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CN 34-1304/R ISSN 1674-3679

2022 Vol. 26, No. 11

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Tuberculosis Prevention and Control
Glycemic control and the risk of tuberculosis: a population-based cohort study
LI Chen, HONG Xin, LIU Qiao, KONG Wen, DING Xiao-yan, ZHU Li-mei, LU Wei, LU Peng
2022, 26(11): 1241-1247. doi: 10.16462/j.cnki.zhjbkz.2022.11.001
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  Objective  To evaluate the association between glycemic control among diabetes and active tuberculosis.  Methods  We conducted a population-based census in eastern China including 40 311 individuals. We investigated risk factors for active tuberculosis by excluding tuberculosis at baseline and linked all participants to the Infectious Disease Reporting Management System and tuberculosis Management Information System of Nanjing City. We followed participants for ten years. We matched participants using unique health identity card numbers, name, age, birthdate, and address. We constructed Cox Proportional hazard models adjusting for age, sex, smoking.  Results  After 10 years follow-up, 204 individuals progressed to tuberculosis (incidence rate, 71.3 per 100 000 person-years, 95% CI: 51.3-67.5), of whom 25 were diabetes, accounting for 12.3% (incidence rate, 59.0 per 100 000 person-years, 95% CI: 47.2-103.8) and 7 diabetes were with poor glycemic control (incidence rate, 84.4 per 100 000 person-years, 95% CI: 50.8-132.4). Diabetic patients had a significantly higher hazard of tuberculosis [hazard ratio (HR)=1.56, 95% CI: 1.01-2.39, P=0.044]. Diabetics with FPG≥7.0 mmol/L showed nearly one-fold increased risk of active tuberculosis (HR=1.89, 95% CI: 1.13-3.13, P=0.014).  Conclusions  In this large population-based cohort study in a medium tuberculosis burden region, we found that diabetes increased the hazard of tuberculosis disease and diabetics with poor glycemic control control aggravated this relationship. Strengthening the screening of diabetes patients with poor glycemic control control can improve the efficiency of tuberculosis detection in diabetes patients and help reduce the prevalence of tuberculosis in China.
Global geographical pedigree distribution and drug resistance of Mycobacterium tuberculosis complex
WANG Yu-ting, TAO Bi-lin, LI Zhong-qi, WU Ji-zhou, DING Jie, WANG Jian-ming
2022, 26(11): 1248-1251. doi: 10.16462/j.cnki.zhjbkz.2022.11.002
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  Objective  To map the global geographical distribution of Mycobacterium tuberculosis complex (MTBC) and describe the main MTBC lineage and drug resistance in different regions.  Methods  We used the whole-genome sequencing data from the TB-profiler platform to plot the global MTBC distribution map and visualized it according to the hierarchical structure of different regions and sub-lineages.  Results  Lineage 4 was widely distributed worldwide, while lineage 2 had the highest risk of drug resistance.  Conclusions  There was a significantly different geographic distribution pattern and drug resistance of MTBC lineages worldwide.
Analysis of the reported incidence of pulmonary tuberculosis in the elderly aged 65 and over in China, 2011-2020
ZHANG Can-you, CHEN Hui, ZHANG Hui, ZHAO Yan-lin, CHENG Jun
2022, 26(11): 1252-1258. doi: 10.16462/j.cnki.zhjbkz.2022.11.003
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  Objective  To analyze the characteristics of pulmonary tuberculosis (PTB) among the elderly aged 65 and over nationwide from 2011 to 2020.  Methods  Using nationwide surveillance data of PTB from 2011 to 2020, to analyze the reported incidence of PTB in the elderly.The distribution characteristic and the average annual change trends were calculated.  Results  The reported incidence of PTB in the elderly decreased from 158.7/100 000 in 2011 to 98.3/100 000 in 2020. The risk of developing PTB in the elderly aged 65 and over was 2.4-2.9 times that of those under the age of 65, and the 70- < 75 and 75- < 80 age groups had the highest incidences. Among the elderly, the risk of developing PTB in men was 2.5-3.1 times than that of women. The numbers of reported cases were the highest in January and March, which belong to winter and spring. From January to April 2020, the number of reported cases decreased significantly compared with that of the same period in previous years. The reported incidences of PTB among the elderly in eastern, central, and western China were 95.9/100 000, 159.0/100 000 and 184.4/100 000, respectively, and the incidences in central and western China were 1.7 and 1.9 times higher than that of eastern China, respectively. From 2011 to 2019, the average annual decline rate of the reported incidence of PTB in the elderly aged 65 and over was 3.5%, and the rates in eastern, central and western China were 4.9%, 4.5% and 1.5%, respectively. The estimated reported incidences were higher than the actual reported incidences in 2020.  Conclusions  From 2011 to 2020, China has remarkable achievements in the prevention and control of PTB in the elderly, but the overall burden is still heavy. We should focus on key provinces in western China, and strengthen the detection of PTB among the elderly.
