中华疾病控制杂志

Risk and influencing factors of HIV infection among adolescent men who have sex with men based on trajectory model

TIAN Jia-wei, HUANG Dan-qin, WEI Li-qing, JIANG Qing-qing, ZHAI Meng-xi, ZHU Biao, GUO Meng-lan, YIN Xiao-hong, LIAO Yu, YU Bin, YAN Hong

2022, 26(12): 1365-1370. doi: 10.16462/j.cnki.zhjbkz.2022.12.001

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Objective To explore the trajectory of HIV infection risk among young men who have sex with men (YMSM), and to analyze associated factors of HIV infection risk. Methods A dynamic cohort among YMSM was conducted in Hubei, Hunan and Jiangxi Provinces. The group-based trajectory model (GBTM) was used to explore the trajectory of HIV infection risk of YMSM, and the generalized estimation equation (GEE) was performed to analyze the risk factors related to HIV infection. Results A total of 460 HIV-negative YMSM were included in the cohort from September 20, 2017 to January 21, 2018. Three groups were identified by GBTM, including low-risk group, medium-risk group and high-risk group. The YMSM were in the group with higher risk, the lower the age at which they first had sex debut, and the higher proportion of rural residents (all P < 0.05).The results of GEE showed that the age of sexual debut, depression, sexual minority stigma and resilience were associated with HIV infection risk (all P < 0.05). Conclusions YMSM were generally at the risk of HIV infection, and those who with high level of stigma were at a higher risk of HIV infection. Importance should be attached to the mental health of YMSM.

Research on incident diabetes among HIV/AIDS receiving antiretroviral therapy in Dehong Dai and Jingpo Autonomous Prefecture

YE Run-hua, SHI Rui-zi, CAO Dong-dong, YAO Shi-tang, TANG Ren-hai, GAO Jie, XIANG Li-fen, YANG Yue-cheng, WANG Ji-bao, DING Ying-ying, HE Na, DUAN Song

2022, 26(12): 1371-1378. doi: 10.16462/j.cnki.zhjbkz.2022.12.002

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Objective To estimate the cumulative incidence and risk factors of diabetes among HIV/AIDS patients receiving antiretroviral therapy (ART) in Dehong Dai and Jingpo autonomous prefecture (Dehong), Yunnan Province. Methods HIV/AIDS patients without diabetes at baseline (Jul 2017 to Jun 2018) were followed from Jan. 2021 to June 2021. Data of participants were extracted from the National HIV/AIDS antiretroviral therapy database in China. All participants underwent hemoglobin A1c (HbA1c) testing. Diabetes was defined as follow-up HbA1c≥6.5% or the most recent FPG≥7.0 mmol/L. Logistic regression analysis was conducted to evaluate the risk factors of diabetes among HIV/AIDS patients. Results A total of 3 647 HIV/AIDS patients were included in this study, with 51.4% being male and median age of 42 (36, 49) years old. Anti-HCV antibodies were detected in 21.5% of participants. The median time since HIV diagnosis and duration on ART were 12.1 (9.3, 14.6) and 9.3 (7.6, 12.2) years, respectively. The 3-year cumulative incidence of diabetes, HbA1c≥6.5% and PFG≥ 7.0 mmol/L were 6.0%, 2.5% and 5.3%, respectively. Multivariate logistics regression analysis showed that baseline age of ≥50 years, male, HCV-coinfection, elevated TG at baseline, baseline HIV viral load of > 50 copies/ml, baseline use of efavirenz (EFV) were significantly associated with higher risk of incident diabetes. (All P < 0.05). Conclusions HIV/AIDS patients receiving ART in Dehong prefecture are at high risk of diabetes, underscoring needs of targeted prevention and intervention programs in this population.

Influencing factors on the death of HIV/AIDS patients receiving antiretroviral therapy in Anhui Province

DAI Se-ying, LIU Ai-wen, SHEN Yue-lan, CHENG Xiao-li, ZHANG Jin, WU Jian-jun, WU Jia-bin, XING Hui, RUAN Yu-hua

