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2021 Vol. 37, No. 8

2021, 37(8): .
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2021, (8): 1-6.
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Special Column – Promoting People′s Health: Efforts of Communist Party of China in the Century
Narrative evolution and basic experience: the Chinese Communist Party′s public health policy over a century
CAO Zhi-li, CAO Hai-jun
2021, 37(8): 1177-1181. doi: 10.11847/zgggws1134251
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The Communist Party of China (CPC) led Chinese people to carry out the revolution, national construction, and reform and development for the national rejuvenation since the party′s founding a century ago. The evolution of CPC′s public health policies could be generalized into four periods: paying equal attention on revolution and health (1921 – 1948), being engaged in public welfare (1949 – 1978), promoting market-oriented reform (1979 – 2003), and improving emergency and health system (2004 – present). The CPC′s policy principle is transformed from curing the sickness and saving the patient, having universal welfare, enhancing market efficiency to providing scientific service. The CPC obtained valuable experiences in making public health policy in different stages of social development and acquired advanced public health concept, which will guarantee the development and progress of public health in China.
Criterion, Guideline, Consensus
Basic guideline of the function for vaccination vehicle (T/CPMA 025 — 2021)
Chinese Preventive Medicine Association
2021, 37(8): 1182-1184. doi: 10.11847/zgggws1136036
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Special Report –
Elimination of mother-to-child transmission of HIV in Yunnan province: an evaluation on 14-year process
ZHENG Min, ZANG Yan, LI Yan,
2021, 37(8): 1185-1190. doi: 10.11847/zgggws1129988
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  Objective  To evaluate the effect and mechanism of intervention measures for the elimination of mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) in Yunnan province from 2006 to 2019 for providing evidences to the control of MTCT of HIV in other regions.   Methods   Information on implemented strategies and measures for prevention of MTCT of HIV in Yunnan province since 2006 were collected with literature reviews. Case records and follow-up registration cards for HIV-infected puerperae and their newborns and monthly reports for the prevention of MTCT of HIV in Yunnan province from 2006 through 2019 were extracted from National Information Management System for Prevention of MTCT of HIV. The collected data were analyzed statistically and relevant indicators were calculated to evaluate the efficiency of the implemented strategies and measures in the province.   Results  Relevant management process and system were established in the province to ensure the implementation of HIV antibody testing in all pregnant women and all measures for HIV-infected puerperae and their newborns including anti-viral treatment, health care, follow-up detection, referral, individualized management and infection assessment, and information monitoring. From 2006 to 2019, the detection rate of HIV antibody in pregnant women increased from 79.09% to 99.97% and the HIV antibody detection rate during the pregnancy increased from 44.56% to 99.89%; the rate of anti-viral treatment among HIV-infected puerperae and their children increased from 75.92% to 99.72%, and from 86.90% to 99.91%, respectively; whereas, the adjusted the rate of MTCT of HIV decreased from 8.78% to 1.93%.   Conclusion   In Yunnan province, the strategies and measures implemented from 2006 to 2019 for elimination of of MTCT of HIV were effective and major outcome indicators for the control of MTCT of HIV met the requirements proposed by World Health Organization.
Epidemic dynamics of HIV/AIDS in Anhui province: a traceback study
WANG Zhen, JIN Xin, WU Hui,
2021, 37(8): 1191-1194. doi: 10.11847/zgggws1133147
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  Objective  To traceback the epidemic dynamics of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in Anhui province.   Methods  Using Bayesian phylogenetic method, we displayed the epidemic dynamics of HIV/AIDS in Anhui province with time-dependent changes in effective reproductive number (Re) estimated based on genomic sequences of the two main subtypes (CRF 01AE and CRF 07BC) of HIV in the province.   Results  The HIV subtype CRF 01AE was estimated to have been originated in 1982 (95% highest posterior density [HPD]: 1973 – 1990); while the subtype CRF 07BC was estimated to have been originated in 1992 (95% HPD: 1976 – 1998). A more obvious time-dependent change in Re from 2011 to 2014 was observed when combining the Bayesian phylogeny of the two main HIV subtypes and the Re median varied from the lowest of 1.34 (95% HPD: 0.94 – 1.80 ) to the highest of 2.20 (95% HPD: 1.67 – 2.84) during the period.   Conclusion   Gene sequence analysis on prevalent HIV strains can reveal the trajectory of HIV/AIDS epidemic transmission in Anhui province.
Internal social capital for social organizations engaged in AIDS prevention and control in China: a cross-sectional study
ZHANG Shan-shan, CHEN Ren, ZHAO Ran,
2021, 37(8): 1195-1200. doi: 10.11847/zgggws1130596
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  Objective  To analyze internal social capital elements of social organizations participating in AIDS prevention and control from the perspective of meso-social capital for promoting the development of internal social capital of relevant organizations.   Methods  With multistage random cluster sampling and a self-designed questionnaire, we conducted a survey among 211 social organizations engaged in AIDS prevention and control in 18 municipalities/prefectures of 8 provinces with different AIDS epidemic intensity across China during August – October 2015. SPSS 18.0 was used in data analysis.  Results  The results of univariate and multivariate analysis demonstrated that influencing factors for different internal social capital elements of social organizations included: (1) an organization′s establishment duration and the number of different types of target population for trust factor; (2) variation in the number of organization members for common language and vision; (3) item and number of AIDS prevention and control domains for informal network; (4) an organization′s establish-ment duration for formal network; and (5) the number of target population and funding resources for support factor.   Conclusion  There is a certain amount of social capital within the social organizations engaged in AIDS prevention and control in China but the internal social capital differs by regional AIDS epidemic intensity, social capital factor, and specific factor item.
