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2023, 39(4)
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2023, 39(4): 1-1.
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Special Report – Mental Health during COVID-19 Pandemic
Prevalence and influencing factors of pandemic fatigue during normalized COVID-19 containment among the public in China: an online cross-sectional survey
LIU Yanni, HAO Yanhua, WANG Ziyu,
2023, 39(4): 409-414. doi: 10.11847/zgggws1141011
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  Objective  To investigate the prevalence of pandemic fatigue and its associates during the period of normalized containment of coronavirus diease 2019 (COVID-19) among the public in China.   Methods  Through an online survey platform ‘Wenjuanxing’ and with self-designed questionnaires on demographics, COVID-19-related risk perception, protective behaviors, negative emotion, and pandemic fatigue, we conducted a self-administered survey during February – March 2021 among web users aged 18 years and above in five provincial level administrative divisions across China. The collected data were analyzed with descriptive statistics, chi-square test and logistic regression analysis.   Results   Of 4 325 participants with eligible responses, 1 082 (25.0%) reported pandemic fatigue symptoms; 1 844 (42.6%) reported only having psychosomatic fatigue and 1 050 (24.3%) only having information fatigue. The results of logistic regression analysis revealed that the participants with following characteristics were more likely to have pandemic fatigue symptoms: with poor health status (odds ratio [OR] = 1.838, 95% confidence interval [ 95%CI]: 1.575 – 2.144), having a higher perceived susceptibility to COVID-19 (OR = 1.435, 95%CI: 1.236 – 1.667), having a lower perceived controllability of COVID-19 (OR = 1.760, 95%CI: 1.495 – 2.070), and with highly negative emotion (OR = 3.493, 95%CI: 2.987 – 4.086).   Conclusion   Pandemic fatigue symptoms were prevalent during the period of COVID-19 containment and the symptoms were associated with self-reported health status, perceived controllability and susceptibility of COVID-19, and negative emotion among adult web users in China.
Construction of a machine learning-based prediction model for emotional eating during COVID-19 pandemic among doctors in North China
WANG Qihe, LIU Sana, FANG Haiqin,
2023, 39(4): 415-420. doi: 10.11847/zgggws1140655
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  Objective   To construct a prediction model for emotional eating behavior during coronavirus disease 2019 (COVID-19) pandemic among doctors in northern region of China for providing evidence to the promotion of healthy dietary patterns in the doctors.   Methods  An on-site self-administered questionnaire survey was conducted among 2 316 doctors randomly recruited at 39 COVID-19 designated hospitals in 8 provincial-level administrative divions in northern China during May – August 2022. Relevant information of the doctors were collected with a general questionnaire, work-family conflict scale, NEO Five-Factor Inventory and emotional eating scale. Deep neural network (DNN) was used to develop a prediction model for associates of emotional eating during the COVID-19 pandemic in the doctors.   Results  For 2 094 participants with complete information, the mean overall score of emotional eating during the COVID-19 pandemic was 51.48 ± 17.37 and the dimensional scores were 11.31 ± 4.07 for anger influenced eating, 16.72 ± 7.56 for anxiety influenced eating, 11.02 ± 3.24 for depression influenced eating, and 12.43 ± 4.27 for positive emotion influenced eating. A DNN model with 21-19-14-9-1 network framework was constructed for predicting emotional eating behaviors in the doctors during the COVID-19 pandemic and the parameters of the model were 0.926 for R2, 0.039 for mean absolute error, 0.003 for mean squared error, and 0.056 for root mean squared error, respectively. Based on the modeling results, the top five predictors for emotional eating model were alcohol consumption, work-family conflict, unbalanced nutrition, male gender, and irregular dietary pattern.   Conclusion  Emotional eating behaviors during the COVID-19 pandemic was not rare and mainly influenced by unhealthy eating habits and work-family conflict among doctors in northern China. Machine learning could be used to predict effectively and accurately the risk of emotional eating behavior for the doctors.
Post-specific difference in mental health among medical staff in Beijing during COVID-19 epidemic: an online survey
LIU Yinqi, WANG Zhe, ZHANG Chunjie,
2023, 39(4): 421-425. doi: 10.11847/zgggws1139423
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  Objective  To analyze the difference in mental health status among medical staff working at different posts in Beijing city during coronavirus disease 2019 (COVID-19) epidemic.   Methods  An online questionnaire survey was conducted among 5 230 medical staff recruited with random cluster sampling at 22 public hospitals in Beijing city during October – November 2020. Psychological status of the stuff working at different posts during the COVID-19 epidemic was assessed with Patient Health Questionnaire (PHQ-9), 7-Item Generalized Anxiety Disorder Scale (GAD-7) and Insomnia Severity Index (ISI).Descriptive analysis and one-way analysis of variance were adopted in data analyses.   Results  Of the 4 931 staff with valid responses, 1 603 (32.51%) were assessed as having anxiety, 1 729 (35.06%) having depressive symptoms, 933 (18.92%) having insomnia during the epidemic period. The detection rate of anxiety, depression and insomnia differed significantly among the staff working at second-/front-line posts in their hospitals formerly belonged to and the staff dispatched to other medical institutions for anti-epidemic work (P < 0.05). The results of logistic regression analysis showed that the type of working post and age were influencing factors of anxiety and depression; while the type of working post, age and education were the influencing factors of insomnia.   Conclusion  The mental health status varied among medical staff working at different posts in Beijing city during COVID-19 epidemic and poor mental health could be detected most frequently among the staff working at front-line posts in their original hospitals.
