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2022, 38(7)
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2022, 38(7): 1-6.
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Special Report – Chronic Disease Management
Health-related quality of life and its influencing factors among urban and rural chronic disease patients in China
FANG Xiao-xiao, XU Wan-chun, LU Shan,
2022, 38(7): 833-837. doi: 10.11847/zgggws1135340
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  Objective   To examine the status and influencing factors of health-related quality of life (HrQoL) among patients with noncommunicable chronic diseases (NCDs) in urban and rural China for improving the health status of the patients and developing targeted measures on the patients′ health management.   Methods  With a general questionnaire and the Three-Level EuroQol Five Dimensional Questionnaire (EQ-5D-3L), face-to-face interviews were conducted among 13 362 residents aged 15 years and older selected using stratified multistage random sampling in a district/prefecture/county of one of 5 provinces in eastern, central and western China during July – August, 2018. From the 12 470 participants with valid information, 4 052 NCDs patients (1 474 [36.38%] and 2 578 [63.62%] from urban and rural regions) were included in the study to analyze HrQoL and its associates among the patients.   Results  Among the urban and rural patients, the proportions of reporting difficulties in mobility, self-care, and daily activities were 12.89% and 27.85%, 8.07% and 19.16%, and 12.21% and 29.09%; while, the proportions of reporting symptoms of pain/discomfort, anxiety/depression were 24.90% and 55.97%, 4.95% and 28.67%, respectively. The health utility value was 0.939 ± 0.105 for all the patients and the health utility value of the urban patients was significantly higher than that of the rural patients (0.966 ± 0.090 vs. 0.924 ± 0.110; t = 13.629, P < 0.001). The results of multivariate linear regression analysis showed that for urban patients, those being smokers and having regular physical examination are more likely to have a higher HrQoL, but those being fremale, suffering from multiple chronic diseases, and in families with poor economic condition are more likely to have a lower HrQoL; for rural patients, those being married, being employed, with education of high school/vocational high school/technical secondary school and above, and having an annual household income of 8 000 yuan RMB per capita are more likely to have a higher HrQoL, whereas, those aged 25 years and older, with medical service provided by contracted family doctors, suffering from multiple chronic diseases, and in families with poor economic condition are more likely to have a lower HrQoL.   Conclusion   Among NCDs patients in China, the HrQoL of urban patients is higher than that of rural patients and suffering from multiple chronic diseases and with poor household economic condition are risk factors of lower HrQoL for both urban and rural patients.
Application of mobile health in self-management on non-communicable chronic diseases – a review
YOU Fang, MA Ya-nan, XU Yuan-yuan,
2022, 38(7): 838-843. doi: 10.11847/zgggws1134585
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With the increasing burden of non-communicable chronic diseases (NCDs) around the world, NCDs have become an important public health problem threatening human health, and the management on NCDs is also facing tough challenges. In the past decade, mobile health has been expanding as an emerging field, showing broad application prospects in the self-management of patients with NCDs. By providing effective self-management support for patients with NCDs, mobile health plays an important role in helping patients monitoring and managing their disease symptoms, improving drug treatment adherence, promoting the change of unhealthy lifestyle and improving the prognosis of patients. The study systematically reviews current status, existing problems and prospects of mobile health applications in the self-management of four NCDs, including cardiovascular disease, cancer, chronic respiratory disease and diabetes for providing reference to further research in this field.
Application of agent-based modeling method in prediction of non-communicable chronic diseases: a review
WANG Run-si, LI Xi
2022, 38(7): 844-847. doi: 10.11847/zgggws1135054
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Non - communicable chronic diseases (NCDs), as a primary global health threat, have caused an increasingly heavy burden all over the world. Compared with traditional statistical model, the agent - based model no longer focuses on fitting general characteristics, but to simulate individual changes under the interaction between individuals and environmental influence on individuals by building individual - based models for simulating the characteristics of a population. By including time - dependent changes in characteristics of human and environment and their interactions, the agent - based model could be used to simulate dynamic changing process of changes in characteristics of human and environment with time. Therefore, the agent - based model can be adopted to simulate complex problems closer to the real situation. The study introduced the structure and characteristics of the agent - based model and reviewed the application and limitations of the model in prediction of NCDs prevalence to provide theoretical and empirical support for the application of the model in NCDs prevention and control.
Association of kidney size with renal function in community patients with chronic kidney diseases
ZHOU Xiao-yan, ZHAO Qi, WANG Na,
2022, 38(7): 848-851. doi: 10.11847/zgggws1135234
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  Objective  To analyze the correlation between kidney size and renal function in community patients with chronic kidney diseases (CKD), and to provide a reference for prognosis evaluation of CKD patients.   Methods  With random cluster sampling, 9 257 permanent residents aged 20 – 75 years were recruited in a town of Songjiang district, Shanghai for a survey including questionnaire survey, physical examination and laboratory test from June 2016 to November 2017. From 8 207 residents completing the survey, 914 CDK patients without unilateral nephrectomy were identified. Then, the CDK patients′ kidney size were measured with B-mode ultrasonography and estimated glomerular filtration rate (eGFR) was adopted to assess the patients′ renal function. Pearson correlation analysis was used to analyze the relationship between kidney size and eGFR, and multivariate logistic regression and areas under the receiver operating characteristics curve (AUC) were used to compare the efficiency of different models for renal function decline prediction.   Results  Of all the patients, 706 (77.2%) had normal renal function and 208 (22.8%) had decreased renal function. Compared to those in the patients with normal renal function, significantly shorter length and width of both kidneys were measured in both male and female patients with decreased renal function (all P < 0.001). Pearson correlation analysis revealed significantly positive correlations of left renal length (r = 0.278) and width (r = 0.268), right renal length (r = 0.263) and width (r = 0.134) with eGFR (all P < 0.001) and the correlation between left kidney size and eGFR was the strongest after adjusting for body surface area (r = 0.411, P < 0.001). Multivariate logistic regression models for kidney size-related renal function decline prediction were constructed with corrected kidney size and other diagnostic indicators. Compared with other models, the model 3 with the independent variables of corrected kidney size, gender, age and hyperuricemic state is of strongest efficiency in predicting renal function decline, with an AUC of 0.836 (95% confidence interval: 0.810 – 0.859).   Conclusion  There is a significant correlation between kidney size and renal function in community CKD patients. Kidney size combined with other related factors are important indicators for predicting the decline of renal function and could be employed to evaluate the prognosis of CKD patients.
