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Vaccination-related contamination-induced false positive SARS-CoV-2 specimen from a suspected COVID-19 case in Chengdu city: a gene tracing-based analysis
XIE Wen-jun, CHEN Heng, FENG Jing,
 doi: 10.11847/zgggws1137810
Abstract(14) HTML(5) PDF 642KB(4)
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  Objective  To conduct a gene tracing-based analysis on a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive oropharyngeal swab specimen from a suspected coronavirus disease 2019 (COVID-19) case without epidemiologically-confirmed exposure history and with negative results in confirmation tests in Chengdu city, Sichuan province for providing evidence to the operation of clinic vaccination with suspected vaccination clinic-related infection.  Methods  An epidemiological investigation was conducted on a suspected COVID-19 case reported by a medical institution providing both COVID-19 vaccination and SARS-CoV-2 nucleic acid screening services in a district of Chengdu city, Sichuan province on February 24, 2021. The information on case′s onset and treatment, travel and close contacts within 14 days before the onset were collected and analyzed. Specimen collection and laboratory nucleic acid testing were conducted for the case, the case′s close contacts and living environment, and the environment and work clothes of medical staff of the reporting medical institution. Second generation gene sequencing and gene tracing analysis were performed for the case′s positive specimen collected for the screening test.   Results  The suspected case was a 57-year old man seeking medication for cough, throat discomfort, and runny nose at a medical institution provided both COVID-19 vaccination and SARS-CoV-2 nucleic acid screening services and having a oropharyngeal swab test for screening SARS-CoV-2 infection at the medical institution on February 23, 2021. The case reported no history of travelling abroad himself and his close contacts, contacting with confirmed/suspected COVID-19 patients, potential exposure to SARS-CoV-2, and COVID-19 vaccination. No positive results of SARS-CoV-2 nucleic acid were detected for case′s oropharyngeal/nasal and anal swab specimens, close contacts′ oropharyngeal swab specimens, swab specimens of living/working/relevant public place environment, swab specimens of environment and working clothes of the staff of the medical institution for retests performed one day after the case′s screening test. The results of gene sequencing for the case′s positive specimen at the screening test showed a 99.99% sequence homology with the sample of COVID-19 vaccine for inoculation service at the medical institution. The Pangolin type was B for both the case′s specimen and the vaccine sample.   Conclusion  The clinical manifestation and laboratory test of the suspected case were not consistent with the diagnosis criterion for COVID-19 patient and asymptomatic SARS-CoV-2 infection. The case′s false SARS-CoV-2 positivity of the suspected specimen at the screening test probably result from vaccination related contamination of the case′s oropharyngeal swab specimen at the medical institution proving both COVID-19 vaccination and SARS-CoV-2 nucleic acid screening services. The result needs to be concerned when conducting SARS-CoV-2 nucleic acid screening.
Safety of inactivated COVID-19 vaccine in 3 – 17 years old healthy children
LI Min-jie, WANG Lei, WU Zhi-wei,
 doi: 10.11847/zgggws1138965
Abstract(20) HTML(3) PDF 568KB(2)
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  Objective   To evaluate the safety of an inactivated coronavirus disease 2019 (COVID-19) vaccine in healthy children and adolescents aged 3 – 17 years.   Methods  Totally 500 healthy children and adolescents aged 3 – 17 years were recruited in Zanhuang county of Hebei province and randomly assigned into a vaccination group (n = 375) and a placebo group (n = 125) during May 2021. Two doses of inactivated COVID-19 vaccine (Sinovac Life Sciences Co., Ltd, Beijing) or placebo only (day 0 and day 28) were administered to the participants. The participants were observed for adverse reactions within 30 minutes after each vaccination. The participants′ information on local and systemic solicited adverse events from day 0 to day 7, and unsolicited adverse events from day 0 to day 28 were collected after the vaccination. Serious adverse events were recorded from the beginning of vaccination to 6 months after the second dose vaccination to evaluate the safety of the vaccine.   Results  The incidence of adverse reactions was 19.2% (72/375) in the vaccination group and 15.2% (19/125) in the placebo group, without significant difference between the incidence of the two groups (P > 0.05). The most common adverse reactions were injection site pain and fever. There was no significant statistical difference in the incidence of other adverse reactions between the two groups except for pain at the injection site. Most observed adverse reactions were grade 1 and 2 in severity, only 3 participants reported grade 3 adverse reactions. The vaccination group′s incidences of adverse reactions of grade 1 (14.93% vs. 12.8%), grade 2 (7.73% vs. 4%), and grade 3 (0.53% vs. 0.8%) were not significantly different from those of the placebo group. No serious vaccination-related adverse event was reported in either group. The incidence of adverse reactions (28%) was higher in the 3 – 5 years old participants than those in the participants aged 6 – 11 and 12 – 17 years (16% and 15.5%) and the age-group- specific adverse reaction incidences were not significantly different between vaccination group and placebo group. The incidence of adverse reactions for the first dose vaccination was significantly higher than that for the second dose (14.6% vs. 5.69%, P < 0.05) and there was no significant difference in the dose order-specific adverse reaction incidence between the vaccination group and the placebo group.   Conclusion  The inactivated COVID-19 vaccine is of good safety when administered in 3 to 17 years ole healthy children.
A discussion on rapid response decision-making mechanism for public health emergency in port cities in China
HUANG Li-qun, FANG Peng-qian, CHEN Dan,
 doi: 10.11847/zgggws1137412
Abstract(20) HTML(5) PDF 672KB(2)
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Severe circumstance of global public health has posed higher requirements for rapid response to public health emergencies in port cities, especially at border ports, and it is urgent to construct a rapid decision-making mechanism for the response to public health emergency in port city in China. In this paper, the basic elements of public health emergency management decision-making, the structure of decision-making system, as well as the experience of port cities in responding to public health emergencies, are summarized. Specific problems in decision-making mechanism for the response to public health emergency in port city were also discussed in the paper, including the risk identification and screening of infectious diseases, novel model for comprehensive risk management of public health event, the application of artificial intelligence technology to construct rapid response infrastructure, and the structure and operation mode of the early-warning decision-making system.
Advances in researches on Transmission route of SARS-CoV-2 and personal health intervention: a review on research advances
TU Hong-wei, GAN Ping, ZHONG Ruo-xi,
 doi: 10.11847/zgggws1138953
Abstract(102) HTML(28) PDF 636KB(55)
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The conronavirus disease 2019 (COVID-19) pandemic exerts a major impact on the world. Understanding the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can help public health personnel to define the prevention and control priorities in practical work. This study summarized the existing literature (update to May 2, 2022) and analyzed and classified the main transmission routes of SARS-CoV-2 based on typical cases and laboratory studies, and proposed relevant prevention and personal protection strategies to provide a basis for more accurate and effective control of SARS-CoV-2 transmission.
Clinical symptoms and severity of elderly COVID-19 patients infected with different SARS-CoV-2 variants
WANG Hai-feng, LI Ya-fei, PAN Jing-jing, You Aiguo, Wang RuoLin, Fan Wei, Wang Wenhua, Wang Yingying, Ye Ying, Huang Xueyong, Guo Wanshen
 doi: 10.11847/zgggws1138940
Abstract(144) HTML(49) PDF 541KB(65)
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  Objective   To analyze differences in clinical symptoms and severity of elderly coronvirus disease 2019 (COVID-19) patients infected with Delta, Omicron BA.1 and Omicron BA.2 variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).   Methods  From China′s Infectious Disease Information System and provincial center for disease control and prevention and local designated hospitals, we collected socio-demographic and clinical information on 60 years and older COVID-19 patients reported in the four large-scale COVID-19 epidemics in Henan province during 2022 and the SARS-CoV-2 variants for the patients′ infections were identified based on gene sequencing in combination with epidemiological investigation. Chi-square and Fisher′s precision probability test were used to compare the differences in the incidence of patients infected with different variants and multivariate logistic regression was adopted analyze the influencing factors of disease severity.   Results  The total number of elderly cases for the four local COVID-19 epidemics was 234, including 118, 36, and 80 cases infected with SARS-CoV-2 Delta, Omicron BA.1, and Omicron BA.2 variant. Of all the cases, 56.8% were female; 47.6% suffered from underlying diseases; and 88.0% had COVID-19 vaccination. The main clinical manifestations for all the cases were fever, fatigue and upper respiratory symptoms such as cough, sore and dry throat. The symptomatic proportion in the cases with Delta variant infection was significantly higher than that in the cases with Omicron variant infection (34.7% vs. 19.0%, P = 0.007). The proportion of severe or critical conditions was significantly higher in the cases with Delta variant infection than that in the cases with Omicron variant infection (12.7% vs. 1.7%, P = 0.002). The results of multivariate logistic regression analysis revealed following risk factors for the occurrence of severe or critical conditions among the elderly cases: infected with Delta variant (odds ratio [OR] = 5.7, 95% confidence interval [95% CI]: 1.1 – 31.2), aged ≥ 80 years (OR = 8.4, 95% CI = 2.0 – 34.4), suffering from dyskinesia (OR = 5.3, 95% CI: 1.5 – 18.3), and suffering from diabetes (OR = 5.7, 95% CI: 1.1 – 31.3).   Conclusion  In COVID-19 patients aged 60 years and above, clinical symptoms and the occurrence of server or critical conditions differ by different SARS-CoV-2 variants and the patients with Delta variant infection, at older age, and with underlying diseases are at a higher risk of having severe or critical conditions.
