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Liu J, Luo B, Zhou Y, Ma X, Liang J, Sang X, Lyu L, Chen W, Fu P, Liu H, Zhen S, Wang C, Wu Y, Huang Q, Liang X, Bai G, Lan Z, Zhang S, Wu Y, Li N, Guo Y. Prevalence and distribution of acute gastrointestinal illness in the community of China: a population-based face-to-face survey, 2014-2015. BMC Public Health 2023; 23:836. [PMID: 37158857 PMCID: PMC10165855 DOI: 10.1186/s12889-023-15337-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 02/28/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND The true incidence of acute gastrointestinal illness in China is underrecognized by surveillance systems. The aims of this study were to estimate the incidence and prevalence of self-reported AGI in the community of China, and to investigate sociodemographic and epidemiological determinants of AGI. METHODS We conducted a 12-months cross-sectional population-based survey in eight provinces of China during 2014-2015. The survey determined the prevalence and incidence of acute gastrointestinal illness (AGI) in the total permanent resident population in China according to the census of the population in 2010. The random multilevel population sample was stratified by geographic, population, and socioeconomic status. We used a recommended case definition of AGI, with diarrhea (three loose or watery stools) and/or any vomiting in a four-week recall. A face-to-face survey was conducted by selecting the member in the household with the most recent birthday. RESULTS Among 56,704 sampled individuals, 948 (1,134 person-time) fulfilled the case definition; 98.5% reported diarrhea. This corresponds to 2.3% (95% CI:1.9%-2.8%) of an overall standardized four-week prevalence and 0.3 (95% CI: 0.23-0.34) episodes per person-year of annual adjusted incidence rate. There was no significant difference between males and females. The incidence rates were higher among urban residents, and in the spring and summer. In the whole study period, 50% of the cases sought medical care, of which 3.9% were hospitalized and 14.3% provided a biological sample for laboratory identification of the causative agent. Children aged 0-4 and young adults aged 15-24, people living in rural areas and people who traveled frequently had higher prevalence of AGI. CONCLUSION Results showed that AGI represents a substantial burden in China, and will contribute to the estimation of the global burden of AGI. Complemented with data on the etiologies of AGI, these estimates will form the basis to estimate the burden of foodborne diseases in China.
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Affiliation(s)
- Jikai Liu
- NHC Key Laboratory of Food Safety Risk Assessment, Food Safety Research Unit (2019RU4) of Chinese Academy of Medical Science, China National Center for Food Safety Risk Assessment, Beijing, China
| | - Baozhang Luo
- Shanghai Municipal Center for Disease Prevention and Control, Shanghai, China
| | - Yijing Zhou
- Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, China
| | - Xiaochen Ma
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Junhua Liang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Xianglai Sang
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Le Lyu
- Jilin Provincial Center for Disease Control and Prevention, Changchun, China
| | - Wen Chen
- Sichuan Provincial Center for Disease Control and Prevention, Chengdu, China
| | - Pengyu Fu
- Henan Provincial Center for Disease Control and Prevention, Zhengzhou, China
| | - Hong Liu
- Shanghai Municipal Center for Disease Prevention and Control, Shanghai, China
| | - Shiqi Zhen
- Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, China
| | - Chao Wang
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Yangbo Wu
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Qiong Huang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Xiaocheng Liang
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Guangda Bai
- Jilin Provincial Center for Disease Control and Prevention, Changchun, China
| | - Zhen Lan
- Sichuan Provincial Center for Disease Control and Prevention, Chengdu, China
| | - Shufang Zhang
- Henan Provincial Center for Disease Control and Prevention, Zhengzhou, China
| | - Yongning Wu
- NHC Key Laboratory of Food Safety Risk Assessment, Food Safety Research Unit (2019RU4) of Chinese Academy of Medical Science, China National Center for Food Safety Risk Assessment, Beijing, China
| | - Ning Li
- NHC Key Laboratory of Food Safety Risk Assessment, Food Safety Research Unit (2019RU4) of Chinese Academy of Medical Science, China National Center for Food Safety Risk Assessment, Beijing, China.
| | - Yunchang Guo
- NHC Key Laboratory of Food Safety Risk Assessment, Food Safety Research Unit (2019RU4) of Chinese Academy of Medical Science, China National Center for Food Safety Risk Assessment, Beijing, China.
