中华疾病控制杂志

Expert consensus on prevention and control of severe fever with thrombocytopenia syndrome

HU Lifen, GONG Lei, LI Chunhui, YIN Jun, YE Ying, GAO Yufeng, YANG Fan, LI Jun, QU Tingting, CHENG Jun, YIN Huafa, XU Xihai, WU Ting, CUI Ning, WANG Gang, HUANG Xiaoping, XU Feng, XU Jing, YANG Jianghua, RAO Jianguo, ZHU Liyu, LIU Zhenjun, WU Jiabing, LIU Wei, LI Jiabin

2024, 28(6): 621-628. doi: 10.16462/j.cnki.zhjbkz.2024.06.001

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Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by Dabie bandavirus (DBV) transmitted through tick bites. It was initially identified in 2009 among febrile patients with leukopenia and thrombocytopenia in central China. SFTS has been recently reported in other Asia countries, resulting in high mortality among severely ill patients. In the recent 10 years, there have been some reports about human-to-human transmission of DBV, particularly among severely ill patients. However, there are currently no established prevention and control measures for medical staff during the clinical treatment for severely ill SFTS patients against human-to-human transmission. Improper precaution measure can cause nosocomial infection of DBV among medical staff during the clinical process of rescue and treatment. Therefore, it is crucial to develop preventive and control measures against DBV′s human-to-human transmission, which would significantly contribute to the management of severely ill SFTS patients. To better regulate the precaution measures strategies against DBV human-to-human transmission, we have invited renowned experts in this field for extensive discussions, and reached a consensus on prevention and control measures concerning SFTS epidemiological features, contact transmission through patient′s blood and bloody secretions, aerosol transmission, as well as patient′s contaminants handling and corpse disposal.

Epidemic characteristics and spatiotemporal clustering of hemorrhagic fever with renal syndrome in Guangdong Province, 2010-2022

HAN Xiaoyu, TAN Xiaohua, LUO Ao, YANG Yuwei, ZHANG Meng

2024, 28(6): 629-635. doi: 10.16462/j.cnki.zhjbkz.2024.06.002

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Objective To conduct a retrospective analysis of the monitoring data on hemorrhagic fever with renal syndrome (HFRS) in Guangdong Province from 2010 to 2022, and explore characteristics and spatiotemporal clustering of HFRS data, so as to identify high-risk areas for HFRS and provide references for the development of targeted prevention and control measures. Methods The data on HFRS were obtained from the Chinese National Disease Reporting Information System. We conducted a trend analysis of HFRS case data using Joinpoint 4.6.0.0 and assessed spatial autocorrelation with GeoDa 1.16. Spatio-temporal clusters were identified using SaTScan 10.1, where the log-likelihood ratio (LLR) indicated the strength of clusters. Results From 2010 to 2022, Guangdong reported 4 322 HFRS cases, with an average annual incidence rate of 0.31 per 100 000. The incidence rate exhibited a decreasing trend (AAPC=-8.4%, 95% CI: -12.6%--3.9%). Peak cases occurred in March and April (RR=1.61, LLR=82.78, P=0.001). Males and those aged 30-69 were disproportionately affected. The Pearl River Delta, especially Guangzhou and Foshan, reported the highest incidence. Occupationally, those engaged in household chores and unemployed individuals (n=973, 22.51%), commercial service personnel (n=726, 16.80%), workers (n=645, 14.92%), and farmers (n=638, 14.76%) were relatively numerous. Spatial clustering was evident, with clusters centered in the Pearl River Delta. Spatio-temporal analysis identified clusters in Guangzhou, Foshan, and other regions of Guangdong. HFRS occurred primarily in winter and spring, with occasional summer outbreaks, consistently affecting the Pearl River Delta, particularly Guangzhou and Foshan. The spatial clustering of HFRS cases is prominent, with "high-high" clusters concentrated in Guangzhou and Foshan within the Pearl River Delta. Through spatiotemporal scanning analysis, we identified one type Ⅰ cluster encompassing nine counties in Guangzhou and Foshan from February to March 2013. Additionally, two type Ⅱ clusters were detected, occurring in January to February 2015 and May to June 2017, respectively. One affected seven cities in the Pearl River Delta, while the other encompassed 25 counties in Yangjiang City in West Guangdong. Annual scans showed that while HFRS primarily occurs in winter and spring, there are occasional early summer outbreaks. The affected cities and counties vary annually, but the Pearl River Delta, especially Guangzhou and Foshan, remains a consistent focal point. Conclusions The incidence of HFRS in Guangdong shows a downward trend. HFRS occurs frequently in winter and spring. The middle-aged and the elderly are the main groups with high incidence. The disease exhibits seasonal and spatial clustering characteristics, with the Pearl River Delta region being the high-incidence area.