2022, 26(12): 1379-1383. doi: 10.16462/j.cnki.zhjbkz.2022.12.003

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Objective To understand the influencing factors on the death of HIV/AIDS patients receiving antiretroviral therapy in Anhui Province. Methods A 1 to 2 matched case-control study was conducted to collect the information of HIV/AIDS patients who received antiretroviral therapy in Anhui Province from 2010 to 2019. The conditional logistic regression was used to analyze the risk factors on the death of HIV/AIDS patients. Results A total of 4 347 HIV/AIDS patients were investigated, with 1 449 cases in the death group and 2 898 cases in the control group. The multivariate conditional logistic regression result showed that among the death risk factors, drug resistance was 1.75 times (95% CI: 1.22-2.52, P=0.003) than that of non-drug resistance; the latest viral load ≥1 000 copies/mL and non-drug resistance tested results were 2.26 times (95% CI: 1.69-3.03, P < 0.001) than that of non-drug resistance; non-viral load and non-drug resistance tested results were 35.27 times (95% CI: 26.54-46.87, P < 0.001) than that of non-drug resistance; patients who age 30-49 years old was 1.40 times (95% CI: 1.01-1.94, P=0.042) than that of the 18-29 years old, and those age ≥ 50 years old was 4.02 times (95% CI: 2.80-5.77, P < 0.001) that of 18-29 years old; male was 1.37 times (95% CI: 1.08-1.74, P=0.011) than that of female, the transmission route of injecting drug use was 6.27 times (95% CI: 2.00-19.61, P=0.002) than that of heterosexual transmission; WHO clinical stage Ⅲ/Ⅳ before treatment was 1.41 times (95% CI: 1.12-1.76, P=0.007) than that of stage Ⅰ/Ⅱ; CD4⁺T lymphocyte count < 200 cells/μL before treatment was 1.95 times (95% CI: 1.50-2.54, P < 0.001) that of CD4⁺≥350 cells/μL before treatment. Conclusions Drug resistance, drug resistance test after antiretroviral therapy, age, gender, transmission route, WHO clinical stage before treatment, and CD4⁺T lymphocyte counts before treatment were the influencing factors of HIV/AIDS death in Anhui Province. Strengthening the monitoring of drug resistance for HIV/AIDS patients is important for reducing AIDS deaths. It is necessary to test viral load and drug resistance in time for HIV/AIDS patients receiving antiretroviral therapy.

Spatial clustering of HIV/AIDS cases aged 50 years and above in Chengdu from 2010 to 2020

SHI Ya-ying, CHEN Si-qi, HE Qin-ying, DUAN Zhen-hua, XI Jing, ZHU Yan-feng

2022, 26(12): 1384-1388. doi: 10.16462/j.cnki.zhjbkz.2022.12.004

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Objective To explore the spatial clustering characteristics and trends of AIDS among HIV/AIDS cases aged 50 years and above in Chengdu from 2010 to 2021. And to provide a reference basis for regionalised prevention and control of AIDS. Methods HIV/AIDS cases aged 50 years or above in Chengdu between 2010 and 2020 were selected from China information system for disease control and prevention, and descriptive analysis was carried out. Moreover, spatial and temporal autocorrelation and spatial aggregation analyses were conducted using ArcGIS 10.6 software. Results The average annual growth rate was 28.95% over the last 11 years among HIV/AIDS cases aged 50 years and above in Chengdu. Of 50.07% AIDS aged 50 years and above have only received primary education, 63.00% were unmarried. 61.98% of cases were farmers. Heterosexual transmission accounts for 95.72% of cases. HIV/AIDS cases were in a pattern of aggregative distribution. Areas of high-high case were clustering over time. In northern region, high-high aggregation areas gradually spreads from two districts in the west eastwards to four districts and southwards to two adjacent districts. However in southern region high-high aggregation areas spreads from three districts to four adjacent districts. Conclusions The spatial distribution of HIV/AIDS cases among aged 50 years and above in Chengdu is not random, and there is spatial clustering. The high-value clustering area gradually develops from central northern regions of Chengdu to central and eastern regions.

Distribution of HIV-1 genotypes and its association with first CD4⁺T lymphocytes among HIV-infected men aged 50 and over newly reported in Guangxi in 2020

LI Jian-jun, CHEN Yan-lan, GE Xian-min, CEN Ping, LAN Guang-hua, YANG Shi-xiong, LIANG Shu-jia, TANG Kai-ling, FANG Ning-ye, PANG Xian-wu, HE Qin, LIN Zhao-sen, GUO Wei-gui, DENG Xin-hui, FENG Xian-xiang, ZHOU Li-fang, HUANG Yun-xuan, YANG Dong, MO Jing-lin, ZHONG Jian, MO Hong-zhi, NONG Ai-dan, LIANG Xu, QIN Xi-mao, MO Shi-de, ZENG Zi, LUO Liu-hong, CHEN Huan-huan, ZHU Qiu-ying, ZHU Jin-hui, LU Hua-xiang, MENG Qin, LIU Shuai-feng, LI Bo