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Cai H, Shao Y, Yu W. Prevalence and associated factors of acute gastroenteritis in children and adolescents aged from 6 to 17 years old: a cross-sectional study based on the National Health and Nutrition Examination Survey database 1999-2018. BMJ Open 2023; 13:e068319. [PMID: 36822803 PMCID: PMC9950896 DOI: 10.1136/bmjopen-2022-068319] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
OBJECTIVE To explore the prevalence of acute gastroenteritis (AGE) and associated factors in children and adolescents in the USA from 1999 to 2018 using nationally representative data. DESIGN A retrospective cross-sectional study. SETTING The National Health and Nutrition Examination Survey (NHANES) database. PARTICIPANTS 25 361 children and adolescents aged 6-17 years old. PRIMARY AND SECONDARY OUTCOME MEASURES Whether the patient suffered from AGE. RESULTS Totally 1882 suffered from AGE. The overall monthly prevalence of AGE in children and adolescents was 7.69%. From 1999 to 2018, the prevalence of AGE in the USA had been decreasing over time. The decreasing trend was observed in all subgroups, including age, gender, body mass index (BMI), education level, poverty index and eating food at the restaurant. There were two small upticks from 2003 to 2007 and 2013 to 2015. AGE was negatively associated with male compared with female (OR=0.86, 95% CI: 0.73 to 0.99, p=0.035), Mexican American (OR=0.82, 95% CI: 0.70 to 0.97, p=0.018) and non-Hispanic Black (OR=0.80, 95% CI: 0.69 to 0.93, p=0.003) compared with non-Hispanic White. AGE was positively associated with obesity compared with underweight and normal weight (OR=1.37, 95% CI: 1.15 to 1.62, p<0.001). CONCLUSION The monthly prevalence of AGE was 7.69% and showed a downward trend from 1999 to 2018 in the USA.
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Affiliation(s)
- Hailun Cai
- Department of Pediatric, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yanyan Shao
- Department of Pediatric, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Weihao Yu
- Department of Pediatric, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
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Huo Y, Gao F, Wang J, Liu Z, Zhou L, Gu B, Zhang X, Ma Y. Economic Burden and Influencing Factors of Acute Gastroenteritis in China: A Population-Based Face to Face Survey in 2018. Front Public Health 2022; 10:905458. [PMID: 35769779 PMCID: PMC9235911 DOI: 10.3389/fpubh.2022.905458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/06/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundAcute gastroenteritis is an important and highly prevalent public health problem worldwide. The purpose of this study was to assess the economic burden of disease and its influencing factors in patients with acute gastroenteritis in Heilongjiang Province, China.MethodsA multi-stage stratified random sampling method was used in a face-to-face household survey in 2018. Demographic and socioeconomic characteristics, clinical symptoms, suspicious dietary history, and disease treatment information were collected from 19,647 respondents. One-way analysis of variance and multiple stepwise regression analysis were used to investigate the factors associated with the economic burden of acute gastroenteritis. Quantitative risk analysis and sensitivity analysis were performed to estimate the uncertainty and risk factors of the economic burden of acute gastroenteritis.ResultsThe total economic burden of patients with acute gastroenteritis was 63,969.22 CNY (Chinese Yuan), of which the direct economic burden accounted for 63.82%; the per capita economic burden was 131.35 CNY per month. Age, region, disease duration, and disease treatment were the main factors significantly associated with the economic burden of acute gastroenteritis (P < 0.05). The average economic burden of patients with acute gastroenteritis was approximately 571.84 CNY/person (95% CI: 227–1,459). Sensitivity analysis showed that the greatest impact was from the indirect economic burden.ConclusionsAcute gastroenteritis brings a substantial health burden to patients due to its high incidence. The economic burden of self-purchased drugs and the indirect economic burden of patients cannot be ignored. To better estimate the economic burden of acute gastroenteritis in China, further studies on the pathogen-specific economic burden of acute gastroenteritis are required.