Anxiety emotion and its associates among adolescents during a major public health emergency: a cross-sectional survey in China
ZHANG Yansheng, YANG Yanjie, QIAO Zhengxue
2023, 39(4): 426-429. doi: 10.11847/zgggws1139238
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  Objective  To explore the prevalence and influencing factors of anxiety emotion among Chinese adolescents during a major public health emergency (PHE) for providing evidence to the development of appropriate intervention strategies.   Methods  An online self-administered survey via Sojump platform was conducted among 208 433 adolescents (16 – 22 years old) in 34 provincial level administrative divisions across China during March 2020. A self-designed questionnaire and Generalized Anxiety Disorder-7 (GAD-7) were adopted in the study.   Results  Among the 170 830 participants with valid responses, 40 448 (23.7%) were identified as having anxiety emotion during the major PHE; of the participants with anxiety emotion, 80.2% (32 458), 14.5% (5 878), and 5.3% (2 152) were assessed as having mild, moderate, and severe anxiety, respectively. Unconditional multivariate logistic regression analysis revealed following risk factors for having anxiety emotion during the major PHE among the adolescents: female gender, living in a region affected by an ongoing major PHE with more than 100 reported cases, with trauma history, and being affected directly or indirectly by the major PHE but not being a confirmed disease case; whereas, having a fair or good relationship with family members and usually with a general or stable emotion before the major PHE were protective factors against anxiety emotion during the PHE.   Conclusion  During the period of a major PHE among Chinese adolescents, the prevalence of anxiety emotion was relatively low and mainly affected by gender, the number of confirmed disease cases within a residential area, relationship with family members, trauma history, and impact severity of the major PHE.
Prevalence and influencing factors of depression symptoms among grass-roots civil servants in Jiaxing city
ZHAO Linghui, LING Jie, ZHANG Jingmin,
2023, 39(4): 430-432. doi: 10.11847/zgggws1139375
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  Objective  To investigate the prevalence and impact factors of depressive symptoms among grass-roots civil servants in Jiaxing city for providing evidence to conduct psychological intervention in the staff.   Methods  Using convenient sampling, an online self-administered survey was carried out among 5 780 civil servants (aged 18 – 60 years) working in government departments at district/county level and below in Jiaxing city, Zhejiang province during November – December 2021, with a self-designed questionnaire and Self-Rating Depression Scale (SDS). Multivariate logistic regression model was adopted in analyses on influencing factors of depressive symptoms among the grass-roots staff.   Results  Among the 5 295 valid participants (91.6% of the civil servants surveyed), 1 330 (25.12%) were assessed as having depressive symptoms and the proportions of the participants having mild, moderate, and severe depression symptoms were 17.79%, 6.04%, and 1.28%, respectively. The detection rate of depressive symptoms differed significantly by gender, administrative rank of working entity, age, educational background and annual income (P < 0.05 for all). Binary multivariate logistic regression analysis showed that the middle-aged participants (31 – 40 years) had a higher risk of depressive symptoms (odds ratio [OR] = 1.303, 95% confidence interval [95%CI]:1.077 – 1.577) but the elder participants (51 – 60 years) had a lower risk (OR = 0.592, 95%CI: 0.451 – 0.777) compared to the young participants aged 18 – 30 years and that female participants had a lower risk of depressive symptoms (OR = 0.702, 95%CI: 0.609 – 0.809) in contrast to male participants.   Conclusion  Depressive symptoms are prevalent among grass-roots civil servants, especially among the male and middle-aged civil servants, in Jiaxing city.
Epidemiological Research
Information construction in centers for disease control and prevention: a nationwide online survey at provincial level and in pilot regions
LI Shaoqiong, MA Jiaqi, CHEN Meng, DU Xue-jie,
2023, 39(4): 433-436. doi: 10.11847/zgggws1140350
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  Objective  To examine the status quo of information construction in centers for disease control and prevention (CDCs) of provincial level and in pilot regions across China.   Methods   An online questionnaire survey was conducted among 32 provincial-level CDCs and 31 prefecture-level and 29 county/district level CDCs in pilot regions during 2021 via China Disease Prevention and Control Information System.   Results  For the CDCs surveyed, there were totally 341 full-time staff engaged in the information construction. Of all the CDCs, 56.04% established specific information departments; 62.64% had the information construction fund less than 1% of their total expenditure; 43.96% put the information construction into the scope of performance evaluation; and 72.83% paid special attention to the integration of new technologies and the information construction. During 2019 – 2021, the professionals of the investigated CDCs were involved in the formulation or revision of 16 standards on health information and the publication of 187 papers about informatization. The Immunization Program Information System was operated in all the provincial CDCs surveyed, together with infectious disease surveillance and early warning system and mental health management system established in 50% and 59.38% of the provincial CDCs. Cross-sectoral information sharing was carried out in 12 provincial CDCs and 3 prefecture-level CDCs in pilot regions.   Conclusion  The pilot work of information construction for disease control has promoted the improvement of the national information system for disease control. However, there are still some problems such as lack of investment, regional imbalance, insufficient specific informatizition support, connectivity and management collaboration.
