Special Report – Influenza Prevention
- Seasonal characteristics and virus strain variation of influenza epidemics in Guangzhou city, 2015 – 2022: seasonal-trend decomposition-based analysis
- Epidemiological characteristics of influenza-like illness during 2021 – 2022 in Xiamen city: a hospital-based sentinel surveillance data analysis
- Influenza vaccine effectiveness in primary and secondary school students: an ILI surveillance-based test-negative design case-control study in a district of Shenzhen city during 2021 – 2022 influenza season
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doi: 10.11847/zgggws1141575
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Objective To investigate associations of changes in waist circumference (WC) and body mass index (BMI) with the variation of fasting blood glucose among middle aged and elderly residents with high cardiovascular risk. Methods Totally 71 758 urban/rural permanent residents aged 35 years or older were recruited at 8 districts/counties of 3 municipalities, Jiangsu province for a baseline survey conducted during 2015 as a part of the ‘Early Screening and Comprehensive Intervention on Cardiovascular Diseases among High-Risk Populations in China’. Out of those residents surveyed, 12 369 individuals with initial records of fasting blood glucose (FBG) were identified as at high-risk of cardiovascular diseases and the individuals were groups were followed up annually in 2017, 2018, and 2019 to observe changes in their FBG levels over time. The generalized estimating equation (GEE) was used to explore associations of the changes in WC and BMI with the variations of FBG among the participants. Results Of the 9 952 participants at the baseline survey, 3 045 (30.6%), 2 130 (21.4%), and 4 777 (48.0%) had normal WC, pre-central obesity, and obesity and 56 (0.6%), 2 669 (26.8%), 4 540 (45.6%), and 2 687 (27.0%) were assessed as having underweight, normal weight, overweight, and obesity, respectively. After adjusting for gender, age, education, place of residence, smoking, alcohol drinking, hypertension, diabetes mellitus, dyslipidemia, baseline WC, baseline BMI, and follow-up sequence, the results of GEE analysis revealed that compared those the participants with normal WC, the participants having declined WC were at a decreased risk of abnormal FBG (odds ratio [OR] = 0.911, 95% confidence interval [95%CI]: 0.867 – 0.958) but the participants having elevated WC were at an increased risk of abnormal FBG (OR = 1.070, 95%CI: 1.022 – 1.120); the results also showed that every one centimeter increase in baseline WC and one unit increase in baseline BMI were associated with 0.011 mmol/L (β = 0.027, 95%CI: 0.013 – 0.041) and 0.027 mmol/L (β = 0.027, 95%CI: 0.013 – 0.041) increase in FBG. Further subgroup analysis demonstrated that every one centimeter increase in baseline WC was associated with 0.011/0.010, 0.014/0.005, and 0.007/0.021 mmol/L increase in FBG for the participants being male/female, living in urban/rural regions, and with/without diabetes (all P < 0.001); while, every one unit increase in baseline BMI was associated with 0.030, 0.026/0.024, and 0.031 mmol/L increase in FBG for the participants being female, living in urban/rural regions, and having diabetes, respectively (all P < 0.05). Conclusion There are positively linear associations of changes in WC and BMI with the variation of FBG among middle aged and elderly populations with high cardiovascular risk.
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, Available online ,
doi: 10.11847/zgggws1140215
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Objective To examine car passenger safety behaviors and its associates among preschool children in a district of Beijing. Methods Using stratified cluster sampling and a self-designed questionnaire, we conducted an online anonymous survey among parents of 3 264 children aged 3 – 6 years recruited from 6 kindergartens in a district of Beijing during 27 – 31 December 2021. Results Of the 3 134 participants (96.29% of the parents recruited) with eligible responses, 38.56% reported using child safety seats for their kids in cars, followed by 31.88% and 21.16% reporting seat belt use and holding the kids in arms by caregivers while driving; taking no safety precautions at all was reported by 8.40% of the participants. Higher rates of child safety seat use were reported by parents of only children (43.75% vs. 34.05%), who were aware of child safety seat legislation (47.66% vs. 20.88%), had correct knowledge of child car passenger safety (47.58% vs. 28.54%), and always buckled up while driving contrasted with those reported by parents of two or more children, who were unaware of child safety seat legislation, had misconceptions about child car passenger safety, and did not always wear seat belt. Multivariate logistic regression analysis following promoting factors for the parents' child car passenger safety practices: having an only child (odds ratio [OR] = 1.376), with an annual household income 240 000 Chinese yuan and more (OR = 1.368), being aware of safety seat legislation (OR = 3.325), with correct knowledge of child car passenger safety (OR = 1.991), and always wearing seat belt while driving (OR = 5.231). Conclusion Child car passenger safety practice is at a relatively low level and influenced by parental demographic and economic status, awareness of knowledge about child car passenger safety, and safety driving behavior among the parents of preschool children in a district of Beijing, suggesting that relevant targeted interventions need to be promoted among the parents.
, Available online ,
doi: 10.11847/zgggws1141707
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Objective To examine iodine nutrition status among pregnant women in Ji'nan city, Shandong province for providing evidence to effective improvement of iodine nutrition in pregnant women. Methods A monitoring survey was conducted among 4 992 pregnant women recruited in 12 districts/counties of Jinan municipality, Shandong province during 2018 – 2021; each of the districts/counties was divided into 5 geographical regions and 20 pregnant women were selected from one subdistrict/town in each of the 5 regions. Table salt samples were collected from households of the pregnant women and urine samples of the pregnant women were also collected. Iodine content of table salt samples was measured with direct titration listed in the General Test Method for Salt Industry: Determination of Iodine (GB/T13025.7) and that of well salt and other fortified table salt samples was determined with arbitration method. Urinary iodine was detected using arsenic cerium catalytic spectrophotometry stated in WS/T107 issued by National Health and Family Planning Commission. Year- and trimester-specific urinary iodine were analyzed. Results The median ( 25% percentile [P25], 75% percentile [P75]) of iodine content was 22.31 (18.18, 25.59) mg/kg for all the 4 992 table salt samples. The coverage rate of iodized table salt was 88.92% (4 439 samples) and the usage rate of qualified iodized table salt was 72.96% (3 642 samples). There were significant yearly and regional differences in iodized salt coverage (χ2 = 72.54, χ2 = 271.04; both P < 0.05) and qualified iodized table salt usage rate (χ2 = 43.03, χ2 = 492.25, both P < 0.05); but the iodized salt coverage and qualified iodized table salt usage rate were not significantly different among the pregnant women in various trimesters of pregnancy (χ2 = 1.07, χ2 = 0.97; both P > 0.05). The median ( P25, P75) of urinary iodine was 145.70 (87.70, 216.00) μg/L for the 4 992 pregnant women. The urinary iodine concentration differed significantly among the pregnant women surveyed in different years (H = 21.97), from various districts/towns (H = 348.78), during various trimesters of pregnancy (H = 41.18), and consuming table salt with different iodine content (H = 13.23) (P < 0.05 for all). Conclusion Mild iodine deficiency existed among pregnant women in Ji'nan city during 2018 − 2021, suggesting that relevant measures should be taken to prevent iodine deficiency in the pregnant women.
, Available online ,
doi: 10.11847/zgggws1139435
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Objective To investigate the prevalence and genetic diversity of human astrovirus (HAstV) strains in untreated domestic sewage. Methods We collected six domestic sewage samples (one liter for each) at an inlet of an urban sewage treatment plant quarterly from January 2018 to June 2019 in in Jining city, Shandong province. After concentrated via anion membrane adsorption elution method, the viral nucleic acid in the samples was extracted with MagMAX Pathogen RNA/DNA Kit and complete open reading frame 2 (ORF2) region of HAstV was amplified using real-time reverse transcription PCR (RT-PCR). Then the amplicons were subjected to next generation sequencing (NGS). Clean data of NGS were assembled de novo to form contigs using CLC Genomics Workbench 12.0 (QIAGEN, USA) with default parameters for homology and phylogenetic analysis. Results All the six sewage samples were positive for HAstV. Totally 43 ORF2 sequences of HAstV were obtained and classified into 9 genotypes including classic HAstV-1 to HAstV-5 and novel MLB1 and VA1-3. HAstV-5 was the most common genotype (47.53%). Phylogenetic analysis revealed that local and foreign sequences clustered together in some branches, indicating the transmission of various genotypes of HAstV among different regions in the world. Conclusion The analysis results demonstrates that NGS-based environmental surveillance could greatly improve the understanding on HAstV genetic diversity.
, Available online ,
doi: 10.11847/zgggws1140415
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Reducing sedentary behavior has become a public health priority due to significantly increased prevalence of leisure-time sedentary behaviors among people; promoting physical activity and interrupting sedentary time are among common interventions on sedentary behaviors. The built environment, as one of determinants of sedentary behavior, is increasingly being investigated and relevant studies have indicated that environmental interventions on sedentary behavior may be a more cost-effective and appropriate approach; however, few studies have specified the extent and mechanism of a distinct built environment’s impact on sedentary behavior. In this review, we summarize researches on the association of characteristics of built environment with sedentary behavior, related measurement tools, and environmental interventions on sedentary behaviors to provide references to domestic studies in this field.
Reducing sedentary behavior has become a public health priority due to significantly increased prevalence of leisure-time sedentary behaviors among people; promoting physical activity and interrupting sedentary time are among common interventions on sedentary behaviors. The built environment, as one of determinants of sedentary behavior, is increasingly being investigated and relevant studies have indicated that environmental interventions on sedentary behavior may be a more cost-effective and appropriate approach; however, few studies have specified the extent and mechanism of a distinct built environment’s impact on sedentary behavior. In this review, we summarize researches on the association of characteristics of built environment with sedentary behavior, related measurement tools, and environmental interventions on sedentary behaviors to provide references to domestic studies in this field.
, Available online ,
doi: 10.11847/zgggws1142044
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Facing with the growing health demands of the people, governments of all countries would promote national health to the level of national strategy, with the national health strategies of the United States and the United Kingdom being the most representative. Based on the theoretical framework of the political systems theory in this paper, we analyze policy texts relevant to health strategies of the two countries in recent years; we also conduct analyses on the semantic network, word frequency of the policy texts in different periods and co-word matrix of the policy documents to interpret the shift of health strategic priorities and the adjustment of measures in the United Kingdom and the United States under the impact of public health emergencies, and then deduce future development direction of the health strategies of the two countries. The study is intended to provide a reference for achieving the strategic goal of Healthy China Initiative.
Facing with the growing health demands of the people, governments of all countries would promote national health to the level of national strategy, with the national health strategies of the United States and the United Kingdom being the most representative. Based on the theoretical framework of the political systems theory in this paper, we analyze policy texts relevant to health strategies of the two countries in recent years; we also conduct analyses on the semantic network, word frequency of the policy texts in different periods and co-word matrix of the policy documents to interpret the shift of health strategic priorities and the adjustment of measures in the United Kingdom and the United States under the impact of public health emergencies, and then deduce future development direction of the health strategies of the two countries. The study is intended to provide a reference for achieving the strategic goal of Healthy China Initiative.
, Available online ,
doi: 10.11847/zgggws1141835
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Objective To genetically characterize microbial community and Anaplasma – a major pathogen harbored by Haemaphysalis tibetensis collected in Yadong county, Tibet Autonomous Region. Methods Totally 141 ticks parasitizing on yaks were collected in Yadong county in May 2022 and the species of the ticks were identified according to amplified sequences of mitochondrial 16s rDNA of Ixodes. High-throughput sequencing was carried on the identified Haemaphysalis tibetensis using the Illumina Novaseq 6000 platform. The resulting raw data underwent processing for assembly, gene prediction, abundance analysis, and taxonomic prediction. The 16S rDNA gene fragment of Anaplasma was amplified and sequenced with nested PCR for phylogenetic analysis. Results Out of 141 adult tick samples collected, 121 were positively identified as Haemaphysalis tibetensis. According to species annotation with the National Center for Biotechnology Information (NCBI) -NR database, the most prevalent microorganisms were eukaryotes (19.78%) and bacteria (13.54%), with the dominant genera of Anaplasma, Trypanosoma, Psychrobacter, and Rickettsia and the dominant species of phagocytophilum group, Trypanosoma theileri, and spotted fever group rickettsia. Among the bacterial florae, the dominant phyla were Proteobacteria, Bacteroidetes, and Firmicutes. The phylogenetic analysis revealed a high homology of the tick-born Anaplasma and Anaplasma ovis. Conclusion In the research area, the dominant tick species parasitizing on yaks in this region is the Haemaphysalis tibetensis and the major genotype of the tick-born Anaplasma is Anaplasma ovis. The results suggest that local residents and livestock could be exposed to various tick-borne pathogens and targeted surveillance and preventive measures against tick-borne diseases should be enhanced.
