中华疾病控制杂志

Prediction of the pulmonary tuberculosis incidence and control measures assessment in China based on Bayesian method and seasonal dynamic model

LI Peiji, WANG Yayi, DAI Mengmeng, LIU Yingbo

2024, 28(4): 373-380. doi: 10.16462/j.cnki.zhjbkz.2024.04.001

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Objective Considering the seasonal periodicity of pulmonary tuberculosis (PTB), a dynamic model is constructed to fit and predict the monthly PTB cases in China, providing a reference for relevant departments to optimize PTB prevention and control measures. Methods First, based on seasonal-trend decomposition using loess (STL) model and susceptible-vaccinated-early latent-late latent-infected-treated (SVELIT) model, a dynamic model (STL-SVELIT) was established. Then, the monthly PTB cases in China from 2017 to 2021 was used to fit the model. The parameters of the model and further the basic reproduction number (R₀) were estimated in the Bayesian framework, in order to predict the epidemic trend of PTB in China. In terms of intervention evaluation, sensitivity analysis based on R₀was conducted to simulate the prevention measures for PTB. Specifically, the effects of various PTB prevention and control measures were evaluated by reducing the value of parameters: β, which represents the disease transmission coefficient; θ₁, θ₂, which accounts for the progression rate from latent individuals to active PTB patients in both early and late stages; and p₃, which indicates the proportion of symptomatic cases. Results The Mean Absolute Percentage Error (MAPE) was 4.30% when using the monthly PTB cases from 2017 to 2021 to fit the STL-SVELIT model. MAPE was 6.57% when predicting the monthly PTB cases from January 2022 to May 2023, which has a good fitting effect and prediction accuracy. The model estimated that the R₀ of PTB in China was 2.076, suggesting that PTB remains prevalent in the population. Simulation results showed that the predicted PTB incidence in China will reach 29.1 per 100 000 in 2035 if β declined by 75.00%; 25.4 per 100 000 in 2035 if θ₁ and θ₂ both decreased by 75.00%; 11.1 per 100 000 in 2035 if parameters β, θ₁, θ₂ and p₃all declined by 75.00%. Conclusions Reducing the disease transmission coefficient and the rate of progression of the latent period is effective in controlling the PTB epidemic. However, comprehensive measures are required to achieve the WHO End TB Strategies target in 2035 (tuberculosis incidence below 10.0 per 100 000).

Epidemiological characteristics and trends of infectious diseases in Gansu province from 2015 to 2022

KANG Xiaojuan, WANG Xiaohui, DING Zhonghang

2024, 28(4): 381-388. doi: 10.16462/j.cnki.zhjbkz.2024.04.002

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Objective This study analyzes infectious disease morbidity and mortality data in Gansu province from 2015 to 2022, aiming to comprehend the epidemiological characteristics and trends, as well as to determine prevention and control priorities. Methods We need Excel 2021 and JPR4.9 1.0 software to calculate morbidity ranks, mortality ranks, fatality rates, annual percentage change (APC) and annual average percentage change (AAPC) in morbidity and morality rates of the infectious diseases. We also analyzed the trend in infectious diseases morbidity and mortality using the Toinpoint regression model. Results From 2015 to 2022, Gansu province reported 670 992 cases of infectious diseases and 1 127 deaths, with an incidence rate of 324.12 per 100 000 and a mortality rate of 0.54 per 100 000 cases. The top five diseases in morbidity were infectious diarrhea, tuberculosis, hepatitis B, influenza, and hand-foot-mouth disease; the top two in mortality were AIDS and tuberculosis. Morbidity (2019-2022) and mortality (2017-2022) showed a decreasing trend, with APC values of -16 (-25.4, -5.3) and -9.1 (-13.7, -1.2). No significant changes in the incidence or mortality trends were observed during the remaining periods. Ten diseases, including tuberculosis and hepatitis A, exhibited decreasing incidence, while acute hemorrhagic conjunctivitis showed an upward trend. Tuberculosis deaths declined, but AIDS-related deaths increased. Plague and rabies had the highest mortality rates. Conclusions In Gansu province, prevention and control efforts should focus on infectious diarrhea, tuberculosis, hepatitis B, influenza, and hand-foot-mouth disease. Special attention is needed for the high mortality risk of AIDS and plague, as well as the incidence of acute hemorrhagic conjunctivitis and brucellosis.