Epidemiological investigation of a rifampicin-resistant tuberculosis outbreak in a middle school in Jiangsu Province
WU Ji-zhou, FU Jian, WANG Jian-ming, LIU Qiao, LU Feng
2022, 26(11): 1259-1263. doi: 10.16462/j.cnki.zhjbkz.2022.11.004
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  Objective  To describe the characteristics and epidemiology of a rifampicin-resistant tuberculosis outbreak in a middle school of Jiangsu Province, and provide suggestions for the prevention and control of the school tuberculosis.  Methods  Combination of field epidemiology investigation and laboratory examinations (including whole-genome sequencing) were taken in this tuberculosis outbreak. Close contacts were screened for tuberculosis suspected symptoms, tuberculin skin test (TST), and chest X-ray. Bacteriological tests, including sputum smear, sputum culture, traditional drug susceptibility test and GeneXpert MTB/RIF test were carried out for contacts with abnormal screening results. Meanwhile, whole-genome sequencing was performed for culture-positive strains.  Results  From June 24, 2019 to July 7, 2019, a total of 352 close contacts were screened in two rounds contacts screening. The strongly positive rate of TST(average diameter ≥15 mm) was 3.69% (13/352) and the abnormal rate of chest X-ray was 3.97% (14/352). A total of 12 patients with pulmonary tuberculosis were diagnosed, including 6 bacteriological positive patients, and 6 bacteriological negative patients. GeneXpert MTB/RIF test detected 6 MTB positive also with rifampicin resistance. The traditional drug susceptibility test of the culture-positive strains of four tuberculosis patients showed that they were all resistant to rifampicin. Whole genome sequencing data indicated that all 4 culture-positive strains belonged to L2 type, with the same mutation and drug resistance site.  Conclusions  Based on the field and molecular epidemiological results, this school rifampicin-resistant tuberculosis was a homologous outbreak. Compared with traditional anti-TB drug susceptibility test, whole-genome sequencing is recommended for tuberculosis outbreak investigation due to its high-speed and accuracy.
Status and influencing factors of latent tuberculosis infection among middle school students in Taizhou from 2019 to 2021
WANG Wen-jin, LIU Qiao, MIAO Chang-dong, CHEN Jing-juan, WANG Zhan, ZHU Li-mei, LU Wei
2022, 26(11): 1264-1270. doi: 10.16462/j.cnki.zhjbkz.2022.11.005
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  Objective  To describe the prevalence of latent tuberculosis infection and analyze the influencing factors of latent tuberculosis infection among middle school freshmen from 2019 to 2021 in Taizhou City, Jiangsu Province, and to provide a reference for tuberculosis prevention and control in school.  Methods  The physical examination data and tuberculin skin test (TST) results of freshmen were collected, and the risk factors related to latent tuberculosis infection were collected by questionnaire. Logistic regression analysis model was used to analyze the data.  Results  A total of 23 910 participants aged 13-18 years old were included. The overall latent tuberculosis infection rate of tuberculosis among middle school students in Taizhou was 5.675%. Multivariate analysis results showed that senior high school students (aOR=1.569, 95% CI: 1.083-2.273, P=0.017), 18.5 kg/m2≤BMI≤23.9 kg/m2(aOR=1.415, 95% CI: 1.196-1.674, P < 0.001), BMI>23.9 kg/m2 (aOR=1.643, 95% CI: 1.358-1.988, P < 0.001), previous tuberculosis (aOR=5.026, 95% CI: 2.264-11.155, P < 0.001) were the risk factors of latent tuberculosis infection.  Conclusions  Effective ways to prevent latent tuberculosis infection in middle school students include increasing outdoor exercise time, reducing stress appropriately, improving body immunity, and balancing diet nutrition to maintain proper BMI.
Post-exposure prophylaxis and tuberculosis prevention
XIN He-nan, GAO Lei
2022, 26(11): 1271-1274. doi: 10.16462/j.cnki.zhjbkz.2022.11.006
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China is one of the high burden countries on tuberculosis, current tuberculosis control strategy need to be further improved in order to achieve the End Tuberculosis Strategy. As a widely used effective tool in preventing infectious diseases, post-exposure prophylaxis (PEP) has not yet been systematically applied in tuberculosis control. Currently, children aged < 5 years with close contacts to microbiologically confirmed tuberculosis patients was the only target population recommended to initiate PEP with anti-tuberculosis agents. The present study illustrated the application of PEP in preventing infectious diseases. The values of PEP in tuberculosis prevention and challenge faced were further discussed. It might provide new insight for improving close contacts management and moving tuberculosis control action forward from preventing disease occurrence to controlling infection.