Social attributes and social prevention and control of disease: a comment
WANG Chao, LU Zu-xun
 doi: 10.11847/zgggws1138138
Abstract(161) HTML(39) PDF 569KB(46)
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The social attributes of people determine that illness is not only a medical problem, but also a social disease. The illness has a wide range of social attributes from its occurrence and development, diagnosis and treatment to its social impacts. The prevention and control of disease require a full participation of the whole society, including the government, medical institutions, social organizations, and individuals. However, a healthy social environment urgently requires further innovations in disease prevention and control concepts and strategies to strengthen social foundations against to various diseases.
Epidemiological characteristics of a local COVID-19 outbreak caused by Omicron (BA.2.2) variant in Henan province
PAN Jing-jing, WANG Ying-ying, WANG Wen-hua,
 doi: 10.11847/zgggws1138726
Abstract(378) HTML(95) PDF 1184KB(100)
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  Objective  To analyze epidemiological characteristic and transmission process of a local coronavirus disease 2019 (COVID-19) outbreak induced by imported cases from other provinces in Henan province.   Methods  The data on all local COVID-19 cases in Xiuwu county, Henan province reported during March 18 – 28, 2022 were extracted from National Notifiable Disease Report System of China. The results of field investigations on the cases were also collected simultaneously. Descriptive statistics was performed on the data collected with SPSS 22.0.   Results  Totally 45 cases (16 males and 29 females, 14 minor or common patients and 31 asymptomatic infections) were reported during the 11-day outbreak period. The median age (25th percentile [P25], 75 percentile [P75]) of the cases was 23.02 (18.57, 28.64) years. The median (P25, P75) of cycle threshold (Ct) value for Orf1ab gene and N gene for positive cases in primary screening were 23.02 (18.57, 28.64) and 23.10 (18.63, 28.03), respectively. A case clustering involving 18 cases was identified in a local textile factory, with an incidence rate of 6.6%; seven family clusters were also identified, with a family secondary attack rate of 20.78% and a secondary attack rate of 3.79% among close contacts. Of all the cases, 12.5% could attributed the infection to the exposure to the asymptomatic infections being negative for nucleic acid test at that time. The results of genome second generation sequencing for the isolates from 29 infections indicated that the pathogen of the outbreak was severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant Omicron (BA.2.2) and the local transmission of the virus variant was traced back to the 2 first generation cases returning home from other epidemic area. The median (P25, P75) of incubation period was 3 (2, 4.25) days and that of generation interval was 3 (2, 3) days. Five generations of transmission were identified for the outbreak . The estimated basic reproductive number (R0) of this epidemic was 6.14, and the effective reproduction number (Rt) decreased 2 days after the control measures were taken and declined to less than 1 in 8 days after the implementa-tion of control measures.   Conclusion  The reported COVID-19 outbreak in Henan province was caused by imported cases from other epidemic area and spread mainly in factories, families and schools. The control measures on the outbreak were effective and subsequent transmission was prevented.
Construction of grounded theory-based vaccination decision-making process model for the public: a empirical study in college students
FAN Kai-sheng, HAO Yan-hua, GUAN Han-wen,
 doi: 10.11847/zgggws1136354
Abstract(368) HTML(85) PDF 654KB(125)
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  Objective  To construct a decision-making process model on vaccination of coronavirus disease 2019 (COVID-19) vaccine and to explore reasons of unwilling to have the vaccination from public perspective for providing theoretical evidences to COVID-19 vaccination promotion.   Methods  Using a self-designed open-ended questionnaire on COVID-19 vaccine hesitancy, we conducted a survey among 347 students in a medical university during March 27 – 29, 2021 – one week after the students′ applying voluntarily for COVID-19 vaccination. Word frequency and text node analysis on collected information were carried out and word cloud maps were generated with NVivo 12 software. A theoretical framework for vaccination decision-making process model was constructed based on grounded theory.   Results  Valid information were collected from all the participants. In the respondents′ responses in writing about reasons for having COVID-19 vaccination, the words with high frequency included COVID-19, prevention, vaccination, and free of charge; while, safety, vaccine, effectiveness and adverse reaction were among the high frequency words in the writings on COVID-19 vaccine hesitancy. In the respondents′ writing texts, 3 parent nodes and 9 child nodes were identified. According to theoretical models of bio-psycho-social medicine, protective behavior decision, and vaccine hesitation/vaccination willingness and considering the results of previous studies, the public motivation for COVID-19 vaccination could be summarized into three aspects with nine causal factors as following: objective biological determination (factors relevant to virology/pharmacology and physiology/pathology), subjective psychological determination (personal risk and benefit judgment, vaccine safety, vaccine efficacy, and perceived social responsibility), and social determination (service accessibility, information accessibility). The three determinant aspects with nine relevant factors ought to be concerned in the construction of theoretical framework of vaccination decision-making process model for the public.   Conclusion  A vaccination decision-making process model for the public was preliminarily constructed for the promotion of COVID-19 vaccination willingness and behavior in Chinese population.
Application of aptamer-based hybridization chain reaction in detections
SU Liu, DENG Sheng-liang, HE Wei-hua,
 doi: 10.11847/zgggws1134506
Abstract(143) HTML(63) PDF 697KB(24)
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Developing simple and sensitive detection methods is of great significance to researches on medical diagnosis, environmental analysis and food safety. As a new biological indicator molecule, aptamers are combined with hybridization chain reaction (HCR) to form a new detection model for sensitive detection of analytes. HCR is a typical amplification technology, which can be carried out without enzyme and self-assembled at room temperature. The aptamer-based HCR technology has be attracted great interest due to its high specificity and sensitivity, simple protocol and low cost. The study reviews basic features of HCR with an emphasis on the application of aptamer-based HCR in detection, such as proteins, enzyme activities, small molecules and tumor cells, etc. Major existing problems of the technology are also discussed. The review is aimed to provide a theoretical reference for establishing a highly efficient and sensitive HCR detection system.
Disease burden of depression among Chinese residents in 1990 and 2019: a comparative analysis
MA Xiao-mei, WANG Jin-jin, XU Xue-qin,
 doi: 10.11847/zgggws1133771
Abstract(290) HTML(76) PDF 483KB(81)
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  Objective  To compare the disease burden of depression among Chinese residents in 1990 and 2019 and to provide a reference for the prevention and control of depression.  Methods  The data on depression in Chinese population in 1990 and 2019 were extracted from the Global Burden of Disease Study 2019 (GBD 2019). Incidence, disability-adjusted life years (DALY) and years lived with disability (YLD) of depression were used to analyze disease burden in 1990 and 2019 and its changing trend during the period.  Results  Among Chinese residents, the number of incidence and DALY of depression increased from 31 303 436 cases and 5 486 751 person-years in 1990 to 41 005 280 cases and 7 561 985 person-years in 2019, with an increase of 31.0% and 37.8%; while, the standardized incidence and the standardized DALY rate of depression decreased from 2 647.72/100 000 and 470.65/100 000 in 1990 to 231.41/100 000 and 416.95/100 000 in 2019. Compared with those in 1990, the number of incidence and DALY of depression increased by 37.0% and 41.9% among male residents and both the increases were higher than those (27.8%, 35.5%) among female residents; but the standardized incidence rate and DALY rate declined by 7.8% and 7.6% among male residents and both the decreases were lower than those (16.5% and 14.2%) among female residents. Declines in DALY rate of depression in 2019 were observed in both male and female residents aged 10 – 49 years but rises in the DALY rate were found in male and female residents age 50 years and above in comparison with those in 1990. Being the heaviest disease burden of depression among Chinese residents in 1990 and 2019, the DALY of major depression was 4 006 829 person-years and 5 087 997 person-years, accounting for 73.0% and 67.3% of the total disease burden of depression, respectively. Compared with those in 1990 in Chinese residents, the DALY rate of major depression and dysthymia increased by 5.7% and 39.1% in 2019, indicating a significantly increased disease burden of the disease.  Conclusion  In 1990 and 2019 in China, the main part of disease burden of depression was contributed to the disease incidents among females but the disease burden of depression also increased among male residents and the middle-aged and elderly residents.
