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ABSTRACT BACKGROUND: Multimorbidity due to non-communicable chronic diseases (NCDs) constitutes a significant challenge for healthcare systems. To attenuate its impacts, it is essential to identify the sociodemographic determinants of this condition, which can discriminate against population segments that are more exposed. OBJECTIVE: To identify associations between multimorbidity conditions and sociodemographic indicators among Brazilian adults and older adults. DESIGN AND SETTING: Cross-sectional telephone-based survey in 26 Brazilian state capitals and the federal district. METHODS: The Vigitel 2013 survey was used, with data collected via a questionnaire. The outcome was multimorbidity (2, 3 or 4 NCDs), and the exposures were sociodemographic indicators (age, sex, skin color, marital status and education). The analysis consisted of multinomial logistic regression (odds ratio), stratified by age. RESULTS: Among adults, multimorbidity comprising two, three or four diseases was associated with advancing age (P < 0.001); two and three diseases, with having a partner (P = 0.004 and P < 0.001, respectively); and two, three or four diseases, with lower education (P < 0.001). Among older adults, two, three or four diseases were associated with female sex (P < 0.001); three diseases, with living with a partner (P = 0.018); two diseases, with black skin color (P = 0.016); and two or three diseases, with lower education (P < 0.001). CONCLUSIONS: To control and prevent multimorbidity, strategies for individuals with existing chronic diseases, with partners and with lower education levels are needed. Particularly for adults, advancing age should be considered; and for older adults, being a woman and having black skin color.
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Humans , Female , Aged , Noncommunicable Diseases/epidemiology , Multimorbidity , Brazil/epidemiology , Chronic Disease , Cross-Sectional StudiesABSTRACT
Objective: To systematically evaluate the relationship between Vitamin D levels and dental caries risk in children. Methods: PubMed, Embase, Web of Science, the Cochrane Library, Wanfang Digital Journal Full-text Database, China National Knowledge Infrastructure (CNKI), and database for Chinese Technical Periodicals (VIP) till Mar. 2019 were searched for the studies to evaluate the relationship between Vitamin D levels in children and the risk of dental caries. Two evaluation staff independently selected the literature, extracted data and evaluated the bias risk of the study. Meta-analysis was performed using Stata15.1 software. Pooled relative risks (RR) with 95% confidence intervals (CIs) were calculated by random-effects models. Results: A total of 14 studies were included in 10 articles, with high methodological quality. Of the 14 studies, 6 cross-sectional studies were grade A, 3 cohort studies were grade A, 4 case control studies were grade B, and one Mendel randomized study was Grade A. A total of 12 596 subjects were included, among them 5338 were caries patients, the caries rate was 42.38%; Among 1075 cases of shortage in Vitamin D, 512 were caries patients, the caries rate was 47.63%; Among 3676 cases of deficiency in Vitamin D, 1580 were caries patients, the caries rate was 42.98%; Among 7845 cases with normal level of Vitamin D, 3246 were caries patients, the caries rate was 41.38%. Meta-analysis showed that the suboptimal Vitamin D level in children increased the risk of caries by 11% (RR=1.11, 95%CI: 1.01-1.21) with statistical significance (P=0.03). The results of subgroup analysis showed that, according to the study type, 4 case-control studies showed that the suboptimal Vitamin D level in children increased the risk of caries by 61% (RR=1.61, 95%CI: 1.09∼2.39, P=0.01); 6 cross-sectional studies and 3 cohort studies showed no significant difference in the correlation between the suboptimal Vitamin D level and the risk of dental caries. According to the age of the subjects, lack or deficiency of Vitamin D level increased the risk of caries by 74% in deciduous teeth group (RR=1.74, 95% CI: 1.37-2.21) with statistical significance (P<0.01). There were no significant difference in the correlation between lack or deficiency of Vitamin D level and the risk of dental caries in groups of constant teeth period and replacement teeth period. Conclusion: The Vitamin D levels in children is associated with the risk of dental caries, and Vitamin D shortage or deficiency may increase the risk of dental caries.
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Objective@#Analysis of occupational poisoning character and laws in Jiangsu Province from 2006-2015, so as to provide scientific basis for the formulation of effective intervention measures and prevention strategies.@*Methods@#According to the data of Jiangsu province occupational poisoning cases reports of year 2006 to 2015, by EXCEL arranged, using SPSS software to do epidemiological data statistical analysis.@*Results@#In the past ten years, the number of occupational poisoning cases reported in Jiangsu province increased first and then declined. 547 cases of acute occupational poisoning reported in Jiangsu province from 2006-2015 years (35.82% of the total poisoning cases, the same below) , 980 cases of chronic occupational poisoning (64.18%) . The ratio of male and female in acute poisoning was 2.48, while 1.55 of chronic poisoning. The cases of poisoning reported were young and middle-aged, and working years was mainly in 5 years. The cases reported in the south of Jiangsu (mainly is chronic poisoning) is higher than that in the northern part of Jiangsu (mainly is acute poisoning) , which is more economically underdeveloped.. The reported highest mortality rate of occupational poisoning is asphyxia gas poisoning (5.43%) , followed by irritating gas poisoning (2.99%) and organic solvent poisoning (0.47%) . Many more occupational poisoning cases reported from large, joint-stock enterprises, especially chronic poisoning. Meanwhile more cases of acute poisoning reported from small, micro private enterprises.@*Conclusion@#Although a decline in occupational poisoning cases in Jiangsu, the prevention and treatment measures are still not lax. According to the species of toxic, regional economic differences, the scale of the enterprises and the type of economy, the characteristic key classification and prevention should be carried out. Expand the coverage of hospitals in the diagnosis and reporting of occupational poisoning diseases, and strive to improve the quality of occupational disease reports.
