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Jiao L, Shen T, Han Y, Liu W, Liu W, Dang L, Wei M, Yang Y, Guo J, Miao M, Xu X. The spatial-temporal distribution of hepatitis B virus infection in China,2006-2018. BMC Infect Dis 2024; 24:811. [PMID: 39129008 PMCID: PMC11318140 DOI: 10.1186/s12879-024-09716-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 08/05/2024] [Indexed: 08/13/2024] Open
Abstract
OBJECTIVES Hepatitis B is a liver disease caused by Hepatitis B virus (HBV) infection and is highly prevalent in China. To better understand the epidemiological characteristics of hepatitis B in China and develop effective disease control strategies, we employed temporal and spatial statistical methods. METHODS We obtained HBV incidence data from the Public Health Science Data Center of the Chinese Center for Disease Control and Prevention for the years 2006 to 2018. Using Geographic Information System (GIS) and SaTScan scanning technology, we conducted spatial autocorrelation analysis and spatiotemporal scan analysis to create a map and visualize the distribution of hepatitis B incidence. RESULTS While hepatitis B incidence rebounded in 2011 and 2017, the overall incidence in China decreased.In the trend analysis by item, the incidence varies from high to low. The global spatial autocorrelation analysis revealed a clustered distribution, and the Moran index analysis of spatial autocorrelation within local regions identified five provinces as H-H clusters (hot spots), while one province was an L-L cluster (cold spot). Spatial scan analysis identified 11 significant spatial clusters. CONCLUSIONS We found significant clustering in the spatial distribution of hepatitis B incidence and positive spatial correlation of hepatitis B incidence in China. We also identified high-risk times and regional clusters of hepatitis B incidence.
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Affiliation(s)
- Liping Jiao
- Laboratory Department, Weinan Center for Disease Control and Prevention, Weinan, Shaanxi, China
| | - Tuo Shen
- Laboratory Department, Weinan Center for Disease Control and Prevention, Weinan, Shaanxi, China.
| | - Yingzi Han
- Laboratory Department, Weinan Center for Disease Control and Prevention, Weinan, Shaanxi, China
| | - Wen Liu
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Wei Liu
- Laboratory Department, Weinan Center for Disease Control and Prevention, Weinan, Shaanxi, China
| | - Lin Dang
- Laboratory Department, Weinan Center for Disease Control and Prevention, Weinan, Shaanxi, China
| | - Mingmin Wei
- Laboratory Department, Weinan Center for Disease Control and Prevention, Weinan, Shaanxi, China
| | - Yunyun Yang
- Laboratory Department, Weinan Center for Disease Control and Prevention, Weinan, Shaanxi, China
| | - Jingjing Guo
- Laboratory Department, Weinan Center for Disease Control and Prevention, Weinan, Shaanxi, China
| | - Meirong Miao
- Laboratory Department, Weinan Center for Disease Control and Prevention, Weinan, Shaanxi, China
| | - Xiangming Xu
- Laboratory Department, Weinan Center for Disease Control and Prevention, Weinan, Shaanxi, China
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Sun N, He F, Sun J, Zhu G. Viral hepatitis in China during 2002-2021: epidemiology and influence factors through a country-level modeling study. BMC Public Health 2024; 24:1820. [PMID: 38978017 PMCID: PMC11232300 DOI: 10.1186/s12889-024-19318-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 07/01/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND Viral hepatitis imposes a heavy disease burden worldwide and is also one of the most serious public health problems in China. We aimed to describe the epidemiological characteristics of hepatitis in China and to investigate the influencing factors. METHODS We first used the JoinPoint model to analyze the percentage change (APC) and average annual percentage change (AAPC) of hepatitis in Chinese provinces from 2002 to 2021. We then explored the influencing factors by using the time-series global principal component analysis (GPCA) and the panel fixed-effects model. RESULTS The disease burden varied across different provinces from 2002 to 2021. The AAPC of the total HAV incidence decreased by 10.39% (95% CI: [-12.70%, -8.02%]) from 2002 to 2021. Yet the AAPC of HBV, HCV, and HEV increased by 1.50% (95% CI: [0.23%, 2.79%]), 13.99% (95% CI: [11.28%, 16.77%]), and 7.10% (95% CI: [0.90%, 13.69%]), respectively. The hotspots of HAV, HBV, HCV, and HEV moved from the west to the center, from the northwest to the southeast, from the northeast to the whole country, and from the northeast to the southeast, respectively. Different types of viral hepatitis infections were associated with hygiene, pollutant, and meteorological factors. Their roles in spatial-temporal incidence were expressed by panel regression functions. CONCLUSIONS Viral hepatitis infection in China showed spatiotemporal heterogeneity. Interventions should be tailored to its epidemiological characteristics and determinants of viral hepatitis.
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Affiliation(s)
- Ning Sun
- School of Mathematics and Computing Science, Guangxi Colleges and Universities Key Laboratory of Data Analysis and Computation, Guilin University of Electronic Technology, Guilin, 541004, China
- Center for Applied Mathematics of Guangxi (GUET), Guilin, 541004, China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Fangli He
- School of Mathematics and Computing Science, Guangxi Colleges and Universities Key Laboratory of Data Analysis and Computation, Guilin University of Electronic Technology, Guilin, 541004, China
- Center for Applied Mathematics of Guangxi (GUET), Guilin, 541004, China
| | - Jiufeng Sun
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.
| | - Guanghu Zhu
- School of Mathematics and Computing Science, Guangxi Colleges and Universities Key Laboratory of Data Analysis and Computation, Guilin University of Electronic Technology, Guilin, 541004, China.
- Center for Applied Mathematics of Guangxi (GUET), Guilin, 541004, China.
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Yun Z, Li P, Wang J, Lin F, Li W, Weng M, Zhang Y, Wu H, Li H, Cai X, Li X, Fu X, Wu T, Gao Y. Spatial-temporal analysis of hepatitis E in Hainan Province, China (2013-2022): insights from four major hospitals. Front Public Health 2024; 12:1381204. [PMID: 38993698 PMCID: PMC11236752 DOI: 10.3389/fpubh.2024.1381204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 06/13/2024] [Indexed: 07/13/2024] Open
Abstract
Objective Exploring the Incidence, Epidemic Trends, and Spatial Distribution Characteristics of Sporadic Hepatitis E in Hainan Province from 2013 to 2022 through four major tertiary hospitals in the Province. Methods We collected data on confirmed cases of hepatitis E in Hainan residents admitted to the four major tertiary hospitals in Haikou City from January 2013 to December 2022. We used SPSS software to analyze the correlation between incidence rate and economy, population density and geographical location, and origin software to draw a scatter chart and SAS 9.4 software to conduct a descriptive analysis of the time trend. The distribution was analyzed using ArcMap 10.8 software (spatial autocorrelation analysis, hotspot identification, concentration, and dispersion trend analysis). SAS software was used to build an autoregressive integrated moving average model (ARIMA) to predict the monthly number of cases in 2023 and 2024. Results From 2013 to 2022, 1,922 patients with sporadic hepatitis E were treated in the four hospitals of Hainan Province. The highest proportion of patients (n = 555, 28.88%) were aged 50-59 years. The annual incidence of hepatitis E increased from 2013 to 2019, with a slight decrease in 2020 and 2021 and an increase in 2022. The highest number of cases was reported in Haikou, followed by Dongfang and Danzhou. We found that there was a correlation between the economy, population density, latitude, and the number of cases, with the correlation coefficient |r| value fluctuating between 0.403 and 0.421, indicating a linear correlation. At the same time, a scatter plot shows the correlation between population density and incidence from 2013 to 2022, with r2 values fluctuating between 0.5405 and 0.7116, indicating a linear correlation. Global Moran's I, calculated through spatial autocorrelation analysis, showed that each year from 2013 to 2022 all had a Moran's I value >0, indicating positive spatial autocorrelation (p < 0.01). Local Moran's I analysis revealed that from 2013 to 2022, local hotspots were mainly concentrated in the northern part of Hainan Province, with Haikou, Wenchang, Ding'an, and Chengmai being frequent hotspot regions, whereas Baoting, Qiongzhong, and Ledong were frequent cold-spot regions. Concentration and dispersion analysis indicated a clear directional pattern in the average density distribution, moving from northeast to southwest. Time-series forecast modeling showed that the forecast number of newly reported cases per month remained relatively stable in 2023 and 2024, fluctuating between 17 and 19. Conclusion The overall incidence of hepatitis E in Hainan Province remains relatively stable. The incidence of hepatitis E in Hainan Province increased from 2013 to 2019, with a higher clustering of cases in the northeast region and a gradual spread toward the southwest over time. The ARIMA model predicted a relatively stable number of new cases each month in 2023 and 2024.
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Affiliation(s)
- Zhi Yun
- Department of Infectious Diseases, Affiliated Hainan Hospital of Hainan Medical University (Hainan General Hospital), Haikou, China
| | - Panpan Li
- Department of Infectious Diseases, Affiliated Hainan Hospital of Hainan Medical University (Hainan General Hospital), Haikou, China
| | - Jinzhong Wang
- Intensive Care Unit, The Second Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Feng Lin
- Department of Infectious Diseases, Affiliated Hainan Hospital of Hainan Medical University (Hainan General Hospital), Haikou, China
| | - Wenting Li
- Department of Infectious Diseases, The Second Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Minhua Weng
- Department of Infectious Diseases, The Second Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Yanru Zhang
- Department of Infectious Diseases, Affiliated Hainan Hospital of Hainan Medical University (Hainan General Hospital), Haikou, China
| | - Huazhi Wu
- Department of Infectious Diseases, Affiliated Hainan Hospital of Hainan Medical University (Hainan General Hospital), Haikou, China
| | - Hui Li
- Department of Infectious Diseases, Affiliated Hainan Hospital of Hainan Medical University (Hainan General Hospital), Haikou, China
| | - Xiaofang Cai
- Department of Infectious Diseases, Affiliated Hainan Hospital of Hainan Medical University (Hainan General Hospital), Haikou, China
| | - Xiaobo Li
- Department of Neurosurgery, Haikou Municipal People's Hospital and Central South University Xiangya Medical College Affiliated Hospital, Haikou, China
| | - Xianxian Fu
- Clinical Lab, Haikou Municipal People’s Hospital and Central South University Xiangya Medical College Affiliated Hospital, Haikou, China
| | - Tao Wu
- Department of Infectious Diseases, Affiliated Hainan Hospital of Hainan Medical University (Hainan General Hospital), Haikou, China
- National Health Commission Key Laboratory of Tropical Disease Control, Hainan Medical University, Haikou, China
| | - Yi Gao
- Department of Infectious Diseases, Affiliated Hainan Hospital of Hainan Medical University (Hainan General Hospital), Haikou, China
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Yin S, Wu S, Huang J, Ren S, Xie W, Peng X. Spatial-temporal analysis of hepatitis B in Fujian Province, China in 2012-2021. INFECTIOUS MEDICINE 2024; 3:100110. [PMID: 38974348 PMCID: PMC11225665 DOI: 10.1016/j.imj.2024.100110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 12/17/2023] [Accepted: 04/02/2024] [Indexed: 07/09/2024]
Abstract
Background Fujian Province has one of the highest reported incidences of hepatitis B virus infection in China. This study aimed to provide a theoretical framework for preventing and controlling hepatitis B in Fujian Province, and to assess the trends and the spatial-temporal distribution patterns of hepatitis B in this region. Methods Data on hepatitis B cases were extracted from the National Notifiable Infectious Disease Surveillance System. Spatial autocorrelation analysis, trend surface analysis, and spatial-temporal scanning statistics were used to identify the spatial and aggregation patterns at the county level. The Joinpoint was used to assess the reported incidence trends. Results The average reported incidence of hepatitis B in Fujian from 2012 to 2021 was 14.46/10,000 population, with 583,262 notified cases. The age-adjusted reported incidence of hepatitis B decreased from 17.44/10,000 population in 2012 to 11.88/10,000 population in 2021, with an average reduction in the annual percentage change of 4.5%. There were obvious spatial-temporal aggregation characteristics in hepatitis B cases, and a high-incidence area was located in eastern Fujian. Spatio-temporal scanning statistics revealed four levels of aggregation of hepatitis B reporting rates. The first level of aggregation area included Minhou, Gulou, Jin'an, Taijiang, and nine other districts and counties. Conclusion The incidence of hepatitis B is declining in Fujian Province. Spatial clusters of hepatitis B cases in Fujian Province were identified, and high-risk areas in eastern Fujian still exist. Closely monitoring the general patterns in the occurrence of hepatitis B and implementing focused control and preventative strategies are important.