Status quo of contracted family doctor services in China: a literature study
Mei-xuan LI, Xiu-xia LI, Xin XING,
 doi: 10.11847/zgggws1122093
Abstract(4460) HTML(2432) PDF 483KB(315)
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  Objective  To examine the status of and research progress in contracted family doctor services in China and to summarize general problems existing in the implementation the services for providing references for the development of applicative mode of contracted family doctor services in China.  Methods  Studies on contracted family doctor services in China published till April 2018 were systematically searched through China National Knowledge Infrastructure (CNKI), Chinese Biomedicine Database (CBM), Wanfang and Chinese Science-Technology Periodical Database (VIP) database. EndNote X7 and Excel 2010 were used to manage and analyze the retrieved studies.  Results  All the 24 finally included articles were cross-sectional studies, of which 20 and 4 were conducted among urban and rural residents. Higher rates (36% – 96%) of awareness about contracted family doctor services were reported by studies conducted among residents in Guangdong province, followed by among those (16% – 90%) in Beijing. Higher proportions (42% – 100%) of participating in contracted family doctor services were reported by the studies conducted among the residents in Beijing, followed by those (30% – 74%) in Shanghai. A higher rate (86.33%) of satisfaction to contracted family doctor services was reported by the studies conducted among the residents in Beijing, followed that (56% – 80%) in Guangdong province. Major hindering factors for the implementation of contracted family doctor services indicated by the studies were shortage of family doctors, lack of awareness on the services among the public, low salary of family doctors, imperfect management, incentive, insurance, and information support for the services.  Conclusion  The rate of awareness about, participating in, and satisfaction to contracted family doctor services are higher among residents in economically developed provinces/municipalities and in urban area than among those in less developed regions and in rural areas in China. More researches on the issue need to be performed for effective implementation of contracted family doctor services.
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Indoor radon concentration and its influencing factors in newly decorated houses and offices in Shenyang city
WU Hao-lan, ZHAO Hang, LI Meng-ge,
 doi: 10.11847/zgggws1132296
Abstract(247) HTML(100) PDF 459KB(14)
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  Objective  To examine indoor radon pollution and its associates in houses and offices with recent interior decoration in Shenyang city of Liaoning province and to provide evidences for developing targeted control measures against the pollution.   Methods  From Shenyang Construction Engineering Quality Testing Center, we collected the data on indoor radon detections for 581 houses and 151 offices after recent interior decoration in 25 buildings in Shenyang city during 2017. The concentrations of radon were described and the relationship between the indoor radon and decoration conditions was analyzed statistically.   Results   The mean indoor radon concentration of the offices was significantly higher than that of the houses (75.822 ± 4.090 vs. 69.285 ± 7.128 Bq/m3, P < 0.05). The most important influencing factor of room-specific radon concentration is the floor number of the room located on. The major influencing factors of indoor radon concentration for houses included whether the white powder (mainly consisted of calcium carbonate, cellulose and white latex) being used for interior wall decoration and the distance from a main road; in addition to whether the white powder being used for interior wall decoration, the indoor radon concentration of an office also influenced by the utilization of floor, marble tile, and polyvinyl chloride floor covering.   Conclusion  Decoration-related factors need to be concerned for the prevention and control of indoor radon pollution in houses and offices.
Performance and support pattern of nonlocal medical relief personnel during containment of coronavirus disease 2019 epidemic in Hubei province
XUE Xiao-jing, LÜ Ru-qi, LI Wei,
 doi: 10.11847/zgggws1128317
Abstract(1335) HTML(2178) PDF 495KB(55)
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  Objective  To examine the performance and support pattern of nonlocal medical relief personnel at designated hospitals during containment of coronavirus disease 2019 (COVID-19) epidemic in Hubei province for providing references to on-site support in the case of controlling similar respiratory infectious disease epidemic.  Methods  During 10 – 15 February 2020, we conducted a questionnaire survey and an interview among 279 medical relief personnel and 15 relief team leaders/managers from Sichuan province. Information on personnel structure, relief support pattern, relief work content and difficulties in relief work in the containment of COVID-19 in Hubei province were collected and analyzed.  Results  The patterns of relief support practice reported by the respondents included: (1) being in the charge of medication for all COVID-19 patients in a designated ward; (2) taking full responsibility for the medication of COVID-19 patients in a designated ward or department by a relief support team; (3) the same as the second pattern but by the relief support team and local medical professionals. The nonlocal medical relief personnel reported executing the relief work smoothly under local professional and social environment but reduced working performance due to the lack of medical equipments, without adequate accompanying articles for daily living, and overworking-induced low work efficiency.  Conclusion  The professional skill of relief personnel, material preparation and pre-service training are important for nonlocal medical relief personnel conducting efficient onsite support in public health emergency response.
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2022, 38(5).  
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2022, 38(5): 0-1.  
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Special Report –
Changing trend in disease burden of lung cancer and its risk factors among Chinese residents, 1990 – 2019
LU You-hua, WANG Bing-xiang, WANG Jia-lin,
2022, 38(5): 513-517.   doi: 10.11847/zgggws1137000
Abstract(56) HTML(29) PDF 520KB(12)
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  Objective  To examine changing trend in disease burden of lung cancer and related risk factors among residents in China from 1990 to 2019 for developing targeted strategies on lung cancer prevention and treatment.   Methods  The open access data relevant to disease burden of lung cancer and its associates among Chinese residents in 1990, 2005 and 2019 were extracted from the Global Burden of Disease (GBD) Study 2019. We used years lived with disability (YLDs), years of life lost (YLLs), and disability adjusted life years (DALYs) to describe changes of lung cancer burden and population-attributable faction (PAF) to analyze the disease burden attributable to risk factors and epidemiological transition among the residents of various age groups from 1990 to 2019.   Results  In 2019 among Chinese male residents, the rates (1/100 000) of YLDs, YLLs, and DALYs of lung cancer were 19.10, 1 632.03, and 1 651.13 and all the rates were higher than those of 8.73, 731.14, and 739.87 among Chinese female residents; the three rates increased with age, with the highest rates of 76.17, 5 243.52, and 5 319.70 in the residents aged 70 years and over. Compared to those in 1990, the rates of YLDs, YLLs, and DALYs increased by 3.61%, 2.49%, and 2.50%, respectively in 2019. Among the 16 known risk factors of lung cancer, the top five with highest contributions to DALYs (million person years), DALYs rate (1/10 000) and PAF were smoking (10.75, 755.91 and 62.06%), environmental particulate pollution (3.86, 271.20 and 22.47%), second-hand smoke (1.35, 94.81 and 7.86%), high fasting plasma glucose (1.11, 77.87 and 6.47%) and home air pollution due to solid fuel use (0.85, 59.72 and 4.94%). Of the PAF for the 16 known risk factors during the period of 1990 – 2019, the PAFs of 8 factors increased, with the highest increase of 110.12% for environmental particulate pollution and other 8 factors′ PAF decreased, with the lowest decrease of 77.74% for home air pollution due to solid fuel use.   Conclusion  During 1990 – 2019 among residents in China, the disease burden of lung cancer was heavy and the YLDs, YLLs and DALYs rate of lung cancer increased; smoking is still a main risk factor for disease burden of lung cancer.
Changing trend in disease burden of mental illness and its risk factors in China, 1990 – 2019
LI Juan-juan, ZHAO Shu-yong, DU Yuan-ze,
2022, 38(5): 518-522.   doi: 10.11847/zgggws1136676
Abstract(41) HTML(13) PDF 591KB(12)
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  Objective  To explore changing trend in disease burden of mental illness and its risk factors in Chinese popula-tion from 1990 to 2019 for providing evidences to prevention and treatment of mental illness.   Methods  The open data of the Global Burden of Disease Study (GBD) were used in the study. Age-sex-specific prevalence rate, years lived with disability (YLDs) and disability-adjusted life years (DALYs) for 1990, 2000, 2010 and 2019 were adopted to describe the burden of mental illness and combined with population attributable fraction (PAF) to assess the changing trend in the burden.   Results  Among Chinese residents in 2019, the rate (1/100 000) for mental illness prevalence, YLDs and DALYs were 12 055.47, 1 426.78 and 1 426.62; the rates increased with the increment of age among the residents of various age groups, with the highest rates in the residents aged 50 – 69 years; compared to those in female residents, the rates were lower in male residents (prevalence: 10 886.21 vs. 11 649.28, YLDs: 1 294.39 vs. 1564.03, DALYs: 1 294.51 vs. 1 564.22). The DALYs (million person years) attributed to child sexual abuse and intimate partner violence increased from 1.063 and 3.094 in 1990 to 1.404 and 3.801 in 2019, with the increases of 32.04% and 22.87%. The DALYs attributed to bullying victimization, child sexual abuse and bullying, lead exposure and other environmental risks declined, with the highest decrease of 39.58% for both DALYs attributed to lead exposure and other environmental hazards. In comparison to that in 1990, the PAF of DALYs attributed to child sexual abuse increased by 1.73% in 2019; however, the PAF of DALYs attributed to bullying, child sexual abuse and bullying, intimate partner violence, lead exposure, and other environmental hazards decreased by 49.17%, 40.09%, 5.39%, 53.47%, and 53.47%, respectively. The DALYs due to intimate partner violence rose but that due to bullying declined during 2010 – 2019.   Conclusion   The disease burden of mental illness gradually increased from 1990 to 2019 among residents in China and disability was a main contributor to the burden. Psychological education and counseling should be promoted among the residents, especially among the elderly women at a higher risk of mental illness.