Professional identity among Chinese medical graduates: a cross-sectional survey
YU Chen, WU Hongbin, WANG Weimin,
2023, 39(4): 437-441. doi: 10.11847/zgggws1137607
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  Objective  To examine the status quo of and group disparity in professional identity among Chinese medical graduates for providing evidence to develop relevant intervention programs.   Methods  Using stratified cluster sampling and China Medical Students Survey (CMSS) designed by National Center for Health Professionals Education Development, an onsite self-administered questionnaire survey was conducted among 11 596 medical graduates in 33 universities in 19 provincial-level administrative divisions across China during July 2019.   Results  For the 10 062 (86.77% of all graduates) valid respondents, the overall average score for professional identity was 3.61 ± 0.63 and the average scores of dimensional professional identity were 3.17 ± 0.60 for cognition, 3.60 ± 0.71 for emotion, 3.68 ± 1.01 for commitment, 4.08 ± 0.75 for behavior, 3.70 ± 0.9 for expectation, and 3.45 ± 0.74 for values, respectively. The results of multivariate regression analysis showed that the respondents with following characteristics were more likely to have a higher professional identity: studying at universities in eastern China (β = 0.034, P = 0.013) and in central China (β = 0.092, P < 0.001), being male (β = 0.025, P = 0.019), from rural regions before entering university (β = 0.023, P = 0.045), with medium family income (β = 0.025, P = 0.028), studying at a university being first choice for admission (β = 0.031, P = 0.002), studying at universities not belonging to double first-class university (β = 0.085, P < 0.001), with the career ideal of to be a doctor while being a senior high school student (β = 0.249, P < 0.001), being a five-year-system medical student (β = – 0.065, P < 0.001), being an integrated long school system (5 + 3 years) student (β = – 0.098, P < 0.001), and with a higher academic performance shortly by the graduation (β = 0.136, P < 0.001 and β = 0.082, P < 0.001 for those with the academic score of highest quartile and second/third quartile in ranking).   Conclusion  The professional identity is at a medium level and affected by multiple individual and academic environment factors among Chinese medical graduates.
Characteristics of Omicron variant-induced SARS-CoV-2 reinfections in Chengdu, China
DAI Yingxue, WANG Yao, DU Xunbo,
2023, 39(4): 442-447. doi: 10.11847/zgggws1141316
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  Objective  To explore the characteristics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfections caused by Omicron variant for providing a reference to the containment of SARS-CoV-2 reinfection.   Methods  From China Information System for Disease Control and Prevention, we extracted 2 567 registered cases of 5 local coronavirus disease 2019 (COVID-19) epidemics in Chengdu city from February to September, 2022. Telephone follow-up surveys were conducted among the cases and their family members to collect the information on demographic characteristics, clinical symptoms, and viral nucleic acid or antigen tests in previous one month. The information on participants' COVID-19 vaccination were extracted from Immunization Program Information Management System of Sichuan Province. Data analyses were performed with SPSS 19.0.   Results  For the 2 263 eligible respondents (88.16% of all the participants), 44.68% were male and 55.32% were female; the ages of the respondents ranged from one month to 90 years, with the mean age of 34.88 ± 19.22 years; the majority (61.82%) of the respondents were mild cases and 31.64% were asymptomatic cases; 55.86% and 29.56% of the respondents reported having been vaccinated with 3 and 2 doses of COVID-19 vaccine. Based on genome sequencing on virus strains isolated from the cases of the 5 local epidemics, the most (98.89%) of the sufferers of the 5 epidemics were infected with Omicron subvariant BA.2. Among all the eligible respondents, 197 (8.71%) reported COVID-19 reinfection appearing during November – December, 2022 – an epidemic period with Omicron subvariant BA.5.2 being the most prevalent strain in local region and there was no reinfection case being reported before the period, and the self-reported median interval from previous infection to the reinfection was 98 (25th percentile: 93, 75th percentile: 104) days. For the 197 reinfections, 193 (97.97%) reported clinic symptoms including fever, throat ache and headache; 113 (57.36%) reported only having self-medication; more reinfections were reported by the respondents without COVID-19 vaccination compared to the respondents with 3 or 2 doses of COVID-19 vaccine.   Conclusion  The survey results suggest that Omicron variant-related SARS-CoV-2 reinfection is relatively low but the most of the reinfections are symptomatic. More researches and control measures on are needed for the control of SARS-CoV-2 reinfection.