Temporal trend of notifiable infectious disease with rash and fever syndrome in Gansu students, 2010-2019

GOU Faxiang, YANG Xiaoting, ZHANG Xiaoshu, XU Die, ZHENG Yunhe, CHENG Yao, WANG Long, LIU Xinfeng

2024, 28(4): 389-392. doi: 10.16462/j.cnki.zhjbkz.2024.04.003

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Objective To determine the temporal trend of notifiable infectious disease with rash and fever syndrome reported in Gansu students during 2010-2019, and to provide guidance for syndromic surveillance of rash and fever illness. Methods Joinpoint regression model was applied to determine the temporal trend of yearly morbidity of notifiable infectious disease with rash and fever among Gansu students aged 6-22 years during 2010-2019. And the overall, diseases-specific, route-of-transmission specific, and pathogen-type specific annual percent changes (APC) and average annual percent changes (AAPC) were estimated with respectively. Results Reported morbidities of scarlet fever, brucellosis, and HIV/AIDS in Gansu students aged 6-22 years were increased with APCs of [14.76%(3.66%-27.05%), P=0.008], [24.88%(7.86%-44.60%), P=0.003], and [12.08%(1.73%-30.11%), P=0.030] respectively during 2010-2019 (P < 0.050). And reported morbidities of zoonosis and bacterial infectious diseases were increased with AAPCs of 33.80% and 15.09%, respectively (P < 0.001). Conclusions Scarlet fever, brucellosis, and HIV/AIDS are increasing in Gansu students during 2010-2019, and syndromic surveillance of rash and fever illness over zoonosis and bacterial infectious diseases should be strengthened further.

Epidemiological characteristics of varicella after class C management and vaccination strategy in Nanjing, China

MA Tao, DING Songning, CHEN Cong, YAN Zikang, WANG Junjun, WANG Hengxue, HU Yang, GU Runhui, DING Jie, LIU Huihui

2024, 28(4): 393-401. doi: 10.16462/j.cnki.zhjbkz.2024.04.004

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Objective To understand the epidemiological characteristics of varicella in Nanjing after Class C management and vaccination strategy, analyzing the effect of prevention and control measures, providing scientific basis for improving the prevention and control strategy. Methods We collected reported varicella cases data from 2013 to 2022 in Nanjing and utilizied the Joinpoint regression model to calculate the annual percent change (APC) and the average annual percent change (AAPC) in incidence rates. We described the characteristics of temporal distribution, population distribution, spatial distribution and spatial clustering of varicella in Nanjing from 2013 to 2022 by R program, and compared the changes of epidemiological characteristics between the Class C management (2017-2018) and the vaccination strategy (2019-2022). Results A total of 87 538 varicella cases were reported. The average annual reported incidence was 102.20/100 000, with the peak of 228.64/100 000 (19 057 cases) in 2018, and declined to 98.32/100 000 (9 262 cases) in 2022, with a decrease of 57.00%. The APC from 2013 to 2018 and from 2018 to 2022 were 71.47% (95% CI: 41.96%-107.10%)、-15.36% (95% CI: -35.20%-10.54%), respectively, and the AAPC was 25.29% (95% CI: 11.03%-41.37%). The median age of cases in 2019-2022 [10 (5, 19)] was higher than that in 2017-2018 [7 (5, 15)] (P < 0.001), and the proportions of reported incidence reduction in each age groupunder 15 years old were between 57.46% and 90.46%, and the peak of incidence in the age group was reduced. The proportion of students, kindergarten children and scattered children decreased from 84.53% to 75.26%, among which the kindergarten children decreased from 32.51% to 28.85%, and the scattered children decreased from 11.13% to 5.55%. The incidence rate in the main urban areas were lower than that in the surrounding areas. After vaccination strategy, the most likely clusters changed from Jianye District, Jiangbei District, Yuhuatai District and Jiangning District to Gaochun District (P < 0.001). Conclusions The quality of varicella surveillance in Nanjing has been improved after class C management. After vaccination strategy, the reported incidence decreased significantly, and the population and spatial distribution characteristics changed.

Influencing factors of monkeypox perceptions and willingness to treat monkeypox patients among medical staff in Beijing

ZHANG Ye, WANG Bingyi, MENG Han, HAN Baihui, WU Ke, JIANG Xiaohong, FU Leiwen, ZHANG Weijie, LI Qian, XU Zhiyuan, YANG Yuan, WANG Jiaqi, QI Xiao, ZOU Huachun