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Affiliation(s)
- Yue Huo
- School of Health Management, Harbin Medical University, Harbin, China
| | - Fei Gao
- Heilongjiang Provincial Center for Disease, Control and Prevention, Harbin, China
| | - Jiayu Wang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Zhongwei Liu
- Heilongjiang Provincial Center for Disease, Control and Prevention, Harbin, China
| | - Liangru Zhou
- School of Health Management, Harbin Medical University, Harbin, China
| | - Baiyang Gu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Xin Zhang
- School of Health Management, Harbin Medical University, Harbin, China
- *Correspondence: Xin Zhang
| | - Yi Ma
- School of Health Management, Harbin Medical University, Harbin, China
- Yi Ma
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Wang JK, He Y, Chen LL, Zhang HX, Qi XJ, Sun L, Zhang SF, Chen J, Zhang RH. A population-based survey of the prevalence of self-reported acute gastrointestinal illness in Zhejiang Province, China. PLoS One 2022; 17:e0268717. [PMID: 35584149 PMCID: PMC9116671 DOI: 10.1371/journal.pone.0268717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 05/05/2022] [Indexed: 11/19/2022] Open
Abstract
Acute gastrointestinal illness (AGI) is a prevalent public health concern worldwide. This study investigated the magnitude, distribution and burden of self-reported AGI among residents of Zhejiang Province, China. A face-to-face household survey was conducted using a multi-stage stratified random sampling method in 10 counties in Zhejiang Province between July 2018 and June 2019. In total, 12,021 participants were recruited. The prevalence of AGI 28 days after standardization was 1.8% (95% confidence interval (CI), 1.6–2.1), with an incidence rate of 0.24 episodes of AGI per person-year and an estimated 14 million cases of AGI in Zhejiang Province. Univariate and multivariable analyses showed a higher AGI prevalence among people who performed housework and were unemployed in summer and autumn among respondents living in western or northern cities (p < 0.05). More than 50% of AGI cases were attributed to the consumption of contaminated food. The disease burden caused by AGI in Zhejiang Province was approximately 975 million Chinses yuan (CNY). These results indicated that the disease burden of AGI in Zhejiang Province should be addressed and highlights the need for an improved active surveillance system of foodborne diseases to assess the impact of AGI on society and health.
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Affiliation(s)
- Ji-Kai Wang
- Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yue He
- Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Li-Li Chen
- Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - He-Xiang Zhang
- Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xiao-Juan Qi
- Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Liang Sun
- Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Shuang-Feng Zhang
- Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Jiang Chen
- Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Rong-Hua Zhang
- Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
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WU G, WANG L, WANG Q, HAN R, ZHAO J, CHU Z, ZHUANG M, ZHANG Y, WANG K, XIAO P, LIU Y, DU Z. Descriptive Study of Foodborne Disease Using Case Monitoring Data in Shandong Province, China, 2016-2017. IRANIAN JOURNAL OF PUBLIC HEALTH 2019; 48:722-729. [PMID: 31110983 PMCID: PMC6500530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND In order to generate data on the burden of foodborne diseases in Shandong Province, we aimed to use the case monitoring data of foodborne diseases from 2016 to 2017 to estimate. METHODS Data were obtained from the foodborne disease surveillance reporting system with dates of onset from Jan 1, 2016, to Dec 31, 2017, in Shandong, China. RESULTS The places of food exposure were categorized by settings as follows: private home, catering facility, collective canteens, retail markets, rural banquets and other. Exposed food is divided into 23 categories. Overall incidence rate and proportions by exposure categories, age, and sex-specific incidence rates were calculated and sex proportions compared. Approximately 75.00% of cases who had at least one exposure settings were in private homes. The most frequently reported exposed food was a variety of food (meaning more than two kinds of food). The two-year average incidence rate was 75.78/100,000, sex-specific incidence rate was much higher for females compared to males (78.23 vs. 74.69 cases per 100,000 population). An age-specific trend was observed in the cases reported (Chi-Square for linear trend, χ2=4.39, P=0.036<0.05). CONCLUSION A preliminary estimate of 14 million cases of foodborne diseases in Shandong province each year. Future studies should focus on cross-sectional and cohort studies to facilitate the assessment of the distribution and burden of foodborne disease of the population in Shandong. Considering strengthening the burden of foodborne diseases in foodborne disease surveillance is also a feasible way.