Trajectory of and impact of macro factors on AIDS incidence in Shaanxi province, 2006 – 2018
ZHU Ni, LI Chao, ZHOU Ti-cao,
2021, 37(8): 1201-1204. doi: 10.11847/zgggws1129184
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  Objective   To analyze variation trend of AIDS incidence and the association of macroeconomy and health service with AIDS incidence in Shaanxi province from 2006 to 2018.  Methods   The data on registered AIDS cases and demographics in Shaanxi province from 2006 to 2018 were extracted from National Disease Prevention Information System; the indicators for macroeconomy and health service of the same period were collected from Shaanxi province statistics yearbooks. Multi-level models were adopted to analyze variation trend in AIDS incidence and influences of macroeconomy on AIDS incidence during the period.  Results   A non-linear correlation between the AIDS incidence and the time of year and an over time accelerated upward trend in the AIDS incidence were observed. The local fiscal revenue was positively correlated with the incidence of AIDS (β = 0.002, P < 0.001); whereas, the number of health institutions per 1 000 people was negatively correlated with the AIDS incidence (β = – 0.306, P = 0.023).  Conclusion   The incidence of AIDS varied with an accelerated upward trend and was closely related to social macro factors during 2006 – 2018 in Shaanxi province.
Epidemiological characteristics of HIV/AIDS patients aged 60 years and above at diagnosis in Fujian province: a retrospective analysis
CHEN Liang, LIAN Qiao-ling, ZHANG Ming-ya
2021, 37(8): 1205-1208. doi: 10.11847/zgggws1128607
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  Objective  To analyze epidemiological characteristics of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients aged 60 years and above at their diagnosis in Fujian province, and to provide evidences for specific intervention on the patients and reasonable allocation of healthcare resources.  Methods  From all HIV/AIDS patients registered in Fujian province between January 2015 through December 2019, we enrolled 2 152 older cases (aged 60 years and above at their diagnoses) and conducted a retrospective survey to collect the cases′ information on demographics, risk behavior history, probable transmission route, and HIV antibody and CD4 +T lymphocyte cell count detection. Descriptive statistics was performed to analyze epidemiological characteristics of the older HIV/AIDS cases.  Results  For the reported older HIV/AIDS patients, the annual number increased and so did its proportion against the total number of patients during 2015 – 2019 (χ2 = 90.411, P < 0.001). The most of the older cases (91.6%, 1 971/2 152)were infected through heterosexual transmission, but the ways of heterosexual transmission were significantly different between the male and female cases. For the cases infected through heterosexual transmission, the majority (67.9%, 1 079/1 589)of the males were infected through commercial sex, while the females were mainly through noncommercial and extramarital sex (44.2%, 169/382) and marital sex (39.5%, 151/382). In the older cases, the proportion of the infection through extramarital and noncommercial sex and marital sex decreased, but that of through commercial sex increased; compared to those aged 60 – 65years, the cases aged ≥ 73 years had decreased proportions of infection through extramarital and noncommercial sex (19.6% [89/455] vs. 24.7% [219/885]) and marital sex (4.0% [18/455] vs. 13.6% [120/885]), but an increased proportion of the infection through commercial sex (66.2% [301/455] vs. 52.0% [460/885]). For the cases infected through heterosexual transmission and having their first CD4+T cell detection within one year after the confirmation of HIV infection, 46.5% (818/1 761) were estimated being infected before the age of 60 and 82.7% (1 457/1 761) with a duration of 3 years or more from the infection to the confirmed diagnosis. Of all the older HIV/AIDS patients, 78.3% (1 685/2 152) were diagnosed during screening examination in medical institutions.  Conclusion  The elder population has become the one of key populations for HIV/AIDS prevention and control; specific and comprehensive interventions should be implemented in the population.
Prevalence of HIV infection and sexually transmitted diseases and their associates among drug users in Ma′anshan city, 2016 – 2018: sentinel surveillance data analysis
QIN Qi-rong, XIANG Ke-xia, GAO Yuan,
2021, 37(8): 1209-1213. doi: 10.11847/zgggws1128033
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  Objective  To examine the prevalence of human immunodeficiency virus (HIV) and sexually transmitted diseases (STDs) and their influencing factors among drug users in Maanshan city, Anhui province and to provide evidences for developing strategies and evaluating interventions on HIV infection and AIDS.  Methods  Under the National AIDS Sentinel Surveillance Program, annual surveillance including face-to-face interview and laboratory detection were conducted among at least 400 drug users in the city from 2016 to 2018. The collected data were analyzed with descriptive statistics.  Results  Totally 1 225 drug users were surveyed during the 3-year period and the majority of the drug users were married men, at ages of 20 – 49 years, being Han nationality, with registered family residence in local province, and with the education of junior high school. The overall awareness rate of AIDS knowledge was 82.3% among the drug users. Of the drug users, 34.4% and 69.7% reported the use of heroin and methamphetamine. No significant between year difference was observed in the awareness rate and type of drugs used among the drug users. Significantly higher rate of hepatitis C virus (HCV) infection (84.4%) was detected among the drug users with the history of injection drug use than among those without the history (χ2 = 802.171, P < 0.05). For the drug users with injection drug use history, the reported proportion of injection drug use during previous one month were 59.3%, 44.0% and 3.6% for the year of 2016 – 2018, respectively, with a significant difference (χ2 = 99.203, P < 0.05). For all the drug users, the reported ratio of receiving peer education were 36.5%, 20.9%, and 14.6% for the year of 2016 – 2018 and the yearly variation in the ratio was significant (χ2 = 56.522, P < 0.05). The overall positive rate of HIV, syphilis and HCV antibody was 0.2%, 9.4% and 32.0% for all the drug users during the 3-year period.  Conclusion  For the period of 2016 – 2018 among the drug users in Ma'anshan city, the HIV infection rate was low but the infection rate of syphilis and hepatitis C virus were high; the rate of awareness on AIDS knowledge was also relatively low and the proportion of receiving peer education decreased yearly.
