Special Report —— Construction of Public Health System
- Discussion on compulsory disclosure of patients′ information during major infectious disease epidemic in China: a literature study
- International researches on public health system: a visual analysis with CiteSpace
- Development and efficiency of public health emergency management system in China
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doi: 10.11847/zgggws1140930
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Objective To investigate the knowledge on cervical cancer and human papillomavirus (HPV) vaccine, and intention choice of daughters′ free HPV vaccination scheme among mothers of school-age girls for providing evidence to administrative departments in developing relevant vaccination strategies. Methods Using convenient sampling and a self-designed questionnaire, we conducted an online survey among 1 648 mothers of girls aged 9 – 15 years through official WeChat website of Suzhou Vaccination during October 2022. The data collected from 1 484 eligible respondents were statistically analyzed. Results Of the 1 484 respondents for the four listed HPV vaccination schemes available to their daughters (including free domestic bivalent or subsidized HPV vaccine supplied by health administrative departments), 699 (47.10%) selected plan 2 (free domestic bivalent HPV vaccine or partially subsidized vaccination of other HPV vaccines); 565 (38.07%) selected plan 1 (with cash subsidy for other HPV vaccination according to the price of two-dose vaccination of domestic bivalent HPV vaccine); 161 (10.85%) selected plan 3 (free vaccination of domestic HPV vaccine or self-paid vaccination of other HPV vaccines); and 59 (3.98%) selected plan 4 (self-paid vaccination of all other HPV vaccines available). Nine-valent HPV vaccine was the most frequently selected vaccine reported by the four groups of respondents with different intention choice of the vaccination scheme, with the selecting ratios of 94.16%, 83.26%, 55.28%, and 98.31% for the respondents reporting the intention choice of vaccination plan 2, 1, 3, and 4, respectively. The respondents' intention choice of daughters′ free HPV vaccination scheme differed significantly by educational background (χ2 = 53.77, P < 0.05), monthly household income (χ2 = 49.07, P < 0.05), and the score of cognition on cervical cancer and HPV vaccine (χ2 = 8.19, P = 0.04). The results of multivariate logistic regression model showed that compared to those with a monthly household income of ≥ 20 001 (Chinese Yuan), the respondents with a monthly household income of ≤ 5 000 were more likely to select the plan 1 (odds ratio [OR] = 5.65), plan 2 (OR = 5.31), and plan 3 (OR = 14.34) other than the plan 4; the respondents with a monthly household income of 10 001 – 15 000 were likely to select the plan 3 (OR = 2.59) other than the plan 4; and the respondents with a monthly family income of 5 001 – 10 000 were more likely to select the plan 3 (OR = 2.60) other than the plan 4. Conclusion In Suzhou city, about one half of the mothers of school-age girls intend to select free domestic bivalent vaccine or partially subsidized vaccination of other vaccines for their daughters′ free HPV vaccination scheme, with nine-valent HPV vaccine being the most frequently selected vaccine, and the intention choice is mainly influenced by maternal monthly household income and education background.
, Available online ,
doi: 10.11847/zgggws1141542
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The negative overlap and cycle between disease and poverty outcomes and burdens has become a core driver of existing poverty in China, and constitutes an essential characteristic factor of health poverty. Compared to economic and cultural poverty, health poverty has become a key constraint in the fight against poverty, and an important risk and challenge in sustaining China′s achievements in the post-poverty reduction era. With bibliometrics method, qualitative expert interview and using social network analysis, we define and explain the connotation and characteristics of multidimensional health poverty from multiple perspectives of disease, economy, culture and education, and governance system; we also try to construct a theoretical model of health poverty involving three dimensions: health capacity, health right, and health risk and deconstruct the action mechanisms of the three aspects in the occurrence, expansion, continuation, and elimination of health poverty.