Transmission characteristics of a COVID-19 outbreak caused by Omicron variant BA.5.2 in Yiwu city, China
WANG Xiaoxiao, WANG Fengying, ZHU Liebo,
2023, 39(4): 448-454. doi: 10.11847/zgggws1141188
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  Objective  To analyze transmission characteristics of a coronavirus disease 2019 (COVID-19) outbreak caused by Omicron variant BA.5.2 in Yiwu city of Zhejiang province, China.   Methods  Medical records and the information on epidemiological investigation, laboratory tests were collected for all local COVID-19 cases diagnosed during August 2 – 21, 2022 – a period of an COVID-19 outbreak in Yiwu city. The transmission characteristics of the outbreak was analyzed using indicators including family secondary attack rate, transmission generations (TG), serial interval (SI), the time interval from symptom onset to positive nucleic acid test, as well as time-varying reproduction number (Rt).   Results  The indicator case of the outbreak was confirmed with the history of living in high-risk area of other provinces and close contact with COVID-19 infected persons 7 days before the onset of disease symptoms. Genome sequencing of the virus isolated from the indicator case's secondary cases indicated that the viral strain of the outbreak was severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant BA.5.2. Totally 713 cases (343 males and 370 females) from 13 subdistricts (except for Chi'an township) of Yiwu city were confirmed during the outbreak lasting for 20 days. The median age of the cases (percentile 25 [P25], percentile 75[P75]) was 33 (20, 74) years. A total of 138 household clusters (involving 74.2% of all infections) were identified in the outbreak. For the 101 household clusters with clear transmission chain, the secondary attack rate was 62.2% (95% confidence interval: 56.5% – 67.5%); 39.6% of the household clusters affected all family members of the households involved; the median TG (P25, P75) was 1.7 (1.0, 2.8) days for the primary cases and 197 secondary cases and the TG was equal or less than 2 days for 50.8% of the cases being involved. For 65 household clusters, the median SI (P25, P75) was 2.0 (1.0, 3.0)days for the primary cases and 99 secondary cases with clinic symptoms and the SI was equal or less than 2 days for 44.4% of the cases being involved. Of the 364 cases (51.1% of the cases undergoing epidemiological surveys) with self-reported symptoms, 64.3%, 23.4%, and 20.1% reported fever, cough, and sore/dry throat, respectively. For the 364 symptomatic cases, the median time interval (P25, P75) from symptom onset to positive nucleic acid test was 0(0, 1)day and the time interval was one day for 67.7% of the cases and two days for 22.6% of the cases. No significant differences were observed in gender, age, site and daily time point of specimen sampling for nucleic acid test, and cycle threshold (Ct) value between the cases with and without lag time (day) of positive nucleic acid test from symptom onset. The maximum Rt was 6.18 in early period of the COVID-19 outbreak and the Rt decreased to less than one week after the implementation of containment measures.   Conclusion  The COVID-19 outbreak caused by Omicron variant BA.5.2 was characterized by high family secondary attack rate, short transmission generation and serial interval, and a high proportion of cases with lag time of positive nucleic acid test from symptom onset.
Correlation between socioeconomic status and metabolic syndrome among adult residents in Guizhou province: a prospective cohort study
LIN Shenrong, ZHANG Ji, WU Yanli,
2023, 39(4): 455-461. doi: 10.11847/zgggws1139523
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  Objective   To investigate the relationship between socioeconomic status (SES) and the incidence of metabolic syndrome (MS) among adult residents in Guizhou province, and to provide references for the prevention and control of MS in the population.   Methods  Totally 9 280 permanent residents aged ≥ 18 years were recruited from 12 counties/prefectures/ districts of Guizhou province with multistage cluster random sampling. Among the participants, a baseline survey including face-to-face interview with the National Chronic Disease Surveillance Questionnaire developed by Chinese Center for Disease Control and Prevention, physical examination and laboratory testing was conducted from November 2010 through December 2012; follow-up visits were carried out from December 2016 through June 2020. After excluding those who did not meet the inclusion criteria, lost to follow-up and died, 2 956 participants were finally included in the analysis on the impact of SES on the incidence of MS.   Results  Individual follow-up periods ranged 5.05 − 9.52 years and the mean period was 6.96 ± 1.10 years. Of the participants followed up, 611 MS cases were identified, with an incidence rate of 20.67% and an incidence density of 29.68/1 000 person-years. After adjusting for sex, age, place of residence, smoking, alcohol consumption, sedentary time, physical activity, sleep duration, body mass index (BMI), family history of hypertension and family history of diabetes, the results of multivariate Cox proportional hazard regression analysis showed that the MS incidence risk increased (hazard risk [HR] = 1.542, 95% confidence interval [95% CI]: 1.126 − 2.110) among the participants being engaged in farm work, forestry, animal husbandry, fishery and water conservancy industry compared to those being unemployed; but MS incidence risk decreased among the participants with regular education in comparison to those with informal education (primary school: HR = 0.699, 95%CI = 0.512 − 0.956; middle school: HR = 0.612, 95%CI: 0.449 − 0.835; high school/secondary specialized school/technical school: HR = 0.563, 95%CI: 0.375 − 0.847; junior college and above: HR = 0.434, 95%CI: 0.236 − 0.798), with higher annual household income per capita contrasting to those with the income of less than 2 000 CNY (5 225 − 8 332 CNY: HR = 0.705, 95%CI: 0.502 − 0.992; 8 333 − 13 757 CNY: HR = 0.655, 95%CI: 0.457 − 0.938; ≥ 13 758 CNY: HR = 0.628, 95%CI: 0.436 − 0.903), and with higher SES scores compared to those with the SES scores of less than 7 (SES score of 9 − 10: HR = 0.682, 95%CI: 0.493 − 0.944 , the score of 10: HR = 0.618, 95%CI: 0.421 − 0.909, the score of 11: HR = 0.578, 95%CI: 0.407 − 0.821).   Conclusion  There is a inverse correlation between SES and MS risk among adult residents in Guizhou province, and the residents with low SES are the key population for MS prevention and control in the province.