AIDS knowledge and condom use among female sex workers in Tibet Autonomous Region: a cross-sectional survey
Ciren Wangmu, Suolang Lamu, Duoji Wangmu
2021, 37(8): 1214-1218. doi: 10.11847/zgggws1128264
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  Objective  To examine the awareness on knowledge about human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and condom use among female sex workers (FSWs) in Tibet Autonomous Region (Tibet) and to provide evidences for HIV/AIDS control.  Methods  Totally 2 047 FSWs were recruited at 7 state-level sites for surveillance on HIV/AIDS in Tibet with stratified random sampling and cluster sampling. Face-to-face interviews were conducted among the recruited FSWs using the questionnaire developed by Chinese Center for Disease Control and Prevention during 2019. Descriptive statistics, chi-square test and unconditional multivariate logistic regression analysis were used to analyze the awareness of HIV/AIDS knowledge and its impact on condom use among the FSWs.  Results  For all the FSWs, the awareness rate of HIV/AIDS knowledge was 83.93% and the proportion of using condom in the last commercial sex was 71.71%. Of the FSWs, 20.86%, 36.59%, and 42.55% reported never, sometimes, and always using condom in commercial sex during the past one month, respectively. Unconditional multivariate logistic regression analysis revealed following promoting factors for being aware of HIV/AIDS knowledge in the FSWs: having unmarried cohabitation (odds ratio [OR]=3.31, 95% confidence interval [95% CI]: 1.14 – 9.64), with the education of senior high school and above (OR = 1.78, 95%CI: 1.25 – 2.54), working in high grade public places (OR = 2.07, 95% CI: 1.38 – 3.11), and ever receiving HIV/AIDS counseling and testing (OR = 2.94, 95% CI: 2.28 – 3.79). Compared to those without HIV/AIDS knowledge, the FSWs with the knowledge were more likely to use condom in commercial sex (OR = 1.72, 95% CI: 1.32 – 2.24) after adjusting for potential confounding variables.  Conclusion  The rate of being aware of HIV/AIDS knowledge and using condom in commercial sex are at a low level among female sex workers in Tibet Autonomous Region in 2019 and improving the awareness on HIV/AIDS knowledge may promote condom use of the female sex workers.
Epidemiological Research
Elderly care need and its influencing factors among older rural residents in five provinces of China
LI Yuan-lei, KANG Zheng, LI Yue-huan,
2021, 37(8): 1219-1222. doi: 10.11847/zgggws1126748
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  Objective  To examine the demand for elderly care and its associates among older rural residents and to provide evidences for improving elderly care services in China.  Methods  Using stratified multistage random sampling, we recruited 600 residents aged ≥ 60 years at 20 villages in 5 provinces across China and conducted a survey among the elderly with a self-designed questionnaire on the status and related factors of elderly care needs from January to March 2019.  Results  Totally 560 (43.2% male and 56.8% female) residents completed the survey. For all the respondents, the average score for overall care was 6.01 ± 1.83 out of the full mark of 17; the average domain score for emotional care was higher than that for daily life care (2.79 ± 0.88 vs. 1.67 ± 1.83) and the score (1.56 ± 0.74) for medical care was the lowest among the domain scores. The top three emotional care needs reported by the respondents were harmonious neighborhood relationship, children′s company and community activity and the top three daily life care needs were caregiver′s service, financial support and children′s care. For medical care, the respondents paid more attentions to improving medical conditions and reducing medical expenses. Based on the results of multivariate linear regression analysis, main impact factors were education, self-care ability, whether with children living nearby, and whether having regular physical examination for care needs of the rural elderly.  Conclusion  The elderly in rural China need more emotional care and daily life care, especially those with lower education, without self-care ability, without children′s care, and having no regular physical examination.
Nutrient supplementation during pregnancy and 6 months postpartum among pregnant women in three cities of China: a cross-sectional and follow-up survey
WANG Mei-chen, BAI An-ying, LI Pin,
2021, 37(8): 1223-1227. doi: 10.11847/zgggws1127867
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  Objective   To explore nutrient supplementation during pregnancy and 6 months postpartum and its influencing factors among pregnant women in three cities of China.   Methods  Using purposive sampling, we recruited 256 puerpera one to five days after their deliveries at maternal and child health hospitals and community health centers in three cities in northern, central and southern China between December 2017 and December 2018. The information on the puerperal′s nutrient supplementation during pregnancy and 6 months postpartum were collected with face-to-face interviews at postnatal 8 – 14 days and postnatal 1, 2, 3, 4, and 6 months. Descriptive statistics and logistic regression analysis were used to analyze related factors of nutrient supplementation.   Results   Of the 207 participants with complete information, 82.03% reported nutrient supplementation. The participants′ main nutrient supplementation included calcium (reported by 61.33% of the participants), folic acid (59.38%), multivitamin (46.48%), iron (20.31%), and zinc (8.20%), respectively. There was a significant regional difference in the ratio of nutrient supplementation among the participants (P < 0.05). The overall proportion of the participants having nutrient supplementation during 6 months postpartum was 47.83% and the main nutrient supplementation was calcium, which was reported by 43.00% of the participants; the proportions for other nutrient supplementations were all less than 10.0%. The participants′ nutrient supplementation differed significantly by age, residential region, and education (P < 0.05 for all).   Conclusion  Among pregnant women in China, calcium and folic acid supplementation during pregnancy are relatively high but iron and zinc supplementation during 6 months postpartum are low. Age, residential region, education and other factors should be concerned in developing targeted health education programs on nutrient supplementation for pregnant women.
