[Related factors and characteristics of common disease multimorbidity among primary and secondary school students in Hunan Province].

Objective

To investigate the prevalence, related factors, and multimorbidity patterns of common diseases among primary and secondary school students in Hunan Province, providing a scientific basis for developing targeted interventions.

Methods

From September to November 2023, a stratified random cluster sampling method was employed to select 255 107 children and adolescents aged 7-18 years in Hunan Province for physical examinations and questionnaire surveys. Data on height, weight, surveillance of common diseases (including the five common diseases of overweight/obesity, myopia, elevated blood pressure, dental caries, and spinal curvature abnor malities), as well as dietary behaviours, physical activity, and health-related behaviors were collected. Multimorbidity was defined as having ≥2 of the above common diseases concurrently. Inter-group comparisons were conducted using Chi-square tests, while ArcGIS software was used to map the spatial distribution and to perform spatial autocorrelation analysis of the multimorbidity detection rates of common diseases. The log-binomial model was used to analyze factors associated with multiple common diseases, and association rules based on the Apriori algorithm were applied to identify the multimorbidity patterns of common diseases in primary and secondary school students.

Results

The overall prevalence of common disease multimorbidities among primary and secondary school students in Hunan Province was 47.23%. The prevalence was highest among high school students (62.30%), followed by middle school (51.08%) and primary school students (38.21%). The prevalence was lower in boys (45.44%) than in girls (49.18%) and higher among urban students (50.77%) than among suburban and rural students (45.33%) (all P<0.001). Multimorbidity prevalence increased with age, rising from 27.88% at age 7 to 60.12% at age 18 (P for trend <0.001). Spatial analysis revealed that the top three being Changsha (55.43%), Yiyang (50.77%), and Yueyang (50.20%), and the lowest being Xiangtan (41.57%). school stage, gender, urban/rural status physical activity, sleep duration, and screen time were identified as significant factors associated with common disease multimorbidities. The patterns with the top three support degrees were "overweight/obesity → myopia", "myopia → overweight/obesity", and "elevated blood pressure → myopia". Multimorbidity patterns demonstrating both high confidence and elevation degrees included "spinal curvature abnormalities → myopia", along with the association rules "myopia + elevated blood pressure → overweight/obesity" and "elevated blood pressure → overweight/obesity".

Conclusions

Common disease multimorbidities are prevalent among primary and secondary school students in Hunan Province, with an increasing trend as age advances. school stage, gender, urban/rural status physical activity, sleep duration, and screen time are key associated factors. Myopia, elevated blood pressure, and overweight/obesity constitute the primary multimorbidity patterns. Early intervention and comprehensive prevention strategies targeting these factors are urgently needed to reduce disease burden and promote adolescent health.