2022, 26(12): 1389-1394. doi: 10.16462/j.cnki.zhjbkz.2022.12.005

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Objective To analyze the compositional characteristics of HIV-1 genotype among HIV-infected men aged 50 and over (referred to as middle-aged and elderly men) newly reported in Guangxi in 2020, and to analyze the association between different genotypes and the CD4⁺ T lymphocyte(referred to as CD4) count at HIV diagnosis. Methods The stratified random sampling method was used to select middle-aged and elderly male HIV-infected patients in 2020 newly reported in 14 cities in Guangxi as the research subjects, and the plasma of infected patients was subjected to viral RNA extraction, reverse transcription amplification, sequencing, HIV-1 genotype and sub-cluster determination. A multivariate model was used to evaluate possible statistically associated influencing factors of CD4 counts. Results A total of 606 HIV-infected patients were included and analyzed, and the main circulating strains were CRF01_AE, CRF07_BC and CRF08_BC, and their proportions were 57.6%(349/606), 17.2%(104/606) and 22.1%(134/606) respectively, and the medians of their first CD4 at diagnosis were 145(51, 271), 212(110, 330) and 178(100, 307) cells/μL, respectively. The first CD4 count at diagnosis of CRF01_AE infected patients was lower than that of CRF07_BC infected patients(Z=-3.363, P=0.002), and lower than that of CRF08_BC infected patients(Z=-2.983, P=0.009). Binary logistic regression model showed that CRF01_AE was an independent risk factor for CD4 ≤200 cells/μL among newly reported middle-aged and elderly men with HIV infection in Guangxi(aOR=1.453, 95% CI: 1.047-2.017). Conclusions CRF01_AE, CRF07_BC and CRF08_BC are the three main circulating strains of HIV infection among middle-aged and elderly males newly reported in Guangxi in 2020, and major in CRF01_AE. CRF01_AE is an independent risk factor for CD4 ≤200 cells/μL, suggesting that the disease progresses rapidly in middle-aged and elderly men with CRF01_AE strain, which is more harmful to the HIV/AIDS epidemic in Guangxi.

Analysis of willingness and influencing factors of on-campus free condom using among college students in Shanghai

ZHAN Chun-lin, ZHOU Hai-wang, LI Hao-bo, XIA Wen-rong

2022, 26(12): 1395-1401. doi: 10.16462/j.cnki.zhjbkz.2022.12.006

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Objective To investigated the willingness and influencing factors of on-campus free condoms using among college students in Shanghai, and protecting the reproductive health of college students, as well as provide a scientific basis for improving national "Free contraceptive services". Methods A cross sectional survey was conducted. A total of 14 612 college students of various degreess in 62 colleges in Shanghai was selected as participants. And their usage and personal perceptions were analyzed. Multivariate logistic regression was used to analyze the influencing factors of willingness to use on-campus free condoms. Results A total of 3 594 who had sex were investigated, including 981 who had willingness to use on-campus free condoms, with the utilization rate of 27.30%. 320 had used on-campus free condoms including, with the utilization rate of 9.04% in 3 538 valid respondents. Logistic regression analysis demonstrated that gender, condoms used or not, on-campus free condoms used or not, the daily cost of condoms, and the evaluation of on-campus free condoms(all P < 0.001) were statistically significant in relation to influencing factors of the on-campus free condom using willingness. Men (OR=1.412, 95% CI: 1.001-1.189), those who had used on-campus free condoms (OR=2.079, 95% CI: 1.114-1.522), those who had higher evaluation of on-campus free condoms lower daily cost of condoms had higher willingness. Ensuring quality and increasing publicity were the main measures to improve the attractiveness of on-campus free condoms. Conclusions The quality and the distribution of free condoms should be improved to increase the recognition and acceptance of free condoms to achieve an effective supply of national "Free contraceptive services" on campus.