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Affiliation(s)
- Shuo Yin
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Shenggen Wu
- Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350122, China
| | - Jingru Huang
- College of Integrated Chinese and Western Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350108, China
| | - Shutong Ren
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Weijiang Xie
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Xian'e Peng
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
- Key Laboratory of Gastrointestinal Cancer (Fujian Medical University), Ministry of Education, School of Basic Medical Sciences, Fujian Medical University, Fuzhou 350108, China
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Yi Y, Sun M, Lu J, Dou X, Yu Y, Zhou L. Psychometric Characteristics of the Chinese Version of the Tuberculosis Related-Stigma Scale in a Population of Medical Students and Its Correlation with Selected Demographic Characteristics. Risk Manag Healthc Policy 2024; 17:815-826. [PMID: 38595754 PMCID: PMC11003432 DOI: 10.2147/rmhp.s446068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 02/08/2024] [Indexed: 04/11/2024] Open
Abstract
Background As future health workers, medical students' attitudes towards tuberculosis (TB) patients can impact TB control. However, in China, there is a lack of well-quantified assessment regarding the stigma among medical students towards TB patients. Therefore, this study aimed to validate the Chinese version of the Tuberculosis related-Stigma Scale (TSS) in medical students and to apply the scale to measure stigma and its determinants. Methods A total of 1035 eligible medical students participated in the cross-sectional questionnaire. Exploratory factor analyses (EFA) and confirmatory factor analyses (CFA) were first conducted to test Chinese version of the TSS construct validity, and then internal consistency was assessed using Cronbach's α. Finally, multiple linear regression analyses were conducted to identify predictors of stigma. Results EFA extracted two factors ("Social distance" and "Exclusionary sentiments"). The CFA further confirmed the two-factor construct. The internal consistency, convergent and divergent validity of the adapted Chinese version of the TSS was acceptable. Furthermore, Whether one has received TB health education and whether know a person with TB are associated with all dimensions of TB stigma, while differences in sex and place of residence play different roles in influencing the different dimensions of stigma. Conclusion The adapted Chinese version of the TSS can be used to assess the level of stigma among medical students in China towards tuberculosis patients. When implementing future interventions to reduce stigma associated with TB, special attention should be given to medical students from urban areas, of male gender, who have not received TB health education, and no know a person with TB. However, these two dimensions ("Social distance" and "Exclusionary sentiments") are impacted by different determinants and should therefore be addressed separately when designing, implementing, and evaluating measures to reduce stigma.
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Affiliation(s)
- Yaohui Yi
- School of Public Health, Dalian Medical University, Dalian City, Liaoning Province, People’s Republic of China
| | - Meng Sun
- School of Public Health, Dalian Medical University, Dalian City, Liaoning Province, People’s Republic of China
| | - Jiachen Lu
- School of Public Health, Dalian Medical University, Dalian City, Liaoning Province, People’s Republic of China
| | - Xiaofeng Dou
- School of Public Health, Dalian Medical University, Dalian City, Liaoning Province, People’s Republic of China
| | - Yingying Yu
- School of Public Health, Dalian Medical University, Dalian City, Liaoning Province, People’s Republic of China
| | - Ling Zhou
- School of Public Health, Dalian Medical University, Dalian City, Liaoning Province, People’s Republic of China
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Ming BW, Li L, Huang HN, Ma JJ, Shi C, Xu XH, Yang Z, Ou CQ. The Effectiveness of National Expanded Program on Immunization With Hepatitis A Vaccines in the Chinese Mainland: Interrupted Time-Series Analysis. JMIR Public Health Surveill 2024; 10:e53982. [PMID: 38416563 PMCID: PMC10938223 DOI: 10.2196/53982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/08/2024] [Accepted: 01/22/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND The high prevalence of hepatitis A delivered a blow to public health decades ago. The World Health Organization (WHO) set a goal to eliminate viral hepatitis including hepatitis A by 2030. In 2008, hepatitis A vaccines were integrated into the Expanded Program on Immunization (EPI) in China to alleviate the burden of hepatitis A, although the effectiveness of the EPI has not been well investigated. OBJECTIVE We aimed to evaluate the intervention effect at both provincial and national levels on the incidence of hepatitis A in the Chinese mainland from 2005 to 2019. METHODS Based on the monthly reported number of hepatitis A cases from 2005 to 2019 in each provincial-level administrative division, we adopted generalized additive models with an interrupted time-series design to estimate province-specific effects of the EPI on the incidence of hepatitis A among the target population (children aged 2-9 years) from 2005 to 2019. We then pooled province-specific effect estimates using random-effects meta-analyses. We also assessed the effect among the nontarget population and the whole population. RESULTS A total of 98,275 hepatitis A cases among children aged 2-9 years were reported in the Chinese mainland from 2005 to 2019, with an average annual incidence of 5.33 cases per 100,000 persons. Nationally, the EPI decreased the hepatitis A incidence by 80.77% (excess risk [ER] -80.77%, 95% CI -85.86% to -72.92%) during the study period, guarding an annual average of 28.52 (95% empirical CI [eCI] 27.37-29.00) cases per 100,000 persons among the target children against hepatitis A. Western China saw a more significant effect of the EPI on the decrease in the incidence of hepatitis A among the target children. A greater number of target children were protected from onset in Northwest and Southwest China, with an excess incidence rate of -129.72 (95% eCI -135.67 to -117.86) and -66.61 (95% eCI -67.63 to -64.22) cases per 100,000 persons on average, respectively. Intervention effects among nontarget (ER -32.88%, 95% CI -39.76% to -25.21%) and whole populations (ER -31.97%, 95% CI -39.61% to -23.37%) were relatively small. CONCLUSIONS The EPI has presented a lasting positive effect on the containment of hepatitis A in the target population in China. The EPI's effect on the target children also provided a degree of indirect protection for unvaccinated individuals. The continuous surveillance of hepatitis A and the maintenance of mass vaccination should shore up the accomplishment in the decline of hepatitis A incidence to ultimately achieve the goal set by the WHO.
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Affiliation(s)
- Bo-Wen Ming
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China
| | - Li Li
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China
| | - Hao-Neng Huang
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China
| | - Jia-Jun Ma
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China
| | - Chen Shi
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China
| | - Xiao-Han Xu
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China
| | - Zhou Yang
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China
| | - Chun-Quan Ou
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China
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Yang D, Zhang C, Chen Y, Lu J, Chen Y, Zhang Z, Chai F, Zhang Z, Wang F, Zhu B. Distribution of hepatitis C virus in eastern China from 2011 to 2020: a Bayesian spatiotemporal analysis. Front Public Health 2024; 12:1282575. [PMID: 38450135 PMCID: PMC10914966 DOI: 10.3389/fpubh.2024.1282575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 02/05/2024] [Indexed: 03/08/2024] Open
Abstract
Objective This study aimed to evaluate the spatiotemporal distribution of patients with hepatitis C virus (HCV) and the factors influencing this distribution in Jiangsu Province, China, from 2011 to 2020. Methods The incidence of reported HCV in Jiangsu Province from 2011 to 2020 was obtained from the Chinese Information System for Disease Control and Prevention (CISDCP). R and GeoDa software were used to visualize the spatiotemporal distribution and the spatial autocorrelation of HCV. A Bayesian spatiotemporal model was constructed to explore the spatiotemporal distribution of HCV in Jiangsu Province and to further analyze the factors related to HCV. Results A total of 31,778 HCV patients were registered in Jiangsu Province. The registered incidence rate of HCV increased from 2.60/100,000 people in 2011 to 4.96/100,000 people in 2020, an increase of 190.77%. Moran's I ranged from 0.099 to 0.354 (P < 0.05) from 2011 to 2019, indicating a positive spatial correlation overall. The relative risk (RR) of the urbanization rate, the most important factor affecting the spread of HCV in Jiangsu Province, was 1.254 (95% confidence interval: 1.141-1.376), while other factors had no significance. Conclusion The reported HCV incidence rate integrally increased in the whole Jiangsu Province, whereas the spatial aggregation of HCV incidence was gradually weakening. Our study highlighted the importance of health education for the floating population and reasonable allocation of medical resources in the future health work.
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Affiliation(s)
- Dandan Yang
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
- Department of Genetic Toxicology, Key Laboratory of Modern Toxicology of the Ministry of Education, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Chuanfeng Zhang
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yuheng Chen
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Jing Lu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yunting Chen
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Zhi Zhang
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Feifei Chai
- Department of Sexually Transmitted Diseases and AIDS, Xuzhou Center for Disease Control and Prevention, Xuzhou, China
| | - Zhendong Zhang
- Department of Genetic Toxicology, Key Laboratory of Modern Toxicology of the Ministry of Education, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Furu Wang
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
- Department of Genetic Toxicology, Key Laboratory of Modern Toxicology of the Ministry of Education, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Baoli Zhu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
- Department of Genetic Toxicology, Key Laboratory of Modern Toxicology of the Ministry of Education, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
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Yi Y, Sun M, Chen X, Pan Y, Lu J, Yu Y, Dou X, Zhou L. Prejudice and determinants regarding tuberculosis patients among medical students in Dalian, Northeast China: a cross-sectional study. Front Public Health 2024; 11:1292333. [PMID: 38269378 PMCID: PMC10806168 DOI: 10.3389/fpubh.2023.1292333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/26/2023] [Indexed: 01/26/2024] Open
Abstract
Background Health workers play a central role in global tuberculosis (TB) elimination efforts. If medical students have prejudiced attitudes toward TB patients, this may make it difficult for them to provide effective health care to TB patients in their future roles as health workers. There is currently no research on prejudice toward TB patients among medical students in China. This study aimed to explore the current status of medical students' prejudice against patients with TB and its associated predictors. Methods We conducted a cross-sectional questionnaire survey among medical students at a medical university in Dalian, Liaoning Province, Northeast China. Multiple logistic regression analysis was employed to determine the predictive factors of medical students' prejudice against patients with TB. Results More than half (57.23%) of the medical students held prejudices against individuals with TB. Multivariate logistic regression analysis revealed that not receiving TB health education (OR: 2.12, 95% CI: 1.35-3.32), not knowing a person with TB (OR: 2.52, 95% CI: 1.39-4.56), and fear of TB/TB patients (OR: 6.79, 95% CI: 4.36-10.56) were identified as risk factors for medical students' prejudice against TB patients. Conversely, residing in rural areas (OR: 0.60, 95% CI: 0.38-0.95), agreeableness (OR: 0.82, 95% CI: 0.73-0.92) and emotional stability (OR: 0.90, 95% CI: 0.81-1.00) in the Big Five personality traits, and a better understanding of TB knowledge (OR: 0.58, 95% CI: 0.38-0.89) were identified as protective factors. Conclusion In China, a considerable number of medical students still exhibit prejudice against patients with TB. Targeted interventions, such as incorporating TB health education into the core curriculum of medical students, and enhance their agreeableness and emotional stability, are still needed. Furthermore, greater focus should be placed on medical students from urban backgrounds or those who harbor fear or do not know a person with TB.
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Affiliation(s)
| | | | | | | | | | | | | | - Ling Zhou
- School of Public Health, Dalian Medical University, Dalian, Liaoning, China
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Yu X, Fang M, Li Y, Yu J, Cheng L, Ding S, Kou Z. Epidemiological characteristics and spatio-temporal analysis of brucellosis in Shandong province, 2015-2021. BMC Infect Dis 2023; 23:669. [PMID: 37814221 PMCID: PMC10561485 DOI: 10.1186/s12879-023-08503-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 07/31/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Brucellosis is one of the major public health problems in China, it not only causes huge economic losses to the society, but also threatens the human's physical and mental health. The reported cases of brucellosis in Shandong province were at a high level, therefore, it is necessary for us to understand the epidemic characteristics and distribution trend of Brucellosis in Shandong province. This study aims to describe the epidemiological characteristics and spatial clustering characteristics of brucellosis in Shandong Province, provide a reference for the scientific prevention and control. METHODS Human brucellosis data in Shandong province from 2015 to 2021 were obtained from the China Information System for Disease Control and Prevention, the data were analyzed by descriptive epidemiological methods, spatial autocorrelation analysis and spatial-temporal cluster analysis methods use ArcGIS and SaTScan software, the results were presented in ArcMap. RESULTS A total of 22,251 human cases of brucellosis were reported, the annual incidence ranged between 2.41/100,000 and 4.07/100,000 from 2015 to 2021 in Shandong province, incidence has been decreasing year by year, while there was a significant increase in 2021. The distribution of brucellosis was of a seasonal trend, mainly concentrating during March to August. The age of the cases was mainly concentrated in the 30-74 age ranges, the average annual incidence rate was significantly higher in males than in females. The spatial analysis showed that the epidemics were mainly concentrated in the north and southwest. For the spatial autocorrelation analysis, a high global autocorrelation was observed at the county level, and the high-high clusters mainly distributed in the north and southwest region. For the spatio-temporal scanning, the most likely cluster areas mainly distributed in the north area, and then gradually moved southward, and the radius of clustered narrowed. CONCLUSIONS Human brucellosis remains a common challenge, particularly in northern region in spring and summer. More disease prevention and control measures should be taken in high-risk populations, and such higher-risk susceptible areas to reduce the incidence of brucellosis and ensure the health of the people.
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Affiliation(s)
- Xiaolin Yu
- Institute for Communicable Disease Control and Prevention, Shandong provincial Center for Disease Control and Prevention, Jinan, Shandong, China
| | - Ming Fang
- Institute for Communicable Disease Control and Prevention, Shandong provincial Center for Disease Control and Prevention, Jinan, Shandong, China
| | - Yan Li
- Institute for Communicable Disease Control and Prevention, Shandong provincial Center for Disease Control and Prevention, Jinan, Shandong, China
| | - Jianmei Yu
- Institute for Communicable Disease Control and Prevention, Shandong provincial Center for Disease Control and Prevention, Jinan, Shandong, China
- Department of public health and health management, Shandong First Medical University, Jinan, Shandong, China
| | - Lixiao Cheng
- Institute for Communicable Disease Control and Prevention, Shandong provincial Center for Disease Control and Prevention, Jinan, Shandong, China
| | - Shujun Ding
- Institute for Communicable Disease Control and Prevention, Shandong provincial Center for Disease Control and Prevention, Jinan, Shandong, China
| | - Zengqiang Kou
- Institute for Communicable Disease Control and Prevention, Shandong provincial Center for Disease Control and Prevention, Jinan, Shandong, China.