, Available online ,
doi: 10.11847/zgggws1141808
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Objective To explore the feasibility of predicting the trend of measles epidemic using long short- term memory (LSTM) neural network model for conducting prevention and control of measles. Methods The data on 51 012 measles cases reported in Hebei province form 2004 through 2020 were collected from China Information System for Disease Control and Prevention. The LSTM neural network model was constructed and the optimal model was selected to predict the trend of measles epidemic in the province. Rooted mean squared error (RMSE) and mean absolute error (MAE) were used to evaluate the prediction of model established. Results The annual number of measles cases reported in the province during the 17-year period were 950, 4 837, 7 953, 4 973, 2 273, 3 359, 14 457, 79, 38, 353, 5 365, 3 825, 1 825, 287, 241, 130, and 67, respectively, with a persistent decline since 2015. In addition, an obvious seasonality was observed in the incidence of measles. Using the collected data of 2017, the window length of 3 was determined for the constructed LSTM neural network model, with the RMSE of 17.288 and the MAE of 12.334, and the model was adopted to predict monthly number of measles cases from 2017 through 2020. The predicted monthly numbers of measles incidence were basically consistent with the number observed and the values of RMSE and MAE for years of 2017, 2019 and 2020 were all below 10, but the values for 2018 were slightly higher. Conclusion The constructed LSTM neural network model in this study showed a good efficiency in predicting monthly measles incidence in Hebei province and the model could be used in the analysis on measles incidence trend and epidemic risk assessment.
, Available online ,
doi: 10.11847/zgggws1141801
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Objective To establish a sensitive, reliable and rapid pre-treatment method for enrichment and nucleic acid extraction of pathogenic bacteria in water for fluorescent quantitative PCR (qPCR) detection of pathogenic bacteria in water. Methods The tester strain used in the experiment was Mycobacterium abscessus (American Type Culture Collection [ATCC] 19977) at concentration of 3.10 × 108 colony form unit (CFU)/mL. The nucleic acid of the tester strain was extracted using centrifugal column and magnetic bead extraction kits combined with elutions of different membranes. The nucleic acid extraction conditions were optimized by using beads of different materials, sizes and numbers and the number of homogenization cycles. The extracted nucleic acid was subjected to qPCR assay to compare the extraction efficiency of each method. qPCR was performed on spiked water samples using optimal extraction conditions to examine the whole process recovery and detection limits. Results The highest recovery of 81.03% ± 19.23% and detection limit of 6.20 CFU/100 mL were achieved using the procedures including 0.20 μm membrane filtration, six homogenization cycles with seven large zirconium beads, and TIANMicrobe Magnetic Envir-DNA Kit based extraction. Conclusion Using homogenizer and TIANMicrobe Magnetic Envir-DNA Kit is more efficient for the enrichment and nucleic acid extraction of pathogenic bacteria in water for qPCR detection.
, Available online ,
doi: 10.11847/zgggws1141094
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Objective To examine the prevalence and influencing factors of gallstone disease among rural adults in a county of Henan province. Methods We recruited 9 511 permanent rural residents aged ≥ 18 years from 17 villages in two townships of Xinxiang county, Henan province using multi-stage random cluster sampling. Face-to-face interview, physical examination, laboratory tests, and abdominal ultrasound detection were conducted among the residents during April – June 2017. Results Among the 9 461 participants completing the survey, totally 299 gallstone disease cases were identified, with a prevalence rate of 3.16% and a standardized prevalence rate of 2.28%. The results of the multivariate unconditional logistic regression showed that the participants aged ≥ 45 years, with central obesity or fatty liver were more likely to have gallstone disease; while, drinking alcohol at least 12 times a year or more was a protective factor against the disease. Conclusion The prevalence rate of gallstone disease was relatively low and mainly influenced by age, central obesity, fatty liver, and alcohol consumption among adult rural residents in a county of Henan province.
, Available online ,
doi: 10.11847/zgggws1141915
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Objective To establish, evaluate and preliminarily apply grey model (1,1) [GM(1,1)] models for predicting the prevalence of common carbapenem-resistant bacteria in China. Methods We extracted the national data of 2015 – 2021 on detection rate of carbapenem-resistant Escherichia coli (CR-E.coli), carbapenem-resistant Klebsiella pneumoniae (CRKP), carbapenem-resistant Pseudomonas aeruginosa (CRPA), and carbapenem-resistant Acinetobacter baumannii (CRAB) from the China Bacterial Drug Resistance Surveillance Network. Four GM(1,1) models were constructed using the data of 2015 – 2019. Posterior difference ratio C, small error probability P, and relative error and residual error were used to assess the accuracy of the established models in predicting prevalence of common carbapenem-resistant bacteria with the data of 2020 – 2021. The prevalence of CR-E.coli, CRKP, CRPA and CRAB for years from 2022 to 2025 in China were predicted using the four GM(1,1) models established. Results For the four established GM(1,1) models, the values of posterior difference ratio C were less than 0.50, the small probability error P were close to 1.0, and the relative errors and residual errors were less than 10%, indicating good efficacies in predicting the prevalence of CR-E.coli, CRKP, CRPA and CRAB. Based on the four established GM(1,1) models, the predicted yearly prevalence of CR-E.coli, CRKP, CRPA, and CRAB in China are 1.668%, 12.208%, 16.663%, and 52.507% for 2022; 1.698%, 12.886%, 15.930%, and 1.549% for 2023; 1.729%, 13.601%, 15.229%, and 50.608% for 2024; and 1.761%, 14.355%, 14.559%, and 49.685% for 2025, respectively, with a upward trend for the prevalence of CR-E.coli and CRKP but a downward trend for the prevalence of CRPA and CRAB. Conclusion In this study, four GM(1,1) models were established for predicting the prevalence of common carbapenem-resistant bacteria and the predictions based on the models could be used in developing strategies on the prevention and control the prevalence of CR-E.coli, CRKP, CRPA and CRAB in China.
, Available online ,
doi: 10.11847/zgggws1141976
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Objective To examine the prevalence and influencing factors of vaccine hesitation among adult citizens during a major public health emergency for promoting vaccination in China. Methods Using random sampling and a self-designed questionnaire on vaccine hesitation and its associates, we conducted an online survey among 4 325 citizens aged 18 – 59 years in five provincial level administrative divisions (Guangdong, Hubei, Hebei, and Heilongjiang province and Beijing municipality) across China during February – March, 2021, a period of with a major public health emergency. Results Of the 4 169 eligible respondents, 1 479 (35.5%) reported vaccine hesitation. The results of unconditional multivariate logistic regression analysis showed that the respondents with following characteristics were more likely to have vaccine hesitation: being female, suffering from chronic diseases, with poor self-rated health, with high perceived risk of the epidemic, and being highly concerned about the epidemic-related information; while, the respondents ever having influenza vaccination, reporting a high community responsibility, with relatives/friends/colleagues being vaccinated with coronoavirus disease vaccine, and with the cognition on the efficacy and the safety of the coronavirus disease vaccine were less likely to have the vaccine hesitation. Conclusion Vaccine hesitation was prevalent among adult citizens in China during a major public health emergency and the hesitation was associated with gender, self-assessed health, chronic disease condition, influenza vaccination, sense of social responsibility, perceived risk of the epidemic, concern about the epidemic, coronavirus disease vaccination of relatives/friends/colleagues, and the cognition of the efficacy and the safety of the coronavirus disease vaccine.
, Available online ,
doi: 10.11847/zgggws1140468
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Objective To explore the relationship between abdominal obesity index and hypertension among the elderly in Zhongshan city for the prevention and control of hypertension. Methods The data of the analysis were from 8 318 residents aged ≥ 65 years and participating in free physical examination project during June - September 2020 in a town and a district of Zhongshan city, Guangdong province. Multivariate logistic regression model was used to analyze the relationship between abdominal obesity indexes and hypertension among the residents; the abdominal obesity indexes included neck circumference (NC), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), lipid accumulation product (LAP), and China visceral obesity index (CVAI). The dose-response correlation between NC and the risk of hypertension was analyzed with restricted cubic splines. Results The observed prevalence rate of hypertension among the elderly physical examinees was 45.5% (44.4% in the males and 46.3% in the females). Compared to those in the male and female non-hypertensives, significantly higher mean values of NC (37.29 ± 2.83 cm vs. 36.41 ± 2.82 cm and 33.91 ± 2.67 cm vs. 33.04 ± 2.55 cm), WC (87.90 ± 9.51 cm vs. 84.40 ± 9.59 cm and 86.52 ± 9.48 cm vs. 83.24 ± 9.50 cm), WHR (0.93 ± 0.07 vs. 91 ± 0.07 and 0.91 ± 0.07 vs. 0.90 ± 0.07), WHtR (0.54 ± 0.06 vs. 0.52 ± 0.06 and 0.57 ± 0.06 vs. 0.55 ± 0.06), LAP (43.00 ± 38.70 vs. 32.54 ± 31.22 and 46.98 ± 39.47 vs. 58.08 ± 46.96), and CVAI (116.19 ± 42.01 vs. 98.42 ± 42.94 and 133.18 ± 30.78 vs. 119.80 ± 30.25) were measured in the hypertensives (all P < 0.001). After adjusting for age, education, marital status, monthly household income per capita, smoking, alcohol drinking, exercise, salted vegetable consumption habits, body mass index (BMI), fasting blood glucose (FPG), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C), multivariate logistic regression analysis showed that the risk of hypertension increased in the male elderly with higher NC compared to that in those with the NC of the lowest quartile (third quartile: odds ratio [OR] = 1.314, 95% confidence interval [CI]: 1.029 – 1.676; the highest quartile: OR = 1.512, 95%CI: 1.131 – 2.022) and in the female elderly with higher WHtR compared to that in those with the WHtR of the lowest quartile (second quartile: OR = 1.214, 95%CI: 1.009 – 1.463; third quartile: OR = 1.289, 95%CI: 1.084 – 1.532; the highest quartile: OR = 1.503, 95%CI: 1.223 – 1.846) ; the analysis also demonstrated that the risk of hypertension decreased in the male elderly with higher WHtR (the second quartile vs. the lowest quartile: OR = 0.636, 95%CI: 0.469 – 0.863). After adjusting for confounding factors mentioned above, the results of restricted cubic spline analysis revealed a linear dose-response relationship between NC and hypertension risk in both the male and the female elderly (χ2 = 94.62 and 128.22, both P < 0.001). Conclusion There is a positive linear correlation between NC and the risk of hypertension among the elderly in Zhongshan City.
, Available online ,
doi: 10.11847/zgggws1143522
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Objective To examine the scale, channels, regions and fields of China's development assistance for health (DAH) from 2000 through 2021 for the integration into global health governance. Method The data of the analysis were extracted mainly from the Development Assistance for Health Database 1990 – 2021 published by Institute for Health Metrics and Evaluation and supplementary from China's Foreign Aid (2014). SPSS Statistics 26.0 was used in descriptive statistics analysis. Results China's DAH increased from 284 million US dollars in 2000 to 1.592 billion US dollars in 2021, with an increase of 460.56%. Of all the DAH, 93.90% were channeled through bilateral agencies, but the proportions of the DAH channeled through government and social capital cooperation, development banks and United Nations agencies went up continuously during the period. The majority (58.59%) of the recipient countries of China's DAH were in sub-Saharan Africa. In terms of health focus area, 92.90% of the China's DAH was applied in strengthening of health systems of the recipient countries. Conclusion During the period from 2000 to 2021, China's DAH increased with diversified channels of disbursement and the DAH were mainly for strengthening of health systems of the recipient countries.
