2021 Vol. 37, No. 3
column
- cover
- contents
- Criterion, Guideline, Consensus
- Special Report – Having Confidence in Vaccination for Healthy Life
- Special Report – Promoting Sexual Health Education among Adolescents
- Special Report – Accessing Health Risk Associated with Microplastics Pollution
- Epidemiological Research
- Experimental Study
- Survey and Report
- Inspection technology
Display Method:
2021, 37(3): 393-397.
doi: 10.11847/zgggws1132836
Abstract:
Objective To analyze the status quo and influencing factors of trust in vaccination among parents of small children. Methods Using stratified multistage random sampling, we recruited 3 292 children aged 0 – 3 years at 34 immunization clinics in 12 districts/counties of 6 provinces across China and conducted a questionnaire survey on vaccination knowledge and information demand, vaccination service received, and satisfaction to vaccination service among the parents of the children from December 2019 to January 2020. Results For the 3 178 parents with valid responses, the mean score for overall trust in vaccination was 3.91 ± 0.72 on a five-point scale, indicating a general trust of 78.20%. Vaccine safety was the key factor affecting the trust in vaccination based on the parents′ responses. The results of binary logistic regression analysis demonstrated that the parents with following characteristics were more likely to have the trust in vaccination of their children: ever receiving health education at immunization clinics (odds ratio [OR] = 1.528, 95% confidence interval [95% CI]: 1.274 – 1.833), ever participating in education programs for parents organized by immunization clinics (OR = 1.616, 95% CI: 1.372 – 1.903), with a higher satisfaction to vaccination service (OR = 4.675, 95% CI: 3.084 – 7.087), perceiving details of vaccination procedures and services (OR = 1.138, 95% CI: 1.094 – 1.183). Conclusion The trust in vaccination could be further promoted among the parents of 0 – 3 years old children by improving health education programs for the parents and vaccination service for the children.
2021, 37(3): 398-400.
doi: 10.11847/zgggws1125938
Abstract:
Objective To evaluate the impact of vaccination with measles-containing vaccine (MCV) among key groups of people aged 15 – 45 years on measles incidence in Heilongjiang province during 2011 – 2017. Methods Data on measles incidence in Heilongjiang province from 2004 to 2017 were extracted from National Infectious Disease Report Information Management System. Information on MCV vaccination in the key populations aged 15 – 45 years in the province from 2011 to 2017 were also collected and analyzed. Interrupted time series (ITS) analysis was used to evaluate the effectiveness of MCV vaccination based on historical measles incidence data of the province. Results Four annual peaks of measles incidence were identified in 2006 (3 425 reported cases), 2008 (1 227), 2010 (6 279), and in 2014 (754), during 2004 – 2017 in the province and a number of the reported cases were aged over 15 years. The results of ITS-discontinuous linear regression analysis demonstrated that the trend in monthly measles incidence changed significantly after the MCV vaccination intervention in 2011, with a slope change value of 3.514 (P = 0.001 59). Conclusion After seven years′ MCV vaccination in key population, the measles epidemic has been effectively controlled and the trajectory of variation in measles monthly incidence changed from a upward trend to a horizontal trend in Heilongjiang province during 2011 – 2017.
2021, 37(3): 401-404.
doi: 10.11847/zgggws1130217
Abstract:
Objective To examine the willingness to have influenza (flu) vaccine vaccination and its influencing factors among community doctors in Shenzhen city and to provide references for developing strategies on flu vaccination in community doctors. Methods Using multistage random cluster sampling, we conducted an online survey among 2 407 doctors working in community healthcare centers in 5 districts of Shenzhen city, Guangdong province during April 1 – 7, 2020. A self-designed questionnaire was used to collect information on demographics, flu vaccination-related willingness, history, knowledge and attitude among the doctors. Chi-square test and logistic regression analysis were adopted to explore factors affecting the willingness of flu vaccination. Results Of the 2 399 respondents (99.67% of all the doctors surveyed) with valid information, 83.83% reported the willingness to have flu vaccination. The results of logistic regression analysis demonstrated that the respondents with following characteristics were more likely to have the willingness for receiving a flu vaccination: with a history of receiving flu vaccination (odds ratio [OR] = 7.738, 95% confidence interval [95% CI]: 5.99 – 9.99), considering the necessity of flu vaccination in adults (OR = 5.525, 95% CI: 3.66 – 8.34), having confidence in the safety of flu vaccine (OR = 3.485, 95% CI: 2.75 – 4.42), regarding the necessity of having some vaccines not covered by national planned immunization program (OR = 2.147, 95% CI: 1.58 – 2.91), having confidence in the quality of domestic-made vaccines (OR = 1.613, 95% CI: 1.21 – 2.16), aged 40 years and younger (OR: 1.331, 95% CI: 1.02 – 1.73), and with a comprehensive knowledge about vaccination (OR = 1.331; 95% CI: 1.03 – 1.72). Conclusion Among community doctors in Shenzhen city, the willingness to have influenza vaccine vaccination is relatively high and mainly influenced by age, history of previous vaccination, attitude towards vaccination, confidence in the safety and quality of flu vaccine, and the knowledge about vaccination.
2021, 37(3): 405-410.
doi: 10.11847/zgggws1128372
Abstract:
Objective To examine the acceptance of “2 + 2” (2 doses of inactivated poliovirus vaccine [IPV] followed by 2 doses of bivalent oral poliovirus vaccine [bOPV]) vaccination schedule and its influencing factors among immunization clinic staff in Hangzhou city and to provide references for implementing the vaccination schedule in other regions in China. Methods During May – August 2019, we conducted a face-to-face survey among 398 medical staff in all immunization clinics (two staff randomly recruited in one of the 199 clinics) in Hangzhou city. A self-designed questionnaire was used to collect participants′ information on demographics, knowledge about poliomyelitis vaccine (14 questions), the acceptance of the “2 + 2” immunization schedule, impeding factors for implementation of the schedule and their countermeasures. Mann-Whitney U test, Kruskal-Wallis H test, chi-square test and the logistic regression model were used in data analysis. Results The age of the participants ranged 30 – 39 years, with a median age of 34 years. The majority (81.7%) of the participants were female. The participants from the clinics in main urban regions had a better knowledge about poliomyelitis vaccine. The participants aged 40 years and above were less likely to accept the “2 + 2” immunization schedule (odds ratio = 2.286, 95% confidence interval: 1.182 – 4.419). Of the 119 participants considering an increased difficulty for the vaccination under the “2 + 2” immunization schedule, 41.18% contributed the difficulty to the disapproval from vaccinees′ parents and the difficulty for persuading the parents to accept the “2 + 2” schedule. Among all the participants, 36.68% (146/398) reported impeding factors for the implementation of the “2 + 2” immunization schedule; of them, 20.55% (30/146) affirmed similarity in outer packing of bOPV and IPV being a main impeding factor. There were 10.80% (43/398) of the participants suggesting some modifications in poliomyelitis vaccine immunization schedule and IPV-only schedule was proposed by 74.42% (32/43) of the suggesters. Conclusion The rate of acceptance of and knowledge about “2 + 2” poliomyelitis vaccine immunization schedule are high among medical staff in immunization clinics in Hangzhou city. The related training programs among medical staff at elder age, the publicity for the new schedule among vaccinees′ parents, and indication in outer packing of bOPV and IPV need to be promoted for the implementation of the “2 + 2” schedule.
2021, 37(3): 411-414.
doi: 10.11847/zgggws1133368
Abstract:
Objective To examine the willingness for coronavirus disease 2019 (COVID-19) vaccination and its influencing factors among adult attendees of outpatient clinics in Kunming city of Yunnan province. Methods Using convenient sampling, we conducted a voluntary self-administered anonymous questionnaire survey among 756 attendees aged ≥ 18 years recruited at outpatient clinics of a grade A tertiary hospital in Kunming city during March – April 2020. Results Of the 730 participants with valid responses, 697 (95.48%) reported the willingness to have the vaccine against COVID-19 and 33 (4.52%) reported the unwillingness for the vaccination. Multivariate binary logistic regression analysis revealed that the participants with following characteristics were more likely to have the vaccination willingness: considering 100 – 499 yuan (RMB) as an acceptable price for per dose of the vaccine (versus less than 100 yuan: odds ratio [OR] = 4.141), with the education of undergraduate and graduate (versus junior high school and lower: OR = 11.807 and OR = 16.974), being public official and professional or technical staff (versus jobless person: OR = 2.166 and OR = 10.092), acquiring COVID-19 epidemic-related information through WeChat (versus newspaper: OR = 4.005), and regarding the vaccination as the most effective measure to prevent COVID-19 (OR = 8.850). Worrying about the safety and effectiveness of the vaccine was the main reason of the unwillingness for the vaccination. Conclusion The willingness for COVID-19 vaccination is at a relatively high level among adult attendees of outpatient clinics in Kunming city a the price of the vaccine, education, occupation, and health literacy should be concerned for the promotion of the vaccination.
