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2022 Vol. 38, No. 11

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2022, 38(11)
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2022, 38(11): .
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Special Column – Healthy China Action:Infectious and Endemic Disease Prevention and Control
Prevalence and genetic characteristics of norovirus epidemics in Guangdong province, 2021
LI Cai-xia, LIANG Yu-feng, XU Jing,
2022, 38(11): 1369-1372. doi: 10.11847/zgggws1138942
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  Objective   To analyze prevalence and genetic characteristics of clusterings/outbreaks of norovirus (NV) infection in Guangdong province in 2021.   Methods   We collected the information on all laboratory confirmed NV infection clusterings (3 correlated cases in 3 days at a venue) and outbreaks (20 correlated cases in 7 days at a venue) reported in Guangdong province throughout 2021. Anal swab/stool specimens of the reported cases were sampled for NV detection with quantitative real-time PCR (qRT-PCR). The NV GI and GII strains screened out from positive specimens were genotyped with PCR amplification, library preparation, gene sequencing and splicing.   Results  Of a total of 141 NV clusterings/outbreaks reported in the province during the year, 92.91% occurred in nurseries or schools and mainly during winter and spring seasons. For the genotyped NV strains isolated from specimens of 73 outbreaks (51.77% of all epidemics), 94.52% were NV GII, with GII.2[P16] and GII.4[P31] accounting for 39.13% and 23.19% of all NV strains, respectively.   Conclusion  In Guangdong province during 2021, the norovirus clusterings/outbreaks occurred mainly in nurseries and schools in winter/spring seasons and the majority of the outbreaks were caused by norovirus GII.2[P16] and GII.4[P31].
Epidemiological features of dengue fever and envelope gene of dengue virus among imported and indigenous cases in Guangzhou city: a comparison analysis on registry data of 2019
JIANG Li-yun, LIU Yuan, SU Wen-zhe,
2022, 38(11): 1373-1378. doi: 10.11847/zgggws1138549
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  Objective  To assess epidemiological features of imported and indigenous dengue fever cases and phylogenetic features of dengue virus prevalent in the cases in Guangzhou, Guangdong province in 2019 and to explore the impact of imported cases on dengue fever epidemics in the city.   Methods  The data on all dengue fever cases registered in Guangzhou city in 2019 were extracted from the National Notifiable Infectious Disease Reporting System. The demographic and epidemiological features of the reported cases were statistically analyzed. The envelope (E) gene of the dengue viruses isolated from the cases was sequenced and analyzed to construct maximum likelihood phylogenetic trees.   Results  Among 1655 dengue fever incidents yearly registered in the city, 273 and 1 382 were imported and local cases. Of the imported cases with a male to female ratio of 2.85 : 1, 86.45% were aged 20 to 49 years, mainly being engaged in commercial service, housework and general industries. The imported cases occurred in every month of the year but more cases were reported during June and August. The most (90.38%) of the imported cases were from Southeast Asia. For the reported local dengue fever cases, the male to female ratio was 1.07 : 1 and 89.87% were at ages of 20 – 69 years; main occupations of the local cases included houseworker, unemployee, commercial service worker and retiree; the local cases were reported during June – December and more cases were reported during August – October of the year. E gene sequences of the virus isolated from the local cases displayed close associations with sequences from imported cases and with those of prevalent virus in Southeast Asia.   Conclusion  The epidemic of dengue fever in Guangzhou city was affected by the imported dengue fever cases and the local prevalence of dengue fever in 2019 was likely being induced by the imported cases.
Spatio-temporal clustering of Vibrio parahaemolyticus detection rate among foodborne disease cases in Zhejiang province, 2016 – 2017: a monitoring data analysis
CHEN Jiang, CHEN Li-li, WANG Ji-kai, , Center for
2022, 38(11): 1379-1381. doi: 10.11847/zgggws1137795
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  Objective  To explore spatio-temporal clustering of Vibrio parahaemolyticus detection rate among reported foodborne disease cases in Zhejiang province and to provide evidence to surveillance and prevention of foodborne disease in the region.   Methods  The data on Vibrio parahaemolyticus detection among foodborne disease cases reported by 101 sentinel hospitals in Zhejiang province during 2016 – 2017 were collected from provincial reporting system for foodborne disease monitoring. Descriptive statistics analysis, spatial analysis and spatio-temporal scanning statistics were performed on the data obtained.   Results  Among 43386 and 33407 specimens from foodborne diarrhoea cases in 2016 and 2017, 1978 and 1346 were positive for Vibrio parahaemolyticus, with the detection rate of 4.56 % and 4.03 %. The Vibrio parahaemolyticus detection rate was the highest in August during a year and the detection rate was higher in adult cases, especially in those aged 26 – 35 years. Obvious temporal and spatial clustering of Vibrio parahaemolyticus detection rate were identified, with spatial clustering in 3 regions in 2016 and another 3 regions in 2017 and temporal clustering during August – October of 2016 and July – October of 2017, respectively.   Conclusion  Among reported foodborne disease cases in Zhejiang province, the Vibrio parahaemolyticus detection rate is of uneven age and seasonal distribution and the detection rate is also of obvious spatial and temporal clustering.
