Estimates of influenza-associated excess mortality by three regression models in Shanxi Province during 2013-2017 / 中华预防医学杂志

Objective@#Using three models too estimate excess mortality associated with influenza of Shanxi Province during 2013-2017.@*Methods@#Mortality data and influenza surveillance data of 11 cities of Shanxi Province from the 2013-2014 through 2016-2017 were used to estimate influenza-associated all cause deaths, circulatory and respiratory deaths and respiratory deaths. Three models were used: (i) Serfling regression, (ii)Poisson regression, (iii)General line model.@*Results@#The total reported death cases of all cause were 157 733, annual death cases of all cause were 39 433, among these cases, male cases 93 831 (59.50%), cases above 65 years old 123 931 (78.57%). Annual influenza-associated excess mortality, for all causes, circulatory and respiratory deaths, respiratory deaths were 8.62 deaths per 100 000, 6.33 deaths per 100 000 and 0.68 deaths per 100 000 estimated by Serfling model, respectively; and 21.30 deaths per 100 000, 16.89 deaths per 100 000 and 2.14 deaths per 100 000 estimated by General line model, respectively; and 21.76 deaths per 100 000, 17.03 deaths per 100 000 and 2.05 deaths per 100 000, estimated by Poisson model, respectively. Influenza-related excess mortality was higher in people over 75 years old; influenza-associated excess mortalityfor all causes, circulatory and respiratory deaths, respiratory deaths were 259.67 deaths per 100 000, 229.90 deaths per 100 000 and 32.63 deaths per 100 000, estimated by GLM model, respectively; and 269.49 deaths per 100 000, 233.69 deaths per 100 000 and 31.27 deaths per 100 000, estimated by Poisson model,respectively.@*Conclusion@#Excess mortality associated with influenza mainly caused by A (H3N2), Influenza caused the most associated death amongold people.

Epidemiological characteristics and risk factors of primary intussusception in children among two years old and below, Ji'nan city / 中华预防医学杂志

Objective@#To study the epidemiological characters and risk factors of primary intussusception among children who were ≤2 years old in Jinan city.@*Methods@#A retrospective study was also applied to collect the disease information of inpatient cases through hospital information system of inpatient during 2011 and 2015. The attack rate (AR) was calculated in total and each year, respectively. 1∶1 matched pared case-control study was conducted to explore the risk factors of primary intussusception. A total of new confirmed 93 residential cases were enrolled with ≤2 years old, diagnosed as primary intussusception or diseases coded as K56.1 according to the International Classification of Diseases, tenth version (ICD-10), and without any other reason for organic lesions. The 93 patients without primary intussusception inpatients were selected from the same hospital and departments as the controls, and matched with the cases as the same gender, ±3 months old, and disease onset within 7 days, visiting the hospital during January 1, 2016 and June 30, 2016. Clinical and epidemiological information was collected both from cases and controls. The difference of AR among different years was compared by Trend Chi-squiare test, and difference between gender, month old and regions was compared by Chi-squiare test, respectively. Multiple-variables factor analysis was applied to analysis the risk factors of cases compared with controls by conditional logistic regression model.@*Results@#A total of 574 cases were found and the overall AR was 86.3 per 100 000. A significant decreasing trend (χ2trend=23.43, P<0.001) of AR was showed between 2011 and 2015, with the highest AR in 2011 (117.6 per 100 000), and the lower AR in 2014 (66.0 per 100 000). The lowest AR was also observed in male (106.9 per 100 000) compared with the female (63.2 per 100 000) (χ2=13.76, P<0.001), and in ≤12 months old (102.1 per 100 000) compared with the >12 months old (70.4 per 100 000) (χ2=19.46, P<0.001). The higher proportion of 57.1% (328/574) was found in 4-12 months old cases. The cases with an overweight before illness (OR=4.98, 95%CI: 1.27-19.50), with mixed feeding of breast-milk and milk-powder (OR=16.90, 95%CI: 5.25-54.20), and with instruction of solid food before 6 months old (OR=16.50, 95%CI: 1.91-143.10) could increase the risk of illness compared with keeping a healthy weight, breast feeding, and instruction of solid food after 6 months old, separately.@*Conclusion@#A higher attack rate of primary intussusception in children with a ≤2 years old in Jinan was observed. Male and 4-12 months group had a higher risk. Body weight, breast feeding, and the instruction of solid food before and after 6 months old were related to the risk of primary intussusception among children who were ≤2 years old.