Trend analysis of COVID-19 incidence and death series based on Bayesian change point model

HE Na-na, ZHAO Hang, SUN Jin-fang, YU Xiao-jin

2022, 26(12): 1402-1406. doi: 10.16462/j.cnki.zhjbkz.2022.12.007

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Objective To analyze the trend of COVID-19 based on the trend analysis of incidence and mortality data and provide analysis strategies for similar epidemiological researches. Methods We used the Bayesian change point analysis model to obtain the time series change points based on the number of cumulative confirmed and cumulative death cases of COVID-19 from January 23, 2020 to March 18, 2020 in Chinese mainland. Interrupted time series (ITS) method was applied to build a segmented linear regression (SLR) model, evaluating the consistency of trends in the series with the intervention or policy. Results There were 3 change points in cumulative confirmed cases and deaths in Wuhan, and 4 change points in cumulative confirmed cases and deaths in Hubei Province (except Wuhan) and Chinese mainland (except Hubei Province). The changes in the number of cumulative confirmed cases in Wuhan after 3 change points were 1 493.885 (P < 0.001), 2 444.913 (P < 0.001) and -4 061.038 (P < 0.001), respectively. The number of cumulative deaths after the second and third change points were -66.917 (P < 0.001) and -19.845 (P=0.034), respectively. The increase in the number of cumulative confirmed cases in Hubei Province (except Wuhan) began to decrease after the third change point, and the change is -845.244 (P < 0.001). The the increase in the number of cumulative deaths decreased after the third and fourth change points, and the slope changes were -10.062 (P < 0.001) and -12.245 (P < 0.001), respectively. The increase in the number of cumulative confirmed cases in Chinese mainland decreased from the second change point, and the changes were -281.494 (P < 0.001), -295.080 (P < 0.001), -145.054 (P < 0.001), respectively. The statistically significant decrease in the increase of cumulative deaths appeared in the third and fourth change points, and the slope changes were -3.199 (P < 0.001) and -1.706 (P < 0.001), respectively. Conclusions The combination of interrupted time series analysis with Bayesian change point analysis can consider the uncertainty of time series trend changes, and provide a basis for epidemiological analysis of infectious diseases and evaluation of prevention and control measures.

The rising trend of severe fever with thrombocytopenia syndrome: based on the data of reported cases in Nanjing from 2015 to 2020, China

MA Tao, ZHANG Min, DU Xue-fei, WANG Jun-jun, WANG Heng-xue, XU Qing, ZHOU Qin-yi, ZHENG Ying, LIN Dan, HONG Lei, LIU Kun

2022, 26(12): 1407-1413. doi: 10.16462/j.cnki.zhjbkz.2022.12.008

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Objective To understand the reported incidence trend and epidemic characteristics of severe fever with thrombocytopenia syndrome (SFTS) in Nanjing, exploring the critical prevention and control population, areas, and influencing factors, and providing scientific basis for guiding the formulation of prevention and control strategies, measures and carrying out scientific intervention actions. Methods The reported incidence trend and characteristics of seasonal distribution, population distribution and spatial distribution of SFTS in Nanjing from 2015 to 2020 were described. Global spatial autocorrelation analysis, local spatial autocorrelation analysis, and FleXScan spatial clustering scans were used to explore the spatial heterogeneity and spatial cluster at the town/street level. Results There were 194 SFTS reported confirmed cases. The annual average reported incidence was 0.39/100 000 (0.13/100 000 to 0.86/100 000), and the annual percent change (APC) was 33.43% (95% CI: 5.41 to 68.89, P=0.03). Seventy-three cases were reported in 2020, with an increased rate of 115% when compared to 2019 (39 cases). Among all reported cases, 79.38% were from May to August, and the peak was in July which accounted for 28.87%. The median age was 64 (54, 71) years, of 64.43% were aged 60 or above, and the group of 45- < 60 years was accounted for 27.32%. In terms of occupations, the proportion of farmers was 61.34%, household and unemployed workers was 12.89%, and for retirees was 11.34%. The number of reported cases in Lishui District accounted for 46.39%. Moran's I for global spatial autocorrelation analysis was 0.58 (Z=9.97, P=0.001). Additionally, local spatial autocorrelation analysis and FleXScan spatial clustering scans showed that Seven towns/streets in Lishui District except Hefeng Town and Hengxi Street in Jiangning District were first cluster areas (LLR=150.24, P=0.001). And secondary cluster areas were Jiangpu Street, Qiaolin Street, and Xingdian Street in Pukou District (LLR=17.81, P=0.001). Conclusions The trend of reported incidence of SFTS in Nanjing rise. The critical populations are those ages 45 and older and farmer. Besides, Lishui District would be critical prevention and control area. It is suggested to carry out monographic research which based on risk factors and trend judgement in time, and strengthen and implement comprehensive prevention and control interventions at the same time.