Spectrum and drug resistance of pathogens isolated from bacterial diarrhea patients in Ningxia Hui Autonomous Region, 2018 – 2020
WEI Qiong, SHEN Mei, ZHANG Yan-fei,
2022, 38(11): 1382-1386. doi: 10.11847/zgggws1136450
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  Objective  To examine the prevalence and drug resistance of bacterial diarrhea-related pathogens in Ningxia Hui Autonomous Region (Ningxia) for providing evidences to the prevention and control of infectious diarrhea.   Methods  Totally 3 486 stool samples were collected from diarrhea patients visiting 15 sentinel hospitals in Ningxia from 2018 through 2020. Bacteria strains were isolated and identified with isolation culture methods and drug susceptibility test was performed for isolated predominant strains using broth dilution method.   Results  Totally 287 pathogenic bacterial strains were isolated, including strains of Salmonella, Diarrheogenic Escherichia coli, Yersinia Enterocolitica, Shigella, Klebella pneumoniae, Staphylococcus aureus and Staphylococcus aureus. For the 83 Samonella strains, the resistance to ampicillin was the highest, followed by that to tetracycline, cefazolin and nalidixic acid; the strains were the most sensitive to imipenem, with the susceptibility rate of 100% for the strains isolated in 2019 and 2020, and the strains were also sensitive to azithromycin. For the 146 strains of diarrheogenic Escherichia coli, the rate of resistance to ampicillin was the highest; while the rate of sensitivity to imipenem was the highest, followed by that to cefastadidine, cefacidine, and azithromycin.   Conclusion  There were multiple pathogenic bacteria inducing diarrheal diseases in Ningxia between 2018 and 2020, with the Salmonella and diarrheogenic Escherichia coli strains being predominant pathogens which were most resistant to ampicillin and sensitive to imipenem. Surveillance on diarrheal pathogens should be strengthened for developing effective measures on diarrhea disease prevention.
Other infectious diarrhoeal disease incidence in Qinghai Plateau: temporal and spatial distribution during 2010 – 2020
ZHAO Jin-hua, MA Bin-zhong, ZHAO Jian-hai,
2022, 38(11): 1387-1390. doi: 10.11847/zgggws1135658
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  Objective  To analyze spatial-temporal distribution characteristics and three-dimensional trend of other infectious diarrhoeal disease (OIDD) incidence in Qinghai Plateau – Qinghai province from 2010 to 2020.   Methods  The data on time (day, month, year)- and county/district-specific incidence of OIDD reported in Qinghai province during 2010 – 2020 were extracted from China Information System for Disease Control and Prevention. Visualization and three-dimensional analysis on average incidence of OIDD were performed with Arc GIS10.2 software and Scan 9.5 software was adopted in space-time scanning analysis.   Results  Two seasonal incidence peaks of OIDD were observed with a major peak in autumn-winter season and a minor peak in summer during the period in the province. The OIDD incidence in male population was significantly higher than that in female population (χ2 = 1894.33, P < 0.001) and the average annual incidence was 897.26/100 000 for the children under 5 years old. Three-dimensional analysis showed that the OIDD incidence was higher in northeast region than that in the southwest region of the province. Spatio-temporal scanning analysis revealed major clusters of OIDD incidence in 4 counties/districts of Xining municipality and Haidong prefecture and minor clusters in 10 counties/districts of 5 prefectures.   Conclusion  In Qinghai province during 2010 – 2020, the incidence of other infectious diarrhea diseases showed an increasing trend with a rising-unchanging-rising circle of every 2 – 3 years and the children under 2 years old were at a higher risk of the incidence.
Molecular and epidemiological characteristics of adenovirus isolated in patients with acute diarrhea in Ningxia, 2015 – 2020
SHI An-qi, WEI Kai-xin, CAO Min,
2022, 38(11): 1391-1396. doi: 10.11847/zgggws1138973
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  Objective  To examine infection characteristics and genetic evolution of adenovirus isolated in patients with diarrhea in Ningxia Hui Autonomous Region (Ningxia) for providing evidence to the prevention and control of human adenovirus infection.   Methods  Totally 6 695 fecal specimens were collected from diarrheal outpatients at 10 diarrhea sentinel hospitals in 5 cities of Ningxia from 2015 through 2020. Adenovirus positive samples were screened out with real-time PCR. The gene of adenovirus hexon was amplified with PCR and sequenced for virus type identification and phylogenetic analysis.   Results  Of all the specimens detected, 4.2% (278) were adenovirus positive and the positive rate was the highest (7.7%) for the specimens collected in 2017. There were significant differences in the adenovirus positive rate among the specimens collected in different seasons and isolated from the outpatients of various age groups. Gene sequences were obtained for the 80 adenovirus strains isolated from the 278 viral positive specimens. For the 80 viral strains, three genotypes were identified and the main type was F41, followed by type F40 and type C1.  Conclusion  Adenovirus-induced diarrhea occured across a year among the people of various ages in Ningxia during 2015 – 2020 and the dominant adenovirus strain causing the diarrheal diseases was type F41.
Special Column – Healthy China Action:Mental Health Promotion
Relationship between sleep quality and mental health before and after COVID-19 epidemic among rural older adults in Shandong province
LI Jie, YANG Shi-jun, LI Zhi-xian,
2022, 38(11): 1397-1400. doi: 10.11847/zgggws1136867
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  Objective  To explore the relationship between sleep quality and mental health before and after the outbreak of coronavirus disease – 2019 (COVID-19) epidemic among rural older adults in Shandong province, and to provide evidence for improving sleep quality and mental health of the adults.   Methods  Using stratified multistage random sampling, 3600 rural adults aged 60 years and above were selected in three prefectures (Qufu, Laoling and Rushan), Shandong province for a baseline survey during May 2019 and a follow-up survey during August 2020. Face-to-face interviews were conducted among the adults with a self-designed questionnaire, Pittsburgh Sleep Quality Index (PSQI), and the Kessler Psychological Distress Scale (K10) to collect relevant information. The cross-lagged path analysis was used to test causal relationship between sleep quality and psychological distress before and during the COVID-19 epidemic.   Results  Among a total of 2 749 adults completing the base line and follow-up survey, significantly increased PSQI score (9.03 ± 4.31 vs. 7.82 ± 4.52, β = 1.21) and K10 score (18.23 ± 8.06 vs. 16.64 ± 7.44, β = 1.59) during the epidemic period were observed in contrast to those 14 months ago (both P < 0.001). After adjusting for gender, age, education, marital status, annual household income per capita, smoking, alcohol drinking, self-rated health status, comorbidity of chronic diseases, and physical exercise, the results of cross-lagged path analysis showed that sleep quality before the epidemic could predict psychological distress during the epidemic (\begin{document}$\rho _1 $\end{document} = 0.041, P = 0.015), but psychological distress before the epidemic could not predict sleep quality during the epidemic (\begin{document}$\rho _2 $\end{document} = − 0.005, P = 0.749), with a significant disparity in the difference between the values of the two coefficients (\begin{document}$\rho _1 $\end{document} > \begin{document}$\rho _2 $\end{document}, P < 0.001), which suggested that there was a one-way causal temporal relationship between sleep quality and psychological distress.  Conclusion  The sleep quality and mental health status of rural older adults in Shandong province were worsen after the outbreak of the COVID-19 epidemic and the older adults with poor sleep quality are more likely to have psychological distress.
