中华疾病控制杂志

Impact on prevention and control of non-communicable disease during COVID-19 pandemic

WANG Wei-dong, HU Yi-song

2021, 25(4): 373-375. doi: 10.16462/j.cnki.zhjbkz.2021.04.001

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Since the first COVID-19 patient was reported in December of 2019, COVID-19 pandemic caused huge challenge to global health. When the world is combating the COVID-19 pandemic, more and more researches are concerning about the possible impact of COVID-19 on non-communicable disease (NCD). Although very little evidence-based studies were reported, the editorial reviewed tertiary prevention of NCD including causal prophylaxis, three-advancement prevention and clinical prevention. Few available evidences showed that COVID-19 pandemic impacted every aspects of tertiary prevention on chronic disease and the effect size depended on COVID-19 pandemic severity in different countries or regions. In addition, the editorial provided some future strategy and direction for prevention and control of NCD.

Exploration on the evolutionary characteristics of COVID-19: a functional data view

LIU Shi-shi, ZHONG Rou, ZHANG Jing-xiao

2021, 25(4): 376-383. doi: 10.16462/j.cnki.zhjbkz.2021.04.002

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Objective We explored and analyzed the evolutionary characteristics of COVID-19 cases numbers in different regions over time since the outbreak of the epidemic, so as to compare kinds of prevention and control measures and gain experience for public health management. Methods From the perspective of functional data, we applied functional principal component analysis to catch the primary temporal characteristics in cases number data over several periods, and performed hierarchical clustering on daily cases curves from various countries based on functional principal component scores to find the similarities among states. Results The first 3 functional principal components were retained for cumulative confirmed, cured and death cases numbers of all countries over each time period, each reflecting certain variability pattern among data at different times. On each period, 5 clusters were obtained, and the countries in clusters has changed over time. Conclusions The global epidemic has been fluctuating that cases numbers repeatedly grew at the end of June, September and November in 2020, which shows that there has been no effective measures so far. Changes in the clustering results also indicated that centralized isolation and strict management of imported persons are still the relative fast and effective intervention measures.

Analysis of the impact of COVID-19 epidemic on weight gain in Chinese adult and its related factors

SONG Yue-ping, LONG Xiu-chen

2021, 25(4): 384-388. doi: 10.16462/j.cnki.zhjbkz.2021.04.003

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Objective To analyze the impact of COVID-19 epidemic on body weight gain for adults in China. Methods Based on the General Impacts Survey of COVID-19 conducted by National Survey Research Center at Renmin University of China, which use random digital dialing method to sample respondents over 18 years old from all prefectural level areas in China, this study included 2 051 adult samples. The Pearson Chi-square test was used to examine the differences in the weight gain of different demographic groups, and multiple Logistic regression models were used to analyze the factors of the weight gain. Results A total of 29.30% adults reported weight gain. And multivariate Logistic analysis showed that women, young people, urban dwellers, residents in Hubei Province, living in communities which had confirmed cases, never had been quarantined or treated at assembly sites, high-educated, and low-income population had higher chance to gain weight (all P < 0.05). Conclusion The short-term increase of body weight affected by the epidemic may lead to long-term health effects for some people. Adults who have high risk of weight gain during the epidemic need to be paid more attention to, and epidemic prevention measures and proposed guidance also need to realize the health risk in this period.

Self protective behavior patterns and influencing factors of Chinese residents during the COVID-19 epidemic