Analysis on epidemiological characteristics and incidence trend of pertussis in Yunnan Province, 2005-2022

GUO Hui, LU Ran, QI Yanbo, LI Zhenhui, ZHANG Yiwen, LIN Yan

2024, 28(6): 636-640. doi: 10.16462/j.cnki.zhjbkz.2024.06.003

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Objective To analyze the epidemiological and spatial-temporal distribution of pertussis in Yunnan from 2005 to 2022, and to provide evidence for improving prevention and control strategy. Methods Pertussis epidemic report and surveillance data in Yunnan Province from 2005 to 2022 were analyzed through the China Disease Prevention and Control Information System. Descriptive epidemiological methods were used to describe the disease distribution characteristics. Cluster analysis was used to analyze inter-regional incidence. Joinpoint regression model was used to analyze the trend of incidence. Results From 2005 to 2022, 2 115 pertussis cases were reported in Yunnan, with an average annual incidence rate of 0.253 4 per 100 000. The cases were mostly in 0-< 5 years group (1 691, 79.95%), the highest average annual incidence rate was in the 0-< 1 years group (11.440 4 per 100 000), adult cases had reports annually since 2018. The cases were reported every month, and in the third and second quarters the average incidence rate was higher, which was 0.073 8 per 100 000 and 0.073 3 per 100 000. The average annual incidence rate showed an upward trend in 2005-2022, with an average annual percentage change (AAPC) of 9.93%. It showed a downward trend in 2005-2014, with an annual percentage change (APC) of -11.82%, and a rapid upward trend in 2015-2022, with APC of 50.62%. The highest endemic area was Yuxi, and the areas with obvious increases was Yuxi, Zhaotong, and Xishuangbanna. Conclusions The average annual incidence of pertussis in Yunnan Province is on the rise in general and increased rapidly after 2015. Pertussis still mainly happens infants and young children aged 0-< 5 years, the second and third quarter are the high incidence season. The incidence rates and growth trends are different between every area. We suggest enhancing diagnosis and surveillance capabilities and strengthening epidemic prevention and control in key regions, seasons and populations.

Epidemiological characteristics of bacterial dysentery in Yunnan Province from 2014 to 2022

ZHANG Rongbing, TIAN Rong, HE Jibo, CHEN Lihua

2024, 28(6): 641-645. doi: 10.16462/j.cnki.zhjbkz.2024.06.004

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Objective To understand the epidemic characteristics of bacillary dysentery in Yunnan Province and provide reference for the prevention and treatment of bacillary dysentery in Yunnan Province. Methods All cases of bacillary dysentery reported in Yunnan Province during 2014-2022 were collected from the "China Disease Prevention and Control Information System". Excel 2019 software was used to map the population characteristics, ArcGIS 10.8 software was used to map the distribution of epidemic areas, and spearman correlation test was conducted on the correlation between incidence and climate characteristics in each region. Descriptive epidemiological methods were used to analyze the bacillary dysentery epidemic in Yunnan Province from 2014 to 2022. Results From 2014 to 2022, a total of 30 309 cases of bacillary dysentery were reported in Yunnan Province, with an average annual incidence rate of 7.03 per 100 000. The high-incidence areas were distributed from northwest to southeast, with an incidence rate of 7.36 per 100 000 in urban areas. Students and children were the main cases. The incidence rate in rural areas was 6.93 per 100 000, mainly farmers. The ratio of males to females in the population distribution was 0.99%; farmers and scattered children accounted for 72.33%; the age group of 0-< 10 years old accounted for the largest proportion, accounting for 40.82%. The peak period of incidence was from May to July, accounting for 37.61%. The main pathogenic bacteria were Shigella flexneri and Shigella sonnei. Conclusions Bacillary dysentery is mainly sporadic in Yunnan Province. Comprehensive measures such as health education according to local conditions should be taken. At the same time, the management of key places should be strengthened to prevent epidemic outbreaks.

Epidemiological analysis on hepatitis E in Anhui Province from 2013 to 2022

WANG Axin, XIAO Yongkang, BI Niannian, GONG Lei, WU Jiabing

2024, 28(6): 646-650. doi: 10.16462/j.cnki.zhjbkz.2024.06.005

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Objective To analyze the epidemiological characteristics of viral hepatitis E (HE) in Anhui Province from 2013 to 2022, providing a scientific basis for the prevention and control of HE. Methods HE case report information in Anhui Province from 2013 to 2022 were collected through the Chinese Center for Disease Control and Prevention Information System for Infectious Disease Reporting. A descriptive analysis of the epidemic characteristics of HEE cases was conducted, and Joinpoint regression analyswas was used to study the temporal trends in the reported incidence of HE. Results Between 2013 and 2022, a total of 15 465 cases of HE were reported in Anhui Province, with an average annual reported incidence rate of 2.52 per 100 000. According to the Joinpoint regression model analysis, the average annual reported incidence rate of HE showed two-phase fluctuations during 2013-2022, with a turning point in 2020. From 2013 to 2020, there was a decreasing trend with an annual percent change (APC) of -6.86% (P=0.005), while from 2020 to 2022, there was a rebound with an APC of 18.33% (P=0.183). In terms of the distribution of cases, a total of 6 663 cases were reported from January to April, accounting for the highest proportion (43.08%); cases were reported in all 16 cities in Anhui Province, with the top three annual average reported incidence rates being in Bengbu City (6.70 per 100 000), Huainan City (6.28 per 100 000), and Suzhou City (4.75 per 100 000), and there was a statistically significant difference in reported incidence rates among regions (χ²= 6 792.45, P < 0.001); there were more male cases than female cases, with a male-to-female ratio of 2.53∶1.00; cases were mainly in middle-aged and elderly people, with 60.7% of cases concentrated in the 45-< 70 age group; the main occupation was farmers, accounting for 61.05%. Conclusions The average annual reported incidence rate of HEin Anhui Province shows an overall fluctuating downward trend from 2013 to 2022, but there has been a slight increase in the past two years. The overall prevention and control of HE should not be underestimated. In the future, HE popularization should be actively carried out in key groups such as middle-aged and elderly people and farmers. Strengthening health interventions and prevention and control efforts for HE during the high-incidence seasons is also crucial.