, Available online ,
doi: 10.11847/zgggws1141850
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Objective To assess the effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPV23) against Streptococcus pneumonia (Spn) --associated respiratory tract infection in children with a test-negative design study. Methods We recruited totally 3 339 children at ages of 2 - 9 years hospitalized due to acute respiratory illness (ARI) and being detected for Spn isolates in sputum/bronchoalveolar lavage fluid (BALF) during 2017 – 2020 at the Soochow University Affiliated Children's Hospital for a test-negative case-control design study. The collected Spn isolates were serotyped with Quellung test. Of the all the participants, 1 264 being positive for PPV23 serotype Spn (VT-Spn) in sputum/ BALF specimens were assigned into a case group; the two control groups were 485 being positive for non-PPV23 serotype (NVT-Spn) and 1 590 being negative for Spn (Spn-).The participants’ information on PPV23 vaccination were collected from the Vaccination Registry Database of Suzhou Municipal Center for Disease Control and Prevention. The adjusted odds ratio of PPV23 vaccination was calculated with logistic regression model to estimate the vaccine effectiveness (VE) of PPV23 against Spn-associated ARI. Results Among the 1 749 Spn strains isolated, the most common serotypes were 19F, 6B, 23F, 6A and 19A; 76.56% and 72.27% were positive for 13-valent pneumococcal conjugate vaccine (PCV13) serotype and PPV23 serotype, respectively. For the participants of VT-Spn, NVT-Spn and Spn- group, the mean age were 3.88 ± 1.27, 4.02 ± 1.43, and 4.52 ± 1.92 years; the vaccination rate of PPV23 were 5.4%, 6.8%, and 5.8%, respectively; and the mean age at the vaccination was 2.53 ± 0.61 years for all the participants vaccinated., When using the NVT-Spn group as the control and after adjusting for age, clinical diagnosis, and other vaccination status, the logistic regression analysis revealed an overall PPV23 effectiveness of 18.3% (95% confidence interval [95%CI]: – 26.3% – 47.1%) for against Spn-associated ARI, an effectiveness of 15.7% for against community acquired pneumonia, and the effectiveness of 32.8, 16.5% and 57.5% for against serotype 19F, 6B and 15B Spn-associated ARI, respectively, and the effectiveness (26.0%) was better in the participants aged 2 – 5 years than that (7.6%) in those aged 5 years or elder; while using the Spn- group as the control and after adjusting for age, household registration, other vaccination status, the year of seeking medication, season of seeking medication, and clinical diagnosis, the logistic regression analysis showed a VE of 29.9% (95% CI: – 22.0% – 59.7%) for the participants aged 2 – 5 years. Conclusion PPV23 is of certain protection against Spn-associated respiratory tract infections in 2 – 9 years old children and the effectiveness decreases with the prolonged time after receiving the vaccination
, Available online ,
doi: 10.11847/zgggws1141803
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Objective To examine the associations of different obesity phenotypes with chronic disease comorbidities among middle-aged and elderly residents in Yangzhong city for precise prevention and control of chronic disease comorbidy in the population. Methods Face-to-face interview with a questionnaire developed by domestic researchers, physical examination and laboratory tests were conducted among 6 899 residents aged 40 – 69 years recruited with stratified multistage random cluster sample in urban and rural regions of Yangzhong city, Jiangsu province from November 2017 through June 2021. Multivariate ordered logistic regression model was applied to analyze the effect of different types of obesity on chronic disease comorbidity in the residents. Results Of 6 581 participants finally included in the analysis, 3 957 (60.1%) were identified as having chronic disease comorbidity; the proportions of body mass index (BMI in kg/m2) -based overweight (24.0 – 27.9) and obesity ( ≥ 28.0) were 40.7% and 12.1%; the proportions of central obesity based on waist circumference (WC, ≥ 90 cm for males and ≥ 85 cm for females), waist to hip ratio (WHR, ≥ 0.90 for males and ≥ 0.85 for females), and waist to height ratio (WHtR, ≥ 0.50) were 35.3%, 79.6%, and 63.7%; the proportions of mixed obesity indicated by BMI + WC, BMI + WHR, and BMI + WHtR were 10.5%, 11.4%, and 11.8%, respectively. After adjusting for gender, age, education, marital status, annual household income, residence region, smoking, alcohol consumption, vegetable intake, fruit intake, physical activity, daily sleep duration and family history of chronic diseases, the results of multivariate ordered logistic regression analysis showed that the participants with following different obesity phenotypes were at increased risk of chronic disease comorbidity: BMI-based overweight (odds ratio [OR] = 1.736, 95% confidence interval [95%CI]: 1.575 – 1.915), BMI-based obesity(OR = 2.325, 95%CI: 2.012 – 2.687), WC-based central obesity (OR = 1.773, 95%CI: 1.615 – 1.947), WHR-based central obesity(OR = 1.956, 95%CI: 1.739 – 2.200), and WHtR-based central obesity (OR = 1.968, 95%CI: 1.788 – 2.166), BMI + WC-based mixed obesity (OR = 2.590, 95%CI: 2.221 – 3.021), BMI + WHR-based mixed obesity (OR = 3.488, 95%CI: 2.908 – 4.185), and BMI + WHtR-based mixed obesity (OR = 2.845, 95%CI: 2.438 – 3.321). Conclusion BMI-based obesity, WC-, WHR-, and WHtR-based central obesity, and mixed obesity are all risk factors for chronic disease comorbidity among urban and rural middle-aged and elderly residents in Yangzhong city and special attention should be paid to the residents with WC-based central obesity and mixed obesity in prevention and control of chronic disease comorbidity.
, Available online ,
doi: 10.11847/zgggws1141072
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Objective To analyze differences in the indicator framework of the Global Health Security Index (GHSI) and the scores of GHSI indicators for 195 contracting countries of International Health Regulations 2005 (IHR2005) between 2019 and 2021. Methods Yearly GHSI evaluation reports and the data on 195 contracting countries of IHR2005 on GHSI indicator scores for years of 2019 and 2021 were downloaded from official GHSI website (https://www.ghsindex.org ) and changes in GHSI indicator framework and contracting country-specific scores of GHSI indicators were analyzed. Paired T-test was used to compare between-year differences in and correlations of country-specific scores of GHSI indicators. General linear regression was adopted to assess the collinearities and correlations between total score and scores of primary/secondary indicators of GHSI for 195 contracting countries of IHR2005 in 2021. Results In 2021, the average GHSI score was 38.9 (in a scale with 5 categories and the maximum score of 100) for the 195 contracting countries of IHR2005 nearly the same as that (40.2) of 2019; none of the 195 contracting countries was assessed as having the GHSI score of the highest category (the scores of > 80 at level 5) and 66.7% of the countries were scored below 40. Compared to that of 2019, the GSHI 2021 index framework was supplemented with 3 secondary indicators, 11 tertiary indicators, and 31 questions. The results of paired T-test showed that the average score of GHSI for the 195 contracting countries in 2021 was increased by 0.1 point against that of 2019, but the difference was not statistically significant (P > 0.05). In comparison with those in 2019, following average scores decreased significantly for primary indicators of preventing the emergence or spread of pathogens (reduced by 0.6, t = – 2.413; P < 0.05) and rapidly responding to/reducing disease transmission (by 4.0, t = – 9.402; P < 0.05), secondary indicators of zoonosis prevention (by 4.8, t = – 6.590; P < 0.001) and trade and travel restrictions (by 58.3, t = – 33.158; P < 0.001). There were strong correlations between country-specific scores of secondary indicators of 2019 and those of 2021, except for the score of trade and travel restrictions (r = 0.117) and the score of implementing response plan (r = 0.237) . General linear regression analysis showed that there was no collinearity among the country-specific scores of 6 primary indicators in 2021, but the total scores of all indicators were significantly correlated with the scores of 6 primary indicators (P < 0.05 for all). Conclusion Based on the assessment using GHSI scores, none of the 195 IHR2005 contracting is well prepared for the next probable disease pandemic and the ability to prevent and respond to public health emergencies needs to be improved for the countries.
, Available online ,
doi: 10.11847/zgggws1141760
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Objective To estimate human and financial resources allocation for tobacco control in three provinces, China in 2019 for providing evidence to relevant policy-making. Methods With stratified sampling, a survey was conducted among 30 administrative agencies, 25 professional institutions and 137 staff in those organizations in 18 districts/counties of three provinces in eastern, central and western China during July – December 2020. The information for the year of 2019 on tobacco control-related financial investment of the organizations and working hours of the staff were collected by investigators. Population weighting was used in data analysis. Results In 2019 for the eastern, central and western province, the working hours-converted number of tobacco control staff were 114.1, 139.4 and 154.2 and the total tobacco control-related investment were 45 089, 27 308 and 36 176 million Chinese yuan, respectively. Higher proportion (more than 80%) of office expenses against overall financial investment for tobacco control implementation was observed in the central and western provinces. The tobacco control-related investment per capita for the three provinces were 0.5, 0.6 and 0.8 Chinese yuan. Tobacco control publicity, smoking prevalence surveillance and smoke-free environment construction were priorities of tobacco control implementation in the three provinces. Conclusion In 2019, there was still an obvious gap in the tobacco control-related financial investment between the three provinces surveyed and those administrative divisions with better tobacco control in China and the situation needs to be concerned in the promotion of tobacco control.
E-cigarette use and its influencing factors among school youths: an online survey in 13 China cities
, Available online ,
doi: 10.11847/zgggws1141844
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Objective To investigate the prevalence and risk factors of e-cigarette smoking among school youths in China. Methods With stratified multistage cluster sampling, we conducted an online survey among 2 405 students aged 15 years and above from 35 high schools/vocational schools/colleges or universities in 13 China cities in 4 regions with different cultural characteristics (the north region, the Yangtze River Delta, the Pearl River Delta, and Southwest region) during September 2022 – March 2023. A questionnaire on e-cigarette use and its potential associates was compiled mainly based on Global Youth Tobacco Survey (GYTS), Chinese Perceived Stress Scale (CPSS), and Adolescent Self-Rating Life Events Checklist (ASLEC). Results Among all the students surveyed, 6.36% (153) reported e-cigarette use, with 4.57% (110) and 1.79% (43) reporting ever use and current use of e-cigarette. The age at first e-cigarette use for the e-cigarette smokers was 15.92 ± 2.03 years and the number of peers on site of the students′ e-cigarette smoking was 2.10 ± 1.34. The results of unconditional multivariate logistic regression analysis revealed following risk factors for e-cigarette use: being male (odds ratio [OR] = 4.81, 95% confidence interval [95%CI]: 3.24 – 7.15), with higher stress score (OR = 1.63, 95%CI: 1.15 – 2.33), falling out of love during past six months (OR = 2.82, 95%CI: 1.89 – 4.21), losing a friend during past six months (OR = 1.67, 95%CI: 1.17 – 2.38), and having more pocket money (compared to less than 800 Chinese Yuan per month: OR800 – 1500 = 1.90, 95%CI: 1.23 – 2.95; OR > 1500 = 2.22, 95%CI: 1.44 – 3.41); while, living with married parents was a protective factor against e-cigarette use (OR = 0.44, 95%CI: 0.29 – 0.67). Conclusion The prevalence of e-cigarette use is low and mainly influenced by gender, negative life events, amount of pocket money, and family relationship currently among school youths in China.
