中华疾病控制杂志

Development and application of prophylactic human papilloma virus vaccines in China

CHEN Qi, WU Ting, ZHANG Jun, XIA Ning-shao

2023, 27(3): 249-253. doi: 10.16462/j.cnki.zhjbkz.2023.03.001

Abstract(494)

HTML (417)

PDF(135)

Abstract:
Human papilloma virus vaccine is an effective tool to prevent HPV infection and related diseases. In recent years, the development of HPV vaccines had made great progress. Two domestic first-generation HPV vaccines have been licensed, several second-generation HPV vaccines are under clinical evaluations, and the development of the third-generation vaccines, such as "20 valent" vaccines, has made substantial progress. There advances in vaccines indicates that China has changed from "follower" to "leader" in the field of HPV vaccine research. The time for launching the campaign of rapid elimination of cervical cancer in China is ripe. At this time point, it is necessary to improve the clinical evaluation capabilities for HPV vaccines, construct the system of active post-marketing safety monitoring, integrate information across multiple platforms to establish an evaluation system for the real-world effectiveness of HPV vaccines, expand the target population and indications of the product, and accelerate the internationalization of domestic HPV vaccines, and contribute China's wisdom to global cervical cancer prevention and control.

Analysis of the transmission characteristics of four childhood infectious diseases in China

ZHAI Xia-fei, HAN Shi-feng, ZHAO Ji-jun

2023, 27(3): 254-261. doi: 10.16462/j.cnki.zhjbkz.2023.03.002

Abstract(302)

HTML (172)

PDF(56)

Abstract:
Objective This research aimed to understand the periodical pattern, transmission rate, and seasonality of four childhood infectious diseases, and to provide theoretical support for prevention and control. Methods We selected four typical childhood infectious diseases, including pertussis, scarlet fever, rubella, and mumps, as research objects. And established time series susceptible infected recovered (TSIR) model respectively for four diseases. The Markov chain Monte Carlo methods were used to estimate the parameters of TSIR models and analyze the seasonal patterns of the transmission rate. According to the seasonal pattern of different infectious diseases' transmission rates, targeted prevention and control measures were adopted to analyze the effect on the number of future cases. Results The transmission rates of the four infectious diseases showed seasonal changes. The lowest transmission rates occured from July to August. The highest transmission rates of scarlet fever, rubella, and mump were from February to March. The transmission rate was affected seasonally by school holidays and the Spring Festival period. Having or not having immunization implementation did not affect the seasonal pattern of the transmission rate. The seasonality of transmission rate was related to the types of pathogens. Conclusions The transmission rates of the four childhood infectious diseases are characterized by seasonal changes. It is more effective to consider seasonality when implementing prevention and control measures to reduce the number of cases.

Epidemiological characteristics and change trend of human rabies onset and exposure in Guangdong, 2006-2019

TAN Xiao-hua, LIN Wen-qing, YANG Yu-wei, LUO Min, PENG Zhi-qiang

2023, 27(3): 262-267. doi: 10.16462/j.cnki.zhjbkz.2023.03.003

Abstract(690)

HTML (139)

PDF(82)

Abstract:
Objective To analyze the epidemiological characteristics and change trends of human rabies onset and exposure in Guangdong for prevention and control of rabies. Methods The descriptive epidemiological analysis was used to analyze the characteristics of human rabies cases and rabies expose population in Guangdong from 2006 to 2019. Joinpoint regression model was performed to analyze change trends of rabies onset and exposure characteristics. Results From 2006 to 2019, the annual average incidence rate of human rabies in Guangdong was 0.17/100 000. And the annual rates showed a downward trend, with an average annual percentage change (AAPC) of -26.15% (95% CI: -31.81%- -20.02%). The annual average exposure rate of human rabies was 687.72/100 000, showed a upward trend, with an AAPC of 5.21% (95% CI: 3.55%- 6.90%). There was a negative correlation between annual incidence rates and annual exposure rates (r=-0.947, P < 0.001). The annual average incidence rates in different regions, gender and age groups showed downward trends to varying degrees, and the AAPCs were between -22.95% and -49.19%. The annual exposure rates in different regions, gender and age groups showed upward trends to varying degrees, and the AAPCs were between 2.92% and 7.93%. Domestic dogs-mediated injuries accounted for 57.58% of all the injuries. According to the wound grading, the proportion of degree Ⅱ exposures was 61.26%, and annual proportions showed a upward trend (P=0.006). The post-exposure prophylaxis services receiving rate of degree Ⅱ and Ⅲ exposures was 99.20%, and showed a upward trend (AAPC: -0.58%, 95% CI: -0.78%--0.38%). The passive immunization rate of degree Ⅲ exposures was 23.78%, and showed a stable trend (AAPC: -0.36%, 95% CI: -2.78%- 2.13%). Conclusions From 2006 to 2019, the incidence rate of human rabies in Guangdong showed a downward trend, and is now in a low incidence state. The exposure rate of human rabies is on the rise, but the passive immunization rate maintain low in degree Ⅲ exposures cases. It is suggested that targeted health education about rabies should be strengthened.