2024, 28(4): 402-408. doi: 10.16462/j.cnki.zhjbkz.2024.04.005

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Objective This study aims to understand the level of awareness of monkeypox, the willingness to treat monkeypox patients and their associated factors among medical workers in Beijing. Thereby contributing to provide a scientific basis for formulating responding strategies. Methods The questionnaire survey was conducted among medical workers using the convenient sampling method between July 24 and August 2, 2023 in Beijing. The contents of the survey mainly included general demographic characteristics, awareness of monkeypox, and the willingness to treat monkeypox patients. Multivariate logistic regression analysis model was employed to analyze the influencing factors associated with the level of awareness of monkeypox and the willingness of receiving monkeypox patients among medical workers. Results A total of 2 148 valid questionnaires were collected in this study, the mean age of the respondents was 36.76±9.08 years old. 83.10% of individuals knew about monkeypox before this survey, and 82.45% were willing to treat monkeypox patients. The results of multivariate logistic regression analysis model showed that medical workers who aged from 41 to 50 years old (OR=1.98, 95% CI: 1.27-3.07), working in tertiary medical institutions (OR=1.53, 95% CI: 1.13-2.07), physician (OR=1.80, 95% CI: 1.32-2.45), with middle professional titles (OR=1.37, 95% CI: 1.05-1.79) had a higher level of monkeypox knowledge. And medical workers who working in other departments such as gynecology/pediatrics departments (OR=0.73, 95% CI: 0.57-0.94) were more likely to have lower level of monkeypox knowledge (all P < 0.05). Medical workers who were female (OR=0.70, 95% CI: 0.51-0.96), with middle (OR=0.62, 95% CI: 0.45-0.87) and senior professional titles (OR=0.55, 95% CI: 0.31-0.95), had high awareness of monkeypox (OR=0.76, 95% CI: 0.61-0.97), were less willing to treat monkeypox patients. Medical staff in other departments were more willing to treat monkeypox patients (OR=1.51, 95% CI: 1.08-2.15) than those in high-risk departments (all P < 0.05). Conclusions Awareness of monkeypox was high among medical workers in Beijing, however some of them were unwilling to treat monkeypox patients. It is necessary for medical workers to strengthen relevant occupational protection training and psychological interventions to protect them from monkeypox transmission, eliminate their concerns about receiving patients, and improve their willingness to treat monkeypox patients.

Differential prevalence and correlates of anemia among newly diagnosed versus formerly reported HIV-infected persons in Taizhou City

LI Chang, WANG Shanling, WANG Tingting, XIE Yali, LIN Haijiang, CHEN Xiaoxiao, HE Na

2024, 28(4): 409-416. doi: 10.16462/j.cnki.zhjbkz.2024.04.006

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Objective This study aims to explore and draw comparison in influencing factors between newly diagnosed and formerly reported HIV-infected persons in Taizhou City. The findings provide scientific evidence for improving preventative measures and treatment for anemia in HIV-infected individuals. Methods A total of 2 756 HIV-infected individuals from the Comparative HIV and aging research in Taizhou (CHART) were recruited in Taizhou, Zhejiang Province, include 620 newly diagnosed cases and 2 136 formerly reported cases. Logistic regression models were used to analyze the factors influencing anemia among HIV-infected individuals and draw comparion in influencing factors between newly diagnosed and formerly reported HIV-infected persons. Results Among the 2 756 HIV-infected individuals surveyed, the prevalence of anemia was 18.7% (516/2, 756). Among the 620 newly diagnosed HIV cases, the prevalence of anemia was 23.6% (146/620), while among the 2 136 formerly reported HIV cases, the prevalence of anemia was 17.3% (370/2 136). Multivariable logistic regression analysis showed that both newly diagnosed and previously infected individuals shared gender and CD4 count as influencing factors for anemia, in addition to which, among newly diagnosed cases, other influencing factors included underweight (OR=2.88, 95% CI: 1.56-5.33, P=0.001), overweight or obesity (OR=0.47, 95% CI: 0.28-0.81, P=0.006), history of tuberculosis (OR=11.16, 95% CI: 1.55-80.27, P=0.017), and mild renal insufficiency (OR=1.87, 95% CI: 1.07-3.25, P=0.027). Among Previously infected individuals, the influencing factors included the age group of 45-59 years (OR=2.05, 95% CI: 1.30~3.24, P=0.002), age ≥60 years (OR=3.48, 95% CI: 2.08~5.83, P<0.001), education level of high school or above (OR=0.62, 95% CI: 0.44-0.90, P=0.010), diabetes (OR=1.60, 95% CI: 1.04-2.47, P=0.034), and hypercholesterolemia (OR=0.73, 95% CI: 0.55-0.96, P=0.023). Conclusions The prevalence of anemia among HIV-infected individuals in Taizhou City is relatively lower compared to other HIV-infected populations in China during the same period. Aside from gender and CD4 cell count, newly diagnosed and formerly reported HIV cases differ in the factors influencing anemia. Therefore, precise interventions of anemia among HIV-infected individuals should be emphasized in the prevention, screening, and treatment of anemia.