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10
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Shi Y, Shen W, Liu W, Zhang X, Shang Q, Cheng X, Bao C. Analysis of the spatial-temporal distribution characteristics of hepatitis E in Jiangsu province from 2005 to 2020. Front Public Health 2023; 11:1225261. [PMID: 37614452 PMCID: PMC10442811 DOI: 10.3389/fpubh.2023.1225261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 07/17/2023] [Indexed: 08/25/2023] Open
Abstract
Objective This study attempts to analyze the spatial clustering and spatial-temporal distribution characteristics of hepatitis E (HE) at the county (city and district) level in Jiangsu province to provide a scientific basis for the prevention and control of HE. Method The information on HE cases reported in the Chinese Center for Disease Control and Prevention Information System from 2005 to 2020 was collected for spatial autocorrelation analysis and spatial-temporal clustering analysis. Result From 2005 to 2020, 48,456 HE cases were reported in Jiangsu province, with an average annual incidence rate of 3.87/100,000. Male cases outnumbered female cases (2.46:1), and the incidence was highest in the 30-70 years of age group (80.50%). Farmers accounted for more than half of all cases (59.86%), and in terms of the average annual incidence, the top three cities were all in Zhenjiang city. Spatial autocorrelation analysis showed that Global Moran's I of HE incidence varied from 0.232 to 0.513 for the years. From 2005 to 2020, 31 counties (cities and districts) had high and statistically significant HE incidence, and two clustering areas were detected by spatial-temporal scanning. Conclusion HE incidence in Jiangsu province from 2005 to 2020 was stable, with age and gender differences, regional clustering, and spatial-temporal clustering. Further investigation of HE clustering areas is necessary to formulate corresponding targeted prevention and control measures.
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Affiliation(s)
- Yao Shi
- Taicang City Centre for Disease Control and Prevention, Suzhou, Jiangsu, China
- Jiangsu Field Epidemiology Training Program, Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Wenqi Shen
- Jiangsu Provincial Centre for Disease Control and Prevention, Jiangsu Institution of Public Health, Nanjing, Jiangsu, China
| | - Wendong Liu
- Jiangsu Provincial Centre for Disease Control and Prevention, Jiangsu Institution of Public Health, Nanjing, Jiangsu, China
| | - Xuefeng Zhang
- Jiangsu Provincial Centre for Disease Control and Prevention, Jiangsu Institution of Public Health, Nanjing, Jiangsu, China
| | - Qingxiang Shang
- School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xiaoqing Cheng
- Jiangsu Provincial Centre for Disease Control and Prevention, Jiangsu Institution of Public Health, Nanjing, Jiangsu, China
| | - Changjun Bao
- Jiangsu Provincial Centre for Disease Control and Prevention, Jiangsu Institution of Public Health, Nanjing, Jiangsu, China
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Wang Y, Xie N, Li F, Wang Z, Ding S, Hu X, Wang K. Spatial age-period-cohort analysis of hepatitis B risk in Xinjiang from 2006 to 2019. Front Public Health 2023; 11:1171516. [PMID: 37325304 PMCID: PMC10264624 DOI: 10.3389/fpubh.2023.1171516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/11/2023] [Indexed: 06/17/2023] Open
Abstract
Objective The objective of this study was to investigate the spatio-temporal distribution and epidemiological characteristics of hepatitis B in 96 districts and counties of Xinjiang and to give useful information for hepatitis B prevention and treatment. Methods Based on the incidence data of hepatitis B in 96 districts and counties of Xinjiang from 2006 to 2019, the global trend analysis method was used to characterize the spatial variability of the disease, and the spatial autocorrelation and spatio-temporal aggregation analysis were used to explore the spatial clustering of hepatitis B and to identify high-risk areas and periods. The Integrated Nested Laplace Approximation (INLA)-based spatial age-period-cohort model was established to further explore the influence of age, period, birth queue effect, and spatial distribution on the incidence risk of hepatitis B, and sum-to-zero constraint was adopted to avoid the issue of model unrecognition. Results The risk of hepatitis B in Xinjiang is increasing from west to east and from north to south, with spatial heterogeneity and spatio-temporal scanning statistics yielding five clustering areas. The spatial age-period-cohort model showed two peaks in the average risk of hepatitis B, at [25,30) years old and [50,55) years old, respectively. The mean risk of hepatitis B incidence fluctuated up and down around 1 with time, and the average risk of disease by birth cohort displayed an increasing-decreasing-stabilizing trend. Taking age, period, and cohort effect into consideration, it was found that the areas with a high risk of hepatitis B are Tianshan District, Xinshi District, Shuimogou District, Changji City, Aksu City, Kashi City, Korla City, Qiemo County and Yopurga County in Xinjiang. According to the spatio-temporal effect item, it was found that there are unobserved variables affecting the incidence of hepatitis B in some districts and counties of Xinjiang. Conclusion The spatio-temporal characteristics of hepatitis B and the high-risk population needed to be taken into attention. It is suggested that the relevant disease prevention and control centers should strengthen the prevention and control of hepatitis B among young people while paying attention to middle-aged and older adult people, and strengthening the prevention and monitoring of high-risk areas.
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Affiliation(s)
- Yijia Wang
- College of Mathematics and System Science, Xinjiang University, Urumqi, China
| | - Na Xie
- Xinjiang Center for Disease Control and Prevention, Urumqi, China
| | - Fengjun Li
- Department of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
| | - Zhe Wang
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Shuzhen Ding
- College of Mathematics and System Science, Xinjiang University, Urumqi, China
| | - Xijian Hu
- College of Mathematics and System Science, Xinjiang University, Urumqi, China
| | - Kai Wang
- Department of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
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12
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Wang Y, Xie N, Wang Z, Ding S, Hu X, Wang K. Spatio-temporal distribution characteristics of the risk of viral hepatitis B incidence based on INLA in 14 prefectures of Xinjiang from 2004 to 2019. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2023; 20:10678-10693. [PMID: 37322955 DOI: 10.3934/mbe.2023473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
This study aimed to explore the spatio-temporal distribution characteristics and risk factors of hepatitis B (HB) in 14 prefectures of Xinjiang, China, and to provide a relevant reference basis for the prevention and treatment of HB. Based on HB incidence data and risk factor indicators in 14 prefectures in Xinjiang from 2004 to 2019, we explored the distribution characteristics of the risk of HB incidence using global trend analysis and spatial autocorrelation analysis and established a Bayesian spatiotemporal model to identify the risk factors of HB and their spatio-temporal distribution to fit and extrapolate the Bayesian spatiotemporal model using the Integrated Nested Laplace Approximation (INLA) method. There was spatial autocorrelation in the risk of HB and an overall increasing trend from west to east and north to south. The natural growth rate, per capita GDP, number of students, and number of hospital beds per 10, 000 people were all significantly associated with the risk of HB incidence. From 2004 to 2019, the risk of HB increased annually in 14 prefectures in Xinjiang, with Changji Hui Autonomous Prefecture, Urumqi City, Karamay City, and Bayangol Mongol Autonomous Prefecture having the highest rates.
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Affiliation(s)
- Yijia Wang
- College of Mathematics and System Science, Xinjiang University, Urumqi 830017, China
| | - Na Xie
- Xinjiang Center for Disease Control and Prevention, Urumqi 830054, China
| | - Zhe Wang
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Shuzhen Ding
- College of Mathematics and System Science, Xinjiang University, Urumqi 830017, China
| | - Xijian Hu
- College of Mathematics and System Science, Xinjiang University, Urumqi 830017, China
| | - Kai Wang
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi 830017, China
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13
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Zhao N, Guo X, Wang L, Zhou H, Gong L, Miao Z, Chen Y, Qin S, Yu Z, Liu S, Wang S. Changing spatiotemporal patterns for hepatitis of unspecified aetiology in China, 2004-2021: a population-based surveillance study. Front Public Health 2023; 11:1177965. [PMID: 37213628 PMCID: PMC10196104 DOI: 10.3389/fpubh.2023.1177965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 04/14/2023] [Indexed: 05/23/2023] Open
Abstract
Objectives As global efforts continue toward the target of eliminating viral hepatitis by 2030, the emergence of acute hepatitis of unspecified aetiology (HUA) remains a concern. This study assesses the overall trends and changes in spatiotemporal patterns in HUA in China from 2004 to 2021. Methods We extracted the incidence and mortality rates of HUA from the Public Health Data Center, the official website of the National Health Commission of the People's Republic of China, and the National Notifiable Infectious Disease Surveillance System from 2004 to 2021. We used R software, ArcGIS, Moran's statistical analysis, and joinpoint regression to examine the spatiotemporal patterns and annual percentage change in incidence and mortality of the HUA across China. Results From 2004 to 2021, a total of 707,559 cases of HUA have been diagnosed, including 636 deaths. The proportion of HUA in viral hepatitis gradually decreased from 7.55% in 2004 to 0.72% in 2021. The annual incidence of HUA decreased sharply from 6.6957 per 100,000 population in 2004 to 0.6302 per 100,000 population in 2021, with an average annual percentage change (APC) reduction of -13.1% (p < 0.001). The same result was seen in the mortality (APC, -22.14%, from 0.0089/100,000 in 2004 to 0.0002/100,000 in 2021, p < 0.001). All Chinese provinces saw a decline in incidence and mortality. Longitudinal analysis identified the age distribution in the incidence and mortality of HUA did not change and was highest in persons aged 15-59 years, accounting for 70% of all reported cases. During the COVID-19 pandemic, no significant increase was seen in pediatric HUA cases in China. Conclusion China is experiencing an unprecedented decline in HUA, with the lowest incidence and mortality for 18 years. However, it is still important to sensitively monitor the overall trends of HUA and further improve HUA public health policy and practice in China.
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Affiliation(s)
- Na Zhao
- School of Ecology and Environment, Anhui Normal University, Wuhu, Anhui Province, China
- Institute of Zoology, Chinese Academy of Sciences, Beijing, China
| | - Xiangyu Guo
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Lan Wang
- Department of Geriatrics, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
- Key Laboratory of Diagnosis and Treatment of Aging and Physic-Chemical Injury Diseases of Zhejiang Province, Hangzhou, Zhejiang Province, China
| | - Hongming Zhou
- The School of Basic Medical Sciences, Wannan Medical College, Wuhu, Anhui Province, China
| | - Lei Gong
- Anhui Provincial Center for Disease Control and Prevention, Hefei, Anhui Province, China
| | - Ziping Miao
- Department of Infectious Diseases, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
| | - Yijuan Chen
- Department of Infectious Diseases, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
| | - Shuwen Qin
- Department of Infectious Diseases, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
| | - Zhao Yu
- Department of Infectious Diseases, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
| | - Shelan Liu
- Department of Infectious Diseases, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
- *Correspondence: Shelan Liu,
| | - Supen Wang
- College of Life Sciences, Anhui Normal University, Wuhu, Anhui Province, China
- Supen Wang,
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Zheng J, Zhang N, Shen G, Liang F, Zhao Y, He X, Wang Y, He R, Chen W, Xue H, Shen Y, Fu Y, Zhang WH, Zhang L, Bhatt S, Mao Y, Zhu B. Spatiotemporal and Seasonal Trends of Class A and B Notifiable Infectious Diseases in China: A Retrospective Analysis (Preprint). JMIR Public Health Surveill 2022; 9:e42820. [PMID: 37103994 PMCID: PMC10176137 DOI: 10.2196/42820] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 03/27/2023] [Accepted: 03/29/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND China is the most populous country globally and has made significant achievements in the control of infectious diseases over the last decades. The 2003 SARS epidemic triggered the initiation of the China Information System for Disease Control and Prevention (CISDCP). Since then, numerous studies have investigated the epidemiological features and trends of individual infectious diseases in China; however, few considered the changing spatiotemporal trends and seasonality of these infectious diseases over time. OBJECTIVE This study aims to systematically review the spatiotemporal trends and seasonal characteristics of class A and class B notifiable infectious diseases in China during 2005-2020. METHODS We extracted the incidence and mortality data of 8 types (27 diseases) of notifiable infectious diseases from the CISDCP. We used the Mann-Kendall and Sen's methods to investigate the diseases' temporal trends, Moran I statistic for their geographical distribution, and circular distribution analysis for their seasonality. RESULTS Between January 2005 and December 2020, 51,028,733 incident cases and 261,851 attributable deaths were recorded. Pertussis (P=.03), dengue fever (P=.01), brucellosis (P=.001), scarlet fever (P=.02), AIDS (P<.001), syphilis (P<.001), hepatitis C (P<.001) and hepatitis E (P=.04) exhibited significant upward trends. Furthermore, measles (P<.001), bacillary and amebic dysentery (P<.001), malaria (P=.04), dengue fever (P=.006), brucellosis (P=.03), and tuberculosis (P=.003) exhibited significant seasonal patterns. We observed marked disease burden-related geographic disparities and heterogeneities. Notably, high-risk areas for various infectious diseases have remained relatively unchanged since 2005. In particular, hemorrhagic fever and brucellosis were largely concentrated in Northeast China; neonatal tetanus, typhoid and paratyphoid, Japanese encephalitis, leptospirosis, and AIDS in Southwest China; BAD in North China; schistosomiasis in Central China; anthrax, tuberculosis, and hepatitis A in Northwest China; rabies in South China; and gonorrhea in East China. However, the geographical distribution of syphilis, scarlet fever, and hepatitis E drifted from coastal to inland provinces during 2005-2020. CONCLUSIONS The overall infectious disease burden in China is declining; however, hepatitis C and E, bacterial infections, and sexually transmitted infections continue to multiply, many of which have spread from coastal to inland provinces.