Characteristics and function analysis of vaginal microbiota in women with cervical cytology abnormalities under different HPV16 infection status

WANG Jia-hao, ZHANG Ming-xuan, ZHANG Le, SONG Li, DING Ling, PEI Rui-xin, YAN Jia-xin, WU Cai-hong, LYU Yuan-jing, CUI Meng, WANG Zhi-lian, WANG Jin-tao

2023, 27(3): 268-273. doi: 10.16462/j.cnki.zhjbkz.2023.03.004

Abstract(252)

HTML (163)

PDF(31)

Abstract:
Objective To explore the characteristics of vaginal microbiota in women with abnormal cervical cytology under different HPV16 infection status, and to predict the function of the vaginal microbiota. Methods A total of 132 women with abnormal cervical cytology by liquid-based thinprep cytologic test (TCT), who came from the gynecological clinic of Second Hospital of Shanxi Medical University during January to June 2018, were enrolled in this study. Flow-through Hybridization technology was used to determine HPV infection typing. The vaginal microbiota was detected by 16S rDNA sequencing. The characteristic of vaginal microbiota were described by bio informatics, and Kyoto Encyclopedia of Genes and Genomes (KEGG) database was used to analyze the function of the vaginal microbiota. Results The Simpson index in the HPV16 positive group (n=59) was lower than that in the negative(n=73) group (P=0.047), while the Shannon index was higher in the positive group (P=0.036). Non-metric multidimensional scaling (NMDS) based on Bray-Curtis dissimilarities showed that there was no significance in Beta diversity between the two groups (P=0.199). Lactobacillus was the dominant bacteria in women with abnormal cervical cytology and different HPV16 infection status, but the proportion of Lactobacillus decreased (57.50%vs.60.69%) and anaerobic bacteria such as Gardnerella (14.29%vs.13.66%), and Peptoniphilus (4.28%vs.2.99%) increased in the HPV16 positive group. The abundance of Lactobacillus, Enterococcus, Staphylococcus and so on in the negative group was higher than that in the positive group, while the abundance of anaerobic bacteria such as Gardnerella, Ureaplasma, Peptoniphilus, Prevotella and so on in the HPV16 positive group was higher than that in the negative group. Ureaplasma and Peptoniphilus were the characteristic bacteria in HPV16 positive women based on Linear discriminant analysis Effect Size (LEfSe) analysis. The functional analysis showed that the function of vaginal microbiota was mainly concentrated on metabolism. The vaginal microbiota function in the HPV16 positive group was mainly to destroy the vaginal microenvironment and promote cell carcinogenesis, while the negative group was mainly to metabolism and inhibit cancer. Conclusions Increased diversity and the composition variation of vaginal microbiota are closely related to HPV16 infection. Ureaplasma and Peptoniphilus might be considered as potential biomarkers for HPV16 infection. Vaginal microbiota under HPV16 infection might induce vaginal microenvironment disorder and promote cancer.

Variable selection methods based on variable importance measurement from random forest and its application in diagnosis of tumor typing

WANG Wen-jie, MA Jin-sha, GAO Qian, WANG Tong

2023, 27(3): 274-280. doi: 10.16462/j.cnki.zhjbkz.2023.03.005

Abstract(395)

HTML (203)

PDF(69)

Abstract:
Objective To explore the variable selecting methods based on variable importance measurement from random forest (RF) for binary outcome in the high-dimensional omics data, and to choose the appropriate methods to construct the outcome prediction model. Methods First, according to the different variable selection objectives, we simulated and compared the ability of minimum optimized variable selection RF methods [recursive feature elimination (RFE)-RF, biosigner] and all relevant variable selection RF methods (Boruta, vita, altmann and r2vim) to identify important variables in high-dimensional data. Then we combined different methods to select genes related to diffuse large B cell lymphoma (DLBCL) classification and constructed the model for diffuse large B cell lymphoma classification diagnosis. Results Simulation study showed that vita had higher sensitivity, and biosigner had higher positive predictive value. Empirical study showed that a total of 1 019 genes related to DLBCL classification were obtained by vita method, and 77 genes related to DLBCL classification were obtained by biosigner method. The area under the receiver operating characteristical (ROC) curve (AUC) of the DLBCL typing diagnostic model was 0.910. Conclusions Vita and biosigner can be used in the preliminary and final selecting stages of genes related to DLBCL classification. The model we developed can effectively distinguish the different subtypes of DLBCL.