Gender differences in sexual health knowledge, attitude and behavior among Chinese college students and the influencing factors of sexual behavior

WANG Siya, WU Haotian, ZHANG Haitao, NIU Xiaoxin, GULINAISI·Kemailebieke, PAN Lutong, WANG Xinyi, QIN Wenzhe, HU Fangfang, LI Lei, YANG Haifeng, XU Lingzhong, LI Yinlong

2024, 28(4): 417-423. doi: 10.16462/j.cnki.zhjbkz.2024.04.007

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Objective To understand the current situation of sexual knowledge, attitude and behavior of Chinese college students, and provide reference for the whole society to carry out sex education, so as to improve the level of sexual health of college students. Methods From August to November 2022, a convenient sampling method was adopted to select 24 816 college students from universities in 34 provinces, municipalities directly under the Central government and autonomous regions across the country. A self-designed questionnaire was used to carry out online survey, and SPSS 26.0 software was used for descriptive analysis. Chi-square test and logistic regression analysis model were used to analyze the sexual health status of college students. Results In terms of sexual knowledge, the knowledge rate of male and female contraceptive methods was 90.4% and 83.5%, respectively, and the difference was statistically significant (P<0.05). In terms of sexual attitudes, the acceptance rates of "premarital sex", "open or cohabitation" and "one-night stand or hookup" were 42.1%, 45.5% and 12.2% for male students, and 20.4%, 20.0% and 2.0% for female students, respectively, with statistical significance (all P<0.05). In terms of sexual behavior, ethnic group, sexual orientation, sexual knowledge, and whether girls are the only child are the influencing factors of sexual behavior. The sexual activity of Han girls was 1.817 times that of minority girls (95% CI: 1.513-2.181). Non-heterosexual girls were 2.163 times likely to have sex than heterosexual girls (95% CI: 1.749-2.675). Women who knew about contraception were 19.898 times likely to have had sex (95% CI: 12.093-32.738) than those who did not know about contraception. Women who were only children were 2.945 times likely to have sex than women who were not only children (95% CI: 2.412-3.595). Conclusions College students have many problems in sexual knowledge, attitude and behavior, so it is suggested that universities and other education departments should attach great importance to it, make full use of Internet, classroom and other platforms to carry out relevant popular science education, and strengthen the general education of sexual health education.

Association between short-term air pollution exposure and placental abruption: a nested case-control study

LIU Han, WANG Tong, ZHAN Yu, GUO Ying, LING Xi, YANG Huan, CHEN Qing, ZHOU Wenzheng, CAO Jia

2024, 28(4): 424-430. doi: 10.16462/j.cnki.zhjbkz.2024.04.008

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Objective To explore the association between short-term air pollution exposure and acute onset of placental abruption. Methods This study is a nested case-control study nested in the large birth cohort of Chongqing. A total of 798 pregnant women with new placental abruption from July 31, 2018 to July 31, 2022 were selected as the case group. A control group of 3, 192 women without abruptio placentae was matched at a ratio of 1∶4 according to age, gestational age, gravidity, parity, and delivery date. The data set of six air pollutants (PM₁₀, PM_2.5, NO₂, CO, O₃, SO₂) and meteorological factors was estimated by machine learning algorithm and matched with the longitude and latitude of each subject′s residence address. A distributed lag non-linear models based on conditional Logistic regression was constructed to explore the exposure-response relationship between short-term air pollutants exposure and placental abruption, controlling the effects of temperature, relative humidity, wind speed, atmospheric pressures and NDVI, as well as the age, gestation week, gravidity (first pregnancy/non-first pregnancy), pravity (first birth/non-first birth), delivery season (cool/warm seasons), whether experienced the epidemic (Yes/No), and residential address (urban/countryside). Results The results of single pollutant model showed that NO₂ was significantly associated with the increased risk of placental abruption within 4 to 7 days of cumulative exposure, and the odds ratio for each increase in IQR of NO₂ was 1.38 (95% CI: 1.11-1.73, P < 0.001) to to 1.54 (95% CI: 1.18-2.02, P < 0.001). The overall dose-response curve showed that the risk of placental abruption increased with the increase of NO₂ concentration, and the exposure-response curve was approximately linear. There was no statistically significant association between short-term exposure to other pollutants and the risk of placental abruption. Conclusions Short-term exposure to NO₂ is associated with an increased risk of acute onset of placental abruption, which may be an influencing factor of placental abruption, and further studies are necessary to verify this.

