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Objective:To investigate the prevalence of positive hepatitis C virus (HCV) antibody, HCV RNA and genotype distribution of HCV in high-risk populations in Pudong New Area, Shanghai City, so that to provide evidence for making "hepatitis C micro elimination" strategies in Shanghai area.Methods:A survey with proportional sampling method was conducted among the high-risk populations, including people who inject drugs (PWID), voluntarily or compulsorily accepted drug detoxification or methadone treatment, human immunodeficiency virus voluntary counseling and testing (HIV VCT) outpatients, sexually transmitted disease (STD) outpatients, and commercial sex workers, who participated in the routine physical examination activities held by the community health service centers and public hospitals of Pudong New Area from July 2021 to November 2022. The residual plasma samples were collected from medical examinations. HCV antibody was tested in all samples. HCV RNA and HCV genotype were tested in samples with positive HCV antibody results.Results:A total of 1 000 HCV high-risk people were screened, including 453 PWID, 166 human immunodeficiency virus (HIV) infectors, 245 STD outpatients, and 136 commercial sex workers. The positive rates of HCV antibody in the four categories of personnel were 21.85%(99/453), 1.81%(3/166), 1.22%(3/245) and 0(0/136), respectively. The positive rate of HCV RNA was 42.68%(35/82) among HCV antibody positive people in high-risk populations. As much as 74.29%(26/35) of HCV RNA positive people had junior high school education or less, and 77.14%(27/35) of them were not married. Among the 12 samples tested for HCV genotype, five were genotype 3, five were genotype 6, and two were subtype 1b.Conclusions:PWID is the main high-risk HCV infection population, who should be the target of the following "hepatitis C micro elimination" strategies. The proportions of genotype 3 and genotype 6 are high in the high-risk HCV infection populations, and the pan-genotype direct-acting antiviral agent treatment may be more suitable in this situation. HCV infected persons in high-risk groups have low education level and marriage rate, which indicates that education and care in community are needed.
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ObjectiveTo investigate the epidemiological traits and potential years of life lost associated with lung cancer mortality among inhabitants of Shanghai's Pudong New Area from 1995 to 2021， in order to serve as a reference for developing intervention approaches. MethodsThe death surveillance system was used to gather statistics on lung cancer deaths. Crude mortality rate （CMR）， standardized mortality rate （SMR）， potential years of life lost （PYLL）， average years of life lost （AYLL）， annual percent change （APC） of the lung cancer deaths were analyzed. The impact of age-structural and non-age-structural factors on changes in lung cancer mortality was quantified using difference decomposition. ResultsThe CMR and SMR of lung cancer among residents in Pudong New Area between 1995 and 2021 were 58.21/105 and 26.75/105， respectively. The CMR of lung cancer increased over the years （APC=1.91%， 95%CI=1.60%‒2.30%； Z=11.487， P<0.001）， and the SMR of lung cancer declined over the years （APC=-1.50%， 95%CI=-1.80%‒-1.20%； Z=-9.006， P<0.001）. Age structure factors and gender factors contributed to the increase of lung cancer mortality， while non-population age structure factors overall appeared to play a protective role which might be related to the improvements in factors such as tobacco control and environmental management. The PYLL of lung cancer was 160 296 person years， the PYLL rate was 2.24‰， and the AYLL was 3.86 years per person. ConclusionAge structure factors are a significant contributor to the disease burden and result in the increase in the crude lung cancer mortality rate of Pudong residents of shanghai. Comprehensive monitoring， preventive， and control methods should be implemented.