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Objective To compare the epidemiological characteristics of glenoid fractures between the east and west areas in China from 2010 through 2011.Methods The data of glenoid fractures treated between January 2010 and December 2011 at 35 east hospitals and 28 west ones in China were analyzed retrospectively.The patients' gender,age and type of Ideberg classification were documented.The data from the 35 east hospitals were classified as group A while those from the 28 west ones as group B.Comparisons were made to find out the general epidemiological characteristics.Results A total of 347 glenoid fractures were collected.The total male/female ratio was 2.69∶ 1.The glenoid fractures predominated in 2 age ranges from 41 to 50 years and from 51 to 60 years (19.60％).According to the Ideberg classification,there were 75 cases (21.61％) of type Ⅰ,152 ones (43.80％) of type Ⅱ,27 ones (7.78％) of type Ⅲ,20 ones (5.76％) of type Ⅳ,46 ones (13.26％) of type Ⅴ and 27 ones (7.78％) of type Ⅵ.The male/female ratio was 2.80∶1 in group A of 228 patients and 2.50∶1 in group B of 119 patients.The median age of group A was 47 years old and that of group B 44 years old.The differences were not statistically significant in male/female ratio,median age or distribution of age between the 2 groups (P ＞ 0.05).The fractures predominated in the age range from 51 to 60 years old (23.68％) in group A and in the age range from 31 to 40 years old (21.85％) in group B.The most frequent fracture type was type Ⅱin both groups,accounting for 41.23％ and 48.74％ respectively.There was a significant difference between the 2 groups in distribution of Ideberg classification (P ＜ 0.05).Conclusions The peak age of glenoid fractures was from 41 to 60 years,the high-risk type was Ideberg type Ⅱ and there were more male patients than female ones.The proportion of Ideberg type Ⅴ in the east area was higher than that in the west area.
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Objective To compare the epidemiological characteristics of scapular neck fracture between the east and west areas in China from 2010 through 2011.Methods Tbe data of scapular neck fractures treated between January 2010 and December 2011 at 35 east hospitals and 28 west ones were analyzed retrospectively.The patients' gender,age and Miller classification were documented.The data from the 35 east hospitals were classified as group A while the data from the 28 west ones as group B.Comparisons were made to find out the general epidemiological characteristics.Results A total of 584 scapular neck fractures were collected.The total male/female ratio was 3.46∶ 1.The scapular neck fractures predominated in an age range from 41 to 50 years (25.17％).According to the Miller classification,there were 150 cases (25.68％) of type Ⅰ,306 ones (52.40％) of type Ⅱ and 128 ones (21.92％) of type Ⅲ.426 cases (72.95％) were stable fractures and 158 ones (27.05％) unstable fractures.The male/female ratio was 3.64∶1 in group A of 427 patients and 3.03∶1 in group B of 157 patients.There were no significant differences between the 2 groups in male/female ratio (P ＞ 0.05).The median age of group A (44 years) was significantly older than that of group B (39 years).The fractures predominated in an age range from 41 to 50 years (24.36％) in group A and in the age range from 31 to 40 years (36.31％) in group B.The most frequent fracture type was type Ⅱ in both groups,accounting for 51.52％ and 54.78％ respectively.There were no significant differences between the 2 groups in distribution of Miller classification (P ＞ 0.05).Conclusions The peak age of scapular neck fractures was from 41 to 50 years,the high-risk type was Miller type Ⅱ and stable fractures were more common.There were more male patients than female ones.The median age in the east area was older than that in the west area.
