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Objective:To analyze the report accuracy and risk factors of congenital syphilis (CS), and to provide references of accurate diagnosis for clinicians.Methods:CS notification data, including suspected cases and confirmed cases, were obtained from national notifiable disease reporting system (NNDRS) reported from 2016 to 2019 in Guangzhou City. Information of syphilis infected pregnant women and their children who were diagnosed or excluded with CS during 2012-2019 were extracted from Guangzhou City'the integrated prevention of mother-to-child transmission of human immunodeficiency virus, syphilis and hepatitis B virus surveillance system’. Their demographic characteristics, serological test results of syphilis, reporting doctors and treatment regimens were analyzed.Chi-square test was used for univariate analysis and multivariate logistic regression analysis was used to identify the influencing factors associated with CS.Results:A total of 95 CS cases were reported in NNDRS, and the reporting accuracy rate was 36.8%(35 cases). The proportion of children younger than 30 days who were reported incorrectly (73.3%(44/60)) was higher than the proportion of those were reported correctly (51.4%(18/35)), and the difference was statistically significant ( χ2=4.679, P=0.031). However, the reporting accuracy was not associated with hospital grade, doctor profession and doctor title of reporting ( χ2=0.283, 0.483 and 3.681, respectively, all P>0.05). Maternal age≤24 years (adjusted odds ratio ( aOR)=4.62), titers of non- Treponema pallidum antigen serologic test before treatment≥1∶8 ( aOR=7.56), initiation of antisyphilitic treatment during delivery ( aOR=25.43), no antisyphilitic treatment during pregnancy ( aOR=14.12), and premature delivery ( aOR=8.97) increased the risks of CS (all P<0.01). Conclusions:The reporting accuracy rate of CS is low. Young mothers, high serological titers of non- Treponema pallidum antigen before treatment, initiation of antisyphilitic treatment during delivery or no antisyphilitic treatment during pregnancy, and premature delivery are risk factors for CS. Doctors may focus on collecting this information to assist clinical diagnosis.
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Objective@#To survey the children under 7 years of age in nine cities of China for a better understanding of the current situation of childhood stunting.@*Methods@#According to a stratified cluster sampling design, a cross-sectional survey on children under 7 years of age was carried out in 9 cities (Beijing, Harbin and Xi′an in northern China; Shanghai, Nanjing and Wuhan in central China; and Guangzhou, Fuzhou and Kunming in southern China) from June to November in 2016. A total of 110 499 children were recruited. Height of children was evaluated using the growth standards for Chinese children (2009 edition) .Children with height less than the 3rd percentile of the growth standards were considered as stunting, and children with height between the 3rd and 10th percentiles of the growth standards were considered as relatively short stature. Chi-square test was used for comparison between data of boys and girls, urban and suburban, as well as among different ages and regions.@*Results@#Totally 113 084 children under 7 years of age should be investigated and actually 110 499 children were investigated, with a rate of 97.7%. The prevalence of stunting was 1.9% (2 141/110 499) among all the children. The prevalence of stunting in urban children (1.6%, 904/55 524) was lower than that in suburban children (2.3%, 1 237/54 975, χ2=56.246, P<0.01). The gender difference in stunting prevalence was not statistically significant (1.9% (1 121/57 921) in boys and 1.9% (1 020/52 578) in girls, χ2=0.003, P=0.965). The prevalence of stunting decreased with age for children younger than 3 years, from 1.8% (312/17 080) in 0-<1 year of age group to 1.2% (168/13 740) in 2-<3 years of age group, but increased to 2.2% (240/11 073) at 6-<7 years group. Comparison among different regions showed that the stunting prevalence in southern region was higher than those in the central and northern regions (0.9% (193/20 374) in northern urban, 0.8% (154/18 486) in central urban, and 3.3% (557/16 664) in southern urban children), showing a statistical significance (χ2=437.736, P<0.01); 1.1% (241/21 924) in northern suburban, 1.4% (227/16 775) in central suburban and 4.7% (769/16 276) in southern suburban children, showing a statistical significance (χ2=646.533, P<0.01). In urban areas, the difference between the central and northern regions showed no statistical significance (χ2=1.429, P=0.232) and the stunting prevalence of central Chinese children was slightly higher than that of northern Chinese children in suburban areas (χ2=5.130, P=0.024). Among the nine cities, the stunting prevalence of Guangzhou (6.1%, 613/10 019) was higher than those of other cities (χ2=1 559.64, P<0.01). Among the stunting children, 78.4% (1 679/2 141) were classified as borderline or mild and only 7.2% (154/2 141) were classified as severe. The prevalence of relatively short stature was 5.2% (5 721/110 499).@*Conclusions@#The prevalence of stunting among children under 7 years of age in nine cities of China is low and most of the stunting children were classified as mild; the prevalence of stunting in suburban children is higher than that in urban children; the gender difference show no statistical significance; and the prevalence of stunting in southern Chinese children is higher than those in central and northern Chinese children.