The negative overlap and cycle between disease and poverty outcomes and burdens has become a core driver of existing poverty in China, and constitutes an essential characteristic factor of health poverty. Compared to economic and cultural poverty, health poverty has become a key constraint in the fight against poverty, and an important risk and challenge in sustaining China′s achievements in the post-poverty reduction era. With bibliometrics method, qualitative expert interview and using social network analysis, we define and explain the connotation and characteristics of multidimensional health poverty from multiple perspectives of disease, economy, culture and education, and governance system; we also try to construct a theoretical model of health poverty involving three dimensions: health capacity, health right, and health risk and deconstruct the action mechanisms of the three aspects in the occurrence, expansion, continuation, and elimination of health poverty.
, Available online ,
doi: 10.11847/zgggws1141549
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Objective To examine spatial and temporal distribution patterns of household-based multidimensional health poverty (MHP) indexes among middle-aged and elderly populations in China, and to provide evidence to precise elimination of MHP in the populations. Methods The data of the analysis were extracted from four rounds of China Health and Retirement Longitudinal Survey (CHARLS) conducted in 2011,2013,2015, and 2018 across China, which collected the information of residents aged ≥ 45 years in 37 296 households on demographics, income and consumption, family structure, economic support, health status, health service utilization and medical insurance. The MHP was assessed and deconstructed with self-established health poverty evaluation index system and multidimensional health poverty measurement index (MHPI) covering three dimensional components (health right, health capability and health risk)of MHP. The year and region specific distribution of MHPI were described. Results For all the middle-aged and elderly residents surveyed in 2011, 2013, 2015, and 2018,the health MHPI were 0.320,0.326,0.349, and 0.29 and the MHP prevalence were 69.7%, 69.0%, 71.9%, and 63.0%, respectively. The mean values of index measuring the contribution of health right, health capacity and health risk to MHP were 0.143, 0.450 and 0.416 for all the residents surveyed in the four rounds of CHARLS study. The results of regional decomposition analysis on MHPI showed that following six provincial-level administrative divisions (PLADs) could be assessed as with severe prevalence of health poverty in 2011: Guizhou, Gansu, Xinjiang Uygur Autonomous Region (Xinjiang), Sichuan, Anhui, and Jilin, with the mean MHPI of 0.365, 0.364, 0.395, 0.377, 0.402, and 0.413,respectively; in 2013, the six PLADs assessed as having severe prevalence of health poverty were Yunnan, Qinghai, Inner Mongolia Autonomous Region (Inner Mongolia), Sichuan, Anhui, and Guizhou and the mean MHPI for those PLADs were 0.359, 0.361, 0.381, 0.378, 0.389, and 0.402; while in 2015 the number of PLADs with severe prevalence of health poverty increased to 16, including Yunnan (mean MHPI = 0.395), Xinjiang (0.388), Qinghai (0.448), Sichuan (0.406), Inner Mongolia (0.39), Anhui (0.388), Chongqing (0.391), Guizhou (0.373), Tianjin (0.370), Heilongjiang (0.366), Guangxi (0.362), Shandong (0.362), Jiangxi (0.359), Jilin (0.355), Fujian (0.351), and Liaoning (0.350); but in 2018, only 3 PLADs (Sichuan, Guizhou, and Yunnan, with the mean MHPI of 0.352, 0.352, and 0.351) could be assessed as with severe prevalence of health poverty. Conclusion According to this analysis, both mean index and prevalence of health poverty declined generally among middle-aged and elderly populations in China during 2011 – 2018; there were regional differences in health poverty prevalence and the multidimensional health poverty was more severe in Southwest region.