Association between carotid artery abnormality and cigarette smoking among male adult residents at high-risk of cardiovascular disease in Jiangsu province
GU Yi-bin, SHENG Hong-yan, WU Ye, BI Yuan,
2021, 37(8): 1228-1232. doi: 10.11847/zgggws1128447
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  Objective   To examine the relationship between carotid artery abnormality and smoking in male adult residents at high-risk of cardiovascular disease (CVD) in Jiangsu province, and to provide evidences for prevention and treatment of subclinical atherosclerosis and early CVD.   Methods   From September 2015 to June 2016, we conducted screenings on individuals at high-risk of CVD among 35 – 75-year-old permanent residents (n = 71 511) in 31 urban communities and rural villages and towns selected with cluster sampling in 6 cities of Jiangsu province; then a questionnaire survey, physical examination, laboratory test and carotid artery ultrasound examination were carried out in 4 821 male residents at high-risk of CVD to analyze the relationship between carotid artery abnormality and smoking.   Results   Among the 4 821 high-risk individuals, 2 783 (57.73%) were diagnosed with carotid artery abnormality; of which, 761 (27.34%), 1 791 (64.57%), and 225 (8.09%) were carotid intima thickening, carotid plaque, and carotid stenosis, respectively. After adjusting confounding factors such as age, education, marriage, average annual family income, residence, and history of alcohol drinking/hypertension/diabetes/dyslipidemia, the results of unconditional multivariate logistic regression analysis demonstrated that for all the high-risk individuals, the smokers were more likely to have carotid artery abnormality (compared to non-smokers: odds ratio [OR] = 1.391, 95% confidence interval [95% CI] = 1.214 – 1.593); the results also revealed two significant risk factors of carotid artery abnormality for the 2 699 high-risk individuals being current or former smokers: smoking filter-tipped cigarettes (compared to smoking cigarettes without filter: OR = 1.440, 95% CI = 1.184 – 1.750) and breathing in cigarette smoke deeply (breathing the smoke into throat vs. into mouth: OR = 1.420, 95% CI = 1.081 – 1.865 and breathing the smoke into lung vs. into mouth: OR = 1.338, 95% CI = 1.104 – 1.622).   Conclusion   The prevalence rate of carotid artery abnormality is relatively high and the abnormality is strongly associated with smoking among male adult residents at high-risk of cardiovascular disease in Jiangsu province.
Effect of sleep disturbance on cognitive impairment among rural elderly in Guizhou province
YANG Xi, YANG Xing, YANG Jing-yuan,
2021, 37(8): 1233-1236. doi: 10.11847/zgggws1127829
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  Objective   To explore the effect of sleep disorder on cognitive impairment among rural elderly in Guizhou province, and to provide references for improving cognitive function of the elderly.   Methods   Using multistate random cluster sampling, we recruited 1 795 permanent residents aged ≥ 60 years in 5 rural towns of Guizhou province for a face-to-face interview conducted during June – August 2019. A self-designed questionnaire, Mini-Mental State Examination (MMSE), and Athens Insomnia Scale (AIS) were used to collect the participants′ information on demographics, cognitive function and sleep condition.   Results   Among the 1 651 residents with valid response, 517 (31.3%) were identified having cognitive impairment and the detection rates of impaired cognitive function were 17.9% (n = 296) for orientation, 12.1% (199) for immediate recall, 31.4% (518) for attention and calculation, 45.5% (752) for delayed recall, and 10.8% (179) for linguistic competence, respectively; 484 (29.3%) reported having sleep disorders. After adjusting for confounder variables as gender, age, ethnicity, education, marital status, and occupation, the results of unconditional multivariate logistic regression analysis revealed that the participants with sleep disorders were more likely to have overall cognitive impairment (odds ratio [OR] = 1.348, 95% confidence interval [95% CI]: 1.056 – 1.719), impaired immediate recall (OR = 1.410, 95% CI: 1.024 – 1.943) and attention and calculation (OR = 1.302, 95% CI : 1.025 – 1.654).   Conclusion   Among rural elderly in Guizhou province, the prevalence of cognitive impairment is relatively high and sleep disorder is one of major risk factors for cognitive impairment, especially for impaired immediate recall and attention and calculation function.
Smoking prevalence among adult residents in Gansu province, 2013 – 2014: a cross-sectional study
HE Hu-peng, ZHANG Jing, DONG Cai-xia,
2021, 37(8): 1237-1240. doi: 10.11847/zgggws1128150
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  Objective   To explore the prevalence of smoking among residents aged 18 years and above in Gansu province for providing evidences to promote tobacco control in the population.   Methods   Using stratified multistage random sampling, we conducted a face-to-face questionnaire survey among 7 750 residents aged ≥ 18 years at 8 national and 6 provincial level disease surveillance points across Gansu province from August 2013 to December 2014.   Results   In all the residents, the number of smokers, current smokers, and daily smokers were 2 311, 1931, and 1 706; the rate of smoking, current smoking, and daily smoking were 29.8%, 24.9%, and 22.0%, respectively; the smoking rate differed significantly by age, gender and geographical area of living (all P < 0.05) and the rate of current and daily smoking varied significantly by age, gender, geographical area of living, and living region (urban or rural) (all P < 0.05). The average number of cigarettes smoked by current smokers was 15.90 ± 10.13 and the number was significantly different for the current smokers of different gender, at different ages, living in various geographical areas and living in different regions (P < 0.001 for all). Among all the smokers, 380 (16.4%) reported the experience of smoking cessation and 280 (12.6%) quitted smoking successfully; both the rates of smoking cessation and successful smoking cessation differed significantly by age, gender, geographical area of living, and living region (all P < 0.05).   Conclusion   In Gansu province, the rate of smoking, current smoking and daily smoking were high among adult residents; among smokers, the average smoking amount per day was relatively high but the rate of smoking cessation and successful smoking cessation were low; the results should be concerned for the promotion of effective tobacco control in the population.
Permanent teeth caries among 12- to 15-year-old school children in Henan province, 2015: prevalence and influencing factors
LI Feng-juan, WANG Li-ru, WANG Xu,
2021, 37(8): 1241-1245. doi: 10.11847/zgggws1128386
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  Objective  To examine the prevalence and impact factors of permanent teeth caries among 12 – 15 years old children in Henan province.   Methods   According to the methodology of the Fourth National Oral Health Survey, we conducted oral examination and questionnaire survey among 3 840 children aged 12 – 15 years recruited from 12 middle schools in four districts/countries of Henan province with stratified multistage probability proportionate to size sampling (PPS) during September – December, 2015.   Results   Among the 3 786 children with complete information, 1 411 had caries; the prevalence rate of permanent teeth caries was 37.27%; the average decay-missing-filled teeth (DMFT) was 0.73; and the caries filling ratio was 9.26%. There were no significant differences in prevalence rate of permanent teeth caries (37.46% vs. 37.07%) and mean DMFT index (0.74 ± 1.37 vs. 0.73 ± 1.23) between the urban and the rural children; but the caries filling ratio was significantly higher among the urban children than that among the rural children (14.31% vs. 4.09%, χ2 = 85.862; P < 0.05). Compared to the boys, the girls had significantly higher prevalence rate of permanent teeth caries (42.34% vs. 32.34%), mean DMFT index (0.86 ± 1.37 vs. 0.60 ± 1.20), and caries filling ratio (10.39% vs. 7.69%) (P < 0.05 for all). Multivariate logistic regression demonstrated that gender, age, paternal education, self-perceived oral health status, and dental care experience were significantly associated with the prevalence of permanent teeth caries among the children.  Conclusion  The permanent teeth caries is prevalent among 12 – 15 years old children in Henan province and interventions on oral health should be promoted among the children.