Pollution change and health risk assessment of cadmium in farmland soil in Shijiazhuang from 2016 to 2022

WU Ruiting, CHEN Fengge, FAN Weiwei, ZHANG Rong, NIU Yujie

2024, 28(4): 431-437. doi: 10.16462/j.cnki.zhjbkz.2024.04.009

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Objective This study aims to clarify the situation of cadmium pollution in the agricultural soil of Shijiazhuang City from 2016-2022, evaluate potential health risks to the population, and assess the effectiveness of "the three-year initiative" in reducing cadmium pollution. Methods In six selected project counties, 20 soil samples were collected annually from each county. Samples were collected from monitoring points in each county annually between July-August. Cadmium levels in the soil were evaluated using standard limits. Additionally, the study used the geo-accumulation index method, and potential ecological risk index method to assess the situation. Results A total of 840 soil samples were collected. In 2016 and 2017, cadmium levels were relatively high, primarily concentrated in Zhengding County and Zanhuang County. After "the three-year initiative", there was a decrease in the average cadmium pollution level in Shijiazhuang City. Specifically, and cadmium levels decreased in Zhengding County, Zanhuang County, Luancheng County, Gaocheng County, and Luquan County after implementation. However, Wuji County saw a slight increase in cadmium levels. Conclusions The level of cadmium pollution in agricultural soil in Shijiazhuang City significantly decreased after the implementation of "the three-year initiative". This indicates that "the three-year initiative" had a certain effect in reducing soil cadmium risk. However, there is still a need to strengthen the investigation and monitoring of cadmium pollution in the soil to formulate timely policies to address potential risks.

Model construction for mortality trend of road traffic injury in Fujian Province

WANG Dengwei, HUANG Shaofen, YIN Yanrong, CHEN Tiehui, ZHONG Wenling

2024, 28(4): 438-442. doi: 10.16462/j.cnki.zhjbkz.2024.04.010

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Objective To analyze the status of road traffic injury deaths in Fujian province from 2014 to 2021, and to explore the applicable trend prediction model. Methods Seasonal autoregressive integrated moving average (SARIMA), support vector regression(SVR) and long short-term memory (LSTM) network were constructed using road traffic injury deaths data from January 2014 to June 2021 in Fujian province to predict the mortality rate from July to December in 2021, and its prediction effects were evaluated by comparison with the actual value. Results The annual reporting rate of road traffic injuies in Fujian Province showed a decreasing trand from 2014 to 2021 (AAPC=-6.29%, P < 0.001). LSTM network had highest prediction accuracy among three models, with root mean square error (RMSE) of 0.070 5, mean absolute error (MAE) of 0.061 2 and mean absolute percentage error (MAPE) of 8.72%. Conclusions The overall road traffic injury deaths in Fujian province showed a downward trend. LSTM network can be used to predict the short-term trend of road traffic injury deaths.

Epidemiological characteristics and trend analysis of injured children aged 0-14 years in Shijiazhuang city, 2015-2021

CHEN Qiwei, MA Xinyan, ZHANG Qingjian, DUAN Yufan

2024, 28(4): 443-450. doi: 10.16462/j.cnki.zhjbkz.2024.04.011

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Objective To explore the epidemiological characteristics and variation tendency of injury among children aged 0-14 in Shijiazhuang city from 2015 to 2021, so as to provide scientific basis for prevention and control of child injury. Methods To collect the information of injury cases of children aged 0-14 who were admitted to the monitoring hospital in Shijiazhuang from 2015 to 2021, and analyze the epidemiological characteristics and the trend of injury change. Results A total of 22 302 child >injury cases aged 0-14 were reported, with the male and female ratio appeared as 1.89∶1.00. Except for the 0-<1-year-old group, the number of cases in boys was higher than that in girls. The main injuries among children were falling/falling (59.77%), at home (47.58%), leisure activities (59.67%) and unintentional injuries (96.92%). The most injuries occurred in September (10.60%) and the least in February (4.81%). The most vulnerable parts of children were the head (40.25%), upper limbs (22.76%) and lower limbs (19.07%), 42.75% cases were bruise. The degree of injury was mild (89.13%) and the outcome was mainly post-treatment hospitalization (94.12%). Joinpoint regression showed that the constituent ratio of injury cases among children aged 1-<4 showed a downward trend from 2015 to 2021, while those aged 7-<11 and 11-14 showed an upward trend. Animal injuries and poisoning injuries showed a downward trend from 2015 to 2021. Sports venues showed an upward trend and walking injuries showed a downward trend, with statistical significance in each year (All P<0.05). Conclusions The epidemiological characteristics of injury in children of different gender and age are not all the same, and the change trend of injury is different. Therefore, targeted prevention and intervention measures should be taken.

