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@#Abstract: Objective To analyze the incidence of pulmonary tuberculosis infection in the elderly(≥ 65 years old) in Xianning City from 2011 to 2021, and to provide scientific basis for formulating strategies and measures for tuberculosis prevention and treatment in the elderly. Methods Descriptive epidemiological analysis was used to analyze the epidemic characteristics and influencing factors of elderly (this article studies elderly people aged 65 and above) pulmonary tuberculosis in Xianning City, Hubei Province from 2011 to 2021. Results From 2011 to 2021, the average annual registration rate of elderly patients with pulmonary tuberculosis in Xianning City, Hubei Province was 211.52/100 000 (5 289/2 500 496), which showed a downward trend （χ2 trend=58.06, P<0.05), and significantly higher than the average registration rate of 96.04/100 000 patients with pulmonary tuberculosis (26 463/27 554 195)(χ2=2 896.69, P<0.05). The average proportion of the registered number of elderly patients with pulmonary tuberculosis in the whole population was 19.99% (5 289/26 463), which showed an upward trend (χ2trend=272.05, P<0.05). The average positive rate of etiology in elderly patients with pulmonary tuberculosis was 51.86% (2 743/5 289), which was significantly higher than that in the whole population 46.41% (12 282/26 463) (χ2=52.53, P<0.05). The average proportion of retreated patients in elderly patients with pulmonary tuberculosis was 8.92% (472/5 289), which was significantly higher than that of retreated patients in the whole population 6.33% (1 674/26 463) (χ2=47.23, P<0.05). The sex ratio of male to female in elderly patients with pulmonary tuberculosis was 2.92∶1. Among the six counties (districts) under the jurisdiction of Xianning City, Hubei Province the registration rate of elderly tuberculosis patients in Xian'an district was the highest 262.20/100 000 (1 267/483 220), and that in Tongcheng County was the lowest 123.83/100 000 (575/464 338), with significant differences (χ2=233.67, P<0.05). Conclusion The overall incidence of tuberculosis in the elderly in Xianning City , Hubei Province showed a downward trend, but the proportion of the incidence of tuberculosis in the elderly in the whole population has increased year by year, suggesting that the elderly are the key population of tuberculosis prevention and control in Xianning City in the future, and comprehensive prevention and control measures should be taken to reduce the incidence of tuberculosis in the elderly population.
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ObjectiveTo understand the epidemiological characteristics of influenza in Jingzhou from 2016 to 2021， so as to provide scientific evidence for the formulation of influenza prevention and control policies in this region， and effectively protect people's health. MethodsData of influenza-like illness （ILI） and pathogen surveillance in Jingzhou during 2016‒2021 were collected and statistically analyzed. ResultsA total of 46 272 ILI cases were reported from two hospitals in Jingzhou City from 2016 to 2021. The difference in the constituent ratio of ILI was statistically significant among different age groups （P<0.05）. A total of 12 812 specimens were collected from two hospitals for influenza surveillance. A total of 1 513 cases were RNA positive，and the positive rate of influenza virus nucleic acid detection was 11.81％. The RNA positive specimens were mainly B （Victoria）， accounting for 39.33％. There were statistically significant differences in the positive rate of influenza virus nucleic acids and different types of influenza virus nucleic acids among different years （P<0.05）. ConclusionThe influenza epidemic in Jingzhou peaks in winter and spring， and the new A （H1），A （H3）， B （Victoria） and B （Yamagata） types alternate and mixed epidemics dominate.