2021, 37(3): 415-418.
doi: 10.11847/zgggws1130143
Abstract:
Objective To analyze the occurrence of inactivated enterovirus 71 (EV71) vaccine-related adverse events following immunization (AEFI) among children and to evaluate the safety of the vaccine for providing evidences for the promotion and use of the vaccine. Methods Passive and active surveillance data on EV71 vaccine-related AEFI reported in Jinhua city, Zhejiang province from September 2016 through December 2019 were extracted from China Information System for Planned Immunization Management and analyzed with descriptive statistics. Results During the 4-year period in the city, totally 391 AEFI were reported among 401 505 doses of inactivated EV71 vaccine vaccination, with a reported incidence rate of 97.38 per 100 000 doses; the reported incidence rate differed significantly by year (χ2 = 80.835), administrative region (χ2 = 71.920), vaccine type (χ2 = 31.609), and dose time (χ2 = 19.955) (P < 0.001 for all); the most of the reported AEFI were general reactions (n = 365), only 15 were abnormal reactions and 11 were coincidence diseases; 82.86% of the AEFI occurred within one day after the inoculation, and the main abnormal reaction was allergic rash. For active surveillance among 6 084 children with a total of 9 090 doses of vaccination during the period, 59 AEFI were identified, and the detection rate was 649.06 per 100 000 doses; there were no significant gender, month age, and dose time differences in the detection rate (all P > 0.05) but the detection rate differed significantly by vaccine type (P < 0.001); the most (96.61%) of the AEFI occurred within 30 minutes to 3 days after the vaccinations and 72.88% of the AEFI were fever; all the AEFI recovered in the observation period. Conclusion Among the children in Jinhua city, the main inactivated EV71 vaccine-related AEFI are general reactions occurred within 3 days after vaccinations, indicating that the vaccination of the vaccine is safe for the children.
2021, 37(3): 419-422.
doi: 10.11847/zgggws1127550
Abstract:
Objective To examine the willingness to pay for nine-valent human papillomavirus (HPV) vaccine and its influencing factors among senior high school girl students. Methods Using multistage cluster sampling, we recruited 900 grade one and two girl students in three senior high schools in a district of Changsha city, Hunan province and conducted a self-administered anonymous questionnaire survey to collect the students′ information on the awareness about and willingness to pay for nine-valent HPV vaccine during October – November 2018. Tobit regression model was adopted to analyze influencing factors of the willingness among the students. Results Of the 782 students with valid response, 245 (31.33%) and 273 (34.91%) reported the awareness about HPV and HPV vaccine; 731 (93.48%) expressed the willingness to have self-paid vaccination of nine-valent HPV vaccine and presented an average acceptable amount of money of 1 244 yuan (RMB) for one dose of the vaccine; 44.36% presented an acceptable price lower than the market value for one dose of the vaccine. The results of Tobit model analysis indicated that paternal education and self-rated susceptibility to HPV infection have positive impacts on the willingness to pay for the vaccine; while the perception on vaccine price has a negative effect on the willingness. Conclusion Paternal education, the perception on vaccine price, and self-rated susceptibility to HPV infection are important factors for willingness to pay for HPV vaccine vaccination among senior high school girl students in Changsha city; the results suggest that health education on HPV infection and significance of HPV vaccine need to be promoted among the students.
2021, 37(3): 423-430.
doi: 10.11847/zgggws1127602
Abstract:
Objective To explore sexual harassment-related perceptions, attitudes, behaviors and their influencing factors among college students in Beijing city, and provide evidences for developing relevant health education programs for the students. Methods Totally 900 students from 6 colleges in Beijing city were recruited with stratified cluster random sampling and interviewed face-to-face with a self-designed questionnaire during March – May 2019. Chi-square test and logistic regression were adopted in statistical analysis. Results Among the 872 students with valid response, 59.52% reported ever having sexual harassment victimization and significantly more girl students reported the victimization than the boy students (63.03% vs. 55.45%, χ2 = 5.182; P = 0.023). Of all the valid respondents, 96.19% reported being aware of sexual harassment; 66.90% and 70.64% reported positive attitude and coping behavior towards sexual harassment; and 78.10% expressed the willingness to acquire knowledge about sexual harassment via online education, respectively. The results of multivariate logistic regression analysis revealed that about sexual harassment among the respondents: (1) better perception was related to gender (female vs. male: odds ratio [OR] = 5.730, 95% confidence interval [95% CI]: 2.584 – 12.708) and registered family residence (urban vs. rural: OR = 0.203, 95% CI: 0.088 – 0.468); (2) positive attitude was influenced by gender (female vs. male: OR = 1.627, 95% CI: 1.191 – 2.221), registered family residence (urban vs. rural: OR = 0.705, 95% CI: 0.516 – 0.96), schooling grade (graduate vs. freshman: OR = 2.517, 95% CI: 1.258 – 5.034), and total perception score (1.226, 95% CI: 1.013 – 1.486); and (3) appropriate coping behavior was impacted by gender (female vs. male: OR = 0.560, 95% CI: 0.412 – 0.760), registered family residence (urban vs. rural: OR = 0.737, 95% CI: 0.543 – 0.999), parental relationship (good vs. neither good nor bad: OR = 0.509, 95% CI: 0.357 – 0.725), and total attitude score (OR = 1.128, 95% CI: 1.068 – 1.191). Conclusion The prevalence of sexual harassment is high among college students and many of the students are lack of adequate cognition, positive attitude and appropriate coping behavior towards sexual harassment.
2021, 37(3): 431-434.
doi: 10.11847/zgggws1126702
Abstract:
Objective To examine the prevalence and influencing factors of sexual behaviors among university freshmen in 2018 and to provide evidences for conducting effective sexual health education in the students. Methods Totally 27 114 newly enrolled students of five universities in different geographical regions of China were invited to have an online survey during November 2018. A self-designed questionnaire was used to collect information on demographics, sexual behaviors and associates. Multivariate logistic regression was adopted to analyze influencing factors of sexual behaviors. Results Among the 19 708 valid respondents averagely aged 17.95 ± 0.80 years, 3.48% reported ever having sexual behavior; of the respondents with sexual behavior, 11.82% reported ever exposed to forced sex. The reported prevalence rate of sexual behavior was significantly higher among the boy students than among the girl students (4.77% vs. 2.18%, P < 0.05). Compared to those among the students from comprehensive universities and the Han students, the reported prevalence rate of sexual behavior was significantly higher among medical students (4.25% vs. 3.19%, P < 0.05) and ethnic minority students (4.84% vs. 3.14%, P < 0.05). The results of multivariate logistic regression analysis revealed following risk factors of having sexual behavior for the students: aged ≥ 18 years, male gender, being ethnic minorities, married or having a love affair, in a single-parent family, and with annual household income of more than 100 000 yuan RMB. Conclusion Sexual behaviors among university freshmen should be concerned and comprehensive and specific sexual health education should be conducted among the freshmen in time.