Association of social capital with sleep disorders among adult Tibetan residents in Tibet Autonomous Region, China
FU Yao, Cideji, Nima Qucuo,
2022, 38(11): 1401-1407. doi: 10.11847/zgggws1135906
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  Objective  To explore the impact of social capital on sleep disorders among adult Tibetan residents in Tibet Autonomous Region (Tibet) and to provide evidences for improving sleep quality in the population.   Methods  Relevant data on 7 737 Tibetan community residents aged 18 – 79 years were extracted from the base line survey of The China Multi-Ethnic Cohort (CMEC) conducted in Tibet with stratified multistage cluster sampling and face-to-face questionnaire interviews from May 2018 to September 2019. Multivariate unconditional logistic regression was used to analyze the correlation of social capital with sleep disorders in the residents.   Results  Sleep disorders were reported by 31.41% (2430) of the residents surveyed. The residents′ mean score for family social capital and community/social capital were 8.2 and 10.0, respectively. After adjusting for demographic characteristics and health risk factors, the residents with higher family social capital were less likely to have sleep disorders (odds ratio [OR] = 0.97, 95% confidence interval [95% CI]: 0.95 – 0.99); no significant effect of community/social capital on sleep disorder was observed (P > 0.05). After stratified by age, the elder residents (≥ 50 years) with higher family social capital were less likely to have sleep disorders (OR = 0.95, 95% CI: 0.92 – 0.99); while, the impact of family social capital and community/social capital on sleep disorders was not significant for the residents under 50 years old (P > 0.05).   Conclusion  The social capital is related to the occurrence of sleep disorders among adult Tibetan residents in Tibet. The result should be concerned when developing interventions on sleep disorder in the population.
Prevalence and influencing factors of insufficient sleep among adults in Anhui province: a cross-sectional survey
XU Wei, DAI Dan, HE Qin,
2022, 38(11): 1408-1411. doi: 10.11847/zgggws1137004
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  Objective  To investigate the status and influencing factors of insufficient sleep among adult residents in Anhui province, and to provide evidences for improving the residents′ sleep quality.   Methods  With stratified multistage cluster random sampling, we conducted face-to-face interviews among 7 344 permanent adult residents (at ages of 18 years and above) recruited at 12 disease surveillance points in Anhui province during October – December 2018. A self-designed questionnaire was used to collect the residents′ information on sleep duration and its associates; the prevalence of insufficient sleep (less than 7 hours per day) and its influencing factors were assessed using complex weighting and post-weighted stratification and logistic regression analysis.   Results  Among 7 253 respondents with complete information, the average sleep duration was 7.5 hours per day and insufficient sleep was reported by 24.5% (2 240) of the respondents. Unconditional multivariate logistic regression analysis showed that aged ≥ 45 years and with a general or poor/very poor self-rated health condition are risk factors for insufficient sleep; while the education of junior high school and above is a protective factor.   Conclusion  The prevalence of insufficient sleep was high and mainly influenced by age, education and self-rated health status among adult residents in Anhui province.
Association of poor sleep with multiple chronic conditions among adult residents in Beijing: a cross-sectional survey
WEI Ying-qi, MA Ai-juan, XIE Jin,
2022, 38(11): 1412-1416. doi: 10.11847/zgggws1136854
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  Objective  To analyze the relationship between poor sleep and multiple chronic conditions (MCC) among residents aged 18 – 79 years in Beijing in 2017 for providing reference to the prevention and control of chronic disease comorbidity.   Methods  A total of 13 240 permanent residents aged 18 – 79 years were recruited from 16 districts of Beijing municipality with stratified multistage cluster sampling. Face-to-face questionnaire interviews, physical examination and laboratory detections were conducted among the residents during August – December 2017. Complex sampling weighting method was used to estimate the prevalence of poor sleep status and MCC and correlations between poor sleep status and MCC were analyzed with unconditional multivariate logistic regression models.   Results  All the residents completed the survey. The self-reported prevalence rate of poor sleep status at least three days in a week during past 30 days was 25.8% (n = 3 413) for snoring / sleep apnea, 19.2% (n = 2 536) for difficulty in falling asleep, 23.4% (n = 3 103) for two and more times of intermediate awakening in one night, 20.2% (n = 2 671) for early awakening, and 2.8% (n = 367) for taking sleeping pills; the complex sampling weighted prevalence rate of poor sleep (reporting one or more bad sleep conditions) was 52.1% (n = 6 490). Totally 4 980 sufferers of MCC were identified among all the participants, with a weighted MCC prevalence rate of 41.7%. Unconditional multivariate logistic regression analysis revealed that the participants reporting the poor sleep status were associated with MCC, with the odds ratios (95% confidence intervals) of 1.955 (1.731 – 2.208) for the participants reporting snoring / sleep apnea, 1.914 (1.591 – 2.202) for intermediate awakening of ≥ two times, 1.802 (1.534 – 2.117) for early awakening, 1.625 (1.380 – 1.913) for difficulty in falling asleep, and 2.617 (1.907 – 3.592) for taking sleeping pills after adjusting for confounding factors such as gender, age, education, marital status, place of residence, smoking, alcohol drinking during past 7 days, physical activity, active physical examination and body weight.   Conclusion  Poor sleep status and MCC were prevalent and a variety of poor sleep conditions were related to MCC among 18 – 79 years old residents in Beijing.