Association between ambient PM10/PM2.5 concentration and outpatient department visits due to respiratory disease in a hospital in Jinan, 2013-2015: a time series analysis / 中华流行病学杂志

Objective To estimate the influence of the ambient PM10 and PM2.5 pollution on the hospital outpatient department visit due to respiratory diseases in local residents in Jinan quantitatively.Methods Time serial analysis using generalized addictive model (GAM) was conducted.After controlling the confotmding factors,such as long term trend,weekly pattern and meteorological factors,considering lag effect and the influence of other air pollutants,the excess relative risks of daily hospital visits associated with increased ambient PM10 and PM2.5 levels were estimated by fitting a Poisson regression model.Results A 10 μtg/m3 increase of PM10 and PM2.5 levels was associated with an increase of 0.36％ (95％ CI:0.30％-0.43％) and 0.50％ (95％ CI:0.30％-0.70％) respectively for hospital visits due to respiratory diseases.Lag effect of 6 days was strongest,the excess relative risks were 0.65％ (95％ CI:0.58％-0.71％) and 0.54％ (95％ CI:0.42％-0.67％) respectively.When NO2 concentration was introduced,the daily hospital visits due to respiratory disease increased by 0.83％ as a 10 μg/m3 increase of PM10 concentration (95％CI:0.76％-0.91％).Conclusion The ambient PM10 and PM2.5 pollution was positively associated with daily hospital visits due to respiratory disease in Jinan,and ambient NO2 concentration would have the synergistic effect.

The hot spot and epidemiologic characteristics of hand, foot and mouth disease in Jinan municipality, 2009-2016 / 中华实验和临床病毒学杂志

Objective@#To investigate the hot spots and epidemiologic characteristics of hand, foot and mouth disease (HFMD) in Jinan municipality from 2009 to 2016.@*Methods@#Disease reports of HFMD in Jinan from 2009-2016 were collected and analyzed with ArcGis 10.2 to show the hot spot in different villages and towns, as well as clustering analysis and descriptive epidemiology to show epidemiologic characteristics.@*Results@#A total of 89 486 HFMD cases were reported and the reported annual incidence rate was 160.94/100000 during the 7-year period, which increased year by year, and within the whole city, each county was at a higher epidemic level; the curve of incidence is unimodal and the incidence peak occurred mostly between May and August, especially in June; 115 severe cases were reported and the ratio was 0.13%. Of the reported cases, 81.51% were between 1 to 4 years old; 60.36 % were children living scattered. The hot spots were like a circle surrounding the core areas, showing a tendency of increase; the proportion of EV71, CVA16 and other enteroviruses were 33.67%、37.22%and 29.09%, respectively, and they appeared in turn, but severe cases were mostly affected by EV71.@*Conclusions@#The HFMD in Jinan is in a highly prevalent level, with low ratio of severe cases. Seasonal(high in summer) and unimodal; more common among children between 1 to 4 years old, living scatted and in urban and rural linking areas, with the tendency of increasing of hot spots; prevalent pathogens appear in turn.

Association between ambient PM10/PM2.5 concentration and outpatient department visits due to respiratory disease in a hospital in Jinan, 2013-2015: a time series analysis / 中华流行病学杂志

Objective To estimate the influence of the ambient PM10 and PM2.5 pollution on the hospital outpatient department visit due to respiratory diseases in local residents in Jinan quantitatively.Methods Time serial analysis using generalized addictive model (GAM) was conducted.After controlling the confotmding factors,such as long term trend,weekly pattern and meteorological factors,considering lag effect and the influence of other air pollutants,the excess relative risks of daily hospital visits associated with increased ambient PM10 and PM2.5 levels were estimated by fitting a Poisson regression model.Results A 10 μtg/m3 increase of PM10 and PM2.5 levels was associated with an increase of 0.36％ (95％ CI:0.30％-0.43％) and 0.50％ (95％ CI:0.30％-0.70％) respectively for hospital visits due to respiratory diseases.Lag effect of 6 days was strongest,the excess relative risks were 0.65％ (95％ CI:0.58％-0.71％) and 0.54％ (95％ CI:0.42％-0.67％) respectively.When NO2 concentration was introduced,the daily hospital visits due to respiratory disease increased by 0.83％ as a 10 μg/m3 increase of PM10 concentration (95％CI:0.76％-0.91％).Conclusion The ambient PM10 and PM2.5 pollution was positively associated with daily hospital visits due to respiratory disease in Jinan,and ambient NO2 concentration would have the synergistic effect.

Discussion of epidemic trend and control strategies of malaria in Jinan City from 1989 to 2013 / 中国血吸虫病防治杂志

Objective To explore the epidemic trend of malaria in Jinan City so as to provide the evidence for improving the prevention and control of malaria. Methods The surveillance and annual report data of malaria were collected and analyzed epidemiologically in Jinan City from 1989 to 2013. Results The prevalence of malaria was low in Jinan City from 1989 to 2013. Totally 179 cases of malaria were reported and 14 cases 7.82% were locally infected and 165 cases 92.18% were imported. Conclusion Most malaria cases were imported since the disease was basically eliminated in Jinan City. The overseas workers from high prevalence areas of malaria should be well managed.