Analysis on epidemiological characteristics of influenza in Qingdao City, 2018-2022

LI Jinru, GAO Yu, ZHANG Jingfei, LU Xuezhao, JIA Jing

2024, 28(6): 651-656. doi: 10.16462/j.cnki.zhjbkz.2024.06.006

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Objective To analyze the epidemiological and etiological characteristics of influenza in Qingdao City from 2018 to 2022 and to summarize the epidemic patterns. The findings will provide a scientific basis for the prevention and control of influenza. Methods Descriptive epidemiological methods were used to analyze the epidemiological characteristics of influenza in Qingdao City from 2018 to 2022. Excel 2019 software and SPSS 21.0 software were utilized for organizing and analyzing the data. Results From 2018 to 2022, a total of 292 912 influenza-like illness (ILI) cases were reported in Qingdao City, and the average ILI% was 8.54%. There was a statistically significant difference in ILI% between years (χ²=10 565.926, P<0.001). The proportion of ILI in the 0-<5 age group was the highest (49.22%), while the proportion in the 15-<25 age group was the lowest (5.80%). The influenza epidemic exhibits high seasonality, with the peak occurring in winter and spring, and fluctuating in summer after 2021. A total of 11 437 swab samples were tested, of which 1 206 samples tested positive for nucleic acid, resulting in a positive rate of 10.54%. The age group of 5-14 years had the highest positive rate of influenza virus (13.73%), followed by the 25-<60 age group (10.96%). The positive rate of the influenza virus varied significantly among different age groups (χ²=60.599, P<0.001). In Qingdao City, the predominant influenza strains included seasonal H3, new A H1 and B Victoria lineage viruses, with the dominant strains varying from year to year. Conclusions Based on the influenza epidemic situation in Qingdao City, it is recommended to implement prevention and control measures, such as surveillance and early warning, before the winter and spring seasons. Meanwhile, surveillance of influenza during the summer should be intensified, and prevention and control strategies should be promptly adjusted.

The healthy lifestyle compliance of 36 000 adult residents in Sichuan Province

ZHA Yuxin, DENG Ying, HE Jun, ZUO Mingliang, LI Xi, CUI Jianlan, ZHANG Yan, XU Wei, HE Yujin, QIN Xiaoyun, WANG Zhuo

2024, 28(6): 657-663. doi: 10.16462/j.cnki.zhjbkz.2024.06.007

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Objective To explore the adherence of four healthy lifestyles, related influencing factors, and potential health benefits for all-cause deaths among adult residents in Sichuan Province, and propose targeted health promotion strategies. Methods Using the multi-stage cluster sampling method, 8 counties (districts) in the province were randomly selected for the four healthy lifestyle conditions of the surveyed residents from 2015 to 2019, including non-smoking, non-drinking or moderate drinking, adequate physical activity, and healthy diet. The relationship between individual characteristics and following the four healthy lifestyle was analyzed using multivariable regression models, and Cox regression models estimated the risk ratios of all-cause deaths (HR) and their 95% confidence intervals. Results A total of 36 066 permanent residents aged 35 to 75 years were included in this study. Among the respondents, 74.6% were non-smokers, 96.2% were non-alcoholic or moderate alcohol, 29.2% had sufficient physical activity, 6.2% followed a healthy diet, and only 2.7% of the respondents followed all the above four healthy lifestyles. Women, the elderly, non-farmers, urban residents, people with high income or high education, or people with a history of cardiovascular disease were more likely to follow all four healthy lifestyles (P < 0.001). After 2.4 years of follow-up, those adhering to three or more healthy lifestyles, adherence to adequate exercise, and non-smoking had lower all-cause mortality [adjusting for age and sex, HR=0.47 (95% CI: 0.22-0.96), HR=0.63 (95% CI: 0.52-0.75), and HR =0.79 (95% CI: 0.64-0.98)]. Conclusions Compliance with adequate physical activity and a healthy diet for adult residents in Sichuan Province is not ideal, which should be the focus of health promotion, and targeted measures should be taken to control different risk factors to achieve better prevention and control effects.