Disease burden of Alzheimer′s disease and other dementias in Chinese residents between 1990 and 2019: an age-period-cohort analysis and prediction
ZHANG Jing-ya, LU Yong-bo, LI Hao-ran,
2022, 38(5): 523-528.   doi: 10.11847/zgggws1138308
Abstract(52) HTML(20) PDF 738KB(15)
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  Objective  To examine changing trend in disease burden of Alzheimer′s disease and other dementias in China for providing suggestions to prevention and treatment of senile dementia.   Methods  The data on the incidence, mortality, years of life lost (YLL), years lived with disability (YLD), and disability adjusted life years (DALY) of Alzheimer′s disease and other dementias in Chinese population aged 55 years and above during 1990 – 2019 were extracted from the Global Burden of Disease Study 2019 (GBD 2019). The effects of age, period and cohort on the disease burden due to senile dementia were assessed with an age-period-cohort (APC) model. The incidence rate of senile dementia in next 30 years in China were also predicted based on the estimated changing trend in senile dementia morbidity and population profile.   Results  The analyses revealed following changing trends for senile dementia during the 30-year period in China: increasing in standardized incidence rate, standardized YLD rate and standardized DALY rate but decreasing in standardized mortality rate and standardized YLL rate. The results of APC model analysis showed that the risk of senile dementia increased with age and time series but decreased with year of birth during the period. The prediction results showed that the incidence rate of senile dementia would continue to rise in the next 30 years in China according to predictive analysis using Bayesian APC model. The estimated incidence rate of senile dementia in 2049 among Chinese population aged 55 – 94 years is 9.651‰ and the estimated incidence rate is 11.419‰ and 7.302‰ for female and male elderly population.   Conclusion  The disease burden of senile dementia increased in China during 1990 – 2019 and the increase in senile dementia risk was dominantly influenced by age effect and period effect. A continuous increase in the incidence rate of the disease, especially among elderly female population, is predicted. The results suggest that targeted health education and specific intervention program should be promoted for the control of the disease in the elderly population.
Changing trend in disease burden of skin and subcutaneous diseases among Chinese residents, 1990 – 2019
CHEN Dong-yu, YANG Xiao-yu, WANG Hong-xin,
2022, 38(5): 529-533.   doi: 10.11847/zgggws1137391
Abstract(43) HTML(22) PDF 553KB(6)
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  Objective  To analyze changing trend in the burden of skin and subcutaneous diseases among Chinese residents during 1990 – 2019 for providing evidences to the development of health policy.   Methods  Data on incidence and prevalence of skin and subcutaneous diseases among Chinese residents in 1990, 2000, 2010, and 2019 were collected from the Global Burden of Disease Study 2019 (GBD 2019). Indicators including incidence and prevalence number, crude and standardized incidence and prevalence, disability-adjusted life years (DALY) and estimated annual percentage change (EAPC) of the indicators were adopted to assess changing trend in disease burden of skin and subcutaneous diseases.   Results  Compared to that in 1990, an upward trend in the burden of skin and subcutaneous diseases was observed among Chinese residents in 2019, with the increases of 29.33% for incidence number, 27.20% for age-standardized incidence rate, 27.23% for prevalence number, 5.52% for age-standardized prevalence rate, and 14.75% for DALY, respectively; but the age-standardized DALY rate decreased by 0.29%. During the period, the age-standardized prevalence rate and DALY rate of skin and subcutaneous diseases in female residents were higher than those in the male residents; while the age-standardized incidence rate for female residents was lower than that for male residents. In terms of different skin and subcutaneous diseases in Chinese residents during the 30-year period, decubitus ulcer showed the highest increase in age-standardized incidence rate (with an EAPC of 1.078, 95% uncertainty interval [95% UI]: 0.826 – 1.317) and in DALY rate (EAPC = 2.202, 95% UI: 0.905 – 3.451); in contrast, cellulitis manifested the highest decrease in age-standardized incidence rate (EAPC = – 1.210, 95% UI: – 1.416 – – 1.019) and in DALY rate (EAPC = – 7.304, 95% UI: – 8.081 – – 7.087); the increase of age-standardized prevalence rate was the highest for acne vulgaris (EAPC = 1.087, 95% UI = 1.052 – 1.110) but the decrease was the highest for cellulitis (EAPC = – 1.097, 95% UI: – 1.289 – – 0.917).   Conclusion  Among Chinese residents during 1990 – 2019, the burden of skin and subcutaneous diseases was under control but still remained at a high level due to increased incidence rate and prevalence rate of the diseases; special concern should be paid to decubitus ulcer to attenuate the burden of skin and subcutaneous diseases.
Disease burden of cervical cancer and breast cancer in Chinese women in 1990 and 2019
YU Xi-he, ZHANG Jing-ru, JIANG Hai-rui,
2022, 38(5): 534-538.   doi: 10.11847/zgggws1136776
Abstract(51) HTML(19) PDF 515KB(10)
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  Objective  To analyze levels and changes of morbidity, mortality and disease burden of breast and cervical cancer among Chinese women in 1990 and 2019 and to provide a reference for developing effective strategies on breast and cervical cancer prevention and control and reducing relevant disease burden in the population.   Methods  The data of 1990 and 2019 on morbidity and mortality of breast and cervical cancer for global and Chinese women were extracted from the dataset of the Global Burden of Diseases (GBD). Disability-adjusted life years (DALY), years of life lost (YLL), and years lived with disability (YLD) were calculated to assess disease burden of breast and cervical cancer among the women.   Results  In 2019 in China, the number of morbidity and mortality were 368 400 and 93 500 for female breast cancer, with the increases of 354.25% and 125.85% compared to those in 1990; while for cervical cancer, the number of morbidity and mortality were 109 800 and 53 400, with the increases of 169.78% and 102.27%, respectively. The morbidity, mortality, DALY, YLL, YLD and their standardization rates for female breast cancer and cervical cancers increased with age, reaching higher levels after the age of 55 in both 1990 and 2019. The DALY for female breast cancer and cervical cancer were 2 877 200 person-years and 1 622 200 person-years in 2019, with the increases of 102.12% and 89.64% compared to those in 1990.   Conclusion  The disease burden of breast and cervical cancer among women in China increased significantly in 2019, suggesting that the prevention and control of the cancer should be further strengthened.
Trend in disease burden of leukemia in China, 1990 – 2019
DAI Meng-na, XI Yan, YIN Wen-qiang,
2022, 38(5): 539-546.   doi: 10.11847/zgggws1135530
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  Objective   To examine the disease burden of leukemia and its changing trend in China during 1990 – 2019 for providing a reference to strategy development of intervention and treatment of leukemia in China.   Methods   The data on leukemia incidence, mortality, and disability adjusted life year (DALY) in China were extracted from the database of the Global Burden of Disease Study 2019. Standardization was conducted for the incidence, mortality, and disability rate and Joinpoint regression model was adopted to analyze chronological trends in the standardized rates and to find meaningful turning points of the changing rates.   Results   The mortality, incidence rate and DALY of leukemia in China have been decreasing form 1990 to 2019. During the period for the standardized rates of leukemia, the mortality decreased averagely per year by 1.8% (1.5% for males and 2.2% for females), the incidence by 2.4 (2.1% for males and 2.2% for females), and the DALY by 1.8% (0.4% for males and 1.0% for females), respectively. The differences in the decreases of leukemia incidence, mortality and DALY rate were all statistically significant among general, male and female populations.   Conclusion   The disease burden of leukemia in China has decreased during 1990 – 2019, but the incidence rate has started to rebound. Under the influence of urbanization, industrialization and aging in China, the disease burden of leukemia may continue to increase, and it is necessary to strengthen researches on pathogenesis and risk factors of leukemia for developing effective intervention measures in high risk populations to slow down the increase in disease burden the disease.