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Affiliation(s)
- Junyao Zheng
- China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
| | - Ning Zhang
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Guoquan Shen
- School of Public Administration and Policy, Renmin University of China, Beijing, China
| | - Fengchao Liang
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
| | - Yang Zhao
- The George Institute for Global Health, Peking University Health Science Center, Beijing, China
- WHO Collaborating Centre on Implementation Research for Prevention and Control of Noncommunicable Diseases, Melbourne, Australia
| | - Xiaochen He
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Ying Wang
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Rongxin He
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Wenna Chen
- Center for Chinese Public Administration Research and School of Government, Sun Yat-sen University, Guangzhou, China
| | - Hao Xue
- Stanford Center on China's Economy and Institutions, Stanford University, Stanford, CA, United States
| | - Yue Shen
- Laboratory for Urban Future, School of Urban Planning and Design, Peking University Shenzhen Graduate School, Shenzhen, China
| | - Yang Fu
- Department of public administration, School of Government, Shenzhen University, Shenzhen, China
| | - Wei-Hong Zhang
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Lei Zhang
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
- Artificial Intelligence and Modelling in Epidemiology Program, Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
- Central Clinical School, Faculty of Medicine, Monash University, Melbourne, Australia
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Samir Bhatt
- MRC Centre for Global Infectious Disease Analysis and the Abdul Latif Jameel Institute for Disease and Emergency Analytics, School of Public Health, Imperial College, London, United Kingdom
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ying Mao
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Bin Zhu
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
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15
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Zheng J, Shen G, Hu S, Han X, Zhu S, Liu J, He R, Zhang N, Hsieh CW, Xue H, Zhang B, Shen Y, Mao Y, Zhu B. Small-scale spatiotemporal epidemiology of notifiable infectious diseases in China: a systematic review. BMC Infect Dis 2022; 22:723. [PMID: 36064333 PMCID: PMC9442567 DOI: 10.1186/s12879-022-07669-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/03/2022] [Indexed: 11/20/2022] Open
Abstract
Background The prevalence of infectious diseases remains one of the major challenges faced by the Chinese health sector. Policymakers have a tremendous interest in investigating the spatiotemporal epidemiology of infectious diseases. We aimed to review the small-scale (city level, county level, or below) spatiotemporal epidemiology of notifiable infectious diseases in China through a systematic review, thus summarizing the evidence to facilitate more effective prevention and control of the diseases. Methods We searched four English language databases (PubMed, EMBASE, Cochrane Library, and Web of Science) and three Chinese databases (CNKI, WanFang, and SinoMed), for studies published between January 1, 2004 (the year in which China’s Internet-based disease reporting system was established) and December 31, 2021. Eligible works were small-scale spatial or spatiotemporal studies focusing on at least one notifiable infectious disease, with the entire territory of mainland China as the study area. Two independent reviewers completed the review process based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results A total of 18,195 articles were identified, with 71 eligible for inclusion, focusing on 22 diseases. Thirty-one studies (43.66%) were analyzed using city-level data, 34 (47.89%) were analyzed using county-level data, and six (8.45%) used community or individual data. Approximately four-fifths (80.28%) of the studies visualized incidence using rate maps. Of these, 76.06% employed various spatial clustering methods to explore the spatial variations in the burden, with Moran’s I statistic being the most common. Of the studies, 40.85% explored risk factors, in which the geographically weighted regression model was the most commonly used method. Climate, socioeconomic factors, and population density were the three most considered factors. Conclusions Small-scale spatiotemporal epidemiology has been applied in studies on notifiable infectious diseases in China, involving spatiotemporal distribution and risk factors. Health authorities should improve prevention strategies and clarify the direction of future work in the field of infectious disease research in China. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07669-9.
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Affiliation(s)
- Junyao Zheng
- China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China.,School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
| | - Guoquan Shen
- School of Public Administration and Policy, Renmin University of China, Beijing, China
| | - Siqi Hu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Xinxin Han
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, 518055, Guangdong, China
| | - Siyu Zhu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Jinlin Liu
- School of Public Policy and Administration, Northwestern Polytechnical University, Xi'an, China
| | - Rongxin He
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Ning Zhang
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China.,MRC Centre for Global Infectious Disease Analysis and the Abdul Latif Jameel Institute for Disease and Emergency Analytics, School of Public Health, Imperial College, London, UK
| | - Chih-Wei Hsieh
- Department of Public Policy, City University of Hong Kong, Hong Kong, China
| | - Hao Xue
- Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, USA
| | - Bo Zhang
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Yue Shen
- Laboratory for Urban Future, School of Urban Planning and Design, Peking University Shenzhen Graduate School, Shenzhen, China
| | - Ying Mao
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Bin Zhu
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, 518055, Guangdong, China.
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16
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Zhang L, Wan X, Shi R, Gong P, Si Y. Comparing spatial patterns of 11 common cancers in Mainland China. BMC Public Health 2022; 22:1551. [PMID: 35971087 PMCID: PMC9377081 DOI: 10.1186/s12889-022-13926-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 07/31/2022] [Indexed: 11/17/2022] Open
Abstract
Background A stronger spatial clustering of cancer burden indicates stronger environmental and human behavioral effects. However, which common cancers in China have stronger spatial clustering and knowledge gaps regarding the environmental and human behavioral effects have yet to be investigated. This study aimed to compare the spatial clustering degree and hotspot patterns of 11 common cancers in mainland China and discuss the potential environmental and behavioral risks underlying the patterns. Methods Cancer incidence data recorded at 339 registries in 2014 was obtained from the “China Cancer Registry Annual Report 2017”. We calculated the spatial clustering degree of the common cancers using the global Moran’s Index and identified the hotspot patterns using the hotspot analysis. Results We found that esophagus, stomach and liver cancer have a significantly higher spatial clustering degree (\documentclass[12pt]{minimal}
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\begin{document}$$p<0.05$$\end{document}p<0.05) than others. When by sex, female esophagus, male stomach, male esophagus, male liver and female lung cancer had significantly higher spatial clustering degree (\documentclass[12pt]{minimal}
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\begin{document}$$p<0.001$$\end{document}p<0.001). The spatial clustering degree of male liver was significantly higher than that of female liver cancer (\documentclass[12pt]{minimal}
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\begin{document}$$p<0.001$$\end{document}p<0.001), whereas the spatial clustering degree of female lung was significantly higher than that of male lung cancer (\documentclass[12pt]{minimal}
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\begin{document}$$p<0.001$$\end{document}p<0.001). The high-risk areas of esophagus and stomach cancer were mainly in North China, Huai River Basin, Yangtze River Delta and Shaanxi Province. The hotspots for liver and male liver cancer were mainly in Southeast China and south Hunan. Hotspots of female lung cancer were mainly located in the Pearl River Delta, Shandong, North and Northeast China. The Yangtze River Delta and the Pearl River Delta were high-risk areas for multiple cancers. Conclusions The top highly clustered cancer types in mainland China included esophagus, stomach and liver cancer and, by sex, female esophagus, male stomach, male esophagus, male liver and female lung cancer. Among them, knowledge of their spatial patterns and environmental and behavioral risk factors is generally limited. Potential factors such as unhealthy diets, water pollution and climate factors have been suggested, and further investigation and validation are urgently needed, particularly for male liver cancer. This study identified the knowledge gap in understanding the spatial pattern of cancer burdens in China and offered insights into targeted cancer monitoring and control. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13926-y.
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Affiliation(s)
- Lin Zhang
- Department of Earth System Science, Ministry of Education Key Laboratory for Earth System Modeling, Institute for Global Change Studies, Tsinghua University, Beijing, 100084, China.
| | - Xia Wan
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing, 100005, China
| | - Runhe Shi
- Key Laboratory of Geographic Information Science, Ministry of Education, East China Normal University, Shanghai, 200241, China
| | - Peng Gong
- Department of Geography and Department of Earth Sciences, University of Hongkong, Hongkong, 999077, China
| | - Yali Si
- Institute of Environmental Sciences CML, Leiden University, Leiden, 2333 CC, The Netherlands.
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17
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Owada K, Sarkar J, Rahman MK, Khan SA, Islam A, Hassan MM, Soares Magalhães RJ. Epidemiological Profile of a Human Hepatitis E Virus Outbreak in 2018, Chattogram, Bangladesh. Trop Med Infect Dis 2022; 7:tropicalmed7080170. [PMID: 36006262 PMCID: PMC9415847 DOI: 10.3390/tropicalmed7080170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 07/28/2022] [Accepted: 08/04/2022] [Indexed: 11/24/2022] Open
Abstract
Hepatitis E virus (HEV) is a waterborne zoonotic disease that can result in a high fatality rate in pregnant women and infants. In 2018, a large HEV outbreak emerged in Chattogram, Bangladesh, resulting in 2800 cases and a significant public health response to mitigate the transmission. While the source of the outbreak remained poorly understood, authorities suggested that possible risk factors for HEV infection included contamination of water supply, exacerbated by concurrent severe flooding events in the community. A cross-sectional study was conducted to investigate the distribution and risk factors for HEV seroprevalence between January and December 2018 in the Chattogram city area. A total of 505 blood samples were collected from symptomatic patients of 10 hospitals who met the case definition for an HEV infection. Standard ELISA tests were performed in all patients to identify anti-HEV antibodies. The size and location of HEV seroprevalence clusters within Chattogram were investigated using SaTScan. We investigated the association between risk of HEV infection and individual and environmentally lagged risk factors using Bernoulli generalised linear regression models. Our results indicate an overall HEV seroprevalence of 35% with significant variation according to sex, source of drinking water, and boiling of drinking water. A positive cross-correlation was found between HEV exposure and precipitation, modified normalised difference water index (MNDWI), and normalised difference vegetation index (NDVI). Our model indicated that risk of infection was associated with sex, age, source of drinking water, boiling of water, increased precipitation, and increased MNDWI. The results from this study indicate that source and boiling of drinking water and increased precipitation were critical drivers of the 2018 HEV outbreak. The communities at highest risk identified in our analyses should be targeted for investments in safe water infrastructure to reduce the likelihood of future HEV outbreaks in Chattogram.
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Affiliation(s)
- Kei Owada
- Queensland Alliance for One Health Sciences, School of Veterinary Science, The University of Queensland, Gatton, QLD 4343, Australia
| | - Joyantee Sarkar
- One Health Institute, Chattogram Veterinary and Animal Sciences University, Chattogram 4225, Bangladesh
| | - Md. Kaisar Rahman
- School of Veterinary Medicine, Texas Tech University, Amarillo, TX 79106, USA
- EcoHealth Alliance, New York, NY 10018, USA
| | - Shahneaz Ali Khan
- Faculty of Veterinary Medicine, Chattogram Veterinary and Animal Sciences University, Chattogram 4225, Bangladesh
| | | | - Mohammad Mahmudul Hassan
- Queensland Alliance for One Health Sciences, School of Veterinary Science, The University of Queensland, Gatton, QLD 4343, Australia
- One Health Institute, Chattogram Veterinary and Animal Sciences University, Chattogram 4225, Bangladesh
- Faculty of Veterinary Medicine, Chattogram Veterinary and Animal Sciences University, Chattogram 4225, Bangladesh
- Correspondence: (M.M.H.); (R.J.S.M.)
| | - Ricardo J. Soares Magalhães
- Queensland Alliance for One Health Sciences, School of Veterinary Science, The University of Queensland, Gatton, QLD 4343, Australia
- Children’s Health and Environment Program, UQ Children’s Health Research Centre, The University of Queensland, Brisbane, QLD 4072, Australia
- Correspondence: (M.M.H.); (R.J.S.M.)
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18
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Prevalence of Viral Hepatitis B, C, and D in Kazakhstan. ScientificWorldJournal 2022; 2022:9102565. [PMID: 35492864 PMCID: PMC9054462 DOI: 10.1155/2022/9102565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 03/14/2022] [Accepted: 03/31/2022] [Indexed: 02/06/2023] Open
Abstract
Background Viral hepatitis is a major burden for the healthcare system worldwide. Up to date, a comprehensive analysis of the prevalence of viral hepatitis in Kazakhstan and Central Asia has not been carried out yet. Our epidemiological study aimed at investigating the frequency and spread of viral hepatitis B, C, and D depending on age and sex in Kazakhstan (5-year period). Materials and Methods We utilized the data from the primary registration of the incidence of hepatitis B, C, and D in 18 regions of Kazakhstan (period: from 2015 to 2020). Age indicators, gender, and territorial characteristics of registered cases were determined and analysed. The data were obtained from the state information system “Electronic Register of Dispensary Patients”, based on the International Classification of Diseases-10 for coding diseases. Results During the period studied, 268 975 cases of hepatitis B, C, and D were detected in Kazakhstan. Hepatitis B was registered in n = 109 734 cases. In women, the incidence rate was 40.6% of all cases (n = 44545), and in men it was 59.4% (n = 65189) of all cases (p ≤ 0.01). Hepatitis D was detected in 8 656 cases, of which 58.3% (n = 5049) were in men and 41.7% (n = 3607) in women (p ≤ 0.01). Hepatitis C was registered in n = 159 585 cases. The rate was higher in the male population (54.6%; n = 82 203) compared to women 45.4% (n = 68382) (p ≤ 0.01). In 2020 (in comparison with 2015), there was a significant increase in the incidence of hepatitis D by 68.3%, hepatitis B by 49.8%, and hepatitis C by 46.4%. The largest prevalence of hepatitis D was recorded in 2016 which is 22.3% higher compared to 2020. A significant increase in hepatitis C was recorded in 2019 compared to 2015, where indicators were 49.2% higher. Conclusion An analysis of the prevalence of hepatitis B, C, and D showed an increase in new cases in Kazakhstan. These findings indicate the need to develop effective preventive measures and screening strategies among people in a high-risk group. The results of the study can be used for the development of a national program to combat the spread of viral hepatitis.