, Available online ,
doi: 10.11847/zgggws1141545
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Objective To measure multidimensional health poverty (MHP) and its urban-rural disparity among Chinese households for providing evidence to the elimination of health poverty among urban and rural households in China. Methods The data of the analysis were extracted from a round of China Family Panel Survey (CFPS) conducted in 2018 across China, which collected the information of 12 494 households (6 409 in urban and 6 085 in rural regions) on economic activity, education access, family relationship and dynamics, migration, and family members' physical and mental health status. The MHP was assessed and the contribution of the three dimensional components (health right, health capability and health risk) to MHP were deconstructed with self established health poverty evaluation index system and multidimensional health poverty measurement index (MHPI). Results For all the households surveyed in 2018, the overall MHPI was 0.216 and the prevalence of MHP was 0.472; the values of MHPI and MHP prevalence were 0.184 and 0.410 for the surveyed urban households but were 0.249 and 0.537 for the rural households. For the households surveyed nationwide, in urban regions, and in rural regions, the contribution indexes of health risk/capability/right to MHP were 0.478/0.268/0.254, 0.267/0.268/0.505, and 0.244/0.299/0.457, respectively. Conclusion During 2018 in China, both the MHPI and MHP prevalence were higher in rural households than those in urban households; health risk was an important contributor to MHP and the urban-rural disparity in the contribution of health capacity to MHP was the greatest among the three dimensional contributors of MHP.
, Available online ,
doi: 10.11847/zgggws1141546
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Objective To examine social region-specific characteristics and transition-differentiation of driving factors for multidimensional health poverty (MHP) in China for providing a reference to precise poverty alleviation and effective governance of health poverty. Methods We collected nationwide data from four rounds of the China Health and Retirement Longitudinal Survey (CHARLS) conducted in 2011, 2013, 2015, and 2018 and other relevant data from the China Statistical Yearbook and the China Health and Family Planning Statistical Yearbook of 2012, 2014, 2016, and 2019 and from the Global Burden of Disease Network in 2019. Based on a self established theoretical framework of MHP associated with three dimensional components of health capability-right-risk, we selected 13 indicators covering the three dimensional components as the driving factors of MHP and used geographic detectors to explore the characteristics of independent and coupled effect of the driving factors and analyze differences in spatial distribution of the driving factors. Results Compared with those in 2011, 2013, and 2015, the ranking of three health capability dimension factors (gross domestic production [GDP] per capita, urbanization rate, and annual hospitalization rate of residents) increased in 2018; while the ranking of three health right dimension factors (per capita expenditure on both social security and employment and the number of public health education programs decreased; the effect of health right empowerment on preventing the occurrence of health poverty increased. The analysis on differences in spatial distribution of driving factors during 2011-2018 showed that urban unemployment rate was a main driving factor for MHP in eastern region; while, the main driving factor for MHP in central region was the concentration of particulate matter less than 2.5 μm in aerodynamic diameter (PM2.5) three years ago and the MHP was driven jointly by multiple factors with regard to health capability-right-risk. The analyses on interactive effect of the driving factors revealed bivariate interactive enhancement effect on MHP among GDP per capita and urbanization rate as factors of health capability dimension and government health expenditure ratio, per capita expenditure on social security and employment, and the number of beds in health care institutions versus per 1 000 population as factors of health right dimension; the joint effect of driving factors regarding to health capability and health right reduced the occurrence MHP; the interaction between PM2.5 concentration three years ago (a health risk indicator) and two health capability indicators (annual hospitalization rate of residents and elderly dependency ratio in 2011/2013/2018) also showed bivariate interactive enhancement effect on MHP. Conclusion The prevalence of MHP is of spatially and temporally heterogeneous pattern across social regions in China and is driven by the coupling of multidimensional factors, suggesting that comprehensive strategies need to be developed for effective health poverty management.