Prevalence and risk factors of poor sleep quality among preschool children: a cross- sectional survey in Chizhou city, Anhui province
CHENG Jin, WEI Suo, PAN Chun,
2022, 38(11): 1417-1422. doi: 10.11847/zgggws1138052
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  Objective   To investigate the prevalence and influencing factors of poor sleep quality in preschool children in Chizhou city, Anhui province, and to provide evidences for improving children′s sleep health.  Methods   An on-site self-administered questionnaire survey was conducted among parents of 1815 children aged 3 – 6 years recruited with stratified random cluster sampling from 14 kindergartens in districts/counties of Chizhou city during June – July 2020. The Children′s Sleep Habits Questionnaire (CSHQ) – Chinese Version and a self-designed questionnaire were used in the survey.   Results  Of the 1 758 children (96.9% of the all children) with valid information, 76.3% were assessed as having poor sleep quality; the detection rates were 85.6% for bad bedtime habit, 46.6% for prolonged sleep latency, 46.6% for irregular sleep duration, 84.7% for sleep anxiety, 19.4% for waking up at night, 45.1% for parasomnia, 11.0% for sleep-disordered breathing, and 71.0% for daytime sleepiness, respectively. The results of multivariate unconditional logistic regression analysis showed that sharing one bed with relatives, sleeping in a separate bed but the same room with relatives, with a primary caregiver having the bedtime of not earlier than 22 o'clock, and with a primary caregiver using electronic products before bedtime were the risk factors for poor sleep quality of the preschool children; while, with a quiet sleeping environment and having siestas habit were the protective factors against poor sleep quality; the results also demonstrated that the children′s various poor sleep behaviors were significantly affected by following factors: in terms of risk effect (1) mean time of ≥ 30 minutes for each time of using electronic products for bad sleeping habit, (2) sharing one bed with relatives and sleeping in separate bed but in the same room with relatives for bad sleeping habit/sleep anxiety, (3) with a primary caregiver having the bedtime of not earlier than 22 o'clock for prolonged sleep latency/daytime spleepiness, (4) being a boy and with a primary caregiver using electronic products before bedtime for parasomnia; and in terms of protective effect (1) with a quiet sleeping environment against bad sleeping habit/prolonged sleep latency/irregular sleep duration/waking up at night/parasomnia/daytime sleepiness, (2) having siestas habit against irregular sleep duration, and (3) aged 5 – 6 years against sleep anxiety.   Conclusion   Among preschool children in Chizhou city, the prevalence rate of poor sleep quality, mainly manifested as unhealthy sleeping habit, is relatively high and affected significantly by sleeping environment, siestas habit, primary caregiver′s bedtime and electronic product usage before bedtime.
Epidemiological Research
Abnormal conditions detected in routine health examinations and their associates among 0 – 6 years children in three provinces of China
ZAN Zi-qing, ZHAO Jin-hong, FAN Zi-xuan,
2022, 38(11): 1423-1428. doi: 10.11847/zgggws1137309
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  Objective   To analyze abnormal conditions detected in routine health examinations covered by national basic public health services (BPHS) and associates of family environment and utilization of health services with the abnormal conditions among 0 – 6 years children.   Methods   Using stratified multistage random sampling and a self-designed questionnaire, we conducted an on-site survey among parents of 3 020 of children aged 0 – 6 years at 10 community health service centers/township health centers in Zhejiang province, Shanxi province and Chongqing municipality during November – December 2019.   Results  Reported by the parents, according to outcomes of physical examinations under the BPHS, the abnormal conditions with top three prevalence rates among the children surveyed were caries (5.9%, 171/2 919), anemia (4.3%, 126/2 922), and calcium deficiency (3.5%, 101/2 920). Caries were more prominent in the children over 3 years of age. Higher prevalence rate of anemia (4.8%, 29/605), calcium deficiency (4.3%, 26/603), and suspected developmental delay for mental and behavioral (1.0%, 6/604) were reported for the children in Chongqing municipality in western China; while higher prevalence rate of calcium deficiency and sleep problems were reported for the children in urban regions and Zhejiang province in eastern China.   Conclusion   There are significant age-, region-, and urban-rural-specific disparity in abnormal conditions detected in routine physical examinations covered by national BPHS among 0 – 6 years old children in China.
Association between ability to choose prepackaged food and preference for front-of-pack labeling among residents in 6 provinces, China
YAN Rui-jie, HU Yi-luan, ZHANG Jing-wen,
2022, 38(11): 1429-1434. doi: 10.11847/zgggws1137061
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  Objective   To explore the association between the ability to choose prepackaged foods with low salt/sugar/fat and the preference for front-of-pack labeling (FOP) among residents in six provincial-level administrative divisions (PLADs) across China and to provide evidences for the development of domestic FOP.   Methods   With multistage sampling and a self-designed questionnaire, 3 037 residents aged 18 – 70 years were recruited in six PLADs for a cross-sectional survey from July 2020 to March 2021. Univariate analysis and multivariate logistic regression analysis were conducted with SAS 9.4.   Results  Complete information were collected from 3 002 of the participants. Of the valid respondents, 54.6% (1 639), 55.3% (1 661), and 54.1% (1 624) reported being able to choose prepackaged foods with low salt, sugar, and fat and 35.4% (1 064) of the respondents considered that the FOP in the format of multiple traffic light (MTL) could help them select healthier food quickly. After adjusting for demographic confounders, the results of logistic regression analysis revealed that in comparison to the respondents with self-reported ability to choose prepackaged food with low salt/sugar/fat, the respondents having a little self-reported ability were more likely to believe the FOP in formats of health logos-smart choice, and nutri-score could help them select healthier food more quickly than the FOP in the format of guideline daily amount (GDA); the respondents having a little ability to choose prepackaged food with low salt or sugar were more likely to believe the FOP in the format of MTL could be more helpful in selecting healthy food than GDA of FOP and the respondents having a little ability to choose prepackaged food with low salt were more likely to believe the FOP in the format of warning labels could be more helpful; while, the respondents without the ability to choose prepackaged foods with low salt/sugar/fat were more likely to believe the FOP in format of smart choice could be more helpful. All the above results are of significance, with the odds ratios of greater than one (P < 0.05 for all).   Conclusion   In China, nearly a half of residents had a low ability to choose prepackaged foods with low salt/sugar/fat; the FOP format integrating summary indicators on the basis of MTL may hopefully play a role in improving the residents′ ability to choose healthier foods.