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Objective To compare and analyze the epidemiological features of adult tibial plateau fractures from 2010 to 2011 between West China and East China.Methods The data of adult patients with tibial plateau fracture treated from January 2010 to December 2011 in 63 hospitals from West China and East China were collected through the PACS system and case reports checking system.The data of 28 hospitals from West China were classified as West group while the data of 35 hospitals from East China as East group.The analytic items included gender,age,age distribution and type of Schaztker classification.Results A total of 4,603 adult tibial plateau fractures were collected.The largest age proportion was from 41 to 50 years,with 41 to 50 years in males and 51 to 60 years in females.The highest age proportion in group A was from 51 to 60 years,and that in group B was from 41 to 50 years,showing significant differences between the 2 groups in age distribution (P ＜ 0.05).There were 3,346 cases in group A,including 2,438 males and 998 females with a male to female ratio of 2.35:1;there were 1,257 cases in group A,including 821 males and 436 females with a male to female ratio of 1.88:1.There were significant differences between the 2 groups in gender distribution (P ＜ 0.05).The high-risk fracture type was Schaztker type Ⅵ in both groups,with 898 cases in group A and 411 ones in group B;the lowest fracture type was Schaztker type Ⅴ in both groups,with 214 cases in group A and 149 ones in group B.There were significant differences between the 2 groups in fracture type ratios (P ＜ 0.05).Conclusions Adult tibial plateau fractures predominated in males in both East and West China.The average age of the patients from East China was higher than that from West China.The high-risk type was Schaztker type Ⅵ in both areas.
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Objective To study the epidemiological features of the endemic arsenism in Hohhot of Inner Mongolia in 2004-2006 in order to get scientific evidence for the control and prevention. Methods The historical data in Huhhot revealed that 51 arsenic villages in 3 counties(Tumotezuo,Tuoketuo and Helingeer) were investigated. When arsenic content in drinking water was 0.05-0.15 mg/L,the situation of endemic arsenism was investigated in the households having high arsenic contents of water. When arsenic content in drinking water was greater than 0.15 mg/L,the survey was conducted to investigate arsenic patients with census. Census rate was not lower than 90%. Patients of endemic amenism were diagnosed by The Standard of Diagnosis for Endemic Arsenism (WS/T 211-2001). Results A total 28 083 people were examined,3978 were determined to be patients with arsenism,including 1722 being suspicious, 1897 mild,329 secondary and 30 severe. The total incidence of arsenism was 14.17% (3978/28 083),while the incidence of suspicious,mild,secondary and severe disease was 6.13% (1722/28 083) ,6.75% (1897/28 083),1.17% (329/28 083) and 0.11% (30/28 083),respectively. Suspicious and mild patients were most frequently seen. The incidence of dyspigmentation,pigmentation,ketatoses,both dyspigmentation and pigmentation and all of skin disorders was 8.65% (2428/28 083),3.19% (895/28 083),6.48% (1821/28 083),2.13%(598/28 083) and 0.94%(265/28 083),respectively. The most seen skin disorders were dyspigmentation and ketatoses. The disease mostly occurred in those aged over 40 years,the incidence was 89.52% (3561/3978). The incidence of male [15.08%(2209/14 644)]was more than that of female[13.16%(1769/13 439)].Conclusions Current condition of arsenism in Hohhot is mild,arsenic disease surveillance should keep going. Prevention and control needs to be reinforced in the future.
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The present paper introduces the definition of prehypertension,summarizes the advances in prehypertensive epidemiology and focus of debate and suggests the outlook of prehypertension.
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The virus family Arenaviridae is a diverse group of RNA viruses and includes the etiologic agents of several emerging zoonoses that are characterized by high case-fatality rates.The purpose of this article is to review the major features of the zoonotic arenaviruses from the angles of their taxonomy and classification,epidemiology and ecology,mode of transmission,clinical signs,prevention and control,etc.Which are important for the reason that viruses causing severe disease in humans are re-emerging somewhere the world.
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Objective To investigate the basic distribution of endemic areas in the type of drinking water arsenism and in Xiantao City,Hubei Province,and to offer a scientific basis for control and prevention.Methods According to"the Chinese Scheme of Implementing Surveillance of Distribution of Endemic Arsenism",considering with the special geography feature of Xiantao,both sampling and overall survey were used in 7 towns chosen.The water arsenic content was determined by half quantitative fast reagent-box method.We began to search for clues and patients according to the endemic areas and the families with high arsenic wells.Results High endemic arsenic water sources were distributed in 7 the towns(districts or farms).In 81 villages of Xiantao City,35 villages had drinking water arsenic content exceeding 0.05 mg/L,accounting for 43.21%(35/81).In 4020 screened wells,269 had arsenic content higher than the national standard,the detective rate of high arsenic wells(more than 0.05 mg/L)was 6.69%(269/4020),with the highest rate in Shahu Seed Plant being 13.56%(115/848).The population exposed to high arsenic was 1091,in a rate of 5.75%(1091/18 975),in which 281 children were exposed in a rate of 5.82%(281/4826).In Shahu Seed Plant,467 people including 129 children were exposed to high arsenic, accounting for 13.26%(467/3522)and 12.91%(129/999),respectively.Conclusions High arsenic sources widely exist in Xiantao City,especially in Shahu Seed Plant,where arsenic content,the exposed rate of population and children are high.Therefore,prevention and control should be carried out in the southeast as soon as possible,as well as in other places where situation is less serious.