, Available online ,
doi: 10.11847/zgggws1141941
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Objective To explore comorbidity pattern, comorbidity burden and economic burden of chronic diseases among inpatients with Parkinson's disease and Parkinsonism in Chengdu city, Sichuan province for effective treatment and management of the patients with the diseases. Methods Based on disease codes of International Classification of Diseases 10th Revision, we collected 30 436 hospitalization records of Parkinson's disease patients and 3 749 records of Parkinsonism patients for years of 2013 – 2017 from the Information System of Chengdu Medical Insurance Bureau. The comorbidity burden of chronic diseases among the inpatients was evaluated with Charlson Comorbidity Index (CCI). The comorbidity spectrum, comorbidity burden and economic burden of chronic disease among the inpatients with Parkinson's disease and Parkinsonism were described and compared statistically; the influence of CCI on economic burden of the inpatients was analyzed with multivarite linear regression model. Results The ratios of chronic disease comorbidity were 72.23% and 73.26% for 30 436 hospitalizations of Parkinson′s disease patients and 3 740 hospitalizations of inpatients with Parkinsonism during the 5-year period in Chengdu city and there was no significant difference in the ratio between the two groups of hospitalization (χ2 = 1.78, P = 0.182). For hospitalizations of both Parkinson′s disease and Parkinsonism patients, the top three most frequent comorbidity diseases (constituent ratios) were cerebrovascular disease (49.21% and 51.23%), chronic pulmonary disease (19.25% and 20.64%) and diabetes with end-organ damage (15.54% and 16.34%). In terms of multicomorbidity, the most frequent comorbid pattern of two chronic diseases was cerebrovascular disease and chronic pulmonary disease (9.45% and 11.34% for both Parkinson′s disease and Parkinsonism hospitalizations) and that three chronic diseases was cerebrovascular disease, chronic pulmonary disease, and diabetes with end-organ damage (1.30% and 2.03%); for the 21 983 hospitalizations of Parkinson's disease patients and 2 740 hospitalizations of Parkinsonism patients, the proportions of with 1, 2, 3, 4, and ≥ 5 comorbid chronic diseases were 51.95% and 47.34%, 34.67% and 35.51%, 11.44% and 14.01%, 1.74% and 2.99%, and 0.20% and 0.15%, respectively, with a significant difference in the proportions between the two groups of hospitalization (χ2 = 45.21, P < 0.001). For the hospitalizations of Parkinson′s disease and Parkinsonism patients, the average CCI of 1.39 ± 1.28 and 1.49 ± 1.36 and the average medical expenses per hospitalization were 11 031.75 ± 110.88 and 12 885.81 ± 288.57 (Chinese yuan), with significant differences in the CCI and the average medical expenses between the hospitalizations of the two groups of the inpatients (both P < 0.001). After adjusting for gender, age, hospital grade and length of stay, the results of multivariate linear regression analysis showed was no significant difference in the average medical expenses per hospitalization between the hospitalizations of Parkinson′s disease and Parkinsonism patients (β = 0.017, 95% confidence interval [95%CI]: – 0.003 – 0.071); while, the expenses increased with the increment of CCI (β = 0.066, 95%CI: 0.061 – 0.071). Conclusion The prevalence, disease and the economic burden of comorbidity of chronic diseases were high and cerebrovascular disease, chronic pulmonary disease, and diabetes with end-organ damage were the most common comorbidities among inpatients of Parkinson's disease and Parkinsonism in Chengdu city.
, Available online ,
doi: 10.11847/zgggws1142008
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Objective To examine the prevalence and influencing factors of spirometry examination among residents aged 40 years in Inner Mongolia Autonomous Region (Inner Mongolia) for promoting prevention and control of chronic respiratory diseases. Methods Using multistage stratified cluster and probability proportionate to size sampling and a questionnaire adopted by Chinese Center for Disease Control and Prevention, we conducted a face-to-face survey among 2 400 permanent residents aged 40 years in four prefectures/banners with chronic obstructive pulmonary disease surveillance project in Inner Mongolia during May – December 2019. The estimated prevalence of spirometry examination in the participants was calculated based on complex sampling weight design; the impact factors of spirometry examination were explored with unconditional multivariate logistic regression analysis. Results Of the 2302 participants with eligible responses, 142 reported ever having pulmonary function test. The complicated weighted proportion of spirometry examination was 5.1% for the population surveyed. The results of logistic regression analysis showed that the residents with the education of junior high school and above, being enterprise clerks or professional and technical personnel in enterprises, being workers not classified or being unemployed, being aware of the names of respiratory diseases, ever suffering from respiratory symptoms, and with the history of respiratory illness were more likely to have spirometry examination; while the female residents were less likely to have the examination. Conclusion The proportion of ever having spirometry examination was relatively low and mainly influenced by gender, education, occupation, the awareness of respiratory disease, respiratory symptoms, and the history of chronic respiratory disease among residents 40 years old and older in Inner Mongolia.
, Available online ,
doi: 10.11847/zgggws1141424
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Objective To explore the associations of body mass index (BMI), waist circumference (WC), and waist to height ratio (WHtR) with dyslipidemia among adult residents in Shaanxi province for developing relevant intervention strategies. Methods Using stratified multistage random cluster sampling, we recruited 6 202 urban and rural permanent residents aged 18 years and above in 10 regions covered by national surveillance on chronic diseases and risk factors in Shaanxi province. Face-to-face interview with the questionnaire for China Adult Chronic Disease and Nutrition Surveillance – 2018, physical examination, and laboratory detections were conducted among the participants during May – November, 2018. Partial correlation analysis and unconditional multivariate logistic regression were adopted in analyses on the correlations of BMI, WC, and WHtR with the risk of dyslipidemia. Results Dyslipidemia were detected in 1 994 (33.04%) of the 6 036 participants completing the survey. Laboratory detections revealed following results: (1) the mean levels (mmol/L) of the participants with underweight or normal weight/overweight/obesity were 4.56 ± 0.89/4.75 ± 0.95/4.79 ± 0.90 for total cholesterol (TC), 1.42 ± 0.99/1.80 ± 1.24/2.14 ± 1.39 for triglyceride (TG); 2.61 ± 0.78/2.79 ± 0.82/2.79 ± 0.81 for low-density lipoprotein cholesterol (LDL-C), and 1.45 ± 0.37/ 1.28 ± 0.32/1.17 ± 0.30 for high-density lipoprotein cholesterol (HDL-C); (2) the mean levels (mmol/L) of the participants with normal WC/mild central obesity/severe central obesity were 4.52 ± 0.90/4.73 ± 0.89/4.83 ± 0.98 for TC, 1.36 ± 0.96/1.76 ± 1.05/2.08 ± 1.57 for TG, 2.59 ± 0.77/ 2.77 ± 0.79/2.82 ± 0.86 for LDL-C, and 1.46 ± 0.37/1.31 ± 0.33/1.21 ± 0.31 for HDL-C; and (3) the mean levels (mmol/L) of the participants with normal WHtR/obesity were 4.46 ± 0.88/4.76 ± 0.92 for TC, 1.32 ± 0.95/1.83 ± 1.24 for TG, 2.55 ± 0.76/2.78 ± 0.81 for LDL-C, and 1.46 ± 0.37/ 1.29 ± 0.34 for HDL-C, respectively. There were significant differences in levels of TC, TG, HDL-C, and HDL-C among the participants with different BMI, WC, and WHtR (all P < 0.001). Partial correlation analysis showed that BMI, WC, and WHtR were correlated positively with TC, TG and LDL-C but negatively with HDL-C (all P < 0.001). After adjusting for gender, age, education, annual household income per capita, place of residence, smoking, and alcohol drinking, the results of multivariate logistic regression analysis demonstrated that the participants with overweight and obesity were at significantly higher risk of dyslipidemia, with the odds ratio (OR) (95% confidence interval [95%CI]) of 1.58 (1.36 – 1.82) and 2.22 (1.79 – 2.74) compared to the participants with underweight/normal weight; the results also showed that the risk of dyslipidemia was significantly higher for the participants with mild central obesity (OR = 1.49, 95%CI: 1.23 – 1.81) and severe central obesity (OR = 2.25, 95%CI: 1.79 – 2.83) in comparison with the participants with normal body weight; the dyslipidemia risk was significantly higher (OR = 1.39, 95%CI: 1.13 – 1.70) for the participants with the WHtR indicating obesity contrasting to the participants with normal WHtR. Conclusion The prevalence of dyslipidemia was high among adult residents in Shaanxi province; the dyslipidemia prevalence was closely correlated with BMI, WC, and WHtR and increased with obese conditions.
, Available online ,
doi: 10.11847/zgggws1142075
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Objective To investigate the prevalence of chronic kidney disease (CKD) and the association of obesity with CKD among hypertension patients registered at community health service centers in suburb of Shanghai. Methods The participants of the study were 3 600 hypertensive patients randomly recruited from chronic disease patients registered at two community health service centers in a suburban district of Shanghai city. Face-to-face interview with a self-designed questionnaire and the International Physical Activity Questionnaire, physical examination, laboratory tests were conducted among the participants during October – December 2021. Unconditional multivariate logistics regression model was adopted to analyze the association between body mass index [BMI] and CKD. Results Of the 2 991 participants finally included in the analysis, 1 037 (34.67%) were identified as having CKD and the number (proportion) of the participants with decreased estimated glomerular filtration (eGFR), proteinuria, and hematuria were 464 (15.51%), 677 (22.63%), and 99 (3.31%), respectively. After adjusting for age, sex, education, smoking, alcohol drinking, physical activity, diabetes,blood lipids and blood pressure control, unconditional multivariate logistic regression analysis revealed that the participants with obesity (BMI ≥ 28.0) were at a significantly increased risk of having CKD (odds ratio [OR] = 1.498, 95% confidence interval [95%CI]: 1.203 – 1.866), decreased estimated glomerular filtration (OR = 1.340, 95%CI: 1.001 – 1.793), and proteinuria (OR = 1.388, 95%CI: 1.088 – 1.771) compared to those with normal or low body weight (≤ 23.9). Conclusion The prevalence of CKD was high and positively correlated with obesity among hypertension patients registered at community health service centers in suburb of Shanghai.
, Available online ,
doi: 10.11847/zgggws1141232
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Objective To explore the prevalence and influencing factors of chronic diseases and chronic multimorbidity among Uygur rural adult residents in Xinjiang Production and Construction Corps (Xinjiang). Methods Using typical sampling, we recruited 14 851 Uygur rural residents aged ≥ 18 years in Xinjiang and conducted face-to-face interview with a self-designed questionnaire, physical examination, and laboratory tests among the residents during August – September 2016. Multivariate logistic regression model was used to analyze influencing factors of chronic diseases and chronic multimorbidity among the residents. Results Of the 12 792 eligible participants, 8 937 (69.9%) were identified as having chronic diseases and 5 770 (45.1%) having chronic multimorbidity. The three diseases most frequently identified among the participants were metabolic syndrome (identified in 33.1% of the participants), dyslipidemia (30.8%), and hypertension (29.9%); the observed top three multimorbidities of two chronic conditions were dyslipidemia and hypertension (observed in 12.2% of the participants), metabolic syndrome and fatty liver (9.7%), and dyslipidemia and fatty liver (8.8%); and the observed top three multimorbidities of three chronic conditions were metabolic syndrome, dyslipidemia and fatty liver (6.8%), metabolic syndrome, hypertension and fatty liver (6.0%), and metabolic syndrome, hypertension and musculoskeletal disorder (4.4%). The results of multivariate logistic regression analysis revealed following risk factors for chronic diseases and chronic multimorbidity of the participants: aged 40 years or older, being married or divorced or widowed, with family history of chronic diseases, being obesity or overweight, and having central obesity; while, having the education of primary school and above was a protective factor against chronic diseases and chronic multimorbidity. Conclusion The prevalence of chronic diseases and chronic multimorbidity was high and mainly influenced by age, education, marital status, family history of chronic disease, obesity or overweight, and central obesity among Uygur rural adults in Xinjiang.