Differences in the characteristics of drinking patterns and their quality-of-life scores in the population of Beijing and Hebei

CAO Rui, ZHU Yanbo, LIANG Xiaomin, REN Jiaju

2024, 28(4): 451-457. doi: 10.16462/j.cnki.zhjbkz.2024.04.012

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Objective To understand the current situation of drinking patterns in Beijing and Hebei, and to investigate the characteristics of different drinking patterns and the differences in quality of life (QOL) scores. Methods Eligible data from the database of "the Systematic Survey of TCM Pulse Diagnosis Physiological Parameters in Normal Adult Populations with Different Constitutions Database "were selected. Drinking patterns based on average daily intake of pure alcohol, and the quality of life (QOL) scores were obtained by the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). Least squares regression was used to analyze differences in QOL scores across drinking patterns. Results A total of 1 994 cases were included in the analysis, including 654 males and 1 340 females, with an age distribution of 31.7 (22.0, 37.0) years. Among them, the number of subjects in non-drinking patten, ex-drinking pattern, middle drinking pattern, moderate drinking pattern, and heavy drinking pattern was 1 375, 74, 368, 90 and 87, respectively. Comparing the 5 groups, there were statistically significant between-group differences in gender, age, marital status, education, subjective economic situation, real per capita family income, family members, BMI, family history, complicated with chronic diseases, tea drinking situation, smoking situation, sleep habits, work and leisure situation, and exercise habits (all P < 0.05). After controlling for confounding variables, there were significant differences of scores on the SF-36 total score, the mental component summary (MCS), and subordinate social functioning (SF), role emotional (RE) and mental health (MH) dimensions for among the five drinking patterns(all P < 0.05). The test of difference and the Minimum Clinically Important Difference (MCID) together showed that the non-drinking pattern has the best QOL, followed by the heavy drinking pattern, then middle and moderate drinking patterns, and the ex-drinking pattern was the worst, especially in the MCS and its subordinate dimensions. Conclusions The ex-drinking pattern has the worst QOL compared to the non-drinking pattern. Although the heavy drinking pattern scores well, given the other health outcomes, it is recommended that the population reduce alcohol consumption or remain alcohol-free for greater health benefits.

Study on the relationship between number of exercise steps and central obesity among elderly residents in Shanxi Province

LU Kangkang, YIN Zixin, ZHANG Peifang, LI Jiantao

2024, 28(4): 458-462. doi: 10.16462/j.cnki.zhjbkz.2024.04.013

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Objective To investigate the current status of central obesity among elderly residents in Shanxi Province and explore the association between number of exercise steps and central obesity. Methods In 2022, a survey on chronic diseases and their risk factors was conducted among permanent residents of Shanxi Province using a multi-stage stratified random sampling method. A total of 4 710 resident elderly residents (60 years old and above) were selected as the respondents. The χ² test was used to analyze the influencing factors of central obesity and logistic regression model to analyze the relationship between number of exercise steps and central obesity. Results The results showed that the prevalence rates of obesity and central obesity were 17.7% and 41.3%, respectively. Number of exercise steps was identified as a impact factor affecting central obesity (P=0.004). Through the analysis of different age groups, after excluding the influence of confounding factors, the exercise step number ≤3 000 group was taken as the comparison group. The prevalence of central obesity decreased by 32.7%, 43.8% and 33.9% in the 60- < 70 age group in the 3 000-6 000 steps group, 6 000-10 000 steps group, and 10 000 steps and above group, respectively (OR=0.673, 95% CI: 0.545-0.832, P < 0.001; OR=0.562, 95% CI: 0.449-0.703, P < 0.001; OR=0.661, 95% CI: 0.497-0.878, P=0.004). In the 70- < 80 age group, the prevalence of central obesity decreased by 44.6% in the above 10 000 steps group (OR=0.554, 95% CI: 0.343-0.895, P < 0.001), while there was no statistical significance in other groups (P > 0.05). Conclusions The impact of number of exercise steps on reducing the prevalence of central obesity among elderly people varies by age groups. Targeted intervention measures should be taken. Encourage younger elderly individuals (aged 60- < 70) to maintain a daily number of exercise steps between 6 000 to 10 000. For middle-aged (aged 70- < 80) and older elderly individuals (aged 80 and above), the number of exercise steps should be reasonably controlled under the intensity and frequency of exercise that their physical condition can withstand, so as to improve their physical health level and prevent central obesity.

