OBJECTIVETo investigate the situation and the influential factors of child neglect between left-behind children and living-with-parents children aged 6-17 years in the rural areas in western China.

METHODSStudents were randomly selected according to the principle of multi-stage stratified cluster sampling and they were from three cities in Shanxi and four districts in Chongqing. Among the 4,131 children, there were 1,874 students in the 6-11 years group and the left-behind children accounted for 50.21% (941/1,874) in this group. There were 2,257 students in the 12-17 years old group and the left-behind children accounted for 53.35% (1,204/2,257) in this group. The questionnaire named "Evaluation on Neglect for Elementary and Secondary School Students Aged 6-17 Years in Rural Areas in China" was used in the field investigation. The students' neglect frequency was described by neglect rate and the factors affecting students' neglect were analyzed by means of binary logistic regression.

RESULTSIn the 6-11 years old group, the neglect rates of left-behind children and living-with-parents children were 63.03% (474/752) and 43.87% (347/791), respectively (χ2=58.86, P<0.001). In the 12-17 years old group, the neglect rates of left-behind children and living-with-parents children were 60.64% (627/1 034) and 53.57% (495/924), respectively (χ2=9.96, P<0.001). For factors influencing left-behind children, compared to the factors about boys, younger mother (≤40 years old), presence of parents' income reduction within the last year and nuclear family, the factors about girls, elder mother (41-49 years), absence of parents' income reduction within the last year and three-generation family or single-parent family were associated with lower neglect risk, and OR values were 0.67, 0.68, 0.70, 0.73, and 0.43 (P<0.05); compared to the factors about Han nationality, only child, with separate room at home, and resident children, the factors about other nationalities, non-only child, no separate room at home, and non-resident children were associated with high neglect risk, and OR values were 1.85, 1.34, 1.46, and 1.32 (P<0.05); compared to the lower father's education background (primary school or uneducated), the higher father's education background (junior middle school, senior middle school, technical secondary school, college and above) was associated with lower neglect risk, and OR values were 0.66, 0.50, and 0.25 (P<0.05); compared to good relationship between children and parents as well as good relationship between parents, fair or poor relationship was associated with high neglect risk, and OR values were 1.57-3.79 (P<0.05). For factors influencing non-left-behind children, compared to the factors about younger mother (≤40 years old), changes of patient's work in the last year, presence of parents' income reduction within the last year and nuclear family, the factors about elder mother (41-49 years), no changes of patients' work in the last year, absence of parents' income reduction within the last year and three-generation family or single-parent family were associated with lower neglect risk, and OR values were 0.69, 0.71, 0.75, 0.82, and 0.56 (P<0.05); compared to the factors about Han nationality, only child and younger father (≤40 years old), other nationalities, the factors about non-only child, and elder father (41-49 years) were associated with high neglect risk, and OR values were 1.45, 1.56, and 1.57 (P<0.05); compared to lower father's education background (primary school or uneducated), higher father's education background (junior middle school, senior middle school, technical secondary school, college and above) was associated with lower neglect risk, and OR values were 0.65 and 0.49 (P<0.05); compared to good relationship between children and parents as well as good relationship between parents, fair or poor relationship was associated with high neglect risk, and OR values were 1.56-7.69 (P<0.05).

CONCLUSIONThe situation of child neglect among left-behind children aged 6-17 years in rural areas of the two provinces in western China was serious, their neglect rates were higher than those of living-with-parents children, and there were many risk factors affecting the neglect rates of the two group children.

Adolescent ; Child ; Child Abuse ; Child, Abandoned ; China ; Demography ; Female ; Humans ; Income ; Logistic Models ; Male ; Mothers ; Parents ; Research ; Risk Factors ; Rural Population ; Schools ; Students ; Surveys and Questionnaires

OBJECTIVETo understand the neglect situation of elementary and high school students aged 6-17 years in western rural areas of China.

METHODSUsing multi-stage stratified cluster sampling method, 4 131 students were recruited from 26 rural elementary and high schools of 7 districts in Shanxi province and Chongqing from September 2012 to April 2013. The investigation was conducted based on 'The Development of Neglect Evaluation Norms and Influence Factors for Primary and Middle School Students' in rural areas of China. SAS 9.21 software was used for analyzing neglect rate and neglect degree for groups of age, sex and neglect types (including neglect of physical, emotional, medical, educational, safety and social).