Correlation analysis of high visceral adiposity index and hyperuricemia

ZHANG Shao-jie, QIN Xian-hui, LI You-bao, ZANG Tong-hua, XU Xi-ping, WANG Bin-yan

2022, 26(12): 1414-1419. doi: 10.16462/j.cnki.zhjbkz.2022.12.009

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Objective The relation between visceral adiposity index (VAI) and new-onset hyperuricemia remains largely understudied. This study seeks to further investigate the association between VAI and the risk of hyperuricemia by examining possible effect modifies in hypertensive patients. Methods A total of 10 513 hypertensive patients with normal uric acid (UA) concentrations [ < 357 μmol/L (6 mg/dL)] who participated the UA Sub-study of the China Stroke Primary Prevention Trial (CSPPT) were enrolled. Our primary outcome was new-onset hyperuricemia, which was defined as a UA concentration ≥417 μmol/L (7 mg/dL) in men or ≥357 μmol/L (6 mg/dL) in women at the exit visit. Results Over a median follow-up of 4.4 years, 1 642 (15.6%) participants developed new-onset hyperuricemia. When VAI was assessed as quartiles, a significantly higher risk of new-onset hyperuricemia was found in participants in quartile 4 (≥2.98; OR: 1.17; 95% CI: 1.01-1.36) compared with those in quartile 1-3 (< 2.98). Furthermore, the positive relation was independent of abnormal VAI components or numbers of abnormal VAI components (all P_interactions > 0.05). Conclusions There is a positive relationship between baseline VAI and the risk of new-onset hyperuricemia in a sample of Chinese hypertensive individuals.

A prospective cohort study on the relationship between hyperuricemia and fatty liver

DUAN Qiong, ZHANG Zi-xing, XU Juan, HONG Wen-qing, ZHOU Cheng, XU Xi-hai, FANG Xin-yu

2022, 26(12): 1420-1425. doi: 10.16462/j.cnki.zhjbkz.2022.12.010

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Objective The study aims to probe the relationship between hyperuricemia (HUA) and the risk of the fatty liver through a prospective cohort study, so as to provide the basis for the prevention and treatment of fatty liver. Methods Based on the Inflammatory and Immune Mediated Diseases Cohort, a total of 16 322 subjects who had completed at least two follow-ups from 2017 to 2021, had no missing key indicators related to the study and fatty liver at baseline were investigated. Cox proportional hazard model was used to analyze the relationship between HUA and the risk of fatty liver. Model 1 was a univariate Cox analysis, model 2 adjusted age, sex and BMI, and model 3 further adjusted hyperglycemia, hypertension, urea nitrogen, creatinine, total bilirubin, AST, ALT and dyslipidemia. Results The subjects were followed up for 42 472.75 person-years, with an average follow-up time of 2.60 years. There were 3 150 incidence cases of fatty liver, with an incidence density of 74.17/1 000 person-years. Cox proportional hazard model analysis showed that the risk of fatty liver was higher in HUA group. The hazard ration(HR) of the three models were 2.049(95% CI: 1.861-2.256), 1.360(95% CI: 1.233-1.501) and 2.049(95% CI: 1.861-2.256) respectively. After stratification of hyperglycemia, hypertension, dyslipidemia and other factors, HUA was still positively associated with the risk of fatty liver (all P < 0.05). In the multiplication model, significant multiplier interactions were found between BMI (P=0.003), hypertension (P=0.012) and HUA. Conclusions HUA is an independent risk factor for fatty liver. The timely intervention of HUA can reduce the occurrence of fatty liver or delay the progress of fatty liver. Our study provides reference for the clinical prevention and treatment of fatty liver.