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Affiliation(s)
- Guangjian WU
- School of Public Health, Jilin University, Changchun, China,Shandong Center for Disease Control and Prevention, Jinan, China,Shandong Center for Food Safety Risk Assessment, Jinan, China,Academy of Preventive Medicine, Shandong University, Jinan, China
| | - Liansen WANG
- Shandong Center for Disease Control and Prevention, Jinan, China,Shandong Center for Food Safety Risk Assessment, Jinan, China,Academy of Preventive Medicine, Shandong University, Jinan, China
| | - Qiang WANG
- Department of Preventive Medicine and Public Health Laboratory Science, School of Medicine, Jiangsu University, Zhenjiang, China
| | - Ru HAN
- Shandong Academy of Occupational Health and Occupational Medicine, Shandong Academy of Medical Sciences, Jinan, China
| | - Jinshan ZHAO
- Shandong Center for Disease Control and Prevention, Jinan, China,Shandong Center for Food Safety Risk Assessment, Jinan, China,Academy of Preventive Medicine, Shandong University, Jinan, China
| | - Zunhua CHU
- Shandong Center for Disease Control and Prevention, Jinan, China,Shandong Center for Food Safety Risk Assessment, Jinan, China,Academy of Preventive Medicine, Shandong University, Jinan, China
| | - Maoqiang ZHUANG
- Shandong Center for Disease Control and Prevention, Jinan, China,Shandong Center for Food Safety Risk Assessment, Jinan, China,Academy of Preventive Medicine, Shandong University, Jinan, China
| | - Yingxiu ZHANG
- Shandong Center for Disease Control and Prevention, Jinan, China,Shandong Center for Food Safety Risk Assessment, Jinan, China,Academy of Preventive Medicine, Shandong University, Jinan, China
| | - Kebo WANG
- Shandong Center for Disease Control and Prevention, Jinan, China,Shandong Center for Food Safety Risk Assessment, Jinan, China,Academy of Preventive Medicine, Shandong University, Jinan, China
| | - Peirui XIAO
- Shandong Center for Disease Control and Prevention, Jinan, China,Shandong Center for Food Safety Risk Assessment, Jinan, China,Academy of Preventive Medicine, Shandong University, Jinan, China
| | - Ya LIU
- School of Public Health, Jilin University, Changchun, China,Corresponding Author:
| | - Zhongjun DU
- Shandong Academy of Occupational Health and Occupational Medicine, Shandong Academy of Medical Sciences, Jinan, China,Corresponding Author:
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Sang XL, Liang XC, Chen Y, Li JD, Li JG, Bai L, Sun JY. Estimating the burden of acute gastrointestinal illness in the community in Gansu Province, northwest China, 2012-2013. BMC Public Health 2014; 14:787. [PMID: 25086445 PMCID: PMC4246514 DOI: 10.1186/1471-2458-14-787] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 07/23/2014] [Indexed: 11/18/2022] Open
Abstract
Background Acute gastrointestinal illness (AGI) imposes considerable social and economic burden on low and middle-income countries. This study aimed to estimate the occurrence, distribution, and burden of self-reported AGI in Gansu Province of northwest China, where economic growth rates have lagged far behind those of other regions in China and systematic studies to investigate the burden of AGI are still lacking. Methods Twelve-month, retrospective face-to-face surveys were conducted in three sentinel sites between June 2012 and May 2013. Respondents were asked if they had experienced diarrhoea or vomiting in the 28 days prior to the interview. Results In total, 2094 interviews were completed. The adjusted monthly prevalence was 8.5% with an incidence rate of 1.16 episodes of AGI per person-year. Healthcare was sought by 73.8% of those reporting illness. Of the cases who visited a doctor, 50.5% submitted a stool sample. The use of antibiotics was reported by 65.6% of the cases and 53.3% took antidiarrhoeals. In the multivariable model, age, household income and sentinel site were significant risk factors of being a case of AGI. Conclusions The burden of AGI was considerable in Gansu Province of northwest China. Ongoing research to identify the main causes of AGI is needed for more accurate estimate of the burden of AGI in this region. Electronic supplementary material The online version of this article (doi:10.1186/1471-2458-14-787) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | - Yan Chen
- Institute of Food Safety, Gansu Provincial Center for Disease Control and Prevention, No, 230 Dong Gang West Road, Chengguan District, Lanzhou 730030 Gansu Province, China.