Effectiveness of 13-valent pneumococcal polysaccharide conjugate vaccine on community-acquired pneumonia: a retrospective cohort study among young children in Suzhou city
LI Zhao-jin, CHEN Qing-hui, LUAN Lin,
2022, 38(11): 1435-1439. doi: 10.11847/zgggws1137785
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  Objective  To evaluate protective effectiveness of 13-valent pneumococcal polysaccharide conjugate vaccine (PCV13) on community-acquired pneumonia (CAP) among young children in Suzhou city.   Methods  A retrospective cohort study was carried out among 59 927 children aged 0 − 18 months and having outpatient visit or hospitalization at Children's Hospital of Soochow University (SCH) from December 1, 2017 to June 30, 2019. The participants' information on outpatient visit or hospitalization were collected from the information system of SCH and that on PCV13 vaccination were extracted from the Immunization Information System of Suzhou Municipal Center for Disease Control and Prevention. Cox proportional hazard model was used to estimate the vaccine effectiveness (VE) of different doses of PCV13.   Results  Of all the children followed-up, 12.4% (n = 7 459) were vaccinated with PCV13. Among the children having at least one dose, two doses, and three doses of PCV13 vaccination, the VE of PCV13 against CAP diagnosed at first outpatient visit or hospitalization during the follow-up period were 10.1% (95% confidence interval [95% CI]: 3.3% − 18.1%), 15.7% (95% CI: 7.6% − 23.1%), and 20.3% (95% CI: 11.5% − 28.3%); while, the VE of PCV13 against CAP diagnosed during the whole follow-up period were 13.1% (95% CI: 6.0% − 20.0%), 17.5% (95% CI: 10.0% − 24.5%), and 22.2% (95% CI: 14.0% − 30.0%), respectively.   Conclusion  PCV13 is of protective effectiveness against CAP in young children and the PCV13 vaccination of 3 doses is the most effective.
Prevalence and clustering of modifiable risk factors of cardiovascular disease in rural residents of Luoping county, Yunnan province: a com-parison between 2011 and 2021
LI Jin-bo, LIU Lan, MO Yi,
2022, 38(11): 1440-1444. doi: 10.11847/zgggws1137907
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  Objective  To compare the prevalence and clustering of modifiable risk factors of cardiovascular disease (CVD) among rural residents of Luoping county, Yunnan province between 2011 and 2021, and to provide evidence for the prevention and treatment of CVD in the population.   Methods  With stratified multistage random sampling, two waves of survey, including face - to - face questionnaire interview and physical examination, were conducted in November 2011 and November 2021 among 3 198 and 2 580 permanent rural residents aged 35 years and over in Luoping county, Yunnan province.   Results  Complete information were collected from 3 092 and 2 539 of the residents. Compared to those in 2011, significantly decreased prevalence rates in 2021 were reported by the participants for current smoking (28.0% vs. 38.3%) , passive smoking (15.8% vs. 29.7%) , alcohol drinking (17.8% vs. 28.0%), not getting three meals a day on time (18.5% vs. 41.7%), having pickled products ≥ 3 days a week (28.9% vs. 62.8%), and consuming oily or fatty food ≥ 3 days a week (17.8% vs. 61.9%) (all P < 0.05); but significantly increased rates were detected or reported in 2021 for overweight (35.2% vs. 19.6%), obesity (13.6% vs. 4.9%), central obesity (68.0% vs. 43.7%), preference for high-salt diet (18.6% vs. 14.7%), and consuming fruits and vegetables < 3 days a week (3.2% vs. 0), respectively (all P < 0.05). The clustering rate of modifiable risk factors of CVD dropped from 90.4% in 2011 to 76.7% in 2021 among all the participants (χ2 = 195.073, P < 0.001) and the rate declined among the participants of various subgroups (all P < 0.05).   Conclusion   Among rural adult residents in Luoping county of Yunnan province, the prevalence rates of several modifiable risk factors of CVD decreased; while some of the rates increased in 2021 contrasting to those in 2011; but the clustering of the CVD risk factors decreased.
Compliance to endoscopic screening and its influencing factors among high-risk population of upper gastrointestinal cancer in urban Beijing: a population-based survey
LI Qing-yu, YANG Lei, ZHANG Xi,
2022, 38(11): 1445-1449. doi: 10.11847/zgggws1137594
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  Objective   To study the compliance to endoscopic screening and its influencing factors among high-risk population of upper gastrointestinal cancer (UGC) in urban Beijing and to provide evidence for developing appropriate health management strategies.   Methods  With cluster sampling, we recruited 73 240 permanent residents aged 40 – 69 years from designated communities of Beijing Cancer Early Diagnosis and Treatment Project in six urban districts of Beijing and conducted a face-to-face questionnaire survey on demographic and UGC-related information among the residents from September 2016 to March 2020. The residents assessed as at high-risk of UGC were advised to have endoscopic screening in designated hospitals. The acceptance of the endoscopic screening and its influencing factors among the high-risk people were analyzed.   Results  Valid responses were collected from all the participants and 23.0% (n = 16 862) of them were assessed as at high-risk of UGC. Of the high-risk participants, 11.9% (n = 2 004) received endoscopic screening. The results of unconditional multivariate logistic regression analysis showed that the high-risk participants with following characteristics were more likely to have a high compliance to endoscopic screening: aged over 50 years, with the education of senior high/technical secondary school and above, suffering from psychic trauma or depression, with upper gastrointestinal disease history, with family history of cancer, having hot food preference in daily diet, and being exposed to a little or much kitchen fume when cooking at home; while the high-risk participants being current smoker and having regular physical exercise were more likely to have low compliance to endoscopic screening.   Conclusion  Among high UGC risk population in urban Beijing, the overall compliance to endoscopic screening was poor and the compliance was influenced mainly by age, education, psychic trauma or depression, history of upper gastrointestinal diseases, family history of cancer, current smoking, regular physical activity, hot food preference in daily diet and kitchen fumes exposure at home.