TANG Li-na, GAI Qin-bao, DENG Wen-qing, WANG Wei-dong

2021, 25(4): 389-394. doi: 10.16462/j.cnki.zhjbkz.2021.04.004

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Objective To analyze Chinese residents′ behavior characteristics in regards to wearing masks, washing their hands upon returning home, avoiding unnecessary leaving home and reducing unnecessary parties during the COVID-19 epidemic in 2020. To investigate the demographic differences and influential factors of the above four individual protective behaviors, and to provide scientific basis for epidemic prevention and control. Methods A total of 4 123 Chinese residents aged 18 years and over were selected from the 2020 COVID-19 Prevention and Control and Its Impact Survey. The Chi-square test was used to examine the differences in the four behaviors among different demographic groups, and multiple Logistic regression analysis models were used to analyze the factors of the four behaviors. Results The percentage of practicing the above four individual protective behaviors was very high, which were 96.09%, 94.66%, 91.12%, 95.22%, respectively. Meanwhile, there were significant difference among different groups. Multivariate Logistic analysis showed that the analysis main factors affecting wearing masks were gender (OR=2.40, P < 0.001), urban or rural area (OR=0.48, P < 0.001), whether in Wuhan (OR=0.27, P=0.001; OR=0.13, P < 0.001); for washing their hands upon returning home the factors were gender (OR=2.18, P < 0.001), group age (OR=3.14, P < 0.001; OR=8.29, P < 0.001; OR=4.69, P < 0.001), urban or rural area (OR=0.73, P=0.050), education level (OR=1.53, P=0.059; OR=2.35, P < 0.001), whether in Wuhan (OR=0.70, P=0.089); for avoiding unnecessary leaving home the factors were gender (OR=2.05, P < 0.001), group age (OR=2.77, P < 0.001; OR=3.30, P < 0.001; OR=5.43, P < 0.001), urban or rural area (OR=1.64, P=0.001), education level (OR=1.50, P=0.026), whether in Wuhan (OR=0.73, P=0.056; OR=0.63, P=0.002); and for reducing unnecessary parties the factors were gender (OR=1.97, P < 0.001), group age (OR=2.94, P < 0.001; OR=3.00, P=0.002; OR=3.33, P=0.003), education level (OR=0.52, P=0.032; OR=0.61, P=0.097), whether in Wuhan (OR=0.69, P=0.094; OR=0.58, P=0.006). Conclusions During the COVID-19 epidemic, Chinese residents did a good job in personal protection. But there were still group differences. So, the formulation of relevant policies and personal protection publicity should be varied based on specific groups of people and specific areas.

The effect of COVID-19 pandemic on chronic disease treatment and health condition among Chinese adults

HU Yi-song, WANG Wei-dong

2021, 25(4): 395-399. doi: 10.16462/j.cnki.zhjbkz.2021.04.005

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Objective To explore the effect of COVID-19 pandemic on chronic disease treatment and health condition among Chinese adults. Methods Random digital dialing method was used to extract respondents aged 18 years old and over from all prefectural level areas in China. A cloud-based telephone interviewing system was administered to do the questionnaire survey. A total number of 5 972 questionnaires were collected nationally from November to December 2020. Results The COVID-19 pandemic had some or high degree impact on hypertension treatment of 2.2% self-reported patients. In addition, 4.6% and 8.8% of patients with dyslipidemia and diabetes or high glucose were affected by COVID-19. Compared with prepandemic, a total number of 4.2% population reported a little bit or significantly worse health condition. Results showed that the treatment of hypertension was affected more by COVID-19 pandemic among patients with worse health condition. The treatment of dyslipidemia was affected more by COVID-19 pandemic among old age and low family income patients with worse health condition. Middle and old age, urban people had higher chance to getting worse heath during COVID-19 pandemic. Conclusions The COVID-19 pandemic has little impact on treatment of hypertension, dyslipidemia, diabetes or high glucose patients and overall health status among Chinese population at present. But special attention should paid to high risk population with chronic disease who disproportionately affected by pandemic.

Spatial epidemiology characteristics and influencing factors of confirmed COVID-19 cases in Shaanxi Province

GUO Wen-wen, GUO Xi-ya, LI Peng, CAO Lei, PEI Lei-lei, ZENG Ling-xia, CHEN Zhi-jun, ZHUANG Gui-hua, QI Xin, LIU Feng

2021, 25(4): 400-404. doi: 10.16462/j.cnki.zhjbkz.2021.04.006

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Objective To describe the spatial distribution of COVID-19 cases in Shaanxi Province and further explore its relevant factors, so as to provide evidence for the prevention and control of COVID-19 in Shaanxi Province. Methods The information of confirmed COVID-19 cases and relevant socioeconomic data in Shaanxi Province were collected. The temporal and spatial distribution characteristics of confirmed cases, and the correlation between the incidence of COVID-19 and socioeconomic factors in the population were analyzed by using a generalized linear model. Results Four cases were first reported in Shaanxi on 23 January 2020, with the highest number of new confirmed cases reaching 23 on 4 February and no new cases after 19 February. The imported cases appeared earlier and reached the new peak than the local cases, and entered the zero stage earlier than the local cases. The spatial distribution showed that Xi′ an (120 cases) had the largest number of confirmed cases, accounting for 48.98% of the total cases, and the districts with more confirmed cases were in Lianhu, Yanta, Xincheng and Weiyang. Socioeconomic factors which significantly associated with the number of confirmed cases in each district and country were education expenditure (IRR=0.287, 95% CI: 0.134-0.612), GDP per capita (IRR=1.143, 95% CI: 1.049-1.245) and the distance from Wuhan (IRR=0.995, 95% CI: 0.992-0.998). Conclusion Measures should be taken in key areas and population at the early stage of the epidemic to control the spread of the epidemic as soon as possible.