Disease burden of gastric cancer in Chinese population: a comparison between 1990 and 2017
GUO Jia, HE Yuan, WANG Xue-mei,
2022, 38(5): 547-552.   doi: 10.11847/zgggws1134352
Abstract(35) HTML(14) PDF 524KB(8)
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  Objective   To compare the disease burden of gastric cancer among Chinese residents in 1990 and 2017 for providing references to decision making on gastric cancer prevention and health management.   Methods   Using the data of 1990 and 2017 from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, we analyzed the changes in years of life lost (YLL), years living with disability (YLD) and disability-adjusted life years (DALY) due to gastric cancer in Chinese population between 1990 and 2017.   Results   In contrast with those in 1990, higher gastric cancer-related YLL (7 648 000 person-years [PYs] vs. 7 340 000 PYs), YLD ( 167 000 PYs vs. 74 000 PYs), standardized YLD rate (8.5/100 000 vs. 8.4/100 000) and DALY (7 815 000 PYs vs. 7 415000 PYs) were observed in 2017 in Chinese population, with the increasing percentage of 4.2%, 125.7%, 1.2%, and 5.4%; but the standardized YLL rate declined from 779/100 000 to 383.2/100 000 and the standardized DALY rate declined from 787.3/100 000 to 391.7/100 000. There were gender, age, and region differences in the changes between 1990 and 2017 for disease burden due to gastric cancer in the population; in the males, the YLD increased by 152.1%, higher than 76.9% in the females; while the standardized YLL and DALY rate decreased by 46.4% and 45.8% in the males, both lower than in female population (58.5% and 58.0%); the YLL, standardized YLD rate, and DALY of the males increased by 13.7%, 11.6%, and 15.1% but those of the females decreased by 12.7%, 19.0%, and 11.9%, respectively; the DALY decreased in people aged < 50 and 55 – 59 years but increased in the people of other age groups, with the highest increase of 133.5% in the people ≥ 80 years; the standardized DALY rate decreased among all age groups and the decrease percentage (75.7%) was the highest for the people aged 20 – 24 years; the highest increase of DALY (86.2%) was observed in the population of Shaanxi province whereas the greatest decrease of DALY (25.1%) was in the population of Tibet Autonomous Region; the standardized DALY rate decreased in all 33 provincial-level administrative divisions, with the greatest decrease (66.7%) in Beijing and the least decrease (14.7%) in Shaanxi province.   Conclusion   The disease burden of gastric cancer in Chinese population decreased in 2017 compared to that in 1990 but the decrease differed by gender and region and the disease burden is still at a relatively high level.
Disease burden associated with road injury in 1999 and 2019: a comparison between China and the world
YU Xi-he, SHANG Pan-pan, JIANG Hai-rui,
2022, 38(5): 553-556.   doi: 10.11847/zgggws1135173
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  Objective  To examine the disease burden due to road injuries in China and the world in 1999 and 2019, and to provide references for the prevention and control of road injuries in China.   Methods  The data of 1999 and 2019 on road injury-related disease burden in population of China and the world were extracted from the Global Burden of Disease (GBD 2019) Study. Years of life lost (YLL), years lived with disability (YLD), and disability adjusted life years (DALY) attributed to road injury for China population and world population were analyzed and compared.   Results   For the years of 1999 and 2019, the mortality rate (1/100 000) of road injury in China population were 20.48 and 17.58, which were higher than those (19.69 and 15.49) in world population; the YLL rate (1/100 000) attributed to road injury in China population were 1 065.77 and 724.09, which were also higher than those (1 042.40 and 723.92) in world population; whereas, compared to those in world population, lower YLD rate (101.65/100 000 vs. 191.80/100 000), DALY (208.02/100 000 vs. 218.27/100 000), and DALY rate (1 171.41/100 000 vs. 1 234.20/100 000) were observed in China population. Among all road injuries in China population for the years of 1999 and 2019, the highest mortality rate (11.56/100 000 and 9.91/100 000), YLL rate (594.38/100 000 and 389.66/100 000), YLD rate (33.98/100 000 and 67.02/100000), and DALY rate (628.37/100 000 and 456.68/100 000) were attributed to pedestrian injury; and the all rates for the year of 2019 were higher than those in world population (mortality rate: 5.82/100 000, YLL rate: 50.86/100 000, YLD rate: 53.42/100 000, and DALY rate: 3.04.28/100 000). For the years of 1999 and 2019 in China population and consistent with the situations in world population, the disease burden of road injury was higher in males than in females; the age-specific road injury-related YLD rate was the highest in the elderly aged ≥ 70 years and the DALY rate was the highest in the people aged 15 – 49 and 50 – 69 years; the age-specific YLL rate was the highest in the people aged 15 – 49 years. For the year of 1999 in China population, the DALY rate of road injury caused by industrial injury and alcohol drinking in China was higher than those in world population; while the DALY rate of road injury correlated to low bone density, smoking and high body temperature were lower than those in world population. For the year of 2019 in China population, the DALY rate of road injury associated with low bone density and alcohol consumption were higher than those in world population; while the DALY rate of road injury caused by work-related injuries, high body temperature and smoking were lower than those in world population.   Conclusion   For China population in years of 1999 and 2019, the disease burden due to road injuries was relatively heavier and the mortality rate and YLL rate of road injuries were higher than those in world population. The study results suggest that males, middle-aged and elderly people, the people with low bone density or alcohol consumption are key populations in road injury prevention in China.
Burden of cardiovascular disease attributable to dietary lead exposure among adults in China, 2017
LI Yi-ling, YAN Yi-zhong, LIU Jia-lin,
2022, 38(5): 557-562.   doi: 10.11847/zgggws1137343
Abstract(47) HTML(11) PDF 582KB(11)
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  Objective  To analyze the burden of cardiovascular disease (CVD) attributable to dietary lead among Chinese adults aged 18 years and over in 2017, and to provide a reference for assessing health hazards caused by exposure to lead in diet.   Methods  The data on disease burden of CVD among residents in China were extracted from the Global Burden of Disease Study 2017 (GBD 2017). The information relevant to blood lead (BLL), bioavailability of lead ingestion through digestive tract and respiratory tract for Chinese adults and lead concentrations in food, air, and drinking water were retrieved form literatures published from January 2000 to July 2020 via searching PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), WanFang Database, and China Biology Medicine Database (CBMdisc). Population attribution fraction (PAF) was calculated using comparative risk assessment to estimate the burden of cardiovascular disease due to lead exposure. Based on the principle of integrated exposure uptake biokinetic (IEUBK) model, the contribution rate of dietary lead exposure to BLL was evaluated.   Results  The pooled mean BLL for Chinese adults was 5.23 μg/dL (5.96 μg/dL for males and 4.90 μg/dL for females). In 2017, the total disability-adjusted life years (DALYs) of cardiovascular disease attributable to lead exposure in Chinese adults was 3.2396 million years and the standardized attributable DALY rate was high for the adults in Sichuan, Yunnan, and Hunan province, resulting in the loss of 635.00, 633.62, and 547.36 healthy life years per 100 000 people, respectively. The dietary lead was a major contributor to the adults′ lead exposure, accounting for 57.01% and 58.60% of total lead exposure in male and female adults. The DALYs of cardiovascular disease attributed to dietary lead exposure was 1.8634 million, including 602.3 thousand DALYs of ischemic heart disease, 997.0 thousand DALYs of stroke, and 193.7 thousand DALYs of hypertensive heart disease.   Conclusion   For Chinese adults in 2017, lead exposure contributes to a significant ratio of burden of cardiovascular disease, and diet is a primary source of lead exposure.