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Objective To examine the impact of COVID-19 pandemic on the epidemic status of imported malaria and national malaria control program in China, so as to provide insights into post-elimination malaria surveillance. Methods All data pertaining to imported malaria cases were collected from Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region during the period from January 1, 2018 through December 31, 2021. The number of malaria cases, species of malaria parasites, country where malaria parasite were infected, diagnosis and treatment after returning to China, and response were compared before (from January 1, 2018 to January 22, 2020) and after the COVID-19 pandemic (from January 23, 2020 to December 31, 2021). Results A total of 2 054 imported malaria cases were reported in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region during the period from January 1, 2018 to December 31, 2021, and there were 1 722 cases and 332 cases reported before and after the COVID-19 pandemic, respectively. All cases were reported within one day after definitive diagnosis. The annual mean number of reported malaria cases reduced by 79.30% in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region after the COVID-19 pandemic (171 cases) than before the pandemic (826 cases), and the number of monthly reported malaria cases significantly reduced in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region since February 2020. There was a significant difference in the constituent ratio of species of malaria parasites among the imported malaria cases in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region before and after the COVID-19 pandemic (χ2 = 146.70, P < 0.05), and P. falciparum malaria was predominant before the COVID-19 pandemic (72.30%), while P. ovale malaria (44.28%) was predominant after the COVID-19 pandemic, followed by P. falciparum malaria (37.65%). There was a significant difference in the constituent ratio of country where malaria parasites were infected among imported malaria cases in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region before and after the COVID-19 pandemic (χ2 = 13.83, P < 0.05), and the proportion of malaria cases that acquired Plasmodium infections in western Africa reduced after the COVID-19 pandemic that before the pandemic (44.13% vs. 37.95%; χ2 = 4.34, P < 0.05), while the proportion of malaria cases that acquired Plasmodium infections in eastern Africa increased after the COVID-19 pandemic that before the pandemic (9.58% vs. 15.36%; χ2 = 9.88, P = 0.02). The proportion of completing case investigation within 3 days was significantly lower after the COVID-19 pandemic than before the pandemic (96.69% vs. 98.32%; χ2= 3.87, P < 0.05), while the proportion of finishing foci investigation and response within 7 days was significantly higher after the COVID-19 pandemic than before the pandemic (100.00% vs. 98.43%; χ2 = 3.95, P < 0.05). Conclusions The number of imported malaria cases remarkably reduced in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region of China during the COVID-19 pandemic, with a decreased proportion of completing case investigations within 3 days. The sensitivity of the malaria surveillance-response system requires to be improved to prevent the risk of secondary transmission of malaria due to the sharp increase in the number of imported malaria cases following the change of the COVID-19 containment policy.
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Objective To identify the spatial distribution pattern of Oncomelania hupensis spread in Hubei Province, so as to provide insights into precision O. hupensis snail control in the province. Methods Data pertaining to emerging and reemerging snails were collected from Hubei Province from 2020 to 2022 to build a spatial database of O. hupensis snail spread. The spatial clustering of O. hupensis snail spread was identified using global and local spatial autocorrelation analyses, and the hot spots of snail spread were identified using kernel density estimation. In addition, the correlation between environments with snail spread and the distance from the Yangtze River was evaluated using nearest-neighbor analysis and Spearman correlation analysis. Results O. hupensis snail spread mainly occurred along the Yangtze River and Jianghan Plain in Hubei Province from 2020 to 2022, with a total spread area of 4 320.63 hm2, including 1 230.77 hm2 emerging snail habitats and 3 089.87 hm2 reemerging snail habitats. Global spatial autocorrelation analysis showed spatial autocorrelation in the O. hupensis snail spread in Hubei Province in 2020 and 2021, appearing a spatial clustering pattern (Moran’s I = 0.003 593 and 0.060 973, both P values < 0.05), and the mean density of spread snails showed spatial aggregation in Hubei Province in 2020 (Moran’s I = 0.512 856, P < 0.05). Local spatial autocorrelation analysis showed that the high-high clustering areas of spread snails were mainly distributed in 50 settings of 10 counties (districts) in Hubei Province from 2020 to 2022, and the high-high clustering areas of the mean density of spread snails were predominantly found in 219 snail habitats in four counties of Jiangling, Honghu, Yangxin and Gong’an. Kernel density estimation showed that there were high-, secondary high- and medium-density hot spots in snail spread areas in Hubei Province from 2020 to 2022, which were distributed in Jingzhou District, Wuxue District, Honghu County and Huangzhou District, respectively. There were high- and medium-density hot spots in the mean density of spread snails, which were located in Jiangling County, Honghu County and Yangxin County, respectively. In addition, the snail spread areas negatively correlated with the distance from the Yangtze River (r = −0.108 9, P < 0.05). Conclusions There was spatial clustering of O. hupensis snail spread in Hubei Province from 2020 to 2022. The monitoring and control of O. hupensis snails require to be reinforced in the clustering areas, notably in inner embankments to prevent reemerging schistosomiasis.