2021, 37(3): 435-440.
doi: 10.11847/zgggws1126433
Abstract:
Objective To explore human immunodeficiency virus (HIV) antibody testing behavior and its influencing factors among university students with sexual experience and provide evidences for developing relevant education programs and promoting HIV testing in the students. Methods Based on the United Sates Centers for Disease Control and Prevention Global AIDS Program – China Cooperation (GAP) conducted in 2015, we carried out an online questionnaire survey among undergraduates and graduates recruited with convenient and snowball sampling in 5 universities in Beijing city. From the participants of the survey, 355 students aged 16 years and above and reporting sexual behaviors were included in the analysis. Results Of the 355 students, 10.14% had HIV antibody testing. Multivariate logistic regression analysis demonstrated that the students ever having anal sex and meeting their sexual partners at public entertainment places were more likely to have HIV antibody testing compared to those never having anal sex and meeting their sexual partners at places other than entertainment places, with the adjusted odds ratio of 4.022 and 9.298. Stratified logistic regression analysis revealed that for the students with an urban birthplace and with more than two sexual partners, the male students and those ever having anal sex were more likely to have HIV antibody testing. Conclusion The HIV-related practice is not consistent with relevant knowledge and attitude and among university students with sexual experience and the male students with anal sex history are more likely to have HIV antibody testing than other students. The results suggest the importance of early education on HIV prevention among adolescents in various regions.
2021, 37(3): 441-445.
doi: 10.11847/zgggws1125717
Abstract:
Objective To examine attitudes toward premarital sexual behavior and their correlates among middle school students in Luzhou city of Sichuan province and to provide evidences for developing sexual education programs in the students. Methods We carried out an anonymous questionnaire survey among 2 515 students recruited with stratified cluster random sampling in 8 middle schools in Luzhou city from December 2016 to January 2017. Results Of the students, 9.30% reported positive attitude toward premarital sexual behavior and the ratio of reporting the positive attitude was 15.00% and 4.29% in the boy and girl students, respectively. Multivariate linear regression analysis demonstrated that the students with following characteristics were more likely to report positive attitude toward premarital sexual behavior: being a senior high school student (b = – 4.90, P < 0.001), male gender (b = – 4.65, P < 0.001), residing in urban regions or counties (b = – 4.13, P < 0.001), with maternal education of undergraduate and above (b = – 6.62, P = 0.005), with parents having affirmative or receptive attitude toward premarital sexual behavior (b = – 3.94, P < 0.001), with friends having affirmative or receptive attitude toward premarital sexual behavior (b = – 4.78, P < 0.001), with friends having indifferent or indeterminate attitude toward premarital sexual behavior (b = – 2.37, P = 0.017), experiencing dating or love affairs (b = – 4.98, P < 0.001), and ever reading pornographic materials (b = – 5.55, P < 0.001). Conclusion A part of middle school students in Luzhou city have positive attitude toward premarital sexual behavior and the attitude is influenced by multiple personal, familial and social factors, suggesting that comprehensive interventions need to be promoted to reduce the risk of premarital sexual activity in the students.
2021, 37(3): 446-450.
doi: 10.11847/zgggws1134472
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Objective To examine the absorption, distribution and affinity with adipose tissue of microplastics (MPs) and nanoplastics (NPs) in digestive organs of mice after oral exposure. Methods Totally 48 male Kunming mice were randomly assigned into 4 groups and exposed to normal saline and 100 nm, 3 μm, 10 μm fluorescent polystyrene (PS) beads at the dosage of 200 mg/kg by a single gavage. The specimens of stomach, small and large intestine, liver, and subcutaneous adipose tissue of the mice were collected at 0.5, 1, 2, and 4 hours after the exposures; feces in colon were also sampled simultaneously. The in vivo imaging system (IVIS) was used to determine fluorescence intensity (FI) of MPs and NPs in the specimens. Histological examinations were performed to corroborate the fluorescence intensity measurements. Results In the mice with 100 nm PS exposure, the FI of stomach and small intestine specimens were the highest at 0.5 hour after the gavage and the FI of large intestine specimens and feces samples were significantly higher than those of the control mice 4 hours after the exposure (both P < 0.05), with a 12.79 times increased intensity for the feces samples (P < 0.05). For the mice with 3 μm PS exposure, the FI of stomach and small intestine specimens increased significantly at 0.5 hour after the treatment (P < 0.05) and the intensity of stomach specimens from the mice with 10 μm PS exposure was also increased at the time. Significant increase in FI was observed in liver specimens 4 hours after the exposure and in subcutaneous adipose tissue specimens 0.5 hour after the exposure only for the mice with 100 nm PS treatment (both P < 0.05). Conclusion After a single oral exposure of nano-microplastics in mice, the nanoplastics could be absorbed through digestive tract and entered into liver tissues and the absorbed nanoplastics could accumulate in the adipose tissue rapidly. By contrast, the microplastics could be detected only in digestive tract 4 hours after exposure.
2021, 37(3): 451-454.
doi: 10.11847/zgggws1134512
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Objective To explore the presence of microplastics in sputum and nasal lavage fluid collected from couriers and to describe the level and characteristics of the microplastics. Methods Nine male couriers were randomly recruited in Shenyang city, Liaoning province and sputum samples (> 3 ml) and nasal lavage fluid samples (by nasal irrigation with 20 ml ultra pure water ) were collected among the couriers. The number, length, width and shape of the suspected microplastics in the samples were observed with a polarizing microscope. Results There were microplastics fibers in the samples of sputum and nasal lavage fluid collected from all of the couriers, with the average abundance of 105.4 and 0.8 per gram, respectively. The observed microplastics were mainly fibrous with the length ranging from 20.5 μm to 2476.8 μm in the sputum samples and 50.8 μm to 6200.0 μm in the nasal lavage fluid samples. The width of the microplastics was in the range from < 1.0 to 61.9 μm for those in the sputum samples and from 5.0 μm to 46.4 μm in nasal lavage fluid samples. Conclusion Suspected microplastics were observed in sputum and nasal lavage fluid samples collected from couriers. Further qualitative and quantitative study on the characteristics of the microplastics in the samples may assess the exposure load of microplastics in human respiratory tract simply and rapidly.
2021, 37(3): 455-460.
doi: 10.11847/zgggws1134513-new
Abstract:
Objective To verify microplastic pollution of a sludge stacking site to surrounding soil, and to explore the microplastics pollution in the feces and large intestine tissues of pigs raised near the sludge stacking site. Methods Samples of surface soil around a sludge dump were collected; feces samples and tissue specimens of large intestine of a black pig raised by a farmer at the place close to the sludge dump site were collected simultaneously. The samples and specimens were observed with stereomicroscope and polarized light microscope for preliminary identification of microplastics. Qualitative and quantitative scanning analysis on the microplastics in the samples and specimens were carried out using laser infrared imaging system (Agilent 8700 LDIR). Results The abundance of microplastics in the surface soil samples, feces samples and large intestine specimens were 354 – 524/10 g, 1 120/10 g and 96/10 g. The main microplastics in the large intestine specimens were polypropylene (PP), polystyrene (PS), polytetrafluoroethylene (PTFE) and polyethylene terephthalate (PET), with the abundances wereof 40/10g, 17/10 g, 13/10 g and 7/10 g, respectively. The majority (72.4%) of the detected microplastics are of the particle size less than 200 μm and the characteristics of microplastics in the large intestine specimens is different from that of the soil sapmples. Conclusion Microplastics were detected in large intestine tissues of a pig raised near a sludge dump site and the microplastics may be related to the microplastic soil pollution attributed to the sludge dump site.
2021, 37(3): 461-464.
doi: 10.11847/zgggws1133486
Abstract:
An increasingly large amount of plastic waste in the environment poses a potential harmful effect on organisms and more and more attentions have been paid to plastic pollution among the public. Plastic pollutants in the environment may be directly ingested by organisms or indirectly transferred into organisms through other pollutants with plastic components. Microplastics is hard to be degraded and will persist unless being eliminated. In this paper we review studies on the effects of microplastics on human health and challenges in detections of plastic particles in biological environment. We reviewed several microplastics-related aspects, including possible sources, interactions with other chemical pollutants, fate in and impact on the environment, possible ways of entering human body, mechanism of cellular uptake, and methods for separation and identification of microplastics in biological samples, for providing technical references to monitoring, risk assessment and management on environmental microplastics pollution.
An increasingly large amount of plastic waste in the environment poses a potential harmful effect on organisms and more and more attentions have been paid to plastic pollution among the public. Plastic pollutants in the environment may be directly ingested by organisms or indirectly transferred into organisms through other pollutants with plastic components. Microplastics is hard to be degraded and will persist unless being eliminated. In this paper we review studies on the effects of microplastics on human health and challenges in detections of plastic particles in biological environment. We reviewed several microplastics-related aspects, including possible sources, interactions with other chemical pollutants, fate in and impact on the environment, possible ways of entering human body, mechanism of cellular uptake, and methods for separation and identification of microplastics in biological samples, for providing technical references to monitoring, risk assessment and management on environmental microplastics pollution.