Epidemiological Research
Public health safety literacy and its influencing factors among residents in four provinces of China
NING Yan, HOU Xiao-hui, WANG Xiao-yan,
2022, 38(5): 563-569.   doi: 10.11847/zgggws1137705
Abstract(45) HTML(17) PDF 601KB(6)
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  Objective  To explore the status and influencing factors of public health safety literacy (PHSL) among residents in four provinces of China for providing references to the development of appropriate intervention strategies.   Methods  We recruited 2 809 urban and rural residents aged 15 – 69 years in three provinces (Hubei, Guangdong and Sichuan) and Beijing municipality using stratified multistage cluster sampling and conducted an on-site self-administered electronic questionnaire survey among the residents during April – June, 2021. A scale with three domains (each with a maximum score of 40) was designed to assess the PHSL of the residents. T-test, one-way analysis of variance (ANOVA), and χ2 test were adopted in univariate analysis and logistic regression in multivariate analysis.   Results   For all the participants, the mean overall PHSL score was 81.61 ± 13.71 and the mean domain scores were 29.21 ± 5.89 for PHS perception, 25.10 ± 5.10 for PHS knowledge, and 27.30 ± 4.87 for PHS skills. There were 80.85% of the participants being assessed with basic PHSL (with the overall scale score of ≥ 72) and there were 86.69%, 61.05%, and 78.96% of the participants being assessed with basic PHS perception, knowledge, and skills (with the domain scores of ≥ 24); also based on the scale of overall score of ≥ 96 and domain scores of ≥ 32, the proportion of the participants with good PHSL was 15.70% and the proportions of participants with good PHS perception, knowledge and skills were 35.32%, 14.03% and 20.15%, respectively. Multivariate logistic regression analysis showed that PHSL was associated with residential region, sex, education and household income. The participants residing in Hubei, Sichuan, and Guangdong province were less likely to have basic/good PHSL, with the odds ratios (OR) of 0.485/0.422, 0.488/0.699, and 0.389/0.566 in contrast to those residing in Beijing municipality. The participants being female (versus male: OR = 1.336/1.283), with the education of higher than primary school education or below (junior high school: OR = 1.786/1.205; senior high or vocational or technical secondary school: OR = 2.204/2.013; college and above: OR = 2.932/3.710), with the annual household income of more than 30 000 RMB yuan (30 000 – 60 000: OR = 1.660/1.648; ≥ 120 000: OR = 1.865/2.145) were more likely to have basic/good PHSL.   Conclusion  For 15 – 69 years old residents in four provincial administrative regions of China, the PHSL still needs to be improved and the residents′ PHSL is influenced mainly by gender, education, annual household income and residential region.
Changing trend in eating away from home and its impact on obesity among Chinese adults aged 18 and over: 2002 – 2015
WEI Xiao-qi, JU La-hong, YU Dong-mei,
2022, 38(5): 570-576.   doi: 10.11847/zgggws1137746
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  Objective  To analyze the trend of eating away from home (EAFH) and its influence on obesity among Chinese adults from 2002 to 2015.   Methods  The data on 44394, 37703 and 77944 residents aged 18 years and above were extracted from three waves of China National Nutrition and Health Survey (CNNHS) conducted during 2002, 2010 – 2012 and 2015 across the country. The proportion and trend of EAFH among the adults by demographic and social-economic factors were analyzed with Chi-square and Cochran-Armitage trend test. Multivariate logistic regression analysis was used to explore influencing factors of EAFH and the influence of EAFH on obesity.   Results  Among all the participants surveyed in 2002, 2010 – 2012, and 2015, the proportions of reporting EAFH in past week were 7.2%, 16.5%, and 20.2%, with a significant increasing trend (P < 0.0001); for the male and female participants, the proportions were 9.8%, 20.0%, and 25.1% and 5.0%, 13.8%, and 15.8%, respectively, both with a significant increasing trend (P < 0.0001). The results of multiple logistic regression showed that the participants with following characteristics were more likely to have EAFH: being male, at ages of 18 – 44 years, unmarried, with the annual household income of ≥ 20 000 yuan RMB per capita, having the education of college and above, and being on-the-job workers of other than agriculture, forestry, animal husbandry, fisheries and water conservancy industry; the results also revealed that the male participants reporting EAFH were at an increased risk of obesity (odds ratio [OR] = 1. 166, ( 95% confidence interval [95% CI]: 1.101 – 1.235; P = 0.002), but the females with EAFH were at a decreased risk of obesity (OR = 0.922, 95% CI: 0.861 – 0.986, P = 0.001).   Conclusion  During 2002 – 2015 among Chinese adults aged 18 and above, the proportion of EAFH showed an increasing trend; the proportion was higher and the increasing trend was more obvious among the 18 – 44 years old unmarried adults with higher education and income. Frequent EAFH could increase obesity risk in the population. The results suggest that health education relevant to EAFH should be promoted among adult population in China.
Allocations of school doctors and clinics in public primary and secondary schools across Chinese mainland, 2019 – a general survey
TANG Xiao-zhe, LIU Yao, LIU Dong-shan,
2022, 38(5): 577-581.   doi: 10.11847/zgggws1138263
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  Objective   To examine the status of doctors and clinics allocation in public primary and secondary schools across the mainland of China for providing a reference to the formulation of school health strategies.   Methods  With Epidemiological Dynamic Data Collection Platform (EDDC) of the Chinese Center for Disease Control and Prevention, we conducted a general survey on school doctors and clinics allocation among primary and secondary schools across 30 provincial-level administrative divisions in the mainland of China from October 2019 to February 2020.   Results  Among the 193 492 public primary and secondary schools surveyed, 33 407 (17.27%) had school doctors and there were 44 881 school doctors providing healthcare services to 155 143 857 students in 2019, with a student-school doctor ratio of 3457 : 1. Of the 66 682 surveyed schools with the total student number of 600 and above, only 1 296 (1.94%) met the national standard (≤ 600 : 1) for the student-school doctor ratio. School clinics were set up in 15.41% (n = 29 809) of all schools surveyed. There were statistical disparities in allocations of part/full time school doctors and school clinics, student-school doctor ratio, proportions of the school doctors taking professional training programs/refresher courses among the schools in different regions and the schools of various types (primary/secondary/vacation school and boarding/non-boarding) (all P < 0.01).   Conclusion  There were significant deficits in allocations of school doctors and clinics among primary and secondary schools across China and region- and school type-specific measures should be taken to improve the situation.
Working status of primary health care workers during the epidemic period: a cross-sectional survey
HUANG Lei, MIAO Yan-qing
2022, 38(5): 582-584.   doi: 10.11847/zgggws1137318
Abstract(46) HTML(10) PDF 470KB(5)
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  Objective  To examine working duty and load and changes in salary among primary health care workers (HCWs) during the epidemic period for improving professional capability construction of medical staff in China.   Methods  Using multistage cluster sampling, we recruited 3030 HCWs from 191 community/township health care centers in 6 provincial level regions (Zhejiang, Hubei, Henan, Yunnan, and Sichuan province and Tianjin municipality) across China. A survey with a self-designed questionnaire among the primary HCWs were conducted during January, 2021.   Results  Valid information were collected from 98.05% (2 971) of the workers. Reported by the respondents, the main involvements during the epidemic period included the dissemination of epidemic prevention and control knowledge, population screening, epidemiological investigation, and home isolation observation. Of the 811 clinicians surveyed, 37.99% (310) reported part-time participation in basic public health services, with the health management for the elderly or major chronic disease patients being the highest reported service item. Decrease in overall income during the epidemic period was reported by 50.82%(1 510) of the respondents; more respondents being clinicians of traditional Chinese medicine reported the decrease and the proportion of reporting the decrease was higher among the respondents in eastern regions.   Conclusion  During epidemic control in China, primary health care workers undertook tasks according their responsibilities and played an important role as health gatekeepers. Talent incentive policies and integration of treatment and prevention should be implemented to promote professional capability of the health care workers.
Experimental Study
Antagonistic effect of andrographolide on cigarette smoke-induced lung injury in mice
LIU Jia-li, DING Gan-ling, WANG Jia-qi,
2022, 38(5): 585-588.   doi: 10.11847/zgggws1136848
Abstract(52) HTML(17) PDF 1711KB(27)
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  Objective  To explore protective effect of andrographolide on lung injury in mice exposed to cigarette smoke, and to provide evidences for the prevention and treatment of chronic obstructive pulmonary disease (COPD).   Methods  Forty mice were randomly divided into a control group (A), cigarette smoke exposure group (B), normal saline group (C), and andrographolide group (D). All the mice were exposed to cigarette smoke (300 mg/m3) for one hour, twice a day, five days in a week for 12 weeks, except for those of group A. The mice of group D were treated with an intraperitoneal injection of andrographolide at dose of 20 mg/kg body weight once a week after last cigarette smoke exposure during the week and the mice of group C were treated simultaneously but with 200 μL saline. By the completion of all the treatments, lung tissue and blood samples of the mice were collected for determinations of alveolus mean lining interval (MLI), mean alveolar area (MAA), interleukin-6 (IL-6)/interleukin-8 (IL-8)/matrix metalloproteinase-9 (MMP-9) in serum and bronchoalveolar lavage fluid (BALF). Correlations among IL-8, IL-9 and MMP-9 were analyzed.   Results  The MLI, MAA, IL-6, IL-8 and MMP-9 of the mice exposed to cigarette smoke were significantly higher than those of the control mice. Compared with those of the mice with cigarette smoke exposure, the MLI, MAA, IL-6, IL-8 and MMP-9 were significantly decreased in the mice of andrographolide group. In BALF, the concentration of IL-6 and IL-8 were significantly correlated with that of MMP-9.   Conclusion  Andrographolide could reduce BALF MMP-9, exerting an anti-inflammatory effect on lung injury induced by cigarette smoke exposure in mice.