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Objective To analyze the trends of human schistosomiasis prevalence in Hubei Province from 2004 to 2018, so as to provide the evidence for formulating the schistosomiasis elimination strategy in the province. Methods All data pertaining to human schistosomiasis prevalence in Hubei Province were collected from 2004 to 2018, and the trends for changes in seroprevalence, egg-positive rate and prevalence of human Schistosoma japonicum infection were analyzed using a Joinpoint regression model. Results Both of the numbers of residents seropositive and egg-positive for S. japonicum infections appeared a tendency towards a decline in Hubei Province from 2004 to 2018, and the prevalence of human S. japonicum infections reduced from 6.85% in 2004 to 0 in 2018. Joinpoint regression analysis showed that the prevalence of human S. japonicum infections appeared an overall tendency towards a reduction in Hubei Province from 2004 to 2018 [average annual percent change (AAPC) = −24.1%, P < 0.01], and the trends for the reduction were both significant during the period from 2004 to 2006 [annual percent change (APC) = −35.1%, P < 0.01] and from 2006 to 2018 (APC = −22.1%, P < 0.01). The prevalence of human S. japonicum infections appeared a tendency towards a decline in islet (AAPC = −25.1%, P < 0.01), inner embankment (AAPC = −26.4%, P < 0.01) and hilly subtypes of schistosomiasis-endemic areas (AAPC = −32.5%, P < 0.01) of Hubei Province from 2004 to 2018, and the prevalence all appeared a tendency towards a decline during the infection control stage (from 2004 to 2008), the transmission control stage (from 2009 to 2013) and the transmission interruption stage (from 2014 to 2018) (AAPC = −28.0%, −24.4% and −63.8%, all P values < 0.01). The seroprevalence of human S. japonicum infections appeared an overall tendency towards a decline in Hubei Province from 2004 to 2018 (AAPC = −14.5%, P < 0.01), and the trends for the reduction were both significant during the period from 2004 to 2012 (APC = −8.4%, P < 0.01) and from 2012 to 2018 (APC = −22.1%, P < 0.01). In addition, the egg-positive rate of human S. japonicum infections appeared an overall tendency towards a decline in Hubei Province from 2004 to 2018 (AAPC = −30.6%, P < 0.05), and the trend for the reduction was significant during the period from 2007 to 2014 (APC = −15.5%, P < 0.01). Conclusions The prevalence of human schistosomiasis appeared a tendency towards a decline in Hubei Province from 2004 to 2018, and the islet and inner embankment subtypes of endemic areas are a high priority for schistosomiasis control during the stage moving towards elimination in Hubei Province.
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Objective:To explore the quality management strategy of clinical blood utilization by analyzing the quality control indexes of clinical blood transfusion in Hubei province from 2018 to 2020.Methods:The quality control indexes of clinical blood utilization in 244 secondary or above hospitals in Hubei province from 2018 to 2020 were investigated, including the number of professional and technical personnel per thousand units of blood transfusion, the internal quality control rate of blood transfusion compatibility test, the participation rate of external quality evaluation in blood transfusion compatibility test, the per capita blood consumption of discharged patients, and the development rate of autologous blood transfusion for patients undergoing surgery, and the differences of each index were compared and analyzed.Results:The indexes in Hubei province showed an increasing trend from 2018 to 2020, but there was no significant difference( P>0.05). The distribution of each index in Hubei province was unbalanced( P<0.05). The average blood consumption of discharged patients(0.13±0.14 U), the internal quality control rate of blood transfusion compatibility test(84.92%), the participation rate of external quality evaluation of blood transfusion compatibility test(93.65%) and the development rate of autologous blood transfusion(55.56%) in the tertiary hospitals were significantly higher than those in the secondary hospitals(0.09±0.10 U, 43.22%, 55.08%, 29.66%), while the number of professional and technical personnel of blood transfusion in thousand units(1.34±1.43) in the tertiary hospitals was significantly lower than that in secondary hospitals(2.41±2.39)( P<0.05). The average blood consumption of discharged patients(0.12±0.11 U), the participation rate of external quality evaluation of blood transfusion compatibility(82.18%) and the development rate of autologous blood transfusion(62.64%) in general hospitals were significantly higher than those in specialized hospitals(0.08±0.13 U, 68.57%, 27.14%), while the number of professional and technical personnel in thousand units of blood transfusion(1.44±1.60) was significantly lower than that in specialized hospitals(2.88±2.53)( P<0.05). The internal quality control rate(73.73%), the participation rate of external quality evaluation(87.10%) and the development rate of autologous blood transfusion(52.07%) in public hospitals were significantly higher than those in private hospitals(29.63%, 51.85%, 25.93%), however, the number of professional and technical personnel in blood transfusion(1.70±1.98) was lower than that in private hospitals(3.95±3.21)( P<0.05). Conclusions:The overall quality of clinical blood utilization in Hubei has been steadily increasing. However, the quality of clinical blood was not balanced among different areas. The overall clinical blood utilization quality of tertiary hospitals was significantly higher than the secondary hospitals, the general hospitals was significantly higher than the specialized hospitals, and the public hospitals was significantly higher than the private hospitals. The professional and technical personnel of blood transfusion in tertiary, general and public hospitals need to be strengthened.