Epidemiological Research
Association of SNP at KIR3DL1 rs35974949 and rs35656676 with HCV susceptibility and chronicity in high-risk populations
SHEN Chao, YAO Min, YIN Rong, ZHU Ping, SHAO Jian-guo,
2022, 38(7): 852-855. doi: 10.11847/zgggws1135392
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  Objective  To explore correlations of single nucleotide polymorphism (SNP) at KIR3DL1 rs35974949 and rs35656676 with the susceptibility and chronicity of hepatitis C virus (HCV) infection and to provide clinical evidences for screening, diagnosis and individualized prevention of HCV infection.   Methods  With cluster sampling from August 2008 to December 2015, we conducted face-to-face questionnaire interview, detections of HCV RNA, anti-HCV antibodies and other related serum indicators, and genotyping of KIR3DL1 r35974949 and rs35656676 with quantitative real-time PCR TaqMan assay among 2 537 people aged 18 – 79 years and at high risk of HCV infection but not ever having interferon and direct antiviral drug treatment, including 1 788 rural residents with paid blood donation history from 25 villages and 749 hemodialysis patients from 9 tertiary hospitals in Jiangsu province. According to detection results, the participants were then assigned into one of the three groups: uninfected control group (1 512 individuals) being seronegative for both anti-HCV antibodies and HCV RNA, spontaneous HCV clearance group (382) being seropositive for anti-HCV antibodies but seronegative for HCV RNA, and persistent HCV infection group (643) being seropositive for both anti-HCV antibodies and HCV RNA. Multivariate logistic regression models were used to analyze relationships between SNP at KIR3DL1 rs35974949 and rs35656676 and the susceptibility and chronicity of HCV infection.   Results  The proportions of KIR3DL1 rs35974949 GG, GT and TT genotype carriers were 78.47%, 20.05% and 1.49% in control group; 76.64%, 19.16% and 4.20% in spontaneous clearance group; and 74.34%, 19.60% and 6.07% in persistent HCV infection group; while, those of KIR3DL1 rs35656676 CC, CG and GG genotype carriers were 31.32%, 50.60% and 18.08% in control group; 31.68%, 49.74% and 18.59% in spontaneous clearance group; and 31.78%, 50.47% and 17.76% in persistent HCV infection group, respectively. After adjusting for gender, age, alanine aminotransferase (ALT) abnormality, aspartate aminotransferase (AST) abnormality and route of HCV infection, unconditional multivariate logistic regression analysis demonstrated that the individuals carrying KIR3DL1 rs35974949 TT genotype were more likely to have an increased HCV susceptibility (codominant model: adjusted odds ratio [aOR] = 2.802, 95% confidence interval [95% CI]: 1.571 – 4.998, P < 0.001; recessive genetic model: aOR = 2.860, 95% CI: 1.607 – 5.090, P < 0.001) compared with those carrying KIR3DL1 rs35974949 GG/GT genotype. However, no significant association of KIR3DL1 rs35974949 genotype with HCV chronicity was derived. Furthermore, no significant associations of KIR3DL1 rs35656676 polymorphism with HCV susceptibility and chronicity were observed.   Conclusion  Single nucleotide polymorphism at KIR3DL1 rs35974949 is associated with increased susceptibility of HCV infection in high risk populations.
Association of urinary copper, zinc and arsenic with nodular goiter: a population-based case-control study
ZHANG Han-shuang, HE Jia-liu, LI Guo-ao,
2022, 38(7): 856-860. doi: 10.11847/zgggws1134924
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  Objective  To examine the relationship between urinary copper (Cu), zinc (Zn) and arsenic (As) and the incidence of nodular goiter and to provide evidences for nodular goiter prevention and treatment.   Methods  The cases of the study were 373 pathologically diagnosed nodular goiter patients hospitalized in the Department of Head and Neck Surgery of Anhui Cancer Hospital from September 2016 through March 2019; while, the controls were 1 : 1 individually gender- and age (± 2 years)-matched healthy people selected from a cohort study conducted in Anhui province. Face-to-face questionnaire interviews and laboratory tests were carried out among the participants.   Results  Significantly lower morning urinary Cu (median [µg/g]; 25th quartile, 75th quartile) was detected in the cases compared to that in the controls (6.13; 2.36, 11.00 vs. 10.36; 6.27, 16.95; Z = – 6.625; P < 0.001); while, no significant differences between the cases and the controls were detected in morning urinary Zn (312.16; 98.65, 500.19 vs. 340.40; 99.41, 580.54) and As (30.44; 4.36, 88.30 vs. 23.75; 3.67, 81.82) (both P > 0.05). After adjusting for confounding factors such as gender, age, marital status, smoking, passive smoking, alcohol consumption, daily sleep time, body mass index, fasting blood glucose, serum total cholesterol, serum triglyceride, serum high density lipoprotein cholesterol, urinary Zn and urinary As, the results of multivariate logistic regression analysis showed that higher urinary Cu was associated with a decreased risk of nodular goiter (the third quartile [Q3] – the highest quartile [Q4] vs. the lowest quartile [Q1]: odds ratio [OR] = 0.73, 95% confidence interval [95% CI]: 0.54 – 0.98; [Q4] vs. Q1: OR = 0.56, 95% CI: 0.39 – 0.81; and Q4 vs. Q1: OR = 0.42, 95% CI: 0.19 – 0.97 only for male participants); the analyses did not revealed significant correlations between urinary Zn and As and nodular goiter incidence (all P > 0.05).   Conclusion  Urinary Cu concentration may reversely associated with nodular goiter incidence in Chinese people.