2021, 37(3): 465-469.
doi: 10.11847/zgggws1126074
Abstract:
Objective To examine the willingness for initial medication-seeking at grassroots institutions and referral and their influential factors among residents participating in different medical insurance in Shandong province for providing references to improve hierarchical diagnosis and treatment system. Methods Face-to-face questionnaire surveys were carried out during January 2017 among 2 969 residents with different medical insurance randomly recruited with stratified sampling in urban and rural regions of 17 municipalities/prefectures across Shandong province. Results Of the 2 965 respondents with valid information, 1 922 (64.8%) reported the willingness to seek medication first at grassroots institutions; 1 599 (53.9%) selected higher medical institutions for their referrals if necessary but 1901 (64.1%) selected lower medical institutions for their referrals under the condition when their illness being stable. The results of unconditional multivariate logistic regression analysis demonstrated that the respondents with following characteristics were more likely to report a higher willingness to seek medication first at grassroots institutions: with a grassroots medical institution near the home, agreeing with hierarchical diagnosis and treatment, considering hierarchical diagnosis and treatment being practicable, and ever taking medical services in community healthcare centers or township hospitals; while, the respondents with a mean annual household income of ≥ 20 000 yuan (RMB), with medical insurance for urban residents or commercial medical insurance, and ever having a referral were likely to report a lower willingness to seek medication first at grassroots institutions. The results also revealed that the respondents aged ≥ 65 years and with a mean annual household income of ≥ 10 000 yuan were more likely to have a higher willingness for a referral to higher grade medical institutions, while those with following characteristics were more likely to have a lower willingness for a referral to higher grade medical institutions: being female, living in rural regions, with grassroots medical institutions near their homes, agreeing with hierarchical diagnosis and treatment, considering hierarchical diagnosis and treatment being practicable, and ever taking medical services in community healthcare centers or township hospitals; in addition, the respondents being female, living in rural regions, agreeing with hierarchical diagnosis and treatment, considering hierarchical diagnosis and treatment being practicable, and ever taking medical services in community healthcare centers or township hospitals were more likely to have a higher willingness for a referral to lower grade medical institutions, but the respondents with a mean annual household income of ≥ 40 000 yuan were more likely to have a lower willingness for a referral to lower grade medical institutions. Conclusion In Shandong province, the urban and rural residents with medical insurance have an inadequate cognition on hierarchical diagnosis and treatment and a lower willingness for initial medication-seeking at grassroots institutions; the residents′ willingness for initial medication-seeking at grassroots institutions and referral are mainly influenced by gender, age, mean annual household income, living region, type of medical insurance, whether with a grassroots medical institution near the home, the attitude towards hierarchical diagnosis and treatment and whether ever taking medical services in community healthcare centers or township hospitals.
2021, 37(3): 470-474.
doi: 10.11847/zgggws1125954
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Objective To investigate the quality of life (QoL) and its influencing factors among adult residents in Shandong province and to provide evidences for improving QoL of the population. Methods We conducted a household survey among 28 000 residents aged ≥ 18 years recruited at 98 urban and rural communities in 54 counties/districts in Shandong province with stratified multi-stage cluster random sampling from October to December 2015. A brief scale was used to evaluate the QoL of the participants. Results For the 27 531 valid respondents, the total QoL score was 22.70 ± 2.93 and 70.78 ± 11.71 out of a full marks of 30 and 100; the QoL domain scores were 3.71 ± 0.76 for physical health, 3.83 ± 0.69 for psychological health, 3.34 ± 0.69 for economic circumstances, 3.55 ± 0.69 for working situation, 4.13 ± 0.58 for family relationships, and 4.13 ± 0.60 for relationships with non-family associates, respectively. The proportions of the respondents assessed as with low, medium, and high QoL were 22.49% (6 191), 34.66% (9 543), and 42.85% (11 797). Multivariate ordinal regression analysis demonstrated that the respondents being female, having school years of 7 and more, married, being retired or retired due to illness, being student, and participating in commercial medical insurance were likely to have a high QoL; while, those with following characteristics were likely to have a low QoL: aged ≥ 31 years, divorced/separated, widowed, unemployed, with religious belief, and living in rural regions. Conclusion The quality of life is generally good and mainly correlated with gender, residential region (rural or urban), age, school years, marital status, employment, religious belief, and type of medical insurance among adult residents in Shandong province.
2021, 37(3): 475-478.
doi: 10.11847/zgggws1126049
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Objective To examine the status and influencing factors of self-medication among rural elderly with diseases or injury during past two weeks (two-week illness) in Shandong province, and to provide a theoretical basis for developing effective interventions on self-medication. Methods With stratified multistage random sampling, we recruited 7 070 residents aged ≥ 60 years living in rural regions of 3 municipalities of Shandong province more than 6 months. A face-to-face questionnaire survey was conducted among the residents during August – September 2017 and the data collected from 3 240 residents with two-week illness were analyzed to explore self-medication and its associates. Results Of all residents with two-week illness, 2 582 (79.7%) reported undertaking self-medication. The results of unconditional multivariate logistic regression analysis demonstrated that the two-week illness residents with the education of junior high school and above and having poor self-rated health were less likely to undertake self-medication; while, those of non-empty nest or not living alone and suffering from at least one chronic disease were more likely to undertake self-medication. Conclusion In Shandong province, the rate of self-medication is relatively high among the rural elderly with two-week illness and the rate is mainly influenced by education, self-rated health, whether being empty nest or living alone, and the number of chronic diseases suffered from.
2021, 37(3): 479-482.
doi: 10.11847/zgggws1126921
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Objective To establish an early diagnosis and testing platform for human immunodeficiency virus (HIV) exposed infants in Yunnan province and to examine application efficiency of the platform for the prevention of mother to child transmission (PTMTCT) of AIDS. Methods Relying on the National Regional Laboratory for early diagnosis of HIV-infected infants and the maternal and child healthcare network sponsored by Yunnan Maternal and Child Health Care Hospital, an early diagnosis and testing platform was established in Yunan province during 2015. The data on specimen detections for early infant diagnosis of HIV infection from 2015 to 2018 in Yunnan province were retrieved and analyzed retrospectively. Results During the 4-year′s operation of the established early diagnosis and testing platform for HIV-exposed infants, a decreasing trend was observed in the periods of specimen transportation, detection, result reporting, and from specimen submission to result reporting. In 2018, the period from specimen submission to detection result reporting was 8 days, being shorter than the national requirement for time limit of the detection. During 2015 – 2018, totally 7 819 specimens from 16 prefecture-level regions were detected and the overall HIV positive rate of the detected specimens was 1.82%, with the yearly positive rates of 3.03% (30/990), 1.76% (36/2 040), 1.64% (39/2 380), and 1.58% (38/2 409) for the year from 2015 to 2018, respectively. The number of specimens submitted to the platform increased but the HIV positive rate of the detected specimens decreased year by year. A significant regional difference was observed in HIV positive rate among the specimens detected (χ2 = 45.603, P < 0.001). Conclusion An early diagnosis and testing platform for HIV-exposed infants was established successfully in Yunan province and the operation of the platform was improved yearly and effectively. The HIV positive rate decreased among the HIV-exposed infants during 2015 – 2018 in the province.
