Beş yaş altı çocuk ölümlerinin nedenleri ve aşılanma durumlarının değerlendirilmesi

Yıl 2023, Cilt: 17 Sayı: 2 - Turkish Journal of Family Medicine and Primary Care, 220 - 225, 20.06.2023

Bahadır Yazıcıoğlu , Muhammet Ali Oruç , Sibel Türkan , Özkan Yaşayancan , Erdinç Yavuz

https://doi.org/10.21763/tjfmpc.1220680

Öz

Amaç: Bebek ve çocuk ölüm oranları ülkelerin gelişmişliğinin, sağlık politikalarının ve sağlık müdahalelerinin etkinliğinin hassas bir göstergesidir. Beş yaş altındaki çocuklar arasındaki ölümlerin önemli kısmı basit ve kanıtlanmış tedbirlerle önlenebilir veya tedavi edilebilir hastalıklardan kaynaklanmaktadır. Bu çalışmada beş yaş altı çocuk ölümlerinin nedenleri ve aşılanma durumlarının değerlendirilmesi amaçlanmıştır.
Metod: Çalışma kesitsel tipte tanımlayıcı bir çalışmadır. Çalışmanın evrenini 3 yıllık sürede Samsun ilinde 5 yaş altında ve 1 yaşını tamamlamış toplam 97 çocuk ölümü oluşturmaktadır. Örneklem seçimi yapılmayıp bütün çocuk ölümlerine ait veriler retrospektif olarak incelenerek elde edilmiştir. Ölen çocukların yaş, cinsiyet ve ölüm nedenleri not edilmiştir. Düşme, trafik kazası, ateşli silah yaralanması ve suda boğulma gibi nedenler travma; sepsis, pnömoni, bronkopnömoni, gastroenterit ve ensefalit gibi nedenler enfeksiyon; doğuma bağlı ve kalıtsal hastalıklar doğumsal anomali ve son olarak metabolik ve kronik hastalıklar da kronik hastalıklar başlığında toplanarak sınıflandırılmıştır.
Bulgular: 3 yıllık dönemde Samsun ilinde toplam 97 çocuk ölümü olmuştur. En sık ölüm nedeni enfeksiyon hastalıkları olduğu görülmüştür. Enfeksiyon nedeniyle ölenlerin en sık tanısı bronkopnömonidir. Ölen çocukların aşılanma durumları ölüm nedenlerine göre incelendiğinde; en düşük aşılanma oranlarının sırasıyla kalıtsal hastalık nedenli ölümler, enfeksiyon kaynaklı ölümler ve kronik hastalık nedenli ölümler olduğu görülmüştür. Ölen çocukların annelerinin doğum öncesi birinci basamak sağlık hizmetlerindeki takip sıklığı 3,26 defa, ikinci basamakta takip sıklığı ortalaması 2,41 defa olduğu görülmüştür. Gebelik süresince toplam izlem sayı ortalaması 5,67 defa olduğu bulunmuştur. Gebelerin %77,3’ü DSÖ’nün önerisine uygun şekilde en az 4 kez gebelik izlemi yaptırmıştır.
Sonuç: Ölen çocukların aşılanma oranı ulusal aşılanma oranının çok altındadır. Aşılanma oranı en düşük kalıtsal hastalık enfeksiyon kaynaklı ölümlerdedir. En sık ölüm nedeni enfeksiyon kaynaklı ölümlerdir. Enfeksiyon kaynaklı ölümlerin fazla olması enfeksiyonla mücadele ve koruyucu hekimlik uygulamaları gibi birinci basamak sağlık hizmetlerine ağırlık verilmesine işaret etmektedir

Anahtar Kelimeler

Aşılar, Aşılama, Aşıyla önlenebilir hastalıklar, Çocuk ölümü, Ölüm nedeni

Evaluation of causes of death and vaccination status of children under the age of five

Öz

Aim: Infant and child mortality rates; it is a sensitive indicator of development in countries, the effectiveness of health policies and health interventions. A significant proportion of deaths among children under the age of five are due to diseases that can be prevented or treated with simple and proven measures. It was aimed to evaluate the causes of death and vaccination status of children under the age of five.
Method: The study is a cross-sectional descriptive study. The population of the study consists of a total of 97 child deaths under the age of 5 and completed the age of 1 in Samsun in a 3-year period. Sample selection was not made, and the data of all child deaths were obtained by retrospectively examining. Age, gender and causes of death of the deceased children were noted. Causes such as falling, traffic accident, firearm injury and drowning are traumas; causes such as sepsis, pneumonia, bronchopneumonia, gastroenteritis and encephalitis as infections; Congenital and hereditary diseases were classified as congenital anomalies, and metabolic and chronic diseases were classified under the title of chronic diseases.
Results: A total of 97 child deaths occurred in Samsun in the 3-year period. The most common cause of death was found to be infectious diseases. The most common diagnosis of those who die due to infection is bronchopneumonia. When the vaccination status of the deceased children is examined according to the causes of death; the lowest vaccination rates were found to be deaths from hereditary disease, deaths from infection, and deaths from chronic disease, respectively. It was observed that the frequency of follow-up in the prenatal primary health care services of the mothers of the deceased children was 3.26 times, and the average frequency of follow-up in the secondary care was 2.41 times. The mean number of total follow-ups during pregnancy was found to be 5.67 times. The rate of pregnant women who had pregnancy follow-up at least 4 times in accordance with WHO's recommendation is 77.3%.
Conclusion: The immunization rate of children who die is well below the national immunization rate. The lowest rate of vaccination is in the deaths caused by the inherited disease infection. The most common cause of death is death due to infection. The high number of infections-related deaths indicates that primary health care services such as infection control and preventive medicine should be focused on.

Anahtar Kelimeler

Vaccines, Vaccination, Vaccine-preventable diseases, Child mortality, Cause of death

Kaynakça

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