Prevalence and risk factors of stroke among adult residents in Binzhou city, Shandong province: a cross- sectional survey in 2019
GAO Xiang-jin, XU Kai, SHAN Wen-ping,
2021, 37(8): 1246-1249. doi: 10.11847/zgggws1126918
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  Objective  To examine the prevalence and impact factors of stroke among community adult residents in Binzhou city, Shandong province and to provide references for stroke prevention and control.  Methods  The participants of the survey were 7 050 permanent community residents aged ≥ 18 years recruited with stratified multistage random cluster sampling in the city. Questionnaire interview, physical examination and laboratory detection were conducted among the participants during April – September 2019.  Results  Among the 6 777 participants completing the survey, 361 stroke patients were identified; the weighted adjusted prevalence rate of stroke was 3 630.0/100 000 and the standardized prevalence rate was 2 780.1/100 000. Unconditional multivariate logistic regression analysis demonstrated that the risk factors of stroke were aged ≥ 60 years, without sufficient physical activity, having prolonged sleep time, with family history of stroke, suffering from hypertension and atrial fibrillation among the participants.  Conclusion  Among the adult residents in Binzhou city, the prevalence of stroke is high and the residents at older age, without sufficient physical activity, sleeping longer, with family history of stroke, and suffering from hypertension or atrial fibrillation are at high risk of stroke.
Dietary iodine intake among adult women in regions with high and appropriate drinking water iodine
ZHANG Ying, MA Wei, LI Xiu-wei,
2021, 37(8): 1250-1253. doi: 10.11847/zgggws1127345
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  Objective  To investigate dietary iodine intake, iodine sources and their contribution rates among adult women in regions with high and appropriate drinking water iodine for providing evidences to develop the guidance on healthy diet for residents in China.  Methods  Information on daily diet, drinking water, table salt intake were collected with the Food Frequency Questionnaire among 1 320 women aged 18 – 60 years in regions with high and appropriate drinking water iodine in two provinces of China duing July – August 2018. Iodine content in food, drinking water and table salt were measured simultaneously and average daily iodine intake was estimated for the women. Iodine intake-related potential risks for the women were assessed according to the national dietary iodine intake recommendations.  Results  The daily dietary iodine intake was 441.52 μg and 180.67 μg for the women in the regions with high and appropriate drinking water iodine and the intakes were between the reference nutrient intake (RNI) and tolerable upper intake level (UL). Of the women in the regions with high drinking water iodine, 18.12% had the iodine intake higher than UL and 27.14% had the intake lower than RNI. For the women in in regions with high and appropriate drinking water iodine, the edible rate of iodized salt was 8.96% and 25.93%; the contribution rate of iodized intake salt to daily iodine intake was 0.03% and 8.39%; the daily intake of drinking water iodine was 383.06 μg and 93.06 μg; and the contribution rate of drinking water iodine to daily iodine intake was 84.22% and 53.71%, respectively.  Conclusion  The iodine intake is appropriate and safe and drriking water iodine is the main source of dietary iodine for the adult women in regions with high and appropriate drinking water iodine. Low edible rate of iodized salt may lead to a risk of iodine deficiency for the adult women in regions with appropriate drinking water iodine.
Prevalence of clonorchiasis among permanent residents in Harbin municipality, 2018: a cross-sectional survey
ZHANG Ya-ming, GAO Sheng-nan, WANG Yue,
2021, 37(8): 1254-1256. doi: 10.11847/zgggws1127986
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  Objective  To examine the infection of Clonorchiasis sinensis among permanent residents in Harbin city for providing evidences to the prevention and treatment of clonorchiasis.  Methods  Using cluster random sampling, we recruited 9 000 permanent residents at 27 rural and 18 urban survey points in 9 districts/counties of Harbin municipality for a survey conducted in 2018. The eggs of Clonorchis sinensis in feces samples of the participants were detected with modified Kato-Katz method. The information on behaviors of fresh water fish were also collected. Descriptive statistics was performed to analyze the data collected.  Results  Among the 8 980 enrollees completing the survey, 351 Clonorchis sinensis infections were detected; the average infection rate of was 3.91% for all the participants and the infection rate was 6.30% and 0.33% for rural and urban participants. Of the Clonorchis sinensis infections, 239 (68.09%), 89 (25.36%), and 23 (6.55%) were mild, moderate, and severe infection, respectively. The infection rate of male participants (5.05%, 236/4 674) was significantly higher than that (2.67%, 115/4 306) of female participants (χ2 = 34.620, P < 0.001). The highest infection rate (7.12%, 77/1 082) was detected among the participants aged 60 – 69 years and the infection rate differed significantly by age among the participants (χ2 = 116.741, P < 0.001). The infection rate was different significantly among the participants of various occupations (χ2 = 233.979, P < 0.001), with the highest infection rate of 5.64% (330/5 855) among farmers (herdsmen and fishermen). The infection rate was also differed significantly by education (χ2 = 125.798, P < 0.001) and the highest infection rate (10.39%, 16/154) was detected in the participants being illiterate or semi-illiterate.  Conclusion  The prevalence of clonorchiasis is relatively serious among rural and urban permanent residents in Harbin municipality and various health education programs on prevention and control of the disease should be promoted in the population.