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Objective To analyze the incidence and mortality of male breast cancer in Hubei Province from 2012 to 2015. Methods The data reported by the Hubei Provincial Cancer Registry from 2012 to 2015 were collected for analyzing the incidence and mortality trends of male breast cancer according to year, urban and rural areas and age. We also compared the difference of incidence and mortality between male and female breast cancer. Results A total of 106 new cases of male breast cancer were reported in Hubei Cancer Registry from 2012 to 2015 with an incidence rate of 0.43/105, and 10052 new cases of female breast cancer with an incidence rate of 42.76/105; the male-to-female incidence ratio was 1:99. Male breast cancer death cases was 37 with the death rate of 0.15/105, and female breast cancer death cases was 2201 with the death rate of 9.36/105; the male-to-female mortality ratio was 1:62. The incidence and mortality of breast cancer between male and female varied by year, urban and rural areas. Male breast cancer was less common in young men (< 35 years old), and the incidence increased with age after 35 years old; male breast cancer deaths were rare in men under 45 years old, and the mortality rate increased with age. The incidence and mortality of male breast cancer patients over 85 years old reached the peak. Conclusion Male breast cancer is rare in clinical practice, and the incidence rate is much lower than that of female breast cancer. Even so, it is necessary to study the epidemiological law of male breast cancers' incidence and mortality, which can be used for prevention and treatment of male breast cancer.
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The general epidemic characteristics of seven key human parasitic diseases in Hubei Province, including schistosomiasis, malaria, filariasis, kala-azar (visceral leishmaniasis), soil-transmitted helminth infection, food-borne parasitic diseases, and echinococcosis, is reviewed in order to analyze the current epidemic situation and trend. At present, the epidemic of parasitic diseases has dropped to the lowest level in history in Hubei Province, but there still exists high risk of infections in some local areas. Along with the deepening of global economic integration and the implementation of the strategy of "the Belt and Road", and the expanding of dietary spectrum for human pursuing diversified material and cultural life, we are facing the transmission risk from imported parasitic diseases and rare parasitic diseases. Current monitoring efforts have been weakened due to the decline in work supporting measures. There will be potential risks of local outbreaks if an epidemic is not effectively controlled in time. It is recommended to maintain the multi-sectoral cooperation mechanism under the leadership of the government, further improve capacity building to ensure a capable and stable professional team for the prevention and control of parasitic diseases, and to increase the monitoring of parasitic diseases during the "14th Five-Year Plan" period, so as to consolidate the achievements of parasitic disease prevention and control and promote the health of people in Hubei Province.
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Objective To establish an indicator system for assessment of schistosomiasis transmission risk after transmission interruption in Hubei Province, so as to provide insights into the precise control of schistosomiasis. Methods The indicator system was preliminarily established based on data collection, literature review, expert interviews. Two rounds of expert consultation were performed. The indicator system was screened based on the importance, operability, sensitivity and comprehensive score of the indicators, and the weights of each indicator were calculated. The credibility of the Delphi method was evaluated by calculating the active coefficient of the experts, degree of expert authority and coordination levels of experts’ opinions. Results An indicator system for assessment of schistosomiasis transmission risk was preliminarily established, including 3 primary indicators, 12 secondary indicators and 44 tertiary indicators. A Delphi consultation was performed among 17 experts participating in schistosomiasis control, management and research. Following two rounds of consultation, a risk assessment indicator system was finally constructed, including 3 primary indicators, 10 secondary indicators and 35 tertiary indicators. Among the primary indicators, the variable with the highest normalized weight was the current status of schistosomiasis (0.420 2), followed by social factors (0.397 3) and natural environments (0.182 5). Among the secondary indicators, those with high combined weights included risk monitoring (0.142 3), current snail status (0.140 1), and current prevalence of human and livestock infections (0.137 8). Among the tertiary indicators, those with high combined weights included the positive rate of wild feces (0.049 8), the prevalence of snail infections (0.047 4), and the area of snail habitats submerged by floods (0.046 8). During the two-round consultation, the active coefficients of the experts were 85.00% and 100.00%, the degree of expert authority was both 0.75 and greater, and the coordination levels of experts’ opinions were 0.405 to 0.521 and 0.592 to 0.695 (all P values < 0.05). Conclusion An indicator system for assessment of schistosomiasis transmission risk is successfully established after transmission interruption in Hubei Province based on the Delphi method, which provides insights into the identification of the schistosomiasis transmission risk and the targets for schistosomiasis control in Hubei Province.