Original Articles
Trend of tuberculosis incidence in China from 1990 to 2019 based on the age-period-cohort model
JIANG Yuan-dong, TENG Zi-hao, WANG Yue, HU Peng-yuan, XIANG Yang
2022, 26(11): 1275-1282. doi: 10.16462/j.cnki.zhjbkz.2022.11.007
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  Objective  To analyze the trend of tuberculosis incidence in China in 1990-2019 and to explore the impact of age, period and cohort on tuberculosis risk.  Methods  The global health data exchange database was used to collect tuberculosis incidence data from Chinese residents aged 0- < 95 years old. Joinpoint regression was used to analyze the changing trend of tuberculosis incidence in China from 1990 to 2019. The age-period-cohort model was used to analyze the age effect, period effect and cohort effect on the risk of tuberculosis in China.  Results  From 1990 to 2019, the standardized incidence of tuberculosis showed a downward trend in the whole population and in the subgroups of males and females. The age-standardized incidence rate decreased from 120.56/100 000 and 99.75/100 000 in 1990 to 56.08/100 000 and 30.60/100 000 in 2019, with an average annual decline rate of 2.60% and 3.98%, respectively. The results of the age-period-cohort model analysis showed that the age effect of tuberculosis incidence in China increased with age from 1990 to 2019, and reached the highest risk at the age of 90- < 95 years old. The RR of males and females were 2.50 (95% CI: 2.33-2.69) and 1.93 (95% CI: 1.76-2.12), respectively. The period effect gradually decreased with the passage of time, and the RR value of incidence risk decreased from [male: 1.13 (95% CI: 1.08-1.17); female: 1.58 (95% CI: 1.51-1.65)] in 1990 to [male: 0.80 (95% CI: 0.76-0.83); female: 0.61 (95% CI: 0.57-0.65)] in 2019. The cohort effect showed that people who were born later have a lower risk of developing the disease.  Conclusions  The incidence of tuberculosis in China showed a downward trend from 1990 to 2019. On the whole, the risk of tuberculosis increased with the increase in age. The farther away from the contemporary period, the higher the risk of people being born earlier. It is suggested that TB screening should be focused on infants, college students, men, the elderly, and other groups. Colleges and universities across the country should carry out more lectures on TB health knowledge, and relevant government departments should use a variety of ways to publicize TB health knowledge to the public.
Three types of treatment delay and influencing factors among Multidrug-resistant Tuberculosis patients in Guizhou Province, 2014-2020
WANG Yun, CHEN Hui-juan, LU Xiao-long, YANG Jing-yuan
2022, 26(11): 1283-1289. doi: 10.16462/j.cnki.zhjbkz.2022.11.008
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  Objective  To analyze the status and influencing factors for three types of treatment delay among multidrug-resistant tuberculosis (MDR-TB) patients in Guizhou Province from 2014 to 2020.  Methods  Data were collected from the TB Management Information System. χ2 trend test was adopted to analyze the rate with time change, meanwhile, univariate analysis with χ2 test and multivariate logistic regression analysis were performed to obtain the influencing factors for treatment delay. Participants were classified into three types based on the days of their treatment delay, including type I (>1 day), type II (>7 days) and type III (>14 days).  Results  The treatment delay rates of type I, II and III among 1 309 MDR-TB patients in Guizhou Province from 2014 to 2020 were 43.6%, 30.0% and 22.7%, respectively. The three types of delay rates showed an overall downward trend with the change of time (all P-values were less than 0.001). However, the delay rate from December 2019 to 2020 was higher than that before, and the highest rate was 47% in December 2019. The overall delay rate increased in 2020 compared with that in 2019. Patients who were farmers, had fixed occupations, were diagnosed with MDR-TB and received treatment in hospital in Bijie City, were diagnosed through traditional drug sensitivity test, received anti-TB treatment in the past and were hospitalized at the time of MDR-TB diagnosis were more likely to experience treatment delay (all P < 0.05).  Conclusions  The three types of treatment delay rates of MDR-TB patients are high in Guizhou Province from 2014 to 2020. Although the delay rates show a downward trend year by year, they have increased since December 2019. Meanwhile, occupation, diagnosis and treatment institution, diagnosis mode, and anti-TB treatment history and treatment mode at the time of diagnosis are the influencing factors for treatment delay. Comprehensive measures should be taken to reduce the occurrence of treatment delay in Guizhou.