Research progress on emerging diarrhea virus and population infection

FAN Shunchang, YOU Fangfei, ZHANG Minyi, CHEN Qing

2024, 28(4): 463-467. doi: 10.16462/j.cnki.zhjbkz.2024.04.014

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The illness known as infectious diarrhea is brought on by different pathogens. It is critical to comprehend the pathogens that cause diarrhea to prevent and treat infectious diarrhea. Diarrhea is known to be caused by numerous viruses, such as rotavirus, norovirus, and adenovirus. But recent studies have suggested that several emerging viruses, such as kobuvirus and bocavirus, may be associated with diarrhea. The epidemiological characteristics of these viruses are yet unknown. Hence, this article provides a brief overview of seven emerging diarrhea viruses and the condition that they produce in individuals.

Influencing factors of occupational injury risk of workers in diverse forms of employment and the prevention and control countermeasures in China

ZHANG Ge, ZHU Xiaojun, ZHANG Peng, MENG Shidi

2024, 28(4): 468-472. doi: 10.16462/j.cnki.zhjbkz.2024.04.015

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There are 200 million workers in diverse forms of employment in China, but there is a lack of systematic analysis on the influencing factors and prevention measures of their occupational injury risk. According to the analysis of the typical survey results of occupational injury of workers in diverse forms of employment in China, it shows that occupational injury risk of workers in diverse forms of employment is generally low but some groups are at higher risk. It is related to industry risk, personal characteristics, occupational vulnerability and employer characteristics. The influencing factors of occupational injury risk of self-employed workers are mainly the injury risk in their industry, type of self-employment, physical labor intensity and flexibility of working hours. Those of part-time workers are the personal safety and health knowledge, group effect, employer′s attention, gender and age. Those of workers in new forms of employment are mainly traffic accidents, long working hours and work pressure. China has gained some experience and achievements in the occupational injury prevention and control for workers in diverse forms of employment, but it also faces many challenges. It is suggested to strengthen the sense of urgency of occupational injury prevention and control among workers in diverse forms of employment, strengthen basic research of safety promotion and health promotion, and improve the rule of law system and supporting policies for workers in diverse forms of employment.

Establishment of early warning threshold of hand, foot and mouth disease based on moving epidemic method and synthetic index method in Guangzhou

ZHANG Tingyu, ZHANG Xiao, LI Junxi, WANG Hui, LUO Lei, QIN Pengzhe, YUAN Jun

2024, 28(4): 473-478. doi: 10.16462/j.cnki.zhjbkz.2024.04.016

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Objective Using moving epidemic method (MEM) and synthetic index method to establish grading early warning threshold of hand, foot and mouth disease, so as to provide scientific evidence for hand, foot and mouth disease prevention and control in Guangzhou. Methods The weekly incidence and clustered epidemic data of hand, foot and mouth disease from 2015 to 2021 were collected. Two peaks of hand, foot and mouth disease were split by plotting the epidemic curve of the average weekly incidence. Then data on weekly incidence and clusters of hand, foot and mouth disease in spring and summer from 2015 to 2021 (except 2020) were extracted to establish grading early warning model by MEM and synthetic index method. The epidemic threshold and grading intensity thresholds in 2022 were estimated and the early warning effect of established model was verified by cross-validation method. Results Based on the established model, the epidemic start threshold of hand, foot and mouth disease in Guangzhou was 0.78 between the 10th and 37th weeks in 2022. And the medium, high and extremely high intensity thresholds of hand, foot and mouth disease were 1.85, 2.72 and 3.22, respectively. The optimal parameter δ was 2.5, and the overall sensitivity, specificity and Youden′s index were 94.15%, 92.67% and 0.87, respectively, which indicated good fitting effect. Conclusions The combination of MEM and the synthetic index method can achieve more objective and comprehensive early warning of hand, foot and mouth disease.

Effects analysis and excess risk assessment on O₃ related emergency calls in Jinan City, 2013-2019