, Available online ,
doi: 10.11847/zgggws1142382
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Objective To examine the progress of health promotion in China′s National Demonstration Zone for Comprehensive Prevention and Control of Chronic Diseases (demonstration zone) from 2010 to 2019 for promoting sustainable and high-quality development of the demonstration zones. Methods The yearly reporting data from 2010 (the year of initiation of the demonstration zone) to 2019 about health promotion in the 483 demonstration zones in 31 provincial-level administrative divisions across China were collected from the National Information Management System for Comprehensive Prevention and Control of Chronic Diseases. The implementation of health promotion in each of the demonstration zones was comprehensively evaluated in four aspects: creation of supportive environment, community participation, development of individual skills and orientation adjustment of health services. Results By the year of 2019, the coverage rate of community room for health education was 91.0% and the coverage rate of community billboard for health education was 96.1% in the demonstration zones. At demonstration zone level, the mean number (25th percentile, 75th percentile) of community-sponsored class-based health education lectures in kindergartens was 6.0 (6.0, 10.0); the mean number of class-based health education lectures in primary and secondary schools was 6.0 (6.0, 10.0); the average number of mass fitness groups was 92.0 (26.0, 250.0); the mean number of volunteers engaged in health promotion was 280.0 (62.5, 1200.0); the mean number of communities with self-health management groups was 89.0 (44.5, 174.5); the average number of self-health management groups was 99.0 (48.8, 204.3) and the mean number of individuals involved in a self-health management group was 2137.0 (842.5, 7 520.5); the average total number of lectures on personal health skill development was 510.0 (191.0, 1241.0); the average awareness rate of core knowledge on chronic diseases was 63.6% (57.8%,71.0%); the average proportion of residents with health literacy was 22.1% (17.0%, 28.1%); the average number of health instructors was 281.5 (67.8, 1207.8) in the adjustment of health service direction. Compared to those for the year of initiation of demonstration zone, significant increases in many health promotion-related indicators (the coverage rate of community room and community billboard for health education, the mean number of community-sponsored class-based health education lectures in kindergartens, the mean number of class-based health education lectures in primary and secondary schools, the mean number of volunteers engaged in health promotion, and the average proportion of residents with health literacy) were observed (all P < 0.05) for all the demonstration zones except for the zones as the fifth batch of the initiation. In 2019 for all the demonstration zones, there were significant geographically regional disparities in the coverage rate of community room and community billboard for health education, the number of mass fitness groups, the number of communities with self-health management groups, the average number of self-health management groups, the average total number of lectures on health education, the average proportion of residents with health literacy, and the number of health instructors (P < 0.05 for all); there were also significant urban-rural disparities in the coverage rate of community billboard for health education, the number of mass fitness groups, the number of communities with self-health management groups, the average number of self-health management groups, the mean number of individuals involved in a self-health management group, the average total number of lectures on health education, the average proportion of residents with health literacy, and the number of health instructors (all P < 0.05). Conclusion Some progress have been made in health promotion in China′s demonstration zones for comprehensive chronic disease prevention but there were geographically regional urban-rural disparities in the progress among the demonstration zones.
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2023, 39(9): 1089-1095.
doi: 10.11847/zgggws1140772
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Objective To evaluate the capacity for hypertension prevention and control and to identify strengths, shortcomings and key control points of the capacity-building in 31 provincial-level administrative divisions (PLADs) in China. Methods Policy documents, information reports, and research literature on hypertension prevention and control in 31 PLADs of China published from January 1995 through December 2019 were systemically collected via searching relevant websites and statistical yearbooks for evaluating on hypertension prevention and control capacity across the 31 PLADs according to the standards for appropriate public health system. Normative gap analysis was used to explore strengths and shortcomings of the capacity-building and multiple linear regression and sensitivity analysis were used to clarify key control points of the capacity-building. Results The average index for the appropriateness of hypertension prevention and control capacity-building was 47.10% among 31 PLADs of China in 2019, and the average annual increasing rate of the capacity-building was 18.75% from 2000 to 2019, showing a significant upward trend (Z = 6.067, P < 0.001). The strengths of hypertension prevention and control capacity-building for the PLADs include more complete organizational structure established, comprehensive coverage of medium- and long-term plans, and sound management and monitoring mechanisms; while the shortcomings are insufficient allocation of human and financial resources and low implementation of multi-dimensional management mechanisms such as management and coordination, medium- and long-term goals and evaluation criteria. The identified key control points for the five aspects in hypertension prevention and control capacity-building are effective motivation of personnel for resource allocation, the coordination for organizational framework, the coverage of incentive measures for management mechanism, practicable assessment criteria for management process evaluation, and the balance between supply and demand of medical service for service offering, with the estimated increment of 23.14%, 66.40%, 15.77%, 23.43% and 7.06%, respectively, in the indexes for the appropriateness of the capacity-building under the conditions of the five key control points being well managed. Conclusion The capacity for hypertension prevention and control has been improved continuously in 31 PLADs of China during 2000 – 2019 but several aspects in hypertension prevention and control capacity-building still need to be improved for the promotion of the capacity-building.
2023, 39(9): 1096-1101.
doi: 10.11847/zgggws1141021
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Objective To investigate the correlation of waist circumference and its change with hypertension incidence among Chinese residents aged 18 – 65 years for providing evidence to the prevention and control of hypertension. Methods A prospective dynamic cohort was established among the participants of 7 waves of the China Health and Nutrition Survey (CHNS) conducted from 1993 to 2015 across the mainland of China. After screening out pregnant women and those with abnormal waist circumference (< 50 or >150 centimeters [cm]), the study enrolled 9 980 community residents aged 18 to 65 years who had participated in at least two waves of the survey and were not identified as having hypertension at the baseline survey. The study period was from 1997 through 2015. The individual period of follow-up was from the baseline survey to the last follow-up for non-hypertensives; but for hypertensives, the follow-up ended by the identification of hypertension incidence. Multivariate Cox proportional hazard regression model was used to analyze the influence of baseline waist circumference and its change on hypertension incidence. Results During the follow-up among 5 060 male and 4 920 female participants aged 36.88 ± 11.42 years and with a median follow-up of 7 years, totally 3 132 hypertension incidences were observed and the incidence density was 32.60/1 000 person-years; among the participants at the baseline survey with normal waist circumference (< 85 cm for males and < 80 cm for females), pre-obesity (85 – 89 cm for males and 80 – 84 cm for females), and central obesity ( ≥ 90 cm for males and ≥ 85 cm for females), the number (incidence density) of observed hypertension incidence were 1 983 (26.71/1 000 person-years), 496 (45.78/1 000 person-years), and 653 (59.45/1 000 person-years), respectively. After adjusting for sex, age, education, marital status, residence place, smoking, current alcohol consumption, total physical activity level, fat intake ratio, baseline chronic disease, baseline waist circumference, and the year at first and last follow-up, multivariate Cox proportional hazard regression showed that an increase of 1cm in waist circumference was associated with a 1.7% increased risk of hypertension (hazard risk [HR] = 1.017, 95% confidence interval [95%CI]: 1.011 – 1.024) and an increase of ≥ 5 cm in waist circumference was associated with a 29.5% increased risk of hypertension (HR = 1.295, 95%CI: 1.130 – 1.484) in comparison to normal waist circumference. The results of restricted cubic spline analysis revealed that the increase of 4.9 cm and higher in waist circumference was correlated with the increased risk of hypertension. In the same way after adjusting for confounding factors listed above, the results of multivariate Cox proportional hazard regression indicated that the risk of hypertension increased by 27.2% (HR = 1.272, 95%CI: 1.117 – 1.449) and 77.5% (HR = 1.775, 95%CI: 1.546-2.038) for all the participants with the waist circumference changed from normal to abnormal level and those with persistent abnormal waist circumference compared with the participants with persistent normal waist circumference; the increased risks were also significant for both male participants (HR = 1.191, 95%CI: 1.004 – 1.412 and HR = 1.485, 95%CI: 1.218 – 1.810) and female participants (HR = 1.374, 95%CI: 1.121 – 1.684 and HR = 2.061, 95%CI: 1.691 – 2.513). Conclusion Both baseline abnormal waist circumference and increased waist circumference over time can increase the risk of hypertension incidence. Keeping a waist circumference within the normal range with an increase of less than 5 cm is of great significance for the prevention and control of hypertension among adult population.
2023, 39(9): 1102-1107.
doi: 10.11847/zgggws1141233
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Objective To analyze correlations of modifiable risks with all-cause deaths and cardiovascular disease (CVD) deaths in hypertension patients. Methods Comprehensive data of 2015 on 51 438 community hypertensive patients aged 35 – 85 years were extracted from the management information system of Essential Public Health Services and were linked to individual records of mortality in the datasets of death registry system up to February 28, 2021 in Hangzhou municipality, Zhejiang province. Cox proportional regression model was used to estimate hazard risks of all-cause and CVD deaths associated with modifiable risk factors of the mortalities. Results By the end of study period, totally 2 365 all-cause and 842 CVD deaths were observed among the participants and the mortality ratios were 4.60% and 1.64%, respectively. Of the 51 438 hypertensives, 3 926 (7.63%), 20 392 (39.64%), 20 292 (39.45%), and 6 828 (13.28%) were assessed as having none, one, two, and three and more modifiable risk factors of CVD. The results of Cox proportional regression analysis showed that after adjusting for gender, age, living region, migration, and diabetes, the hypertensives being lack of good blood pressure control (systolic blood pressure [SBP] of ≥ 140 mmHg/diastolic blood pressure (DBP) of ≥ 90 mmHg at three measurements not in the same day) were at significantly increased risks of all-cause death (hazard risk [HR] = 1.39) and CVD death (HR = 1.52) compared to those under effective blood pressure control (SBP < 140 mmHg/DBP < 90 mmHg); the hypertensives being current smoker had significantly increased risks of all-cause death (HR = 1.21) and CVD death (HR = 1.24) contrasting to nonsmoking hypertensives; the hypertensives not having daily physical exercise were at significantly increased risks of all-cause death (HR = 1.52) and CVD death (HR = 1.73) in comparison to those reporting daily physical exercise; the results also revealed significantly increased risks of all-cause death (HR = 1.53, HR = 1.69, and HR = 1.97) and CVD death (HR = 2.32, HR = 2.35,and HR = 2.94) for the hypertensives with one, two, and three modifiable risk factors compared to those without any modifiable risk factor; while, the obese hepertensives had a significantly decreased risk of all-cause death (HR = 0.84) compared to the non-obese hypertensives. Conclusion The risks of all-cause and CVD death increased with the number of modifiable risk factors among adult community hypertension patients.
2023, 39(9): 1108-1113.
doi: 10.11847/zgggws1141912
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Objective To explore critical indicators for identifying hypertension patients at high risk of hypertension-related complications for prevention and control of complications among community hypertension patients. Methods With boundary analyses, the checklists of major hypertension complications and their risk factors were established through systematic reviews on hypertension-related literatures published domestically and internationally up to April 2021, including 275 research articles, 36 entries on websites of professional institutions, 89 entries on official websites of organizations and associations, 529 entries on social medium websites, 10 guidelines and standards issued by professional institutions, and 7 professional books. Three rounds of expert consultations involving 34 experts were conducted to screen out critical indicators of hypertension complications in the checklist established. Using the screened-out critical indicators and electric health records of 62 150 community hypertension patients registered from January 2014 through January 2020 in Minhang district of Shanghai city, a subsequent empirical analysis was performed on the data on 37 483 hypertension patients without complications at the enrollment of community-based disease management. Results Totally 13 critical indicators for hypertension complications were identified, including poor blood pressure control, high salt diet, overweight/obesity (body mass index ≥ 24.0), irregular medication, aged ≥ 60 years, smoking, excessive drinking, family history of cardiovascular disease, abdominal obesity, long disease course, dyslipidemia, lack of physical exercise, and psychological pressure. The three rounds of expert consultation achieved positive coefficients of 100.0%, 100.0%, and 91.2% and authority coefficients of 0.86, 0.86, and 0.88, respectively; the expert opinion coordination coefficient was 0.281 for the first round (P < 0.05), indicating a good agreement among the experts. Resulted from the expert consultations, the hypertension patients with 5 or more of the 13 critical indicators could be assessed as being at high risk of hypertension-related complications. The assessment based on the analysis result indicated that 9.17% of the individuals were at high-risk of complications among 37 483 community hypertension patients without hypertension-related complications previously diagnosed. Conclusion The critical indicators established in this study could be adopted conveniently in rapid identification of individuals at high risk of complications among community hypertension patients.