Relationship between oral health and mental health in rural older people with chronic diseases and mediating role of sleep quality
ZHOU Yanxin, ZHAO Dan, WANG Xiyuan,
2023, 39(4): 462-466. doi: 10.11847/zgggws1139666
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  Objective  To explore the relationship and internal mechanism between sleep quality, oral health and mental health of the older people with chronic diseases in rural Shandong, China.   Methods  Using stratified multistage cluster sampling, face-to-face interviews were conducted among 2 064 rural people aged 60 years and above and with chronic diseases in Shandong province during July – August 2020. Oral Health Impact Profile-5 (OHIP-5), Kessler Psychological Distress Scale (K10) and Pittsburgh Sleep Quality Index (PSQI) were adopted in the survey. Statistical analyses were performed with IBM SPSS 24.0.   Results  For all the respondents, the median score (25th percentile, 75th percentile) was 9 (6, 13) for PSQI, 2 (0, 5) for OHIP, and 18 (12, 25) for K10. The sleep quality and oral health were positively correlated with mental health (rs = 0.43, P < 0.001; rs = 0.20, P < 0.001); sleep quality was positively correlated with oral health (rs = 0.17, P < 0.001). The results of mediating effect analysis revealed that sleep quality played a partial mediation effect on the association between oral health and mental health, with an effect value of 95% confidence interval of 0.09 – 0.17 and accounting for 32.50% of the total effect.   Conclusion  Sleep quality is a mediator between oral health and mental health among rural older people with chronic diseases; improving oral health and reducing sleep disorders may improve mental health in the population.
Validation of the National Disability Rating Criteria for the Elderly with Long-term Care: a hierarchical model-based empirical analysis
ZHAO Yuanping, DING Rui, XIE Hong
2023, 39(4): 467-471. doi: 10.11847/zgggws1139527
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  Objective  To verify the reliability and rationality of the National Disability Rating Criteria for the Elderly with Long-term Care – Trial Edition using hierarchical model.   Methods  Using complex sampling method and a self-designed questionnaire, we conducted face-to-face interview and onsite assessment among 9 577 long-term caretakers aged 60 years and above in urban nursing facilities in 23 cities of 12 provincial level administrative divisions across various geographical areas in China during March 2022. The collected data were analyzed with analytic hierarchy process, rank sum ratio method and paired Chi-square test to comprehensively evaluate the long-term caretakers' disability degrees and to compare the evaluations with those based on the national criteria.   Results  For the 9 577 valid participants averagely aged 81.43 ± 8.46 years, 80.0% were assessed as having disability and 47.0% as having moderate and severe disability. A four-level hierarchical model was established based on the regression equation (weighted rank-sum ratio [WRSR] = – 0.5679 + 0.2097 × probit) obtained with analytic hierarchy process and rank sum ratio method. Paired comparison with the original hierarchical model, the Kappa value of the analysis was 0.540 (P < 0.001) and the value of McNemar-Bowker test was 3 376.471 (P < 0.001). There were some differences between the two hierarchical models, and the overall coincidence rate between the two models was 63.6% although there were some differences. Of all the elderly long-term caretakers, 566 (5.9%) were assessed as having severe disability based on combined evaluation with the two hierarchical models; whereas, of all the long-term caretakers assessed as having moderate disability using the hierarchical model established in the study, 30.1% were assessed as having severe disability according to the evaluation with the National Disability Rating Criteria.   Conclusion  Based on the analysis using the hierarchical model established in the study, there are some defects in the original hierarchical model adopted by the National Disability Rating Criteria and further researches are needed to address the issue.
Survey and Report
Trend in coordination for integration of medical treatment and disease prevention in the mainland of China, 2004 – 2020: a statistical data based analysis
YAN Wenxin, GUO Xin, LIU Xia,
2023, 39(4): 472-478. doi: 10.11847/zgggws1140422
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  Objective  To examine the development of coordination for the integration of medical treatment and disease prevention (treatment-prevention) in 31 provincial level administrative divisions (PLADs) across China during 2004 – 2020 and to provide a reference for promoting the integration of treatment and prevention in Healthy China construction.   Methods  Base on the data collected from the China Health Statistical Yearbook and the China Statistical Yearbook of 2004 – 2020, we compiled relevant indicators for measuring comprehensive development of the medical system and the public health system at national level and PLAD level. We conducted a coupling coordination model analysis and an interrupted time series model analysis (ITSA) to test instantaneous and persistent impact of the “New Medical System Reform Policy” on the development, the degree of coupling, and coordination of the treatment-prevention integration subsystem.   Results  From 2004 to 2020, the index for comprehensive development of medical system (SY) increased from 0.560 to 0.692 at national level and the SY also increased for all the PLADs with the ranges from 0.385 – 0.655 to 0.524 – 0.758; during the same period, the index for comprehensive development public health system (SG) increased from 0.747 to 0.875 at national level and the SG of all the PLADs increased similarly in the ranges from 0.501 – 0.846 to 0.696 – 0.995. The range-specific SY and SG were the highest for the PLADs in eastern China in 2020, with the ranges of 0.573 – 0.703 for SY and 0.764 – 0.901 for SG. The results of ITSA showed that the “New Medical System Reform Policy” had a significant transient impact (β2 = 0.024 – 0.145, P < 0.05) and persistent impact (β3 = 0.004 – 0.032, P < 0.05) on the development of medical system (SY) in most PLADs, but not on public health system (SG). From 2004 to 2020, the coupling degree (C) of medical system and public health system at national and PLADs level were all above 0.9, indicating a good system coupling. The index (D) for degree of coordination in treatment-prevention integration increased from 0.805 in 2004 to 0.880 in 2020 at national level and the range of D increased from 0.663 – 0.852 in 2004 to 0.777 – 0.930 in 2020 at PLAD level.   Conclusion  Comprehensive development of treatment-prevention integration subsystem in has been improving during 2004 – 2020 in China, and the degree of coupling coordination in treatment-prevention integration has been gradually strengthened, but regional difference still exists.