Prevalence and influencing factors of coronary heart disease among rural adult residents in Xinxiang county, Henan province
LI Hui-jun, LI Wen-long, WU Hui,
2022, 38(7): 861-865. doi: 10.11847/zgggws1125491
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  Objective  To investigate the prevalence and influencing factors of coronary heart disease (CHD) among rural adult residents in Xinxiang county of Henan province for providing evidences to CHD prevention.  Methods  Using random cluster sampling, we recruited 10 691 adult residents (≥ 18 years old) in 17 villages of Xinxiang county and conducted face-to-face interview, physical examination and laboratory tests among the residents during April – June 2017.  Results  Among the 10 267 residents with complete data, 892 were identified with CHD; the crude and age-standardized prevalence rate of CHD was 8.69% and 6.65%. Unconditional multivariate logistic regression analysis indicated that aged ≥ 50 years, divorced or separated, smoking cessation, abstinence of alcohol, and suffering from hypertension/diabetes/stroke/central obesity were risk factors for CHD and current alcohol drinking was a protective factor against CHD.  Conclusion  The prevalence of CHD is relatively high and influenced by age, marital status, central obesity, history of smoking and alcohol drinking, and condition of hypertension, diabetes and stroke among adult rural residents in Xinxiang city, Henan province.
Vaccination coverage and associates of hepatitis B vaccine among adult residents in Xiangyang and Xiaogan city of Hubei province
ZHANG Fan, WANG Lei, XU Yang-huan,
2022, 38(7): 866-869. doi: 10.11847/zgggws1134698
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  Objective   To investigate the prevalence of hepatitis B (HB) vaccination, causes of without the vaccination and their influencing factors among 15 – 59 years old residents in Xiangyang and Xiaogan city of Hubei province, and to provide evidences for developing strategies on HB prevention and control in the population.   Methods  Using a self-designed questionnaire, we conducted a voluntary survey among 1 398 permanent residents aged 15 – 59 years recruited with multistage random sampling in urban and rural regions of Xiangyang and Xiaogan city during March – November, 2020. Chi-square test and binary logistic regression were used to analyze the data collected.   Results  Of all the participants, 65.38% (914) reported having HB vaccination and 37.7% (527) reported full-does HB vaccination. Among the participants never having HB vaccination, 308 (63.64%) reported the willingness to have the vaccination; while, the main reason for being unwilling to have the vaccination was considering that the vaccination is unnecessary due to self-perceived good health. Multivariate logistic analysis indicated that occupation, education, monthly income, and whether with HB patients around were significant influential factors of HB vaccination.   Conclusion  For adult residents in Xiangyang and Xiaogan city, being a farmer, with lower education and having high income are risk factors for without HB vaccination and the residents with HB patients around could pay attention to HB vaccination.
Dynamics and influencing factors of quality of life among community elderly empty-nesters in Ma′anshan city
LI Jie, QIN Qi-rong, BIAN Zheng-ping,
2022, 38(7): 870-875. doi: 10.11847/zgggws1134808
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  Objective  To examine the 2-year dynamics of quality of life (QoL) and its influencing factors among community elderly empty-nesters in Ma'anshan city and to provide evidence for developing health care strategies and conducting health care services and health education in the elderly.   Methods  With stratified cluster random sampling, we conducted a baseline survey among 3 476 permanent residents aged 60 years and above in Ma′anshan city from December 2016 to March 2017 and a follow-up interview was conducted from December 2018 to March 2019. Finally, the information on 2 344 elderly being empty-nesters during the period of baseline and follow-up survey were extracted to analyze dynamics and influencing factors of QoL for the elderly empty-nesters. World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF), Activity of Daily Living Scale (ADL), Geriatric Depression Scale-15 (GDS-15), Stress Resilience Quotient Scale (SRQS), and a self-designed questionnaire were used in the study.   Results  Compared to those in the baseline survey in all the elderly empty-nesters, significantly lower scores of WHOQOL-BREF′s psychological domain (55.40 ± 10.76 vs. 65.71 ± 13.52) and social relationship domain (65.70 ± 12.56 vs. 67.43 ± 12.42) were measured in the follow-up survey (both P < 0.05); while there were no significant differences in the scores of physiological domain (64.62 ± 13.92 vs. 65.22 ± 14.55) and environmental domain (63.53 ± 11.90 vs. 63.97 ± 12.67) (both P > 0.05). The results of generalized estimating equation analysis revealed following influencing factors of elderly empty-nesters′ QoL: (1) for psychological domain, aged ≥ 70 years, impaired ADL, and depression were risk factors and moderate or good self-rated economic condition, smoking, alcohol-drinking, taking part in physical exercise, moderate or high resilience were protective factors; (2) for physiological domain, aged ≥ 70 years, with the education of primary school or above, living alone, suffering from a chronic disease, declined or impaired ADL, and depression were risk factors and moderate or good self-rated economic condition, smoking, alcohol-drinking, taking part in physical exercise, moderate or high resilience were protective factors; (3) for social relationship domain, aged 70 – 79 years, living alone, impaired ADL, and depression were risk factors and being female, moderate or good self-rated economic condition, alcohol-drinking, moderate or high resilience were protective factors; and (4) for environmental domain, impaired ADL and depression were risk factors and moderate or good self-rated economic condition, smoking, alcohol- drinking, taking part in physical exercise, moderate or high resilience were protective factors.   Conclusion  For community elderly empty-nesters in Ma′anshan city, the main problem in quality of life is the declined quality of psychology and social relationship domains and the quality of the two domains are influenced in common by age, self-rated economic condition, alcohol-drinking, activity of daily living, depression, and resilience.