The effect of chronic disease, disability, and dementia on all-cause mortality among older adults in China: a population-based prospective cohort study

HU Xi-yuan, GUO Chao

2022, 26(12): 1426-1432. doi: 10.16462/j.cnki.zhjbkz.2022.12.011

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Objective To analyze the effects of chronic diseases, disability, and dementia on all-cause mortality among older adults in China using a prospective population-based cohort study. Methods Based on 13 540 older adults aged 65 years and above from the Chinese Longitudinal Healthy Longevity Survey, the Cox proportional hazard model was used to analyze the relationship between chronic diseases, disability as well as dementia, and all-cause mortality. Results The median survival time of older adults aged 65 years old and above was 5.75(2.33. 13.00) years. After adjusting for confounders, cancer respondents had a 50% risk of mortality than those without cancer (HR=1.50, 95% CI: 1.16-1.94), while the relationship between noncancerous chronic disease and mortality risk was not statistically significant. With a view to a disability, the mortality risk increased by 40% in subjects with activities of daily living (ADL) restriction than in those without ADL restriction (HR=1.40, 95% CI: 1.32-1.47). In terms of cognitive ability, subjects with cognitive impairment had a 30% higher risk of mortality than those without cognitive impairment (HR=1.30, 95% CI: 1.23-1.37), and those with dementia had a 26% risk of mortality than those without dementia (HR=1.26, 95% CI: 1.09-1.46). Conclusions During the past 20 years, the health factors associated with all-cause mortality risk among older adults in China are mainly cancer, ADL restriction, cognitive impairment, and dementia, suggesting that for the all-cause mortality risk of the older adults, compared with diseases, especially noncancerous chronic diseases themselves, the disability and dementia after suffering from diseases are particularly worthy of attention.

Study on factors influencing gut microbiota α diversity in the older people

YIN Zhao-xue, BAI Xue-mei, ZHANG Jing-rui, JIANG Yuan-jing, YAN Fei, MUKARAM·Yunus, GAO Xin, WU Jing

2022, 26(12): 1433-1437. doi: 10.16462/j.cnki.zhjbkz.2022.12.012

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Objective To explore factors influencing α diversity of gut micro-biota in the older people. Methods Stool samples were collected to extract gut microbiota DNA, 16Sr-DNA sequencing was conducted, and gut microbiota α diversity was analyzed. α diversity was categorized as 'High' or 'Low' according to the quantile of every indicator. Logistic regression models were run to analyze the potential factors that influencing gut microbiota diversity. Results Multivariate logistic regressions showed, compared with the lowest tertile group, OR(95% CI) of high Shannon index in the higher tertile group of refined grain and fruit intake was 0.57(0.37-0.88) and 2.03(1.27-3.24), respectively. Compared with the low group, the possibility of high Shannon index in the high group of pickle intake frequency declined, with OR of 0.45(0.26-0.78). Similarly with Shannon index, refined grain, pickles intake frequency, and fruit intake were all factors influencing the Simpson's index, as well as sex (P=0.028). Conclusions Increasing fruit intake may be beneficial for α diversity of gut microbiota, while intake of refined grain and pickles may be harmful in the older people.

Association between maternal iron nutrition during pregnancy and congenital heart disease in offspring based on a case-control study

YAN Ming-xin, ZHAO Dou-dou, PEI Lei-lei, ZHANG Ruo, QU Peng-fei, DANG Shao-nong

2022, 26(12): 1438-1444. doi: 10.16462/j.cnki.zhjbkz.2022.12.013

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Objective The study aims to explore the relationship between maternal iron nutrition during pregnancy and congenital heart disease (CHD) in offspring. Methods A matched case-control study was conducted in Shaanxi Province from January 2014 to December 2016, and a food frequency questionnaire was used to collect dietary nutrition during pregnancy among women. The conditional logistic regression model was adopted to examine the association between maternal iron nutrition during pregnancy and CHD and its subtypes in offsprings, and subgroup analysis was further performed to test results stability. Results After adjusting for confounding factors, maternal iron supplementation during pregnancy reduced the risk for CHD in offsprings (< 30 days: OR=0.54, 95% CI: 0.37-0.79; ≥ 30 days: OR=0.25, 95% CI: 0.16-0.38). Higher dietary iron intake during pregnancy (≥29mg/d) reduced the risk for CHD in offsprings (OR=0.69, 95% CI: 0.54-0.88). The subgroup analysis showed that the relationship between maternal iron nutrition during pregnancy and CHD was stable. In addition, the risk of ventricular septal defect (VSD), atrial septal defect (ASD), patent ductus arteriosus (PDA), and tetralogy of fallot (TOF) in the offspring was lower among mothers with iron supplementation ≥30 days during pregnancy. If the mothers supplemented iron less than 30 days, the risk for ASD in the offspring would reduce. The risk of VSD and PDA in the offspring was lower among mothers with a higher dietary iron intake during pregnancy (≥29mg/d). Conclusions The higher iron nutrition level of mothers during pregnancy is associated with the reduced risk for CHD in offspring. Pregnant women should ensure adequate iron intake during pregnancy to promote the health of mothers and babies.