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Leal PR, José de Paula E Sousa Guimarães R, Kampel M. Sociodemographic and spatiotemporal profiles of hepatitis-A in the state of Pará, Brazil, based on reported notified cases. GEOSPATIAL HEALTH 2021; 16. [PMID: 34730318 DOI: 10.4081/gh.2021.981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 06/18/2021] [Indexed: 06/13/2023]
Abstract
Hepatitis-A virus is a worldwide healthcare problem, mainly affecting countries with poor sanitary and socioeconomic conditions. This communication evaluates the spatiotemporal variability of the disease's socioepidemiological profile in one of the endemic Brazilian regions (Pará State) prior to (2008-2013) and after (2014-2017) the launch of the national public vaccination programme. Hepatitis-A epidemiological reports concerning Pará State - Brazil - were used for this study including municipalitylevel data of the disease's reported positive notification cases (PNCs). The analyses involved socioepidemiological profiling and space-time scan statistics. A total of 5500 PNCs were reported in the study period. On average, PNCs decreased over time throughout the state, with strongest drops after 2015. The PNCs were specific for gender, race/ethnic origin and age group. The predominant gender and race/ethnic groups was male and brown, respectively. While children were the most susceptible age group prior to 2015, there was a shift towards older ages (young and adults) in later years. Those found to be the most affected by the disease, as shown by space-time scan statistics, were people in densely populated municipalities with unsatisfactory sanitary conditions and also less well covered by the public vaccination programme. Despite drops in the number of hepatitis-A PNCs, thanks to the national vaccination programme, the disease still persists in Pará State and elsewhere in Brazil. The present study reinforces the need of continuous prevention and control strategies for effective control and erradication of hepatitis-A.
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Affiliation(s)
| | | | - Milton Kampel
- National Institute for Space Research, São José dos Campos, SP.
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20
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Zhang Y, Zhang M, Kang D, Sun W, Yang C, Wei R. Spatio-temporal analysis of bacillary dysentery in Sichuan province, China, 2011-2019. BMC Infect Dis 2021; 21:1033. [PMID: 34602058 PMCID: PMC8489051 DOI: 10.1186/s12879-021-06738-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 09/24/2021] [Indexed: 11/23/2022] Open
Abstract
Background Bacillary dysentery (BD) is a common infectious disease in China and causes enormous economic burdens. The purpose of this study was to describe the epidemiological characteristics of BD and to identify its possible hot spots and potentially high-risk areas in Sichuan province of China. Methods In this study, we collected monthly BD incidence reports of 181 counties in Sichuan province, China, from January 2011 to December 2019. Descriptive statistics were used to evaluate the epidemic characteristics of BD. Moran’s I index was applied to investigate the yearly patterns of the spatial distribution. And spatio-temporal scanning statistics with the spatial unit set as county and the temporal unit set as month were used to investigate the possible high-risk region. Meanwhile, the circular moving windows were also employed in the spatio-temporal scanning to scan the study areas. Results The annual incidence of BD ranged between 16.13/100,000 and 6.17/100,000 person-years from 2011 to 2019 in Sichuan. The majority of the cases were children aged 5 years or younger. For the descriptive statistics, a peak from May to October was observed in temporal analysis, the epidemics were mainly concentrated in the northwest and southwest of Sichuan in spatial analysis. After 2016, the scope of BD significantly narrowed and severe epidemic areas were relatively stable. For the spatial autocorrelation analysis, a high global autocorrelation was observed at the county level, and the high–high clusters mainly distributed in the northwest and southwest of Sichuan. For the spatio-temporal scanning, the spatiotemporal clusters of BD occurred every year from 2011 to 2019. The most likely cluster areas mainly distributed in the southwest and northwest of Sichuan at the beginning, and then gradually concentrated in the southwest. The secondary cluster mainly concentrated in the northwest and its surrounding areas. Moreover, the 2nd secondary cluster was relatively small and mainly distributed in the central area. No clusters were noted in eastern Sichuan. Conclusions Based on our current analysis, BD is still a common challenge in Sichuan, especially for counties in the southwest and northwest in summer and autumn. More disease prevention and control measures should be taken in such higher-risk susceptible areas at a certain time to allocate the public health resources rationally, and finally reduce the spread of BD.
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Affiliation(s)
- Yao Zhang
- Department of Emergency Management, Sichuan Center for Diseases Control and Prevention, Chengdu, 610041, China
| | - Mengyuan Zhang
- Department of Emergency Management, Sichuan Center for Diseases Control and Prevention, Chengdu, 610041, China
| | - Dianju Kang
- Department of Emergency Management, Sichuan Center for Diseases Control and Prevention, Chengdu, 610041, China
| | - Wei Sun
- Department of Emergency Management, Sichuan Center for Diseases Control and Prevention, Chengdu, 610041, China
| | - Changhong Yang
- Department of Emergency Management, Sichuan Center for Diseases Control and Prevention, Chengdu, 610041, China.
| | - Rongjie Wei
- Department of Emergency Management, Sichuan Center for Diseases Control and Prevention, Chengdu, 610041, China.
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21
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Hu X, Zhou W, Zhang L, Lv J, Yan B, Zhou Y, Hu W, Dong Y, Chen B, Liu M, Cao J, Xu F, Li L. Implementing sequencing-based surveillance in developing countries: findings from a pilot rollout for hepatitis A in China. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1119. [PMID: 34430560 PMCID: PMC8350710 DOI: 10.21037/atm-21-1193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 06/10/2021] [Indexed: 01/15/2023]
Abstract
Background The emergence of SARS-Cov2 variants has highlighted the need to implement sequencing-based surveillance in developing countries for early response to mutant viruses of concern. However, limited information on how to implement sequencing-based surveillance is available, and the feasibility and performance of this new type of surveillance are still in question. Methods To understand the challenges with the implementation and to promote sequencing-based surveillance, we reported findings from a pilot for hepatitis A (HepA) in five sentinel provinces in China as an example of sequencing-based surveillance implementation. The performance of the surveillance system was evaluated by indicators related to acceptability, data quality, simplicity, utility, and timeliness. We use a scale from 1 to 3 was used to provide a score for each aspect. Results During the pilot, 306 cases of HepA were reported, and 49.79% of samples were available for sequencing. Eleven genomic clusters were found, of which seven clusters were potentially related to a foodborne outbreak oyster based on identical viral sequence and epidemiologic investigations. The greatest strength of the system was its simplicity (Score: 2.63). The acceptability (Score: 2.0) and utility (Score: 2.33) were modest, but data quality (Score: 1.75) and timeliness (Score: 1.75) were the main challenges. Conclusions Overall, the system performed satisfactorily and proved to be useful for virological characterization of cases and early outbreak detection, with a great potential for scale-up. Further efforts are required to address financial and human resource constraints and inadequate support among physicians. Education should be given to health care professionals to improve the data quality. The establishment of decentralized surveillance networks can be an approach to improve timeliness for emerging infections.
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Affiliation(s)
- Xiaotong Hu
- The First Affiliated Hospital, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, College of Medicine, Zhejiang University, Hangzhou, China
| | - Wenting Zhou
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Li Zhang
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China
| | - Jingjing Lv
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China
| | - Bingyu Yan
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China
| | - Yang Zhou
- Zhejiang Provincial Center for Disease Control and Prevention, Dept. of Immunization Program, Division of Immunization Surveillance & Evaluation, Hangzhou, China
| | - Weijun Hu
- Immunization Program Department, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, China
| | - Yuanyuan Dong
- Immunization Program Department, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, China
| | - Biyu Chen
- Hainan Center for Disease Control and Prevention, Haikou, China
| | - Man Liu
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Jingyuan Cao
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Fujie Xu
- The First Affiliated Hospital, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, College of Medicine, Zhejiang University, Hangzhou, China.,China Country Office, Bill& Melinda Gates Foundation, Beijing, China
| | - Lanjuan Li
- The First Affiliated Hospital, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, College of Medicine, Zhejiang University, Hangzhou, China
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22
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Jiang Y, Dou X, Yan C, Wan L, Liu H, Li M, Wang R, Li G, Zhao L, Liu Z, Zhao X, Wan K. Epidemiological characteristics and trends of notifiable infectious diseases in China from 1986 to 2016. J Glob Health 2021; 10:020803. [PMID: 33214900 PMCID: PMC7649044 DOI: 10.7189/jogh.10.020803] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background Since the 1980s, China has undergone significant social change and the incidence of infectious diseases has also changed considerably. Here, we report the epidemiological features and changes in notifiable infectious diseases in China from 1986 to 2016 to explore the factors contributing to the successful control of infectious diseases and the challenges faced in the prevention and control of infectious diseases. Methods The data of notifiable infectious diseases in China from 1986 to 2016 were collected from the monthly analysis report of the National Infectious Disease Surveillance System. Joinpoint regression models were used to examine incidence and mortality trends from 1986 to 2016. IBM SPSS Statistics version 22.0, Excel 2010 and R x64 3.5.2 were used for data analysis. Results A total of 132 858 005 cases of notifiable infectious diseases were reported over these 31 years, with an average yearly incidence of 342.14/100 000. There were 284 694 deaths with an average yearly mortality rate of 0.73/100 000. The overall incidence and overall mortality of notifiable infectious diseases both showed a "U" distribution (ie, a decrease, stable, an increase, stable again). The top five diseases in terms of incidence were hand, foot and mouth disease, viral hepatitis, tuberculosis, other infectious causes of diarrhea and dysentery, accounting for 78.0% of all reported cases. The top five causes of death were HIV/AIDS, rabies, tuberculosis, viral hepatitis and epidemic encephalitis B, which accounted for 76.07% of all mortalities. The diseases with the top five fatality rates were rabies, H5N1, H7N9, HIV/AIDS and plague, with rates of 91.06%, 66.07%, 38.51%, 25.19% and 10.31%, respectively. Conclusions This analysis will benefit the future monitoring of infectious diseases and public health measures in China.
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Affiliation(s)
- Yi Jiang
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiangfeng Dou
- Beijing Center for Diseases Prevention and Control, Beijing, China
| | - Chenqi Yan
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China.,Foshan Women and Children Hospital, Guangdong Province, China
| | - Li Wan
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China.,Department of Physiology, Xiangya School of Medicine, Central South University, Changsha, China
| | - Haican Liu
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Machao Li
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ruibai Wang
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Guilian Li
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lili Zhao
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhiguang Liu
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiuqin Zhao
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Kanglin Wan
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
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23
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Li T, Wang R, Zhao Y, Su S, Zeng H. Public awareness and influencing factors regarding hepatitis B and hepatitis C in Chongqing municipality and Chengdu City, China: a cross-sectional study with community residents. BMJ Open 2021; 11:e045630. [PMID: 34341038 PMCID: PMC8330590 DOI: 10.1136/bmjopen-2020-045630] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Hepatitis B and hepatitis C cause a heavy disease burden in China. This paper aims to investigate the public's knowledge on hepatitis B and hepatitis C in Chongqing municipality and Chengdu City, China. DESIGN A cross-sectional study was conducted from December 2016 to April 2017. SETTING Two communities from Chongqing and Chengdu were involved in this study. PARTICIPANTS Data from 928 community residents were analysed. OUTCOME Demographic characteristics, knowledge on hepatitis B and hepatitis C and sources of hepatitis knowledge were obtained from questionnaires. The participants' scores ranged from 0 to 24, and a test score about more than 14.4 (60% of the total score) was defined as sufficient knowledge. RESULTS Among the participants, only 36.10% presented sufficient knowledge on hepatitis B and hepatitis C, and about 40% were unaware of the two antidiscrimination policies in China. The sources of information about hepatitis were mainly from doctors and the internet. Unmarried individuals, people with secondary education and above and those with an annual income above US$2108 tended to exhibit a higher level of knowledge on hepatitis B and hepatitis C. CONCLUSIONS The community members demonstrated limited awareness and level of knowledge on hepatitis B and hepatitis C, particularly in relation to the antidiscrimination policies. Extensive health education should be provided to the public, particularly to those with low educational status and income.
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Affiliation(s)
- Tingting Li
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Ruoxi Wang
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
- Blood Components Department, Chengdu Blood Center, Health and Family Planning Commission of Sichuan Province, Chengdu, China
| | - Yong Zhao
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Child Nutrition and Health, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Shu Su
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, ShanXi, China
| | - Huan Zeng
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
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24
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Arce LP, Raya Tonetti MF, Raimondo MP, Müller MF, Salva S, Álvarez S, Baiker A, Villena J, Vizoso Pinto MG. Oral Vaccination with Hepatitis E Virus Capsid Protein and Immunobiotic Bacterium-Like Particles Induce Intestinal and Systemic Immunity in Mice. Probiotics Antimicrob Proteins 2021; 12:961-972. [PMID: 31630331 DOI: 10.1007/s12602-019-09598-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The hepatitis E virus (HEV) genotype 3 (GT3) is an emergent pathogen in industrialized countries. It is transmitted zoonotically and may lead to chronic hepatitis in immunocompromised individuals. We evaluated if the major antigen of HEV, the capsid protein, can be used in combination with immunobiotic bacterium-like particles (IBLP) for oral vaccination in a mouse model. We have cloned and expressed the RGS-His5-tagged HEV GT3 capsid protein (ORF2) in E. coli and purified it by NiNTA. IBLP were obtained from two immunobiotic Lactobacillus rhamnosus strains acid- and heat-treated. ORF2 and the IBLP were orally administered to Balb/c mice. After three oral immunizations (14-day intervals), blood, intestinal fluid, Peyer´s patches, and spleen samples were drawn. IgA- and IgG-specific antibodies were determined by ELISA. Mononuclear cell populations from Peyer's patches and spleen were analyzed by flow cytometry, and the cytokine profiles were determined by ELISA to study cellular immunity. Orally administered recombinant ORF2 and IBLP from two L. rhamnosus strains (CRL1505 and IBL027) induced both antigen-specific humoral and cellular immune responses in mice. IBLP027 was more effective in inducing specific secretory IgA in the gut. IFN-γ, TNF-α, and IL-4 were produced by Peyer's plaques lymphocytes stimulated with ORF2 ex vivo suggesting a mixed Th1/Th2-type adaptive immune response in immunized mice. Oral vaccines are not invasive, do not need to be administered by specialized personal, and elicit both systemic and local immune responses at the port of entry. Here, we present an experimental oral vaccine for HEV GT3, which could be further developed for human and/or veterinary use.