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ObjectiveTo investigate the risk factors of anemia in HIV-infected patients receiving highly active antiretroviral therapy （HAART） in the Pudong New Area. MethodsA retrospective cohort study was conducted among HIV-infected patients who started HAART from 2005 to 2020 in Pudong New Area. Cox proportional hazards model was used to analyze the risk factors of anemia， moderate or severe anemia， and chronic anemia. The piecewise linear mixed-effect model was used to analyze the association between initial HAART classes and hemoglobin change in the follow-up. ResultsA total of 2 403 HIV-infected patients were included in the analysis. Among them， there were 357 cases of new onset anemia， 86 cases of chronic anemia and 102 cases of moderate or severe anemia， with the incidence density of 4.41/100 person years， 0.89/100 person years and 0.96/100 person years respectively. Multifactorial Cox regression analysis results showed that female， age >45 years， baseline CD4+ T lymphocyte count （CD4） <200 cells‧μL-1， opportunistic infections， glomerular filtration rate （eGFR） <60 mL‧min-1‧（1.73 m2）-1， and zidovudine （AZT） or protease inhibitor （PIs） based regimens were associated factors for the development of anemia. Female， age >45 years， CD4 <200 cells‧μL-1， opportunistic infections， and AZT-based regimens were associated with the development of chronic anemia. Mild anemia at baseline and AZT-based regimens were associated with the development of moderate or severe anemia. Linear mixed-effects model showed that the use of AZT （-7.87 g‧L-1， 95%CI： -9.42 to -6.32） or PIs （-3.43 g‧L-1， 95%CI： -5.57 to -1.30） was associated with lower Hb at follow-up. ConclusionInitial use of AZT and PIs is associated with progression to anemia and a lower follow-up hemoglobin level. Increased hemoglobin monitoring in users of AZT and PIs may be beneficial， especially during the first 6 months after initiation of HAART.
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ObjectiveTo explore the relationship between the intestinal flora and the impairment of liver and kidney in HIV-infected men who have heterosexual sex with healthy women. MethodsFecal samples from 41 HIV-infected heterosexual men who have sex with women （PMSW） and 43 age- and BMI-matched healthy heterosexual men who have sex with women （NMSW） were collected and subjected to 16S rDNA sequencing. The blood levels of AST， ALT， TBIL， UREA， Cr， UA， β2-MG and other liver and kidney function indicators were measured. Bioinformatics methods were used to analyze the characteristics of the intestinal flora of the patients in these two groups， to compare the differential bacteria strains， and to analyze their correlation with liver and kidney function indicators. ResultsIn comparison with NMSW， the alpha diversity of intestinal flora was decreased in PMSW， and the beta diversity analysis showed significant differences in flora characteristics between the two groups （P<0.05）. The abundance of Clostridium， Phylum thick-walled， Trichosporon， and Clostridium tumefaciens decreased but Fusobacteriota increased （LDA score >4）. The comparison of liver and kidney function indexes revealed that AST， β2-MG levels were higher in PMSW than in NMSW， while TBIL was lower in PMSW than in NMSW. The number of patients with abnormal β2-MG was much higher in PMSW than in NMSW， and the difference was statistically significant （P<0.001）. It was also found that AST was negatively correlated with Clostridium （P<0.05）； TBIL was negatively correlated with Clostridium and positively correlated with Phylum thick-walled and Trichosporon （P<0.05）. β2-MG was negatively correlated with Phylum thick-walled， Clostridium， Trichosporon and Rumenococcus （P<0.05） and positively correlated with Clostridium （P<0.05）. ConclusionIn PMSW group， the alpha diversity of the flora is decreased. AST and β2-MG levels are increased， and TBIL level is decreased. These changes were significantly correlated with different strains of bacteria in the intestinal flora.
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ObjectiveTo determine the situation of vaccination certificate inspection and supplementary immunization among children attending kindergarten and primary school in Pudong New Area. MethodsThe study was conducted based on the annual report form“vaccination record inspection summary” of all community health service centers in Pudong New Area， Shanghai. Data related to vaccination certificate inspection and supplementary immunization among children attending kindergarten and primary school were retrieved in Pudong New Area from 2018 to 2021 and statistically analyzed. ResultsFrom 2018 to 2021， a total of 1 850 kindergartens and 887 primary schools in Pudong New Area inspected the vaccination certificates of children attending kindergarten and school，with a coverage rate of 100.00%. There were 375 407 children enrolled in kindergarten and primary school.A total of 373 820 children were inspected with an examination rate of 99.58%. The average certificate holding rate among children was 99.48%．The full-course immunization rate of eight national immunization programs vaccines was 94.95%. Furthermore， a total of 73 407 doses of eight national immunization vaccines were supplemented，with an average supplementary rate of 92.95%. The supplement rate increased annually．In terms of supplemented doses，the top three vaccines were meningococcal vaccine， measles vaccine and polio vaccine. As a vaccine of local immunization program in Shanghai， a total of 14 143 doses of varicella vaccine were supplemented with a supplementary rate of 86.99%. ConclusionIn Pudong New Area， vaccination certificate inspection of children attending kindergarten and primary school has been strictly performed . Inspection rate in the kindergartens and primary schools， children's certificate holding rate， full-course immunization rate and supplementary immunization rate remain high.