Identification of immune molecular markers for ischemic stroke based on genomic data

ZHANG Wenjing, XU Yaqi, HUANG Yiming, WANG Fenglin, WANG Aimin, WANG Qinghua, SHI Fuyan

2024, 28(6): 664-671. doi: 10.16462/j.cnki.zhjbkz.2024.06.008

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Objective To explore the immune-related molecular markers for ischemic stroke based on genomic data, and to provide theoretical basis for the prevention and clinical treatment of ischemic stroke. Methods GSE16561 and GSE58294 from the gene expression omnibus (GEO) database were used for the analysis and exploration of molecular markers immune-related to ischemic stroke. Based on the immunology database and analysis portal (ImmPort) database, immune-related genes were obtained and their differential expression in ischemic stroke group and normal controls group were also analyzed to identify differentially expressed immune genes (DEIGs). Immune-related hub genes were identified by protein-protein interaction (PPI). Pathway analysis of DEIGs was performed to find the possible molecular signaling pathways of ischemic stroke. Finally, the infiltration abundance of 22 immune cells was evaluated based on the CIBERSORT algorithm, and the difference between ischemic stroke group and normal control group was subsequently calculated to determine ischemic stroke-related immune cells. Results Differential analysis results showed that 37 DEIGs had statistically significant differences between two groups (all P < 0.05), including 31 up-regulated genes and 6 down-regulated genes in ischemic stroke samples. Pathway analysis results showed that the identified DEIGs were mainly enriched in immune-related molecular pathways. PPI analysis results showed that TLR4, TLR2, MMP-9, CCR7, STAT3, TNFSF13B, S100A12, CD19, CAMP and SLC11A1 were key hub immune genes closely related to ischemic stroke. Based on CIBERSORT results, we found that immune response cells were less enriched in ischemic stroke samples (all P < 0.05). However, the levels of immunosuppressive cells were higher (all P < 0.05). Conclusions Based on transcriptome expression data, this study identifies immune genes, immune signaling pathways and immune cells associated with ischemic stroke. This study reveals the immune molecular markers associated with ischemic stroke at three molecular levels, which is of great significance for the effective prevention and control of ischemic stroke and the formulation of targeted treatment strategies.

A cohort study on the relationship between sedentary time and all-cause mortality in community residents in Shanghai

ZHANG Yan, DUAN Chunmei, JIN Yaqin, GONG Gang, ZHAO Qi, ZHAO Genming, PENG Qian, YU Hongjie

2024, 28(6): 672-677. doi: 10.16462/j.cnki.zhjbkz.2024.06.009

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Objective To explore the relationship between sedentary time and mortality of the community residents aged 20-74 in Jiading District, Shanghai, in order to provide a scientific basis for the guidance of sedentary behavior. Methods Based on the project site data of Shanghai Peak Cohort in Jiading District, a total of 10 038 individuals without missing sedentary time were used as baseline data. Sedentary time was obtained through baseline questionnaires, and individual death information was obtained from the death surveillance system and active surveillance. The Cox proportional risk model was used to assess the risk of death. Results As of December 31, 2022, the mean follow-up was (5.4±0.4) years (53 985.7 person-years). During the follow-up period, 205 deaths occurred. The mortality rates in the groups 0-<4 h/d, 4-<6 h/d, 6-<8 h/d and ≥8 h/d were 1.8% (89/5 040), 2.0% (54/2 654), 2.8% (26/945) and 2.6% (36/1 399), respectively. Kaplan-Meier curve showed that the risk of all-cause death increased with the increase of follow-up time in the four groups, but there was no statistically significant difference between groups (Log-Rank $\chi^2$=6.230, P=0.101). Compared to the community residents with sedentary time 0-<4 h/d, those with sedentary time 6-<8 h/d and ≥8 h/d had an increased risk of all-cause death (HR_{6-<8 h/d group}=1.602, 95% CI: 1.007-2.548, P=0.047; HR_{≥8 h/d group}=1.670, 95% CI: 1.100-2.538, P=0.016). Conclusions Sedentary time is an independent risk factor for all-cause mortality in the community residents, and those with sedentary time ≥6 h/d have an increased risk of all-cause death. In the future, we need to take personalized intervention to avoid high levels of sedentary behavior.

Impact of temperature changes between neighboring days on ischemic stroke

WANG Ying, HU Wanqin, SUN Haoxiang, YANG Jidan, KANG Ruihan, HU Huaqing

2024, 28(6): 678-684. doi: 10.16462/j.cnki.zhjbkz.2024.06.010

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Objective To assess the effect of temperature changes between neighboring days on the risk of ischemic stroke outpatient visits. Methods A distributional lag nonlinear model combined with a Poisson generalised linear regression model was used to analyse the relationship between temperature changes between neighboring days and ischemic stroke outpatient visits at a large tertiary hospital in Hefei city, with corrections for relevant environmental factors and stratified by different gender and age groups. Results In this study, there were 32 560 ischemic stroke patients, with an average of 17.8 ischemic stroke visits per day. Exposure relationship curves show significant association between TCN and ischemic stroke outpatient visits. The relative risk over 0-7days Reached 1.796(95% CI: 1.150-2.805) for extreme negative temperature changes between neighboring days (5th percentile), whereas the relative risk of extreme positive temperature changes between neighboring days (95th percentile) was 0.686(95% CI: 0.499-0.945) and maximized at a cumulative lag of 6 days. Subgroup studies revealed that men and ischemic stroke patients over the age of 65 were more vulnerable to negative temperature changes between neighboring days. Conclusions Temperature changes between neighboring days and ischemic stroke are nonlinearly related in Hefei; with negative temperature changes between neighboring days increases the likelihood for ischemic stroke patients, watch for ischemic stroke when temperature drops suddenly; and positive temperature changes between neighboring days decreases the risk of ischemic stroke patients, who require protection from heat and other health concerns induced by rising temperature.