Integrative bioinformatic and functional analyses of genes related to non-small cell lung cancer in female

WANG Xiang-hai, ZHU Yu

2023, 27(3): 281-287. doi: 10.16462/j.cnki.zhjbkz.2023.03.006

Abstract(188)

HTML (150)

PDF(18)

Abstract:
Objective To explore the pathogenesis and prognostic biomarkers of non-small cell lung cancer (NSCLC) in female patients by bioinformatic analysis and functional prediction of potential NSCLC-associated genes. Methods Gene expression profile data for female patients with NSCLC were downloaded from the Gene Expression Omnibus (GEO) database, and differentially expressed genes (DEGs) were identified using limma package. Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) and protein-protein interaction (PPI) analyses were performed for DEGs. The igraph package was used to screen the key DEGs from PPI. The expression pattern of key DEGs were confirmed in Oncomine database and NSCLC cell lines. The Log-rank test was used to assess the association between key DEGs and overall survival. Results A total of 500 DEGs were identified, and GO analysis showed that these genes were mainly involved in cell proliferation, cell migration, and extracellular structure organization (P < 0.05). The KEGG analysis indicated that these genes were primarily related to ECM-receptor interactions, protein digestion and absorption, and leukocyte transendothelial migration signalling. Three key DEGs [interleukin-6 (IL-6), epidermal growth factor (EGF), matrix metalloprotein-9 (MMP-9)] were screened from the PPI network. The expression of IL-6 was downregulated in NSCLC tissues and cell lines, while EGF and MMP-9 expressions were upregulated. The log-rank test found that IL-6 and EGF were associated with overall survival of female patients with NSCLC. Conclusions In female patients, IL-6 (χ² =6.90, P=0.009) and EGF (χ² =7.73, P=0.005) may be key genes for pathogenesis and prognosis of NSCLC, and represent novel therapeutic targets.

BMI, WC, and waist-hip ratio and the risk of death in type 2 diabetes mellitus: a cohort study

WANG Sai-yi, MIAO Dan-dan, SUN Zhong-ming, WEN Jin-bo, MEI Dong-meng, LI Dian-jiang, SU Jian, WU Ming, PAN En-chun

2023, 27(3): 288-293. doi: 10.16462/j.cnki.zhjbkz.2023.03.007

Abstract(313)

HTML (130)

PDF(34)

Abstract:
Objective To investigate the effects of different obesity indicators on the risk of death in diabetes mellitus type 2 (T2DM) patients in Huai 'an City. Methods A total of 9 759 T2DM patients were followed up in Huai 'an City from 2013 to 2020, and the cause of death was matched through the cause of death monitoring platform. The follow-up population was classified according to BMI, WC, waist-to-hip ratio (WHR), and Cox proportional risk model was adopted to explore the effect of obesity indicators on all-cause mortality risk of T2DM patients. Sensitivity analysis was then used to exclude smokers, those with less than three years of follow-up, and those who died in the first year of follow-up, and baseline patients with cardiovascular and cerebrovascular risk for all-cause mortality. Results The research results indicated the BMI groups in different age, WC, WHR and other indexes were different (P < 0.05). After adjusting for confounding factors, it was found that the risk of death decreased by 17% and 27% in overweight and obese people compared with normal people, respectively, with statistical significance (P < 0.05). Compared with non-central obesity, the waist circumference of patients with central obesity can reduce the risk of death in both pre-central obesity and central obesity, and there was no statistical significance in the risk of death among people with different WHR ratios. Conclusions The "obesity paradox" exists in the risk of death. It is found that BMI has a protective effect on the risk of death in overweight and obesity, as well as in the early stage of central obesity.

Relation of family health and depression to nicotine dependence in adult smokers

MIN He-wei, WU Yi-bo, SUN Xin-ying

2023, 27(3): 294-299. doi: 10.16462/j.cnki.zhjbkz.2023.03.008

Abstract(245)

HTML (135)

PDF(35)

Abstract:
Objective To explore the relationships between family health, depression, and nicotine dependence in adult smokers in China. Methods Smokers in nuclear families aged over 18 years were selected to explore demographic characteristics, family health, depression level, and nicotine dependence status. The binary logistic regression was performed to analyze the influencing factors of nicotine dependence. And the relationships between family health, depression, and nicotine dependence were analyzed by binary logistic regression and structural equation modeling. Results A total of 707 smokers were collected. And 640(90.5%) smokers were had mild nicotine dependence, while 67(9.5%) were with severe nicotine dependence. Logistic regression showed that being married, starting smoking at a young age (under 18 years), daily drinking, depression, poor family external social support were all associated with severe nicotine dependence (all P < 0.05). Structural equation model showed that family health resources could indirectly influence nicotine dependence by affecting depression (β=-0.246, P < 0.001). Conclusion Family health was directly related to nicotine dependence and may also indirectly influence it through depression level.

Study on reporting and handling capacity of primary doctors on infectious dieases and public health emergencies

CAO Dong-li, LI Si-qing, WANG Xuan-xuan, HU Dan, ZHU Ya, CHEN Jia-ying, ZHANG Yuan-yuan

2023, 27(3): 300-303. doi: 10.16462/j.cnki.zhjbkz.2023.03.009

Abstract(201)

HTML (129)

PDF(28)

Abstract:
Objective To understand the current situation of the abilty of primary doctors in China to report and handle infectious diseases and public health emergencies, and to explore strategies to improve their capacity. Methods Multi-stage sampling and typical sampling were used to select primary doctors from eastern (Jiangsu Province), central (Anhui Province, Henan Province) and western (Chongqing City, Gansu Province) region. And a questionnaire survey was conducted. Results Among 8 374 primary doctors included in the analysis, 6 906 (82.5%) had the ability to report infectious diseases and public health emergencies. Of 7 261 (86.7%), 7 633 (91.2%) and 7 867 (93.9%) of the primary doctors were competent in risk management, discovery and report management, and assistance with treatment and management, respectively. The doctors who work closer to the grassroots have more work experience and higher level of competence. Conclusions The ability of reporting infectious diseases and public health emergencies of primary doctors in China is generally good, but the ability of risk management needs to be improved. It is necessary to strengthen training and accumulate work experience to achieve effective response to infectious diseases and public health emergencies.