2021, 37(3): 483-487.
doi: 10.11847/zgggws1126710
Abstract:
Objective To examine the prevalence of crown caries among 12 – 15 years old students in Shenzhen city and to provide evidences for oral health care in the city. Methods Using stratified multistage proportional to size sampling in Shenzhen city, we recruited 5 509 students aged 12 – 15 years in 12 high schools in 4 districts with different gross domestic production (GDP) per capita; an oral health survey was conducted among the students based on the method recommended by World Health Organization (WHO) during September – October 2018. WHO community periodontal index (CPI) probe was used to check crown caries of all permanent teeth. Caries prevalence rate, mean decayed, missing, and filled teeth (DMFT), and filling rate among the students were calculated. Results For the students aged 12 to 15 years, the caries prevalence rate was 39.98%, 43.44%, 44.77%, and 49.91%; the mean DMFT was 1.03, 1.26, 1.39, and 1.62; and the filling rate was 30.97%, 33.52%, 35.45%, and 31.5%, respectively. Both the caries prevalence rate and the mean DMFT increased significantly with the increment of age (both P < 0.001). Compared with those in boy students, caries prevalence rate and mean DMFT were significantly higher in the girl students (both P < 0.05). In comparison with those in 1997, significantly decreased caries prevalence rate (39.98% vs. 56.72%) and the mean DMFT (1.03 vs. 1.53) but increased filling rate (30.97% vs. 7.60%) were detected among the students aged 12 years (P < 0.001 for all). Compared with the results of the Fourth National Oral Health Epidemiological Survey, the filling rate (30.97%) is higher than the average national level (16.5%) and the average level of Guangdong province (20.19%) for the 12-year-old students in Shenzhen city. Conclusion Among the students aged 12 – 15 years in Shenzhen city, the caries prevalence rate and mean DMFT increase with age. Both the caries prevalence rate and mean DMFT are higher in girl students than in boy students; the filling rate of the students is significantly higher than the average national level and the average level of Guangdong province.
2021, 37(3): 488-492.
doi: 10.11847/zgggws1127678
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Objective To analyze survival rate and its related factors in human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients with antiretroviral therapy (ART) in Guangxi Zhuang Autonomous Region (Guangxi). Methods We collected information on 2 174 HIV/AIDS patients registered at health care clinics in Guangxi for their first ART from December 2003 through 2017 for a retrospective cohort study. The cumulative survival rate of patients was calculated with life table method and Cox proportional hazards model was used to analyze influencing factors of the patients′ survival. Results The median age of the patients was 35.35 ± 12.38 years and the median duration of follow-up was 64.34 ± 47.63 months. The overall mortality was 0.978/100 person-years and the average survival time was 158.27 months (95% confidence interval = 156.46 – 160.08) with a 14-year survival rate of 89.79% by the end of the follow-up. The results of multivariate Cox regression analyses demonstated that age, baseline CD4+T lymphocyte cell count and transmission route were influential factors of the survival rate. Conclusion The survival rate of patients receiving ART at health care clinics of Guangxi is relatively high, but special attention should be paid to the patients less than 30 years old and with a baseline CD4+T lymphocyte cell count less than 200/μL at the initial treatment, and those infected via homosexual transmission.
2021, 37(3): 493-497.
doi: 10.11847/zgggws1129870
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Objective To explore operation condition of pre-examination/triage desks and fever clinics in medical institutions during early stage of coronavirus disease 2019 (COVID-19) epidemic in Guangzhou city of Guangdong province and to provide references for standardized setting, management and infection control in the operation of pre-examination/triage desk and fever clinic. Methods We carried field study and questionnaire survey on the operation of all pre-examination/triage desks and 40 fever clinics in 46 medical institutions selected with stratified sampling in 11 districts of Guangzhou city from January 25 to February 28, 2020 – the early period of COVID-19 epidemic. The assessment on operation condition of the pre-examination/triage desks and fever clinics was performed based on relevant management regulations and technical specifications issued by national health administrations. Results The overall qualification rate for the operation condition of the pre-examination/triage desks and fever clinics was 78.26% (36/46). Among the pre-examination/triage desks surveyed, the qualification rates were relatively low for adequate medical personnel (73.91%, 34/46), most suitable allocation to reduce the probability of cross-infection (76.09%, 35/46), and most suitable allocation to facilitate attendees′ visits (78.26%, 36/46). For the fever clinics surveyed, the qualification rates were relatively low for separating an attendee from visitors of other departments during whole process of medication-seeking (37.50%, 15/40), sufficient natural/forced ventilation (55.00%, 22/40), setting-up of a spare consulting room (57.50%, 23/40), setting-up of contaminated/semi-contaminated/clean zones with clear boundary (72.50%, 29/40), being allocated in a separated area with clear sign (72.50%, 29/40), and the establishment of both medical staff and patient passageway (75.00%, 30/40). For the reserved rooms for isolation and medical observation, the qualification rates were relatively low for good ventilation (55.00%, 22/40), sufficient number (72.50%, 29/40), and reserved single rooms with separated sanitary facilities for suspected cases (75.00%, 30/40). The shortage of personal protective equipment was reported by medical staff in 50.00% (23/46) of the medical institutions surveyed and much more medical staff in community health service centers reported the shortage (28.57%, 6/21). Conclusion The establishment and management of pre-examination/triage desks and fever clinics in Guangzhou city were not met the requirements of national health administrations and posed a risk of cross-infection during early stage of COVID-19 epidemic. The situation needs to be improved..
2021, 37(3): 498-502.
doi: 10.11847/zgggws1126565
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Objective To explore the relationship between pregnancy exposure to household chemicals and adverse birth outcomes. Methods Totally 1 000 pregnant women were recruited during their 1st prenatal care at the First Affiliated Hospital of Chongqing Medical University from August 2015 through December 2016. The pregnant women were interviewed with a self-designed questionnaire to collect relevant information including household chemical use and followed up. The health status during pregnancy and pregnancy outcome of the women were extracted from their medical records. The association between pregnancy exposure to five kinds of household chemicals were analyzed with Chi-square test and logistic regression. Results Of the 708 participants with completed information, 27.26%, 3.81%, 2.82%, 2.12%, and 1.84% reported the use of mosquito repellents, insecticides, cosmetics, air fresheners, and hair dyes and perm, respectively. Chi-square test and Fisher exact analysis demonstrated that the participants with air freshener use during pregnancy had a significantly higher detection rate of gestational diabetes mellitus (GDM) and those with insecticide use had a significantly higher incidence of premature birth compared to the participants not using the two kinds of chemicals (both P < 0.05). Logistic regression analysis revealed that the use of air fresheners during pregnancy was significantly associated with GDM (odds ratio [OR] = 3.62, 95% confidence interval [95% CI]: 1.29 – 10.92) and the use of insecticides during pregnancy was significantly associated with premature birth (OR = 5.47, 95% CI: 1.51 – 15.82) after adjusting for potential confounding variables. Conclusion During pregnancy, maternal use of air fresheners may be associated with an increased risk of gestational diabetes mellitus and that of insecticides with an increased risk of premature birth.
2021, 37(3): 503-507.
doi: 10.11847/zgggws1126126
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Objective To examine the prevalence of and the impact of personal and family factors on campus violence perpetration among pupils. Methods Using stratified cluster sampling, we recruited 6 066 grade 3 – 5 students at 12 primary schools in urban Luzhou of Sichuan province and conducted a self-administered anonymous survey with a self-designed questionnaire between November 2018 and January 2019. Results Of the 6 048 students with valid response, 30.20% reported campus violence perpetration during previous one year. The results of multivariate logistic regression analysis demonstrated that significant risk factors for the students' campus violence perpetration included general relationship with siblings (compared to good relationship: odds ratio [OR] = 1.28, P = 0.046), maternal education of lower than college level (senior high school/technical secondary school: OR = 1.26, P = 0.036; junior high school: OR = 1.42, P = 0.002; primary school: OR = 1.59, P < 0.001), in a non-native family (compared to in a family-of-origin: OR = 1.34, P = 0.001); while, significant protective factors were no witnessed quarrel between parents (OR = 0.53, P < 0.001) and with positive parenting style (OR = 0.54, P < 0.001). Conclusion Poor family structure, tense family environment, negative parenting style and lower maternal education are associated with campus violence perpetration among primary school students.
