Epidemiological characteristics of Yersinia enterocolitica in patients with diarrhea from 2013 to 2019 in Pudong New Area, Shanghai / 中华预防医学杂志

Objective: To investigate the epidemiological characteristics of Yersinia enterocolitica in patients with diarrhea in Pudong New Area, Shanghai. Methods: Active surveillance of diarrhea was conducted in 14 sentinel hospitals (three tertiary-level hospitals, nine secondary-level hospitals, and two primary-level hospitals) from January 2013 to December 2019 in Pudong New Area of Shanghai, China base on their location, catchment area, and patient volume. Cold enrichment method was used to isolate Y. enterocolitica and further detection of bioserotype, virulence genes and antimicrobial susceptibility of the isolates were conducted. The difference of rates was determined using chi-square test or Fisher's exact test. Results: A total of 12 941 diarrhea cases were included, and 0.7% (88/12 941) cases were confirmed with Yersinia enterocolitica infection. 67.0% (59/88) cases were single infection, 33.0% (29/88) cases were mixed infections. Detection rates of Y. enterocolitica increased annually (0.3%-1.2%) and were highest in children<5 years of age (1.1%, 37/3 218) and in spring (1.1%, 32/2 998) (χ2 were 18.64 and 9.76, respectively, P<0.05). 58.0% (51/88) cases had watery diarrhea, 15.9% (14/88) had fever and 14.8% (13/88) had vomiting. The predominant bioserotypes were 3/O:3 (53.4%, 47/88), followed by 1A/O:8 (15.9%, 14/88) and 1A/O:5(6.8%, 6/88), respectively. Bioserotype 3/O:3 counted for the highest proportions (89.2%, 33/37) in children <5 years of age. All the strains of bioserotype 3/O:3 harbored ail, ystA, yadA and virF genes, which encoded pathogenic Y. enterocolitica. 11/14 strain of 1A/O:8 and 4/6 strains of 1A/O:5 harbored ystB gene. Most strains were resistant to ampicillin (80.7%,71/88) and amoxicillin/clavulanic acid (71.6%,63/88), and 63.8% (56/88) strains were multidrug resistance (MDR). The difference of antimicrobial resistance rates between 3/O:3 and non 3/O:3 was statistically significant in ampicillin, cefoxitin, nalidixic acid, tetracycline and ampicillin/sulbactam (χ2 was 14.68, 43.80, 41.86, 30.54 and 5.07, respectively, P<0.05). Conclusion: The detection rate of Yersinia enterocolitica was higher in children than in adults in Pudong New Area , Shanghai. The predominant bioserotype was pathogenic 3/O:3 with multidrug resistance.

Mosquito density monitoring data by ARIMA model / 上海预防医学

Objective To forecast the trend of mosquito density index in Pudong New Area, Shanghai so as to provide evidence for disease control and risk-control measures for vector-borne diseases. Methods Mosquito monitoring data was collected in Pudong New Area between 2011 and 2015 at the city-level monitoring sites for analysis on the trend of the mosquito density index in Pudong New Area of Shanghai by using the Autoregressive Integrated Moving Average Model (ARIMA). Results From 2011 to 2015, a total of 135 times labor-hour monitoring were carried out at the city-level monitoring points in Pudong New Area.The mosquito density index averaged 6.17/labor-hour with a standard deviation at 4.93, S=[0, 18]/labor-hour.Using ARIMA to analyze the change trend of mosquito density index in Pudong New Area, ARIMA(2, 0, 1)became the final fitting model, with R2=0.808.In the model, the Ljung-Box Q test value was 19.632(AR1=1.866, AR2=-0.907), and MA parameter was 0.999. Conclusion ARIMA model can be used to predict mosquito density monitoring data, but low monitoring frequency and irregular cycle length will affect the prediction results.

Study on the etiology of rash and fever illness in Pudong New Area of Shanghai from 2010 to 2017 / 中华疾病控制杂志