Survey and Report
Construction of health effect-oriented comprehensive evaluation index system for essential national public health service
YOU Li-li, CHEN Xin-yue, YANG Ling-he,
2022, 38(5): 589-596.   doi: 10.11847/zgggws1137292
Abstract(35) HTML(16) PDF 573KB(3)
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  Objective   To construct an effect-oriented comprehensive evaluation index system for national basic public health services, and to provide methods and tools for innovating evaluation method of basic public health projects and promoting the transformation from process evaluation to health outcome evaluation.   Methods  Primary, secondary and tertiary indexes were constructed and selected with literature review, field interview of senior professionals, expert Delphi consulting and logical analysis; subjective and objective weights of the indexes were calculated through analytic hierarchy process and entropy weight method.   Results  Through literature analysis and interview consultation, an index pool consisting of 3 first-, 25 second- and 104 third-level indicators was preliminarily formed, including 47 third-level indicators reflecting health effects. For the first round of expert Delphi consultation on indicator screening, the positive coefficient of experts is 97.5%, the expert authority coefficient is 0.82, and the expert familiarity coefficient is 0.88. The final comprehensive evaluation index system consists of three first-level indexes of project investment, implementation and health effect, with the weights of 11.35%, 26.48% and 62.18%, along with 20 second- and 54 third-level indexes. Among the health effect indicators, the weight of awareness of and satisfaction to health services was the highest (16.39%), followed by the weight of health management in chronic disease patients (14.97%), children′s health management (12.42%), maternal health management (12.42%), and health education (5.43%). Among the three-level effect indexes, the weight of residents′ satisfaction to health service was the highest (7.25%), followed by the incidence of hypertension and diabetes complications in the managed population (5.35%) and the incidence of diabetes complications in the managed population (5.27%). Besides the health statistics from routine monitoring system in China, the electronic health records in residents′ information system can be used as a main data source for health effect indicators.   Conclusion  The comprehensive index system constructed in this study for the evaluation on essential national public health service is effect-oriented and can be used for regular and periodical evaluation on the basis of making full use of residents′ health records in the basic public health information system.
Effectiveness of NPIs and vaccine coverage in the prevention and control of COVID-19 epidemic – an ecological comparative study among Australia, Korea, Singapore, Israel and India
YAN Wen-xin, ZHU Zheng, WU Yun-xiao,
2022, 38(5): 597-603.   doi: 10.11847/zgggws1138325
Abstract(185) HTML(63) PDF 915KB(45)
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  Objective  To compare measures and effectiveness of case detection, transmission control, and vaccination for containment of coronavirus disease 2019 (COVID-19) epidemic in Australia, South Korea, Singapore, Israel, and India for providing evidences to the development of strategies on worldwide prevention and control of the epidemic.   Methods  The data on COVID-19 epidemic from January 1st 2020 through 2021 in the five countries were retrieved from the website of Our World in Data. Country-specific effects of non-pharmacological interventions (NPIs) and vaccinations on infectious source tracing, intercepting transmission, and protecting susceptible populations in the five countries were assessed by comparing correlations between the daily numbers of testing and incidence cases, the Oxford-stringency index and daily incidences, and the number of fully vaccinated persons per 100 population and daily mortalities.   Results  The severity of COVID-19 epidemic was controlled by increased daily number of detection in a certain extent and the daily number of confirmed incidence cases decreased after the day with the highest detection number. The Oxford-stringency index increased with the worsening of COVID-19 epidemic but decreased somewhat with the weakening of the epidemic and the decrease in the index could relate to a rebound of the epidemic. The case-fatality rate of COVID-19 decreased with the increase of fully vaccination rate.   Conclusion  Countries around the world should actively learn from international experience, follow the laws of epidemiology, start from controlling the source of infection, cutting off the transmission route and protecting susceptible people, adapt NPIs and promote booster vaccination universally, further research and development, for coping effectively with the global public health challenge.
Revenue of maternal and child health institutions in China – an analysis on monitoring data of 2020
MA Zhong-hua, HU Huan-qing, HUANG Ai-qun,
2022, 38(5): 604-609.   doi: 10.11847/zgggws1137260
Abstract(32) HTML(13) PDF 489KB(4)
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  Objective  To examine revenue situation of maternal and child health (MCH) institutions at all administrative levels in China and to provide evidences for governmental decision-making.   Methods  The data on revenue of 3 094 MCH institutions in 31 provincial level administrative regions across the mainland of China in 2020 were collected through the national monitoring and direct reporting system for MCH institutions; other relevant information were also extracted from China Health Statistical Yearbook of 2020. The revenue and financial subsidy income of the MCH institutions in 2020 were analyzed and compared.   Results  The entire financial subsidy income of 63.09 billion yuan RMB accounted for 28.7% of the total revenue of MCH institutions in 2020 and the proportion was much lower than that for other public welfare institutions including the centers for disease control and prevention (73.6%) and health supervision institutes (91.5%). There were obvious differences in the median values (million yuan) of the revenue for the MCH institutions in various regions, at different administrative levels, and belong to different financial management categories, with significant higher medians for the MCH institutions in the eastern region (25.81), at provincial level (712.17) and under the combined financial management for public welfare of first- and second-category (70.33) compared to other MCH institutions.   Conclusion  At present, unreasonable composition, single source, and insufficient financial support are main problems for revenue of MCH institutions in China, suggesting that guarantee mechanism and policy flexibility relevant to revenue of MCH institutions need to be improved urgently.
Epidemiological characteristics of metabolic phenotypic heterogeneity in adults with obesity in Shaanxi province
JING Hui, TENG Yu-xin, Samuel Steven Chacha,
2022, 38(5): 610-613.   doi: 10.11847/zgggws1136326
Abstract(25) HTML(11) PDF 483KB(1)
Abstract:
  Objective  To examine epidemic characteristics of obesity metabolic phenotype heterogeneity among urban adults in Shaanxi province, and to provide evidences for individualy stratified identification and classification management of obesity metabolic phenotype.   Methods  Data on 13 072 urban adults aged 20 – 89 years without major diseases were collected from Shaanxi Urban Cohort Baseline Survey of Natural Population Cohort Study in Northwest China conducted from 2017 to 2019. According to the status of obesity and metabolic abnormality, the adults were further divided into four subgroups of metabolic healthy non-obesity (MHNO), metabolic unhealthy non-obesity (MUNO), metabolic healthy obesity (MHO) and metabolic unhealthy obesity (MUO), and the heterogeneity and epidemiological characteristics of different obesity metabolic phenotype groups were analyzed.   Results  Of all the adults, the majority (66.55%, 8 700) were with MHNO, followed by those with MUNO (22.56%, 2 949), MHO (4.09%, 535) and MUO (6.79%, 888). For the male adults, the proportion of MHNO, MUNO, MHO and MUO population was 55.8%, 27.9%, 6.1% and 10.2%, respectively; the metabolic phenotype of obesity changed with age (χ2trend = 9.143, Ptrend = 0.002), with the proportion of MUNO increasing with the increase of age (χ2trend = 217.096, Ptrend < 0.001) and the proportions of NHNO and MHO decreasing with the increase of age (both Ptrend < 0.001). For the female adults, the proportion of MHNO, MUNO, MHO and MUO were 55.8%, 27.9%, 4.09% and 6.79%, and the proportion also changed with age (χ2trend = 486.235, Ptrend < 0.001); the proportion of MUNO, MHO and MUO increased with the increase of age (Ptrend < 0.05 all) but the proportion of MHNO decreased with the increase of age (χ2trend = 738.600, Ptrend < 0.001). When the obesity standard changed from body mass index (BMI) ≥ 28.0 to BMI ≥ 25.0, the proportion of MHO increased from 4.09% to 16.06%; when the metabolic abnormality criterion changed from ≥ 2 to ≥ 0, the proportion of MHO decreased from 4.09% to 1.02%.   Conclusion  The metabolic heterogeneity of obesity exists obviously among urban adults in Shaanxi province; the proportion of the adults with obesity but normal metabolism is low, while the metabolic abnormality is prominent in obese adults.