Lag effect of temperature on the incidence of COVID-19 in Hunan Province

MAO Qian, LIU Yu-jie, WANG Zhe, GUAN Pei-xia, XIAO Yu-fei, ZHU Gao-pei, MENG Wei-jing, WANG Su-zhen, SHI Fu-yan

2021, 25(4): 405-410. doi: 10.16462/j.cnki.zhjbkz.2021.04.007

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Objective To explore the lag effect of daily average temperature on the incidence of coronavirus disease 2019 (COVID-19) in Hunan Province and to provide scientific evidences for effective prevention of COVID-19. Methods The meteorological factors, the air quality factors and the data conincidence of COVID-19 reported in Hunan Province during January 21, 2020 to March 2, 2020 were collected. Spearman correlation and distributed lag non-linear model analysis were performed. Results A total of 1 018 COVID-19 cases were reported in Hunan Province. The distribution lag non-linear model results showed that the influence of daily average temperature on the incidence of COVID-19 presented a nonlinear relationship. The cumulative relative incidence risk of COVID-19 decreased with the increase of daily average temperature, and the lowest temperature risk of the patients was 0 ℃. Both cold temperature and hot temperature increased incidence risk of COVID-19. It was indicated that the hot effects were immediate, however, the cold effects with obvious lag effect persisted up to 12 days. The highest relative risk of COVID-19 incidence was associated with lag 8-day daily average temperature of -5 ℃(RR=2.20, 95% CI=1.16-4.19). The influence of high temperature(10 ℃) was more significant than that of low temperature(6 ℃). Conclusion The daily average temperature, especially cold or hot temperature, was an important influencing factor of the incidence of COVID-19 in Hunan Province, which had lag influence on the incidence of COVID-19. We suggested that some related preventive measures should be adopted to protect vulnerable population and severe patients to reduce the incidence risk.

Spatiotemporal evolution and influencing factors of coronavirus disease 2019 in Jiangxi Province

GAO Xing, LI Gang, WANG Jiao-bei, XU Ting-ting, ZHANG Xiao-han, NING Qian

2021, 25(4): 411-415. doi: 10.16462/j.cnki.zhjbkz.2021.04.008

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Objective To analyze the epidemiological characteristics, spatiotemporal evolution and influencing factors of coronavirus disease 2019 (COVID-19) in Jiangxi Province. Methods Text analysis was used to extract epidemiological information, ArcGIS 10.3 was performed to capture the evolution, spatial analysis method was applied to explore the spatiotemporal characteristics, and Partial Least Square (PLS) estimation was used to analyze the influencing factors of the epidemic distribution. Results In Jiangxi Province, 930 cases have been confirmed in total, with young and middle-aged people accounting for the most (60.40%), and the service industry, migrant workers and labors accounted for the largest proportion. According to the activity track and contact history, the cases can be divided into three types: imported, mixed and diffuse. The diffuse cases account for 85.48% of the total. The development of the epidemic can be divided into three stages: import period, diffusion period and control period. The spatial distribution of the epidemic showed the pattern of "southwest-northeast" and "the northern part of Jiangxi was more heavily affected than the southern and middle part of Jiangxi, with high primary ratio in Nanchang-Xinyu". Population concentration, the intensity of communication and the distance from the worst-hit area were the main factors affecting the distribution of the epidemic. Conclusions The gender distribution of confirmed cases was balanced, with young and middle-aged people as the main group. The epidemic had great influence on service industry. The epidemic developed with the pattern of "rapid increase followed by slow decrease", and with significant spatial heterogeneity. Population concentration and mobility as well as the overall epidemic pattern were the key factors affecting the epidemic distribution.