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Risk factors for sporadic Vibrio parahaemolyticus gastroenteritis in east China: a matched case-control study. Epidemiol Infect 2014; 143:1020-8. [PMID: 24992005 DOI: 10.1017/s0950268814001599] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
SUMMARY To determine risk factors for sporadic Vibrio parahaemolyticus gastroenteritis, we conducted a population-based case-control study in sentinel hospital surveillance areas of Shanghai and Jiangsu province, China. Seventy-one patients with diarrhoea and confirmed V. parahaemolyticus infections were enrolled, and they were matched with 142 controls for gender, age and residential area. From the multivariable analysis, V. parahaemolyticus infections were associated with antibiotics taken during the 4 weeks prior to illness [odds ratio (OR) 7·6, 95% confidence interval (CI) 1·1–54·4)], frequent eating out (OR 3·3, 95% CI 1·0–10·4), and shellfish consumption (OR 3·4, 95% CI 1·0–11·1), with population-attributable fractions of 0·09, 0·24, and 0·14, respectively. Protective factors included keeping the aquatic products refrigerated (OR 0·4, 95% CI 0·2–1·0) and pork consumption (OR 0·2, 95% CI 0·1–0·9) [corrected] .
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Chen Y, Yan WX, Zhou YJ, Zhen SQ, Zhang RH, Chen J, Liu ZH, Cheng HY, Liu H, Duan SG, Lan Z, Sun JC, You XY, Li JG, Wu YN. Burden of self-reported acute gastrointestinal illness in China: a population-based survey. BMC Public Health 2013; 13:456. [PMID: 23656835 PMCID: PMC3655923 DOI: 10.1186/1471-2458-13-456] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Accepted: 05/03/2013] [Indexed: 11/25/2022] Open
Abstract
Background Acute gastrointestinal illness (AGI) is an important public-health problem worldwide. Previous national studies of the incidence of AGI in China were performed decades ago, and detailed information was not available. This study therefore sought to determine the magnitude, distribution, and burden of self-reported AGI in China. Methods Twelve-month, retrospective face-to-face surveys were conducted in 20 sentinel sites from six provinces between July 2010 and July 2011. Results In total, 39686 interviews were completed. The overall adjusted monthly prevalence of AGI was 4.2% (95% confidence interval, 4.0–4.4), corresponding to 0.56 episodes of AGI per person-year. Rates of AGI were highest in children aged < 5 years. Healthcare was sought by 56.1% of those reporting illness. Of the cases who visited a doctor, 32.7% submitted a stool sample. The use of antibiotics was reported by 49.7% of the cases who sought medical care and 54.0% took antidiarrhoeals. In the multivariable model, gender, age, education, household type, residence, season, province and travel were significant risk factors of being a case of AGI. Conclusions This first population-based study in China indicated that AGI represents a substantial burden of health. Further research into the specific pathogens is needed to better estimate the burden of AGI and foodborne disease in China.
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Affiliation(s)
- Yan Chen
- Key Laboratory of Food Safety Risk Assessment of Ministry of Health, China National Center for Food Safety Risk Assessment, 7 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
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