A school cluster outbreak of COVID-19 caused by SARS-CoV-2 Omicron variant
LI Ya-fei, FAN Wei, WANG Wen-hua, et.al,
2022, 38(5): 614-618.   doi: 10.11847/zgggws1138512
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Abstract:
  Objective  To analyze a cluster outbreak of coronavirus disease 2019 (COVID-19) caused by the Omicron variant of severe acute respiratory syndrome coronavirus virus 2 (SARS-CoV-2) in a boarding school for providing a reference to COVID-19 epidemic prevention and control.   Methods  From China Information System for Disease Control and Prevention, we extracted the information on all COVID-19 cases laboratory-confirmed during January 8 – 19, 2022 among the students and teachers in a boarding school at a county in Henan province. Incidence rate (proportion) and histogram were used to describe epidemiological characteristics of the outbreaks. Basic reproduction number (R0) and time-varying reproduction number (Rt) were calculated with R software.   Results  Totally 283 COVID-19 cases infected with SARS-CoV-2 Omicron BA.1 variant were diagnosed during the 12-day period and the attack rate was 6.8% for the 4 124 students and teachers of the school. The cases occurred in 23 classes (all for senior high school students and only one for junior high school students) and the class-specific attack rate ranged 1.6% – 76.8%. For the 269 student cases at a mean age of 17.0 ± 0.9 years, the male to female ratio was 1 : 1.09; while the mean age was 24.0 (25th percentile = 23.0, 75th percentile = 30.0) years for the 14 teacher cases. The estimated R0 was 5.46 (95% confidence interval: 3.11, 8.77); the estimated Rt increased first and then declined. Obvious symptoms were observed among 18.4% (52) of all cases and major clinical manifestations included fever, sore throat and cough, which occurred in 69.2%, 30.8% and 19.2% of the 52 sufferers. The confirmed cases were clinically classified as common or mild type patients.   Conclusion  The Omicron variant of SARS-CoV-2 identified among the cases of the school cluster outbreak of COVID-19 was highly contagious but induced relatively mild clinical symptoms. Follow up studies need to be conducted among the cases of the epidemic outbreak to assess long-term adverse effects of the viral infection in the infected people.
Epidemic characteristics and key measures of prevention and control in key places and units under regular COVID-19 prevention and control – a literature analysis
GAO Peng, LI Meng-yao, LI Qiao-sheng, Yawen Jia, Liangyu Kang, Jue Liu, Min Liu,
2022, 38(5): 619-623.   doi: 10.11847/zgggws1138136
Abstract(75) HTML(27) PDF 561KB(16)
Abstract:
  Objective  To examine weaknesses in epidemic prevention and control in key places and units during regular coronavirus disease 2019 (COVID-19) containment for improving control measures on the epidemic in the future.   Methods  Totally 11 studies on COVID-19 epidemic and its control published up to January 20, 2022 were retrieved from China CDC Weekly. The information on key strategies for COVID-19 epidemic control was collected from relevant documents issued by government departments during the epidemic period.   Results  The places or units with more COVID-19 infections were characterized by frequent gathering of people, high pedestrian flow, and with relatively closed spaces. Most of the index cases were detected among examinees attending medical institutions for compulsory/voluntary/routine screening test and most of the epidemic outbreaks were related to imported cases or imported good with virus contamination. For the key places and units involved in epidemics without local cases, the implemented preventive measures included preparing anti-epidemic materials, keeping ventilation and cleaning of indoor environment, conducting routine disinfection, improving staff management, implementing monitoring on migrant people, and strengthening the publicity of epidemic prevention knowledge; additional measures implemented in the key places and units with local cases were carrying out immediate epidemiological investigations to identify risk areas and performing nucleic acid testing among populations in risk areas.   Conclusion  In prevention and control of COVID-19 epidemic, special concern should be paid to medical institutions and places and units correlated with overseas affairs or imported goods. In future, the measures to be strengthened for epidemic containment are the identification of high risk population, the quarantine of imported cargoes, , strict control of nosocomial infection, and epidemic prevention in holidays.
Emotional responses and behavioral coping mechanism to sufferers′ privacy leakage among Chinese internet users during public health emergencies
LIU Zhi-xin, LIU Jun-ping, SUN Ming-lei,
2022, 38(5): 624-628.   doi: 10.11847/zgggws1136921
Abstract(39) HTML(13) PDF 830KB(4)
Abstract:
  Objective  To study emotional reactions to and behavior intentions about sufferers′ privacy leakage among internet users in China during public health emergencies (PHE) and to provide references for improving government supervision capability and risk communication strategy.   Methods  Totally 54 blogs and 6 946 comments relevant to two events of PHE sufferers′ privacy leakage were retrieved from Sina Weibo during March 2021 using Octoparse software. High-frequency words were extracted from the retrieved corpus with ROST Content Mining software and a grounded theory-based textual analysis was performed after open, spindle and selective coding with NVivo12.0.   Results  Finally 25 initial and 11 main categories were identified; a 'situation-perception-reaction' theoretical model was constructed; and a logical framework was formed for the internet users′ emotional response and coping behaviors to the incidents of PHE sufferers′ privacy leakage.   Conclusion   Influenced by personal characteristics, risk information and other factors, the self-perception on sufferers′ privacy leakage would occur among internet users in public health emergencies; based on the self-perception, the internet users may produce corresponding emotional reactions, and finally make behavioral response choices.
Dissemination of research findings in public health among science and technology professionals in China
LIU Jing, HU Yi-luan, YIN Xue-jun,
2022, 38(5): 629-633.   doi: 10.11847/zgggws1138373
Abstract(51) HTML(47) PDF 583KB(5)
Abstract:
  Objective  To investigate the dissemination of research findings in public health and its influencing factors among science and technology professionals in China.   Methods  An online survey was conducted in January 2022 among 1 466 science and technology professionals recruited from Chinese Preventive Medicine Association, Chinese Nutrition Society, Chinese Antituberculosis Association, and Chinese Association of STD and AIDS Prevention and Control. The information on the professionals′ research experience, working years, academic papers published, ways of funding support to dissemination, training experience in dissemination and implementation (D&I) research, and work experience in research-related setting were collected and associations of the professionals′ characteristics with dissmination of research findings were analyzed.   Results  Valid responses were collected from 956 (65.2%) of the professionals recruited and of the valid respondents, 737 reported being engaged in researches. For all the 737 respondents conducting research works, 58.1 % stated ever having disseminated their research findings, while the proportions of ever conducting the dissemination were 64.3%, 64.4%, and 67.8% for the respondents spending most of working time in research practice, doing research work for more than 20 years, and having published more than 6 academic papers during past 3 years, respectively. The respondents with following characteristics were more likely to conduct the dissemination of research finding: receiving funds that support to the disseminations through various ways (odds ratio [OR] = 2.39, 95% confidence interval [95% CI]: 1.61 – 3.54), ever taking a part in D&I research-related training (OR = 2.05, 95 % CI: 1.36 – 3.09), and having work experience in a practice or policy setting (OR = 5.38, 95% CI: 3.75 – 7.73) according to the results of multivariate binary logistic regression analysis.   Conclusion  A lot of effort is required for promoting the dissemination of scientific research findings among Chinese science and technology professionals in public health.
Overview
Research progress in carcinogenicity of metalworking fluids
ZOU Li-hai, KANG Dian-min
2022, 38(5): 634-636.   doi: 10.11847/zgggws1135442
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Abstract:
Metalworking fluids (MWFs) is used in the machinery manufacturing industry in huge quantities and with a large number of exposed workers. MWFs can simply be divided into 2 categories: oil-based and water-based fluids, or by its nature into 4 categories: straight oils, soluble oils, synthetic fluids and semi-synthetic fluids. During machining and grinding operations, MWFs is sprayed directly onto the exposed skin of the operator′s hands or face, or is dispersed into the air of the workplace environment and inhaled by the operator, resulting in occupational health hazards due to mechanical splashing, rotating workpiece forces, atomisation and evaporation, burning or pyrolysis due to increased surface temperature of the metal cutting workpiece. The health hazards of MWFs to skin and respiratory system are well established, but the issue of its carcinogenicity is still debated. In this study, the carcinogenicity of MWFs is reviewed in terms of the relationship between exposure to MWFs and cancer, the relationship between MWFs types and cancer, and the carcinogenic factors of MWFs for providing a reference for further research on the health hazards of MWFs.
Public Health Forum
Establishment and application of a multisectoral coordination mechanism for containment of COVID-19 epidemic in Fujian province – a brief discussion
MAO Yi-meng, WU Sheng-gen, ZHENG Kui-cheng,
2022, 38(5): 637-640.   doi: 10.11847/zgggws1138330
Abstract(230) HTML(39) PDF 507KB(40)
Abstract:
For effective containment of coronavirus disease 2019 (COVID-19) epidemic, a multisectoral coordination mechanism was established and applied in emergency responses to three local and two major imported epidemics in Fujian province. The multisectoral coordination mechanism is characterized by the involvement of three departments (public health, public security, and industry and information technology) and comprehensive utilization of big data from the three departments. The application of the multisectoral coordination mechanism improved the efficiency of routine control measures and played an important role in successful coping with the COVID-19 epidemics in the province by adopting more active procedures instead of passive managements.