Epidemiological characteristics of 17 coronavirus disease 2019 in Puyang, Henan

WANG Jian-wei, WANG Sheng-shu, YANG Shan-shan, JIA Wang-ping, HAN Ke, CAO Wen-zhe, TAI Peng-gang, KOU Fu-yin, LI Jing, LIU Miao, HE Yao

2021, 25(4): 416-420. doi: 10.16462/j.cnki.zhjbkz.2021.04.009

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Objective To explore the epidemiological characteristics of confirmed cases of coronavirus diseases 2019 (COVID-19) in Puyang, Henan Province, so as to provide basis for diseases control and preventive. Methods The epidemiological data of 17 cases of COVID-19 in Puyang were collected, and the time, regional and population distribution characteristics of COVID-19 were described and analyzed by drawing disease sequence diagram and case relationship diagram. Results Among the 17 cases, 7 were male (41.2%); the median age was 36 years old with age ranged from 12 to 66 years. A total of 4 clustered outbreaks occurred, involving 12 cases (70.6%), all of which were family recurrent cases. The median incubation period was 6.5 days, the shortest 3 days and the longest 13 days. The onset time of a second-generation case was 11 days earlier than that of the indicator case. The median time between onset and treatment was 4 days, the shortest was 0 days and the longest was 12 days. Of the 17 cases, 6 had a sojourning history in Hubei Province within 14 days, and 1 had a history of overseas tourism. The other cases were all local infections, 8 of them were close contacts of the confirmed cases, and 2 of them were from unknown sources. Among the close contacts, the cases involved in the family clustering epidemic were transmitted through close contact and respiratory tract. After detailed investigation and inquiry, it was inferred that the transmission route was the staircase droplet transmission. Conclusion In Puyang City, most of the cases were from Hubei Province, and was dominated by family clustering epidemic. There was a possibility of infection in the incubation period.

Epidemic characteristics of 69 COVID-19 cases in Lu'an City

WEI Qian-nan, YI Wei-zhuo, PAN Ru-bing, LI Kai-chun, CHU Zhao-yang, YU Liang, YUAN Wei, WEI Xiang, ZHANG Qin, LENG Rui-xue, PAN Hai-feng, WANG Ying, TAO Sha-sha, YE Dong-qing, SU Hong

2021, 25(4): 421-426. doi: 10.16462/j.cnki.zhjbkz.2021.04.010

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Objective To explore the epidemic characteristics of COVID-19 in Lu'an city, so as to provide scientific basis for the prevention and control of COVID-19 in this area. Methods All the confirmed cases of COVID-19 were selected from the Infectious Disease Reporting System from the onset of disease to 24:00 on February 18th, 2020 in Lu'an City. The general demographic, onset and medical information, and epidemiological characteristics of confirmed cases were collected to describe the feature of patients. The spatial and temporal distribution of disease transmission was analyzed by SaTScan 9.6.0.0 software, and Excel 2010 software was used to draw the epidemic curves of all cases. Results A total of 69 confirmed cases were reported in Lu'an City by February 18th, 2020. There were more male cases (44) than female (25), and cases mainly aged 36-45 years old (37.68%). The proportion of workers was the highest (24.64%). The first symptom of conformed cases was fever (50, 72.46%), cough (25, 36.23%) and fatigue (12, 17.40%). The epidemic was more serious in Jinzhai County (23), Huoshan County (17) and Huoqiu County (13). The number of cases in Lu'an showed that the first epidemic peak occurred between January 25th and January 28th, and the largest number of cases occurred on January 27th, then showed a downward trend. A total of 45 aggregate cases were found. Conclusion The COVID-19 epidemic in Lu'an City is generally preventable and controllable. It will be alert to the risk of family clustering, spread of asymptomatic infections and imported cases. Future work should focus on the investigation of close contacts.

Investigation on cognitive level of COVID-19 of medical staffs in Anhui Province

ZHENG Tao, HE Xin-ran, YUAN Hong-xu, RONG Jian, CHEN Gui-mei, CHEN Ren, WANG Li, XU Wang-quan, DING Hong