The revision and evaluation of the Short Self-reported Adolescent Version of Autism Spectrum Quotient

HU Yan, FAN Yin-guang, WAN Yu-hui, SU Pu-yu, YE Dong-qing

2022, 26(12): 1445-1449. doi: 10.16462/j.cnki.zhjbkz.2022.12.014

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Objective To revise and evaluate the Short Self-reported Adolescent Version of Autism Spectrum Quotient (AQ-SSAV). Methods A total of 2 644 junior and senior high school students from Fuyang, Hefei and Wuhu City were selected by stratified cluster sampling. The questionnaire was revised from the perspectives of sensitivity, representativeness and internal consistency. Factor analysis was used to reduce the dimensions. The reliability and validity were also be evaluated. Results Through item analysis and factor analysis, AQ-SSAV was finally divided into 2 dimensions with 22 items in total. The cumulative contribution rate of variance was 52.29% on the 5 remained factors. The retest-reliability, Cronbach's α coefficient and split reliability coefficient of the total questionnaire were 0.752, 0.843 and 0.859, respectively. The average of all item-level content validity index on the scale was 0.98. The correlation coefficient between the total score of autistic trait and the total score of empathy was -0.329 (P < 0.001). Conclusion The AQ-SSAV meets the psychometric requirements and can be used to evaluate the autism traits in adolescents.

The current status of neglected tropical diseases and the coping strategy exploration of China

LIU Yi-yun, YANG Hai-tao, YANG Kun, HUANG Yu-zheng

2022, 26(12): 1450-1456. doi: 10.16462/j.cnki.zhjbkz.2022.12.015

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Neglected tropical diseases (NTDs), as a group of chronic infectious diseases, are common in tropical and subtropical countries or regions with underdeveloped economic and sanitary conditions. Patients are often ignored due to the limited access to health services, resulting in serious damage to health and even discrimination. With the development of globalization, the control and elimination of NTDs have become the consensus of all countries in the world. Based on the analysis of the global status of NTDs, this paper reviews the current prevention and control process, coping strategies and challenges of NTDs in China. Combined with China's participation in global health governance and foreign aid under the background of global NTDs prevention and control, this paper also summarizes relevant experience and practices, and provides reference.

A comparative study on elements of master of public health training programs at home and abroad based on the perspective of general system theory

WANG Dan-yang, LIU Ying, WANG Jian-ming, SHEN Hong-bing

2022, 26(12): 1457-1461. doi: 10.16462/j.cnki.zhjbkz.2022.12.016

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Objective Compare the programs of master of public health (MPH) in some representative universities at home and abroad. Analyze the core elements affecting the education quality, and provide suggestions and recommendations for the optimization of the MPH programs in China. Methods The MPH training programs and policies related to talent training of target institutions were collected through databases and official websites of institutions, and comparative analysis was conducted based on the system theory from five elements, including training objective, training mode, curriculum, professional practice, and performance evaluation. Conclusions (1) The overall design of the program should be competency-oriented, strengthen the synergy of all elements, and maintain the self-adjustment and development capability of the training system; (2) A curriculum system with course-type diversity, and interdisciplinary integration is an important foundation for cultivating compound and application-oriented high-level public health talents. Space for independent selection can be increased by setting curriculum modules to accommodate more diverse needs. Innovative teaching methods can be used so as to cultivate self-learning capabilities. (3) Practical ability is the focus of MPH training. The length of practice, practice areas and contents, and performance evaluation methods all contribute to ensure the quality of practical training.

Screen time and sleep status associated with emotional and behavioral problems in preschool children

