban areas,the three leading cause were drowning (41.45%),accidental asphyxia (33.79%) and traffic accident (12.08%) in rural areas. Conclusions Accidental injury has become the major causes of death in children under 5 years old in Chengdu.Accidental injury should be strengthed to reduce the mortality in children under 5 years old.Enhancing the health education for parents and improving social emergency management system are the important strategies to reduce the accidental mortality in children under 5 years old in Chengdu.   

Key words: children under 5 years old, accidental mortality, Chengdu

摘要： 目的 了解成都市5岁以下儿童意外死亡的现状和特点,为制定降低和控制5岁以下儿童死亡率政策提供依据。方法 采用回顾性分析对2005-2014年成都市儿童意外死亡监测资料进行分析。结果 5岁以下儿童各年龄组总死亡率均呈下降趋势(P＜0.05),下降最明显的是新生儿死亡率和28 d以上婴儿死亡率。1~4岁儿童死亡率的下降趋势和意外死亡率各年龄组下降趋势均不明显。同时,5岁以下儿童意外死亡占总体死亡的比例呈上升趋势(χ²=4.50,P=0.03)。从意外死亡原因来看,新生儿期和大于28 d婴儿意外死亡的主要原因是意外窒息(分别占88.37%和83.85%),1~4岁儿童意外死亡主要死因是溺水和交通意外(分别占58.16%和16.51%)。城乡比较,城市意外死亡无下降趋势(P＞0.05),而农村意外死亡有下降趋势(P＜0.05).且城乡间主要死亡原因顺位不同。城市前三位是意外窒息(38.48%),溺水(22.49%)和交通意外(15.44%);农村前三位是溺水(41.45%),意外窒息(33.79%),交通意外(12.08%)。结论 控制和降低儿童意外伤害的死亡将是下一步降低儿童死亡的重要工作内容,应根据地区的环境特点、儿童年龄特点,加强对家长的健康宣教及建立和完善意外伤害的社会急救体系等干预措施,最大限度的降低儿童因意外造成的死亡,提高儿童的生存水平。

关键词: 5岁以下儿童, 意外死亡, 成都市