2021, 25(4): 427-431. doi: 10.16462/j.cnki.zhjbkz.2021.04.011

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Objective During the COVID-19 epidemic period, we investigated the cognitive level of COVID-19 knowledge of medical staffs in Anhui Province and analyzed the influencing factors of cognitive level of COVID-19 knowledge. Methods From February 12, 2020 to March 4, 2020, a self-made questionnaire was used to evaluate the knowledge of COVID-19 among medical staff in Anhui Province. A total of 15 342 valid questionnaires were obtained. By SPSS 17.0 statistical software, and descriptive analysis, t-test, ANOVA analysis, and multiple linear regression were used to analyze the cognitive level of COVID-19 knowledge of medical staffs and the influencing factors. Results The total score of COVID-19 knowledge of medical staffs in Anhui Province was (6.95±2.67) points, the average score of diagnosis knowledge was (2.58±1.74) points, the average score of treatment knowledge was (1.53±1.03) points, and the score of nosocomial infections knowledge was (2.84±1.01) points. There were significant differences in COVID-19 diagnosis knowledge, nosocomial infections knowledge and total score between doctors and nurses (all P < 0.05). Multivariate linear regression analysis showed that the scores in senior and intermediate professional title groups were higher than those in primary professional title group; the scores in master′s degree group and above and undergraduate education group were higher than those in junior college education group; the knowledge scores in municipal, county-level hospitals, primary medical institutions and private medical institutions were lower than those in provincial hospital group; the scores in patients aged 30~ years and ≥40 years were lower than those in group < 30 years. The scores in senior and intermediate professional title groups were higher than those in junior professional title group; the scores in municipal, county-level hospitals, primary medical institutions and private medical institutions were lower than those in provincial hospitals; the scores of 30~ years old and ≥40 years old were lower than those of < 30 years old group, and the scores of nurses with bachelor′s degree were higher than junior college degree or below (all P < 0.05). Conclusions The score of COVID-19 knowledge of medical staffs in Anhui Province is low, so we should train them COVID-19 knowledge systematically. We should pay attention to the influencing factors like occupation, title, education background, age and hospital rank when selecting and training anti-epidemic medical staffs.

Investigation on molecular characters of SARS-CoV-2 Nsp8 gene and protein

ZHANG Ling-han, JIN Yue-fei, CHEN Shuai-yin, YUE Li-min, DUAN Guang-cai

2021, 25(4): 432-438. doi: 10.16462/j.cnki.zhjbkz.2021.04.012

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Objective To explore SARS-CoV-2 nsp8 genetic variation, Nsp8 protein structure, biological function and targeted drugs, and to lay foundation for establishing more effective prevention and control strategies. Methods Analyses of nsp8 genetic variability, physical and chemical characteristics, spatial structure, antigenic epitopes, biological function, and drug combined targets of Nsp8 were carried out using bioinformatics technology and large biological databases. Results Based on nsp8 sequences of 28 isolates of coronavirus of three species, evolutionary tree was successfully constructed. SARS-CoV-2 isolates showed 99%-100% conservation of nsp8 genes, less genetic distance to SARS than MERS isolates. Nsp8 had no signal peptide and transmembrane area. In reticulocytes in vitro, Nsp8 had a half-life of 4 h and was hydrophilic. A secondary model and a tertiary structure model were established. Linear B cell and CTL antigenic epitopes, phosphorylation and SUMB modification sites were found in Nsp8. Using the DrugBank database, four drugs targeted Nsp8 were obtained. Conclusions Nsp8 possesses the characteristics of typical antigens, participates in viral replication, and various isolates of the same species share high conservation of nsp8 gene, suggesting potential applications in researches on pathogenic mechanism, genotyping and prevention of this virus. Notably, this is the first report on Nsp8-targeted chemotherapeutic drugs, and the findings can be of considerable scientific significance and application value, under the conditions that measures with special effect for COVID-19 prevention and control are urgently needed.

Molecular characteristics of SARS-CoV-2 Nsp16 protein and analysis of its potential effect on male reproductive function