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Objective:To explore the current status of human resources allocation and occupational situation of community child health care medical staff (CCHCMS) in Guangzhou.Methods:A questionnaire survey of job burnout and turnover intention was conducted from January 2 to January 10, 2020 among CCHCMS in 11 districts of Guangzhou. Lorentz curve and Gini coefficient were used to analyze the equity of human resources allocation. Influencing factors of turnover intention of CCHCMS were explored using structural equation model.Results:There were 5.63 CCHCMS per 10 000 children aged 0 to 6 years old, and 0.08 CCHCMS per square kilometer in Guangzhou. According to the distributions of service population and area, the Gini coefficients of CCHCMS were 0.13 and 0.47, respectively. A total of 574 CCHCMS completed the questionnaire survey, and 197 (34.3%) showed higher turnover intention. The constructed structural equation model fit well (RMSEA=0.04, CFI=0.97). The standardized coefficients of the average monthly income before tax, job satisfaction and career burnout on turnover intention were -0.30, -0.46 and 0.22, respectively. Job satisfaction indirectly affected turnover intention through the mediating role of career burnout (standardized cofficient=0.10) . Income and mode of employment were negatively correlated with job burnout, and standardized cofficient were -0.10,-0.16,respectively. The standardized coefficients of education and work area on job satisfaction were -0.16 and 0.20, respectively.Conclusion:The number of CCHCMS in far suburbs of Guangzhou is insufficient. CCHCMS have a high turnover intention. Income, mode of employment, education and work area are the factors that influence the turnover intention of CCHCMS.
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Objective@#To evaluate the influence of antiretroviral prophylaxis on the growth and development of HIV-exposed uninfected infants in Guangzhou.@*Methods@#Data were from the national information system for prevention of mother-to-child transmission of HIV infection, syphilis and hepatitis B. After excluding death and perinatal HIV infection cases, 564 HIV-exposed uninfected infants were included. The infants were divided into three groups, nevirapine (NVP) group, zidovudine (AZT) group and untreated group. The influences of antiretroviral prophylaxis on the body weight and height of the HIV-exposed uninfected infants were analyzed by using generalized estimating equations.@*Results@#The HIV-exposed uninfected infants at 1-month old had lower Z scores of body weight-for-age and body height-for-age than the World Health Organization’s reference standard. The prevalence of wasting in AZT group (17.5%) was higher than that in NVP group (6.2%) for 1-month old infants. Taking NVP or AZT was a protective factor for Z score of body length-for-age (P<0.05). Intrauterine exposure to triple antiviral drugs was a risk factor for the Z scores of body weight-for-age and body length-for-age (P<0.05).@*Conclusion@#The physical growth and development of HIV-exposed uninfected infants at 1-month old was not well, and HIV-exposed uninfected infants who taking AZT had a higher incidence of wasting. Attention should be paid to these infants.
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Objective@#To investigate the association of both maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with childhood overweight and adiposity in preschool children.@*Methods@#A total of 4 303 preschool children aged 3-5 years were enrolled in our study during June and November 2016 in Guangzhou. Children defined as overweight and obesity were according to the criteria of WHO while weight status during maternal pre-pregnancy was using the China Adult Reference. Gestational weight gain was defined according to the Institute of Medicine guidelines.@*Results@#After adjusting the possible confounding factors, results from the logistic regression analysis showed that both maternal pre-pregnancy overweight and obesity would increase the risk for both childhood overweight and obesity (OR=1.820, 95%CI: 1.368-2.422). The analysis of covariance results also showed that both maternal overweight and obesity before pregnancy and excessive maternal weight gain during pregnancy increased the BMI Z-score in children. Maternal GWG over the recommended level were associated with both the childhood overweight and obesity (OR=1.296, 95%CI: 1.007-1.667). Joint associations of pre-pregnancy BMI and inappropriate GWG were also noticed in the study. Stratified analysis was conducted in three groups according to the pre-pregnancy BMI of the mothers. Result showed that there was no statistical difference in the risks of either overweight or obesity in children (P>0.05). However, when compared to mothers with adequate pre-pregnancy higher BMI and adequate GWG, under the combination of high pre-pregnancy BMI and excessive GWG, their adverse effects on childhood overweight and obesity were much higher (OR=1.574, 95%CI: 1.029-2.409).@*Conclusions@#Both high pre-pregnancy BMI and inappropriate GWG were associated with greater BMI of their offspring. Pregnant women should follow the appropriate weight gain program and help their children to prevent from becoming obese.
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【Objective】To comprehensively evaluate the therapeutic effect of Professor Yu's spleen-strengthening,stomach-regulating and blood-activating therapy for chronic atrophic gastritis(CAG).【Methods】Thirty-two CAG patients collected in recent 3 years were treated with Weiwei Fuyuan Decoction(WFD),a prescription embodying Professor Yu's spleen-strengthening,stomach-regulating and blood-activating therapy.WFD is mainly composed of Radix Astragali,Radix Pseudostellariae,Radix Rehmanniae,Radix Notoginseng,Faeces Trogopterori,Herba Scutellariae Barbatae,Herba Hedyotis Diffusae,Fructus Aurantii Immaturus,Rhizoma Corydalis,etc..CAG was classified into mild,moderate and severe degree in this study.The treatment lasted 3 months to half a year.After treatment,the effect of WFD on clinical symptoms,gastroscope,pathological changes,helicobacter pyloria(HP)infection was observed and compared to that before treatment.【Results】After treatment,the clinical symptoms were much relieved,and atrophy of gastric mucosa(GM)under gastroscope was also relieved(P