Spatial difference and dynamic time evolution of public health resources in China, 2012 – 2020
ZHOU Ying, KE Pan, SHEN Xin,
2023, 39(4): 479-484. doi: 10.11847/zgggws1140114
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  Objective  To analyze spatial difference and dynamic time evolution of public health resources in China, and to provide evidence for optimizing the allocation of public health resources.   Methods  The data of 2012 to 2020 on public health resources were collected from China Health and Family Planning Statistics Yearbook and the China Health Statistics Yearbook. Entropy method was used to calculate annual index of public health resource supply at provincial level; the Dagum Gini coefficient and the Kernel density estimation method were applied to examine spatial difference and dynamic time evolution of public health resources in China.   Results  During 2012 – 2020, the Dagum Gini coefficient for public health resource supply increased slowly from 0.2362 to 0.2786 first, and then fluctuated and decreased to 0.2409; the Kernel density estimation curves suggested that the public health resource supply in China increased sharply from 2012 to 2014, but the supply was insufficient after 2014.   Conclusion  The supply of public health resources in China needs to be increased in quantity and equity among different regions.
Mental health prevention and control management facilities and personnel in the mainland of China, 2020: a cross-sectional survey
WU Xiamin, MA Ning, CHEN Runzi,
2023, 39(4): 485-488. doi: 10.11847/zgggws1140264
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  Objective  To examine the status quo of mental health prevention and control management facilities (MHPCMFs) up to 2020 in the mainland of China for providing evidence to the development of infrastructure and strategies of mental health prevention and control.   Methods  The information on the status of MHPCMFs at province, municipality/prefecture, and district/county level in 31 province-level administrative divisions (PLADs) across China was collected during May – June 2021 using a questionnaire designed by The National Mental Health Program Office. The organizational system and personnel of the MHPCMFs were analyzed.   Results  By the end of 2020, totally 3 315 MHPCMFs were established at all PLADs, 99.70% of 333 municipalities/prefectures and 99.73% of 2960 districts/counties in the mainland of China. Of the established MHPCMFs, only 7 were independent legal entities and 3 308 were affiliated to health institutions or government departments, with 77.42% of the province-level and 76.51% of the municipality/prefecture-level MHPCMFs affiliated to mental health medical facilities and 61.25% of the county/district-level MHPCMFs affiliated to centers for disease control and prevention. The total number of personnel in the established MHPCMFs was 9 846, among which 34.43% were public health physicians, 17.79% were registered nurses, and 15.57% were psychiatrists and there were a few psychological therapists/counselors and social workers in the MHPCMFs. The average number of personnel engaged in services provided by the MHPCMFs was 0.7 for 100 000 population. The median number of staff was 6, 3 and 2 for the MHPCMFs at province-, municipality/prefecture-, and county/district-level, respectively.   Conclusion  The management system for mental health promotion has been developed nationwide and at various administrative level across the mainland of China, but the established MHPCMFs were lack of mental health professionals, suggesting that professional allocation in the MHPCMFs needs to be improved.
Changes in online medicine purchases before and after the COVID-19 pandemic among urban young and middle-aged adults
CHENG Zheyu, SUN Wenjun, ZHAO Ziyin,
2023, 39(4): 489-494. doi: 10.11847/zgggws1140533
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Abstract:
  Objective  To examine the changes in online medicine purchases before and after the coronavirus disease 2019 (COVID-19) pandemic and its correlates among urban young and middle-aged adults.   Methods  Based on Wenjuanxing online survey platform, adults aged ≥ 18 years were randomly recruited for a electronic questionnaire survey during October 21 – 28, 2021. The collected information on 748 urban adults aged 18 – 59 years and ever purchasing medicine during the past year were finally included in the analysis. Multinomial logistic regression was adopted to examine the correlates of the changes in online medicine purchases.   Results  Of all the respondents, 178 (23.80%) reported no online medicine purchases before and after the COVID-19 pandemic; 477 (63.77%) reported ever purchasing medicine online before and after the pandemic; and 71 (9.49%) had purchased medicine online only after the pandemic. The results of regression analysis showed that, compared with those not ever purchasing medicine online before and after the COVID-19 pandemic, the respondents with the education of bachelor degree or above were more likely to purchase medicine online after the COVID-19 pandemic (relative risk ratio [RRR] = 3.64, 95% confidence interval [95%CI]: 1.37 – 9.68); the respondents purchasing medicine at medical facilities after the epidemic were less likely to purchase medicine online after the epidemic (RRR = 0.41, 95%CI = 0.22 – 0.75); the respondents with the education of bachelor degree or above and having chronic diseases were more likely to purchase medicine online both before and after the COVID-19 pandemic, with RRR (95%CI) of 2.06 (1.25 – 3.39) and 2.54 (1.65 – 3.92); the respondents living in central and western regions were less likely to purchase medicine online before and after the COVID-19 pandemic (RRR = 0.53, 95%CI: 0.33 – 0.84 and RRR = 0.58, 95%CI: 0.36 – 0.93).   Conclusion  Under the context of normalized COVID-19 pandemic control, online medicine purchases increased among urban young and middle-aged adults, especially among those with higher education, suffering from chronic disease, and not purchasing medicine at medical facilities.
