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Objective To discuss the spatial-temporal distribution and epidemic trends of autumn-winter type scrub typhus in Shandong province,and provide scientific evidence for further study for the prevention and control of the disease.Methods The scrub typhus surveillance data during 2006-2014 were collected from Shandong Disease Reporting Information System.The data was analyzed by using software ArcGIS 9.3 (ESRI Inc.,Redlands,CA,USA),GeoDa 0.9.5-i and SatScan 9.1.1.The Moran' s I,log-likelihood ratio (LLR),relative risk (RR) were calculated and the incidence choropleth maps,local indicators of spatial autocorrelation cluster maps and space scaning cluster maps were drawn.Results A total of 4 453 scrub typhus cases were reported during 2006-2014,and the annual incidence increased with year.Among the 17 prefectures (municipality) in Shandong,13 were affected by scrub typhus.The global Moran' s I index was 0.501 5 (P＜0.01).The differences in local Moran' s I index among 16 prefectures were significant (P＜0.01).The "high-high" clustering areas were mainly Wulian county,Lanshan district and Juxian county of Rizhao,Xintai county of Tai' an,Gangcheng and Laicheng districts of Laiwu,Yiyuan county of Zibo and Mengyin county of Linyi.Spatial scan analysis showed that an eastward moving trend of high-risk clusters and two new high-risk clusters were found in Zaozhuang in 2014.The centers of the most likely clusters were in the south central mountainous areas during 2006-2010 and in 2012,eastem hilly areas in 2011,2013 and 2014,and the size of the clusters expanded in 2008,2011,2013 and 2014.One spatial-temporal cluster was detected from October 1,2014 to November 30,2014,the center of the cluster was in Rizhao and the radius was 222.34 kilometers.Conclusion A positive spatial correlation and spatial agglomerations were found in the distribution of autumn-winter type scrub typhus in Shandong.Since 2006,the epidemic area of the disease has expanded and the number of high-risk areas has increased.Moreover,the eastward moving and periodically expanding trends of high-risk clusters were detected.
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Objective To discuss the spatial-temporal distribution and epidemic trends of autumn-winter type scrub typhus in Shandong province,and provide scientific evidence for further study for the prevention and control of the disease.Methods The scrub typhus surveillance data during 2006-2014 were collected from Shandong Disease Reporting Information System.The data was analyzed by using software ArcGIS 9.3 (ESRI Inc.,Redlands,CA,USA),GeoDa 0.9.5-i and SatScan 9.1.1.The Moran' s I,log-likelihood ratio (LLR),relative risk (RR) were calculated and the incidence choropleth maps,local indicators of spatial autocorrelation cluster maps and space scaning cluster maps were drawn.Results A total of 4 453 scrub typhus cases were reported during 2006-2014,and the annual incidence increased with year.Among the 17 prefectures (municipality) in Shandong,13 were affected by scrub typhus.The global Moran' s I index was 0.501 5 (P＜0.01).The differences in local Moran' s I index among 16 prefectures were significant (P＜0.01).The "high-high" clustering areas were mainly Wulian county,Lanshan district and Juxian county of Rizhao,Xintai county of Tai' an,Gangcheng and Laicheng districts of Laiwu,Yiyuan county of Zibo and Mengyin county of Linyi.Spatial scan analysis showed that an eastward moving trend of high-risk clusters and two new high-risk clusters were found in Zaozhuang in 2014.The centers of the most likely clusters were in the south central mountainous areas during 2006-2010 and in 2012,eastem hilly areas in 2011,2013 and 2014,and the size of the clusters expanded in 2008,2011,2013 and 2014.One spatial-temporal cluster was detected from October 1,2014 to November 30,2014,the center of the cluster was in Rizhao and the radius was 222.34 kilometers.Conclusion A positive spatial correlation and spatial agglomerations were found in the distribution of autumn-winter type scrub typhus in Shandong.Since 2006,the epidemic area of the disease has expanded and the number of high-risk areas has increased.Moreover,the eastward moving and periodically expanding trends of high-risk clusters were detected.