RESULTSThe total neglect rate and degree were 55.50% (1 943/3 501) and 49.96 ± 9.67; the neglect rates for males and females were 56.78% (1 018/1 793) and 54.16% (925/1 708) (P = 0.119); the neglect degrees were 50.08 ± 9.31 and 49.83 ± 10.02 (P = 0.479), respectively. The girls' medical neglect rate (18.25%, 348/1 907) was significantly higher than that in boys (14.72%, 294/1 997) (P < 0.01); the boys' neglect degrees of physical, educational and social neglect (50.05 ± 10.46, 49.99 ± 10.81, 57.63 ± 14.63) were significantly higher than that in girls (49.34 ± 10.70, 49.07 ± 11.30, 56.37 ± 14.80) (P < 0.05). The total neglect rates of 6-8, 9-11, 12-14 and 15-17 groups were 44.48% (310/697), 60.40% (511/846), 60.89% (601/987) and 53.66% (521/971) (P < 0.01), and the total neglect degrees among these groups were 46.89 ± 8.57, 51.88 ± 9.25, 51.88 ± 9.25 and 51.72 ± 8.89 (P < 0.01), respectively. Except the neglect rates of medical and social neglect, significant differences were found in other three neglect rates and neglect degrees. The rates of social, emotional and safety neglect in 9-11 group were higher than that in other groups (28.39% (264/930), 26.41% (239/905), 20.35% (187/919)). The 12-14 group has the highest educational neglect rate(29.41%, 317/1 078). While the physical and emotional neglect degrees in 12-14 and 15-17 group were higher than that in other groups(12-14 group: 51.59 ± 10.02, 53.43 ± 12.02, 15-17 group: 51.96 ± 9.80, 52.61 ± 11.59). The social, safety, educational and medical neglect degrees were the highest in 6-8, 9-11, 12-14 and 15-17 group (60.91 ± 13.13, 48.29 ± 11.34, 52.43 ± 10.55, 51.15 ± 17.25), respectively. The neglect rates and neglect degrees were significantly higher in minorities(68.88% (374/543) and 52.91 ± 9.14) than those in Han population (53.04% (1 569/2 958), 49.44 ± 9.67)(P < 0.01 in both indexes); and the neglect rates and neglect degrees were significantly higher in children with siblings group (58.20% (1 504/2 584), 50.58 ± 9.54) than those the in one-child group (47.87% (439/917), 48.27 ± 9.80) (P < 0.01 in both indexes); and the neglect rates and neglect degrees were significantly higher in left-hand students (61.65% (1 101/1 786), 51.41 ± 9.51) than those in living-with-parents students(49.10% (842/1 715), 48.56 ± 9.61) (P < 0.01 in both indexes).

CONCLUSIONThe children neglect situation is serious in western rural areas, close attention from families, schools and the society is in urgent need.

Adolescent ; Child ; Child Abuse ; ethnology ; statistics & numerical data ; China ; epidemiology ; ethnology ; Female ; Humans ; Male ; Minority Groups ; Parents ; Risk Factors ; Rural Population ; Safety ; Sex Factors ; Socioeconomic Factors ; Students

Objective:To monitor and investigate the long-term growth trend and nutritional status of very preterm infants (VPIs, born at gestational age between [28~31 +] weeks) with extrauterine growth restriction (EUGR) from birth to preschool period. Methods:VPIs who met with the following criteria were enrolled: infants born in Huai'an Maternity and Child Heath Care Hospital from January 1 to December 31, 2015; infants admitted to the Neonatal Medical Center and discharged alive; infants who received multi-disciplinary treatment in Child Care Division from discharge to preschool period. All of the VPIs were divided into the EUGR group and the non-EUGR group according to whether the weight at hospital discharge was below the 10 th percentile for corrected age in body weight. The weight for age Z score (WAZ), height for age Z score (HAZ), and head circumference for age Z score (HCZ) were calculated at each specified time point (at 40 weeks of age; at 1, 2, 3, 4, 5, 6 and 24 months of corrected age; and at 48 months of age). The growth trend and the nutritional status at 48 months of age were compared between the two groups. Results:1. A total of 53 VPIs were enrolled, among whom 35 cases were boys and 20 cases were with EUGR. The differences in the gestational age, birth weight, incidence of very low birth weight infants, neonatal respiratory distress syndrome (NRDS) and bronchopulmonary dysplasia (BPD) were all statistically significant between the EUGR group and the control group ( x 2= 2.306, 3.543, 10.852, 9.515, 0.001, respectively; all P<0.05). 2. The WAZ and HAZ of the EUGR group were lower at each time point. The WAZ at 40 weeks of age and the HAZ at 3 months of corrected age were significantly different between the two groups. From 40 weeks of age to 2 months of corrected age and from 6 months to 24 months of corrected age, the WAZ, HAZ and HCZ in both groups showed an increasing trend. However, the WAZ in the EUGR group and the WAZ, HAZ and HCZ in the non-EUGR group showed a declining trend from 24 months of corrected age to 48 months of age. 3. There was no significant differences in growth restriction incidence at each time point between the EUGR group and the control group. 4. The nutritional status showed no significant difference between the two groups, either ( P>0.05). Conclusions:Low gestational age, low birth weight, NRDS and BPD are the risk factors of EUGR. The growth trend of the EUGR VPIs shows an overall upward trend from hospital discharge to 24 months of corrected age but declined thereafter, while the nutritional status is good at 48 months of age. Thus, in addition to the integrated management, continuous monitoring of long-term growth and nutrient input after 24 months of age is required for VPIs.