Prevalence and risk factors of healthy lifestyle among 30 – 79 years old Yi ethnic residents in Chuxiong Yi Autonomous Prefecture, Yunnan province: a cross-sectional survey in 2019
ZENG Su-su, MENG Qiong, ZHANG Xue-hui,
2022, 38(7): 876-878. doi: 10.11847/zgggws1135713
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  Objective  To examine the prevalence and risk factors of healthy lifestyle among Yi ethnic residents aged 30 to 79 years in Chuxiong Yi Autonomous Prefecture (Chuxiong) of Yunnan province for providing evidences to chronic disease prevention and control in ethnic minorities.   Methods  The participants of the survey were 6 493 Yi ethnic residents (aged 30 – 79 years) recruited using stratified multistage random cluster sampling in two counties of Chuxiong. Face-to-face interviews with a self-designed questionnaire and physical examination were carried out among the participants from December 2018 through March 2019. The seven characteristics of healthy lifestyle for this study included not smoking currently, never or almost not consuming alcohol, with healthy diet behavior, having relatively high physical exercise, having sufficient sleep, with normal weight, and without central obesity and one score was assigned for each of the characteristics in healthy lifestyle scale.   Results  Of the 6 122 participants completing the survey, 55.8% (3 418) were assessed as with healthy lifestyle based on their healthy lifestyle scores of 4 and above; the mean of healthy lifestyle score was 3.69 ± 1.26 for all the participants and only 0.1% (8) of the participants had the maximum score of 7 for the healthy lifestyle scale. Unconditional multivariate logistic regression analysis revealed that the females (odds ratio [OR] = 2.889, 95% confidence interval [95% CI]: 2.570 – 3.247) and those being married (OR = 1.356, 95% CI: 1.151 – 1.599) are more likely to have a healthy lifestyle compared to the males and those unmarried; while, in comparison to those aged less than 45 years, the participants aged 45 – 59 years (OR = 0.752, 95% CI: 0.654 – 0.865) and ≥ 60 (OR = 0.712, 95% CI: 0.599 – 0.846) are less likely to have a healthy lifestyle.   Conclusion  The prevalence of healthy lifestyle is at a low level and affected mainly by gender, age and marital status among 30 – 79 Yi ethnic residents in Chuxiong prefecture.
Access to vaccine information and recommendation practice of non-EPI vaccines among vaccination service providers in China
WANG Qian, HAN Kai-yi, TU Shi-yi,
2022, 38(7): 879-883. doi: 10.11847/zgggws1135050
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  Objective   To investigate the access to vaccine information and recommendation practice of non-Expanded Programme on Immunization (EPI) vaccines among vaccination service providers (VSPs) in China and to provide suggestions on promoting recommendation intention of non-EPI vaccines among VSPs.   Methods   A cross-sectional online survey was conducted among 584 VSPs recruited using two-stage cluster sampling in Anhui and Shaanxi province and Shenzhen municipality in central, western, and eastern China during January 2019. The participants′ information on socio-demographic characteristics, recommendation practice of non-EPI vaccines, channels and sources for getting knowledge about vaccination were collected with a self-administered questionnaire. Univariate chi-square test and multivariate logistic regression model were adopted in data analyses.   Results   Of the 555 participants with valid responses, only 51.53% reported frequent recommendation of non-EPI vaccines to clinic attendees. Among the participants, 83.60%, 61.08%, 36.64%, and 58.92% reported getting information on non-EPI vaccines from training programmes/seminars, medical workers, professional books, and media and the proportions of the participants getting the information disseminated by Chinese Center for Disease Control and Prevention (CDC), vaccine manufacturers, and government agencies were 97.48%, 31.17%, and 29.73%, respectively. The results of multivariate logistic regression analysis indicated that the participants working in Shenzhen municipality (odds ratio [OR] = 0.66, 95% confidence interval [95% CI]: 0.51 – 0.85), being nurses (OR = 0.65, 95% CI: 0.46 – 0.92) were less likely to carry on recommendation of non-EPI vaccines; while, the participants aged over 45 years (OR = 2.04, 95% CI: 1.01 – 4.11), getting non-EPI vaccine-related information from training programmes/seminars (OR = 2.11, 95% CI: 1.62 – 2.76)/professional books (OR = 1.28, 95% CI: 1.08 – 1.51) and disseminated by vaccine manufacturers (OR = 1.55, 95% CI: 1.11 – 2.18) were more likely to recommend non-EPI vaccines to clinic attendees.   Conclusion   The practice of recommendation on non-EPI vaccines among VSPs is at a low level in China. The results of the study suggest that effective measures such as promoting dissemination of non-EPI vaccine-related information in training programmes/seminars and professional books should be implemented to increase the VSPs′ recommendation practice.
Experimental Study
Bactericidal effect of UVA combined with isothiocyanate on enteropatho-genic Escherichia coli and Vibrio parahaemolyticus
HOU Yan-fei, HAN Hui-fang, Takahashi Akira,
2022, 38(7): 884-886. doi: 10.11847/zgggws1136417
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  Objective  To study bactericidal effect of ultraviolet A – light emitting diode (UVA-LED) irradiation combined with phytochemical of allyl isothiocyanate (AITC) on two diarrhea-causing pathogens.   Methods  Two diarrhea-causing pathogenic bacteria, enteropathogenic Escherichia coli (ETEC) and Vibrio parahaemolyticus (VP), were used as the subjects. Bactericidal experiments in 3 × 2 factorial design were performed with the combined treatment of different concentrations of AITC and UVA365 nm-LED irradiation; and the bacteria survival was assessed with colony form unit (CFU) and logarithm value of survival rate was calculated. The interactive effect of AITC and UVA365 nm-LED irradiation was evaluated with analysis of variance for factorial design and illustrated with schematic diagram.   Results  The bactericidal effect of AITC alone was gradually increased with the increment of concentration (P < 0.05). The effect of the combination of UVA-LED irradiation with AITC on the two pathogenic bacteria were statistically significant (P < 0.05). When UVA365 nm irradiation was combined with 1 mg/ml AITC, the survive ratio of Vibrio parahaemolyticus was even reduced to – 6.15 lg.   Conclusion  Synergistic bactericidal effect exists for combined treatment of UVA-LED irradiation and AITC on ETEC and VP.
