Comparing the timeliness of three types of influenza surveillance data in mainland China / 中华疾病控制杂志

Objective To evaluate the timeliness of the three sets of influenza surveillance data (influenza reported cases from Nationwide Notifiable Infectious Diseases Reporting Information System (NIDRIS), influenza-like illness consultation rate (ILI%) and influenza virus positive rate from Chinese Influenza Surveillance Information System) in mainland China. Methods The three sets of influenza surveillance data of North and South China from 2017 to 2018 were compared using peak comparison, cross correlation and Early Aberration Reporting System C3 method. Results The influenza epidemic trends reflected by the three sets of influenza surveillance weekly data from 2017 to 2018 were generally consistent and significantly correlated. However, the three sets of data had different timeliness. From 2017 to 2018, ILI% in the North was not timely at alarming the first epidemic peak, which was 6 weeks and 9 weeks later than influenza cases from NIDRIS and positive rate of influenza virus respectively. While in the South, ILI% was the most sensitive indicator, which was 4 weeks and 7 weeks earlier than influenza cases from NIDRIS and positive rate of influenza virus respectively. However, the three sets of data had little difference in the timeliness of the second epidemic peak both in the North and South. Conclusions The three sets of influenza surveillance data in mainland China could all roughly reflected the epidemic trend of influenza. After comparing the timeliness, a combination of influenza reported cases from NIDRIS together with ILI% and influenza virus positive rate could improve timeliness and accuracy for early warning of influenza.

Analysis on the clustering of liver cancer mortality in Lingbi county, Anhui province, from 2005 to2010 / 中华流行病学杂志

Objective To observe the mortality and its changes on liver cancer in the past 30 years as well as to describe the spatial distribution of liver cancer deaths between 2005 and 2010 in Lingbi,Anhui province.Methods Using the mortality data from 1973-1975 and from 2005 to 2010 in Lingbi to compare with the relative national and historical data,to observe the trend of rapid increase on liver cancer mortality in Lingbi.Using the Poisson model,BYM model and hotspot detection method,standardized mortality ratio (SMR),relative risk(RR) value of liver cancer deaths of each village were calculated and the clustering of high liver cancer deaths was identified.Results Through an increase of 223.7％ on the SMR of liver cancer in the past 30 years,the standardized mortality of liver cancer in Lingbi had an increase of 74.1 percent than the national level in 2005-2010 but it was 22.7％ lower than the country level in 1973-1975.The SMR and RR values and their P values were higher in the villages which were located along the Kuisui River.Data from the clustering analysis showed that there had been significantly positive autocorrelation at the altitude of 5300 meters,and a very obvious hot spot of liver cancer deaths existing along the Kuisui River,especially at the bifurcation of the old Sui River and new Sui River was observed.Conclusion There was an alarming increase of liver cancer mortality in the past 30 years in Lingbi.The high mortality area mainly covered the villages along the Kuisui River,suggesting that there were common risk factors for hepatocellular carcinoma in the population at risk.