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Affiliation(s)
- L P Arce
- Instituto Superior de Investigaciones Biológicas (INSIBIO), CONICET-UNT, and Facultad de Medicina, UNT, Av. Kirchner 2100, (4000) San Miguel de Tucumán, Tucumán, Argentina.,Laboratorio de Ciencias Básicas. OR. Genética. Facultad de Medicina de la Universidad Nacional de Tucumán, Tucumán, Argentina
| | - M F Raya Tonetti
- Instituto Superior de Investigaciones Biológicas (INSIBIO), CONICET-UNT, and Facultad de Medicina, UNT, Av. Kirchner 2100, (4000) San Miguel de Tucumán, Tucumán, Argentina.,Laboratorio de Ciencias Básicas. OR. Genética. Facultad de Medicina de la Universidad Nacional de Tucumán, Tucumán, Argentina
| | - M P Raimondo
- Laboratorio de Ciencias Básicas. OR. Genética. Facultad de Medicina de la Universidad Nacional de Tucumán, Tucumán, Argentina
| | - M F Müller
- Instituto Superior de Investigaciones Biológicas (INSIBIO), CONICET-UNT, and Facultad de Medicina, UNT, Av. Kirchner 2100, (4000) San Miguel de Tucumán, Tucumán, Argentina.,Laboratorio de Ciencias Básicas. OR. Genética. Facultad de Medicina de la Universidad Nacional de Tucumán, Tucumán, Argentina
| | - S Salva
- Laboratorio de Inmunobiotecnología, CERELA (CONICET), Chacabuco 145, (4000) San Miguel de Tucumán, Tucumán, Argentina
| | - S Álvarez
- Laboratorio de Inmunobiotecnología, CERELA (CONICET), Chacabuco 145, (4000) San Miguel de Tucumán, Tucumán, Argentina
| | - A Baiker
- LGL, Bavarian Health and Food Safety Authority, Oberschleissheim, Germany
| | - J Villena
- Laboratorio de Inmunobiotecnología, CERELA (CONICET), Chacabuco 145, (4000) San Miguel de Tucumán, Tucumán, Argentina.
| | - M G Vizoso Pinto
- Instituto Superior de Investigaciones Biológicas (INSIBIO), CONICET-UNT, and Facultad de Medicina, UNT, Av. Kirchner 2100, (4000) San Miguel de Tucumán, Tucumán, Argentina. .,Laboratorio de Ciencias Básicas. OR. Genética. Facultad de Medicina de la Universidad Nacional de Tucumán, Tucumán, Argentina.
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Spatio-Temporal Analysis of Influenza-Like Illness and Prediction of Incidence in High-Risk Regions in the United States from 2011 to 2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137120. [PMID: 34281057 PMCID: PMC8297262 DOI: 10.3390/ijerph18137120] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/27/2021] [Accepted: 06/29/2021] [Indexed: 01/04/2023]
Abstract
About 8% of the Americans contract influenza during an average season according to the Centers for Disease Control and Prevention in the United States. It is necessary to strengthen the early warning for influenza and the prediction of public health. In this study, Spatial autocorrelation analysis and spatial scanning analysis were used to identify the spatiotemporal patterns of influenza-like illness (ILI) prevalence in the United States, during the 2011-2020 transmission seasons. A seasonal autoregressive integrated moving average (SARIMA) model was constructed to predict the influenza incidence of high-risk states. We found the highest incidence of ILI was mainly concentrated in the states of Louisiana, District of Columbia and Virginia. Mississippi was a high-risk state with a higher influenza incidence, and exhibited a high-high cluster with neighboring states. A SARIMA (1, 0, 0) (1, 1, 0)52 model was suitable for forecasting the ILI incidence of Mississippi. The relative errors between actual values and predicted values indicated that the predicted values matched the actual values well. Influenza is still an important health problem in the United States. The spread of ILI varies by season and geographical region. The peak season of influenza was the winter and spring, and the states with higher influenza rates are concentrated in the southeast. Increased surveillance in high-risk states could help control the spread of the influenza.
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26
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Pu X, Deng D, Chu C, Zhou T, Liu J. High-dimensional hepatopath data analysis by machine learning for predicting HBV-related fibrosis. Sci Rep 2021; 11:5081. [PMID: 33658585 PMCID: PMC7930086 DOI: 10.1038/s41598-021-84556-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 02/16/2021] [Indexed: 11/09/2022] Open
Abstract
Chronic HBV infection, the main cause of liver cirrhosis and hepatocellular carcinoma, has become a global health concern. Machine learning algorithms are particularly adept at analyzing medical phenomenon by capturing complex and nonlinear relationships in clinical data. Our study proposed a predictive model on the basis of 55 routine laboratory and clinical parameters by machine learning algorithms as a novel non-invasive method for liver fibrosis diagnosis. The model was further evaluated on the accuracy and rationality and proved to be highly accurate and efficient for the prediction of HBV-related fibrosis. In conclusion, we suggested a potential combination of high-dimensional clinical data and machine learning predictive algorithms for the liver fibrosis diagnosis.
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Affiliation(s)
- Xiangke Pu
- Institute of Hepatology, The Third People's Hospital of Changzhou, Changzhou, 213001, China
| | - Danni Deng
- Department of Neurosurgery, The First People's Hospital of Changzhou, Changzhou, 213001, China
| | - Chaoyi Chu
- Library, Jiangsu University of Technology, Changzhou, 213001, China
| | - Tianle Zhou
- School of Computer Science and Engineering, Jiangsu University of Technology, Changzhou, 213001, China.
| | - Jianhong Liu
- Institute of Hepatology, The Third People's Hospital of Changzhou, Changzhou, 213001, China.
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Fei-fei S, Xiao-dan R, Hai-qiang L, He-wei Z. Value of anti-hepatitis B virus in serum tested by enzyme linked immunosorbent assay 3 in diagnosis of hepatitis B: A protocol for systemic review and meta analysis. Medicine (Baltimore) 2021; 100:e23961. [PMID: 33545977 PMCID: PMC7837889 DOI: 10.1097/md.0000000000023961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 12/01/2020] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION This protocol is for a meta analysis that aims to systematically review the diagnostic value of anti-hepatitis B virus in serum tested by the enzyme linked immunosorbent assay in patients with hepatitis B. METHODS AND ANALYSIS The following electronic databases will be searched from inception to Mar 2021: PubMed, Web of Science, ScienceDirect, EMBASE, MEDLINE, Springer, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, VIP Chinese Science and Technology Periodical Database, and Wanfang Database. All study about enzyme linked immunosorbent assay reagents have been published at home and abroad to diagnose hepatitis B virus will be included. MetaDisc 1.4 soft will used to calculate pooled effect size in sensitivity, specifi city, likelihood ratio, diagnostic odds ratio and summary receiver operating characteristic curve, and area under the curve as well. ETHICS AND DISSEMINATION Formal ethical approval is not required, as the data are not individualized. The findings of this systematic review will be disseminated in a peer-reviewed publication and/or presented at relevant conferences. REGISTRATION NUMBER INPLASY2020100051.
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Affiliation(s)
- Shen Fei-fei
- Department of Medical Laboratory Technology, Luoyang Polytechnic
| | - Ren Xiao-dan
- Department of Traditional Chinese Medicine, The Second Affiliated Hospital of Army Medical University
| | - Liu Hai-qiang
- Department of Medical Imaging Technology, Luoyang Polytechnic
| | - Zhang He-wei
- The college of Food and Drugs, Luoyang Polytechnic
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Zhu J, Wang P, Ye H, Shi J, Wang X, Wang K, Duan F, Yang Q, Sun G, Zhang J. Trend of the mortality of major liver diseases and its impact on life expectancy in China from 2006 to 2017. J Public Health (Oxf) 2021; 44:100-110. [PMID: 33454770 DOI: 10.1093/pubmed/fdaa261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 11/03/2020] [Accepted: 12/14/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Liver diseases are the serious cause of death in China. We aim to describe the trends and disparities of major liver disease mortality rates and the loss of life expectancy (LLE) in China. METHODS Annual percentage change (APC) and average APC (AAPC) were calculated using the Joinpoint regression model. LLE was calculated using cause eliminated life table. RESULTS From 2006 to 2017, the overall age-standardized mortality rate (ASMR) of liver cirrhosis lightly declined (AAPC: -2.97%), whereas the ASMR of viral hepatitis and liver cancer remained stable. Viral hepatitis (AAPC: -4.36%) and liver cirrhosis (AAPC: -4.35%) ASMRs both declined for females. The highest ASMRs of viral hepatitis and liver cirrhosis were in the west region, while that of liver cancer was in the middle region. The ASMRs of liver cirrhosis in the middle region and liver cancer in the east region significantly decreased. The means of LLE on viral hepatitis, liver cirrhosis and liver cancer were 0.05, 0.1 and 0.46 years, respectively. CONCLUSIONS The burden of liver diseases is still severe and there are disparities between genders and different regions in China. Accurate early diagnostic approaches for high-risk populations should be established to eliminate the burden of liver diseases.
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Affiliation(s)
- Jicun Zhu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China.,Henan Key Laboratory of Tumor Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Peng Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China.,Henan Key Laboratory of Tumor Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Hua Ye
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China.,Henan Key Laboratory of Tumor Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Jianxiang Shi
- Henan Key Laboratory of Tumor Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China.,Precision Medicine Center, BGI College & Henan Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, China
| | - Xiao Wang
- Precision Medicine Center, BGI College & Henan Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, China
| | - Keyan Wang
- Henan Key Laboratory of Tumor Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China.,Precision Medicine Center, BGI College & Henan Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, China
| | - Fujiao Duan
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China.,Henan Key Laboratory of Tumor Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Qian Yang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China.,Henan Key Laboratory of Tumor Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Guiying Sun
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China.,Henan Key Laboratory of Tumor Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Jianying Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China.,Henan Key Laboratory of Tumor Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China.,Precision Medicine Center, BGI College & Henan Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, China
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Chimungu B, Fu M, Wu J, Wu J, Huang L, Dai Y, Tang S, Zhang J, Wan C. Prevalence of sexually transmitted infections among foreigners living in Guangzhou, China: a cross-sectional study (2010-2017). BMC Infect Dis 2020; 20:345. [PMID: 32410628 PMCID: PMC7222532 DOI: 10.1186/s12879-020-04995-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 03/27/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The prevalence of HIV/HCV/HBV/ Treponema pallidum is an essential health issue in China. However, there are few studies focused on foreigners living in China. This study aimed to assess the prevalence and socio-demographic distribution of HIV, HBV, HCV, and T. pallidum among foreigners in Guangzhou in the period of 2010-2017. METHODS A cross-sectional study was conducted to screen serological samples of 40,935 foreigners from 2010 to 2017 at the Guangdong International Travel Health Care Center in Guangzhou. Samples were tested for hepatitis B surface antigen (HBsAg), anti-HCV, syphilis antibody (anti-TPPA) and anti-HIV 1 and 2. We collected secondary data from laboratory records and used multiple logistic regression analyses to verify the association between different factors and the seroprevalence of HIV/HBV/HCV/ T. pallidum. RESULTS The prevalence of HBV/HCV/HIV/ T. pallidum was 2.30, 0.42, 0.02, and 0.60%, respectively, and fluctuated slightly for 7 years. The results of multiple logistic regression showed that males were less susceptible to HBV than females (odds ratio [OR] = 0.77, 95% CI: 0.67-0.89). Participants under the age of 20 had a lower risk of HBV (OR = 0.25, 95% CI: 0.18-0.35), HCV (OR = 0.06, 95% CI: 0.02-0.18), and T. pallidum (OR = 0. 10, 95% CI: 0.05-0.20) than participants over the age of 50. Participants with an education level below high school were more likely to have HBV (OR = 2.98, 95% CI: 1.89-4.70) than others, and businessmen (OR = 3.02, 95% CI: 2.03-4.49), and designers (OR = 3.83, 95% CI: 2.49-5.90) had a higher risk of T. pallidum than others. Co-infection involved 58 (4.20%) total cases, and the highest co-infection rate was observed for HBV and T. pallidum (2.60%). CONCLUSION The prevalence of HBV/HCV/HIV/ T. pallidum was low among foreigners in Guangzhou. Region, gender, age, educational level, and occupation were risk factors for positive infection.