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ObjectiveTo analyze the re-examination results of malaria cases captured from the National Notifiable Communicable Disease Reporting System in Hubei Provincial Malaria Diagnostic Reference Laboratory from 2017 to 2019, so as to pro- vide the scientific evidence for improving the malaria control capability in the province. MethodsMicroscopy and nested PCR assay were performed to re-examine the diagnosis of malaria cases registered in the National Notifiable Communicable Disease Reporting System in Hubei Provincial Malaria Diagnostic Reference Laboratory from 2017 to 2019, and the coincidences of ma- laria diagnosis and malaria parasite species were evaluated. Results A total of 410 malaria cases were reported in Hubei Province from 2017 to 2019 according to the data retrieved from the National Notifiable Communicable Disease Reporting System. Among the 407 samples re-examined by Hubei Provincial Malaria Diagnostic Reference Laboratory from 2017 to 2019, the diag- nosis 374 malaria cases were confirmed, with an overall coincidence of 91.89% (374/407) for malaria diagnosis and 89.04% (333/374) for parasite species identification. The coincidence rates of malaria diagnosis and parasite species identification were 50.00% to 100.00% and 66.67% to 100.00% in 16 cities (prefectures) of Hubei Province during the re-examinations, which both varied in regions (χ2 = 40.46 and 42.30, both P values < 0.01). The coincidence rates of Plasmodium falciparum, P. vivax, P. malariae and P. ovale identification were 95.80%, 100.00%, 58.33% and 51.92% during the re-examinations, respectively (χ2 = 76.66, P < 0.01). The consistency rate between microscopic and nested PCR results was 89.83% (362/403). Conclusions The overall diagnostic quality of malaria is high in medical institutions at all levels in Hubei Province; however, the diagnostic capability of malaria remains to be improved in some regions.
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ObjectiveTo analyze the changing tendency in the endemic situation of schistosomiasis in the national surveillance sites of Hubei Province, so as to provide the scientific evidence for facilitating the progress towards the elimination of schistosomiasis in the province. Methods According to the National Schistosomiasis Surveillance Scheme (2014 version), a total of 65 national schistosomiasis surveillance sites were assigned in Hubei Province, and the Schistosoma japonicum infections in humans, domestic animals, snails and wild feces were monitored in these national surveillance sites from 2015 to 2019. All data pertaining to the surveillance results were descriptively analyzed. Results There were 151 159 person-time local residents and 70 928 person-time mobile populations screened for S. japonicum infections in the 65 national surveillance sites of Hubei Province from 2015 to 2019, and the seroprevalance of S. japonicum infections reduced from 3.45% (1 077/31 197) in 2015 to 1.57% (431/27 371) in 2019 among local residents and from 1.06% (98/9 249) in 2015 to 0.81% (116/14 318) in 2019 among mobile populations. During the period from 2015 through 2019, there were 22 egg-positive local residents and 2 egg-positive mobile populations identified in 2015, with 0.07% and 0.02% prevalence rates of S. japonicum infections, respectively. During the 5-year period, a total of 7 025 herd-time domestic animals examined for S. japonicum infections, with no infections detected, and a total of 2 035 wild feces were tested, with no egg-positives identified in the 65 national surveillance sites of Hubei Province. Snail survey was conducted covering 28 767.35 hm2 during the 5-year period, and the area of snail habitats ranged from 1 609.82 to 2 119.81 hm2. The mean density of living snails and occurrence of frames with snails reduced from 0.360 5 snails/0.1 m2 and 11.26% in 2015 to 0.175 9 snails/0.1 m2 and 8.43% in 2019, respectively, and no S. japonicum infection was found in snails during the 5-year period. In addition, no snails were found in the potential schistosomiasis transmission foci in the two national surveillance sites in the Three Gorges Dam. Conclusions The overall endemic situation of schistosomiasis appears a tendency towards a decline in Hubei Province during the period from 2015 through 2019; however, the schistosomiasis transmission risk remains. Improving the surveillance system of schistosomiasis and increasing the sensitivity and performance of the surveillance system are required to provide insights into the implementation of precision control strategy and interventions in Hubei Province.
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Objective To systematically evaluate the completion and implementation effect of the medium-long-term program for schistosomiasis control in Tianmen City, and to provide references for formulating the next-stage control plan. Methods According to "National Medium-long-term Plan for Prevention and Control of Schistosomiasis (2004-2015) Final Evaluation Scheme", data on population, livestock, and infection status of snails in Tianmen City from 2004-2019 was retrospectively collected database was established with Excel. SPSS 19.0 software was used for statistical analysis to evaluate the achievement of goals, and task completion and implementation effects. SaTScan was used to detect the aggregation area of schistosomiasis cases. Results From 2004 to 2019, Tianmen City completed the planned tasks. All 23 villages and towns in the epidemic area reached the transmission interruption standard. In 2004, the infection rate of schistosomiasis among the residents was lower than 0.01%, then decreased to 0 in 2015, with no acute cases occurring for 11 consecutive years. In 2004, the infection rate of farm cattle in the city was 3.5%, and it then decreased to 0 in 2011. The area of snails increased from 2.4735 million square meters in 2004 to 5.132 million square meters in 2010, and no infectious snails was detected after 2009. The awareness rate of schistosomiasis knowledge and correct behavior formation rate of primary and secondary school students and housewives in the city exceeded 95%. Through spatial distribution analysis, schistosomiasis cases in Tianmen City showed a certain aggregation. Conclusion The medium-long-term program for the prevention and control of schistosomiasis in Tianmen City from 2004 to 2019 achieved the expected results. The overall epidemic situation declined year by year, but schistosomiasis control still faces many challenges.