, Available online ,
doi: 10.11847/zgggws1141548
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Objective To explore spatiotemporal non-stationarity in health poverty prevalence and its influencing factors among middle-aged and elderly residents in China for providing evidence to promote comprehensive and effective management on health poverty alleviation in the populations. Methods The data of the analysis were extracted from four rounds of China Health and Retirement Longitudinal Survey (CHARLS) conducted in 2011, 2013, 2015, and 2018 across China, which collected the information on 37 296 households with family members aged ≥ 45 years. Other relevant data were extracted from the China Statistical Yearbook of 2012, 2014, 2016, and 2019, the China Health and Family Planning Statistical Yearbook of 2012 and 2016, the China Tertiary Industry Statistical Yearbook of 2014 and 2019, and from the Global Burden of Disease Network in 2019. Based on the self-developed indexes for measurement of multidimensional health poverty (MHP), we used the ordinary least squares model (OLS), the geographically weighted regression model (GWR), the temporally weighted regression model (TWR), and the geographically and temporally weighted regression model (GTWR) to model the impacts of influencing factors on health poverty among the middle-aged and elderly residents during the period. The spatiotemporal modes of the estimation coefficients in the optimal model were further described. Results After adjusting for fixed effects of year and region, the global OLS regression results showed that the MHP index increased with the increment of the prevalence of non-communicable diseases (NCDs) and disabilities, gross domestic production (GDP) per capita, average out-of-pocket medical expenditure, and mean annual concentration of particulate matter less than 2.5 μm in aerodynamic diameter (PM2.5) in previous 3 years; but the index decreased with the increment of population density, the coverage of basic medical insurance, and the number of nurses per 10 000 population. Among all partial regression models constructed, GWR fitted the survey data best, with the increased R2 from 70.57% to 88.68% and the decreased sum of squares of the residuals from 797.791 to 585.277 compared with the global OLS regression model. The impacts of the eight covariates mentioned above on MHP index were non-stationary based on the results of GWR modeling; the aggravating impact of NCDs prevalence rate on MHP index was much stronger for Inner Mongolia Autonomous Region (Inner Mongolia) and the four provinces including Hebei, Shanxi, Yunnan, and Guizhou; the aggravating impact of disability prevalence rate on MHP index was much more stronger for Jiangsu, Anhui, and Henan province; the alleviating impact of population density on MHP index was stronger for the five provinces of Heilongjiang, Jilin, Liaoning, Shandong, and Shanxi and much more stronger for Inner Mongolia, Gansu and Hebei provinces, and Beijing municipality; both the alleviating impact of the coverage rate of basic medical insurance and the number of nurses versus 10 000 population and the aggravating impact of GDP per capita on MHP index were the strongest for Xinjiang Uygur Autonomous Region, Qinghai province, and Gansu province; the aggravating impact of average out-of-pocket medical expenditure on MHP index was much more stronger for Henan, Anhui and Jiangsu province; the aggravating impact of mean annual PM2.5 concentration in previous 3 years on MHP index attenuated gradually from a central region including Beijing municipality, Hebei province and Inner Mongolia to the surrounding area of whole Bohai rim region. Conclusion There is a spatial non-stationarity for the impacts of multiple factors on health poverty among middle-aged and elderly residents in China. Partial weighted regression analysis could be adopted to examine the non-stationarity in studies on improving administrative efficiency of regional health poverty reduction.
, Available online ,
doi: 10.11847/zgggws1141547
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Objective To establish an index system with three dimensions of health capacity, right and risk and multidimensional indexes for the measurement of household health poverty. Methods An indicator system for evaluating health poverty was preliminary established through reviewing 225 relevant studies published in Chinese or English from 1983 till 2023. Delphi qualitative interview and two rounds of consultation were conducted among 10 senior experts working in regions with higher prevalence of health poverty or better implementation of healthy poverty alleviation to screening the identified indicators. The weights of the selected indicators were calculated using hierarchical analysis and a set of multidimensional health poverty indexes was constructed using the key performance indicator method and the Alkire-Foster method. Results For the two rounds of expert consultation, the positive coefficient was 100% and the authority coefficients were 0.8145 and 0.8667; the coordination coefficients of the experts′ opinions on the second/third level indicators were 0.342/0.233 and 0.487/0.353 for the first and second round of consultation, respectively (all P < 0.05), indicating a good coordination between the expert opinions. According to the results of the expert consultations and qualitative interviews, a health poverty evaluation index system was constructed; the index system includes 3 primary, 11 secondary, 39 tertiary indicators covering the three dimensions (health right, capability and risk) for health poverty measurement; in addition, 10 specific indicators were screened out from all the indicators for the measurement of multidimensional health poverty using key performance indicator method and double threshold method based on Alkire-Foster model. Conclusion The study establishes the index system and multidimensional indexes for household-based measurement on health poverty and multidimensional health poverty and the index system could provide a reference to the promotion of healthy poverty alleviation in China.