Study on influencing factors of spatial and temporal distribution difference of tuberculosis in Ningxia from 2004-2019
WANG Ruo-nan, YANG Zheng-gui, MA Ning, LIU Wei-chen, ZHAO Yu
2022, 26(11): 1290-1295. doi: 10.16462/j.cnki.zhjbkz.2022.11.009
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  Objective  The purpose of this study was to explore the potential influencing factors of the Spatio-temporal distribution difference of tuberculosis in Ningxia Hui Autonomous Region (referred to as "Ningxia"), which may provide a reference for an in-depth understanding of the transmission mechanism of tuberculosis.  Methods  Based on the standardized morbidity ratio (SMR) data of tuberculosis in Ningxia from 2004 to 2019, the spatial Dubin model (SDM) was established to analyze the potential influencing factors of the Spatio-temporal distribution difference of tuberculosis in Ningxia.  Results  The SDM showed that the sunshine hours (β=0.000 336 4, P=0.021), the number of health institutions (β=0.003 058 8, P < 0.001) and per capita gross domestic product (GDP) (δ=0.000 013 3, P < 0.001) were positively correlated with SMR, while precipitation (δ= -0.000 919 9, P=0.028) and the number of health institution personnel (β= -0.000 109 2, P=0.005; δ= -0.000 148 0, P=0.034) were negatively correlated with SMR. The sunshine hours, the number of health institutions and the number of health institution personnel showed the direct effects. Precipitation, the per capita GDP and the number of health institution personnel dispalyed the indirect effects, where per capita GDP had a positive spatial spillover effect, and precipitation and the number of health institution personnel has a negative spatial spillover effect.  Conclusions  The study shows that the Spatio-temporal cluster of tuberculosis in Ningxia may be related to the economic development level (population mobility), the climate environment with drought and long sunshine, and the allocation of medical and health resources. Thus, it is suggested that relevant departments adjusted the corresponding policies to improve the tuberculosis prevention and control ability among different counties (districts) in Ningxia.
Relationship between TAP2 gene polymorphism and susceptibility to pulmonary tuberculosis based on a case-control family study
LUO Jia-ze, HU Kuan, ZHANG Kai-xuan, LIAO Yin-qian, LUO Fang, LUO Dan, ZOU Pin-ang, WANG Bao-guo
2022, 26(11): 1296-1302. doi: 10.16462/j.cnki.zhjbkz.2022.11.010
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  Objective  Pulmonary tuberculosis (PTB) infection has individual differences. To explore the effect of transporter-associated with antigen processing 2 (TAP2) gene polymorphism on pulmonary tuberculosis, and to analyze the interaction between TAP2 gene and demographic characteristics, behavioral factors and environmental factors in the pathogenesis of pulmonary tuberculosis.  Methods  Based on the case-control family study, patients with confirmed pulmonary tuberculosis in multiple pulmonary tuberculosis families collected by tuberculosis prevention and control units in Guangdong Province were selected as the case group. The healthy members in these families were included in the healthy household contacts (HHC) group, and the members of healthy families collected in the same period were included in the healthy controls (HC) group. Multivariate logistic regression model was used to analyze the association between the factors and pulmonary tuberculosis, and classification and regression tree (CART) model was used to analyze the interaction between risk factors of pulmonary tuberculosis.  Results  Multivariate logistic regression analysis showed that age, male, smoking and lack of fitness activities were risk factors of pulmonary tuberculosis for HHC group. For healthy controls, urban residence registration, BMI>18.5 kg/m2 and indoor dryness were protective factors of pulmonary tuberculosis, while, male, smoking, lack of fitness activities and poor indoor environmental sanitation were risk factors. There was a significant correlation between rs3819721 and susceptibility to tuberculosis between PTB group and HHC group, PTB group and HC group. The CART model of PTB group and HHC group showed that co-existence of no smoking and fitness activities could significantly reduce the risk of tuberculosis. The CART model of PTB group and HC group showed that people who lacked fitness activities and carried AG+AA genotype had a higher risk of tuberculosis.  Conclusions  The gene polymorphism of TAP2 rs3819721 is associated with pulmonary tuberculosis. And there is an interaction between TAP2 rs3819721 and lack of fitness activities in the pathogenesis of pulmonary tuberculosis. The gene polymorphism of rs241447 has not been found to be related to the pathogenesis of pulmonary tuberculosis.