Predictive study on discharge status of hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease

LI Shaofan, LI Lifang, HE Hangzhi, ZHANG Yaoye, YUAN Yiwei, ZHAO Hui, ZHANG Yanbo

2024, 28(6): 685-690. doi: 10.16462/j.cnki.zhjbkz.2024.06.011

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Objective A machine learning prognosis prediction model was created by innovatively combining discharge status and length of hospital stay, to accurately predict the prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). This was done in order to address the issues of difficult to obtain pulmonary function tests and large measurement error. Methods A total of 3 035 inpatients with AECOPD were recruited from the second hospital of Shanxi Medical University between October 2011 and May 2020. The outcome variable is whether or not the patient recovered and was discharged within the median length of hospitalization.The prediction model is created using five distinct machine learning models: logistic regression, support vector machine, random forest, Catboost, and multi-layer perceptron. By contrasting evaluation metrics like area under the working characteristic curve (AUROC), the optimal model is determined. In order to verify the decision curve's clinical applicability, the best model was used to assess it. Results In comparison to other machine learning models, random forest has the greatest overall prediction performance, with AUC of 0.780, accuracy of 69.69%, precision of 64.50%, recall of 75.18%, F1 score of 69.44%, and Brier score of 18.77%. The decision curve analysis has high clinical value, and the calibration curve is largely compatible with the diagonal. Conclusions The prediction model based on random forest may reliably forecast the prognosis of patients with AECOPD and provide some aid to physicians in evaluation and treatment decision-making when the important indices of the lung function test cannot be acquired.

Effects of TRPV1 on biological behavior of hepatocellular carcinoma and prediction of possible mechanisms

WEI Liling, LIU Meiliang, LI Deyuan, YANG Yu, XIAO Suyang, LI Chanhua, WU Siqian, SONG Anhua, ZENG Xiaoyun

2024, 28(6): 691-701. doi: 10.16462/j.cnki.zhjbkz.2024.06.012

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Objective To clarify the expression of transient receptor potential vanilloid subfamily 1 (TRPV1) in hepatocellular carcinoma (HCC) and its relationship with prognosis, and to explore its effect on the biological behavior of HCC cells. Methods The cancer genome atlas (TCGA), genotype-tissue expression (GTEx) and gene expression ominbus (GEO) databases were utilized to verify the expression of TRPV1 in HCC and its relationship with prognosis. The effects of TRPV1 on the proliferation, migration, invasion, and cell cycle of HCC cells were detected by CCK-8 assay, scratch assay, Transwell assay, and flow cytometry. The expression of cyclin-dependent kinase 4 (CDK4) and cyclin-dependent kinase 6 (CDK6) was detected by Western blot, and the tumor proliferation ability was detected by subcutaneous tumor formation assay in nude mice. Finally, the TRPV1 co-expression network was constructed and analyzed for functional enrichment. Results The expression level of TRPV1 in HCC tissues was down-regulated in TCGA, GTEx, and GEO databases (P < 0.001) and was associated with a shorter overall survival time of patients (P=0.032), with an area under the ROC curve of 0.91. Overexpression of TRPV1 suppressed the proliferation, migration, and invasion ability of HCC cells, blocked cell cycle progression, and CDK4 and CDK6 protein expression levels decreased (both P < 0.05), and the opposite was true for knockdown of TRPV1 (both P < 0.05). After stable overexpression of TRPV1, the subcutaneous tumor volume of nude mice was reduced (P=0.015), the mass of nude mice was reduced (P=0.033), and the positive expression level of Ki-67 protein was down-regulated (P=0.010). TRPV1 co-expressed genes were mainly involved in the processes of RNA splicing, cell cycle protein binding, and cell proliferation. Conclusions TRPV1 inhibited the proliferation, migration, and invasion of HCC cells and blocked cell cycle progression, which exerted an oncogenic role in HCC and provided a new direction for the prognostic analysis and treatment of HCC.

Study on the current situation and influencing factors of the knowledge, attitude and practice of cervical cancer prevention and treatment among women in Shanxi Province