2023, 39(9): 1114-1119.
doi: 10.11847/zgggws1140381
Abstract:
Objective To investigate the effect of blood pressure control its influencing factors in hypertensive patients under disease management of basic public health services (BPHS) in Yunnan province for improving the patients′ blood pressure control and BPHS′ community disease management. Methods The participants of the study were 1 521 previously diagnosed hypertension patients aged ≥ 35 years identified via questionnaire interview, physical examination, and laboratory tests conducted among 9 600 permanent adult residents recruited with multistage stratified random sampling in 8 counties/districts of Yunnan province during 2021. Of the participants, 1 011 (66.5%) were assigned into a management group (under the BPHS′s disease management confirmed by matching the participants′ identification card [ID] number with the records in the BPHS′s disease management information system) and 510 (33.5%) into a non management group (with the ID numbers not matched with the records of the information system). Demographic characteristics, disease management/blood pressure control (maintaining a systolic/diastolic blood pressure below 140/90 mmHg) and their associates of the participants were analyzed and compared between the two groups. Results The observed blood control rate was significantly higher among the participants of management group than that among those of non management group (33.2% vs. 22.0%, P < 0.05). Compared to those of the non management group, the participants of management group reported significant higher proportions of having received doctors′ lifestyle guidance on decreasing salt intake (89.5% vs. 81.7%), regular physical exercise (86.9% vs. 79.2%), body weight control (84.6% vs. 77.4%), smoking cessation (83.8% vs. 78.7%), restricting alcohol consumption (84.1% vs. 78.3%), and psychological counseling (81.3% vs. 72.9%) (all P < 0.05); for all the participants having accepted the six items of lifestyle guidance mentioned above, the observed blood pressure control rates of the management group′s participants were significantly higher than those of the non management group′s participants ( 33.6% vs. 22.8%, 33.5% vs. 22.0%, 34.3% vs. 22.3%, 33.7% vs. 22.4%, 34.0% vs. 22.5%, and 33.4% vs. 21.7%, all P < 0.05). The results of multivariate logistic regression analysis showed that the participants with higher education, being urban residents, having medication according to physician′s prescription, and receiving BPHS′s disease management were more likely to have their blood pressure under control. Conclusion In Yunnan province, the community hypertension patients under BPHS′ disease management have a better blood pressure control compared to the patients without the management, suggesting a good efficiency of the BPHS′ disease management in the province.
2023, 39(9): 1120-1129.
doi: 10.11847/zgggws1141964
Abstract:
Objective To explore the prevalence and determinants of hyperuricemia (HUA) among hypertensive patients registered at community health service centers in suburb of Shanghai for promoting prevention and management of HUA in primary health institutions. Methods The participants of the study were 3 600 hypertensive patients randomly recruited from chronic disease patients registered at two community health service centers in a suburban district of Shanghai city. Face-to-face interview with a self-designed questionnaire and the International Physical Activity Questionnaire, physical examination, laboratory tests were conducted among the participants during October − December 2021. The prevalence of HUA was described and unconditional multivariate logistic regression analysis was used to analyze determinants of HUA. Results Among the 2 899 eligible participants, 882 were identified as having HUA, with an overall prevalence of 30.42% and not significantly different gender-specific prevalence of 31.96% for the males and 29.15% for the females (P > 0.05). The results of unconditional multivariate logistic regression analysis indicated that hyperlipidemia, chronic kidney disease, overweight, and obesity were risk factors for HUA but suffering from diabetes, medication with angiotensin receptor blockers (ARBs) or with calcium channel blockers (CCBs) were protective factors against HUA for all the participants; while for the male participants, hyperlipidemia, chronic kidney disease, overweight, obesity were risk factors and suffering from diabetes was a protective factor; for the female participants, aged 80 years and above, hyperlipidemia, chronic kidney disease, overweight, obesity were risk factors but medication with ARBs or with CCBs were protective factors. Conclusion The prevalence of HUA was relatively high in hypertensive patients at community health service centers in suburb of Shanghai. The result suggests that uric acid should be monitored among the hypertensive patients with chronic kidney disease, hyperlipidemia, overweight or obesity and antihypertensive drugs should be selected carefully for hypertensive patients complicated with HUA.
2023, 39(9): 1130-1134.
doi: 10.11847/zgggws1140949
Abstract:
Objective To investigate the relationship between sleep duration and blood pressure control among community adult hypertension patients for providing evidence to blood pressure control in the population. Methods The participants of the study were 15 686 hypertension patients identified from 61 098 adult residents (aged ≥ 18 years) recruited with stratified multi-stage cluster sampling for the Nanjing Chronic Disease and Risk Factor Surveillance in communities of 5 districts of Nanjing city. Face-to-face interview with a self-designed questionnaire and International Physical Activity Questionnaire (IPAQ), physical examination and laboratory tests were conducted among all the residents during January 2017 – June 2018. Multiple logistic regression model was used to analyze the association of sleep duration with blood pressure control of the hypertension patients. Results Of all the hypertension patients, 45.1% (7 082) were assessed as having effective blood pressure control (systolic blood pressure <140 mm Hg and/or diastolic pressure <90 mm Hg) and the proportions of effective blood pressure control were 43.8%, 45.6%, 47.2%, 43.7%, and 40.2% for the patients reporting the night sleep duration of < 6.0 , 6.0 – 6.9 , 7.0 – 7.9 , 8.0 – 8.9, and ≥ 9.0 hours per day (h/d), respectively, with a significant difference (χ2 = 23.354, P < 0.001). After adjusting for gender, age, residential area, education, smoking, alcohol consumption, physical activity, body mass index, diabetes, dyslipidemia, and anti-hypertensive medication, the results of multivariate logistic regression analysis for all hypertension patients revealed that compared to the patients with the sleep duration of 7.0 – 7.9 h/d, those with a shorter or longer sleep duration were less likely to have an effective blood pressure control (for sleep duration of < 6 h/d: odds ratio [OR] = 0.88, 95% confidence interval [95%CI]: 0.77 – 0.99; for sleep duration of ≥ 9 h/d: OR = 0.75, 95%CI: 0.65 – 0.87); further analysis using the comparison groups with the sleep duration of 7.0 – 7.9 h/d also showed that some subgroups with a shorter or longer sleep duration were also less likely to have an effective blood pressure control: (1) the male patients with the sleep duration of < 6 h/d (OR = 0.74, 95%CI: 0.62 – 0.89), 8.0 – 8.9 h/d (OR = 0.86, 95%CI: 0.76 – 0.95) or ≥ 9 h/d (OR = 0.75, 95%CI: 0.65 – 0.87); (2) the female patients with sleep duration of ≥ 9 h/d (OR = 0.73 95%CI: 0.59 – 0.91); (3) the elderly patients (aged ≥ 60 years) with the sleep duration of < 6 h/d (OR = 0.80, 95%CI: 0.68 – 0.94) or ≥ 9 h/d (OR = 0.68, 95%CI: 0.56 – 0.83). Conclusion The study results suggest that night sleep duration is associated with effective blood pressure control among community adult hypertension patients, especially among those being male and those aged 60 years and above.
2023, 39(9): 1135-1140.
doi: 10.11847/zgggws1140715
Abstract:
Objective To examine the impact of extreme apparent temperature (AT) on daily emergency visits for hypertension in Shenzhen city, Guangdong province for providing evidence to revision of public health policies relevant to hypertension management and ambulances allocation. Methods The data on daily emergency visits for hypertension from January 2013 to December 2020 were collected from the Shenzhen First-Aid Service Platform and daily meteorological data of Shenzhen city over the same period were collected simultaneously for the estimation of daily average AT. Distributed lag nonlinear model (DLNM) was used to analyze the lag day and lag period effects of extreme AT on daily emergency visits for hypertension. Relative risk (RR) and population attributable risk percent (PARP%) were adopted in estimating the effects. Results During the 8-year period in the city, totally 14 491 outpatient emergency visits for hypertension occurred based on the records of the platform; the daily number of visits ranged from 1 to 28 and the average number of daily visits was 9.28 ± 0.90. During the same period for the city, the lowest daily average AT was – 4 ℃ and the highest was 39.4 ℃, with an average AT of 25.62 ± 7.95 ℃. A nonlinear effect of extreme AT on daily emergency visits for hypertension was observed; the number of the daily visits decreased with daily average AT but increased with daily average AT when the daily average AT being 30 ℃ and above. The results of DNLM analysis showed that in comparison to appropriate AT (30 ℃), both extreme low AT (9 ℃) and extreme high AT (36 ℃) were associated with an increased risk of daily emergency visit for hypertension during the lag period of 0 – 21 day, with the relative risk (RR) (95% confidence interval [95%CI]) of 1.783 (1.303 – 2.433) and 1.315 (0.994 – 1.747); the lag effect of the extreme low AT was much stronger on the daily emergency visits of male hypertension patients and those aged under 65 years, with the RR (95%CI) of 1.721 (1.050 – 2.811) and 1.872 (1.184 – 2.982), respectively. The PARP of extreme low AT-related daily emergency visits for hypertension was 13.64% generally for the study period. Conclusion The extreme AT is of significant impact on daily emergency visit of hypertension patients in Shenzhen city, especially for the male patients and the patients aged under 65 years.
2023, 39(9): 1141-1146.
doi: 10.11847/zgggws1139640
Abstract:
Objective To compare the prevalence of asthma and the impact of socioeconomic position (SEP) on economic burden of asthma among rural residents in Yunnan province in 2011 and 2021, and to provide evidence for the prevention and treatment of asthma in the population. Methods Using stratified multistage random sampling, we conducted face-to-face surveys during 2011 and 2021 among 8 187 and 7 572 rural residents aged ≥ 35 years in Yunnan province. A self-designed questionnaire was used to collect information on demographics, SEP, asthma clinically diagnosed at township and upper level hospitals, and asthma-related economic burden for analyses on asthma prevalence and the influence of SEP on asthma-induced economic burden among the participants. Results Among the rural adults surveyed in 2011 and 2021, totally 111 and 122 asthma cases were identified, with the asthma prevalence rate of 1.36% and 1.61% and without significant difference between the two prevalence rates. Compared to those reported by the adults with asthma incidence in 2011, significantly higher per capita asthma-related direct cost (4 230.11 vs. 2 776.85 Chinese Yuan), indirect cost (69.57 vs. 49.86), and total cost (4 299.68 vs. 2826.71) were reported by the adults with asthma incidence in 2021 (all P < 0.05). Contrasting to that in 2011, the per capita asthma-related total cost increased significantly in 2021 for the asthma sufferers of various SEP groups (P < 0.05 for all) and the total cost increment varied in a descending order for the asthma sufferers with high, low, lower-middle, and upper-middle SEP. Conclusion Among the rural adult residents in Yunnan province, the prevalence of asthma was not significantly different but the economic burden of asthma sufferers increased substantially between 2011 and 2022 and the sufferers' economic burden varied with their socioeconomic position.
2023, 39(9): 1147-1151.
doi: 10.11847/zgggws1140880
Abstract:
Objective To explore the prevalence of chronic obstructive pulmonary disease (COPD), knowledge about antibiotics and their influences on self-medication with antibiotics (SMA) among middle-aged and elderly adults in communities of Songjiang district, Shanghai city. Methods The participants of the survey were 3 500 residents aged 40 years and over recruited using random sampling at four communities in Songjiang district of Shanghai city. Face-to-face interview with a self-designed questionnaire and Pittsburgh Sleep Quality Index (PSQI), physical examination and spirometry test were conducted among the participants during June – December 2021. Unconditional multivariate logistic regression model was adopted to analyze the influences of COPD, knowledge and awareness about antibiotics on SMA. Results Of the 3 184 participants ultimately included in the analysis, 259 (8.1%) were identified as having COPD. The number (proportion) of the participants with the antibiotic awareness score of 0, 1, 2, and 3 – 4 (indicating complete awareness) were 969 (30.4%), 461 (14.5%), 1462 (45.9%), and 292 (9.2%), respectively. The number (proportion) of the participants reporting SMA was 537 (16.9%). The results of unconditional multivariate logistic regression analysis showed that compared to the participants without COPD, the COPD sufferers aged under 60 years had a significantly increased risk of SMA (odds ratio [OR] = 3.31, 95% confidence interval [95% CI]: 1.11 – 9.90) after adjusting for sex, education level, marital status, place of residence, smoking, exercise, sleeping status, digestive system disease, other respiratory system diseases, cough and sputum symptoms, shortness of breath symptoms, and body mass index; but the increased risk was not significant for the COPD sufferers aged ≥ 60 years (OR = 1.09, 95% CI: 0.74 – 1.60); the results also revealed that in comparison to those with the antibiotic knowledge and awareness score of 0, the participants with the knowledge and awareness scores of 1, 2, and 3 – 4 were less likely to conduct SMA, with the ORs (95% CI) of 0.26 (0.18 – 0.36), 0.17 (0.13 – 0.22), and 0.17 (0.10 to 0.26) after adjusting for age and the confounding factors mentioned above. Conclusion The prevalence of SMA was high and the prevalence might be associated positively with suffering with COPD and reversely with the awareness about antibiotics among middle-aged and elderly community adults in Songjiang district, Shanghai.