Prevalence of vitamin D deficiency during autumn and winter among adults in Henan province
FENG Shi-xian, WANG Guo-jie, TIAN Hui-zi,
2022, 38(11): 1450-1454. doi: 10.11847/zgggws1137307
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Abstract:
  Objective  To examine the status of vitamin D deficiency (VDD) during the autumn and winter among adults in Henan province and to provide references for reducing adverse health effect of VDD.   Methods  Using multistage cluster random sampling, we conducted a survey among 8 455 urban and rural residents aged 18 years and above in 14 districts/counties of Henan province from October 2018 through February 2019. The participants′ serum 25(OH)D2 and 25(OH)D3 were determined with high-performance liquid chromatography-tandem mass spectrometry. Complex sampling weighting adjustment was adopted to estimate the prevalence of VDD (PVDD) among the participants.   Results  The estimated PVDD for all participants was 24.2% (95% confidence interval [95% CI]: 19.5% – 29.6%); the PVDD for the males was significantly lower than that for the females (16.0% vs. 32.0%, P < 0.05); the age-specific PVDD was highest (29.6%) for the participants aged 18 – 39 years; and the unmarried participants had significantly higher PVDD compared to those married (37.2% vs. 22.2%, P < 0.05). Multivariate log binomial regression analysis showed that in comparison with control groups, the adjusted prevalence ratio (APR) of VDD was significantly higher in following subgroups: females (vs. males: 2.04, 95% CI: 1.56 – 2.68), the unmarried (vs. the married: 1.29, 95% CI: 1.01 – 1.64), being employed in industries other than agriculture/forestry/animal husbandry/fishery/aquaculture (vs. being employed in the industries listed above or the unemployed: 1.81, 95% CI: 1.27 – 2.58; vs. the employed/housekeepers: 1.56, 95% CI: 1.05 – 2.30; vs. retirees: 1.76, 95% CI: 1.22 – 2.54), with higher education attainment (vs. primary school and below: 1.33 [95% CI: 0.99 – 1.80] for those with junior high school attainment, 1.44 [95% CI: 1.03 – 2.03] for senior high /technical secondary / technical school, and 1.78 [95% CI: 1.32 – 2.40] for college and above), being surveyed in winter season (vs. in autumn season: 1.44, 95% CI: 1.14 – 1.82 ).   Conclusion  The prevalence of vitamin D deficiency is high during the autumn and winter season among adults in Henan province and the prevalence was mainly influenced by gender, marital status, education attainment, occupation, and season.
Experimental Study
Single and combined effect of vinyl chloride monomer and high-fat diet on gut microbiota in mice
HAO Yan, CHENG Shi-qi, ZHAO Xiao-tian,
2022, 38(11): 1455-1459. doi: 10.11847/zgggws1136689
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Abstract:
  Objective  To investigate the impact of vinyl chloride monomer (VCM) alone or in combination with high-fat diet on gut microbe in mice.   Methods  Twenty 6-week-old male specific pathogen-free C57BL/6J mice were divided into four groups: control, high-fat diet (40% of fat), VCM (static inhalation of 2 hours at dosage of 800 mg/m3, 5 times per week continuously for 13 weeks), and VCM plus high-fat diet. By the end of treatments, fecal samples were collected from the mice for 16S rDNA sequence analysis to examine alterations of the mice′s gut microbe.   Results  The abundance and community structure of gut microbe changed in the mice with high-fat diet and VCM exposure. In terms of phylum, the ratio of Firmicutes to Bacteroidetes of the mice exposed to VCM and high-fat diet were higher than those of control mice. At genus level, the degree of gut microbes aggregation was different among the four groups. Alpha diversity analysis revealed that the observed gut species of the mice with high-fat diet were inferior to those of the mice of control and VCM plus high-fat diet group (both P < 0.05); the Shannon index for the mice with high-fat diet was significantly lower than that for the mice of other three groups (all P < 0.05). Beta diversity analysis indicated that there were differences in community composition of gut microbes among the four groups.   Conclusion  Exposure to VCM and high-fat diet, alone or combined, could lead to gut microbial imbalance in mice and the combined exposure mainly affect the abundance of gut microbial genera.
Temporospatial distribution of particles released by printer and influence of ventilation: an experimental study
GUO Xin, LÜ Li-zhi, WANG Yun
2022, 38(11): 1460-1464. doi: 10.11847/zgggws1135873
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Abstract:
  Objective  To explore temporospatial distribution of particulate matter (PM) released by printer and the influence of ventilation factors on the distribution.   Methods  An experimental chamber with a sized of 0.606 cubic meter (1.035 × 0.711 × 0.823) was fabricated for the study. The concentration of PM released by a printer at different times and locations was measured with a aerosol particle spectrometer. A ventilator was utilized to evaluate the influence of ventilation timing, flow rate and duration on the concentration of PM released by the printer.   Results  No significant difference was observed in the time of PM concentration reaching to the peak value at different positions in the experimental chamber (P > 0.05). The peak value of PM concentration decreased with the increase in the height of detection position (rs = – 0.740, P < 0.001) and horizontal distance between the printer and detection point (rs = – 0.351, P < 0.01). In terms of ventilation, the peak value of PM concentration (number of particulates/per cubic centimeter) was – 26.96 ± 8.42 for the ventilation before printing, – 5.67 ± 4.72 for the ventilation at the beginning of printing, 39.23 ± 16.85 for the ventilation at the end of printing, and 75.43 ± 15.37 for without ventilation, respectively, with a significant difference among the peak values (P < 0.05). The peak value of PM concentration decreased with the increase in ventilation flow rate and duration.   Conclusion  The particles released by printer spread rapidly in the experimental chamber and the number of released particulate matter presents an obvious vertical distribution and a horizontal distance attenuation. Ventilation timing, flow rate, and duration can affect the concentration of released particulate matter.