ZHANG Ling-han, ZHANG Wan-yu, XU Xiao-lu, GUO Yi-hong

2021, 25(4): 439-444. doi: 10.16462/j.cnki.zhjbkz.2021.04.013

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Objective The possibility of coronavirus disease 2019 (COVID-19) involving injury to reproductive function has attracted attention. This study analyzed the genetic characteristics, molecular structure and biological function of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Nsp16 protein, and explored potential effects of Nsp16 on germ cells following the virus′ invading testicular tissue, aiming to lay basis for studies of pathogenic mechanisms and therapeutic strategies. Methods Bioinformatic techniques and international biological databases were used to analyze nsp16 genetic variability, Nsp16 spatial structure and function, and effects on genes and proteins of germ cells. DrugBank databases were applied in screening for drugs targeted at Nsp16. Results An evolutionary tree was constructed based on the nsp16 sequences of 30 isolates of 3 coronavirus species. The nsp16 conserved property was 99% amongst SARS-CoV-2 isolates. Nsp16 is a hydrophilic protein, with a 1.9 h half-life inside cells in vitro. Nsp16 has methyltransferase activity, showing potential to regulate gene and functional protein methylation of sperm and Leydig cells. Nsp16 has both linear B cell epitopes and CTL cell epitopes, with capacity to induce immune responses and damage to testicular tissue. Two inhibitory drugs targeted at Nsp16 were found by screening the DrugBank database. Conclusions SARS-CoV-2 Nsp16 is a functional protein encoded by a highly conserved gene, may affect germ cell growth and development by promoting methylation of host cellular genes and proteins following the virus′ invasion into testis tissue through angiotensin-converting enzyme 2 receptors. This report presents Nsp16-targeted chemotherapeutic drugs for the first time, showing high reference value for prevention and treatment of COVID-19 and related lesions of the male reproductive system.

Asymptomatic transmission in the COVID-19 pandemic: a systematic review and Meta-analysis

LI Zi-shuai, LIN Jian-sheng, PU Rui, ZHAO Yue, CHEN Yi-fan, CAO Guang-wen

2021, 25(4): 445-453. doi: 10.16462/j.cnki.zhjbkz.2021.04.014

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Objective To determine the differences in the epidemiological characteristics of asymptomatic patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 2019 (COVID-19) patients. Methods The relevant data of asymptomatic SARS-CoV-2 transmission literature in PubMed, Web of Science, CNKI, VIP medicine and Wanfang medical database were extracted as of August 1, 2020. Epidemiological information was screened and extracted according to pre-established inclusion and exclusion criteria. Age, gender, virus shedding duration and virual load of asymptomatic carriers were summarized and analyzed. Results A total of 38 articles met the criteria, 17 of which were asymptomatic case reports related to the virus shedding duration. Compared with symptomatic infected persons, asymptomatic individuals were younger [Weighted Mean Difference (WMD), WMD=-5.27, 95% CI: -9.78--0.76, P < 0.001] and the viral load was lower (WMD=2.36, 95% CI: 0.65-4.07, P=0.007). The virus shedding duration of asymptomatic individuals (median=11 days) was shorter than symptomatic patients (median=16 days). Conclusion Asymptomatic individuals with SARS-CoV-2 were younger, had a lower viral load and a shorter virus shedding duration than COVID-19 patients.

Trend change of ischemic stroke incidence and mortality between 2012 and 2018 in Chongqing

DING Xian-bin, JIAO Yan, MAO De-qiang, XU Jie, TANG Wen-ge

2021, 25(4): 454-459. doi: 10.16462/j.cnki.zhjbkz.2021.04.015

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Objective To understand the trend change of ischemic stroke incidence and mortality between 2012 and 2018 in Chongqing, so as to provide suggestions for ischemic stroke prevention and control. Methods Cases of the ischemic stroke, were collected from the surveillance system of cardiovascular and stroke from 2012 to 2018 in Chongqing. Indicators including incidence, age standardization incidence rate(ASIR), mortality, age standardized mortality rate(ASMR), and proportion of ischemic stroke were analyzed by SPSS 25.0. The differences of the ischemic stroke incidence and mortality were compared by Chi-square test between male and female, urban and rural area. The trend change of the incidence and mortality of ischemic stroke were indicated by annual change percent (APC). Results The incidence and ASIR of ischemic stroke were 172.78/100 000 and 140.80/100 000 in 2012, Chongqing. The incidence and ASIR of ischemic stroke were 186.63/100 000 and 139.17/100 000 in 2018, Chongqing. APC of incidence and ASIR were 1.71% and 0.80%. And the trend changes of the incidence and ASIR had no significance (all P>0.05). The incidence of ischemic stroke in male was higher than that in female (all P < 0.05). The incidence of ischemic stroke in urban area was higher than that in rural area (all P < 0.05). The incidence of ischemic stroke increased by 6.29% annually in rural area (t=2.83, P=0.037). The mortality and ASMR of ischemic stroke increased from 17.89/100 000, 16.11/100 000 in 2012 to 39.03/100 000, 26.12/100 000 in 2018 significantly. And its APC were 15.37% (t=6.68, P=0.001) and 7.79% (t=5.43, P < 0.001). The mortality of ischemic stroke in male were higher than that in female(all P < 0.05). The mortality and ASMR of ischemic stroke increased by 14.91% (t=8.72, P < 0.001) and 12.86% (t=7.63, P=0.001) in rural area significantly. Conclusion The incidence and mortality of ischemic stroke in Chongqing were high. The incidence of ischemic stroke was stable in Chongqing. However, the mortality of ischemic stroke increased rapidly in Chongqing. The male and rural area were crucial for ischemic stroke prevention and control.