Promote the cultivation of compound public health talents and the construction of high-level schools of public health

CHANG Jiang, SHEN Min, PAN An

2023, 27(3): 304-306. doi: 10.16462/j.cnki.zhjbkz.2023.03.010

Abstract(182)

HTML (176)

PDF(32)

Abstract:
The Chinese government has issued guidelines for the construction of high-level public health schools in China, and a total of 18 schools of public health have been initially approved for the construction. However, the specific paths and strategies to achieve this goal are yet to be explored. In this narrative review, we compare and analyze the philosophy and modes of education programs of cultivating interdisciplinary public health talents among several domestic and international schools of public health. We discuss possible "novel paradigms" for the cultivation of high-level public health talents, providing possible paths and strategies for the construction of high-level public health schools.

Practical path of optimizing the training model of master in public health and improving job competency

SHEN Min, ZHOU Dan, JIA Ji-feng, CHEN Qiu-sheng, PAN An

2023, 27(3): 307-312. doi: 10.16462/j.cnki.zhjbkz.2023.03.011

Abstract(170)

HTML (140)

PDF(32)

Abstract:
Objective To understand the job competencies among graduates of master of public health (MPH) in health-related work experience, and provide evidences for revising MPH training model. Methods The job competencies after graduation and previous training experiences during the MPH study period were surveyed by an self-made questionnaire. Details about the coursework, pattern of public health practice and dissertation study were included in the survey and data analysis. Results A total of 69 graduates were enrolled in the survey, 53 of them have been currently working in public health. The average age was (37.5±2.3) years old, and the average working years was (2.0±1.6) years. The curriculum was satisfied with the need of job competencies, but the pattern and duration of public health practice should be increased and standardized in future training program of MPH. Conclusions Strengthening the core curriculum, upgrading the procedure of public health practice and deepening the cooperation with public health sectors are needed to improve the job competencies of MPH.

An epidemiological survey on knowledge, attitudes and practices related to COVID-19 among employees during the early and the normalized prevention and control stage of the epidemic

ZHANG Xi-ru, LI Zhi-hao, ZHANG Pei-dong, FU Qi, WANG Jin-dong, SHEN Dong, ZHONG Wen-fang, CHEN Pei-liang, HUANG Qing-mei, WANG Xiao-meng, SONG Wei-qi, LIU Dan, MAO Chen

2023, 27(3): 313-320. doi: 10.16462/j.cnki.zhjbkz.2023.03.012

Abstract(251)

HTML (84)

PDF(13)

Abstract:
Objective To investigate the level of knowledge, attitudes and practices (KAP) related to COVID-19 among employees in large labor-intensive enterprises during the early stage and the normalized prevention and control stage of the COVID-19 epidemic, we aimed to provide scientific evidence for the formulation of prevention and control strategies to avoid COVID-19 epidemic in the process of resuming work and production and in the employees' daily work and life. Methods Two rounds of epidemiological surveys were conducted among employees in a large labor-intensive enterprise in Shenzhen from February 1 to April 30, 2020, and from January 2 to February 15, 2022, respectively. Results A total of 15 107 participants [mean (SD) age, 32.42 (6.02) years] completed two rounds of self-administered questionnaires. The COVID-19-related knowledge level (72.3% vs. 84.9%) and attitude level (82.7% vs. 89.1%) of participants improved during the normalized prevention and control stage of the COVID-19 epidemic compared with the eraly stage. In terms of COVID-19-related knowledge, almost every item on transmission route and physical protection measures had a high correct rate, while most items on the main clinical symptoms and consequences of being infected, and the knowledge of COVID-19 prevention or treatment had a poor correct rate during the different stages of the COVID-19 epidemic. In the light of COVID-19-related attitudes, most of participants were able to be aware of the adverse effects of the COVID-19 epidemic and said they would actively seek treatment if infected with SARS-CoV-2. However, they were less confident that SARS-CoV-2 infected individuals could be cured, and it was difficult for participants to determine the COVID-19-related symptoms. The overall implementation of the COVID-19-related practices of participants decreased (92.37% vs. 88.21%) from the early stage to the normalized prevention and control stage of the COVID-19 epidemic, mainly reflecting in a decline in the proportion reporting "Fully achieved" in most practices items. Conclusions Active guidance should be given in the following health education in time to address the misconceptions on COVID-19 related KAP among employees in the large labor-intensive enterprise during the different stages of the COVID-19 epidemic.