Experimental Study
Regulative effect of konjac flour on lipid metabolism through AMPK signaling pathway and its mechanism in obese rats
LIN Qing, SHI Hong-xin, LIU Yue-huan,
2021, 37(8): 1257-1260. doi: 10.11847/zgggws1128614
Abstract(788) HTML (276) PDF 607KB(17)
Abstract:
  Objective  To explore the effect of konjac compound (konjac) on AMP-activated protein kinase (AMPK)-related signal transduction pathways and the mechanism of the compound in regulating lipid metabolism (weight loss effect) in rats.  Methods  Obesity model was established in 60 Sprague-Dawley (SD) rats and the rats were randomly assigned into 6 groups (10 in each group): a control group, a model group, three konjac groups at dosages of 0.344, 0.172, 0.086 g/kg, and a positive control group with orlistat capsules. By the end of the 6-week treatment, the rats′ serum triglyceride (TG), total cholesterol (TC), AMPK, fatty acid synthesis (FAS), 3-hydroxy-3-methylglutaryl coenzyme-A reductase (HMGCR), and acetyl-CoA carboxylase (ACC) were detected with kit method.  Results  In comparison with those in the control rats, the serum TG,TC, and FAS and HMGCR activity increased but AMPK activity decreased in the model rats. Commpared with the model rats, the high dose konjac-treated rats had significantly reduced serum content of TG (1.08 ± 0.13) and TC (2.02 ± 0.31), expression of FAS (13.48 ± 6.98) and HMGCR (40.47 ± 4.35), but elevated serum AMPK expression (2014.45 ± 724.25) (P < 0.05 for all); in addition, the high and moderate dose konjac-treated rats had significantly decreased the serum ACC expression (125.75 ± 6.75 and 126.02 ± 7.15) (both P < 0.05).  Conclusion  Konjac compound could regulate lipid metabolism through AMPK signaling pathway and impact on obesity in rats.
Survey and Report
Use of hearing aids and assistive listening devices and its influencing factors among the elderly with disabling hearing loss in China
GAO Jia-min, ZHENG Xiao-ying
2021, 37(8): 1261-1266. doi: 10.11847/zgggws1125831
Abstract(580) HTML (199) PDF 633KB(34)
Abstract:
  Objective  To analyze the prevalence and determinants of hearing aids and assistive listening devices utilization among the elderly with disabling hearing loss in China.  Methods  Data on 29 495 residents aged 60 years and above with isolated disabling hearing loss were extracted from the second wave of National Sample Survey on Disability in China conducted in 2006. Descriptive analysis and multivariate logistic regressions were used to explore the prevalence and determinants of assistive listening devices utilization among the participants.  Results  The utilization rate of assistive devices was 7.62% among the participants and the utilization rate was higher among the participants at older age, being male, living in cities or towns, being married, with the education of junior high school and above, with higher household income, having disability certificate, with severe hearing impairment, with self-care ability, and with restricted ability in getting along with others. The results of unconditional multivariate logistic regression analysis indicated that the utilization of assistive listening devices was associated with demographics, social economic condition, the severity of disabling hearing loss, and the dysfunction in daily life among the participants; the participants at elder or eldest age, living in cities or towns, being married, with the education of primary school/junior high school and above, with an annual household income of 1 500 yuan (RMB) per capita, and having disability certificate were more likely to use assistive listening devices; and those most likely to use assistive listening devices were the participants with severe disabling hearing loss and with impaired functions in daily self-care, getting along with others, and social participation.  Conclusion  The utilization of listening assistive devices was at a low level among the elderly with disabling hearing loss in China and the utilization is associated with the disabled elderly′s demographics, social economic status, the extent of disabling hearing loss and health condition.
Prevalence characteristics and temporal-spatial clustering of hand, foot and mouth disease in Yunnan province, 2009 – 2019
SHEN Xiu-lian, JIA Yu-chen, HE Ji-bo,
2021, 37(8): 1267-1272. doi: 10.11847/zgggws1129557
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Abstract:
  Objective  To analyze prevalence characteristics and spatial-temporal aggregation of hand, foot and mouth disease (HFMD) in Yunnan province from 2009 to 2019.  Methods  The data on HFMD incidents in 129 counties/districts of Yunnan province during 2009 – 2019 were extracted from National Disease Prevention and Control Information System and relevant population data were collected from statistics yearbooks issued by provincial statistical bureau. The prevalence characteristics of HFMD was analyzed with descriptive statistics and spatial-temporal clustering of HFMD was assessed using SaTScan 9.5 software.  Results  A total of 752 209 HFMD cases were reported in Yunnan province during the period, with an average annual incidence of 145.93/100 000. More HFMD incidents were reported among scattered living children aged < 5 years and more incidents occurred during April – July in a year. In 2009, the counties/districts with higher HMFD incidence were mainly located in the central region of Yunnan province; but from 2010, more counties/districts with higher HFMD incidence were gradually identified around the central region along with the increase in annual HFMD incidence in the province. SaTScan spatial-temporal scanning analysis demonstrated an obvious temporal clustering of HFMD mainly during April – July in a year; the scanning analysis also revealed spatial clustering of HFMD incidence in three prefecture regions (Kunming, Yuxi and Honghe) in 2009 and 2010, while, another three prefecture regions (Qujing, Wenshan and Chuxiong) with spatial clustering of the incidence were identified during 2011 – 2018 and totally eight prefecture regions with spatial clustering of the incidence were found in 2019.  Conclusion  There were obvious spatial-temporal clustering of HFMD incidence in Yunnan province from 2009 to 2019 and the regions with spatial clustering of HFMD incidence enlarged from the central to southeastern Yunnan gradually; the situation should be concerned for effective control of HFMD epidemic in the province.