HE Lu, QIN Mengxia, LI Sitian, LI Wenai, CAI Yutong, CAO Xi, WU Dahong

2024, 28(6): 702-709. doi: 10.16462/j.cnki.zhjbkz.2024.06.013

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Objective To understand the current status and the influencing factors of knowledge, attitude, and behavior about cervical cancer prevention and treatment among women in Shanxi Province. And we aims to provide a basis for promoting women's participation in cervical cancer screening and emphasizing health education efforts among rural women. Methods A self-designed questionnaire was used. The data of 3 460 women was conducted with $\chi^2$ test and binary logistic regression to explore the influencing factors of cervical cancer knowledge, attitude, and behavior. Results The knowledge awareness rate of cervical cancer among women in Shanxi Province was 51.3%. The positive attitude toward prevention and treatment was 75.9%. The screening rate of cervical cancer was 42.6% and 92.4% women were willing to be screened for cervical cancer in the future. Age(OR=0.737, 95% CI: 0.681-0.799, P < 0.001), education(OR=1.321, 95% CI: 1.219-1.431, P < 0.001), occupation [compared to the group with civil servant, the OR for other groups were 1.166(95% CI: 0.953-1.429, P=0.136), 2.690(95% CI: 2.143-3.377, P < 0.001), 3.114(95% CI: 2.323-4.174, P < 0.001), amd 1.444(95% CI: 1.051-1.984, P=0.023), respectively], and annual per capita household income(OR=1.103, 95% CI: 1.051-1.158, P < 0.001) were the influencing factors for women's knowledge of cervical cancer prevention and treatment. Age(OR=0.719, 95% CI: 0.660-0.785, P < 0.001), education(OR=1.206, 95% CI: 1.108-1.313, P < 0.001), occupation [compared to the group with civil servant, the OR for other groups were 1.202(95% CI: 0.956-1.512, P=0.116), 1.621(95% CI: 1.241-2.118, P < 0.001), 1.389(95% CI: 0.984-1.962, P=0.062), 1.327(95% CI: 0.958-1.840, P=0.089), respectively], annual per capita household income(OR=1.085, 95% CI: 1.029-1.145, P=0.003), and smoking(OR=0.666, 95% CI: 0.490-0.907, P=0.010) were the influencing factors for women's attitude toward cervical cancer prevention and treatment. Age(OR=1.161, 95% CI: 1.051-1.284, P=0.003), household registration(OR=1.474, 95% CI: 1.230-1.767, P < 0.001), occupation [compared to the group with civil servant, the OR for other groups were 1.019(95% CI: 0.832-1.248, P=0.854), 1.840(95% CI: 1.427-2.372, P < 0.001), 0.758(95% CI: 0.477-1.206, P=0.243), 0.626(95% CI: 0.463-0.845, P=0.002), respectively], marital status [compared to the group with not married, the OR for other groups were 8.306(95% CI: 6.164-11.194, P < 0.001), 10.480(95% CI: 6.031-18.212, P < 0.001), respectively], annual per capita household income(OR=1.114, 95% CI: 1.058-1.174, P < 0.001), women's disease prevalence(OR=1.322, 95% CI: 1.142-1.530, P < 0.001), breakfast(OR=1.423, 95% CI: 1.178-1.720, P < 0.001), physical exercise(OR=1.192, 95% CI: 1.061-1.340, P=0.003), and abortion(OR=1.237, 95% CI: 1.119-1.367, P < 0.001) were the influencing factors for cervical cancer screening behavior. Age(OR=0.760, 95% CI: 0.683-0.845, P < 0.001), annual per capita household income(OR=1.133, 95% CI: 1.050-1.223, P=0.001), breakfast(OR=1.390, 95% CI: 1.074-1.800, P=0.012), and smoking (OR=0.441, 95% CI: 0.309-0.630, P < 0.001) were the influencing factors for cervical cancer screening willingness. Conclusions Women's knowledge of cervical cancer prevention and screening behaviors were poor, and the attitude toward prevention and treatment need to be improved. Screening willingness was high, and there was a large gap between urban and rural areas in the cervical cancer screening rate. It is still necessary to promote women's participation in cervical cancer screening through a variety of ways and to pay attention to the health education work of rural women.

The current status and epidemic-related influencing factors of the symptoms of anxiety, depression and insomnia among residents in mainland China in the post-epidemic era

LIU Xiaochang, CHENG Guirong, LI Chunli, ZENG Yan

2024, 28(6): 709-714. doi: 10.16462/j.cnki.zhjbkz.2024.06.014

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Objective To explore the current status of psychological symptoms of anxiety, depression and insomnia among residents in mainland China in the post-epidemic era and the influence of epidemic-related factors on psychological symptoms. Methods Standardized measures of anxiety, depression, and insomnia as well as measures of risk factors known to be associated with poor mental health outcomes were administered through an online cross-sectional survey from January to April, 2023. One-way analysis of variance, t test, and χ² test were used to analyze the differences of anxiety, depression and insomnia among different groups. Pearson correlation analysis was used to explore the correlation between epidemic-related factors and psychological symptoms. The linear regression model was used to determine the quantitative relationship between epidemic-related factors and anxiety, depression and sleep quality. Results Among of 35 213 participants aged ≥16 years, 8 464 (24.0%) had anxiety symptoms with generalized anxiety disorder-7 (GAD-7) score (6.30±5.06), 12 216 (34.7%) had depression with patient health questionnaire-9 (PHQ-9) score (7.98±6.12), and 12 416 (35.3%) had insomnia with PSQI score (8.75±3.94) points. The scores of anxiety, depression and sleep quality were negatively correlated with INI (infection index) (β=-0.083, -0.042, -0.069, P < 0.001), while the scores of anxiety, depression and sleep quality were positively correlated with IMI (impact index) and COI (concern index) (β=0.401, 0.365, 0.207, P < 0.001). Conclusions The symptoms of anxiety, depression and sleep quality among residents in mainland China were severe in the post-epidemic era. It is necessary to continue to pay attention to the mental health of residents and help people cope with the long-term effects of corona virus disease 2019 (COVID-19) with a good level of mental health.

