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To understand the characteristics and changes of the incidence of amoebic dysentery in China during 2015-2018, explore the causes of high incidence in some areas and provide a data base for the development of national prevention and control strategies and measures. Data were collected from the infectious disease reporting management information system from Chinese Disease Control and Prevention. To understand the seasonal, population and area distributions of amoebic dysentery, descriptive epidemiological method and software SPSS 16.0 were used to analyze the amoebic dysentery data. A total of 4 366 amoebic dysentery cases were reported without death in China during 2015-2018. The reported average annual incidence was 0.08/100 000, and the overall proportion of laboratory confirmed cases was 68.23(2 979/4 366). Amoeba dysentery mainly occurred during May to October. One seasonal peak was observed in 2015 and 2017 (July and June, respectively), and two seasonal peaks were observed in 2016 and 2018 (June and October). The patients were mainly children aged under 5 years (42.28, 1 846/4 366), and the incidence rate decreased with age in children aged under 10 years. Of these, children under 1 years of age had the highest incidence rate (1.28/100 000). The number of cumulative reported cases in Guangxi, Henan, Guangdong, Heilongjiang and Jiangxi provinces ranked top five from 2015-2018, accounting for 64.50 (2 816/4 366) of the total. The cumulative cases in Dongxing county, Guangxi, in Suixian county, Henan and in Ranghulu district, Heilongjiang, respectively accounted for more than 50.00 of the total number of cases in their provinces. The incidence rate of amoebic dysentery reported in China during 2015-2018 showed a decreasing trend, with a higher incidence in children under 5 years old and a higher number of cases in some areas. It is suggested to further investigate and analyze the diagnosis and reporting of amoeba dysentery in key areas and promote the update of the diagnostic standards for amoeba dysentery.
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<p><b>OBJECTIVE</b>To understand the incidence rates of both typhoid fever and paratyphoid fever in the high prevalent areas of Guizhou province so as to provide evidence for the development of programs on comprehensive intervention and effectiveness evaluation.</p><p><b>METHODS</b>Six townships in Pingba county were selected as intervention areas while six townships in Kaiyang county were taken as control. All hospitals and clinics were classified into A, B and C types according to its level and the capacity of the blood culture. Surveillance on typhoid and paratyphoid fever was conducted based on all population and all hospitals, clinics and county CDCs among the patients with unknown fever.</p><p><b>RESULTS</b>In the surveillance area in those two counties, there were 12 944 blood samples from patients with unknown fever which have been tested and cultured. Among them, 200 strains of Salmonella including 16 typhoid strains, 184 paratyphoid A strains were identified, with the total positive rate as 1.55%. The positive rate before the intervention program was higher than the after. The detection rate was 1.91% in the type A hospitals. 39 strains of Salmonella have been cultured from 2039 samples which accounting for 19.50% (39/200) of the total strains. 4315 blood samples were cultured at the 'Class B' sites which isolated 82 strains of Salmonella, accounting for 41.00% (82/200), with a detection rate as 1.90%. 6590 samples were cultured at the 'Class C' sites, which identified 79 strains of Salmonella, accounting for 39.50% (79/200), with a detection rate as 1.20%. The detection rate was much higher before the use of antibiotics than after using them (P < 0.05). The annual peak time of positive detection was in spring and fall. The outbreaks or epidemics often appeared in the same places, with farmers, students as the high-risk populations. Symptoms of both typhoid and paratyphoid fever were not typical.</p><p><b>CONCLUSION</b>Typhoid and paratyphoid monitoring programs which covered primary health care institutions in the high incidence area seemed to be effective in reflecting the pictures as well as the burden of both typhoid and paratyphoid.</p>
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Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , China , Epidemiology , Fever , Epidemiology , Incidence , Paratyphoid Fever , Epidemiology , Population Surveillance , Salmonella paratyphi A , Salmonella typhi , Typhoid Fever , EpidemiologyABSTRACT
Objective Through analyzing the national statutory reporting data on typhoid,paratyphoid fever in 2012,we were trying to understand the whole picture of typhoid,paratyphoid fever at the national level as well as to understand the trends and characteristics of typhoid and paratyphoid fever in provinces with high incidence rate,so as to the development of prevention and control strategies of the diseases in those high-incidence rate provinces.Methods We descriptively analyzed the national typhoid and paratyphoid fever statutory reporting data which was reported through disease surveillance information reporting system in 2012.Results 11 998 cases with typhoid and paratyphoid fever were reported with 3 fatal ones,in 2012 in the whole country.The incidence rate was 0.89 per 100 000.Compared to the data gathered in 