Breast-feeding among neonatal inpatients in neonatal departments before and after the COVID-19 pandemic in Guangdong province: a multicenter retrospective survey
ZHANG Chunyi, ZHOU Wenji, LONG Fang,
2023, 39(4): 495-498. doi: 10.11847/zgggws1140089
Abstract:
  Objective   To examine breast-feeding among neonatal inpatients in neonatal departments before and after normalized containment of coronavirus disease – 2019 (COVID-19) pandemic in Guangdong province.   Methods   With convenient sampling and a self-designed questionnaire, we conducted a retrospective survey on breast-feeding and its associates among neonatal inpatients in neonatal departments of 40 hospitals at provincial or municipal/county or district level before the COVID-19 pandemic (October – December, 2019) and after normalized containment of the pandemic (October – December, 2020) in Guangdong province. Chi-square test and corrected Chi-square test were used in data analysis.   Results  Before the COVID-19 outbreak, the breast-feeding rate was less than 50% among the neonatal inpatients in 20 neonatal departments and the rate was higher than 70% only in 5 (12.5%) of the 40 departments surveyed. During the period of normalized containment of the pandemic, the breast-feeding rates declined significantly compared to those before the pandemic among the neonatal inpatients in the departments of the hospitals at various administrative levels, with the rates of higher than 30% in only in 10.0% (4) of the 40 departments and lower than 10% in 60% (24) of the 40 departments (all P < 0.001). There were no significant differences in the breast-feeding rate among the neonatal inpatients in the neonatal departments of hospitals at various administrative levels before the pandemic and during the normalized containment of the pandemic (P > 0.05 for all) . The proportions of the implementation of 15 measures for promoting breast-feeding ranged 5.0% – 87.5% among the 40 neonatal departments, with the proportions of less than 25.0% for the implementations of 6 measures including breastfeeding education before delivery (22.5%), breast-feeding-related oral hygiene (17.5%), and collection of breast milk donation (5.0%). During the normalized containment of the pandemic, only 8 (20.0%) of the 40 neonatal departments continued to collect donated breast milk and the decreased donated breast milk was associated with the declined breast-feeding rate among the neonatal inpatients (P < 0.001).  Conclusion  The breast-feeding rate was low among neonatal inpatients in neonatal departments of hospitals in Guangdong province and the rate decreased significantly during the period of normalized containment of COVID-19 pandemic.
Effect of local rainfall on frailty among older adults: a generalized linear mixed model analysis on CLHLS data
ZHOU Fenfen, ZHOU Wensu, WANG Wenjuan,
2023, 39(4): 499-504. doi: 10.11847/zgggws1138143
Abstract(53) HTML (18) PDF 589KB(12)
Abstract:
  Objective   To evaluate the relationship between local rainfall and frailty in the elderly.   Methods  The information on 10 424 elderly aged 65 years and above were extracted from four rounds of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) conducted between 2005 and 2014 across China. Frailty index (FI) was used to assess frail status of the elderly; generalized linear mixed model and natural cubic spline function were adopted to explore the association of local rainfall with the prevalence of frailty.   Results   The baseline prevalence of frailty was 18.6% for all the elderly aged 82.84 ± 11.30 years at baseline survey; at the last follow-up, the frailty prevalence increased to 27.8%. The results of multivariate regression analysis showed that the elderly living in regions with higher annual average local rainfall (highest quartile) had a lower risk of frailty (odds ratio = 0.60, 95% confidence interval: 0.50 – 0.71) compared to those living in regions with lower local rainfall (lowest quartile); while the correlation of local rainfall with prefrailty of the elderly was not significant.   Conclusion   Local rainfall has a protective effect on the frailty of the elderly and specific concern should be paid when developing relevant healthcare strategies for the elderly in regions with different amount of rainfall.
Incidence and disease burden of acute gastroenteritis among residents in Heilongjiang province, 2018
GAO Fei, ZHANG Jianfeng, LI Jingjing,
2023, 39(4): 505-508. doi: 10.11847/zgggws1138765
Abstract(94) HTML (36) PDF 563KB(19)
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  Objective  To estimate the incidence and burden of acute gastroenteritis among residents in Heilongjiang province, and to provide evidence for developing strategies on food-borne disease prevention and control.   Methods  The data on residents′ acute gastroenteritis incidence during 2018 were collected from community population surveys and hospital-based foodborne disease surveillance in Heilongjiang province and a pyramid model of disease burden was constructed to estimate total number of acute gastroenteritis cases in the province. The health burden of acute gastroenteritis was measured with disability adjusted life years (DALYs).  Results  For whole population of the province in 2018, the estimated number of acute gastroenteritis cases was 133 814 (95% confidence interval [95%CI]: 105 635 – 169 334); the monthly prevalence was 3.54% (95%CI: 3.28% – 3.80%); and the incidence was 0.470/person year. The DALYs due to acute gastroenteritis was 11 320.40 (95%CI: 9239.09 – 13947.73) and the DALYs rate of the disease was 0.30 (95%CI: 0.25 – 0.37)/1 000 population, with the highest DALYs rate for the residents aged < 5 years (0.526 [95%CI: 0.24 – 1.41]/1 000 population) and the residents aged ≥ 60 years (0.680 [95%CI: 0.49 – 0.96]/1 000 population), respectively.   Conclusion  The incidence of acute gastroenteritis was high among residents of Heilongjiang province, especially among the children under 5 years and the elderly over 60 years.