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Affiliation(s)
- Benard Chimungu
- Department of Microbiology, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Muqing Fu
- Department of Microbiology, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Jian Wu
- Clinical laboratory, Guangdong International Travel Health Care Center, Guangzhou, 510635, China
| | - Jiali Wu
- Department of Microbiology, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Liping Huang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Yingchun Dai
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Shixing Tang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Jianming Zhang
- Clinical laboratory, Guangdong International Travel Health Care Center, Guangzhou, 510635, China.
| | - Chengsong Wan
- Department of Microbiology, School of Public Health, Southern Medical University, Guangzhou, 510515, China. .,Key Laboratory of Tropical Disease Research of Guangdong Province, Southern Medical University, Guangzhou, 510515, China.
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Mao Y, He R, Zhu B, Liu J, Zhang N. Notifiable Respiratory Infectious Diseases in China: A Spatial-Temporal Epidemiology Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2301. [PMID: 32235375 PMCID: PMC7177391 DOI: 10.3390/ijerph17072301] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 03/25/2020] [Accepted: 03/26/2020] [Indexed: 12/21/2022]
Abstract
Nowadays, tuberculosis, scarlet fever, measles, influenza, and mumps are five major notifiable respiratory infectious diseases (RIDs) in China. The objective of this study was to describe, visualize, and compare the spatial-temporal distributions of these five RIDs from 2006 to 2016. In addition to descriptive epidemiology analysis, seasonality and spatial autocorrelation analysis were also applied to explore the epidemiologic trends and spatial changing patterns of the five RIDs, respectively. The results indicated that the incidence of tuberculosis, measles, and mumps presented a downtrend trend, while those of scarlet fever and influenza was in a strong uptrend across the research period. The incidences of the five diseases all peaked in spring. There were significant spatial disparities in the distribution of tuberculosis, scarlet fever, and measles cases, with the hotspots mainly located in the western plateau region, northern plain region, and southern mountainous region. To conclude, notable epidemiological differences were observed across regions, indicating that some provincial units should pay more attention to prevent and control respiratory infectious diseases.
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Affiliation(s)
- Ying Mao
- School of Public Policy and Administration, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an 710049, China; (R.H.); (B.Z.); (J.L.); (N.Z.)
- Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an 710049, China
| | - Rongxin He
- School of Public Policy and Administration, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an 710049, China; (R.H.); (B.Z.); (J.L.); (N.Z.)
- Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an 710049, China
| | - Bin Zhu
- School of Public Policy and Administration, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an 710049, China; (R.H.); (B.Z.); (J.L.); (N.Z.)
- Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an 710049, China
- Department of Public Policy, City University of Hong Kong, Hong Kong 999077, China
| | - Jinlin Liu
- School of Public Policy and Administration, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an 710049, China; (R.H.); (B.Z.); (J.L.); (N.Z.)
- Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an 710049, China
- Walter H. Shorenstein Asia-Pacific Research Center, Stanford University, Stanford, CA 94305, USA
| | - Ning Zhang
- School of Public Policy and Administration, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an 710049, China; (R.H.); (B.Z.); (J.L.); (N.Z.)
- Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an 710049, China
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Zhu B, Hsieh CW, Mao Y. Spatio-temporal variations of licensed doctor distribution in China: measuring and mapping disparities. BMC Health Serv Res 2020; 20:159. [PMID: 32122387 PMCID: PMC7053041 DOI: 10.1186/s12913-020-4992-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 02/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The licensed doctor misdistribution is one of the major challenges faced by China. However, this subject remains underexplored as spatial distribution characteristics (such as spatial clustering patterns) have not been fully mapped out by existing studies. To fill the void, this study aims to explore the spatio-temporal dynamics and spatial clustering patterns of different subtypes of licensed doctors (i.e., clinicians, traditional Chinese medicine doctors, dentists, public health doctors, general practitioners) in China. METHODS Data on the licensed doctor quantity and population during 2012-2016 was obtained from the National Health (and Family Planning) Yearbook. Functional boxplots were used to visualize and compare the temporal trends of densities of different subtypes of licensed doctors. This study adopted two complementary spatial statistics (space-time scan statistics and Moran's I statistics) to explore the spatio-temporal dynamics and spatial clustering patterns of licensed doctor distribution in China. The former was used to explore the spatial variations in the temporal trends of licensed doctor density during 2012-2016, and the latter was adopted to explore the spatial changing patterns of licensed doctor distribution during the research period. RESULTS The results show that the densities of almost all subtypes of licensed doctors displayed upward trends during 2012-2016, though some provincial units were left behind. Besides, spatial distribution characteristics varied across different subtypes of licensed doctors, with the low-low cluster area of general practitioners being the largest. CONCLUSIONS The misdistribution of licensed doctors is a global problem and China is no exception. In order to achieve a balanced distribution of licensed doctors, the government is suggested to introduce a series of measures, such as deliberative policy design and effective human resource management initiatives to educate, recruit, and retain licensed doctors and prevent a brain drain of licensed doctors from disadvantaged units.
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Affiliation(s)
- Bin Zhu
- School of Public Policy and Administration, Xi'an Jiaotong University, 28 Xianning West Road, Beilin District, Xi'an, 710049, China.,Department of Public Policy, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong, SAR, China
| | - Chih-Wei Hsieh
- Department of Public Policy, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong, SAR, China
| | - Ying Mao
- School of Public Policy and Administration, Xi'an Jiaotong University, 28 Xianning West Road, Beilin District, Xi'an, 710049, China.
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Ullah S, Daud H, Dass SC, Fanaee-T H, Kausarian H, Khalil A. Space-Time Clustering Characteristics of Tuberculosis in Khyber Pakhtunkhwa Province, Pakistan, 2015-2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041413. [PMID: 32098247 PMCID: PMC7068355 DOI: 10.3390/ijerph17041413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 01/15/2020] [Accepted: 01/21/2020] [Indexed: 12/23/2022]
Abstract
The number of tuberculosis (TB) cases in Pakistan ranks fifth in the world. The National TB Control Program (NTP) has recently reported more than 462,920 TB patients in Khyber Pakhtunkhwa province, Pakistan from 2002 to 2017. This study aims to identify spatial and space-time clusters of TB cases in Khyber Pakhtunkhwa province Pakistan during 2015-2019 to design effective interventions. The spatial and space-time cluster analyses were conducted at the district-level based on the reported TB cases from January 2015 to April 2019 using space-time scan statistics (SaTScan). The most likely spatial and space-time clusters were detected in the northern rural part of the province. Additionally, two districts in the west were detected as the secondary space-time clusters. The most likely space-time cluster shows a tendency of spread toward the neighboring districts in the central part, and the most likely spatial cluster shows a tendency of spread toward the neighboring districts in the south. Most of the space-time clusters were detected at the start of the study period 2015-2016. The potential TB clusters in the remote rural part might be associated to the dry-cool climate and lack of access to the healthcare centers in the remote areas.
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Affiliation(s)
- Sami Ullah
- Department of Fundamental & Applied Sciences, Universiti Teknologi PETRONAS, Seri Iskandar 32610, Perak, Malaysia;
- Correspondence:
| | - Hanita Daud
- Department of Fundamental & Applied Sciences, Universiti Teknologi PETRONAS, Seri Iskandar 32610, Perak, Malaysia;
| | - Sarat C. Dass
- School of Mathematical and Computer Sciences, Heriot-Watt University Malaysia, Putrajaya 62200, Malaysia;
| | - Hadi Fanaee-T
- Center for Applied Intelligent Systems Research (CAISR), Halmstad University, SE-301 18 Halmstad, Sweden;
| | - Husnul Kausarian
- Department of Geological Engineering, Universitas Islam Riau, Pekanbaru 28284, Indonesia;
| | - Alamgir Khalil
- Department of Statistics, University of Peshawar, Peshawar 25120, Pakistan;
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Mao Y, Zhang N, Zhu B, Liu J, He R. A descriptive analysis of the Spatio-temporal distribution of intestinal infectious diseases in China. BMC Infect Dis 2019; 19:766. [PMID: 31477044 PMCID: PMC6721277 DOI: 10.1186/s12879-019-4400-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 08/23/2019] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Intestinal infectious diseases (IIDs) have caused numerous deaths worldwide, particularly among children. In China, eight IIDs are listed as notifiable infectious diseases, including cholera, poliomyelitis, dysentery, typhoid and paratyphoid (TAP), viral Hepatitis A, viral Hepatitis E, hand-foot-mouth disease (HFMD) and other infectious diarrhoeal diseases (OIDDs). The aim of the study is to analyse the spatio-temporal distribution of IIDs from 2006 to 2016. METHODS Data on the incidence of IIDs from 2006 to 2016 were collected from the public health science data centre issued by the Chinese Center for Disease Control and Prevention. This study applied seasonal decomposition analysis, spatial autocorrelation analysis and space-time scan analysis. Plots and maps were constructed to visualize the spatio-temporal distribution of IIDs. RESULTS Regarding temporal analysis, the incidence of HFMD and Hepatitis E showed a distinct increasing trend, while the incidence of TAP, dysentery, and Hepatitis A presented decreasing trends over the last decade. The incidence of OIID remained steady. Summer is the season with the greatest number of cases of different IIDs. Regarding the spatial distribution, approximately all p values for the global Moran's I from 2006 to 2016 were less than 0.05, indicating that the incidences of the epidemics were unevenly distributed throughout the country. The high-risk areas for HFMD and OIDD were located in the Beijing-Tianjin-Tangshan (BTT) region and south China. The high-risk areas for TAP were located in some parts of southwest China. A higher incidence rates for dysentery and Hepatitis A were observed in the BTT region and some west provincial units. The high-risk areas for Hepatitis E were the BTT region and the Yangtze River Delta area. CONCLUSIONS Based on our temporal and spatial analysis of IIDs, we identified the high-risk periods and clusters of regions for the diseases. HFMD and OIDD exhibited high incidence rates, which reflected the negligence of Class C diseases by the government. At the same time, the incidence rate of Hepatitis E gradually surpassed Hepatitis A. The authorities should pay more attention to Class C diseases and Hepatitis E. Regardless of the various distribution patterns of IIDs, disease-specific, location-specific, and disease-combined interventions should be established.
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Affiliation(s)
- Ying Mao
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, 710049 China
| | - Ning Zhang
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, 710049 China
| | - Bin Zhu
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, 710049 China
- Department of Public Policy, City University of Hong Kong, Hong Kong, 999077 China
| | - Jinlin Liu
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, 710049 China
| | - Rongxin He
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, 710049 China
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Zhu H, Zhao H, Ou R, Xiang H, Hu L, Jing D, Sharma M, Ye M. Epidemiological Characteristics and Spatiotemporal Analysis of Mumps from 2004 to 2018 in Chongqing, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173052. [PMID: 31443544 PMCID: PMC6747306 DOI: 10.3390/ijerph16173052] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 08/17/2019] [Accepted: 08/19/2019] [Indexed: 01/16/2023]
Abstract
Mumps vaccines have been widely used in recent years, but frequent mumps outbreaks and re-emergence around the world have not stopped. Mumps still remains a serious public health problem with a high incidence in China. The status of mumps epidemics in Chongqing, the largest city in China, is still unclear. This study aimed to investigate the epidemiological and spatiotemporal characteristics of mumps and to provide a scientific basis for formulating effective strategies for its prevention and control. Surveillance data of mumps in Chongqing from January 2004 to December 2018 were collected from the National Notifiable Diseases Reporting Information System. A descriptive analysis was conducted to understand the epidemiological characteristics. Hot spots and spatiotemporal patterns were identified by performing a spatial autocorrelation analysis, a purely spatial scan, and a spatiotemporal scan at the county level based on geographic information systems. A total of 895,429 mumps cases were reported in Chongqing, with an annual average incidence of 36.34 per 100,000. The yearly incidence of mumps decreased markedly from 2004 to 2007, increased sharply from 2007 to 2011, and then tapered with a two-year cyclical peak after 2011. The onset of mumps showed an obvious bimodal seasonal distribution, with a higher peak of mumps observed from April to July of each year. Children aged 5–9 years old, males, and students were the prime high-risk groups. The spatial distribution of mumps did not exhibit significant global autocorrelation in most years, but local indicators of spatial autocorrelation and scan statistics detected high-incidence clusters which were mainly located in the midwestern, western, northeastern, and southwestern parts of Chongqing. The aggregation time frame detected by the purely temporal scan was between March 2009 and July 2013. The incidence of mumps in Chongqing from 2004 to 2018 featured significant spatial heterogeneity and spatiotemporal clustering. The findings of this study might assist public health agencies to develop real-time space monitoring, especially in the clustering regions and at peak periods; to improve immunization strategies for long-term prevention; and to deploy health resources reasonably.
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Affiliation(s)
- Hua Zhu
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China
| | - Han Zhao
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing 400042, China
| | - Rong Ou
- Department of Medical Informatics Library, Chongqing Medical University, Chongqing 400016, China
| | - Haiyan Xiang
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China
| | - Ling Hu
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China
| | - Dan Jing
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China
| | - Manoj Sharma
- Department of Behavioral and Environmental Health, Jackson State University, Jackson, MS 39213, USA
| | - Mengliang Ye
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China.
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Spatial Analytics Based on Confidential Data for Strategic Planning in Urban Health Departments. URBAN SCIENCE 2019. [DOI: 10.3390/urbansci3030075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Spatial data analytics can detect patterns of clustering of events in small geographies across an urban region. This study presents and demonstrates a robust research design to study the longitudinal stability of spatial clustering with small case numbers per census tract and assess the clustering changes over time across the urban environment to better inform public health policy making at the community level. We argue this analysis enables the greater efficiency of public health departments, while leveraging existing data and preserving citizen personal privacy. Analysis at the census tract level is conducted in Mecklenburg County, North Carolina, on hypertension during pregnancy compiled from 2011–2014 birth certificates. Data were derived from per year and per multi-year moving counts by aggregating spatially to census tracts and then assessed for clustering using global Moran’s I. With evidence of clustering, local indicators of spatial association are calculated to pinpoint hot spots, while time series data identified hot spot changes. Knowledge regarding the geographical distribution of diseases is essential in public health to define strategies that improve the health of populations and quality of life. Our findings support that spatial aggregation at the census tract level contributes to identifying the location of at-risk “hot spot” communities to refine health programs, while temporal windowing reduces random noise effects on spatial clustering patterns. With tight state budgets limiting health departments’ funds, using geographic analytics provides for a targeted and efficient approach to health resource planning.