2011,the incidence rates of typhoid/paratyphoid fever increased by 1.20％.The total number of the confirmed cases on typhoid and paratyphoid fever was 6522 and was accounted for 54.36％ of the total cases,in which paratyphoid fever accounted for 36.86％.Cases were mainly involved farmers and followed by students and children.Incidence rates of typhoid and paratyphoid fever in children aged 0-4 years old appeared the highest (respectively 1.31/100 000 and 0.46/100 000).Yunnan,Guizhou,Guangdong,Guangxi,Zhejiang,Hunan and Xinjiang provinces (autonomous regions) were identified as provinces with high-incidence rates of typhoid and paratyphoid fever.During 2005-2012,the incidence rates in most of the above high-incidence provinces showed a downward trend,except for in Guangdong which had only showed a slight change.There were variations on peak period and highly-hit population in seven high-incidence provinces.Conclusion The incidence rate of typhoid/paratyphoid fever was in a relatively low level in China.Prevention and control strategies on the diseases in children under 5 years old remained a challenge,warranted more work to be done.The epidemiological situation is still severe in some high-incidence rate provinces.
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Objective To characterize the spatial distribution of typhoid and paratyphoid fever(TPF)in Yunnan province, China and to determine the effectiveness of meteorological factors on the epidemics of TPE Methods Data of reported TPF cases in Yunnan province(2001 -2007)from the China Information System for Diseases Control and Prevention was applied to GIS-based spatial analyses to detect their spatial distribution and clustering of TPF incidence at the county level.Panel data analysis was used to identify the relationships between the TPF incidence and meteorological factors including monthly average temperature, monthly cumulative precipitation and monthly average relative humidity. Results During the study period, the average incidence of TPF in Yunnan province was 23.11/100 000, with majority of the TPF cases emerged in summer and autumn. Although widely distributed, two TPF clusters were detected in Yunnan province based on the spatial analysis:one area around Yuxi city with the average annual incidence as 207.45/100 000 and another at the junctions of Yunnan province with Burma and Laos. Based on results from panel data analysis, the incidence of TFP was shown to be associated with meteorological factors such as temperature,precipitation, relative humidity and one month lag of temperature increase [10 ℃ increase in the monthly average temperature:IRR=1.30(95%CI: 1.24-1.36);10% increase in monthly average relative humidity:IRR= 1.07(95%CI: 1.05-1.09); 100 mm rise in monthly cumulative precipitation:IRR=1.02(95%CI: 1.00-1.03); and 10 ℃ average temperature increase, the last month: IRR=1.73(95%CI: 1.64-1.82)]. Conclusion Areas with high TPF incidence were detected in this study,which indicated the key areas for TPF control in Yunnan province. Meteorological factors such as temperature, precipitation and humidity played a role in the incidence of TPF.
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Objective To clarify the seasonal and geographical difference and pathogen patterns so as to provide reference of prevention and control of the disease through analyzing the epidemical characteristics of reported hand-foot-mouth disease(HFMD)cases in China,2008-2009.Methods We analysed the epidemiological data of HFMD from the Chinese national notifiable infectious diseases reporting system in 2008 and 2009.Results There were 488 955 and 1155525 reported HFMD cases in 2008 and 2009,in China,of which 1165 and 13810 were severe and 126 and 353 were fatal,respectively.The notification rates were 50.09/10 million,68.47/10 million and 59.04/10 million in high,medium and low latitudes areas,respectively.The epidemic periods in Medium and Low latitude were from 12 to 24 weeks in 2009,and in high latitude it was from 23 to 35 weeks.HFMD cases were concentrated mainly in 5 year-old or even younger children,accounted for 92.23% of the total cases.The incidence rate of two years old appeared to be the highest.The features of severe and death case concentrated in lower age groups were more evident,and the proportion of severe case and case fatality rate under 1 vears old was higher than that in other age groups.We also noticed that with the increasing of age,the proportion of severe case and case fatality rate had a decreasing trend.There was a difference between the pathogens seen.The relative risk(RR)for an human enterovirus 71(HEV71)isolate was higher among severe case than in common cases(RR=1.82),whereas the RR for an EV71 isolate was higher among the death cases than in common cases (RR=2.11).There was seasonal variation of pathogen composition.There were 477 clusters of cases from 2008 to 2009,of which 389 found in preschools,47 in rural villages,outbreaks of clusters were mainly from April to July. Conclusion The HFMD epidemics was increasing in 2009.The epidemic of HFMD in different latitudes area and seasons was different.Children of five year old or under were the major population groups at risk,of HFMD.The younger ones had higher risk of becoming severe and death cases.HEV71 and coxsackievirus A16 were both the major etiologic agents of HFMD.The preschool and rural villages were the main senings of clusters of cases.