Spatial characteristics and influencing factors of the incidence rate of COVID-19 in Shanghai

SHEN Jia-ying, FAN Jun-yan, ZHAO Yue, NIU Zhe-yun, JIANG Dong-ming, ZHANG Zi-han, CAO Guang-wen

2023, 27(3): 321-325. doi: 10.16462/j.cnki.zhjbkz.2023.03.013

Abstract(223)

HTML (156)

PDF(37)

Abstract:
Objective The spatial characteristics of COVID-19 in Shanghai were investigated based on spatial autocorrelation analysis, and the impact of various vital factors on the spread of COVID-19 was also analyzed. Methods The COVID-19 epidemic data published on the official website of the Shanghai Municipal Health Commission from March 1, 2022, to May 31, 2022, were collected. And the GeoDa software was used for spatial autocorrelation regression analysis. We selected the typical data in demongraphic, economic, medicine and policy strategies from the 2021 statistical yearbook in each Shanghai administration region. Subsequently, we screened out four variables by correlation analysis and multicollinearity analysis. The ordinary least squares model (OLS) test was preferentially selected to analyze the transmission factors among OLS model, spatial lag model (SLM) and spatial error model (SEM). Results The spread of the epidemic in Shanghai was spatially concentrated, with high-high areas (HH) in Hongkou District, Jingan District, Huangpu District and Xuhui District, low-low areas (LL) in Songjiang District and Jinshan District, and Moran's I insignificance in other areas. The OLS model indicated that population density and GDP per capita positively affected the COVID-19 prevalence rate, while number of hospitals per unit and public expenditure on education per capita had no significance. Conclusions Currently, after China manage COVID-19 with measures against Class B infectious disease, residents are encouraged to manage their own health, to do personal health monitoring, to strengthen health protection when traveling. The mild and asymptomatic COVID-19 cases should be isolated at home, while the severe cases should be treated in hospital.

Analysis on the influencing factors for COVID-19 Omicron variant cases' clinical symptoms in Henan Province

PAN Jing-jing, FAN Wei, LI Ya-fei, YU Ming-yang, WANG Ying-ying, WANG Wen-hua, WANG Ruo-lin, YOU Ai-guo, NIE Yi-fei, WANG Hai-feng, YE Ying, HUANG Xue-yong, GUO Wan-shen

2023, 27(3): 326-328. doi: 10.16462/j.cnki.zhjbkz.2023.03.014

Abstract(202)

HTML (109)

PDF(40)

Abstract:
Objective To analyze the influencing factors for COVID-19 Omicron variant cases' clinical symptoms in Henan Province, so as to guide epidemic prevention and control. Methods Local Omicron variant cases in Anyang City, Henan Province in January, 2022, were selected as the study subjects. Epidemiological investigation and laboratory testing result were collected, and statistical descriptive analysis was conducted. Results A total of 468 cases of infection were reported, including 2 severe cases (0.4%). No death cases was reported. Among them, 90 cases (19.2%) had clinical symptoms, 38 cases (8.1%) were not vaccinated or did not receive full vaccination, 92 cases (19.7%) completed full vaccination for more than 6 months (including booster vaccination within 28 days), and 338 cases (72.2%) completed full vaccination within 6 months or booster vaccination for more than 28 days. In the patients with symptoms, the proportion of female was higher than that of male patients (χ²=4.270, P=0.039), and the proportion of completed full vaccination within 6 months or booster vaccination for more than 28 days was lower than that of asymptomatic cases (χ²=9.882, P=0.007). Multivariate logistic regression analysis showed that less than 6 months after full vaccination and more than 28 days after intensive vaccination were protective factors for symptoms (OR=0.455, 95% CI: 0.212-0.978, P=0.044). Conclusions For Omicron variant strains, full vaccination within 6 months and booster vaccination can reduce or alleviate symptoms.Vaccination should be continued.

Incidence comparison of notifiable communicable diseases in Guangzhou during the outbreak of COVID-19 in 2020 and 2015-2019

ZHOU Qin, LI Hai-lin, LIU Yuan, HU Wen-sui, DONG Zhi-qiang, LIU Wei, HOU Jian-rong, YANG Zhi-cong

2023, 27(3): 329-333. doi: 10.16462/j.cnki.zhjbkz.2023.03.015

Abstract(206)

HTML (109)

PDF(37)

Abstract:
Objective To understand the change of incidence of notifiable communicable diseases in Guangzhou during the epidemic of COVID-19 in 2020. Methods The data in this study were collected from the National Communicable Disease Reporting Information System. We applied descriptive analysis to compare the incidence of reported notifiable communicable diseases in Guangzhou for COVID-19 in four different time stages in 2020 and 2015-2019. R 3.5.0 software was used for statistical analysis. Results The incidence rate of reported notifiable communicable diseases in four different time stages in Guangzhou was 272.38/10⁵, 51.16/10⁵, 130.34/10⁵ and 664.25/10⁵ in 2020, respectively. The incidence rates increased by 187.76%, -30.37%, -57.64% and -41.85% respectively, compared with the average level in 2015-2019, especially the incidence rate of class C communicable diseases. All kinds of different transmission communicable diseases of class A and B decreased significantly after starting the first-level response. However, it decreased slowly in the second and third level response except for natural focal communicable diseases and vector-borne diseases. The incidence rate of acute communicable diseases such as influenza decreased significantly after the first-level response and decreased faster after the second-level response. However, the incidence rate of chronic communicable diseases such as HIV/AIDS, syphilis and hepatitis B decreased after the first-level response, but declined narrowed after the second and third level response. Conclusions The incidence rate of reported notifiable communicable diseases has changed significantly before and after the epidemic of COVID-19, especially that of acute communicable diseases such as influenza, and even in the late stage of the epidemic.