Survey and Report
Trends in spatiotemporal distribution of pulmonary tuberculosis morbidity and mortality in China: 2004 – 2018
CHU Nan, GAO Qian-qian, ZHOU Cheng-chao
2022, 38(7): 887-890. doi: 10.11847/zgggws1135003
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  Objective  To explore spatiotemporal distribution of pulmonary tuberculosis (TB) morbidity and mortality and their changing trend in China from 2004 to 2018 and to provide evidence for conducting relevant studies and developing strategies on TB prevention and treatment.   Methods  Nationwide data of 2004 – 2018 on TB surveillance were collected and demographic data of the same period were extracted from China Statistical Yearbook. The 15-year period was divided into three stages. The spatial characteristics of TB morbidity was analyzed with Excel 2010 software and Stata 14.0 was used to analyze spatial autocorrelation.   Results   During the period, totally 14 816 329 TB incidents were reported in China, with an average incidence rate of 73.9029/100 000 and an average annual reported mortality of 0.2114/100 000. Spatial autocor-relation of TB morbidity in different regions was observed.   Conclusion  During 2004 – 2018 in China, the incidence rate of pulmonary tuberculosis was decreasing generally and there were aggregations and significant regional differences in TB morbidity.
Variation and prevalence characteristics of influenza in Giuzhou province, 2011 – 2021
ZHENG Qin-ni, REN Li-juan, ZHUANG Li,
2022, 38(7): 891-894. doi: 10.11847/zgggws1136927
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  Objective   To analyze prevalence characteristics and variation trend of influenza in Guizhou province during 2011– 2021 and to provide evidences for influenza prevention and control.   Methods   Throat swab specimens were collected from influenza-like illness (ILI) cases at fever/internal medicine and pediatric clinics of 13 national influenza sentinel surveillance hospitals in Guizhou province during 2011 – 2021 and detected with real-time reverse transcription-polymerase chain reaction (RT-PCR). Statistical analysis was conducted on the basis of annual influenza seasons.   Results  Of the 135 537 specimens detected during the 10-year period, 16.73% (22 676) were positive for influenza virus nucleic acid. Among the positive specimens, the detection rate was the highest (34.3%) for subtype of H3N2 and the lowest (13.69%) for subtype of BY. Various viral subtypes were prevalent alternately during the period. Two prevalence peaks of influenza virus infection in winter-spring season and in summer season were observed, with slightly more infectious cases among females than among males and more cases among the people aged 5 – 24 years. There was a subtype-specific difference in the susceptibility of influenza virus in various populations and there was a significant difference in annual positive rate for the specimens detected.   Conclusion  During 2011 – 2021 in Guizhou province, influenza was prevalence periodically with alternative prevalent viral subtypes; more influenza infections occurred in winter-spring and in summer seasons, especially among young people. The results suggest that surveillance and analysis on viral strain variation timely should be strengthened.
Epidemic characteristics of food poisonings in Yunnan province, 2004 – 2019
SHEN Xiu-lian, YANG Shan-hua, PENG Xia,
2022, 38(7): 895-901. doi: 10.11847/zgggws1132578
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  Objective  To explore epidemic characteristics of food poisonings reported in Yunnan province and to provide evidences for developing strategies on the prevention and control of food poisoning.  Methods  From the Public Health Emergency Reporting System, a subsystem of the China Information System for Disease Control and Prevention, we extracted all data on food poisoning-related public health emergencies in Yunnan province reported from 2004 through 2019 for a descriptive epidemiological analysis.  Results  Totally 1 014 food poisoning incidents were reported in the province during the 16-year period; the incidents involved 27 965 sufferers and 864 mortalities, with a fatality rate of 3.09%. Of all the incidents, 45.17% (458) occurred during June – August in a year, a season with more food poisoning caused by intake of toxic wild mushrooms. More than a half (56.48%, 488 deaths) of the food poisoning mortalities were due to poisonings associated with toxic wild mushrooms. Three minority autonomous prefectures (Wenshan, Honghe and Chuxiong prefectures) were among the top five regions with more food poisonings and the number of reported food poisonings was 143, 100, and 97 for the three prefectures, respectively. Homes and schools in rural regions were top two settings with higher food poisoning incidents and 520 (51.28%) and 181(17.85%) of all the reported incidents occurred at the two settings. For all the reported food poisonings, more than one third (39.94%, 11 168) of the all sufferers were associated with dinner parties and the most (85.42%, 733) of the mortalities were related to home settings in rural regions.  Conclusion  During 2004 – 2019 in Yunnan province, the incidence rate of food poisonings was relatively high in prefectures (municipalities) heavily or scatteredly inhabited by ethnic minorities; the epidemic peaks for the food poisoning were observed during June – August in a year; the most of the mortalities due to the food poisonings was associated eating toxic wild mushrooms and more food poisoning occurred in home and school settings in rural regions. The results suggest that in food poisoning prevention, special concerns should be paid to health education on food hygiene and wild mushroom poisoning in minority regions and rural home and school settings.