2021, 37(3): 508-511.
doi: 10.11847/zgggws1129509
Abstract:
Objective To investigate the effect of hydrogen sulfide on renal function in rats with acute kidney injury induced by sepsis. Methods A model of sepsis-induced acute kidney injury in male Sprague-Dawley (SD) rats was established with cecal ligation and puncture. Totally 120 male SD rats were randomly divided into a control group (with sham operation), a model group and low-, moderate-, and high- hydrogen sulfide treatment group (20, 50, 100 μmol/L). The rats′ renal function, inflammatory response, histological changes, apoptosis and fibrosis in renal tissues were observed. Western blot was used to detect cleaved caspase-3, cleaved caspase-9, B-cellymphoma-2 (Bcl-2), Bcl-2 associated X protein (Bax), transforming growth factor β (TGF-β), fibronectin, and α-smooth muscle actin (α-SMA) in renal tissues. Serum inducible nitric oxide synthase (iNOS), interleukin 6 (IL-6), and interleukin 10 (IL-10) were detected with enzyme-linked immunosorbent assay (ELISA). Results In the model rats, renal cell necrosis and exfoliation, glomerular capillary congestion/edema/vacuolar degeneration, and narrowing of renal tubular lumen were observed and compared with those in the control rats, urinary protein, urea nitrogen and creatinine increased significantly (P < 0.05 for all); cleaved caspase-3, cleaved caspase-9, the ratio of Bax/Bcl-2, TGF-β, fibronectin, and α-SMA in kidney tissues were significantly up-regulated. In the rats treated with hydrogen sulfide, significantly reduced urinary protein and urea nitrogen/creatinine, down-regulated iNOS and IL-6 but up-regulated anti-inflammatory factor IL-10, significantly down-regulated apoptosis-related cleaved caspase-3, cleaved caspase-9, and Bax/Bcl-2, fibrosis-related TGF-β, fibronectin, and α-SMA were detected in comparison with the model rats. Conclusion Hydrogen sulfide could inhibit inflammatory response, apoptosis and renal fibrosis in rats with acute kidney injury induced by sepsis.
2021, 37(3): 512-515.
doi: 10.11847/zgggws1129301
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Objective To explore improvement effect of plant sterol ester of α-linolenic acid (ALA-PS) on non-alcoholic fatty liver disease (NAFLD) and its underlying mechanism in mice. Methods After one week′s adaptive feeding, 50 male C57BL/6J mice were randomly divided into five groups: a control group with normal diet, a model group with high fat diet (HFD), a plant sterol group (PS) with HFD added by 2% PS, an α-linolenic acid (ALA) group with HFD added by 1.3% ALA, and a plant sterol ester of α-linolenic acid group (ALA-PS) with HFD added by 3.3% ALA-PS, respectively. By the end of 16 weeks′ continuous treatment, the body weight and liver index of all the mice were determined; serum and liver tissue triglyceride (TG) and total cholesterol (TC) were measured. Hematoxylin-eosin (HE) staining was used to observe lipid accumulation and steatosis in liver tissues; endoplasmic reticulum morphology was examined with transmission electron microscopy. Protein expressions of c-Jun amino-terminal kinase (JNK), phospho-JNK (p-JNK), B cell lymphoma 2 (Bcl-2) and Bcl-2-as-sociated X protein (Bax) were measured with Western blot. Results Compared with that in the control mice, a large amount of lipid accumulation was observed in the model mice. Improved hepatic steatosis and restored hepatic endoplasmic reticulum were examined and significantly decreased TG and TC in serum and liver tissues were detected in the mice of ALA-PS group (both P < 0.05). Significantly decreased protein expression of p-JNK and Bcl-2 and increased protein expression of Bcl-2 were also detected in the mice of ALA-PS group. Conclusion ALA-PS could effectively improve NAFLD induced by high-fat diet and the underlying mechanism of the effect may related to the inhibition of apoptosis caused by endoplasmic reticulum stress.
2021, 37(3): 516-519.
doi: 10.11847/zgggws1126827
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Objective To examine the issuance and management of birth certificate in seven provinces of China for providing suggestions of improvement. Methods Using a self-designed questionnaire based on expert consultation, we conducted a survey among seven provincial-level administrative departments during September – October 2018 to collect information on issuance, replacement, reissue and invalidation of birth certificate. Results The requirement for direct issuance of birth certificate by midwifery agencies was implemented in all the provinces and for two of the provinces, 58.33% and 57.89% of all initial birth certificates were issued by primary public medical institutions in 2016 and 2017, respectively. The annual ratios of estimated number of birth certificates to be issued versus that of actually issued were 1.26, 0.96, and 0.99 in 2015, 2016, and 2017, respectively. The timeliness of the issuance was gradually improved, with an increased ratio from 70.29% to 88.78% for the initial birth certificate issuance; both the ratios of birth certificates reissued and replaced were increased from 0.75% to 1.09% and from 0.70% to 0.93%; but the ratio of the birth certificates being invalidated was decreased from 0.66% to 0.42% during the three year period. Conclusion The regulation on issuance and management of birth certificate were well implemented during 2015 – 2017 in seven provinces across China.
2021, 37(3): 520-524.
doi: 10.11847/zgggws1126803
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Objective To examine variations in height, weight and prevalence of overweight and obesity among 10 – 15 years old children in China during 2010 – 2016 for providing evidences to physical health promotion of the children. Methods We used the data on 10 939 children aged 10 – 15 years surveyed in four waves of the China Family Panel Studies conducted in 2010, 2012, 2014 and 2016 in 25 provincial level regions across China. Data processing and statistical analysis were performed with Stata 13 and SPSS 19.0. Results Compared to those in 2010, the average height increased by 3.7 and 1.9 centimeters for the urban boys and girls and 4.2 and 3.2 centimeters for the rural boys and girls in 2016; while the average weight increased by 3.4 and 1.8 kilograms for the urban boy and girls and 3.5 and 2.7 kilograms for the rural boys and girls; the variations in the height and weight were all statistically significant (all P < 0.05), except for those for urban girls. Significant differences in yearly prevalence rate of overweight and obesity were observed in the all boys and in the rural boys and girls (P < 0.05 for all) but not in the all girls and in the urban boys and girls (all P > 0.05). Conclusion During 2010 – 2016 among 10 – 15 years old Chinese children, the height and weight increased rapidly, but the prevalence rate of overweight and obesity also increased; the increases were more obvious among the rural children and there were regional disparities in the growth and development indicators between the urban and the rural children.
2021, 37(3): 525-529.
doi: 10.11847/zgggws1124117
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Objective To compare domestic violence (DV) incidence in single- and multi-child families in 2002 and 2012 among the employees in a large enterprise in Hunan province and to provide references for interventions on DV. Methods Using stratified random sampling, we selected 100 families with DV for a survey during 2001 – 2002 and another 100 families for a survey during 2011 – 2012 among the employees in a large state-owned enterprise in Xiangtan city of Hunan province. A self-designed questionnaire on DV and its related factors was administered to 174 perpetrators and victims in the selected families (128 and 46 in single- and multi-child families) in 2001 – 02 survey and 125 perpetrators and victims (95 and 30 in single- and multi-child families) in 2011 – 12 survey, respectively. The incidence of DV in the single- and multi-child families were analyzed and compared. Results The leading precipitating factor of DV was child′s education and the most common form of DV was verbal abuse reported by the respondents. There were no significant differences in the reported proportions of leading precipitating factor (2001 – 02: 60.9% vs. 73.9%, 2001 – 12: 70.5% vs. 60.0%) and the most violence form (2001 – 02: 85.9% vs. 97.8%, 2001 – 12: 90.5% vs. 93.3%) between the respondents in single- and multi-child families (all P > 0.012 5). Compared to those in 2001 – 02, significantly higher proportions of victims in single-child families reported DV-related mental injury (40.0% vs. 15.6%) and physical injury (21.1% vs. 3.1%) in 2011 – 12 (both P < 0.012 5). The victims of multi-child families reported a significantly higher proportion of DV-related mental injury in 2011 – 12 than in 2001 – 02 (60.0% vs. 13.0%, χ2 = 18.530; P < 0.012 5). There were no significant between-group and between-year differences in the proportion of the respondents reporting tolerant attitude toward DV (between 2001 – 02 and 2011 – 12: 62.5% vs. 48.4% for respondents of single-child families and 60.9% vs. 60.0% for those of multi-child families) (all P > 0.012 5). Conclusion For the families surveyed, child′s education was a leading precipitating factor and psychological abuse was the most common form of domestic violence in both single- and multi-child families; the victims of domestic violence suffered more mental injury in 2012 than in 2002.