Haze-related health protective behaviors among citizens in Beijing city: an online survey
FU Xiu-ying, HUANG Lu, ZHU Wen-li,
2021, 37(8): 1273-1276. doi: 10.11847/zgggws1124158
Abstract(2354) HTML (3090) PDF 544KB(39)
Abstract:
  Objective  To examine the status quo of haze-related health protective behaviors among citizens in Beijing city for providing evidences to develop targeted health education strategies and intervention measures.  Methods  In November 2018, we distributed a self-designed questionnaire about cognition on haze-related health risk and protective behaviors via internet to all members of official account of Dongcheng District Center for Disease Control and Prevention registered in Beijing city. All voluntary responses were collected two weeks after the distribution.  Results  A total of 15 698 questionnaires were distributed and 15 334 valid response questionnaires were received, with a response rate of 97.7%. Of all the respondents, 93.5% and 92.4% reported decreased going out and physical exercise under smog weather; 96.2% and 86.1% reported wearing mask when going out and using air purifiers at home under smog weather condition, respectively. The proportion of reporting haze-related health protective behaviors was significantly higher among the respondents aged 18 – 44 years, females, and the college students (all P < 0.05) and the proportion was positively correlated significantly with the level of cognition on health hazards of haze and the concern about haze weather condition (P < 0.05 for all).  Conclusion  The prevalence rate of haze-related health protective behaviors is relatively high among citizens in Beijing city but health education on cognition and protection of haze condition still needs to be promoted in key population groups.
Effects of family-involved hand washing intervention on prevention of infectious diseases among children in kindergartens
ZHANG Li-feng, QIN Xiu-qun, ZHANG Ning-ning,
2021, 37(8): 1277-1281. doi: 10.11847/zgggws1128071
Abstract(2148) HTML (2476) PDF 567KB(79)
Abstract:
  Objective  To determine the efficacy of a family-involved hand washing intervention on the improvement of hand hygiene of children and the prevention of infectious diseases among children in kindergartens.  Methods  A cluster-randomized controlled trial was conducted among 490 children (averagely aged 4.28 ± 0.33 years) and their parents at 16 classes from 4 kindergartens in Guangzhou city from March to June in 2018, and there were 8 classes in each group by randomization. Totally 247 children and their families were enrolled in the intervention group with family-involved hand washing intervention, and 243 children and their families in the control group with regular health education. The behavior of hand washing among the children and their parents and the incidence of infectious diseases of children between the two groups were compared.  Results  Hand washing behaviors of the children were significantly different between the two groups after the intervention (hand washing before eating [b = − 0.207], after toilet use [b = − 0.106], after going out [b = − 0.149], and with seven-step procedure [b = − 0.113]; all P < 0.05). The hand washing before eating, after toilet use and going out, and with seven-step procedure 2 months after the intervention, the hand washing before eating 4 months after the intervention, and the hand washing before eating and with seven-step procedure 6 months after the intervention were significantly better among the children of intervention group than among those of the control group (all P < 0.05). The hand washing of the parents in the intervention group were significantly better than that of parents in the control group 2 months after the intervention (hand washing before eating [χ2 = 8.750], after toilet use [χ2 = 7.243], after going out [χ2 = 15.557]; all P < 0.05). The cumulated incidence of acute gastrointestinal and respiratory infections was significantly lower among the children in the intervention group than among those in the control group (9.3% vs. 16.0%, χ2 = 5.031; P = 0.025) during the 12-month follow-up.   Conclusion  The family-involved hand washing intervention is effective in improving hand hygiene behaviors among kindergarten children and their parents and reducing infectious diseases in the children, suggesting that the intervention is of significance for infectious disease prevention in kindergartens.
Interactive effect of temperature and air pollutants on years of life lost due to lung cancer among residents in Hexi district of Tianjin city
ZHANG Jing-wei, FENG Li-hong, WANG Miao,
2021, 37(8): 1282-1289. doi: 10.11847/zgggws1125192
Abstract(5794) HTML (1128) PDF 1046KB(69)
Abstract:
  Objective  To explore interactive effect of air pollutants and temperature on years of life lost (YLL) due to lung cancer and to provide references for studies on impacts of lung cancer mortality.  Methods  We collected data of Hexi district on lung cancer mortality in the residents, air pollutants monitoring, and meteorology observation during the period from January 1, 2015 to December 31, 2017. Bivariate response surface model, uni- and multi-pollutant and temperature interactive model were established using non-linear lag distribution to analyze the interactive effect of air pollutants and temperature on lung cancer-related YLL in the population of the district.  Results  Relative to the reference temperature of 16.3 ℃, high temperature (34 ℃) and low temperature (– 13 ℃) increased YLL of lung cancer by 1.12% (95% confidence interval [95% CI]: 0.58% – 2.16%) and 1.49% (95% CI: 0.16% – 14.25%). Particulate matter less than 2.5 μm in aerodynamic diameter (PM2.5), nitrogen dioxide (NO2), carbon monoxide (CO), one-hour average ozone (O3-1h), and eight-hour average ozone (O3-8h) could increase YLL of lung cancer by 1.00% (95% CI: 0.98% – 1.03%), 1.01% (95% CI: 0.95% – 1.08%), 1.01% (95% CI: 0.99% – 1.03%), 1.03% (95% CI: 0.98% – 1.09%), and 1.03% (95% CI: 0.98% – 1.09%), respectively. Under the low temperature, a 10 μg/m3 increment in PM2.5 and NO2 could increase the YLL of lung cancer by 4.14% (95% CI:0.55% – 7.85%) and 5.44% (95% CI: – 4.80% – 16.78%).   Conclusion  High and low temperature, PM2.5, NO2, CO, O3-1h and O3-8h can all increase daily YLL of lung cancer in an exposed population and the effect of PM2.5 and NO2 are stronger under low temperature.
Variation in scope of government concerns over infectious diseases in Liaoning and Jilin province: a literature study
PAN Lin, WU Qun-hong, CHEN Chao-yi,
2021, 37(8): 1290-1293. doi: 10.11847/zgggws1125734
Abstract(1815) HTML (859) PDF 545KB(25)
Abstract:
  Objective  To analyze variations in the scope of infectious disease epidemics concerned by government departments and the relationship between the changes and incidences of class A and B infectious diseases in Liaoning and Jilin province for developing strategies on infectious disease prevention and control.  Methods  By searching official websites and internet databases, we retrieved policy documents referring to the prevention and control of infectious diseases published by government departments and health institutions of Liaoning and Jilin province from 2005 through 2016. Descriptive analyses were performed and Spearman correlation and univariate linear regression analysis were used to explore the correlation between the concern scope and local incidences of notifiable class A and B infectious diseases.  Results  We totally retrieved 32 and 45 documents issued by Liaoning and Jilin provincial departments and institutions during the period. Compared to that in 2005 in Jilin province, the indicator for the scope of infectious diseases concerned by provincial departments increased by 41.00% and the incidence of notifiable class A and B infectious diseases decreased by 79.63/100 000 in 2017, respectively, with an obvious inverse correlation between the indicator and the incidence. During the period, the indicator for the scope of infectious diseases concerned by Liaoning provincial departments increased from 28.85% to 75.00% but no significant correlation was observed between the indicator and the local incidence of notifiable infectious diseases.  Conclusion  The scope of infectious disease epidemics was increasingly concerned by local government departments of Liaoning and Jilin province during the period from 2005 to 2017 and the governmental concern is one of important factors for the prevention and control of infectious diseases.