Status of acute upper respiratory infection, influenza-like illness, and influenza vaccination coverage among community residents in Jinan / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the status of acute upper respiratory infection and influenza-like illness (ILI) among community residents in Jinan in 2015, and to make a understand of the patient's medical treatment behavior and influenza vaccination coverage status in 2014.</p><p><b>METHODS</b>Balloting method and convenient sampling method were used to launch a household survey. The residents who had been in Jinan for more than 3 months were selected, to investigate the residents' attack ratio of acute upper respiratory and influenza-like from Jan. 8 to Feb. 7, 2015. Totally, 1 300 persons from 410 families were involved in this survey which recovered 1 241 valid questionnaires with the efficiency of 95.5%. Based on the national age-urban demographic statistics in 2010, the attack rates of acute respiratory infections, influenza-like illness were estimated by the direct standardization method, and the influenza vaccination rates were also calculated in this study. χ(2)-test method was used to compare the different status of incidence and vaccination among residents with different features.</p><p><b>RESULTS</b>The attack rate of acute upper respiratory infection and influenza-like illness in Jinan from January 8, 2015 to February 7, 2015 were 30.2% (375 cases), and 6.1% (76 cases), respectively, with a standardized rate of 29.1% and 5.4%. 5.3% (66 cases) of the residents have vaccinated with the influenza vaccine inoculation, with an adjusted rate of 3.8%. The attack rate difference of acute upper respiratory tract infections was statistically significant between each age group (χ(2)=17.121, P= 0.002). The 0-4 age group had a highest attack rate (45.4%) of acute respiratory infection, while the 15-24 age group got the lowest (26.5%). 38.9% (146 cases) of patients went for a treatment in hospital. Among them, 37.7% (55 cases) of them selected the county level hospitals for treatment, 37.7% (55 cases) selected the community level hospitals, and 24.6% (36 cases) selected the individual clinic. Significant differences of influenza-like illness attack rate between each age group were also found in this study (χ(2)=76.79, P<0.001). 0-4 age group had the highest attack rate (22.7%). 81.6% (62 cases) of the ILI sought treatment in the hospital, of which 53.2% (33 cases) selected county level hospital or above, and 33.9% (21 cases) selected community hospital, and 12.9% (8 cases) selected the individual clinic.</p><p><b>CONCLUSION</b>The attack rate of acute upper respiratory infections among the residents of Jinan was high, whereas that of influenza-like illness was relatively low. 0-4 age group had a higher risk of ILI than other age groups. Most of the cases were likely to take the treatment in large hospitals. In general, the coverage rate of influenza vaccination was relatively low.</p>

Short term effect of weather patterns on the incidence of hand foot and mouth disease aged ≤5 years old in Jinan city / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the effect of weather patterns on the incidence of hand foot and mouth disease (HFMD) in Jinan.</p><p><b>METHODS</b>HFMD confirmed cases aged ≤5 years old for the period of 2012-2014 were collected from National Notifiable Disease Report System (NNDRS). Simultaneous meteorological data, including daily average temperature, relative humidity, atmospheric pressure, wind velocity, rainfall and duration of sunshine were obtained from the website of Jinan meteorological bureau. A negative binomial multivariable regression was used to identify the relationship between meteorological variables and HFMD.</p><p><b>RESULTS</b>During the study period, a total of 40 405 HFMD cases aged ≤5 years old were reported. The incident peak occurred from May to July, a total of 22 254 cases were reported during this period, which accounted for 55.08% of whole cases. After adjusting by "year", each 1 °C rise of weekly average temperature corresponded to an increase of 6.70% (95%CI:6.35% to 7.06%) in the weekly number of HFMD cases, while a 1 kPa rise of weekly average atmospheric pressure corresponded to a decrease in the number of cases by 44.77% (95%CI: -46.23% to -41.91%). Likewise, a one percent rise in weekly average relative humidity corresponded to an increase of 1.96% (95%CI: 1.84% to 2.09%), a 1 m/h rise in weekly average wind velocity corresponded to an increase of 16.63% (95% CI:14.08% to 19.25%), a hour add in weekly duration of sunshine corresponded to a decrease of 0.82% (95% CI : -0.93% to -0.72%), in the weekly number of HFMD cases.</p><p><b>CONCLUSION</b>Weather factors including temperature, atmospheric pressure, relative humidity, wind velocity, and duration of sunshine had a significant influence on occurrence and transmission of HFMD in Jinan city.</p>

Epidemiological characteristics of human avian influenza A (H7N9) virus infection in China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the epidemiological characteristics of human infections with avian influenza A (H7N9) in China and to provide scientific evidence for the adjustment of preventive strategy and control measures.</p><p><b>METHODS</b>Demographic and epidemiologic information on human cases were collected from both reported data of field epidemiological investigation and the reporting system for infectious diseases.</p><p><b>RESULTS</b>A total of 433 cases including 163 deaths were reported in mainland China before June 4, 2014. Two obvious epidemic peaks were noticed, in March to April, 2013 and January to February, 2014. Confirmed cases emerged in 14 areas of China. Five provinces, including Zhejiang, Guangdong, Jiangsu, Shanghai, and Hunan, reported about 85% of the total cases. Median age of the confirmed cases was 58 years (range, 1-91), with 70% as males. Of the 418 cases with available data, 87% had ever exposed to live poultry or contaminated environments. 14 clusters were identified but human to human transmission could not be ruled out in 9 clusters.</p><p><b>CONCLUSION</b>Human infections with avian influenza A (H7N9) virus showed the characteristics of obvious seasonal distribution, with certain regional clusters. The majority of confirmed cases were among the elderly, with more males seen than the females. Data showed that main source of infection was live poultry and the live poultry market had played a significant role in the transmission of the virus.</p>