2023, 39(9): 1152-1158.
doi: 10.11847/zgggws1140023
Abstract:
Objective To estimate the incidence of all-cause otitis media (OM) in children under 5 years old (under-5) in Suzhou city, Jiangsu province. Methods From the Health Information System (HIS) of Soochow University Affiliated Children′s Hospital (SCH), we extracted outpatient visit and hospitalization records of local under-5 children (born from 2017 to the end of 2020) during the period from January 2017 through June 2021 for a retrospective cohort analysis. The children with the diagnosis of all-cause otitis media were followed up for the estimation of overall and age specific all-cause otitis media incidence among the children. Results Among the 507 678 children followed-up during the 4-year period, 9 378 otitis media incidents of 7 903 children were identified, including 8 979 outpatient incidents and 399 hospitalizations. The overall incidence rate of otitis media was 6.37/1 000 person-years and the incidence rate was 6.10/1 000 person-years for outpatient children and 0.27/1 000 person-years for inpatient children, respectively. The incidence rate of otitis media was higher among the children aged 3 – 4.5 years and the highest incidence rate of 24.59/1 000 person-years was observed in the children aged 4 – 4.5 years. Higher otitis media incidence rate of 21.45/1 000 person-years was also observed for the children with allergic rhinitis and recurrent acute upper respiratory infections. Conclusion The incidence rate of all-cause otitis media was low and influenced by age and other diseases among under-5 children in Suzhou city.
2023, 39(9): 1159-1164.
doi: 10.11847/zgggws1139954
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Objective To examine time-dependent variations in serum antibodies of severe acute respiratory disease coronavirus 2 (SARS-CoV-2) among confirmed coronavirus disease 2019 (COVID-19) cases at different stages and inactivated COVID-19 vaccine recipients after inoculation. Methods The study was conducted in a city of Henan province. Totally 86 serum samples were collected from 43 confirmed COVID-19 cases at acute stage (1th – 23rd day of onset) and recovery state (25th – 58th day of onset) during January 2020 – October 2021; other 184 serum samples from 46 healthy recipients of inactivated COVID-19 vaccine at 4/8/12/31 weeks after inoculations and 50 serum samples from 50 residents without confirmed SARS-CoV-2 infections were also collected during March – October 2021. Anti-SARS-CoV-2 immunoglobulin A/G/M (IgA/G/M) were detected with magnetic particle chemiluminescence method and enzyme-linked immunosorbent assay for all the serum samples. The levels of the serum antibodies among the three groups′ participants were analyzed statistically. Results Among the confirmed COVID-19 cases, the positivity rates of anti-SARS-CoV-2 IgA, IgM and IgG of the serum samples collected at recovery stage were significantly higher than those at acute stage (all P < 0.05) ; while, the concentrations of anti-SARS-CoV-2 IgM and IgG of the serum samples collected at recovery stage were significantly higher than those at acute stage (both P < 0.05). Among the healthy COVID-19 vaccine recipients 31 weeks after the inoculations, the positivity rate was 63.04% (29/46) for anti-SARS-CoV-2 IgG and 36.96% (17/46) for anti-SARS-CoV-2 IgA, but all samples were negative for anti-SARS-CoV-2 IgM. No significant differences were observed in the absorbance ratios anti-SARS-CoV-2 IgA among the samples collected 4, 8, 12, and 31weeks after the inoculation (F = 2.365, P = 0.073), but there were significant differences in the concentrations of anti-SARS-CoV-2 IgM and IgG (both P < 0.05) among the samples. Both the positivity rate of anti-SARS-CoV-2 IgA and IgM and the concentrations of anti-SARS-CoV-2 IgG and IgM were significantly higher among the confirmed COVID-19 cases than those among the inactivated COVID-19 vaccine recipients during a comparable period of time (P < 0.05 for all). Conclusion The positivity rate of serum anti-SARS-CoV-2 IgG is the highest during early stage and recovery stage among COVID-19 cases. The positivity of serum anti-SARS-CoV-2 IgA and IgG occur earlier than that of IgM and could maintain till 31 weeks after the inoculation among inactivated COVID-19 vaccine recipients. The concentration of serum anti-SARS-CoV-2 IgG and IgM are higher among COVID-19 cases than those among inactivated COVID-19 vaccine recipients during a comparable period of time.
2023, 39(9): 1165-1170.
doi: 10.11847/zgggws1141819
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Objective To investigate the protective effect and mechanism of fucoidan on intestinal mucosal barrier function in hyperuricemic mice. Methods Forty specific pathogen-free (SPF) C57BL/6J mice were randomly assigned into a control, hyperuricemia model, fucoidan treatment (by gavage administration at the dosage of 200 mg/kg/day continuously for 10 weeks) , and allopurinol positive control group (10 in each group). By the end of the treatments for the mice of the four groups, serum uric acid (UA) was measured with colorimetric method; serum lipopolysaccharides (LPS), diamine oxidase (DAO), tumor necrosis factor (TNF-α) and interleukin-1β (IL-1β) were measured with enzyme-linked immunosorbent assay (ELISA). Histopathological changes in ileum mucosa were observed with hematoxylin-eosin (HE) staining; the expressions of tight junction proteins in ileum mucosa and autophagy-related proteins in small intestine were determined with Western blot. Results Significant decreases in serum UA (52.45%), TNF-α (29.18%), IL-1β (25.36%), LPS (27.24%), and DAO (21.78%) were detected in the hyperuricemic mice with fucoidan treatment ( P < 0.05 for all ); in addition, the fucoidan-treated hyperuricemic mice had significantly improved intestinal cell junctions and permeability, increased expressions of zonula occludens-1 (ZO-l), occludin and autophagy-related proteins (all P < 0.05). Compared to those in model mice, significantly increased ratio of autophagy-related proteins light chain 3B II/I (LC3BII/I), beclin-1, and phosphorylated p38 mitogen-activated protein kinase (p-p38 MAPK) but significantly decreased phosphorylated mammalian target of rapamycin (p-mTOR) were observed in the hyperuricemic mice with fucoidan treatment. Conclusion Oral administration of fucoidan could effectively reduce serum uric acid and improve intestinal mucosal barrier damage by increasing autophagy via p38 MAPK/mTOR pathway in hyperuricemic mice.
2023, 39(9): 1171-1179.
doi: 10.11847/zgggws1141631
Abstract:
Objective To investigate potential inflammatory effect of polystyrene microplastics (PS-MPs) in small intestine of mice and its molecular mechanisms. Methods Thirty-five male BABL/c mice were randomly assigned into five groups and gavaged daily with H2O and PS-MPs of 50 nm, 500 nm, 5 μm, 50 μm in diameter at the dosage of 1mg/day continuously for 42 days. Body weight of the mice were measured during the administration and pathological changes in ileum of the mice were observed using hematoxylin and eosin (HE) staining at the end of the treatments. Murine intestinal epithelial MODE-K cells were cultured with fluorescent PS-MPs of 50 nm, 5 μm, 50 μm in diameter at concentration of 10 μg/ml. The internalization of the PS-MPs in the cultured MODE-K cells was examined with flow cetometry after the treatments of 10 mins, 30 mins, 1 h, 2 hs, and 4 hs and the viability of the MODE-K cells treated with PS-MPs at various concentrations was assessed with 3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay. The expressions of cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING) pathway-related mRNAs and proteins in the in small intestine tissues and the MODE-K cells after PS-MPs treatment were determined with real-time PCR and Western blot test. Results Pathological changes of different severity were observed in small intestinal tissues of the mice exposed to PS-MPs. PS-MPs of 50 nm was internalized more rapidly and efficiently into the cytoplasm of MODE-K cells than 5 μm and 50 μm PS-MPs, and the PS-MPs significantly affected the viability of the MODE-K cells. Compared with those of the control mice, significant upregulations of the mRNAs of pro-inflammatory cytokines IL-6 (increased by 589%), IL-10 (573%), IL-22 (475%) and TNF-β (177%) were detected in small intestinal tissues of the mice treated with 50 nm PS-MP (P < 0.01 for all); meanwhile, protein expressions of IL-1β, IL-6 and IL-10 also increased significantly in the tissues of the mice (P < 0.05 for all). In MODE-K cells treated with PS-MPs of 50 nm at high dosage (20μg/mL), the expressions of IL-6, IL-10, IL-22, TNF-α, and TNF-β were significantly higher than those in the control cells, with the increases of 74%, 85%, 83%, 75% and 69%, respectively (P < 0.05 for all). Then, compared with those of the control mice, the mRNA expressions of cGAS and STING increased by 485% and 136% in small intestinal tissues of mice treated with PS-MPs of 50 nm ( both P < 0.05), and the protein expressions of STING and p-NF-κB also increased by 61% and 54%, respectively (both P < 0.05). In addition, the protein expressions of STING and p-NF-κB increased by 96% and 178% in the MODE-K cells treated with high-dose (20 μg/mL) 50 nm PS-MPs, respectively. Conclusion PS-MPs exposure could trigger small intestinal inflammation in mouse and exposure to PS-MPs of 50 nm in diameter could activate cGAS-STING signaling pathway through cellular internalization and then act on related downstream inflammatory factors, finally contributing to chronic inflammation in small intestine.
2023, 39(9): 1180-1184.
doi: 10.11847/zgggws1141479
Abstract:
Objective To establish a set of indicators for assessing the public health emergency response capacity at county/district level in China. Methods An indicator system for evaluating public health emergency response capacity at county/district level was initially formulated based on theoretical research and literature review. Three rounds of Delphi consultation were conducted among 18 senior professionals to determine the indicators and their weights of the system using hierarchical analysis method. Results For the 3 rounds of expert consultation, the positive coefficients of the were 100.0%, 88.9%, and 88.9%; the expert authority coefficients were 0.87, 0.84, and 0.87; and the coordination coefficients of expert opinions were 0.207, 0.210, and 0.295 (all P < 0.001), indicating a good coordination of the experts′ opinions. The finally established indicator system for assessing public health emergency response capacity at county/district level included 5 first-, 19 second-, and 61 third-level indicators. For the third round of Delphi consultation, the experts′ mean scores and ranges of coefficients of variance for importance/feasibility of all the indicators were 4.83 ± 0.13/4.48 ± 0.21 and 0.00 – 0.18/0.07 – 0.22, respectively. The weights for the first-, second-, and third-level indicators ranged from 0.094 to 0.290, 0.011 to 0.119, and 0.001 to 0.087, respectively. Conclusion The established indicator system could be used to develop tools for evaluating public health emergency response capacities at county/district level, while the reliability and validity of the indicator system need to be assessed further.
2023, 39(9): 1185-1190.
doi: 10.11847/zgggws1141646
Abstract:
Objective To examine the implementation of diabetes health management project and its influence on knowledge awareness, health behavior, medication, and blood glucose control among the diabetes patients with the standardized management for the improvement of the project. Methods Using multistage random sampling, we recruited 3 995 diabetes patients aged 35 years and over and being followed-up in the Survey for Assessment on Chronic Disease Patients Management in the National Primary Public Health Services in 8 provincial level administrative divisions. A questionnaire survey and peripheral blood glucose test were conducted among the participants during August – October 2018. Binary logistic regression model was used to analyze the impact of standardized management on diabetes patients′ knowledge awareness, health behavior, medication and blood glucose control. Results Of the 3 938 participants with complete information, 71.28%, 88.69%, 51.98% reported having standardized management (receiving 4 times and more health care follow-ups per year), medication for diabetes, and effective blood glucose control (fasting and postprandial blood glucose < 7.0 and < 10.0 mmol/L), respectively. Compared with those without standardized management, the participants with the management reported significantly higher ratios of relevant knowledge awareness (56.11% vs. 41.54%), better dietary diversity score (48.79% vs.43.26%), and effective blood glucose control (53.16% vs. 47.96%) (all P < 0.05) but significantly lower ratios of current smoking (10.17% vs. 12.49%) and alcohol consumption during past one year (13.34% vs. 18.78%) (both P < 0.05 ). Binary logistic regression analysis showed that the standardized management on diabetes patients was significantly correlated positively with the patients′ better knowledge awareness and better dietary diversity, and negatively with the patients′ current smoking and alcohol drinking (all P < 0.05). Conclusion The standardized management on diabetes patients was positively related to the patients′ better knowledge awareness and dietary diversity but negatively related to the patients′ current smoking and alcohol drinking, suggesting that the management achieved good primary outcomes in China.