Survey and Report
Situation and development balance of major chronic disease service provision in the Yangtze River Delta of China: a literature- and coupling coordination degree model-based analysis
QI Yu-cheng, SHI Pei-wu, SHEN Qun-hong,
2022, 38(11): 1465-1468. doi: 10.11847/zgggws1137731
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Abstract:
  Objective  To analyze the status quo and balanced development of major chronic disease service provision capabilities in the Yangtze River Delta region of China, and to provide a reference for promoting high-quality and balanced development of major chronic disease prevention and control capabilities in the region.   Methods  We retrieved documents on prevention and control of major chronic diseases published by local administrations in the Yangtze River Delta region (including Shanghai municipality and three provinces of Jiangsu, Zhejiang and Anhui) during the period from January 2009 through December 2019. Taking a page from service provision elements for an appropriate public health system, service coverage rate (SCR) and assessable service coverage rate (ASCR) were constructed for quantitative analysis on major chronic disease service provision capability of the municipality and the three provinces in the region. Coupling coordination degree model was adopted to assess the balance of the service provision capacity development in the Yangtze River Delta region.   Results  The overall SCR and ASCR of major chronic disease service provision for the Yangtze River Delta region increased from 21.2% and 10.0% in 2009 to 82.8% and 51.5% in 2019. In the year of 2019, the prevention level-specific SCR and ASCR were the highest for tertiary prevention; the administrative division-specific SCR of tertiary prevention was the highest (96.0%) for Shanghai municipality and the lowest (71.0%) for Anhui province, while, the administrative division-specific ASCR of tertiary prevention was the highest (71.0%) for Jiangsu province and the lowest (33.0%) for Zhejiang province. The overall index value for coupling coordination degree of SCR and ASCR of the Yangtze River Delta region increased from 38.97 and 11.58 in 2009 to 90. 73 and 70.72 in 2019; the overall scores of 2019 for the balance of SCR of primary, secondary and tertiary prevention in the region were 9, 9 and 10, and the overall scores for the balance of ASCR were 7, 7 and 8 respectively.   Conclusion  In the Yangtze River Delta region during the period of 2009 – 2019, the major chronic disease service provision capacity and the balance for the capacity development increased yearly; the service provision capacity was higher for tertiary prevention than that for primary and secondary prevention and the development balance was higher for SCR than that for ASCR.
Accessibility of immediate reimbursement for cross-provincial healthcare and its influencing factors for rural residents: a nationwide cross-sectional survey
GUO Min-jiang, LI Ya-zi, ZHANG Fang-yuan,
2022, 38(11): 1469-1473. doi: 10.11847/zgggws1137544
Abstract(234) HTML (89) PDF 517KB(11)
Abstract:
  Objective  To examine the status and influencing factors of accessibility to immediate reimbursement for cross-provincial healthcare among rural residents and to provide evidence for improving related policies.   Methods   With simple random sampling, a nationwide online questionnaire survey was conducted among 2 497 rural residents having cross-provincial hospitalization during past one year in 100 designated hospitals providing healthcare service to non-local residents and with leading amount of immediate reimbursement for the services from September 2019 through September 2020. Macro- and micro-factors affecting the accessibility of immediate reimbursement for cross-provincial healthcare of rural residents were analyzed using hierarchical model.   Results   Of the 2 363 participants with valid responses, only 19.2% (n = 454) received cross-provincial immediate reimbursement for their out-of-pocket medical costs; the ratio of receiving cross-provincial immediate reimbursement was the highest among the participants with severe disease referrals (31.7% [152/480]) and cross-provincial medication in tertiary hospitals (21.0% [351/1 674]). For the participants with long-term living/working in non-home provinces, the probability of receiving immediate reimbursement for cross-provincial healthcare was only 25.4%/54.5% of that for the participants with severe disease referrals; for the participants having the cross-provincial healthcare in secondary hospitals, the probability was 64.4% of that for the participants having the healthcare in tertiary hospitals. Each 1% increase in the proportion of designated hospitals with immediate reimbursement for cross-provincial healthcare against all hospitals in a region is associated with a 36.8% increase in the probability of immediate reimbursement for cross-provincial healthcare among rural residents.   Conclusion   The accessibility to immediate reimbursement for cross-provincial healthcare among rural residents is poor probably due to the gap between cross-provincial healthcare and the coverage of immediate reimbursement network and due to the restriction of the rural residents' migration. The results suggest that targeted strategies need to be developed to increase the accessibility.
Health literacy among contracted family doctors in Shanghai, 2020: a cross-sectional survey in 2020
YANG Kai-yue, WAN He-ping, PAN Xin-feng,
2022, 38(11): 1474-1477. doi: 10.11847/zgggws1137508
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Abstract:
  Objective  To examine health literacy among contracted family doctors in Shanghai for providing evidence to the formulation of strategies and measures on health literacy promotion in the doctors.   Methods  Using National Health Literacy Questionnaire (HLQ), we conducted an online survey among all doctors engaged in contracted family doctor services during October – December 2020 in Shanghai city.   Results   Of the 5 826 respondents (99.96% of the doctors surveyed) with valid responses, 96.74% were assessed as with basic overall health literacy according to their total scores of HLQ; the proportions of the respondents with the three health literacy domains were 96.74% for basic health knowledge and concept, 87.38% for healthy lifestyle and behavior, and 78.82% for basic skills; and the proportions of the respondents with the health literacy associated with public health problems were 94.82% for safety and first-aid, 93.82% for scientific health perspective, 91.01% for health information, 85.96% for basic medical skills, 81.14% for chronic disease prevention and treatment, and 72.91% for infectious disease prevention and treatment, respectively. Univariate analysis indicated that the health literacy level differed significantly by gender, age and education among the respondents.   Conclusion  The health literacy level of the contracted family doctors in Shanghai is generally at a relatively high level, but some literacy domains need to be improved and health literacy related practice should be promoted among the doctors.