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Objective To investigate the distribution of Oncomelania snails in Four-Lake Basin of Hubei Province, so as to provide scientific evidence for the development of snail control interventions. Methods The snail distribution was surveyed by means of the retrospective study and cross-sectional survey in the Four-Lake Basin in Spring of 2016. The data pertaining to the endemic situation of schistosomiasis were collected and analyzed in the Four-Lake Basin from 2008 to 2018, and the associations of snail habitat areas with the prevalence of Schistosoma japonicum in humans and bovines were examined. Results There were 16 003 snail habitats in the 9 schistosomiasis-endemic counties (districts) in the Four-Lake Basin in 2016, covering an area of 246 million m2. The mean density of living snails was 0.622 5 snails/0.1 m2, which was relatively high in weed-type settings (0.688 0 snails/0.1 m2) and ditches (0.706 4 snails/0.1 m2). Type I (current snail habitats, 53.03%) and Ⅱ- Ⅳ (historical snail habitats, 46.97%) settings were predominant snail habitats. A big change was seen in snail habitats in dry farmland, marshland and paddy farmland, and environmental modification resulted in satisfactory snail control effectiveness. In addition, the area of snail habitats positively correlated with the changes in the prevalence of S. japonicum infections in humans (r = 0.842, P < 0.01) and livestock (r = 0.695, P < 0.01). Conclusions The integrate strategy with an emphasis on the control of the source of S. japonicum infections results in remarkable snail control effectiveness in the Four-Lake Basin; however, there is a risk of re-emerging snail habitats.
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Objective To provide reference for formulating scarlet fever prevention and control strategies by analyzing the epidemiological characteristics and predicting the incidence trend of scarlet fever. Methods Spearman correlation analysis, clustering analysis, seasonal index model and seasonal ARIMA model were used for analysis and prediction. Results The average annual incidence of scarlet fever in 2010-2018 was 1.37/100 000, and there was a positive correlation between annual incidence and year (rs=0.817,P=0.007). April-June and November-December were high incidence months. The clustering analysis was significant(F=4795.30，P<0.001), showing that the high-incidence areas are Shennongjia, Yichang, Enshi, Wuhan. Reported cases were concentrated in 1-14 years old, mainly for students, child care children and scattered children. The incidence rate of males was higher than that of females. The optimal model is ARIMA(0,1,1)(0,1,0)12. The prediction showed that the monthly incidence characteristics of 2019 were consistent with previous years, and the annual incidence rate was 10.22/100 000(95% CI:2.33/100 000-30.43/100 000), which was higher than the incidence of 2018. Conclusions The incidence of scarlet fever in Hubei Province is generally on the rise from 2010 to 2018. The incidence is bimodal. Students are the main disease group. The incidence rate of males is higher. The incidence is mainly concentrated in the mountainous areas of southwest and capital cities. The ARIMA model has a good applicability in the prediction of scarlet fever. The incidence level will continue to rise in 2019, and it is necessary to strengthen monitoring and control measures with reference to epidemiological characteristics.
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Background@#A novel coronavirus (2019-nCoV) causing an outbreak of pneumonia in Wuhan, Hubei province of China was isolated in January 2020. This study aims to investigate its epidemiological history, and analyzed the clinical characteristics, treatment regimens and prognosis of patients infected with 2019-nCoV during this outbreak.@*Methods@#Clinical data from 137 2019-nCoV-infected patients admitted to the respiratory departments of nine tertiary hospitals in Hubei province from December 30, 2019 to January 24, 2020 were collected, including general status, clinical manifestations, laboratory test results, imaging characteristics, and treatment regimens.@*Results@#None of the 137 patients (61 males, 76 females, aged 20-83 years, mean age 55 ± 16 years) had a definite history of exposure to Huanan Seafood Wholesale Market. Major initial symptoms included fever (112/137, 81.8%), coughing (66/137, 48.2%), and muscle pain or fatigue (44/137, 32.1%), with other, less typical initial symptoms observed at low frequency, including heart palpitations, diarrhea, and headache. Nearly 80% of the patients had normal or decreased white blood cell counts, and 72.3% (99/137) had lymphocytopenia. Lung involvement was present in all cases, with most chest computed tomography scans showing lesions in multiple lung lobes, some of which were dense; ground-glass opacity co-existed with consolidation shadows or cord-like shadows. Given the lack of effective drugs, treatment focused on symptomatic and respiratory support. Immunoglobulin G was delivered to some critically ill patients according to their condition. Systemic corticosteroid treatment did not show significant benefits. Notably, early respiratory support facilitated disease recovery and improved prognosis. The risk of death was primarily associated with age, underlying chronic diseases, and median interval from the appearance of initial symptoms to dyspnea.@*Conclusions@#The majority of patients with 2019-nCoV coronavirus pneumonia present with fever as the first symptom, and most of them still showed typical manifestations of viral pneumonia on chest imaging. Middle-aged and elderly patients with underlying comorbidities are susceptible to respiratory failure and may have a poorer prognosis.