Extent of performance incentive among maternal health care staff in Beijing and Shanghai: a comparison analysis
MA Dong-ping, YIN Wen-qiang, ZHENG Wen-gui,
2021, 37(8): 1294-1296. doi: 10.11847/zgggws1123239
Abstract(583) HTML (230) PDF 590KB(10)
Abstract:
  Objective  To analyze the extent of deficit in performance incentive among maternal health care (MHC) staff, 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 appropriate performance incentive among MHC staff.   Methods   We searched China National Knowledge Infrastructure (CNKI) and Web of Science for research literatures on human resource for MHC in Beijing and Shanghai municipality published during 1995 – 2017. The information on performance incentive among the MHC staff was extracted from 115 retrieved studies (61 relevant to Shanghai and 54 to Beijing) for calculation of a severity score to evaluate the deficit in the performance incentive. Spearman correlation and linear regression analysis were used to analyze the relationship between the deficit in performance incentive among MHC staff and MMR.   Results   For Beijing municipality, the severity score for the deficit in performance incentive among MHC staff decreased from 3.79 in 2000 to 2.61 in 2017, while for Shanghai municipality, the score decreased from 3.45 to 2.13. A significant correlation between the severity score and MMR was detected for Shanghai (r = 0.542, P < 0.05).   Conclusion   The performance incentive among maternal health care staff increased gradually in both Beijing and Shanghai municipality during 2000 – 2017 and the impact of the improvement in the performance incentive on the decrease of maternal mortality rate is more obvious for Shanghai. The study verified the feasibility of quantitative assessment on the performance incentive among maternal health care staff.
Comparison of public needs-based scientific decision-making in health emergency management between Liaoning and Jilin province: a literature study
GUO Yang, WANG Lu, CHEN Chao-yi,
2021, 37(8): 1297-1300. doi: 10.11847/zgggws1124766
Abstract(2433) HTML (1401) PDF 643KB(24)
Abstract:
  Objective  To analyze the status of public needs-based scientific decision-making in health emergency management in Liaoning and Jilin province and the disparity in the decision-making between the two provinces for improving health emergency management.  Methods  By searching official websites and internet databases, we systemically and extensively retrieved 163 authoritative documents and reports on health emergency management published by government agencies and health institutions of Liaoning and Jilin province from 2000 through 2017. Descriptive analyses on scientific decision-making were performed using SPSS 22.0; Spearman correlation analysis and liner regression were adopted to assess the correlation between scientific rationality in target setting and the efficiency of health emergency management.  Results  The measure of scientific rationality in target setting for health emergency management increased from 2.1% in 2000 to 55.7% in 2017 in Liaoning province and from 2.1% in 2000 to 39.3% in 2017 in Jilin province. There were positive correlations between scientific rationality in target setting and the efficiency of health emergency management in both Liaoning and Jilin province, with the correlation coefficients of 0.735 and 0.691 and the adjusted R2 of 0.511 and 0.445, respectively.  Conclusion  The measure of scientific rationality in target setting for health emergency management increased greatly and the management efficiency was promoted in Liaoning and Jilin province.
Overview
Progress in researches on HIV self-testing among men who have sex with men
SHANG Xiao-xu, SHENG Yu
2021, 37(8): 1301-1304. doi: 10.11847/zgggws1129577
Abstract(591) HTML (301) PDF 470KB(53)
Abstract:
With the benefit of keeping privacy and easiness in operation, human immunodeficiency virus (HIV) self-testing provides an alternative way for expanding conventional HIV testing in men who have sex with men (MSM), which is also significant in HIV surveillance and control of HIV pandemic. Besides all the advantages mentioned above, HIV self-testing plays an important role in scaling up first-time and continuous HIV testing based on professional environment as well. In this review, we summarize current HIV testing prevalence, the development of HIV self-testing, and the acceptance, implementation pattern and challenge of HIV self-testing among MSM in China for providing evidences to promote HIV self-testing in the MSM.
Public Health Forum
Blockchain and artificial intelligence technology-based health data management and utilization: a brief introduction
LI Jian-si, YANG Bing-bing, FAN Li-juan, XING Li-ying, , PANG Shuai
2021, 37(8): 1305-1309. doi: 10.11847/zgggws1126496
Abstract(847) HTML (254) PDF 833KB(52)
Abstract:
We briefly introduced the application of data center network, which integrates blockchain, interplanetary file system (IPFS), artificial intelligence (AI), security sandbox and other technologies, in multiple and continuous collection, collation, management and distribution of population-based health-related information. We also discussed potential utilization of these technologies in disease prevention and control practices in Liaoning province.
Teaching mode of clinical drug evaluation in clinical pharmacy under public health priority strategy: a brief discussion
GONG Jian, WANG Meng-meng, CHEN Ming-zhu,
2021, 37(8): 1310-1312. doi: 10.11847/zgggws1134609
Abstract(654) HTML (189) PDF 422KB(13)
Abstract:
Clinical drug evaluation is a main course in clinical pharmacy. In the study, we briefly analyzed objective demand on the teaching of clinical drug evaluation for college students under public health priority strategy in the post-epidemic era and discussed concepts and the application of a mode of clinical drug evaluation teaching characterized by self-directed learning with teaching staff′s effective guiding, assisting and promoting for exploring ways of clinical pharmacy-related talent training to meet the needs of public health development and health promotion.