Health literacy and its influencing factors among residents in areas out of poverty in Yunnan province, 2020: a cross-sectional survey
PU Shi-chuan, LIU Mei, LI Ling-qing,
2022, 38(11): 1478-1480. doi: 10.11847/zgggws1138214
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Abstract:
  Objective  To examine the health literacy and its influencing factors among residents living in areas out of poverty in Yunnan province for providing evidence to the development of regional health promotion policies.   Methods  Totally 36 410 permanent residents aged 15 – 69 years were recruited in 88 formerly impoverished counties of Yunnan province with stratified multistage random cluster sampling for a household survey. The National Health Literacy Questionnaire was self-administered to the participants under the guidance of interviewers during August – October, 2020.   Results  For the 34 510 participants with valid responses, only 5 129 (14.86%) were assessed as having adequate health literacy (with an overall score of ≥ 80 for a maximum health literacy score of 100). The results of multivariate unconditional logistic regression analysis showed that the participants aged 25 – 54 years or with the education of primary school and above were more likely to have a higher health literacy; while, those being ethnic minority or living in rural areas were more likely to have a lower health literacy.   Conclusion  The health literacy is at a low level and mainly influenced by age, ethnic, education and residential area among the residents living in areas out of poverty in Yunnan province.
Co-benefits effect of non-pharmacological intervention against COVID-19 on tuberculosis in Ningxia Hui Autonomous Region: a SARIMA analysis
WANG Ruo-nan, YANG Zheng-gui, LIU Wei-chen,
2022, 38(11): 1481-1485. doi: 10.11847/zgggws1138106
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Abstract:
  Objective  To analyze the influence of non-pharmacological interventions (NPIs) against coronavirus disease 2019 (COVID-19) on tuberculosis (TB) incidence in Ningxia Hui Autonomous Region (Ningxia) in 2020.   Methods  Using TB incidents reported in Ningxia during 2004 – 2018 as a training set and those during 2019 – 2020 as a prediction set, a seasonal autoregressive moving average (SARIMA) model was established to predict TB incidents during the three COVID-19 epidemic periods with different response level in 2020 in Ningxia. The relative rate of change in the number of TB incidence for the three response periods were calculated by comparing the TB incidence number in the COVID-19 response periods with the number of same periods in 2019 or the number predicted based on the established SARIMA model.   Results   The established ARIMA(1,1,2) (1,1,2)12 model was fitted to the data well, with a root mean square error of 1280.50 and a mean absolute percentage error of 13.15%. The NPIs against COVID-19 showed an inhibitive co-benefits effect on the incidence of TB in Ningxia, resulting the expected incidence reductions of 63.58%, 29.61% and 8.59% for the response periods of level I, level II and level III, respectively.   Conclusion  Non-pharmacological interventions against COVID-19 could exert an incidence reduction co-benefits effect on TB in Ningxia, and the effect may be positively related to the grade of emergency response.
Indoor radon concentration and its influencing factors in newly decorated houses and offices in Shenyang city
WU Hao-lan, ZHAO Hang, LI Meng-ge,
2022, 38(11): 1486-1488. doi: 10.11847/zgggws1132296
Abstract(727) HTML (239) PDF 470KB(122)
Abstract:
  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 evidence 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.
Overview
Advances in epidemiologic researches on human papillomavirus-associated head and neck cancer
JIA Xin-hua, SU Zheng, LI Yu-fei,
2022, 38(11): 1489-1493. doi: 10.11847/zgggws1136127
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Abstract:
The cause of head and neck cancer (HNC) is mainly tobacco and alcohol exposure. With the promotion of smoking cessation, the incidence of smoking-related HNC is decreasing but that of HNC associated with human papillomavirus (HPV) infection is gradually increasing, especially in developed countries. In the United States, HPV-related HNC has became the number one HPV-related tumor with higher incidence than that of HPV-related cervical cancer. In addition, with successive implementation of HPV vaccine vaccination, cervical cancer research is gradually entering the post HPV-related vaccine era, and the research on other HPV-related tumors, especially HNC, is becoming the next hot spot of relevant studies.
Public Health Forum
Influenza-related burden in China: current situation, challenges and response strategies
CHEN Chen, LIU Guo-en, ZENG Guang
2022, 38(11): 1494-1498. doi: 10.11847/zgggws1140026
Abstract(908) HTML (1337) PDF 564KB(376)
Abstract:
Influenza and coronavirus disease 2019 (COVID-19) are both contagious respiratory illnesses. A co-infection of influenza and COVID-19 will prolong the illness, worsen the severity of COVID-19 symptoms and increase fatality, especially for senior citizens, children and people with chronic diseases; the co-infection condition could also bring heavy disease and economic burden to the sufferers, their families, and the society. Therefore, it is crucial to enhance influenza prevention strategies under the global COVID-19 pandemic. In this paper, we summarize the disease and economic burden of influenza and discuss current problems and challenges in influenza prevention and related researches in China. In the end, we put forward relevant strategies to achieve the goal of long-term influenza prevention.
New connotation of primary health care for the future: a brief description
DONG Yi-han, LI Bo-yang
2022, 38(11): 1499-1504. doi: 10.11847/zgggws1137914
Abstract(298) HTML (217) PDF 767KB(54)
Abstract:
Conventional concept and connotation of primary health care are no longer being well adapted to the development of human society, economy and health. After reviewing the development of conventional concept of primary health care, we analyze the concept′s characteristics that do not adapt to social development. Based on the conventional concept, the future - oriented connotation of primary health care is to provide community - based, integrated and people - oriented services which rely on technology, social innovation and multi - sectoral collaboration, and with the capacity to respond to health emergencies and climate and environmental change. The new connotation of primary health care would possess following six features: providing community - based service, with integrative and continuous framework, incorporating technological and social innovation, participating in emergency management, being capable of participating in response to climate and environmental change, and with policy environmental support.