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Objective To explore the spatial and temporal characteristics of human brucellosis in Shandong province and to provide scientific basis for the development of related regional public health strategies.Methods 1 802 diagnosed cases of human brucellosis patients were selected based on the data that was collected by Diseases Reporting Information System between year 2004 and 2012 in Shandong province.Methods on spatial thematic mapping,spatial autocorrelation analysis,spatial clustering analysis,and temporal clustering analysis were applied to describe the temporal and spatial distribution on human brucellosis cases.Results The incidence rate of human brucellosis increased from 0.038 2/100 000 (35 cases) to 0.620 5/100 000 (598 cases),with annual average incidence rate as 0.211 1/100 000 and the incidence was evidently increased.The value of M (0.375 3) showed that this disease was seasonal,with the epidemic months between March and June,accounting for 56.27％ (1 014/1 802).The Global Moran' s I index was 0.198 901 (P=0.000 120),showing that there was a positive correlation between space and the incidence of brucellosis.The incidence rates in 2006,2007,2009 and 2012 and the space distribution appeared a positive correlation (P＜0.05) in Shandong province.The local Moran's I index showed that there were 8 “High-High” (HH) clustering areas,which were proved to have statistical significance (P＜0.05).Local indicators of spatial association (LISA) revealed that southwest and north districts of Shandong were highly clustered districts of brucellosis and the areas paralleled to the areas that having higher incidence rates.There were two spatial clustering areas in this study,one as the center of Juanchen with radiation radius at 33.83 km whose RR was 9.78 (P＜0.05) and the other was the center of Binchen with radiation radius at 62.78 km with RR as 4.99 (P＜0.05).All the 8 HH counties (districts) were included in the two cluster regions.Conclusion Incidence of human brucellosis showed an obvious increase in Shandong during year 2004-2012.Months with epidemics were between March and June.The incidence of brucellosis in counties (districts) was non-randomly distributed.A positive spatial correlation and the feature of clusters was noticed.
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Objective To explore the utilization and effectiveness of ultrasound screening for neural tube defects (NTDs),so that to provide scientific evidences for the secondary prevention of NTDs.MethodsFour hundred and fifty-nine women who delivered or gestated NTDs babies or fetuses were randomly selected from Shandong Province and Shanxi Province,and the related information was collected with structured questionnaire by trained interviewers.Results Of the 459 cases,the ultrasonography utilization rate was 98.7%,and 6 cases (1.3%) never took examinations by ultrasonography during the whole pregnancy period.The total diagnosis rate of ultrasound screening for NTDs was 85.9%,and those of anencephalus,spina bifida and encephalocele were 96.4%,79.6% and 73.8% respectively (P0.05).Conclusions The detection rates of NTDs and the subtypes by ultrasonography are low at different pregnant periods and in different medical institutions.It is important to increase the utilization rate of ultrasound screening by pregnant women and improve the NTDs diagnostic level of primary health care institutions,so that to improve the efficacy of secondary prevention strategy for NTDs in China.
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Folic acid supplementation is one of the most important measures to prevent neural tube defects(NTDs)among child-bearing age women.This article reviews the NTDs prevention efficacy of the studies including field intervention trials,population folic acid supplementation and fortification in different countries,and analyzes the efficacy variation and their influencing factors of the related studies.The results of the article may provide references for folic acid supplementation,fortification and its efficacy evaluation in the population.
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Objective: To study the effect of community intervention on mental health of patients with type 2 diabetes mellitus (DM) Method:Two communities in a city of Shandong province were chosen as intervention community and control community respectively after an epidemiological investigation of diabetes mellitus in 1997 After four years intervention, a case-control study was done by assessing mental status with SAS (self-rating anxiety scale), SDS (self-rating depression scale) and SSRS (social support rating scale) Result:Compared with baseline levels, after intervention for 4 years, the SAS score, SDS score and SSRS score (including subject score and object score) of patients in intervention community improved significantly, while the counterparts of patients in control community had no improvement But patients in intervention community still had poorer results than health controls By adjustment of the potential confounding effect of age, sex and occupations, diabetes mellitus still had influence on anxiety, depression and social support with ORs of 1 41, 1 69 and 0 69 respectively Multivariable stepwise analysis showed that, suffering from other chronic diseases was risk factor for mental health of diabetes patients, and the higher the education level, the better results of intervention Conclusion:The DM community intervention program improves mental health of patients significantly, but patients still have poorer mental health than healthy control Education level and suffering from other chronic disease are main factors having influence on effects of the intervention