Association of schizophrenia onset with exposure to outdoor thermal comfort: effect modification by individual characteristics

ZHAO De-sheng, BAO Ping, CHENG Jian, WANG Xu, FANG Shi-yuan, SU Hong

2021, 25(4): 460-465. doi: 10.16462/j.cnki.zhjbkz.2021.04.016

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Objective To investigate the association between exposure to high humidex and the risk of schizophrenia onset. Methods Daily schizophrenia and meteorological data from 1 January 2005 to 31 December 2014 in Hefei, China, were collected. We quantified the relationship between humidex and schizophrenia onset using a distributed lag nonlinear model (DLNM). The effect modifications by gender, age, marital status and study periods were also examined. Results High humidex was significantly associated with schizophrenia onset, with the largest effect at two days lag (RR=1.031, 95% CI: 1.011-1.051, P < 0.05). When conducting subgroup analyses by individuals characteristics, we found that patients aged 21-60 years, males and married patients were more vulnerable to high humidex than patients aged 0-20, ≥60 years, females and unmarried patients, respectively. In addition, we also observed a clear decline in the effect of high humidex on schizophrenia from the first five years (2005-2009) to the second five years (2010-2014). Conclusion This study suggested that high humidex was a risk factor for schizophrenia onset, and patients aged 21-60 years, males and married patients were particularly vulnerable to the effect of high humidex.

Study on the associations of density indexes of Aedes albopictus for dengue with meteorological factors in Baoshan District of Shanghai

YANG Ying-yu, WANG Ying-ying, CHEN Yun, FU Chao-wei

2021, 25(4): 466-471. doi: 10.16462/j.cnki.zhjbkz.2021.04.017

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Objective To analyze the influence of meteorological factors on the density indexes of Aedes albopictus in Baoshan District of Shanghai, and its application in the prevention and control of dengue fever and other mosquito-borne infectious diseases. Methods The monitoring data and meteorological data on Aedes albopictus in Baoshan District of Shanghai City from April 2019 to October 2019 were collected, and the generalized additive model (GAM) was used for analysis. Results The density index of Aedes albopictus in summer and autumn were higher than that in winter and spring. Results from GAM indicated that the daily average temperature was positively associated with the logarithm of perched index (F=27.64, P < 0.001), the logarithm of Breteau Index (BI) (F=24.75, P < 0.001), and the logarithm of mosq-ovitrap index (MOI) (F=101.56, P < 0.001); the daily cumulative precipitation was positively associated with the logarithm of the MOI (F=14.73, P < 0.001), and was non-linearly associated with the logarithm of net trap index (P < 0.001). Conclusion Temperature and precipitation were the main meteorological factors affecting the distribution of Aedes mosquitoes in Baoshan District of Shanghai. Scientific and effective vector mosquito monitoring and prediction based on the correlation between meteorology and mosquito growth can lay a foundation for the early warning, risk assessment and scientific prevention and control of diseases transmitted by Aedes mosquitoes.

Suggestions and thoughts on the reform of China′s public health system during COVID-19

JIANG Yu, LIU Xuan, YUE He-xin, JING Ao, MENG Yao-han, LYU Tian-chen, WU Pei-xin

2021, 25(4): 472-477. doi: 10.16462/j.cnki.zhjbkz.2021.04.018

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This paper analyzed many problems in the construction of China′s public health system exposed in the process of prevention and control of novel coronavirus′s epidemic situation. Conscientiously studying the spirit of the two sessions, combined with the national conditions of our country, this paper put forward several specific reform suggestions on the legal system construction of the public health system, the improvement of the institutional system, the training direction of public health personnel, the public health service system, the information construction and the construction of the health emergency system, to made a preliminary exploration on the further improvement of the emergency response mechanism of major epidemic situations.