Overview
A review on advances in global malaria epidemiology
LIU Qiao, LIU Jue
2023, 39(4): 509-513. doi: 10.11847/zgggws1139898
Abstract(60) HTML (24) PDF 546KB(28)
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Malaria is one of major global public health problems. Although China′s success in eliminating indigenous malaria cases having been recognized by World Health Organization in 2021, China is still at risk of imported malaria from abroad and local transmission of the disease. Therefore, it is necessary to fully understand global malaria epidemic and to assess the risk of imported malaria in China for consolidating the achievement of malaria elimination. In this paper, we reviewed research progress in global malaria epidemiology, malaria-related health risk, malaria prevention and control measures, and imported malaria epidemic from 2017 through 2021 in China.
Progress in researches on self-amplifying RNA vaccines
WANG Shuo, LI Jianmin
2023, 39(4): 514-520. doi: 10.11847/zgggws1140223
Abstract(119) HTML (91) PDF 550KB(27)
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Self-amplifying RNA (saRNA) vaccines are a new generation of mRNA vaccines. In addition to containing mRNA sequences encoding antigen proteins, saRNA vaccines also have unique self-amplifying elements, so self-amplification of antigen sequences can be performed in vivo. With rapidly developing and maturing in recent years, the application of mRNA vaccine technology in infectious diseases and cancer is increasing. Derived from mRNA vaccine technology, researches of saRNA vaccines in the prevention and treatment of infectious diseases and cancer have been carried out, and the existing research results show its huge development space. saRNA vaccines have a substantial impact on the development and application of mRNA vaccines. In this article, we summarize structural characteristics, biological mechanisms, and delivery principle and materials of saRNA vaccines.
Progress in researches on influencing factors of lung cancer screening
LI Yuting, WAN Shaoping, YANG Zhonghua
2023, 39(4): 521-525. doi: 10.11847/zgggws1140313
Abstract(50) HTML (61) PDF 560KB(19)
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High incidence and mortality rate of lung cancer is a serious health problem. Lung cancer screening can improve the chances of early detection and early surgical intervention of lung cancer. Currently, lung cancer screening participation rate in China is low and lung cancer screening services are underutilized. What factors influence the lung cancer screening behavior of our population is unclear. In this paper we summarize current status of research on factors influencing lung cancer screening behavior at home and abroad, and provide references to the development and implementation of lung cancer screening programs in China.
Potential impact of microplastics on human health: research progress
PAN Yanbin, YAN Jianlong, DONG Shaohong,
2023, 39(4): 526-530. doi: 10.11847/zgggws1140359
Abstract(61) HTML (13) PDF 515KB(22)
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Microplastic pollution is a growing ecological problem and human exposure to micrioplastic through dietary intake, air inhalation and skin-to-skin contact is inevitable. This study provides an overview on the properties of microplastics, the pathways of microplastic exposure in humans, and potential impact of microplastics on human body systems as a reference to future research.
Public Health Forum
Syndromic surveillance in COVID-19 pandemic control: experience and comparison among countries
WANG Xiaowen, QIU Xiaoyi, DUAN Lizhong,
2023, 39(4): 531-535. doi: 10.11847/zgggws1140595
Abstract(96) HTML (23) PDF 548KB(20)
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Syndromic surveillance is a critical component of intelligent warning and multi-point event-triggered mechanism for surveillance on public health emergency. In this paper using literature analysis, we discussed the characteristics of syndromic surveillance implemented during coronavirus disease 2019 (COVID-19) pandemic and summarized performance experiences of those syndromic surveillance programs in typical countries or regions for providing a reference to construct effective syndromic surveillance framework in China.
Strategy for prevention and control of mpox epidemic in China: a strengths, weaknesses, opportunities and threats (SWOT) analysis
CHEN Qi, WU Yang, CHEN Chuding,
2023, 39(4): 536-539. doi: 10.11847/zgggws1140743
Abstract:
On July 23, 2022, the World Health Organization (WHO) declared the mpox epidemic as a Public Health Emergency of International Concern (PHEIC), indicating the seriousness of the mpox epidemic. Mpox is a rare zoonotic infectious disease caused by mpox virus infection, mostly occurred among the men who have sex with men (MSM), but general populations are susceptible to the infection and the risk of imported infection is high. In this paper, we discussed the strategy for prevention and control of mpox epidemic in China using strengths, weaknesses, opportunities and threats (SWOT) analysis based on the experience in the containment of severe acute respiratory syndromes (SARS) in 2003 and coronavirus disease 2019 (COVID - 19) in recent three years, for providing a reference to relevant decision - making.
Development history, bottleneck and suggestions of evaluation system on centers for disease prevention and control in China
ZHANG Na, MAO Ayan, WANG Danlei, , QIU Wuqi
2023, 39(4): 540-544. doi: 10.11847/zgggws1141428
Abstract(88) HTML (20) PDF 514KB(32)
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The establishment of the National Administration of Disease Prevention and Control marks the beginning of the reform of disease prevention and control system in China. With the transformation of the functions of centers for disease prevention and control (CDCs), the evaluation system on CDCs′ performance should also be adjusted accordingly. In this paper, we systematically summarize the development process of the evaluation system on CDCs′ performance in China; we also analyze current problems for the evaluation system in detail, including untimely update of evaluation policy documents, lack of theoretical basis for the establishment of evaluation indicators, coexistence of multiple problems in evaluation methods, insufficiency of horizontal comparability and vertical dynamics of the evaluation indexes. At last, we put forward suggestions for improving the evaluation system.