2023, 39(9): 1191-1196.
doi: 10.11847/zgggws1140926
Abstract:
Objective To examine the financial toxicity (FT) of cancer care among cancer patients covered by urban customized supplementary medical insurance (customized insurance) and its influencing factors for providing evidence to the optimization of customized insurance and the development of FT-related intervention measures. Methods Using random sampling and a self-designed questionnaire, we conducted telephone interviews among 600 registered cancer patients with customized insurance and ever attending local public hospitals for medication after December 2020 during July – August 2021 in a city. The Comprehensive Scores for Financial Toxicity (COST) scale was adopted to assess FT of cancer treatment. The influencing factors of FT were analyzed with stepwise multivariate linear regression model. Results For the 560 participants finally included in the analysis, the COST score was 17.90 ± 8.01 and the number (proportion) of the participants with the scores indicating mild, moderate, and severe FT were 89 (15.89%), 307 (54.82%), and 164 (29.29%), respectively. The results of regression analysis showed that the participants with following characteristics were more likely to have a lower COST score indicating severe FT: with agricultural residence registration, aged 45 – 59 years, having an out-of-pocket medication expenditure of 10 000 Chinese Yuan (CNY) and more in the past year, ever borrowing money for cancer treatment in the past year, and abandoning treatment due to financial difficulties in the past year; while, the participants with other commercial health insurance in addition to customized insurance, having a total household income of 100 000 CNY and more in the past year, having a total household consumption expenditure of 100 000 CNY and more in the past year, and having been hospitalized 1 – 4 times for cancer treatment in the past year were more likely to have a higher COST score indicating mild FT. Conclusion FT of cancer is common among cancer patients covered by customized insurance in a Chinese city and the prevalence of FT is impacted by sociodemographic factors and family financial factors, suggesting that effective intervention on FT needs to be carried out in various ways.
2023, 39(9): 1197-1200.
doi: 10.11847/zgggws1141219
Abstract:
Objective To examine the awareness of and responding to a nationwide road traffic safety campaign named “One Helmet, One Seatbelt” among motor vihicle riders/passengers in China. Methods An online questionnaire survey was conducted among e-bike or motorcycle riders/passengers and automobile drivers/passengers recruited with snowball sampling in 18 provinces, 5 autonomous regions, and 3 municipalities across China between July and August 2021 – one year after the initiation of the program. We analyzed the awareness of the campaign and the increase of helmet-wearing and seatbelt usage after the campaign among the participants. Results Eligible responses were collected from a total of 564 participants including 314 (55.68% of the participants) e-bike/motorcycle riders, 17 (3.01%) e-bike/motorcycle passengers, 137 (24.29%) automobile drivers, and 96 (17.02%) automobile passengers. Of the 451 e-bike/motorcycle riders and automobile drivers, 91.13% (411) reported the awareness of the road traffic safety campaign and there was no significant difference in the awareness rate between the e-bike/motorcycle riders and automobile drivers (92.04% vs. 89.05%, χ2 = 1.053; P > 0.05). Among the 331 e-bike/motorcycle riders/passengers, 245 (74.02%) reported increased helmet-wearing after the implementation of the campaign and significantly more e-bike/motorcycle riders reporting increased helmet-wearing compared to e-bike/motorcycle passengers (76.11% vs. 35.29%, χ2 = 13.973; P < 0.001). Of the automobile drivers/passengers, 43.78% reported increased seatbelt usage after the campaign and the proportion of reporting increased seatbelt usage was not significantly different between the drivers and the passengers (43.07% vs. 44.79%, χ2 = 0.068; P > 0.05). Conclusion The awareness rate of the nationwide “One Helmet, One Seatbelt” road traffic safety campaign was high among e-bike/motorcycle riders and automobile drivers; meanwhile, helmet-wearing increased in e-bike/motorcycle riders/passengers and seatbelt usage increased in automobile drivers/passengers one year after the initiation of the campaign.
2023, 39(9): 1201-1206.
doi: 10.11847/zgggws1138076
Abstract:
Objective To examine annual number of first registered human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) cases aged ≥ 50 years and its changing trend in Hubei province during 2011 – 2020 for providing evidence to the development of targeted strategies on HIV/AIDS epidemic prevention. Methods The data on 9 224 HIV/AIDS cases aged ≥ 50 years first registered in Hubei province during 2011 – 2020 were extracted from the Information System for AIDS Prevention and Control of China′s Disease Prevention and Control Information System and analyzed using descriptive statistics. The changing trend of annual number of the HIV/AIDS cases was analyzed with joinpoint regression model. Results The 9 224 cases aged ≥ 50 years accounted for 35.04% of all the HIV/AIDS cases (n = 26 324) first registered in the province during the 10-year period. The annual number of the cases ≥ 50 years showed a significant increasing trend in the period (Z = 21.01, P < 0.001). The results of joinpoint regression analysis revealed gender- and infection route-different changing trajectories for the annual number of first registered cases aged ≥ 50 years during the period: (1) increasing from 2011 to 2017 for all the male and the female cases, with the annual percentage change (APC) of 24.68 and 23.91; (2) decreasing from 2017 to 2020 for the male cases (APC = – 1.93); (3) increasing slowly from 2017 to 2022 for the female cases (APC = 2.25); (4) increasing rapidly from 2011 to 2016 (APC = 29.31) but slowly from 2016 to 2020 (APC = 2.76) for the male cases sexually infected; (5) increasing from 2011 to 2017 (APC = 26.12) but decreasing from 2017 to 2022 (APC = – 6.34) for the male cases infected homosexually; (6) increasing obviously from 2011 to 2016 (APC = 28.77) and the increase slowing down from 2016 to 2022 (APC = 3.73) for the male cases infected heterosexually; (7) increasing from 2011 to 2017 (APC = 26.01) and the increase slowing down from 2017 to 2020 (APC = 1.47) for the female cases with sexually transmitted infection; and (8) decreasing from 2011 to 2020 for the cases with non sexually transmitted infection or unknown transmission routes (APC = – 25.66). Conclusion The annual number of first registered HIV/AIDS cases aged ≥ 50 years increased from 2011 to 2020 in Hubei province and the majority of the cases were infected due to heterosexual transmission. The results suggest that targeted interventions should be developed for the prevention and control of HIV/AIDS epidemic in the elderly population.
2023, 39(9): 1207-1211.
doi: 10.11847/zgggws1141655
Abstract:
The phenomenon of "information islands" in medical studies is becoming increasingly prevalent since healthcare information resources are generally characterized by multiple sources, multiple types, and non - standardization. The data from large cohort studies in China have complex sources and multiple types and it is difficult for the data from different cohorts to be integrated, shared and utilized. For promoting the standardized integration of healthcare resource data in China, we conduct an in - depth literature analysis on the research on common medical data models (CDM) at home and abroad and patterns of CDM establishment for cross - cohort studies. The study also proposes some recommendations regarding the problems of medical data integration and sharing in the context of precision medicine in China for effective integration, consolidation, sharing, and utilization of cross - cohorts data.
The phenomenon of "information islands" in medical studies is becoming increasingly prevalent since healthcare information resources are generally characterized by multiple sources, multiple types, and non - standardization. The data from large cohort studies in China have complex sources and multiple types and it is difficult for the data from different cohorts to be integrated, shared and utilized. For promoting the standardized integration of healthcare resource data in China, we conduct an in - depth literature analysis on the research on common medical data models (CDM) at home and abroad and patterns of CDM establishment for cross - cohort studies. The study also proposes some recommendations regarding the problems of medical data integration and sharing in the context of precision medicine in China for effective integration, consolidation, sharing, and utilization of cross - cohorts data.
2023, 39(9): 1212-1216.
doi: 10.11847/zgggws1141818
Abstract:
Population medicine is a medical discipline that uses and integrates the knowledge, technology, art and academic of contemporary medicine and related disciplines as the basis of public health practice to maximize the overall and long - term health benefits of the population. The construction of population medicine talent teams is in line with the strategy of reinvigorating China through human resource development, and the practice of population medicine tends to be consistent with the construction of Healthy China. In this paper, we discussed the necessity and reality of the construction of talent teams in population medicine and putted forward some considerations on the construction of talent teams in China by summarizing and drawing lessons from the relevant experience and practice of foreign countries in medical talent training.
Population medicine is a medical discipline that uses and integrates the knowledge, technology, art and academic of contemporary medicine and related disciplines as the basis of public health practice to maximize the overall and long - term health benefits of the population. The construction of population medicine talent teams is in line with the strategy of reinvigorating China through human resource development, and the practice of population medicine tends to be consistent with the construction of Healthy China. In this paper, we discussed the necessity and reality of the construction of talent teams in population medicine and putted forward some considerations on the construction of talent teams in China by summarizing and drawing lessons from the relevant experience and practice of foreign countries in medical talent training.
2023, 39(9): 1217-1220.
doi: 10.11847/zgggws1141632
Abstract:
Information technology is one of effective means to promote school health implementation. However, the existing school health information systems are fragmented, isolated, and lack of integration and suffer from serious information barrier. Additionally, some of the existing systems have incomplete functions, low level of intelligence, and slow update and iteration, witch seriously restricting the development of school health informatization. To break through the information barrier and promote the development of school health informationization, as well as to provide scientific means to improve the level of school health management and student health, it is imperative to build a smart and integrated school health management system platform. In this article, we briefly presented construction goal, technical framework, application, and utilization effects of the Shenzhen Intelligent Campus School Health Management System.
Information technology is one of effective means to promote school health implementation. However, the existing school health information systems are fragmented, isolated, and lack of integration and suffer from serious information barrier. Additionally, some of the existing systems have incomplete functions, low level of intelligence, and slow update and iteration, witch seriously restricting the development of school health informatization. To break through the information barrier and promote the development of school health informationization, as well as to provide scientific means to improve the level of school health management and student health, it is imperative to build a smart and integrated school health management system platform. In this article, we briefly presented construction goal, technical framework, application, and utilization effects of the Shenzhen Intelligent Campus School Health Management System.
2023, 39(9): 1221-1224.
doi: 10.11847/zgggws1138879
Abstract:
We established a government cloud platform-based epidemiological survey information management system to improve the capability of response to public health emergencies in Liaoning province. By using big data, cloud computing, image recognition, speech recognition, fifth generation (5G), geographic information systems (GIS) and other technologies, the system takes the advantages of government cloud platform including strong computing power, safe and reliable data exchange, flexible server deployment, and efficient data collection. The system could be used to construct multi-dimensional transmission model of epidemics, to conduct big data analysis, to link the data collected at provincial/municipal and district levels, to assist real-time cross-provincial collaborative investigation, and to carry out closed-loop management on the information of joint prevention and control of epidemic. The established system came into operation in August 2021 in Liaoning province and played an important role in regional epidemic control and prevention.
We established a government cloud platform-based epidemiological survey information management system to improve the capability of response to public health emergencies in Liaoning province. By using big data, cloud computing, image recognition, speech recognition, fifth generation (5G), geographic information systems (GIS) and other technologies, the system takes the advantages of government cloud platform including strong computing power, safe and reliable data exchange, flexible server deployment, and efficient data collection. The system could be used to construct multi-dimensional transmission model of epidemics, to conduct big data analysis, to link the data collected at provincial/municipal and district levels, to assist real-time cross-provincial collaborative investigation, and to carry out closed-loop management on the information of joint prevention and control of epidemic. The established system came into operation in August 2021 in Liaoning province and played an important role in regional epidemic control and prevention.
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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