Distribution characteristics of intelligence level among primary and secondary school students in China

WANG Zhifang, ZHANG Qian, YANG Titi, XU Peipei, GAN Qian, CAO Wei, WANG Hongliang, LUO Ruihe, PAN Hui, SUN Wenxin, FU Yimeng, YANG Zhenyu, ZHAO Wenhua, XU Juan

2024, 28(6): 714-720. doi: 10.16462/j.cnki.zhjbkz.2024.06.015

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Abstract:
Objective To analyze the intelligence level and the distribution characteristics of different primary and secondary school students covering 14 provinces in China. Methods The students in this study were from 3 348 primary and middle school students in the project of "Systematic Investigation and Application of Nutrition and Health in children aged 0-18 years in China". The Wechsler intelligence scale for children fourth edition (WISC-IV) was used to evaluate the intellectual level of 3 348 primary and secondary school students. Multiple logistic regression analysis model was used to analyze the factors affecting primary and secondary school students' intelligence. Results The median FSIQ score of 3 348 primary and secondary school students was 101, and the proportion of intelligence level with excellent or above, medium, critical or below was 8.12%, 87.04% and 4.84%, respectively. Multivariate logistic regression analysis showed that the probability of primary and secondary school students in urban with excellent and above intelligence level was 1.533 times of those in rural (OR=1.533);the probability of primary and secondary school students in eastern and central areas with excellent or above intelligence level was 3.183 times (OR=3.183) and 1.893 times (OR=1.893) of those in western areas; Primary and secondary school students whose parents' education level is college/university or above are 2.279 times more likely to have excellent or above intelligence than primary and secondary school students whose parents' education level is high school/technical secondary school or below (OR=2.279). Living in urban (OR=0.376), located in central area (OR=0.476), parents earned college/university degree or above (OR=0.205) are the protective factors for primary and secondary school students with critical or below intelligence level (all P < 0.05). Left-behind status is the risk factor for primary and secondary school students with critical or below intelligence level (OR=1.934, P=0.007). Conclusions Primary and secondary school students with medium intelligence level taking the largest proportion, rural areas, western regions, low parental education level and left-behind status are risk factors for the intelligence level of primary and secondary school students. It is suggested that more attention should be paid to the intellectual development of primary and secondary school students in rural areas, western regions, parents with low education level and left-behind status, so as to comprehensively promote the intellectual development of primary and secondary school students in China.

Systematic review of the incidence and risk factors of hypertension among HIV-positive individuals

HE Chunyan, XU Xiaohui, HE Na, DING Yingying

2024, 28(6): 721-728. doi: 10.16462/j.cnki.zhjbkz.2024.06.016

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Objective To systematically review the incidence density and influencing factors of hypertension in HIV positive people in order to explore the potential mechanisms of hypertension in HIV positive individuals. Methods We search literature related to incident hypertension among HIV-positive individuals through CNKI, Wanfang, PubMed, EMbase, Web of Science and Medline, databases and the basic information, incidence density and risk factors were extracted. Results A total of 20 studies were included, comprising 5 from North America, 5 from Africa, 4 from Asia, 2 from Europe, and 4 from multicenter studies. The incidence density of hypertension in HIV-positive individuals ranged from 26.0 to 320.1 per 1 000 person-years. The risk factors of incident hypertension in HIV-positive individuals include traditional risk factors such as age, gender, race, BMI and abdominal obesity, diabetes, kidney disease, dyslipidemia, etc. HIV-specific factors included time of HIV infection, duration of antiviral therapy (ART), and antiviral drugs. Conclusions The incidence density of hypertension is relatively high among HIV-positive individuals, and the geographical variations are particularly pronounced. The contribution of traditional risk factors to incident hypertension among HIV-positive individuals is well established, underscoring the importance of implementing comprehensive strategies and interventions for primary prevention within this population's lifetstyles. However, the role of HIV and ART-related risk factors in hypertension remains unclear, and prospective studies are needed to better elucidate the epidemiology of hypertension in HIV-positive individuals.

A review of the incidence and influencing factors of perinatal depression in fathers

ZHANG Xiaotong, XU Jihong

2024, 28(6): 729-735. doi: 10.16462/j.cnki.zhjbkz.2024.06.017

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The perinatal period is not only a period of high incidence of depression among women, but fathers also face a high risk to depression during this period. In order to better understand the characteristics and causes of paternal perinatal depression, this study aims to review the incidence and influencing factors of perinatal depression among fathers at home and abroad during 2018-2023. The results showed that the incidence of paternal perinatal depression was relatively high, particularly in early pregnancy and 6 months postpartum. The incidence rates varies due to the different scales, cutoff points, study populations, perinatal periods, as well as cultural and social backgrounds. The influencing factors of paternal perinatal depression could be summarized into five aspects: demographic factors, social and family factors, psychological factors, pregnancy and childbirth-related factors, and newborn-related factors. Therefore, to better identify, prevent and intervene in paternal perinatal depression, it is necessary to conduct targeted research from multiple perspectives and integrate various factors in order to provide more professional support and intervention.