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Objective To evaluate the burden of paratyphoid fever A in Hongta district, Yuxi city, Yunnan province from May 1, 2008 to April 30, 2009 so as to provide information for the development of comprehensive intervention measures. Methods Based on the Fever Syndromic Surveillance System, information as attendance rate of patients with fever, rate of patients being sampled, laboratory testing rate, sensitivity on the detection of blood culture and the rate of case reporting etc. were calculated. According to the pyramid model of food-borne disease on disease burden, the local actual incidence of paratyphoid fever A was estimated and analyzed. Results Under the Fever Syndromic Surveillance System, there were 6642 fever cases being detected, among whom 6570 cases were sampled and undergone testing, with the sampling rate as 98.92% and all the samples received laboratory testing. There were 354 positive cases of paratyphoid fever A reported,all from the Hongta district. Data showed that the attendance rate of the feverish patients was 73.53%,with the highest rate seen in whose under 10 years old (100%). Assumed that the sensitivity of paratyphoid fever blood culture was 70%, and the case reporting rate was 90%, we estimated that the annual incidence of paratyphoid fever A in Hongta was 220.33 (95% CI: 170.1-521.4) per 100 thousand, with 965 (95%CI: 745-2284) as new cases. Among all the age groups, the incidence in the age group from 15 to 44 years old was estimated to be at the highest (318.27 per 100 thousand).Conclusion Hongta seemed to be an endemic region for paratyphoid fever A, with the highest incidence occurred in the age group of between 15 and 44 years old. These findings highlighted the urgent need to carry out further investigation on the risk factors and to implement targeted effective prevention and control measures.
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Objective To acknowledge the epidemiology of gastroenteritis outbreaks caused by norobiruses and their genotypes. Methods Epidemiologic data and specimens were collected from 19 gastroenteritis outbreaks. 201 specimens were detected for norovirus, rotavirus, astrovirus,adenovirus and sapovirus by RT-PCR methods and PCR products were sequenced. Sequence alignment and phylogenetic analysis were performed by Clustal X 1.83 and MEGA 4.0 programs.Results Noroviruses were one of the most predominant pathogens causing viral gastroenteritis outbreaks ( 12 of 19 outbreaks, accounting for 63.2% ). Variant G Ⅱ -4/2006b was the predominant strain responsible for 11 of the 12 NV-associated outbreaks. Other genotypes would include G Ⅱ -17,G Ⅱ -6 and G Ⅱ -3. The NV-associated gastrocnteritis outbreaks occurred mainly in winter and spring between December 2006 and April 2007. These gastroenteritis outbreaks caused by noroviruses would involve all age groups in various locations. Meantime, 2 out of 12 outbreaks were caused by norovirus or other viruses. In addition, multiple viruses and multiple genotypes of noroviruses were found in the same outbreak. Conclusion Noroviruses were one of the most major pathogens causing gastroenteritis outbreaks while G Ⅱ -4/2006b variant was identified as the predominant strain in China.