Epidemiological investigation of a family clustering of COVID-19 caused by SARS-CoV-2 Delta variant in Guangzhou, China

HE Shi-yu, MIAO Yu-tian, HAN Zhi-gang, LUO Ye-fei, CAI Yan-shan, MA Meng-meng, CHEN Yuan-yuan, CHEN Zong-qiu, YUAN Jun, GU Yu-zhou

2023, 27(3): 334-338. doi: 10.16462/j.cnki.zhjbkz.2023.03.016

Abstract(295)

HTML (150)

PDF(21)

Abstract:
Objective To investigate the epidemiological characteristics of a family clustering of COVID-19 caused by SARS-CoV-2 Delta (B.1.617.2) variant in Guangzhou, China. Methods The information of this case were extracted from Chinese CDC Infectious Disease Information System and epidemiological investigation. Demographic and epidemiological characteristics of this case were analyzed and described through descriptive epidemiological analysis. Results This family clustering included 6 cases, 3 of them were male, and the median age was 24.50 years. None of them accepted vaccination. 4 cases (case 1-4) of them developed symptoms successively 4-7 d after they had an exposure history in a restaurant with a confirmed case. Due to close contact, the other two family members (case 5, 6) developed symptoms 2-5 d after the onset of the 4 cases aforementioned. Case 1 and 2 were found after taking the centralized nucleic acid testing of SARS-CoV-2 in the community, case 3-6 were reported during the centralized health observation as the close contacts of case 1 and 2. A total of 24 key locations were involved in the activity trajectories of the 6 cases, and 427 close contacts were found. Except for other 4 cases, none of the close contacts were infected. Conclusions With vaccination and non-pharmaceutical interventions, focusing on stopping transmitting in family is still an important and useful strategy in preventing and controlling the community transmission of COVID-19 epidemic.

Study on the influence of COVID-19 epidemic to hand, foot and mouth disease based on intervention analysis model

ZHANG Hao-dan, GUI Guo-ping, GUO Feng, ZHA Ri-sheng, SUN Hong-peng, ZHANG Min

2023, 27(3): 339-344. doi: 10.16462/j.cnki.zhjbkz.2023.03.017

Abstract(310)

HTML (191)

PDF(41)

Abstract:
Objective To establish a prediction model based on the incidence data of hand, foot and mouth disease (HFMD) among children in a district of Suzhou in recent years, to judge the trend of HFMD incidence, and to predict the impact of COVID-19 prevention and control on HFMD. Methods Based on the HFMD surveillance database from January 2009 to December 2019, the seasonal autoregressive integrated moving average (SARIMA) model was selected to establish the HFMD data prediction model to predict the number of HFMD cases from January to October 2020. The differentials between the actual values and the predicted values were compared to confirm the change of HFMD incidence. Intervention variables were added in the optimal SARIMA model to determine the impact of COVID-19 on the incidence of HFMD in children. Results Compared with the incidence of HFMD in the same period of 2019, the incidence of HFMD in children decreased from January to October in 2020. The actual and predicted incidence trends of HFMD in children from January to October in 2020 were significantly different, and the actual case numbers were all lower than those in the prediction, and the deviation degrees from February to September in 2020 were all more than 100%. After adding intervention variables in the SARIMA model, the coefficient of intervention variables was -135.4 (P=0.010), suggesting that the incidence of HFMD in children decreased by about 135 cases per month on average. Conclusions The incidence of HFMD in children in a district of Suzhou from January to October in 2020 was lower than that in the historical period. It is inferred that strict and normalized prevention and control measures have not only effectively controlled the outbreak of COVID-19, but also affected the incidence of HFMD in children.

Economic burden of human papilloma virus related diseases in China: a systematic review and synthetic analysis

HE Ni-nan, ZOU Zhuo-ru, ZHANG Yun-bo, HE Xiao-qing, XIONG Su-qiang, LIU Chang-xin, BAO Jia-wei, XIA Ru-yi, ZHUANG Gui-hua

2023, 27(3): 345-351. doi: 10.16462/j.cnki.zhjbkz.2023.03.018

Abstract(419)

HTML (341)

PDF(104)