2021, 37(3): 530-536.
doi: 10.11847/zgggws1127062
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Objectives To evaluate potential application of serum detections of dengue virus (DENV) nonstructural 1 antigen (NS1), viral RNA, and immunoglobulin M (IgM) antibody in early laboratory diagnosis of dengue virus infection. Methods Totally 432 serum specimens were collected consecutively from June to November 2014 from patients clinically suspected with dengue fever in Guangdong province, China. All the specimens were simultaneously detected for NS1 with flow immune chromatographic rapid diagnosis test (RDT) and enzyme-linked immunosorbent assay with (ELISA), viral RNA with real time quantitative polymerase chain reaction (qRT-PCR), and DENV IgM/IgG antibody with ELISA. Results Of all the specimens, 361 (83.6%) were positive for one of or more of the three indicators and the indicator with the highest positive rate was DENV NS1 (358, 82.9%), followed by viral RNA (268, 74.3%) and IgM antibody (179, 49.5%). For the all positive specimens, 87.8% (317) and 11.9% (43) were collected from primary and secondary dengue fever patients. For the specimens collected from dengue fever patients in acute or late acute phase, the positive rate of DENV NS1 RDT (97.0%) and ELIZA (98.6%) were significantly higher than that of viral RNA qRT-PCR (88.9%) and IgM antibody ELISA (59.3%) (both P < 0.01). The results of DENV NS1 detection with RDT and ELISA were significantly consistent (κ = 0.363, P < 0.001). For the specimens collected from acute phase patients, the positive rate of viral RNA detection with qRT-PCR was significantly higher than that of IgM antibody detection with ELISA (P < 0.01). Conclusion The study results suggest that DENV NS1 antigen detection is highly sensitive in diagnosis of primary dengue fever patients in non-endemic regions; DENV RNA test is of significance in early diagnosis of dengue fever; while, DENV IgM antibody detection is a suitable test for auxiliary diagnosis of dengue fever at or after the 5th day of the incidence.
2021, 37(3): 537-541.
doi: 10.11847/zgggws1127362
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Objective To explore the association of meteorological factors with influenza incidence in Hunan province with time series model analysis and to evaluate predictive effectiveness of the established model for developing influenza prevention and control strategies. Methods We retrieved the data on reported influenza incidents and daily meteorological parameters in Hunan province and divided the data into three sets: a dataset from January 2008 through December 2016 for establishing a time series model and two datasets of first and second half year of 2017 for assessing effectiveness of the constructed model in influenza incidence prediction. SPSS 20.0 software was used to process the data collected and Spearman correlation was adopted to analyze the correlation between meteorological factors and influenza incidence. Results (1) Influenza cases were reported throughout the period from 2008 to 2017 and more cases were reported during winter and spring seasons. (2) The monthly number of reported influenza cases was correlated negatively with monthly average temperature (r = – 0.195, P < 0.05), sunshine hours (r = – 0.483, P < 0.05), and amount of precipitation (r = – 0.116, P < 0.05) but positively with monthly average air pressure (r = 0.195, P < 0.05), relative humidity (r = 0.260, P < 0.05), and maximum wind speed (r = 0.279, P < 0.05). (3) Aafter introducing meteorological factors, the average relative errors of autoregressive integrated moving average (ARIMA) (1, 0, 0) (0, 1, 1) 12 model and ARIMAX model were 43.90% and 31.48% for the prediction of influenza incidence from January to June 2017 and 70.65% and 67.17% from July to December 2017. Conclusion The predictive effectiveness of ARIMAX model is better than that of ARIMA model after the introduction of meteorological parameters, but the two established models are not good when used to predict the influenza incidence for the period of July – December 2017, suggesting that more factors should be included for improving the ARIMAX model.
2021, 37(3): 542-545.
doi: 10.11847/zgggws1124873
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Objective To evaluate the implementation of basic public health services (BPHS) in 14 prefectures of Xinjiang Uygur Autonomous Region (Xinjiang), and to provide references for the improvement of BPHS in Xinjiang. Methods Surveillance data and annual reports on the implementation of BPHS in Xinjiang during 2018 were collected from Xinjiang Health Commission and rank sum ratio (RSR) method was adopted in the evaluation of BPHS practice. Results The rate of establishing health records for community residents was greater than 80% for all the 14 prefectural administrative regions in Xinjiang and the rate was 100% for Urumqi and Bazhou prefecture. The rate of follow-up visit and health management for the newborns in all the regions were greater than 90%, except for those (87.85% and 86.83%) in Urumqi city. The registration rate of pregnancy in first trimester in all the prefectures were > 80% and the highest and the lowest rate were 95.29% and 82.75% in Urumqi and Karamay city. The rate of postpartum visit in all the regions were greater than 90%, except for that (87.80%) in Urumqi city. The rate of standard hypertension patient management in all the regions were greater than 70%, except for those (64.90% and 65.92%) in Karamay city and Tacheng prefecture; the rate of standard type 2 diabetes patient management in all the regions were greater than 70%, except for those (68.59% and 65.92%) in Turpan and Tacheng prefecture. The highest RSR value of BPHS implementation was 0.68 for Turpan city and the lowest RSR value was 0.32 for Changji prefecture; while the highest geographically regional RSR value was 0.79 for Southern Xinjiang was and the lowest was 0.50 for Urumqi city. Conclusion There are item-specific and regional imbalance in the implementation of BPHS in Xinjiang, suggesting that local medical institutions should improve their BPHS according to characteristics of target population to be served.
2021, 37(3): 546-550.
doi: 10.11847/zgggws1124536
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Objective To analyze spatial and temporal distribution characteristics of hand, foot and mouth disease (HFMD) in Weifang city and to explore lag effect of ambient temperature on HFMD and populations vulnerable to the effect. Methods Data on HFMD incidence and meteorological factors from 2015 through 2017 were collected for descriptive statistics. Distributed lag nonlinear model was applied to explore lag effect of ambient temperature on daily HFMD incidence and quantitative relationship between ambient temperature and HFMD incidence. Results During the 3-year period in the city, totally 18 963 HFMD cases were reported and the male to female ratio of the cases was 1.58 : 1, with more cases reported between May and July in a year. An obvious lag effect of ambient temperature on HFMD incidence was observed. The highest relative risk (RR) of 1.76 (95% confidence interval: 1.26 – 2.34) of HFMD incidence was associated with lag 6-day high daily average ambient temperature of 33 ℃. Considering the influence of 50th percentile daily average ambient temperature as the reference, high daily average ambient temperature (24 ℃/29 ℃) had stronger effect on HFMD incidence than low daily average ambient temperature (– 2 ℃/4 ℃). The cumulative RR of HFMD incidence associated with ambient temperature exposure was higher among children under 5 years old than among other population groups. Conclusion Ambient temperature, with obvious lag effect, is an important influencing factor of HFMD incidence in Weifang city. The lag effect of ambient temperature differs by daily average temperature and in various populations; the effect of high daily average ambient temperature is stronger than that of low temperature and children under 5 years old are more vulnerable to the influence of ambient temperature.
2021, 37(3): 551-554.
doi: 10.11847/zgggws1124283
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Objective To examine the cooperation in releasing and sharing of information on infectious disease epidemic in Liaoning and Jilin province and to explore how information sharing affects the prevention and control of infectious disease epidemic and to provide references for infectious disease prevention and control. Methods We searched data, reports and literatures on sensitive indicators for tertiary prevention of infectious diseases published by government agencies and medical institutions of the two provinces from 2013 to 2017 via governmental and institutional websites, the China National Knowledge Infrastructure (CNKI) and Web of Sciences. Descriptive method was used to analyze variations in jointly releasing and sharing of the information. Spearman correlation and linear regression were adopted to analyze and the relationship between the jointly release of the information and the incidence of category A and B notifiable infectious diseases in the two regions. Results Totally 111 pieces of information or literatures were retrieved. In Jilin province, the index for jointly releasing of infectious diseases information increased from 23.69% in 2013 to 33.72% in 2017; the incidence of category A and B notifiable infectious diseases decreased from 194.96/100 000 to 152.60/100 000 during the same period; an inverse correlation between the index for jointly information releasing and the incidence of infectious diseases was observed. While, in Liaoning province, the index declined from 4.48% in 2013 to 3.32% in 2017; the incidence of category A and B notifiable infectious diseases fluctuated during the period and no obvious correlation between the index and the incidence was observed. Conclusion The jointly releasing of infectious disease information was improved from 2013 to 2017 in Jilin province but the jointly releasing needs to be promoted in Liaoning province. The study suggests that jointly releasing of infectious disease information may play a role in the prevention and control of infectious disease epidemics.