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<p><b>OBJECTIVE</b>In order to develop strategies on prevention and cure for obesity, a study regarding dynamic analyses on the prevalence of obesity and overweight of Chinese children and adolescents was carried out.</p><p><b>METHODS</b>Data of more than 980 thousands students of Han nationality, aged 7 through 18 years old were collected from National Surveys on Chinese Students' Constitution and Health which were carried out in 1985, 1991, 1995 and 2000. Samples were divided into four groups as "metropolis", "medium and small sized cities", "prosperous village" and "below-averaged village". Study targets were screened using the new criterion-the "Reference Norm for Screening Overweight and Obesity in Chinese Children and Adolescents" which was set up by the Working Group on Obesity in China. The prevalence of overweight and obesity in various groups in different years were compared and analyzed.</p><p><b>RESULTS</b>The prevalence rates of obesity in 1985 including from the metropolis area, were only 0.2% and 0.1% for boys and girls, and the prevalence of overweight was between 1% and 2% indicating that was no trend of obesity epidemic then. However, a rapid increase of overweight prevalence has been noticed since the early 1990s, and the increments were more seen in the urban than in the rural areas and more in boys than in girls. In the most developed cities including Beijing, the prevalence rates of obesity appeared to be 4.7%, 3.8% and 3.2%, among three groups with higher risk: the 7 - 9, 10 - 12 year-old boys and 7 - 9 year-old girls, respectively. Both high prevalence rates of malnutrition and overweight were also found in that period. Around 1995, a large scale of increments of overweight were found both in the urban and rural groups. In the most developed metropolis, the prevalence of overweight was two to three folds more than that of 10 years ago. The prevalence of obesity were 6% - 8% for boys and 4% - 6% for girls, respectively. Since 2000, most of the Chinese metropolis have started the so called 'overall increment period' of obesity. The prevalence rates of obesity plus overweight had reached 25.4%, 25.5%, 17.0% and 14.3% for boys aged 7 - 9 years and 10 - 12 years, and girls aged 7 - 9 years and 10 - 12 years, respectively. Among them, the prevalence rates of obesity were 12.9% and 9.1% for boys aged 7 - 9 and 10 - 12 years, which had already reached the average level seen in the medium-developed countries in the world. Although the increments of overweight were high, the prevalence of obesity was still low in most of the other groups: 4.8% for boys and 2.6% for girls in the "medium sized" group, 1.5% for boys and 1.7% for girls in the "prosperous village" group, and 0.9% for boys and 1.2% for girls in the "below-averaged village" group, respectively.</p><p><b>CONCLUSIONS</b>The prevalence of obesity in Chinese children and adolescents was considered to be still relatively low. However, the rapid increasing of both obesity and overweight, in both urban and rural areas would arouse special attention. Comprehensive strategies of intervention should include periodical monitoring, education on pattern of nutrition, oxygen-consuming physical exercises and healthy dietary behavior. Two areas on obesity prevention to protect the child from becoming overweight in early ages, and to control the tendency of obesity from overweight, should be emphasized in order to improve the health status and life quality of the Chinese children and adolescents.</p>
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Adolescent , Child , Female , Humans , Male , Age Factors , China , Epidemiology , Obesity , Epidemiology , Prevalence , Rural Population , Sex Factors , Time Factors , Urban PopulationABSTRACT
<p><b>OBJECTIVE</b>By analyzing the group variations of Chinese school-aged youth, to gather scientific bases for establishing a screening norm for obesity.</p><p><b>METHODS</b>More than 228,250 students aged 6 through 18 years participated in the 2000 National Surveillance on Students Health and Physical Fitness were enrolled as subjects, and were divided into various groups. The P(5), P(50) and P(95) of BMI were calculated and compared.</p><p><b>RESULTS</b>The differences of BMI among various groups were mainly reflected in the P95 high level of BMI, e.g., the means of BMI of boys aged 13 in large cities and in relatively underdeveloped rural areas were 25.7 and 21.1 with a difference of 4.6, and 22.8 and 20.3 for girls aged 11 with a difference of 2.5. Evident north-south differences were also found, especially during adolescent growth spurt. The means of BMI of those lived in the north and south China were 22.3 and 21.0 for girls aged 11 (difference 1.3), and 25.4 and 23.5 for boys aged 14 (difference 1.9), respectively. These findings clearly showed that much more obese youth exist in the metropolis than in the rural areas, and in the north than in the south China. The difference in BMI between the developed areas and developing areas could be found in early school ages. They were 22.5 and 16.7 for boys aged 7, and 19.8 and 16.7 for girls aged 7, respectively, which is a dominant difference among Chinese youth groups. However, that the BMI differences in the P(5) level were not as evident as in the high level means that malnutrition and under-weight were still popular in all Chinese youth groups.</p><p><b>CONCLUSION</b>In making a national norm for screening obesity in China, we'd better take high-level growth population as reference, to adapt the secular growth changes of Chinese youth. However, the huge urban-rural, north-south, developed-developing differences shown in this study should also be taken into full consideration, in order to make the screen norm be accepted by most of the Chinese youth groups.</p>