Abstract:
Objective To integrate cost-related data of human papilloma virus (HPV) related diseases from Mainland China and estimate the economic burden. Methods We uesd "Cost/expense" combined with names of the nine major HPV-related diseases, i.e. cervical cancer, vaginal cancer, vulva cancer, anal cancer, penile cancer, oropharyngeal cancer, cervical intraepithelial neoplasia (CIN), anogenital warts (AGW), and recurrent respiratory papillomatosis (RRP), as keywords. Seven databases including PubMed and China National Knowledge Infrastructure were selected, for literature targeting patients in mainland China published between 2001-2020. Various cost-related data were extracted, and cost data were adjusted annually to 2020 according to appropriate consumer price indices. Data were used to estimate per-capita direct medical costs, direct non-medical costs, and indirect costs for each of the nine diseases. The incidence, prevalence, and HPV attribution fraction of each of the nine diseases were collected to further estimate the total economic burden of HPV-related diseases in Mainland China in 2020. Results A total of 247 articles were included. Annual per-capita total costs of each of the six cancers ranged from 58 189 to 79 567 yuan in the first year of the disease and from 13 025 to 27 965 yuan in each subsequent year. Annual per-capita total costs of RRP were 41 329 yuan. Per-capita total costs of CIN and AGW ranged between 6 452 and 13 602 yuan. The total economic burden due to HPV-related diseases in Mainland China in 2020 was about 18.03 billion yuan, with cervical cancer accounting for 9.69 billion yuan. Direct medical costs were a significant part of the economic burden, accounting for 70% of the total burden, with 7.0 billion yuan in direct medical costs due to cervical cancer. Conclusions The annual economic burden of HPV-related diseases in Mainland China cannot be ignored. Scaling up HPV vaccination is needed to reduce associated economic losses.

Analysis on epidemiological characteristics of acute hemorrhagic conjunctivitis in the Longhua District, Shenzhen City, 2016-2020

ZHANG Min-yi, FAN Shun-chang, LIANG Min-yi, CHEN Hong-biao, CAO He, GU Zi-hao, ZHOU Xiao-feng, CHEN Qing

2023, 27(3): 352-356. doi: 10.16462/j.cnki.zhjbkz.2023.03.019

Abstract(243)

HTML (108)

PDF(41)

Abstract:
Objective To analyze the epidemiological characteristics of acute hemorrhagic conjunctivitis (AHC) in the Longhua District of Shenzhen City between 2016 and 2020, so as to provide evidence on improving the prevention and control of acute hemorrhagic conjunctivitis. Methods Data on the incidence of AHC in the Longhua District from 2016 to 2020 were collected from the Chinese Disease Prevention and Control Information System. The descriptive epidemiological method was employed to analyze the collected data. Results A total of 986 AHC cases were reported in the Longhua District during 2016-2020, with an average annual incidence of 6.73/10⁵. The incidence peaked in 2019 and significantly declined in 2020. The annual incidence rate in males was significantly higher than that in females (χ²=19.203, P < 0.001). The incidence was highest in the age group < 10 years old, and the incidence was higher in summer. The largest proportion of cases was accounted for workers (50.30%). Conclusions In the past five years, the incidence of AHC indicates an overall upward trend in the Longhua District. However, it is significantly declined in 2020 due to a series of preventive measures against COVID-19. Hence, continuous monitoring of AHC is supposed to be carried out in the future.

Effect of the free pneumococcal vaccination policy on the hospital admissions for pneumonia among the elderly in Beijing

LI Yu-tong, PANG Yuan-jie, LYU Min, HUANG Yang-mu

2023, 27(3): 357-362. doi: 10.16462/j.cnki.zhjbkz.2023.03.020

Abstract(127)

HTML (131)

PDF(17)

Abstract:
Objective To analyze the hospitalization trends for elderly pneumonia patients before and after implementing the free pneumococcal vaccination policy in Beijing, and to evaluate the policy's influence on the prevention and treatment of pneumonia in the elderly. Methods Monthly hospital admission data was obtained from Urban Employee Basic Medical Insurance (UEBMI) in Beijing from 2014 to 2019. The policy intervention cut-off point was set in January 2019. The interruption time series (ITS) model was used to analyze the changes of hospital admissions among elderly pneumonia patients in Beijing before and after implementing the policy. Results Before the implementation of the policy, the number of hospital admissions for pneumonia among people over 65 years old in Beijing showed an upward trend (RR=1.019, P < 0.001), and the trend slowed down after the implementation of the policy (RR=0.971, P=0.013). In the sensitivity analysis, there was no significant change in the number of hospital admissions for femoral fracture among people over 65 years old after the implementation (RR=0.992, P=0.503). Conclusions The free pneumococcal vaccination policy in Beijing is associated with the reduction of the risk of hospital admission for pneumonia among the elderly. Further strategies are needed to improve the accessibility of the vaccine.