Method-specific suicide mortality and its spatial autocorrelation among residents in Hubei province, 2019: a vital registry-based analysis
PAN Jing-ju, ZHOU Meng-ge, ZHANG Lan,
2022, 38(7): 902-907. doi: 10.11847/zgggws1135192
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Abstract:
  Objective   To analyze method-specific suicide mortality and its spatial distribution among residents in Hubei province in 2019 for providing evidences to the development of effective measures on suicide prevention.   Methods   The data on suicide deaths among permanent residents over 10 years old in Hubei province during 2019 were extracted from the Death Reporting System of Chinese Center for Disease Control and Prevention. SAS software and ArcGis 10.6 were utilized in analyses on suicide methods and its spatial autocorrelation.   Results   During the year in the residents, the number of suicide deaths, mortality and standardized mortality rate (SMR) were 7 868, 14.88/100000 and 12.56/100 000, respectively. The top three methods for all the registered suicide mortalities were pesticide poisoning (with the death number of 3 481, the mortality rate of 6.58/100 000, and the SMR of 5.36/100 000), hanging (2 497, 4.72/100 000, and 3.87/100 000), jumping from a high place (709, 1.34/100 000, 1.33/100 000) and the deaths attributed to the three methods accounting for 84.99% of all suicide deaths. The top three methods for the male, female and urban suicide mortalities among residents were the same as for all the suicide mortalities; while for the rural suicide mortalities, the top two methods were the same but the third method was other substances poisoning. Jumping from a high place was the major suicide method for the suicide mortalities aged 10 – 24 and 25 – 44 years; whereas, for the suicide mortalities aged 45 – 64 years and 65 years and above, the major suicide method was pesticide poisoning. Global spatial autocorrelation analysis showed that there were spatial clustering in suicide mortality, the main suicide methods of pesticide poisoning, hanging, and jumping from a high place, with the global Moran′s indicies of 0.473, 0.387, 0.482, and 0.244 (P < 0.001). Local spatial autocorrelation analysis revealed high-high clustering of suicide mortality in some districts/prefectures of 7 municipalities, low-low clustering in some urban districts of 2 municipalities, high-low clustering in one prefectures, and low-high clustering in one prefecture and two districts of a prefecture; local spatial autocorrelation analysis also revealed various types of clustering of suicide methods as following: high-high clustering of pesticide poisoning in 5 counties and 5 prefectures, high-high clustering of hanging in some districts/counties/prefectures in western region of Hubei province, low-low clustering of pesticide poisoning and hanging in some urban districts of two municipalities, and high-high clustering of jumping from a high place in some urban districts of two municipalities.   Conclusion  Among suicide mortalities during 2019 in Hubei province, pesticide poisoning, hanging, and jumping from a high place were main methods and there were obvious spatial clustering and significant gender, age, and regional differences in the main suicide methods.
Incidence of low-level viraemia among HIV/AIDS patients with antiviral therapy in Yunnan province, 2004 – 2018: a retrospective analysis
AN Jing, LAO Yun-fei, TANG Song-yuan
2022, 38(7): 908-913. doi: 10.11847/zgggws1132975
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Abstract:
  Objective  To examine general situation and change trend of low-level viraemia (LLV) among human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients under antiviral therapy (ART) in Yunnan province and to provide evidences to further relevant studies.  Methods  From the Data and Information Management System for Integrated HIV/AIDS Prevention and Control of Chinese Center for Disease Control and Prevention, we extracted demographical, clinical and viral load (VL) detection data on all HIV/AIDS patients receiving ART at the age of more than 15 years in Yunnan province during the period from 2004 through 2018. The incidence of LLV among the HIV/AIDS patients with different ART regimens was analyzed statistically.  Results  Of the 93 944 HIV/AIDS patients included in the study, 21 203 (22.6%) were detected with LLV. Among the patients with LLV, 25% were detected with LLV at least two times; the most detected LLV level was 51 – 199 copies/mL, followed by 400 – 999 and 200 – 399 copies/mL; the once-only LLV was detected most frequently and the detection frequency decreased in turn for successive two times, discontinuous two times, successive several times, and discontinuous several times; the detected incidence of LLV was the highest during the first year of ART and the incidence declined yearly after the initiation of ART. During the retrospective observation period among the 76 736 HIV/AIDS patients receiving first-line ART, the detected frequency of 51 – 199 and 200 – 399 copies/mL LLV increased first, with the highest frequency in 2010, then declined, with the lowest frequency in 2016, and increased again; the detected frequency of 400 – 999 copies/mL LLV and virologic failure (VF) of ≥ 1 000 copies/mL decreased yearly before 2012 and then remained at a stable level. While among the 17 208 HIV/AIDS patients receiving second-line ART, the detected frequencies of the four levels of LLV mentioned above varied similarly, with a decreasing trend between 2008 – 2012 and a stabilization later after.  Conclusion  The detected incidence of LLV is relatively high among HIV/AIDS patients with different ART regimen in Yunnan province. The effect of LLV on outcomes of ART needs to be explored.
Total financial investment in maternal health care in Beijing and Shanghai: a comparison analysis
MA Dong-ping, YIN Wen-qiang, TIAN Zhuang,
2022, 38(7): 914-916. doi: 10.11847/zgggws1122657
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Abstract:
  Objective  To analyze the extent of deficit in total financial investment in maternal health care (MHC), the changing trend of maternal mortality rate (MMR) and their regional disparities in Beijing and Shanghai municipality during the period from 2000 through 2017 and to explore suitable total financial investment in MHC.   Methods   We searched China National Knowledge Infrastructure (CNKI) and Web of Science for research literatures on financial investment in MHC in Beijing and Shanghai municipality published during 1995 – 2017. The information on deficit in total financial investment in MHC was extracted from 205 retrieved studies for calculation of a severity score to evaluate the deficit in total financial investment in MHC. Spearman correlation and linear regression analysis were used to analyze the relationship between the deficit in total financial investment in MHC and MMR.   Results   For Beijing municipality, the severity score for the deficit in total financial investment in MHC decreased from 3.54 in 2000 to 2.78 in 2017, while for Shanghai municipality, the score decreased from 3.94 to 1.41. Regression analysis on the correlation between the deficit severity score and MMR resulted in statistically significant regression equations for both Beijing (P < 0.05) and Shanghai (P < 0.01).   Conclusion   The total financial investment in maternal health care increased gradually over the years in both Beijing and Shanghai municipality during 2000 – 2017. The influence of total financial investment on maternal mortality rate is more obvious for Shanghai. The study verified the feasibility of quantitative assessment on total financial investment in maternal health care.
Status and impact factors of self-reported health among migrant minority population in China, 2017
DU Jie, WANG Na, YU Li-ping,
2022, 38(7): 917-921. doi: 10.11847/zgggws1128065
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Abstract:
  Objective  To examine self-reported health and its influencing factors among migrant ethnic minority people in China and to provide evidences for improving health of the population.  Methods  The data on 14 226 migrant ethnic minority people were extracted from the China Migrants Dynamic Survey conducted during 2017 across the country. Unconditional logistic regression model was used to analyze factors associated with self-reported health in the population.  Results  Of the people surveyed, 11 207 (79.2%) and 2 384 (16.8%) reported normal and basically normal self-rated health; 555 (3.9%) reported poor self-rated health but being able to take care of themselves; and only 17 (0.1%) reported poor self-rated health and being unable to take care of themselves, respectively. The results of logistic regression analysis demonstrated that the migrant ethnic minority people with following characteristics were more likely to reported good self-rated health: being male, aged 15 – 34 years, with the education of undergraduate and above, with migration experience of less than 10 years, having a stable employment, with a monthly income more than 6 000 yuan RMB, having their health records being established in immigration region, ever participating in at least one health education program, without chronic disease, and being aware of National Basic Public Health Service Project.  Conclusion  Health status in migrant ethnic minority population in China should be concerned, especially in those being female, with long migration experience, at elder age, without stable employment, and with low monthly income.