CHANG Huiyun, WANG Liheng, HUANG Ke, LI Mingjun, CUI Liangliang

2024, 28(4): 479-485. doi: 10.16462/j.cnki.zhjbkz.2024.04.017

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Abstract:
Objective To explore the effect of Ozone (O₃) exposure on the risk of excess emergency calls of residents in Jinan City from 2013 to 2019. Methods The daily emergency calling event information of residents, as well as the average concentration of air pollutants (O₃, PM_2.5, PM₁₀, NO₂, SO₂, CO) and meteorological factors (daily average temperature, average relative humidity and average wind speed) in Jinan City from January 1st to December 31st of 2013 to 2019, were collected. The case-cross design method was used to determine the expose-response relationship coefficient, which was introduced into the proportional risk model for health risk assessment. Further, stratified analysis was conducted by respiratory system diseases, circulatory system diseases and neurological diseases, and the differences in excess emergency call risk caused by O₃ exposure in different seasons were compared. Results There were 653 473 emergency call incidents in Jinan from 2013 to 2019, and average daily emergency calls volume were 250. Impact analysis and excess risk assessment on total emergency calls found that for every 10 μg/m³ increase in O₃ concentration, the risk of emergency calls increased by 0.375% (95% CI: 0.288%-0.461%), resulting in excess emergency calls of 7 226. Disease-stratified analyses found that the effect estimate of O₃ exposure on emergency calls was statistically significant only for neurologic disorders during the study period, with a corresponding effect estimate of 0.471% (95% CI: 0.250%-0.692%), and resulted in excess emergency calls of 1 371. In addition, the excess emergency calls caused by O₃ exposure had seasonal differences, which were higher in summer and autumn than in winter and spring. Conclusions In Jinan City, exposure of O₃ increases the risk of excess emergency calls of residents, and manifests as higher in summer and autumn than in winter and spring. Especially, neurological diseases are significantly affected.

Analysis of prevalence and influencing factors of hyperkalemia among people in elderly care institutions in southeastern Shanxi

DUAN Peifen, YUAN Jianhui, HAN Yanbo, ZHAI Yanli, FENG Xiangxian

2024, 28(4): 486-489. doi: 10.16462/j.cnki.zhjbkz.2024.04.018

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Objective To examine the prevalence and factors associated with hyperkalemia among the elderly residing in care facilities in the southeastern area of Shanxi province. Methods A questionnaire survey was carried out on individuals from 16 care institutions in the southeastern province of Shanxi between September and November, 2017. A random cluster sampling method was employed to select subjects. In addition, peripheral blood samples were collected for laboratory examination. The analysis of hyperkalemia was conducted using logistic regression to determine the contributing factors. Results A total of 523 individuals were included in this study [average age: (66.20±8.61) years old], and the average serum potassium concentration was (4.50±0.45)mmol/L. The prevalence of hyperkalemia (>5.0 mmol/L) was 13.95% (95% CI: 11.02%-16.93%). Logistic regression analysis showed that the risk of hyperkalemia increased with a decreasing estimated glomerular filtration rate(eGFR) (χ² =8.189, P=0.017). Compared with eGFR>90 mL/(min·1.73m²), the risk of hyperkalemia was 4.11 times with eGFR 60-90 mL/(min·1.73m²) (OR=4.11, 95% CI: 1.06-16.01, P=0.042) and 6.04 times with eGFR < 60 mL/(min·1.73m²) (OR=6.04, 95% CI: 1.64-22.17, P=0.007). Conclusions The prevalence of hyperkalemia is higher in the institutionalized elderly population, and the lower level of eGFR is a risk factor for hyperkalemia.

Comparison and application of Mendelian randomization methods for correcting weak instrumental variable bias

YANG Boran, PENG Liuqing, GAO Xue, WANG Juping, WANG Tong

2024, 28(4): 490-496. doi: 10.16462/j.cnki.zhjbkz.2024.04.019

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Objective To provide suggestions to choose the appropriate two-sample Mendelian randomization methods when no instrumental variables are available or weak instrumental variable bias exist. Methods In the case of no pleiotropy, balanced pleiotropy, and directional pleiotropy, respectively, the impact of weak instrumental variables on each method was investigated by changing the intensity of instrumental variables. The study simulated different number of instrumental variables to access the impact on MR-Mix under the condition that both directional pleiotropic effects and weak instrumental variables existed. MR-Mix served as the primary analytical method, while the other two methods were employed as sensitivity analyses to explore the causal associations between BMI, HDL, LDL, TG, TC, and serum uric acid. Results Under scenarios of no pleiotropy and balanced pleiotropy, MW-IVW performed the best, while MR-Mix performed the worst. In the case of directional pleiotropic, MR-Mix exhibited the best performed, whereas MW-IVW performed the worst. BMI(β=0.280, P=0.003) and TG(β=0.370, P < 0.001) were identified as risk factors for elevated serum uric acid. HDL(β=-0.250, P=0.002) was identified as a protective factor. Conclusions Under scenarios of no pleiotropy and balanced pleiotropy, MW-IVW demonstrates better statistical performance. However, in the presence of directional pleiotropy, MR-Mix exhibits superior robustness. BMI and TG are identified as risk factors for elevated serum uric acid.

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2024 Vol. 28, 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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