Epidemiological analysis and short-term prediction of bacillary dysentery in Hubei Province from 2005 to 2021
CAI Jing, HUANG Shu-qiong, ZHANG Peng, ZHANG Chun-xiao, LI Ming-yan
2022, 26(11): 1303-1308. doi: 10.16462/j.cnki.zhjbkz.2022.11.011
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  Objective  To analyze the epidemiological characteristics of bacillary dysentery and predict its incidence trend in Hubei Province, in order to provide a reference for a scientific formulation of prevention and control measures.  Methods  Based on the incidence data of bacillary dysentery in Hubei Province from 2005 to 2021, the Spearman rank correlation test, seasonal index and K-means cluster analysis were used to analyze its epidemiological characteristics, and the auto-regressive integrated moving average (ARIMA) model was used to fit the data and make predictions.  Results  The average annual incidence of bacillary dysentery was 14.07/per 100 000. The incidence showed a downward trend year by year, with the correlation coefficient between the incidence and the year was -0.985. K-means cluster analysis divided 2005-2011 into one category, and 2012-2021 into another. The seasonal index from May to October was greater than 1, and the largest index was in July, and the second index was in August. The city of Wuhan, Xiantao, and Yichang were the high-incidence areas. The male-female incidence ratio was 1.23∶1. The ratio first decreased and then increased with age, with people aged 0-4 have the highest incidence, followed by those aged 85 and older. The cases were mainly scattered children, farmers and students. The best fitting model was ARIMA(1, 0, 0) (0, 1, 1)12, and the predicted incidence rate in 2022 was 1.61/per 100 000.  Conclusions  The incidence of bacillary dysentery in Hubei Province was significantly negatively associated with the year. The 2005-2011 belonged to the high prevalence level period, and 2012-2021 belonged to the low prevalence level period. The epidemiological characteristics of the two periods were basically the same. Bacillary dysentery has a high incidence in summer, males, children and elderly groups, and densely populated areas with convenient transportation. In 2022, the incidence will continue to decline, and it will be at a low prevalence level.
Prevalence and risk factors of optrA-positive Enterococcus in healthy human gut
XIANG Qiu-mei, LYU Zi-quan, SHEN Ying-bo, WANG Yang, SHEN Jian-zhong, WU Si-ying, KE Yue-bin
2022, 26(11): 1309-1314. doi: 10.16462/j.cnki.zhjbkz.2022.11.012
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  Objective  To investigate the prevalence and risk factors of optrA-positive Enterococcus in the healthy people in Shenzhen City.  Methods  A total of 565 feces of the healthy pepople during 2018-2019 was cultured on enterococcal-selective plates to obtain florfenicol-resistant Enterococcus. MALDI Biotyper, Bruker, Germany (MALDI-TOF MS) was used for the species identification and PCR was used for optrA gene confirmation. People carrying optrA-positive enterococci were defined as positive cases and four times people with optrA-negative were randomly selected as control cases using the age of matching condition. A multivariate logistic regression model was used to analyze the risk factors of optrA-positive Enterococcus colonization in the human intestines.  Results  Overall, the prevalence of optrA-positive individuals was 18.10% (102/565, 95% CI: 14.90%-21.20%) in Shenzhen during 2018-2019. A total of 447 optrA-enterococci strains was isolated from the above samples, of which the Enterococcus faecalis was the most prevalent species (76.06%). Pork intake >50 g/d (OR=1.615, 95% CI: 1.017-2.565, P=0.042) and hospitalization within 3 months (OR=11.551, 95% CI: 2.153-61.963, P=0.004) were risk factors for optrA-positive Enterococcus colonization in the healthy human intestines.  Conclusions  optrA-positive Enterococcus have been already widespread in the human intestines in Shenzhen, and these bacteria may spread to humans through the food chain. Meanwhile, hospitalization will increase the risk of optrA-positive Enterococcus colonizing in the healthy hunman intestines.
Relationship between creatinine clearance rate and simple renal cysts: a nested case-control study
MA Zhi-bin, QUAN Pei-qin, YANG Chao, DOU Feng, DU Hong-mei, LI Jian-jian, ZHAO Yi-ni, BAI Ya-na, REN Xiao-wei, HU Xiao-bin
2022, 26(11): 1315-1320. doi: 10.16462/j.cnki.zhjbkz.2022.11.013
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  Objective  To explore the correlation between baseline creatinine clearance rate (Ccr) and follow-up of simple renal cysts (SRCs) in Jinchang cohort population, and to provide a scientific basis for the prevention and treatment of SRCs.  Methods  Based on the Jinchang cohort, nested case control method was used in this study, the subjects included 859 cases of SRCs and 859 controls matched according to follow-up time, age, gender and hypertension. The association between baseline Ccr and follow-up of SRCs was analyzed by univariate and multivariate conditional logistic regression models respectively, and the OR with 95% CI values were calculated. Then the dose-response relationship between baseline Ccr and follow-up of SRCs was analyzed by using restrictive cubic spline.  Results  After adjusting for confounding variables, compared to the interval with baseline Ccr higher than 80.00 mL·min-1·1.73m-2, the result of multivariate conditional logistic regression showed that the risk of SRCs in the interval with baseline Ccr lower than 60.00 mL·min-1·1.73m-2 and interval with baseline Ccr between 60.00- < 70.00 mL·min-1·1.73m-2 was 2.10 times [95% CI: 1.13-3.89)], and 1.57 times [95% CI: 1.03-2.39)], respectively. The results of restricted cubic spline showed that there was an inverse nonlinear dose-response relationship between baseline Ccr and follow-up of SRCs in the Jinchang cohort population.  Conclusions  Low creatinine clearance is an independent risk factor for SRCs, and when the baseline Ccr was lower than 80.00 mL·min-1·1.73m-2, the risk of SRCs in the Jinchang cohort population increased with the decrease of Ccr.