Acceptance of mental health education and its influencing factors among elderly migrants in China, 2017
LIAO Zhi-liu, WANG De-wen
2022, 38(7): 922-927. doi: 10.11847/zgggws1135395
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Abstract:
  Objective  To examine the acceptance of mental health education and its associates among elderly migrants and to provide evidences for developing strategies and programs to promote mental health education service and mental health literacy in the population.   Methods  The data on 5 729 migrant people aged 60 years and above and living locally at least 6 months were extracted from the China Migrants Dynamic Survey conducted in 31 provincial level administrative divisions across China in 2017. SPSS 25.0 was used in data analyses.   Results  Among all the participants, only 29.2% (1 672) reported having received mental health education during past one year in villages/communities and the reported proportions were 29.2%, 30.5%, 29.9%, and 24.2% in the participants aged 60 – 64, 65 – 69, 70 – 74, and ≥ 75 years, respectively. The major patterns of the mental health education were via publicity materials (papers, films and television programs), billboards/electronic displays, public health consultation, and health knowledge lectures, which were reported by 90.1%, 82.0%, 70.0%, and 67.5% of the 1 672 health education receivers; other two patterns reported by 48.8% and 39.4% of the receivers were via personalized face-to-face consultation and via community short message service/WeChat/networks. The results of binary logistic regression analysis showed that the participants with following characteristics were more willing to receive mental health education service: immigrating to regions in western China, having personal health records being established, being aware of national basic public health service, with a good self-rated health, with a strong willingness to integrate into local social environment, and having a high community involvement; while, aged 75 years and above, with the education of primary school or below, with difficulties in local region, experiencing the migration for more than 10 years, and migrating due to the migration of family members such as the elderly or children to be cared were less likely to receive mental health education.   Conclusion  In elderly migrant population in China, the acceptance of mental health education was at a relatively low level and mainly influenced by age, education, whether having difficulties in local region, self-rated health, duration of migration, reasons for migration, inflow region, the awareness about national basic public health services, the establishment of personal health record, community involvement, and the willingness to be assimilated into local social environment.
Characteristics of high-risk sexual behaviors before infection confirmation among middle-aged and elderly people living with human immunodeficiency virus
HU Rong, LUO Li, CAO Lin,
2022, 38(7): 928-933. doi: 10.11847/zgggws1133385
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Abstract:
  Objective   To analyze the characteristics and influencing factors of high-risk sexual behaviors before infection confirmation among middle-aged and elderly people living with human immunodeficiency virus (PLHIV) transmitted via different routes.   Methods   We recruited 449 PLHIV in Wuhan city of Hubei province and aged 50 years and older at the diagnosis during the period from 2017 to June 30, 2019. A face-to-face anonymous survey was conducted among the PLHIV using a self-designed questionnaire to collect information on high-risk sexual behaviors and HIV-related knowledge before the confirmation of HIV infection. Chi-square test and multivariate analysis were used to explore influencing factors for high-risk sexual behaviors.   Results   Complete information were collected from 419 participants (353 males and 66 females with a mean age of 59.67 ± 7.48 years). The reported HIV transmission routes included extramarital heterosexual behaviors for 215 (51.3%) of the participants, heterosexual behaviors between HIV-discordant couples for 40 (9.5%) of the participants and homosexual behaviors for 164 (39.1%) of the participants. Multivariate analysis showed that for the participants being infected via extramarital heterosexual behaviors, ever working in places other than hometown (odds ratio [OR] = 4.55), being capable of making annual balance between income and expenditure (OR = 4.22), and history of commercial heterosexual behavior (OR = 11.20) were risk factors for multiple sexual partners before HIV infection confirmation; while for the participants being infected via homosexual behaviors, ever working in places other than hometown (odds ratio [OR] = 10.04), being capable of making annual balance between income and expenditure (OR = 26.29), and history of non-commercial temporary homosexual behavior (OR = 35.37) were risk factors for multiple sexual partners before HIV infection confirmation, but with a common knowledge/without knowledge about AIDS prevention (OR = 0.04/0.07) was a protective factor against multiple sexual partner.   Conclusion   Ever working in places other than hometown and being capable of making annual balance between income and expenditure are risk factors for multiple sexual partners before infection confirmation among middle-aged and elderly people living with human immunodeficiency virus.
Body image perception among 316 young adults: a cross-sectional analysis in Beijing and Guangzhou
YAN Xin-yu, LI Yong, GUO Wen,
2022, 38(7): 934-938. doi: 10.11847/zgggws1131819
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Abstract:
  Objective  To investigate body image perceptions among young adults and to provide evidences for developing intervention measures towards obesity.  Methods  With advertisements in Beijing and Guangzhou city, we recruited 316 volunteers aged 18 – 44 years for a survey conducted from May to August, 2019. The body image stimuli were used to assess participants′ perceptual body image, ideal body image, body dissatisfaction and standard body image. Meanwhile, height, weight, waist circumference and hip circumference of the participants were measured.  Results  The participants′ mean scores for perceptual and ideal body image were 4.25 and 3.15, respectively. In terms of body weight, the participants with underweight had the lowest mean perceptual body image score, followed by those with normal weight, overweight, and obesity, with a significant difference among the groups (P < 0.05); the mean perceptual body image score of the participants with the education of middle school and lower was significantly lower than that of participants with college and above education (P < 0.05); the mean ideal body score also differed significantly by participants′ body weight, the score of the participants with underweight was lower than those with obesity; the participants with normal weight had relatively lower score, followed by the scores for those of overweight and obesity (P < 0.05). Of the participants, only 13.9% were completely satisfied with their body size; but 54.1% and 32.0% were moderately and slightly dissatisfied with their body size. The participants′ mean body dissatisfaction scores varied with their body weight in an ascending order of underweight, normal weight, overweight, obesity; the mean body dissatisfaction score of the younger participants (≤ 35 years) was significantly lower than that of the participants aged 35 – 39 years (P < 0.05). Significantly positive associations of body weight, body mass index (BMI), waist circumference, hip circumference, and waist-to-hip ratio with perceptual body image score and body dissatisfaction score were observed, with the correlation coefficients ranging between 0.185 − 0.630 (all P < 0.01).  Conclusion  Among young adults in two Chinese cities, the body image perception is related to somatotype and educational level and most of the young adults are dissatisfied with their body size, suggesting that appropriate intervention measures should be taken for the prevention and control adulthood obesity in the population.