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, Available online ,
doi: 10.11847/zgggws1140803
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Objective To explore the application of moving epidemic interval method (MEM) in early warning of influenza incidence intensity in winter-spring season in Ningbo city and to provide a reference for developing effective intervention measures. Methods Influenza surveillance data for the period of January 2013 – May 2022 were collected from 2 national influenza sentinel hospitals in Ningbo city, Zhejiang province and a part of the data on positive rate of influenza virus detection among the registered cases in winter-spring seasons from January 2013 to December 2019 were extracted to establish a MEM model. The constructed MEM model was adopted to analyzed the beginning, the end and incidence intensity seasonal influenza epidemic during 2019 – 2020 (40th week, 2019 – 20th week, 2020) in Ningbo city; the model analysis results were compared with actual situation of the epidemic. Results For the virus- positive cases in the city during the 2013 – 2022, the proportions of isolated viral strains were 24.59% for influenza A (H1N1), 37.03% for influenza A (H3N2), and 38.38% for influenza B (mainly Victoria and Yamagata strain), respectively. The established MEM model showed a better goodness-of-fit, with the parameter δ of 2.7, the sensitivity of 87.97%, the specificity of 87.68%, and the Yoden index of 0.76. Based on the fitting results of the established MEM model, the thresholds of virus-positive rate were 22.76% and 25.05% for identifying the onset and the end of the influenza epidemic and the thresholds were 43.18%, 63.22%, and 74.83% for indicating a moderate-, high-, extremely high-intensity of the influenza epidemic during 2019 – 2020 influenza season. With the established MEM threshold estimations, the trajectory of the influenza could described as following: pre-epidemic stage from 40th week to 48th week of 2019, onset/low- intensity stage from 49th week of 2019, moderate-intensity stage from 51th week if 2019 to third week of 2020, subsequent low-intensity stage from 4th week of 2020, late stage from 7th week of 2020, and the end of the epidemic by the 10th week of 2020. Compared to the seasonal epidemics between 2013 – 2019, the 2019 – 2020 winter spring influenza epidemic occurred one week earlier but ended three weeks sooner. Conclusion MEM model could be adopted effectively in early identification and intensity warning of seasonal influenza epidemic.
, Available online ,
doi: 10.11847/zgggws1140334
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Objective To evaluate the effect of an intervention with a required non-mandatory vaccination rate on improving influenza vaccination among healthcare workers in 2021 – 2022 influenza season. Methods We conducted a non-randomized community intervention trial on influenza vaccination among healthcare workers in 7 hospitals in Nanshan district of Shenzhen city during an influenza season from October 2021 to April 2022. Free on-site influenza vaccination and prompt publicity for the vaccination were carried out among all the participants; compared to the 2 139 control participants in 3 hospitals, an additional dissemination about the expected non-mandatory vaccination rate of 80% and 60% for the staff working in departments assessed as at high- and low-risk of influenza infection was implemented among 4 599 participants in 4 hospitals of the intervention group. Pearson′s chi-squared test for adjusted ratio estimators was used to test the baseline and post-intervention vaccination rates for the intervention and control group. Results Over the influenza season for the participants working in high-risk departments, the influenza vaccination rate was 62.67% and 23.71% in the intervention and the control group, with a significant absolute rate difference (ARD) of 38.96% (95% confidence interval: 14.17% – 63.75%) between the two groups (P < 0.05); for the participants of low-risk departments, the influenza vaccination rate was 34.57% and 22.96% in the intervention and the control group(P > 0.05); for all the participants, the influenza vaccination rate was 43.90% and 23.19% in the intervention and in the control group (P > 0.05). The intervention of dissemination about the expected vaccination rate showed a significant impact upon the influenza vaccination rate for the participants working in high-risk departments but not for those in low-risk departments. Conclusion Under the premise of without both reward and punishment for having influenza vaccination, the dissemination of a high expected non-mandatory vaccination rate may increase the influenza vaccination rate among healthcare workers intervened.