A study on the correlation between chronotype and quality of life among medical college students
CHANG Wei-wei, CHANG Wan-yu, ZHU Li-jun, WEN Li-ying, ZHOU Meng-jie, CHANG Xin, TONG Xin, JIN Yue-long
2022, 26(11): 1321-1325. doi: 10.16462/j.cnki.zhjbkz.2022.11.014
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  Objective  This paper aims to understand the current situation of the quality of life of medical college students and to explore the relationship between chronotype and quality of life, to provide a scientific basis for improving the health level of medical college students.  Methods  A questionnaire survey was conducted among 2 400 medical students in a medical college using Morningness-Eveningness Questionnaire 19 (MEQ-19) and Short Form 36 (SF-36).  Results  The total score of quality of life of medical students was (75.20 ±14.54) points, the scores of physical component summary (PCS) and mental component summary (MCS) were (81.19±15.50) points and (69.21±16.82) points, respectively. The score of mental health (MH) was the lowest (64.61±16.06) points. Multiple linear regression analysis showed that the PCS score (after adjustment: β=-3.478, t=-5.169, P < 0.001) and MCS score (after correction: β=-4.357, t=-6.030, P < 0.001) of quality of life among medical students whose sleep rhythm tends to be evening types were lower than that of neutral types.  Conclusions  The quality of life of medical students is not high, especially in the field of mental health. The quality of life of medical students whose sleep rhythm tends to be evening types is low. The school should strengthen the management of rest time to improve the quality of life among medical students.
Study on the relationship between reduced short-term memory and peripheral blood Aβ1-42 protein concentration in occupationally people who were exposed to 50 Hz power frequency electromagnetic field
BIAN Hong-ying, ZHANG Yao, WANG Yan, DONG Yi-wen, YE Meng
2022, 26(11): 1326-1331. doi: 10.16462/j.cnki.zhjbkz.2022.11.015
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  Objective  To study the relationship between reduced short-term memory and peripheral blood Aβ1-42 protein concentration induced by a 50 Hz power frequency electromagnetic field.  Methods  Fifty-one thermal power plant electrical operators were selected as the exposure group, and twenty-six administrative staffs of the same plant were selected as the control group. Both groups were tested for short-term memory, and the concentration of Aβ1-42 protein in peripheral blood was measured simultaneously. The correlation between the two groups was compared.  Results  The 8 h time-weighted average intensity of the exposed group was 1.690 kV/m, and the magnetic field intensity was 4.578 μT. In the control group, the average electric field strength was 0.008 kV/m, and the magnetic field strength was 0.026 μT for 8h time-weighted average electric field intensity. The digit span score of the two groups in the exposed group was significantly lower than that in the control group (t=3.702, P < 0.001); the incidence of autonomic symptoms of insomnia (15.69%) and memory loss (21.57%) in the exposed group was significantly higher than the control group (all P < 0.05); the scores of three emotional state indicators in the exposed group were significantly lower than those in the control group, which incllding anger-hostility (t=2.239, P=0.028), fatigue-inert (t=2.024, P=0.047), and confusion-confusion (t=2.489, P=0.015); Aβ1-42 protein concentration in peripheral blood (pg/mL) with significantly higher in exposure group when compared to the control group (t=-2.414, P=0.018). No correlation was found between digital span scores and changes in Aβ1-42 protein concentration (r=-0.173, P=0.133).  Conclusions  50 Hz power frequency electromagnetic field can cause short-term memory impairment in the occupational population and change the concentration of Aβ1-42 protein in peripheral blood. However, the causal relationship between them needs further study.