Objective To investigate the pathogens spectrum and epidemiological characteristics of rash and fever illness (RFIs) from January 2010 to December 2017 in Pudong New Area, in order to provide scientific evidence for the prevention and control ofRFIs.Methods Enzyme-linked immunosorbent assay and real-time fluorescence quantitative polymerase chain reaction were used to detect the pathogens of enterovirus, measles virus, rubella virus and others from 2 831 clinical samples, and statistical analysis was performed.Results Pathogens were found in 1 633 samples in total, accounting for 68.59%. The top 4 viruses in the pathogen spectrum were enterovirus (52.54%), measles virus (28.54%), rubella virus (13.04%), and varicella-zoster virus (3.37%). There was significnat difference in the detection rate of rubella pathogens among patients of different genders(P=0.026). In the pathogen spectrum of infections of different age groups, the detection rate of enteroviruses at the age of 3-6 years was higher than that of other age groups. The detection rate of varicella-zoster virus at the age of 6-18 years old was higher than that of other age groups. The detection rate of virus including measles virus, rubella virus, dengue virus and small DNA virus in age of 18 and older was higher than that of other age groups. There was significant difference in the detection rate of pathogens in different age groups (all P<0.05).The incidence of RFIs was the highest in spring (41.52%) and the lowest in winter (15.00%). There was a statistical difference in the detection rate of enterovirus, measles, rubella and dengue virus in different seasons (P<0.05).Conclusions Enteroviruses and measles viruses are the main pathogens leading to RFIs in Pudong New Area, and the activity level of RFIs pathogens should be monitored for a long time.

Analysis on recurrence of cerebral infarction and assoc iated risk factors in Pudong New Area of Shanghai / 上海预防医学

Objective To investigate the risk factors for recurrence of cerebral infarction and to propose secondary prevention methods . Methods Data of 628 patients with cerebral infarction from Jan.2012 to Dec.2014 were collected by the community reported network into a cohort study .The prevalence of recurrence and associated risk factors of cerebral infarction were investigated . Results Recurrence rate of cerebral infarction was 9.08%.History of hypertension (OR=4.797, P=0.001), long term of tobacco use ( OR=2 .844 , P=0 .005 ) , abdominal obesity or overweight ( OR=2 .421 , P=0.041) and farming(OR=3.723, P<0.001)were the independent risk factors for recurrence of cerebral infarction. Conclusion The recurrence rate of cerebral infraction is high , which is affected by various factors.

Impact of community-based different hypertension management models on the incidence of cardio-cerebrovascular disease in hypertensive patients / 上海预防医学

Objective To evaluate different hypertension management models in communities and their impact on incidence of cardio-cerebrovascular disease in hypertensive patients. Methods A total of 1 578 hypertension patients in several communities in Pudong New Area were recruited in the study ( August 2008 to December 2012 ) according to the inclusion criteria and randomly divided into two groups.The control group was given routine hypertension management and the study group was given detailed hypertension management, while health commissioners and community physicians were in charge of the follow-up and data collection. Results The incidence of cardio-cerebrovascular disease (1.33%) in study group (1.33%) was significantly lower than that of the control group (4.22%) ( P <0.05). Multivariate logistic regression analysis showed that age, male, course-of-disease, patients with hypertension family history, increase in SCr and LDL-C increased the risk for getting ardio-cerebrovascular disease (P <0.05).The risk of study group was 0.348 times the control group ( P <0.05). Conclusion Compared with control group, detailed hypertension management model conducted in study group has the advantages that effectively reduced the rate of cardio-cerebrovascular disease.

Prevalence and related factors of hypertension among residents aged above 15 years in Pudong New Area of Shanghai / 上海预防医学

Objective To investigate epidemic characteristics and risk factors of hypertension among residents aged above 15 years in Pudong New Area of Shanghai. Methods We selected the subjects through a multistage stratified cluster sampling procedure; all thirty towns of Pudong New Area were stratified into three levels according to their economic status and 10 657 people selected as survey subjcets from each economic level.A questionnaire survey was conducted in conjunction with measurements of body height and weight, fasting plasma glucose, 2-hour postprandial blood glucose, blood lipid and blood pressure among 10 657 inhabitants aged above 15 years.Multivariate unconditional regression model was employed to analyze the influence factors of hypertension. Results The crude prevalence rate of hypertension in the residents was 41.3%.The prevalence rates of male was high than female (P<0.001). With the increment of age, the hypertension prevalence rate of all residents were obviously elevated.The residents with lower education had a higher hypertension prevalence rate.There was no significant difference in hypertension prevalence between rural and urban.The results of logistic regresssion showed that the risk factors of hypertension were age,gender,educational level,family history of hypertension,central obesity, body mass index, C-reactive protein, 2-hour postprandial blood glucose and urinary albumin/creatinine ratio(P<0.05). Conclusion The results indicated that hypertension was highly prevalent in Pudong New Area.Body mass index ( BMI) and central obesity were related factors for hypertension which were changeable.