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Objective To explore the epidemiological characteristics and the potential years of life lost of gynecological malignant tumors among female residents in Pudong New Area of Shanghai between 2002 and 2019. Methods Crude mortality rate (CMR), age-standardized mortality rate (SMR), potential years of life lost (PYLL), average years of life lost (AYLL) and annual percent change (APC) of the cervical cancer，uterine cancer and ovarian cancer deaths were calculated to analyze the mortality situation of gynecological malignant tumors among female residents in Pudong New Area. Results The crude mortality rate were 2.65/100 000, 2.44/100 000 , 4.55/100 000, and age-standardized mortality rate were 1.33/100 000, 1.06/100 000, 2.26/100 000, respectively, among female residents in Pudong New Area during 2002 to 2019. In the study period, both the crude mortality rate and the age-standardized mortality rate of cervical cancer rose over the years; Both the crude mortality rate and the age-standardized mortality rate of uterine cancer kept stable; The crude mortality rate of ovarian cancer showed an upward trend, and the age-standardized mortality rate kept stable. The PYLL of cervical cancer was 7335 years, the PYLL rate was 0.30‰, and the AYLL was 11.20 years per person; The PYLL of uterine cancer was 3556 years, the PYLL rate was 0.14‰, and the AYLL was 5.90 years per person; The PYLL of uterine cancer was 10017 years, the PYLL rate was 0.41‰, and the AYLL was 8.91 years per person. Conclusion The mortality rate of cervical cancer and ovarian cancer rose over years, and the mortality of uterine cancer kept stable among female residents in Pudong New Area during 2002 to 2019. The gynecological malignant tumors caused severe disease burden.
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Objective To explore the use of new media technology to estimate the size of the online MSM population in Pudong New Area, to understand the frequency of new media software use, HIV testing and high-risk behavior, and to provide a basis for AIDS prevention and control. Methods The online MSM registration information in Pudong New Area was collected through a gay dating APP. At five time points on March 28 and April 11, 2019, MSM who logged into the gay dating APP were counted. The MSM were confirmed by comparing the login name and registration information. The capture-recapture (C-R) method was used to calculate the MSM population size. Meanwhile, a questionnaire survey was conducted on the online MSM. Results The MSM population size in Pudong New Area was estimated at 13 174 [95% CI: 9,672~16,676] through the C-R method. The proportion of multiple sexual partners accounted for 72.5%. According to the ordered multi-classification logistics analysis, age, education level, experience of attending a talk on AIDS, and experience of receiving AIDS publicity and education in the VCT clinic were the influencing factors of AIDS awareness. Conclusion New media technology provided new technical means for estimating the size of MSM population. The MSM population’s awareness of AIDS risk and prevention still needs to be strengthened. It is worthy of further studies on the role of new media technology in AIDS prevention and health education in the future.
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Objective To explore the death characteristics and the potential years of life lost from chronic obstructive pulmonary disease (COPD) among residents in Pudong New Area of Shanghai from 2002 to 2019, so as to provide a reference for formulating corresponding prevention and control strategies for chronic obstructive pulmonary disease. Methods The death data of chronic obstructive pulmonary disease was extracted from the Pudong New Area's death surveillance system. Crude mortality, age-standardized mortality, potential years of life lost (PYLL), average years of life lost (AYLL) and annual percent change (APC) of chronic obstructive pulmonary disease deaths were calculated to analyze the situation of COPD death in Pudong New Area. Results The crude mortality and age-standardized mortality of chronic obstructive pulmonary disease among residents in Pudong New Area between 2002 and 2019 were 64.94/100,000 and 21.04/100 000, respectively. The chronic obstructive pulmonary disease showed a downward trend (APC=-2.05%, Z=- 5.342, P<0.001), and the standardized mortality rate decreased year by year (APC=-6.23%, Z=-13.052, P<0.001). The crude mortality and age-standardized rates in male residents were both higher than those in females (Z-crude mortality=46.471, P<0.001, Z-standardized mortality=-48.961, P<0.001). The PYLL of chronic obstructive pulmonary disease was 16,997 years, the PYLL rate was 0.34‰, and the AYLL was 0.53 years per person. Conclusion From 2002 to 2019, the mortality of chronic obstructive pulmonary disease among residents in Pudong New Area was relatively high and caused serious life loss. Both crude mortality and age-standardized rate showed a downward trend during the study period. Comprehensive prevention and control measures should be further developed.
