ABSTRACT
ObjectiveTo systematically evaluate the incidence rate of low-level viremia （LLV） in chronic hepatitis B （CHB） patients and related influencing factors， and to provide evidence-based medicine evidence for effective intervention and prevention of LLV in clinical practice. MethodsThis study was conducted according to the PRISMA guideline， with a PROSPERO registration number of CRD42023455304. CNKI， Wanfang Data， VIP， SinoMed， PubMed， Embase， Web of Science， and the Cochrane library were searched for observational studies on LLV and related influencing factors in CHB patients published up to July 21， 2023. Stata 16.0 software was used to perform the meta-analysis. ResultsA total of 12 articles were included， with a total sample size of 3408 cases， among whom there were 1181 patients with LLV. The meta-analysis showed that the incidence rate of LLV was 32.8% （95% confidence interval ［CI］： 27.6% — 38.3%） in treatment-experienced CHB patients. High HBsAg quantification （odds ratio ［OR］=2.107， 95%CI： 1.782 — 2.491， P<0.001）， positive HBeAg （OR=3.258， 95%CI： 2.629 — 4.038， P<0.001）， high HBV DNA level at baseline （OR=1.286， 95%CI： 1.157 — 1.430， P<0.001）， and history of entecavir treatment （OR=3.089， 95%CI： 1.880 — 5.074， P<0.001） were risk factors for LLV； duration of antiviral therapy ≥3 years （OR=0.175， 95%CI： 0.093 — 0.331， P<0.001） and high alanine aminotransferase level at baseline （OR=0.985， 95%CI： 0.978 — 0.992， P<0.001） were protective factors against LLV. The sensitivity analysis showed no significant change in effective value， suggesting that the results of the meta-analysis were relatively stable. The funnel plot of the studies included was basically symmetrical， and the results of the Egger’s test and the Begg’s test suggested that there was no obvious publication bias in the articles included. ConclusionClinicians should guide decision making based on the influencing factors for LLV and related clinical evidence， so as to reduce long-term clinical risks and avoid adverse outcomes.
ABSTRACT
Objective@#To analyze the epidemiological characteristics of school foodborne disease outbreaks in Henan Province from 2011 to 2020 and to provide the basis for effective prevention and control of school foodborne disease outbreaks.@*Methods@#The outbreaks of foodborne diseases in schools in Henan Province reported by the foodborne disease outbreak surveillance system from 2011 to 2020 were statistically analyzed.@*Results@#A total of 47 outbreaks of school foodborne diseases were reported in Henan province in the past 10 years, with a total of 1 258 cases, 701 hospitalizations and 1 death. Zhengzhou, Zhumadian, Xinyang and Xinxiang were the top 4 cities in Henan Province in terms of the number of school foodborne disease outbreaks reported. The peak of foodborne illness incidents in schools was in June and September. The largest number of incidents occurred in middle school canteens and primary school canteens(all 12). The number of reported incidents (12) and the number of cases of foodborne diseases (371) in schools caused by cereals and their products were the largest. Pathogenic bacteria and their toxins were the main pathogenic factors that caused the outbreaks of foodborne diseases in schools, accounting for 78.26% of the identified causes. Bacillus cereus was the top pathogens causing foodborne diseases outbreaks in schools. The pathogenic factor that caused the largest number of cases was Diarrheogenic Escherichia Coli, and the pathogenic factor that caused the death cases was poisonous mushrooms. Apart from unexplained incidents, improper processing was the main link leading to foodborne diseases outbreaks in schools.@*Conclusion@#The primary and middle school students are the group with high incidence of foodborne diseases in schools. The supervision and management of school canteen should be strengthened in summer to prevent the outbreak of bacterial foodborne diseases caused by improper processing and storage of grain food.