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Objective To analyze the epidemiological characteristics of measles, predict the incidence trend of the disease, and provide reference for the development of measles prevention and elimination strategies. Methods Descriptive analysis, seasonal index method, clustering analysis and ARIMA model were used for data analysis and trend prediction. Results The average annual incidence of measles in 2005-2018 was 3.01/100,000. It was at a low level after 2009, and rebounded in 2018. The seasonal index of March-June was greater than 1, which was the month of high incidence. The incidence of men was higher than that of women. The 0-3 years old and 10-30 years old groups had a high incidence, and the population was mainly scattered children, students, and nursery children. The areas with high incidence were mainly northwestern and southeastern Hubei. ARIMA (0,1,0) (0,1,1) was the optimal model. The prediction analysis showed that the incidence rate in 2019 will be 1.26/100 000. Conclusion After the implementation of booster immunization, the measles epidemic in Hubei Province was at a low level, but it fluctuated greatly in recent years and is currently showing a rising trend. The incidence was high in spring. Cases were "biphasic shift" in groups 0-3 years old and 10-30 years old. Occupational distribution was consistent with the characteristics of high incidence in the age group. The mountain areas with poor sanitary conditions and economic backwardness, and regions with large population bases and high floating populations had a high incidence. The ARIMA model had good applicability in predicting the trend of measles incidence, which shows measles will continue to rise in 2019.
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Objective To analyze the spatial clustering of human schistosomiasis at the village level in key counties in Hubei Province, to provide scientific evidence for formulating strategies for human schistosomiasis prevention and control in the next stage. Methods Gong'an County and Jiangling County in Hubei Province were selected as representative counties for this study. A town or village was set up as a research unit. Schistosomiasis cases of a positive fecal examination in 2015 and cases with positive detection for schistosomiasis serological antibody titer equal or above 80 in 2016-2018 were selected as research subjects in these two counties. The Kulldorff circular scan statistic was used for the spatial clustering analysis of human schistosomiasis infection status in the population. Results There was spatial clustering of positive schistosomiasis cases of fecal examination, at the level of a town or village in both counties in 2015. There was spatial clustering of positive human serological antibody detection at the level of town or village from 2016-2018. Eighty-six endemic villages in five towns in the northeast of Gong'an County, along the Yangtze river,including Mahaokou Town, Zhakou Town, Yangjiachang Town, Jiazhuyuan Town and Douhuti Town, were the most prominent. There was no spatial clustering of positive results of human serological antibody detection at the town and village level in Jiangling County, in2017, while there was spatial clustering of human serological antibody detection in 2016 and 2018,respectively. Fifty-seven endemic villages in two towns (Puji Town and Xionghe Town) in the southwest of Jiangling County, along the Yangtze river,were the most prominent. Conclusion There were spatial clustering of human schistosomiasis epidemic at village level both in Gong'an County and Jiangling County, Hubei Province. Compared with the previous studies, there was a trend of shrink and decline of clustering areas. Therefore, the current situation of the epidemic has put forward higher requirements for the implementation of precise prevention and control in the progress of schistosomiasis elimination work in various epidemic areas.
