A cross-sectional survey on hepatitis C virus infection among residents aged 18-59 years in a former commercial blood donating community, Shanxi Province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To determine sero-prevalence of and risk factors for hepatitis C virus infection (HCV) among residents aged 18-59 years in a former commercial blood donating community, Shanxi province.</p><p><b>METHODS</b>A community-based cross-sectional survey was conducted among 660 randomly selected residents aged 18-59 years from 12 villages in a rural county of Shanxi province. Structured questionnaire was administered to collect socio-demographic,medical and risk behavioral information. 7 ml-volume venous blood was collected for HCV antibody testing.</p><p><b>RESULTS</b>The overall HCV sero-prevalence rates were 8.2% and 27.7% among former commercial blood donors in the community. Data from multivariate logistic regression analysis showed that people ever selling blood (adjusted OR = 14.28, 95% CI: 6.83-29.87) and receiving blood transfusion (adjusted OR = 8.66,95% CI: 2.31-32.47) were the primary risk factors for HCV infection. Subgroup analysis in blood donors explored that ever selling plasma (adjusted OR = 8.56,95% CI: 2.87-25.54) was the risk factor for HCV infection. Villagers who stopped selling blood in 1994 and thereafter were less likely to be HCV positive than those stopping selling blood before 1994 (adjusted OR = 0.32,95% CI: 0.11-0.93). Female donors had a lower risk than male ones (adjusted OR = 0.28, 95% CI: 0.10-0.83).</p><p><b>CONCLUSION</b>A HCV epidemic was once existing in rural community residents in the province that former commercial blood/plasma donation was the main reason for HCV epidemic in the community. It is urgent to make efficient measures to prevent HCV secondary transmission and provide patients with care and treatment to this community.</p>

A retrospective cohort study on the survival of blood-borne human immunodeficiency virus cases in a county, China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the survival rate of adult blood-borne human immunodeficiency virus (HIV) cases in a county.</p><p><b>METHODS</b>A retrospective cohort study was carried out to determine the survival from HIV infection and related factors among 78 adult HIV cases infected by blood and confirmed by the end of 2002. Kaplan-meier method was used to describe the survival distribution and Cox proportional hazard model was used to determine the factors associated with the survival time.</p><p><b>RESULTS</b>The total mortality after infection was 78.57/1000 p-y and AIDS related mortality was 72.95/1000 p-y. The median survival time was 7.40 years (95% Confidence Interval: 6.79 - 8.02). After adjustment for the clinical stage at presentation (HIV or AIDS), people who got infected at the age of 30 - 40 years or infected by the end of 1995 would proceed to death slower than the other groups.</p><p><b>CONCLUSION</b>The survival of HIV cases infected by blood at the county level might have been underestimated and should be adjusted when HIV/AIDS was estimated and projected. Survival was associated with age when infection started so different survival functions should be used on different age groups that infection started.</p>

Distribution and timing of antibody to SARS-CoV in SARS cases of transmission chain or non-transmission chain / 中华实验和临床病毒学杂志

<p><b>BACKGROUND</b>To find out the timing of serologic responses after illness onset and distribution of IgG antibody to SARS-CoV in SARS cases of transmission chain or non-transmission chain.</p><p><b>METHODS</b>The IgG and IgM antibodies to SARS-CoV were tested by indirect ELISA in serum samples from 301 clinically diagnosed SARS cases.</p><p><b>RESULTS</b>Totally 158 SARS cases were involved in 15 chains of transmission. The positive rates of SARS-CoV IgG in those chains were 85.70%-100.00% and the overall rate was 94.30% (149/158). The chain of transmission could spread to four generations, but the SARS cases were reduced with increase of generations. There was no significant difference among positive rates of SARS-CoV IgG for generations, Chi square=5.11, P greater than 0.05. The positive rate of SARS-CoV IgG in cases who were not in chain of transmission was 12.59%(18/143) which was statistically significantly different from that of cases in chain of transmission, Chi square=199.64, P less than 0.001. During days 0-7,8-14,15-21,22-30 after onset, the cumulated positive rate of SARS-CoV IgG was 16.67%, 40.00%, 70.00% and 93.10%, respectively, then was kept at the level above 90% and lasted for 217 days. The cumulated positive rate of SARS-CoV IgM during days 0-7 after onset was the same to that of IgG. During days 8-14, 55.17% of cases had seroconversion for IgM which reached a peak (86.96%) during days 21-30. Then the rate rapidly declined.</p><p><b>CONCLUSION</b>More than 94% of cases with SARS could produce IgG antibody when they were infected by SARS-CoV. Detecting SARS-CoV IgG could provide a diagnostic evidence for case confirmation. SARS-CoV IgG appeared as early as 7 days after onset and reached the peak at about weeks 4. Then the high rate of antibody was maintained for more than 6 months.</p>

Study on the epidemiological characteristics of severe acute respiratory syndrome in Shanxi province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To describe the epidemiological characteristics and related factors of SARS in Shanxi in order to provide scientific basis for prevention and control of severe acute respiratory syndrome (SARS).</p><p><b>METHODS</b>Data on clinically-diagnosed SARS cases reported to Shanxi Center for Disease Control and Prevention through SARS reporting system of Shanxi province and epidemiological reports were collected from early March to 20 May, 2003. The characteristics of SARS distribution in time, place and population in Shanxi were described. The epidemiological characteristics and related influential factors were analyzed with EPI info 6.0 software.</p><p><b>RESULTS</b>Since the first imported SARS case was diagnosed clinically on 7 March and till 20 May in Shanxi province, the number of cumulative clinically-diagnosed SARS cases were 445 with an attack rate of 1.34/10,000. 20 deaths occurred in that period with the mortality rate 4.49%. The number of cases increased from 28 March and formed the first peak. However, the number continued to increase until 18 April to have formed the second peak. Since then, the number of cases has gradually decreased gradually. Since 19 May, there has been no clinically-diagnosed cases being reported. SARS cases were mostly seen in urban areas of the city (83.82% of the total SARS cases) with sporadic cases found in rural areas. Students and medical staff and people from 20 - 59 years of age occupied the large part of the cases. Age specific mortality rate increased with age and the male/female ratio was 1:0.87.</p><p><b>CONCLUSION</b>In Shanxi province, the SARS epidemic seemed to have had the following stages: importation of the first case, gradual increase of the number of cases to reach the peak and decreasing. Case identification at early stage as well as taking measures to decrease the chance of transmission were strategically crucial for controlling the spread of SARS virus in the community.</p>