2021, 37(3): 555-559.
doi: 10.11847/zgggws1127694
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Objective To study the impact of household drinking water source and toilet condition on diarrhea among children under 5 years of age and to analyze whether household drinking water and toilet sanitation conditions have joint effects on infantile diarrhea. Methods The data on 4 256 children aged ≤ 5 years were extracted from the dataset of China Health and Nutrition Survey conducted between 1989 and 2015 across China. Logistic regression was used to explore the effect of household drinking water and toilet conditions and probable multiplicative interaction of the two variables on diarrheal disease among the under-5 children. The indices of interaction on an additive scale was calculated by introducing an Excel spreadsheet set up by Tomas Andersson. Results Of all the infants surveyed, 248 (5.83%) were identified having diarrhea during previous four weeks. Logistic analysis demonstrated that improved household sanitation conditions of drinking water and toilet were protective factors against infantile diarrhea, with the odds ratios (95% confidence interval) of 0.59 (0.42 – 0.82) and 0.64 (0.45 – 0.91), respectively. No interactive protective effect of household drinking water and toilet sanitation conditions on infantile diarrhea was observed. Conclusion Improving household sanitation is an effective way to reduce the incidence of diarrhea among under-5 children in China and protective roles of improved drinking water and toilets on diarrhea may be played through different mechanisms.
2021, 37(3): 560-563.
doi: 10.11847/zgggws1125623
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Objective To investigate the awareness of knowledge about cytomegalovirus (CMV) infection and its prevention among mothers of young children in Yi′nan county of Shandong province and to provide evidences for the prevention of congenital CMV infection among pregnant and childbearing women. Methods Using stratified cluster random sampling, we conducted a self-administered questionnaire survey among 2 321 mothers of young children in 3 township and 5 village kindergartens during October 2018. Chi-square test and multivariate logistic regression analysis were used to explore influencing factors of the awareness. Results Among the 2 109 responders (90.87% of the mothers recruited) completing the survey, 50.73% were being aware of CMV, of them, 56.07% and 45.51% acquiring CMV-related knowledge from internet and medical professionals. The CMV-related knowledge item with the highest ratio of correct answer (61.40%) was “frequent hand washing reducing CMV transmission” and that with the lowest ratio (24.66%) was “congenital CMV infection inducing epilepsy in newborns”. The overall awareness rate of five key items of knowledge about the prevention of CMV infection was 59.12%. Logistic multivariate regression analysis demonstrated that the responders aged more than 35 years were likely to have a lower key knowledge about CMV infection (odds ratio [OR] = 0.54, P = 0.001) compared to those aged < 30 years; the responders not being informed on CMV-related knowledge by medical professional during antenatal examination were likely to have a lower key knowledge about CMV infection (OR = 0.76, P = 0.014) in comparison with those being informed. Conclusion The awareness of knowledge about the prevention of cytomegalovirus infection is insufficient among mothers of young children, suggesting that health education on cytomegalovirus infection needs to be promoted among childbearing and pregnant women.
2021, 37(3): 564-567.
doi: 10.11847/zgggws1128260
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Objective To explore prevalent pathogens of foodborn diseases in Nanjing city, Jiangsu province in 2018 and to provide evidences for active surveillance and early warning on foodborn diseases. Methods Clinical information and stool specimens for pathogen detection were collected among 1 246 foodborn disease patients at 17 sentinel hospitals for active surveillance on foodborn disease in the city during 2018. Results Totally 110 pathogenic strains were isolate from all the specimens and the overall detection rate of pathogen was 8.83%. Among 442 specimens with virus detections, 38 (8.60%) were positive for pathogenic virus. There were statistically significant differences in the detection rate of Salmonella (χ2 = 13.921, P < 0.001), Vibrio parahaemolyticus (χ2 = 22.836, P < 0.001), and norovirus (χ2 = 30.287, P < 0.001) and in the overall detection rate of pathogenic virus (χ2 = 44.635, P < 0.001) among the foodborn disease patients at various ages. Conclusion The results of the active surveillance could contribute to analyzing prevalence characteristics of foodborn diseases and developing targeted prevention measures.
2021, 37(3): 568-569.
doi: 10.11847/zgggws1134565
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Objective To describe pharmacoepidemiological characteristics of antibacterial drug application and to evaluate the rationality of antibiotics use among inpatients with neurosurgery operation. Methods Real-world study design was adopted in the study. With a self-designed questionnaire on application of antibacterial drug application and from medical records, we collected relevant information on 1 446 inpatients with neurosurgery operations in a grade A tertiary hospital in Shenyang city during a period from January 2015 to January 2020. The rationality of antibiotics use was assessed based on the national guideline and expert consensus for clinical antibiotics application. Results All the inpatients, including 852 and 594 with type I and II surgical incision in the operations, had operation-related antibiotics treatment and the total times of antibacterial drug application was 5 152 case-times. The rational proportion of antibacterial drug application was 83.20% (1 203 inpatients) for right indication, 92.19% (1 333) for treatment before operation, 92.95% (1 344) for additional use during operation, and 90.25% (1 305) for treatment after operation. Totally 382 case-times of antibiotics application were irrational use in terms of medication time. Conclusion Medication time for antibacterial drug application needs to be improved for promoting rational use of antibiotics among inpatients with neurosurgery operation.
2021, 37(3): 570-573.
doi: 10.11847/zgggws1128828
Abstract:
Objective To describe the prevalence of pulmonary tuberculosis (TB) among children in Guizhou province from 2009 to 2018 and to provide references for TB prevention and control in the children. Methods The data on 5 775 TB cases aged ≤ 14 years registered and treated in Guizhou province during 2009 – 2018 were extracted from National Tuberculosis Control Information System and analyzed with descriptive statistics. Results During the 10-year period in the province, the average annual registration rate of TB was 7.39/100 000 and the rate was significantly different from that (116.34/100 000) of general population (χ2 = 460.852, P < 0.05); the total number of child TB cases accounted for 1.46% of the all TB cases registered and the annual number of the child TB cases declined generally during the period but slowly increased from 2015 to 2018. There were registered child TB cases in all seasons of a year but more cases were registered in the first and the second quarter of a year. More total cases were registered in Bijie prefecture, accounting for 37.44% of all the registered child TB cases in the province. The male to female ratio was 1.10 : 1 (51.39% vs. 48.61%) for all the registered child TB cases. The majority of the registered cases (2 258 boy cases and 2 281 girl cases) were aged 10 – 14 years. Visiting a doctor actively due to self-perceived symptoms and referral were main ways for the TB cases being registered. For all the registered cases, the ratio of initial treatment versus retreatment was 75 : 1. The successful treatment rate was 91.02% for the initially diagnosed smear positive cases and 82.69% for retreatment smear positive cases, respectively. Conclusion During 2009 – 2018, the prevalence of pulmonary tuberculosis declined among children in Guizhou province but some targeted preventive measures still need to be promoted among the children aged 10 – 14 years, in the boys and in some regions of the province.
2021, 37(3): 574-576.
doi: 10.11847/zgggws1128507
Abstract:
Objective To establish a duplex-PCR assay for the detection of Escherichia coli (E.coli) in drinking water and to assess detection results of the assay. Methods First, the conservative sequence 16SrRNA gene of E.coli (E-16SrDNA) and the lactose operon LacI gene sequence (E-LACI) were selected as the two segments amplification gene of the duplex-PCR assay. According to the known sequence from the GenBank, the primers of the two segment genes were designed and synthesized, and duplex-PCR assay was established using the standard E.coli strain. Then, E.coli in drinking water samples was detected with both the duplex-PCR assay and the national standard method to evaluate the validity, reliability and prediction probability of the established assay. Results For the duplex-PCR assay established, the minimum detection concentration of the E.coli in water samples was 40 colony forming unit (CFU)/L; the sensitivity was 66.7%; the specificity was 100%; the positive predictive value was 100%; the negative predictive value was 97.7%; and the consistent rate for the detection results versus those with the national standard method was 97.8%. Conclusion The established duplex-PCR assay is of high validity and sensitivity and is suitable for rapid detection of E.coli in drinking water samples.