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Objective To investigate the spatial distribution of Oncomelania hupensis snail habitats at the administrative village scale in schistosomiasis-endemic areas of Hubei Province, so as to provide scientific bases for precise control of O. hupensis snails in the province. Methods Data regarding snail distribution at the village level in Hubei Province in 2017 were collected to create a spatial analysis database of snail distribution in Hubei Province. The spatial aggregations of O. hupensis distribution were analyzed using Moran’s I index and Local Moran’s I index. In addition, the distances from schistosomiasis-endemic villages to the Yangtze River were captured using the software ArcGIS 13.0, and their correlations with area of snail habitats were examined with the Spearman correlation method. Results O. hupensis snails were mainly distributed in 5 450 endemic villages from 63 counties of 13 cities in Hubei Province in 2017. The global spatial autocorrelation analysis showed spatial aggregations in the areas of historically accumulated snail habitats, current areas of snail habitats, areas of snail habitats outside the embankment and snail habitats inside the embankment (all Z Scores > 0, all P values < 0.05), and no spatial aggregation was seen in the areas of snail habitats in hilly areas (Z Score > 0, P > 0.05). There were four types of spatial distribution of historically accumulated areas of snail habitats, areas of current snail habitats, areas of snail habitats outside the embankment and snail habitats inside the embankment, including the high-high type (H-H type), high-low type (H-L type), low-high type (L-H type) and random distribution type, and a high percentage of the H-H type was found. There were 340, 125 and 110 endemic villages with the H-H type of areas of historically accumulated snail habitats, current areas of snail habitats and areas of snail habitats outside the embankment, and these villages were mainly concentrated in Wuhan and Jingzhou cities, with almost consistent spatial aggregation locations. There were 319 endemic villages with the H-H type of distribution of snail habitats inside the embankment, which were mainly distributed in Jingzhou, Xiaogan and Huangshi cities. In addition, the areas of historically accumulated snail habitats, current areas of snail habitats and areas of snail habitats outside the embankment negatively correlated with the distance from the endemic villages to the Yangtze River (r = −0.094, P < 0.01; r = −0.225, P < 0.01; r = −0.177, P < 0.01). Conclusion The clustering areas of snail habitats along the Yangtze River Basin, notably the villages near the Yangtze River are key regions for snail monitoring and control in Hubei Province.
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Objective To evaluate the health education effect of schistosomiasis in Hubei Province after implementing of the Outline of National Mid-Long-Term Plan for Schistosomiasis Prevention and Control (2004–2015). Methods Based on questionnaires and datum review, the data of health education for integrated prevention and control of schistosomiasis in Hubei Province from 2004 to 2015 were collected to evaluate the effect of health education. Results A total of 16 662 499 schistosomiasis health education publicity materials were distributed, 28 712 times of media propaganda were conducted, 174 506 warning signs were established, 185 985 promotional slogans were issued, 1 212 810 pieces of personal protective equipment were distributed, 9 248 village officer training courses were organized, and 5 569 school teacher training courses in primary and secondary schools were conducted in 63 counties (cities, districts) of 13 cities in Hubei Province from 2004 to 2015. A total of 4 815 people were surveyed in 3 counties in 2015. The awareness rate of schistosomiasis control knowledge was 91.62%, and the correct rates of beliefs and attitudes were 89.54% and 96.91% respectively. The overall rate of correct behavior of the population was 91.91%. The related indicators, such as schistosomiasis infection rate, acute infection cases, and others, declined year by year over the same period. Conclusions The schistosomiasis health education in Hubei Province has obvious effects on enhancing the knowledge and attitudes of schistosomiasis control in populations and promoting the formation of correct schistosomiasis control behavior among residents. It has played an active role and is an important mean in comprehensive prevention and control of schistosomiasis.
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Objective To evaluate the health education effect of schistosomiasis in Hubei Province after implementing of the Outline of National Mid-Long-Term Plan for Schistosomiasis Prevention and Control (2004–2015). Methods Based on questionnaires and datum review, the data of health education for integrated prevention and control of schistosomiasis in Hubei Province from 2004 to 2015 were collected to evaluate the effect of health education. Results A total of 16 662 499 schistosomiasis health education publicity materials were distributed, 28 712 times of media propaganda were conducted, 174 506 warning signs were established, 185 985 promotional slogans were issued, 1 212 810 pieces of personal protective equipment were distributed, 9 248 village officer training courses were organized, and 5 569 school teacher training courses in primary and secondary schools were conducted in 63 counties (cities, districts) of 13 cities in Hubei Province from 2004 to 2015. A total of 4 815 people were surveyed in 3 counties in 2015. The awareness rate of schistosomiasis control knowledge was 91.62%, and the correct rates of beliefs and attitudes were 89.54% and 96.91% respectively. The overall rate of correct behavior of the population was 91.91%. The related indicators, such as schistosomiasis infection rate, acute infection cases, and others, declined year by year over the same period. Conclusions The schistosomiasis health education in Hubei Province has obvious effects on enhancing the knowledge and attitudes of schistosomiasis control in populations and promoting the formation of correct schistosomiasis control behavior among residents. It has played an active role and is an important mean in comprehensive prevention and control of schistosomiasis.