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Xie Q, Xuan JW, Tang H, Ye XG, Xu P, Lee IH, Hu SL. Hepatitis C virus cure with direct acting antivirals: Clinical, economic, societal and patient value for China. World J Hepatol 2019; 11:421-441. [PMID: 31183003 PMCID: PMC6547290 DOI: 10.4254/wjh.v11.i5.421] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 04/05/2019] [Accepted: 04/19/2019] [Indexed: 02/06/2023] Open
Abstract
About 10 million people in China are infected with hepatitis C virus (HCV), with the seroprevalence of anti-HCV in the general population estimated at 0.6%. Delaying effective treatment of chronic hepatitis C (CHC) is associated with liver disease progression, cirrhosis, hepatocellular carcinoma, and liver-related mortality. The extrahepatic manifestations of CHC further add to the disease burden of patients. Managing CHC-related advanced liver diseases and systemic manifestations are costly for both the healthcare system and society. Loss of work productivity due to reduced well-being and quality of life in CHC patients further compounds the economic burden of the disease. Traditionally, pegylated-interferon plus ribavirin (PR) was the standard of care. However, a substantial number of patients are ineligible for PR treatment, and only 40%-75% achieved sustained virologic response. Furthermore, PR is associated with impairment of patient-reported outcomes (PROs), high rates of adverse events, and poor adherence. With the advent of direct acting antivirals (DAAs), the treatment of CHC patients has been revolutionized. DAAs have broader eligible patient populations, higher efficacy, better PRO profiles, fewer adverse events, and better adherence rates, thereby making it possible to cure a large proportion of all CHC patients. This article aims to provide a comprehensive evaluation on the value of effective, curative hepatitis C treatment from the clinical, economic, societal, and patient experience perspectives, with a focus on recent data from China, supplemented with other Asian and international experiences where China data are not available.
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Affiliation(s)
- Qing Xie
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - Jian-Wei Xuan
- Health Economic Research Institute, School of Pharmacy, Sun Yat-Sen University, Guangzhou 510006, Guangdong Province, China
| | - Hong Tang
- Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xiao-Guang Ye
- Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, Guangdong Province, China
| | - Peng Xu
- Gilead Sciences Inc, Shanghai 200122, China
| | - I-Heng Lee
- Gilead Sciences Inc, Foster City, CA 94404, United States
| | - Shan-Lian Hu
- School of Public Health, Fudan University, Shanghai 200032, China
- Shanghai Health Development Research Center, Shanghai 200032, China.
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Cao S, Liu F, Wang T, Tan Y, Liu S, Liu Y, Gao L, Chen L. New patterns emerge after a sustained increase in the incidence of hepatitis C virus infection from 2004 to 2017: a joinpoint regression analysis. Public Health 2019; 170:49-56. [PMID: 30928613 DOI: 10.1016/j.puhe.2019.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 01/02/2019] [Accepted: 01/18/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Hepatitis C virus (HCV) infection continues to be a major public health concern in China. There is little information available in the literature about age- and sex-specific HCV incidence trends. The goal of this study was to examine recent trends in HCV incidence rates in Hunan, China, according to age and gender. STUDY DESIGN A descriptive study was implemented with a joinpoint analysis. METHODS Based on the annual reported incidence data of hepatitis C in Hunan, China, from 2004 to 2017, we performed a joinpoint regression analysis to examine trends in the annual percentage change (APC) and the average annual percentage change (AAPC) in the incidence of HCV infection throughout the study period; we stratified the analysis by gender and age. The software calculates the APC, AAPC and the 95% confidence intervals for each trend segment and tests whether the slope for each segment has a significant difference from the prior segment using a Z test. RESULTS From 2004 to 2017, the overall incidence rate of HCV infection rose from 0.93 per 100,000 to 20.88 per 100,000 (AAPC, 25.2%). In particular, women aged ≥65 years had the fastest increasing rate (AAPC, 29.9%). The incidence of different demographic groups showed no significant difference in increasing trends before 2013. However, new patterns emerged after 2013: the incidence of people aged 0-14 years was no longer significantly elevated; a significant yearly decline occurred in the incidence of HCV in people aged 15-29 years; the incidence of HCV in people aged ≥30 years continued to increase, with significantly slower increasing rates than before; and women aged ≥65 years showed a significantly higher yearly increase in incidence than that in men in the same age group (APC, 11.1% in women versus 5.3% in men). CONCLUSION The overall increasing rate of HCV infection significantly slowed after 2007 and 2013. The differences in incidence trends among demographic groups have obviously increased in the last 5 years, and the reasons underlying these different trends urgently require further study. People in older age groups, especially women aged ≥65 years, still experienced increases in incidence rates in the last 5 years. This finding indicates that programmes for the prevention and control of HCV infection in older people require continued strengthening.
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Affiliation(s)
- Shiyu Cao
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, 410078, China
| | - Fuqiang Liu
- Department of Public Health Emergency Treatment, Hunan Center for Disease Control and Prevention (CDC), Changsha, Hunan Province, 410005, China
| | - Tingting Wang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, 410078, China
| | - Yaqing Tan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, 410078, China
| | - Shujun Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, 410078, China
| | - Yuan Liu
- Department of Chronic Disease Control and Prevention, Hunan Center for Disease Control and Prevention (CDC), Changsha, Hunan Province, 410005, China
| | - Lidong Gao
- Department of Public Health Emergency Treatment, Hunan Center for Disease Control and Prevention (CDC), Changsha, Hunan Province, 410005, China.
| | - Lizhang Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, 410078, China.
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Spatio-Temporal Analysis of Infectious Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16040669. [PMID: 30823539 PMCID: PMC6406380 DOI: 10.3390/ijerph16040669] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Accepted: 02/20/2019] [Indexed: 12/29/2022]
Abstract
Epidemiological research on the pathogenesis, diagnosis, and treatment of infectious diseases is a broad field of study with renewed validity in the face of social changes and new threats [...].
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Barriers to the Prevention and Control of Hepatitis B and Hepatitis C in the Community of Southwestern China: A Qualitative Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16020231. [PMID: 30650581 PMCID: PMC6352215 DOI: 10.3390/ijerph16020231] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 12/20/2018] [Accepted: 12/27/2018] [Indexed: 02/06/2023]
Abstract
Objective viral hepatitis is a big challenge in China. However, few studies have focused on mapping the difficulties from a broader view. This study aimed to identify the barriers to the prevention and control of hepatitis B and hepatitis C in communities from the perspectives of hepatitis patients, residents, and healthcare providers. A total of 26 participants were recruited through purposive sampling. Data were collected by in-depth face-to-face interviews from September 2015 to May 2016 in two communities from Chongqing and Chengdu, China. A thematic framework was applied to analyze the qualitative data from the interviews. The critical factors of barriers to hepatitis prevention and control in the districts included poor cognition of residents regarding hepatitis B and hepatitis C, severe stigma in society, inadequate health education, and the provision of unsatisfactory medical services. Strengthening health education and improving services for treating patients with hepatitis are suggested to make further progress. A substantial gap remains between the need and currently available services for hepatitis patients and residents. Delivering quality prevention and control health services, improving health education, and reducing stigma in society are recommended to improve the prevention and control program for hepatitis B and C in communities.
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Zhu B, Fu Y, Liu J, He R, Zhang N, Mao Y. Detecting the priority areas for health workforce allocation with LISA functions: an empirical analysis for China. BMC Health Serv Res 2018; 18:957. [PMID: 30541543 PMCID: PMC6292090 DOI: 10.1186/s12913-018-3737-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 11/19/2018] [Indexed: 01/21/2023] Open
Abstract
Background Health workforce misdistribution leads to severe inequity and low-efficiency in health services in the developing countries. Targeting at China, this research aims to reveal, visualize and compare the geographical distribution patterns of different subtypes of urban and rural health workforce and identify the priority regions for health workforce planning and allocation policies designing. Methods The health workforce density (workforce-to-population ratio) is adopted to represent the accessibility to health workforce in each geographical unit. Besides a descriptive geography of health workforce as a whole, the local indicators of spatial association (LISA) are used to explore the spatial clusters of different subtypes of health workforce, which are visualized by geographical tools. Results Results reveal that regional disparities and spatial clusters exist in China’s health workforce distribution, with different types of workforce exhibiting relatively different spatial distribution characteristics. Besides, huge urban-rural disparities are found in the distribution of health workforce in China. Unexpectedly but intriguingly, most of the high-high and high-low cluster area of urban health workforce are concentrated in the western China (Xinjiang, Xizang etc.), indicating the relative abundant stock of urban health workforce in these units, while the low-low and low-high cluster area of different types of urban health workforce are mainly distributed in middle China. Regarding the rural health workforce, there is an obvious and similar low-low and low-high clustering pattern in western provinces (Sichuan, Yunnan) for the licensed doctors, pharmacists, technologists, which play a critical role in health services delivery. Conclusions Different types of health workforce displayed distinct spatial distribution patterns, while the misdistribution of rural health workforce imposed more challenges to the Chinese health sector due to its poorer stock and more disadvantaged positions of backward regions (i.e., low-low and low-high cluster area). Subtype-specific and region-oriented health workforce planning and allocation policies are suggested to be made, aiming at the urban and rural health workforce respectively, by prioritizing the identified low-low and low-high cluster areas. Electronic supplementary material The online version of this article (10.1186/s12913-018-3737-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bin Zhu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, 710049, China.,Department of Public Policy, City University of Hong Kong, Hong Kong, 999077, China
| | - Yang Fu
- College of Management, Shenzhen University, Nanhai Ave 3688, Shenzhen, Guangdong, China
| | - Jinlin Liu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Rongxin He
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Ning Zhang
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Ying Mao
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, 710049, China.
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Spatiotemporal Characteristics of Bacillary Dysentery from 2005 to 2017 in Zhejiang Province, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091826. [PMID: 30149494 PMCID: PMC6163953 DOI: 10.3390/ijerph15091826] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 08/10/2018] [Accepted: 08/17/2018] [Indexed: 11/24/2022]
Abstract
Background: This study aimed to analyze the epidemiological and spatiotemporal characteristics of bacillary dysentery in Zhejiang Province and to provide the basis for its monitoring, prevention and control. Methods: This study included cases registered in China Information System for Diseases Control and Prevention from 1 January 2005 to 31 December 2017 in Zhejiang. Descriptive methods were employed to investigate the long trend of this disease: gender distribution, high-risk population, seasonality, and circular distribution was explored to detect the peak period; incidence maps were made to show the incidence trend of disease at county level; spatial autocorrelation was explored and the regions with autocorrelation were detected; and spatiotemporal scan was conducted to map out the high-risk regions of disease and how long they lasted. Statistical significance was assumed at p value of <0.05. Results: A total of 105,577 cases of bacillary dysentery were included, the incidence declining sharply from 45.84/100,000 to 3.44/100,000 with an obvious seasonal peak from July to October. Males were more predisposed to the infection than females. Pre-education children had the highest proportion among all occupation categories. Incidence in all age groups were negatively correlated with the year (p < 0.001), and the incidences were negatively correlated with the age groups in 2005–2008 (p = 0.022, 0.025, 0.044, and 0.047, respectively). Local autocorrelation showed that counties in Hangzhou were high-risk regions of bacillary dysentery. The spatiotemporal scan indicated that all clusters occurred before 2011, and the most likely cluster for disease was found in Hangzhou, Jiaxing and Huzhou. Conclusions: The incidence of bacillary dysentery in Zhejiang from 2005 to 2017 featured spatiotemporal clustering, and remained high in some areas and among the young population. Findings in this study serve as a panorama of bacillary dysentery in Zhejiang and provide useful information for better interventions and public health planning.
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Incorporating Spatial Statistics into Examining Equity in Health Workforce Distribution: An Empirical Analysis in the Chinese Context. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15071309. [PMID: 29932139 PMCID: PMC6068954 DOI: 10.3390/ijerph15071309] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 06/06/2018] [Accepted: 06/20/2018] [Indexed: 12/30/2022]
Abstract
Existing measures of health equity bear limitations due to the shortcomings of traditional economic methods (i.e., the spatial location information is overlooked). To fill the void, this study investigates the equity in health workforce distribution in China by incorporating spatial statistics (spatial autocorrelation analysis) and traditional economic methods (Theil index). The results reveal that the total health workforce in China experienced rapid growth from 2004 to 2014. Meanwhile, the Theil indexes for China and its three regions (Western, Central and Eastern China) decreased continually during this period. The spatial autocorrelation analysis shows that the overall agglomeration level (measured by Global Moran’s I) of doctors and nurses dropped rapidly before and after the New Medical Reform, with the value for nurses turning negative. Additionally, the spatial clustering analysis (measured by Local Moran’s I) shows that the low–low cluster areas of doctors and nurses gradually reduced, with the former disappearing from north to south and the latter from east to west. On the basis of these analyses, this study suggests that strategies to promote an equitable distribution of the health workforce should focus on certain geographical areas (low–low and low–high cluster areas).
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