Analysis on the spatial-temporal distribution characteristics of pulmonary tuberculosis in the elderly in Jiangsu Province from 2017 to 2022

JIANG Hui, CHEN Ke, WANG Zhan, YU Hao, ZHU Limei, ZHOU Yong, LIU Qiao

2024, 28(6): 736-739. doi: 10.16462/j.cnki.zhjbkz.2024.06.018

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Objective This study aimed to analyze the spatiotemporal distribution characteristics of pulmonary tuberculosis among the elderly population in Jiangsu Province, China, from 2017 to 2022. The findings will provide a scientific basis for implementing and adjusting pulmonary tuberculosis prevention and control strategies in the province. Methods We collected data on pulmonary tuberculosis incidence in the elderly population of Jiangsu Province from 2017 to 2022, along with the corresponding elderly population figures for each county. ArcGIS 10.7 software was used for visualization mapping. Global and local spatial autocorrelation analysis was conducted using Geoda 1.18.0 software to explore spatial clustering of pulmonary tuberculosis cases. Finally, SaTScan 10.1 software was employed for spatiotemporal scan analysis to identify areas with spatiotemporal aggregation. Results The reported incidence rate of pulmonary tuberculosis in the elderly population of Jiangsu Province decreased significantly from 78.99/100 000 in 2017 to 55.17/100 000 in 2022 (χ_trend²=439.493, P < 0.001), with an average annual incidence rate of 64.14/100 000. The Moran's I values ranged from 0.243 to 0.600, indicating an overall spatial clustering distribution of pulmonary tuberculosis cases. Spatiotemporal scan analysis identified five statistically significant spatiotemporal clusters (P < 0.05), including a primary cluster encompassing 22 counties, a secondary cluster of 3 counties, a tertiary cluster of 5 counties, and a quaternary cluster of 14 counties. And the time of spatiotemporal aggregation was 2017-2019. Conclusions Despite a year-by-year decrease, the incidence rate of pulmonary tuberculosis in the elderly population of Jiangsu Province remains higher than the general population. Furthermore, the presence of evident spatial clustering necessitates focused attention in these areas for improved pulmonary tuberculosis prevention and control strategies.

Epidemiological characteristics and etiological analysis of norovirus gastroenteritis outbreaks among children in Nanchang from 2016 to 2023

HE Fenglan, YI Liu, Gan Xia, TU Junling, HUANG Siping, LI Mei, QIAN Ke, XIA Wen, NI Xiansheng

2024, 28(6): 740-744. doi: 10.16462/j.cnki.zhjbkz.2024.06.019

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Objective To analyze the epidemiological characteristics and genetic diversity of norovirus gastroenteritis outbreaks among children in Nanchang from March 2016 to February 2023, and to provide scientific basis for the prevention and control of viral gastroenteritis in children. Methods The epidemiological characteristics of norovirus gastroenteritis outbreaks in children were analyzed in Nanchang City from March 2016 to February 2023. Anal swab samples and/or vomits were collected. real-time fluorescence quantitative polymerase chain reaction (RT-PCR) was used to identify norovirus GI and GII genogroups. Specific primers were used to amplify the nucleic acid among positive samples. The amplified products were sequenced and analyzed for genotype and recombination. Results A total of 89 outbreaks of norovirus gastroenteritis in children were investigated during 7 years, including 49 outbreaks in kindergartens and 40 outbreaks in primary schools. The average number of cases involved in each outbreak was 14.71, and the total attack rate was 3.18 %. The sex ratio was 1.22∶1.00 (male/female), and the average epidemic time was about 3 days. The high incidence month was from October to February of the following year of the total epidemic. Urban childcare institutions were places with high incidence of epidemic. A total of 823 samples were collected, and the positive rate of norovirus nucleic acid was 55.65%. There were 6 outbreaks of GI norovirus, 81 outbreaks of GII norovirus, and 2 outbreaks of co-infection. Among them, 73 outbreaks were sequenced successfully, and 14 genotypes were identified. The GI norovirus was GⅠ.3[P13], GⅠ.6[P11]P, GⅠ.4[P4]. GII norovirus was dominated by GⅡ.2, GⅡ.6 and GⅡ.7 subtypes, with 11 genotypes. GⅡ.2 [P16] accounted for the highest proportion, and the dominant genotype changed from GⅡ.2 to other types. Conclusions In recent years, the epidemic of norovirus gastroenteritis in children was mainly concentrated in urban kindergartens, and winter was the high incidence season in Nanchang. The main pathogen was GII norovirus, with multiple gene recombination types mainly GⅡ.2 [P16] circulating at the same time.

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2024 Vol. 28, No. 6

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Editor

Editor-in-Chief Ye Dongqing M.D.

Assistant editor Fan Yinguang M.D.

Assistant editor Pan Haifeng M.D.

Assistant editor