, Available online ,
doi: 10.11847/zgggws1140344
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Objective To evaluate the vaccine effectiveness (VE) of inactivated trivalent influenza vaccine in primary and secondary school students. Methods Respiratory specimens were detected with PCR for influenza virus nucleic acid among 286 primary and secondary school students (6 – 15 years old) diagnosed as influenza-like illness (ILI) cases at all fever clinics in Nanshan district of Shenzhen city during an influenza season (from November 2021 to May 2022) and the ILI cases’ information on demography and influenza vaccination were collected simultaneously. The ILI cases positive for viral nucleic acid were assigned into a case group and those negative into a control group. Influenza vaccination ratio and odds ratio [OR] of viral nucleic acid positive the two groups were analyzed and compared to estimate the VE of influenza vaccination. Results Of the 286 ILI cases, 68 (23.78%) were positive for influenza nucleic acid (all belonging to B strain) and 218 (76.22%) were negative. The ratio of seasonal influenza vaccination was 5.88% (4/64) for the cases and 15.14% (33/216) for the controls, and the OR of being virus nucleic acid positive was 0.3886 (95% confidence interval [CI]: 0.1528 – 0.9880) for the vaccinated ILI cases. The estimated VE was 61.14% (95%CI: 1.20% – 84.72%) for seasonal influenza vaccination. Conclusion Seasonal influenza vaccination can protect primary and secondary school students from influenza virus infection. The result suggests that seasonal influenza vaccination needs to be promoted among the school age children.
, Available online ,
doi: 10.11847/zgggws1140813
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Objective To describe epidemiological characteristics of influenza-like illness (ILI) cases reported during 2021 – 22 by sentinel hospitals in Xiamen city, Fujian province for providing evidence to influenza prevention and control. Methods Demographic and medical information for 6 018 ILI cases reported by sentinel hospitals in Xiamen city from August 2021 to July 2022 were collected from National Influenza Surveillance Information System. Epidemiological and pathogenetic characteristics of the ILL cases were analyzed statistically. Results Of all the registered ILI cases, 51.99% (3 129) were male and 48.01% (2 889) were female; 49.72% (2 992) were at ages of 3 – 6 years; and 52.64% (n = 3168) were reported during June 2022. For 2 794 pharyngeal swab specimens randomly collected from 46.43% of all cases, 1 683 were positive for influenza virus nucleic acid, with a detection rate of 60.24%. Single-strain infection were detected among most (1 536, 91.27% ) of the cases positive for influenza virus and the ratios of the isolated strains for the single infections were 57.75% for influenza A H3N2, 31.91% for influenza B Victoria lineage, and 1.60% for influenza A H1N1, respectively. The most detected co-infections were caused by influenza B Victoria lineage combined with human metapneumovirus infection, which was identified in 32 cases, accounting for 1.90% of the nucleic acid-positive ILI cases. Conclusion According to hospital-based sentinel surveillance, the ILI incidence showed a mono-peak in summer season and mainly caused by influenza A H3N2 and 3 – 6 years children were more susceptible to the influenza-like infection during 2021 – 22 in Xiamen city.
