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中国上海市および江西省の児童生徒のう蝕に及ぼす行動因子と生活環境の影響．学校を基盤とした横断的研究
Impact of Behavioural Factors and Living Conditions on Dental Caries Among Pupils from Shanghai and Jiangxi Province in China: A School-based Cross-sectional Study.
PMID: 31268050 DOI: 10.3290/j.ohpd.a42742.
抄録
目的:
歯の健康は、子供の成長と発達（身体的または心理的）に関連している。数多くの予防策があるにもかかわらず、中国では小学生のう蝕は依然として公衆衛生上の懸念事項である。中国の農村部と都市部の子どもの歯の健康状態の格差を理解することで，う蝕の予防についてのさらなる洞察が得られる可能性がある．
PURPOSE: Dental health is associated with the growth and development, physical or psychological, of children. Although numerous preventive measures are available, dental caries among primary schoolchildren remains a public health concern in China. Understanding the disparity of children's dental health between rural and urban areas in China could provide further insight into the prevention of caries.
方法:
中国の浦東区（上海市）と立川市（江西省）の6～12歳の児童生徒の口腔保健を横断的に調査した。小児う蝕の潜在的な危険因子を特定するために、児童の保護者を対象にアンケート調査を実施した。
METHODS: A cross-sectional study was conducted to examine the oral health of pupils aged 6-12 years in Pudong District (Shanghai) and Lichuan (Jiangxi Province) in China. A questionnaire survey was performed among children's guardians to identify the potential risk factors for childhood dental caries.
結果:
この研究には合計1922人の小学生が含まれており、そのうちの815人は浦東から、1107人は四川からであった。平均年齢は8.57歳（SD=1.61歳）であり、統計学的に有意に低い値であった。う蝕の有病率は、浦東で63.4％、四川で75.0％であった。人口統計学的に有意な差が、浦東と四川の学童の間で観察された。一般的に、四川の児童は浦東の児童に比べてう蝕リスクが高かった（OR = 3.43、95%CI 2.65-4.28）。さらに、親以外の介護者、低所得、親の教育レベルの低さ、食生活の悪さがう蝕の危険因子として同定された。
RESULTS: A total of 1922 primary schoolchildren were included in this study, with 815 from Pudong and 1107 from Lichuan. The mean age of children from Pudong was 8.57 (SD = 1.61), which was statistically significantly lower than their counterpart from Lichuan (9.36 ± 1.75). The prevalence of caries in Pudong and Lichuan was 63.4% and 75.0%, respectively. Statistically significant differences of demographical and behavioural features were observed between schoolchildren in Pudong and Lichuan. In general, Lichuan children had a higher caries risk compared with their Pudong counterparts (OR = 3.43, 95%CI 2.65-4.28). Moreover, the non-parental caregivers, low family income, low parental educational level, as well as bad dietary habits, were identified as risk factors for caries.
結論:
農村部の小児う蝕は都市部よりもはるかに深刻であった。この格差は、農村部の取り残された子どもの割合が高いこと（例えば、親が都市部に出稼ぎに行っている間に中国の農村部に残っている子どもなど）など、いくつかの要因によって決定された。我が国政府は、農村部と都市部の格差を縮めるために、近い将来、農村部の子供たちのう蝕予防をより高い優先順位に置くべきである。
CONCLUSIONS: Childhood caries in the rural area was far more severe than that in the urban area. This disparity was determined by several factors such as the high proportion of left-behind children in the rural area (e.g. children who remain in rural regions of China while their parents leave to work in urban areas). Our government should put the prevention of caries among rural children at a higher priority in the near future to narrow the gap between rural and urban areas.