Teaching practice of field epidemiological investigation based on COVID-19 epidemic

CHEN Yan-feng, JIANG Li-ying, CHEN Lin-jun, HAN Dan, LUO Ying-yi, SUN Wen-wen, SUN Dian-jun

2021, 25(4): 478-482. doi: 10.16462/j.cnki.zhjbkz.2021.04.019

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Abstract:
The coronavirus disease 2019 (COVID-19) pandemic is accelerating in the world. Although the epidemic has been basically controlled across China at the present stage, the domestic epidemic prevention and control situation is still complex and grim. Field epidemiology played an important role in the prevention and control of infectious diseases during this epidemic and the past epidemics. In order to improve the teaching content of field epidemiology in undergraduate medical education, and to explore the practice of training in epidemiology with the present situation, this paper explored the teaching practice of field epidemiology investigation based on COVID-19. This study will help to enhance both the ability of students from theory to practice, and the adaption of high-level talents in field epidemic under the new situation.

The roles of nonprofit organizations in the management of COVID-19 emergency

ZHU Ming, GUO Jian-wei, HUANG Yi-xiang

2021, 25(4): 483-487. doi: 10.16462/j.cnki.zhjbkz.2021.04.020

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Coronavirus disease 2019 (COVID-19) is a major public health emergency, which needs broad-based participation of the government and all other sectors of society in crisis management. This article analyzed the characteristics of COVID-19 event and experience of international public health crisis management of nonprofit organizations. Based on real cases and roles of nonprofit organizations in COVID-19 crisis in Wuhan City, we put forward policy suggestions on greater roles of nonprofit organizations in COVID-19 emergency.

The diagnosis situation of the patients with COVID-19 in outpatients with fever in Wuha General Hospital

LIU Li, TONG Xiao-ling, WEI Jing-jing, LIANG Xiao-ming, WANG Xiao-meng

2021, 25(4): 488-491. doi: 10.16462/j.cnki.zhjbkz.2021.04.021

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Objective To analyze the epidemiological characteristics of febrile patients during the outbreak of the COVID-19 in Wuhan and explore its pathogenesis, so as to provide scientific basis and theoretical support for the prevention and control of the epidemic. Methods The data of 2 698 fever cases in fever clinic of general hospital were collected, including pneumonia cases and the positive cases of nucleic acid test of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and analysed by descriptive epidemiology. Results From January 1, 2020 to February 12, 2020, a total of 2 698 febrile patients were treated in the General outpatient department of Wuhan, including 683 (25.3%) patients with pneumo nia, in which 377 patients(55.2%) with virus pneumonia. Combined with imaging examination results and clinical manifestations, 289 cases were confirmed as COVID-19. However, 286 cases were confirmed as COVID-19 according to the results of nucleic acid detection. Compared with other age groups, the rates of people over 50 years old was higher in confirmed cases of COVID-19, especially for aged 60-69. Conclusion For viral pneumonia patients in fever clinic, if COVID-19 nucleic acid test is false negative or not detected, it should be determined according to imaging results and clinical manifestations.

The characteristics and trends of traffic death in Shanghai from 2002 to 2019

QIAO Jia-ying, FANG Bo, CHEN Lei, QIAN Nai-si, CAI Ren-zhi, WANG Chun-fang

2021, 25(4): 492-496. doi: 10.16462/j.cnki.zhjbkz.2021.04.022

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Objective To analyze the characteristics and trends of people who died of traffic accidents. Methods The data of traffic death were collected from Shanghai Death Registration System. The differences of mortality were tested by t test and Kruskal-Wallis rank test, and the annual percent change (APC) was calculated by Joinpoint Analysis. Results The mortality of traffic accidents in Shanghai from 2002 to 2019 was decreasing (APC=4.13). In 2019, the standardized mortality rate (SMR) was 3.75 per 100 000 population, and the SMR of males (4.86 per 100 000 population) was higher than that of females (2.59 per 100 000 population). People aged 65 had the highest mortality rate, which was 18.65 per 100 000 population. The mortality rate of rural areas (9.18 per 100 000 population) was higher than that of urban areas (3.41 per 100 000 population). Vulnerable road users including pedestrians, cyclists, and motorcyclists accounted for 84.06% of all traffic death. Conclusion It is recommended that Shanghai should build a safer traffic environment to realize the Sustainable Development Goals of '50% reduction in the number of road traffic death′ goal.

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2021 Vol. 25, No. 4

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Editor

Editor-in-Chief Ye Dongqing M.D.

Assistant editor Fan Yinguang M.D.

Assistant editor Pan Haifeng M.D.

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