Epidemiological characteristics and outbreak management of influenza in Yunnan province, 2010 – 2021
, Available online ,
doi: 10.11847/zgggws1140233
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Objective To analyze epidemiological characteristics and outbreak management of influenza in Yunnan province and to provide evidence for developing effective prevention and control strategies. Methods The data on reported influenza cases and outbreaks in Yunnan province during 2010 – 2021 were collected from China Information System for Disease Control and Prevention and analyzed using descriptive statistics. Results Totally 85 018 influenza cases and 13 deaths were reported in the province during the 12-year period, with the average annual incidence of 14.9895/100 000. Although the cases were reported in populations of various ages, the majority (52.64%) of the cases were at ages of 0 – 9 years and only 7.18% of the cases were elderly people aged ≥ 60 years. The top three average annual influenza incidence (82.7681, 37.9560, and 34.1800 per 100 100 population) were observed in three prefectures, namely Dehong, Honghe and Diqing). There were altogether 16 000 reported cases with laboratory confirmation, of them, 50.99% and 48.14% had influenza A and B virus infection, and 0.87% had combined infection of influenza A and B. Among 127 influenza outbreaks identified during the period in the province, 120 occurred in schools; 64 and 54 caused by influenza B and A virus infection, and 9 were induced by combined infection of influenza A and B virus. For the outbreaks, the average total number of reported cases in one outbreak was 69.6; the interval between the report of first case and the identification of the outbreak ranged 4.5 – 10 days; and the median duration of the outbreaks was 12 days (25th, 75 th percentile: 8, 19). The interval between the report of first case and the identification of an outbreak was positively correlated with the duration of the outbreak (rS = 0.518, P < 0.05). Conclusion During 2010 – 2021 in Yunnan province, influenza was prevalent from November of a year to January of the next year, especially among children aged 0 – 9 years and the most of the influenza outbreaks occurred in schools, suggesting that influenza vaccination should be promoted among high-risk populations to control the epidemic in the province.
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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.
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.
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.
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.
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.
2023, 39(4): 433-436.
doi: 10.11847/zgggws1140350
Abstract:
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.
2023, 39(4): 437-441.
doi: 10.11847/zgggws1137607
Abstract:
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.
2023, 39(4): 442-447.
doi: 10.11847/zgggws1141316
Abstract:
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.
2023, 39(4): 448-454.
doi: 10.11847/zgggws1141188
Abstract:
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 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.
2023, 39(4): 455-461.
doi: 10.11847/zgggws1139523
Abstract:
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.
2023, 39(4): 462-466.
doi: 10.11847/zgggws1139666
Abstract:
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.
2023, 39(4): 467-471.
doi: 10.11847/zgggws1139527
Abstract:
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.
2023, 39(4): 472-478.
doi: 10.11847/zgggws1140422
Abstract:
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.
2023, 39(4): 479-484.
doi: 10.11847/zgggws1140114
Abstract:
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.
2023, 39(4): 485-488.
doi: 10.11847/zgggws1140264
Abstract:
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.
2023, 39(4): 489-494.
doi: 10.11847/zgggws1140533
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.
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.
2023, 39(4): 499-504.
doi: 10.11847/zgggws1138143
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
2023, 39(4): 505-508.
doi: 10.11847/zgggws1138765
Abstract:
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.
2023, 39(4): 509-513.
doi: 10.11847/zgggws1139898
Abstract:
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.
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.
2023, 39(4): 514-520.
doi: 10.11847/zgggws1140223
Abstract:
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.
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.
2023, 39(4): 521-525.
doi: 10.11847/zgggws1140313
Abstract:
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.
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.
2023, 39(4): 526-530.
doi: 10.11847/zgggws1140359
Abstract:
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.
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.
2023, 39(4): 531-535.
doi: 10.11847/zgggws1140595
Abstract:
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.
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.
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.
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.
2023, 39(4): 540-544.
doi: 10.11847/zgggws1141428
Abstract:
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.
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.
CN 21-1234/R
ISSN 1001-0580
Governed by: National Health Commission of the People’s Republic of China
Sponsored by: Chinese Preventive Medicine Association
Published by: Editorial Office of Chinese Jounral of Public Health
Address: No.242, Shayang Road Heping District, Shenyang, China
Telephone: 024-83380011，23388443
Email: office@zgggws.com
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