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Objective To analyze the results of HIV antibody screening test and confirmation test results in Pudong New Area from 2014 to 2018, and to understand the situation of HIV infection in the region in recent years. Methods Samples that responded to initial screening of HIV in this jurisdiction area were tested by enzyme-linked immunosorbent assay (ELISA), chemiluminescence assay or immunochromatographic rapid diagnosis test. The samples that showed a positive response to one of the reexamination methods were subjected to confirmatory tests by Western blot assay. EXCEL and SPSS 16.0 statistical software were used to collate and analyze the data. Results Confirmatory tests were performed on a total of 2 100 retested samples. HIV positive samples were 1485 (70.7%), and HIV negative and uncertainty samples were 452 (21.5%) and 163 (7.8%), respectively. The confirmed positive male/female sex ratio was 7.95:1, and the difference was statistically significant (χ2=3.745, P<0.001). The age of confirmed positive patients was mainly 15~39 years old. The proportion of voluntary testing and counseling was the highest among the population receiving HIV tests. The positive coincidence rate between the review test and confirmation test was 91.3%. The gp160 and gp120 bands appeared most frequently in WB-confirmed positive samples, which was 100%. The gp160 band was the most frequent band of uncertain samples, accounting for 71.4%. Conclusion The positive rate was high in the confirmatory test of samples with positive results by both methods, and the samples with one negative and one positive were mostly uncertain or negative in the confirmatory test. When the results were uncertain, CD4, nucleic acid detection, and viral load detection should be used as auxiliary diagnosis.
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Objective To understand the distribution characteristics of death causes and potential life loss of residents in Pudong New Area from 2009 to 2018, assess the disease burden caused by different diseases, and provide a basis for formulating regional prevention and control strategies. Methods The mortality data of residents in Pudong New Area of Shanghai from 2009 to 2018 were collected. The death causes were classified by International Classification of Diseases (ICD-10). The crude mortality rate, standardized mortality rate, potential years of life lost (PYLL), potential years of life lost rate (PYLLR), and average years of life lost (AYLL) were calculated. Results The crude mortality and standardized mortality of residents in Pudong New Area between 2009 and 2018 were 7.55‰ and 3.65‰, respectively. The top five causes of death in Pudong New Area residents were circulatory system diseases, tumors, respiratory diseases, endocrine nutrition and metabolic diseases, and injury and poisoning, accounting for 87.85% of the total deaths. The PYLL was 687 729 person-years, the PYLLR was 24.11‰ and the AYLL was 3.19 years per person. The top 5 causes of life loss of residents in Pudong New Area was tumor, circulatory system disease, injury and poisoning, endocrine nutrition and metabolism illness, and congenital anomalies, accounting for 82.08% of total life loss of residents. Conclusion Chronic non-infectious diseases, including circulatory diseases, tumors, and endocrine nutritional metabolism diseases, were the main causes of death of residents in Pudong New Area, and caused a heavy disease burden, which should be the focus of prevention and control in the future. Comprehensive preventive and control measures should be taken to protect the residents from the harm due to chronic non-communicable diseases and improve the health condition of the residents in Pudong New Area.
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Objective To evaluate the vaccine effectiveness ( VE) in children who received one dose of live attenuated varicella vaccine. Methods A questionnaire-based 1 ∶ 2 matching case-control study was conducted during May, 2015 to April, 2016 to evaluate the VE based upon the demographic data, vacci-nation status and clinical symptoms of 127 children with varicella and 254 healthy subjects under 12 years old. Results Compared with the healthy subjects, 83. 46% of the patients with varicella were immunized with one dose of varicella vaccine, which was lower than that of the control group (90. 55%) (χ2=4. 08, P<0. 05). The overall protective rate of one dose of varicella vaccine reached 64. 29% (95% CI:42. 00%-78. 00%). Of the 127 cases of varicella, 83. 46% were breakthrough cases immunized with one dose of var-icella vaccine. Primary cases presented more severe clinical symptoms than breakthrough cases. The longer the interval between vaccination and varicella-zoster virus infection was, the more severe the breakthrough cases would be. Conclusion Varicella vaccine is effective for preventing varicella, but the VE of one dose of varicella vaccine is limited. A two-dose varicella vaccination strategy should be proposed in our country as soon as possible.