Genetic characteristics of coxsackie A4 virus in a cluster of human infections in Suzhou

DONG Ze-feng, XU Zhi-hui, WANG Di, WU Xue-fei, YA Xue-rong, XIA Yu, SHEN Qiang

2023, 27(3): 363-367. doi: 10.16462/j.cnki.zhjbkz.2023.03.021

Abstract(174)

HTML (156)

PDF(25)

Abstract:
Objective This study aimed to conduct a preliminary molecular identification of pathogens in throat swab samples from a cluster of of cases with unexplained respiratory infections in Suzhou City. Methods Throat swab specimens of the outbreak cases were collected, and Real-time reverse transcription polymerase chain reaction (Real-time RT-PCR) method was employed to detect nucleic acid of common pathogens (influenza A/B viruses, parainfluenza viruses, respiratory syncytial viruses, coronaviruses, rhinoviruses, metapneumoviruses and adenoviruses) for clustered respiratory infections. Concurrently, FilmArray automatic medical PCR analysis system was used for multi-pathogen screening. High-throughput sequencing was performed on the throat swab specimens. And the sequenced results were verified by using specific kit to detect coxsackievirus A4 (CV-A4). Results Among the 18 throat swab samples submitted for testing during this outbreak, 4 were positive for CV-A4 by Real-time RT-PCR. CV-A4 specific gene fragments were identified in the throat swab samples via both Real-time RT-PCR and high-throughput sequencing method. Sequence analysis indicated that the complete genome sequence of the virus strain involved in this outbreak in Suzhou City shared the highest similarity (98.11%) to the MN964082 viral nucleic acid in the NCBI database. The VP1 protein amino acid sequence demonstrated a 98.03% similarity to the prototype strain AY421762. Six mutation sites were identified (T23V, A34T, S102A, A200T, I262V, and Y285H) when compared to AY421762. Conclusions CV-A4 has the potential to cause clustered respiratory infections. Enhanced health monitoring is necessary for vulnerable groups, particularly school-aged children, to facilitate prompt detection and management of such outbreaks.

Status and influencing factors of insufficient hyperopia reserve among children without myopia in Guangzhou in 2021

SUN Yi, LIN Rong, XIONG Li-hua, CHEN Si-yu, CHEN Kun-cai, WU De-ping, LIU Wei-jia

2023, 27(3): 368-372. doi: 10.16462/j.cnki.zhjbkz.2023.03.022

Abstract(327)

HTML (140)

PDF(32)

Abstract:
Objective To understand the status and influencing factors of insufficient hyperopia reserve among children without myopia in Guangzhou. Methods Using stratified cluster random sampling method, 2-3 kindergartens, 2 primary schools and 2 junior high schools were selected from 11 districts in Guangzhou for ophthalmic examinations and questionnaire survey, Sep-Dec, 2021. Among them, 8 335 non-myopic children aged 6-12 years were selected as subjects to analyze the status of refraction and insufficient hyperopia reserve. And the influencing factors of insufficient hyperopia reserve were investigated among 3 216 non-myopic children aged 9-12 years using by χ² test and multivariate Log-binomial regression models. Results In 2021, the spherical equivalent (SE) of non-myopic children aged 6-12 years in Guangzhou was +0.13(-0.25, +0.50) D, and the detection rate of insufficient hyperopia reserve was 85.18%. The SE of each age group from 6 to 12 years was +0.38(0.00, +0.75) D, +0.25(-0.13, +0.50) D, +0.13(-0.13, +0.50) D, +0.13(-0.25, +0.38) D, 0.00(-0.38, +0.38) D, 0.00(-0.38, +0.25) D, -0.13(-0.50, +0.25) D, and the detection rate of insufficient hyperopia reserve was 88.57%, 91.56%, 93.80%, 90.58%, 79.47%, 66.43%, 57.31%, respectively. Female (PR=1.08, 95% CI: 1.00-1.28, P=0.047), age < 12 years old (PR₉=4.58, 95% CI: 3.65-5.75, P < 0.001; PR₁₀=3.92, 95% CI: 3.11-4.95, P < 0.001; PR₁₁=2.36, 95% CI: 1.86-3.00, P < 0.001), suburb area (PR=1.57, 95% CI: 1.32-1.86, P < 0.001), long homework time (≥3 h/d) (PR=1.27, 95% CI: 1.02-1.59, P=0.034), the distance between the eyes and the books always or often < 33 cm when reading and writing (PR=1.19, 95% CI: 1.05-1.34, P=0.006), always or often lying down reading books or watching electronic screen (PR=1.31, 95% CI: 1.07-1.61, P=0.010), parental myopia (PR=1.16, 95% CI: 1.03-1.30, P=0.014) could be the risk factors for insufficient hyperopia reserve of the non-myopic children aged 9-12 years old. However, outdoor activity during recess could be the protective factor (PR=0.70, 95% CI: 0.62-0.80, P < 0.001). Conclusions The detection rate of insufficient hyperopia reserve among non-myopic children aged 6-12 years in Guangzhou was still at a high level. It is associated with genetic factors, gender, age, region, place for recess activity, distance between the eyes and the books when reading and writing, duration of doing homework, reading and writing posture.

User Login

DownloadMore >

LinksMore >

2023 Vol. 27, No. 3

NewsMore >

Cetificate

Cetificate-1

Cetificate-2

Cetificate-3

Editor

Editor-in-Chief Ye Dongqing M.D.

Assistant editor Fan Yinguang M.D.

Assistant editor Pan Haifeng M.D.

Assistant editor