Analysis of prevalence and determinants of chronic obstructive pulmonary disease in rural Yunnan Province based on structure equation modeling
LIU Lan, WANG Xu-ming, LI Jin-bo, MO Yi, LI Guo-hui, HUANG You, LI Qin, ZUO Mei, CAI Le
2022, 26(11): 1332-1338. doi: 10.16462/j.cnki.zhjbkz.2022.11.016
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  Objective  The aim of this study was to analyze the prevalence and determinants of chronic obstructive pulmonary disease (COPD) in rural areas of Yunnan Province.  Methods  The multi-stage stratified random sampling method was used to conduct on-site questionnaire survey and physical examination among 7 572 rural residents aged ≥35 years from three counties in Yunnan Province. Principal component analysis was used to construct individual socioeconomic status (SES). Structure Equation Modeling (SEM) was used to analyze possible influencing factors of prevalence of COPD.  Results  Among the study population, the prevalence of COPD was 12.60%. Males had a significantly higher prevalence of COPD than females (15.54% and 9.73%, χ2 =57.973, P < 0.001). Prevalence of COPD increased with age (χtrend2=165.616, P < 0.001). Ethnic minority groups had a higher prevalence of COPD than Han majority (χtrend2=33.785, P < 0.001). Individuals with lower SES had a higher prevalence of COPD than their counterparts (χ2 =10.751, P < 0.001). The results of SEM analysis indicated that the following associated factors had both direct and indirect statistically significant effect on prevalence of COPD: gender (0.09), age (0.15), ethnicity (0.06), and SEP (-0.05) had both direct and indirect effects on prevalence of COPD, whereas family history of COPD (0.06), low BMI (0.03), current smoking (0.08), and passive smoking (0.08) only directly associated with prevalence of COPD.  Conclusions  The prevalence of COPD is high in rural Yunnan Province. Future health education and intervention to prevent and control COPD should focus on males, elderly people, current smokers, individuals with low BMI, and individuals with family history of COPD and low SES.
Epidemiological characteristics of street-crossing distraction among pedestrians at road intersections in Changsha City based on video-taping
NING Pei-shan, HU Guo-qing
2022, 26(11): 1339-1343. doi: 10.16462/j.cnki.zhjbkz.2022.11.017
Abstract(228) HTML (109) PDF(36)
Abstract:
  Objective  To analyze the incidences and epidemiological characteristics of common types of street-crossing distraction among pedestrians in Changsha City.  Methods  Multi-stage random sampling was used to obtain study objects. Video-taping and artificial transcription were used to obtain the data of common types of distraction and their characteristics (including frequency and duration of distraction) among street-crossing pedestrians at 20 road intersections in Changsha. Chi-square test, Cochran-Armitage trend test, and Kruskal-Wallis H test were used for statistical analysis.  Results  A total of 25 436 pedestrians aged 20 years and older were observed, with distraction incidence of 34.32%. Females, pedestrians aged 20- < 40 years and appeared in the afternoon and weekend had higher incidences of distraction than males, other age groups, and appeared in the morning and weekday (all P < 0.05). Mobile phone use, the incidences of talking with other pedestrians, and eating/drinking/smoking were 11.06%, 19.62%, and 2.13%, respectively. One to two times was the most common frequency among three types of distraction. The median of total duration of distraction for talking with other pedestrians (10.0 s) was higher than mobile phone use (9.0 s) and eating/drinking/smoking (8.0 s).  Conclusions  Street-crossing distraction was prevalent among pedestrians at road intersections in Changsha City. Talking with other pedestrians and mobile phone use were the most prevalent type of distraction. The frequency and duration of distraction differed significantly among different types of distraction.
Review
Strategy for COVID-19 vaccination for patients with tuberculosis during the COVID-19 pandemic
WANG Yuan-zhou, JIA Si-yue, ZHU Feng-cai, LI Jing-xin
2022, 26(11): 1344-1348. doi: 10.16462/j.cnki.zhjbkz.2022.11.018
Abstract(489) HTML (294) PDF(42)
Abstract:
The pandemic of COVID-19 is still rampaging all over the world, so it is urgent to popularize vaccination. Meanwhile, pulmonary tuberculosis is one of the chronic infectious diseases with a high incidence in China. Since these diseases all occur in lung tissue, patients with TB and COVID-19 co-infection show more serious conditions and poorer treatment effects. However, we have limited knowledge about the protective efficacy, immunogenicity and safety of COVID-19 vaccine in patients with TB at present, with a lack of corresponding evidence-based medicine as well. Therefore, this paper reviews the pathogenesis and epidemiology of TB, discusses the immune status of patients with TB and summarizes the existing proposals for vaccination of patients with TB at home and abroad. Furthermore, we analyze the existing clinical trials in TB patients and other special populations, and finally discuss the strategy of vaccination for patients with TB during the COVID-19 pandemic and the necessity of clinical research on COVID-19 vaccines with target population of TB patients.