CHEN Yao, ZHANG Lei, LI Si, SUN Lei, YU Wei-ping, TAO Fang-biao, WANG Lei

2022, 26(12): 1462-1467. doi: 10.16462/j.cnki.zhjbkz.2022.12.017

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Objective To study the impact of screen time and sleep status on emotional and behavioral problems in preschool children. Moreover, to explore the combined effect of screen time and sleep status on preschool children's emotional and behavioral problems. Methods From November to December 2017, a total of 2 946 preschool children aged 3-6 years in 8 kindergartens in Yangzhou were included. Information on screen behavior, sleep status, emotional and behavioral problems of children were obtained by questionnaire. Binary logistic regression model was used to analyze the effect of screen time and sleep status on emotional and behavioral problems in preschool children. Results After adjusting for confounding factors, preschool children with screen time >1 h/d had a higher risk of conduct problems, hyperactivity, peer problems, strengths and difficulties questionnaire (SDQ) difficulties (all P < 0.05). The risk of hyperactivity and peer problems were higher in preschool children with sleep time < 10 h/d (P < 0.05). And higher risk of emotional symptoms, conduct problems, hyperactivity, peer problems, and SDQ difficulties were associated with poor sleep quality (P < 0.001). Combined analysis showed that preschool children with sleep time < 10 h/d combined screen time >1 h/d had a higher risk of hyperactivity and SDQ difficulties (P < 0.05). And children with poor sleep quality combined screen time >1 h/d were more prone to have a higher risk of emotional symptoms, conduct problems, hyperactivity and SDQ difficulties (P < 0.001). Conclusion Screen time >1 h/d and poor sleep quality are more likely to have a negative impact on emotional and behavioral problems in preschool children.

Analysis of intestinal detoxication time and its influencing factors in norovirus infectious diarrhea

ZHANG Wei, GU Zi-hao, MAN Yun-xiang, CHEN Hong-biao, HUANG Xiao-yun, HE Shen-li

2022, 26(12): 1468-1472. doi: 10.16462/j.cnki.zhjbkz.2022.12.018

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Abstract:
Objective To study the regularity of norovirus intestinal detoxification and to find out the factors affecting norovirus intestinal detoxification time. Methods To collect and test the anal swabs of the people involved in three outbreaks of norovirus infectious diarrhea in Longhua district of Shenzhen City, and regularly monitor and calculate the detoxification period, to analyze the influence of detoxication period on clinical symptoms and basic characteristics. Results A total of 255 subjects, all of which were GII type, were monitored in 3 clusters of 91 subjects. After the suspension of classes (3-5 days after the outbreak), the virus infection rate reached its highest level, the detoxication time of infants was longer than that of adults (HR=0.235, P < 0.001), and the detoxication time of different groups was significantly different (H=8.528, P=0.014). The detoxication period of non-febrile patients was longer than that of febrile patients (HR=2.281, P=0.025). Conclusions There was no difference in the detoxification period between the patients with latent norovirus infection and the patients with latent norovirus infection, but the patients with latent norovirus infection had a longer detoxification period than the patients with latent norovirus infection.

Study on the phylogenetic relationship and epidemic characteristics of Tibetan sheep Yersinia pestis in Qinghai Plateau

XIONG Hao-ming, JIN Juan, XIN You-quan, HE Jian, YANG Xiao-yan, WANG Yu-meng, WANG Wen-long, LIU Zhong-kai, WEI Bai-qing, DAI Rui-xia, LI Wei, Zhang Qiang

2022, 26(12): 1473-1478. doi: 10.16462/j.cnki.zhjbkz.2022.12.019

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Abstract:
Objective In order to offer a scientific basis for the prevention and management of the Tibetan sheep plague in Qinghai Province, the study looked into the epidemiology of the human plague caused by Tibetan sheep on the Qinghai plateau, as well as the genetic characteristics of the associated Yersinia pestis. Methods To summarize and analyze the human plague data caused by Tibetan sheep in Qinghai Province from 1958 to 2020, as well as to describe its temporal, regional, and population distribution and other epidemiological characteristics. A total of 38 Yersinia pestis strains recovered from humans, Tibetan sheep, and Himalayan marmots were sequenced. The phylogenetic relationship between the strains was created using the gene sequences of other reference strains to assess the properties of single nucleotide polymorphisms in the full genomes of the strains. Results Between 1958 and 2020, there were 16 incidents of human plague in which Tibetan sheep were the source of infection, resulting in 69 illnesses and 42 deaths, with a mortality rate of 60.86%. All Yersinia pestis strains connected to Tibetan sheep belong to the same evolutionary branch of the phylogenetic tree (1.In2) and exhibited distinct regional characteristics. Human, Tibetan sheep, and neighboring Himalayan marmot isolates were all found in the same cluster during the same plague outbreak, which was consistent with epidemiological data. Conclusions Epidemiological and phylogenetic analysis confirmed that human plague originated from Tibetan sheep, and Tibetan sheep plague originated from marmots. Given the Tibetan sheep is an important domestic animal in the Qinghai Plateau, the harm of the Tibetan sheep plague should not be underestimated.

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2022 Vol. 26, No. 12

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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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