Inspection technology
Application of liquid-phase chip technology in infectious diarrhea pathogen detection
CAO Jun, GUAN Hong-xia
2022, 38(7): 939-943. doi: 10.11847/zgggws1133735
Abstract:
  Objective  To evaluate application value of liquid phase chip technology in the detection of infectious diarrhea pathogens.   Methods  From April 2015 through April 2016, 179 stool samples of diarrhea cases treated in the intestinal outpatient department of Wuxi People's Hospital (including Children′s Hospital) of Jiangsu province were collected and detected with xTAG® Gastrointestinal Pathogen Panel (xTAG GPP), and the detection results were compared to those with real-time PCR.   Results  Totally 9 pathogens were detected in the samples from 82 diarrhea cases with xTAG GPP, with a positive detection rate of 45.81% (82/179); while, 9 pathogens were detected in 81 cases with real-time PCR, with a positive detection rate of 45.25% (81/179). The total coincidence rate for the two detections was 92.17% (165/179). The sensitivity and specificity of xTAG GPP for diarrhea pathogen detection were 84.44% and 93.33%, and positive and negative predictive value were 92.68% and 85.71%, respectively.   Conclusion  Compared with real-time PCR detection, liquid phase chip technology is of high throughput, speed, sensitivity and specificity in common diarrhea pathogen detections, and could be used for rapid pathogenic diagnosis of diarrhea diseases.
Overview
Obtaining epidemiological information based on a new method – wastewater analysis: a review
ZANG Jin-xin, YANG Qi-fan, WANG Na
2022, 38(7): 944-947. doi: 10.11847/zgggws1136112
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Abstract:
The trend of illicit drug abuse has become more severe due to the lack of measures for real-time monitoring. In recent years, a novel method of obtaining relevant information through wastewater analysis has become a tracking method to deal with the problem. The information obtained from chemical analysis of specific human excretion products (biomarkers) in urban wastewater can be used to estimate the exposure or consumption of the population under investigation to a defined substance, which is named wastewater-based epidemiology. With further development of the novel method, multi-domain and multi-disciplinary information related to the population can be obtained through wastewater analysis in addition to the identification of illicit drugs. In this study, we introduced principles and applications of wastewater-based epidemiology and discussed reviewe the development and prospects of wastewater-based epidemiology in China.
Current status and challenges of meningococcal vaccines development in China
XU Ying-hua, LI Ya-nan, YE Qiang
2022, 38(7): 948-951. doi: 10.11847/zgggws1136615
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Abstract:
Vaccination is the most effective and economical way to prevent meningococcal meningitis. In the past few decades, with widespread use of meningococcal vaccines, the incidence of meningococcal meningitis has dropped significantly. There are some vaccines available in Chinese markets, of which mainly included groups A, C, W, and Y monovalent and multivalent polysaccharide meningococcal vaccines (MPV), group A and C polysaccharide meningococcal conjugated vaccines (MPCV-AC), and meningococcal groups A and C and haemophilus b conjugate vaccine (MPCV-AC-hib). With the nearly 50 years of development of meningococcal vaccines in China, significant achievements have been made in vaccine production, quality control, and related research, but the burden of meningococcal disease is still underestimated; the meningococcal vaccine immunization strategy has not been perfected; meningococcal vaccines from different manufacturers have inconsistent immunization procedures and no group B meningococcal vaccines are available in the market. Therefore, it is suggested that meningococcal monitoring methods should be continuously improved and research on meningococcal disease burden should be carried out for facilitating the improvement of meningococcal vaccine immunization procedures and strategy. Furthermore, considering the serogroup highly variable and antigen drift characteristics of Neisseria meningitides, a vaccine with longer immunity and better protection effect should be developed by using genetic recombination and other technologies.
Progress in researches on methodology of disability weight
HU Kui-ru, WAN Xia
2022, 38(7): 952-955. doi: 10.11847/zgggws1134564
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Abstract:
Disability weight (DW), one of important indicators for estimating disability-adjusted life years (DALY), represents the severity of health loss in a particular disability state. Currently, DW has two sets of methodology named as “disability weight from the Global Burden of Disease Study” (GBD DW) and “health status weight from Health-Related Quality of Life” (HRQOL HSW). In order to promote the further development of DW methodology, this study briefly reviewed and compared these two sets of methodological study, including the respondents for the assessment, definition of health status, assessment methods and the methods' strength and weakness, which would provide a comprehensive reference for the improvement of DW research.
Effects of dietary fiber from brown algae on energy intake: a review
QIU Xia, WANG Fa-he, SUN Zhan-yi,
2022, 38(7): 956-960. doi: 10.11847/zgggws1134771
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Abstract:
Obesity is a risk factor for many diseases. Energy intake plays an important role in the development of obesity. Studies have shown that increasing the amount of dietary fiber in diet can boost gut motility, increase satiety, and reduce energy intake. Alginate is a marine fiber extracted from the cell wall of alga. Recently, researchers have paid much attention to the role and mechanism of alginate in controlling dietary energy. In the study, mechanisms and influencing factors for dietary fiber from algae in regulation on energy production, storage and consumption were reviewed.