Short Reports
Analysis on the factors that influence the treatment outcome of students with pulmonary tuberculosis in Qinghai Province
MA Bin-zhong, LI Er-chen, JIANG Ming-xia, WANG Zhao-cai, WEI Yu-jia
2022, 26(11): 1349-1352. doi: 10.16462/j.cnki.zhjbkz.2022.11.019
Abstract(350) HTML (166) PDF(34)
Abstract:
  Objective  This paper analyzes the current situation and influencing factors of the treatment outcome of students with pulmonary tuberculosis in Qinghai Province, and provides a basis for improving the tuberculosis prevention and control strategy in schools.  Methods  Through collect the epidemiological information of students with PTB in Qinghai Province from 2015 to 2019, this paper analyzed and described the current status of treatment outcome, and analyzed the relevant factors affecting the outcome by constructing a binary logistic regression model.  Results  The success rate of treatment of students with PTB was 89.08%, and was rising year by year (χ2 =120.630, P < 0.001). The difference in the success rate of students patients who lives in different regions was statistically significant (χ2 =67.866, P < 0.001). The multivariate analysis showed that ethnic minorities, delayed visits, re-treatment and non-full-course supervision management were risk factors affecting the outcome of treatment.  Conclusions  The success rate of the treatment of students with PTB is relatively high, but due to a variety of factors, it should be paid more attention to and effective measures should be taken for further improvements.
Analysis of the prevalence trend of drug resistance among high risk population of multi drug resistant-tuberculosis in Wuhan from 2007 to 2020
WANG Jian-jie, ZHOU Mei-lan, REN Xin, WU Gang, ZHANG Zheng-bin, TIAN Dan, WANG Xiao-jun, LI Yue-hua
2022, 26(11): 1353-1359. doi: 10.16462/j.cnki.zhjbkz.2022.11.020
Abstract(482) HTML (200) PDF(31)
Abstract:
  Objective  To retrospectively analyze the drug resistance prevalence trend of drug resistance-tuberculosis(DR-TB) high-risk populations in Wuhan from 2007 to 2020.  Methods  From January 1, 2007 to December 31, 2020, a total of 5 139 at risk individuals of DR-TB newly registered in Wuhan were screened. By carrying out a descriptive study, χ2 test and multivariate unconditional logistic regression, the prevalence trend and influencing factors of drug resistance were analyzed.  Results  The overall drug resistance rate among these individuals was 35.51% (1 600/4 506). The ranking of resistance rates of six different anti-TB drugs was as following, Isoniazid (H)>Rifampin (R)>Streptomycin (S)>Ofloxacin (O)>ethambutol (E)>Kanamycin (K). From 2007 to 2020, except the O resistance rate, the overall drug resistance rate, multidrug resistance rate, drug resistance rates of H, R, E, S and K showed an upward trend (R resistance rate: P=0.002, all the others have P < 0.001). From 2015 to 2020, except an upward trend was observed in R resistance rate (P=0.002), the overall drug resistance rate, multidrug resistance rate and drug resistance rates of H, E, S, O and K remained stable.  Conclusions  From 2007 to 2020, an upward trend of drug resistance among Wuhan's DR-TB at risk populations was observed. Although no upward trend was observed in the period between 2015 and 2020, further strengthening of management and control of such groups is still urgently needed.
Study on the correlation between the incidence of human brucellosis and natural and social factors in Northwest China
WANG Ying, GUO Wei-quan, XIANG Yuan-yuan, BAO Kai, GAO Wen-long
2022, 26(11): 1360-1364. doi: 10.16462/j.cnki.zhjbkz.2022.11.021
Abstract(227) HTML (248) PDF(45)
Abstract:
  Objective  To describe the epidemiology of Brucellosis in northwest China and to explore the association of incidence with natural and social factors.  Methods  The national surveillance data of brucellosis from 2004 to 2015, the report data of brucellosis from five Provinces in Northwest China from 2004 to 2015 and the data of natural and social factors were collected to describe the temporal distribution characteristics of brucellosis. The principal component regression analysis was used to explore the influence of various factors on the incidence of brucellosis.  Results  From 2004 to 2015, the incidence of brucellosis in northwest five Provinces increased year by year, and was higher than the national level. The incidence peak was from May to August every year. The total value of livestock production, regional GDP and the yield of beef and milk were positively correlated with the incidence of disease, while the number of cattle at the end of the period was negatively correlated with the incidence of disease.  Conclusions  The incidence of brucellosis in Northwest China is higher than that in the same period of the country. Social factors such as regional GDP, the total value of livestock production, beef and milk production have an impact on the incidence of brucellosis. Prevention and control of brucellosis as early as possible in spring and summer warm season and control of breeding scale are of great significance for the control of brucellosis epidemic.

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