Association between mortality rate of hepatic carcinoma and the distance from Suihe River in Lingbi county, Anhui province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the association between mortality rate of hepatic carcinoma and the distance from Suihe River in Lingbi county, Suzhou, Anhui province.</p><p><b>METHODS</b>Using the disease mapping and spatial statistical analysis techniques,we described the spatial distributions of the mortality rate of hepatic carcinoma from 2005 to 2010 in Lingbi county. Taking the distance between villages and polluted rivers as proxy variable of environmental exposure, mortality rate of hepatic carcinoma in each village as dependant variable, and using the Glimmix model and Bayesian spatial model (BYM) to undertake the univariate and multivariate analysis, we investigatived the association between mortality rate of hepatic carcinoma and the water pollution of Suihe River in Lingbi county.</p><p><b>RESULTS</b>Obvious clustering of high mortality rate of hepatic carcinoma along the polluted river was observed in Lingbi county. Results of Glimmix model showed that whether spatial autocorrelation was considered or not, closer to the polluted river has higher mortality rate of hepatic carcinoma. Results of univariate analysis of the BYM model showed that, compared with the villages far from the polluted river more than 12 km (the mortality rate of hepatic carcinoma was 33.12/100 000(1068/3 224 562) ), the RR values of the hepatic carcinoma mortality was 1.38(95%CI:1.06-1.82) for the villages apart from the polluted river within 6 km (the mortality rate of hepatic carcinoma was 42.48/100 000(777/1 829 064)), and 1.13 (95%CI:0.92-1.39) for villages apart from the river between 6 and 12 km (the mortality rate of hepatic carcinoma was 35.65/100 000(651/1 825 848)). In the BYM model multivariate analysis, adding the volume of fertilizer and pesticides used per cultivated area, GDP per capita to do multivariate analysis were, the relation between mortality rate of hepatic carcinoma and distance from polluted rivers remains unchanged.</p><p><b>CONCLUSION</b>The mortality rate of hepatic carcinoma was associated with the exposure to the polluted river in Lingbi county. The polluted river may increase the hepatic carcinoma mortality of nearby residents.</p>

Evaluation on birth defects surveillance system in four counties of Shanxi province, China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To evaluate the reliability of the birth defects surveillance system in four counties with high prevalence of birth defects (Pingding, Xiyang, Taigu and Zezhou counties) in Shanxi province, China.</p><p><b>METHODS</b>One township was selected from each county as study site. The health workers chosen from township or village level were trained to visit families on the outcomes of each pregnancy who gave birth during year 2003 in the study site. The number of births and cases collected in the study were compared with that from the surveillance system. The number of births reported by surveillance system in four counties was also compared with the data from the local government. The criteria of evaluation were: 1) number of the missing report of births should < or = 5%, 2) the number of missing report on major external birth defects cases should < or = 10%. Researchers from the Peking University were responsible for examining the quality of surveillance in some terminal units of surveillance system.</p><p><b>RESULTS</b>The numbers of births reported in the study and from the surveillance system for four-township were 1043 and 997, respectively. 46 births were missing and the rate of misreporting for births was 4.4%. The numbers of birth defects cases reported in the study and from the surveillance system were 30 and 29, respectively. 1 case of birth defect as missed, and rate of misreporting for birth defects cases was 3.3%. The total number of births reported from surveillance was similar to that in the study in four counties, with a difference of 1.2%. Birth registry data was rather readable and special health workers responsible for surveillance work were present in all the terminal units of the surveillance system.</p><p><b>CONCLUSION</b>The misreporting of births and cases existed in the birth defects surveillance system of the four counties in Shanxi province, but were lower than the allowable criteria. The surveillance units had better registration, reporting and administration of births and birth defect cases. Hence, the quality of the data from the surveillance system in these four counties was reliable.</p>

Differences in serum retinol level between the breastfed and non-breastfed children aged 0 to 23 months / 中华流行病学杂志

<p><b>OBJECTIVE</b>Some recent studies found that high prevalence of vitamin A deficiency in the breastfed children. This study aimed to understand the differences in serum retinol level between breastfed and bottle-fed children aged 0 to 23 months and the possible causes of low level of serum retinol for the breastfed children.</p><p><b>METHODS</b>Data for children aged 0 to 23 months were extracted from a population-based cross sectional study for vitamin A nutrition status. Fluorescence method was used to measure the serum retinol. Mothers or caregivers were asked to answer a pre-designed questionnaire and socioeconomic status, peri-natal care, breastfeeding status, morbidity histories and other related factors were collected. Semi-quantitative food frequency questionnaire was used to investigate the child's dietary intake one week prior to the survey. Data were analyzed using SAS 8.1.</p><p><b>RESULTS</b>Of 401 children aged 0 to 23 months, the breastfeeding rate was 50.37%. The means of the serum retinol level between bottle-fed (30.67 +/- 0.57) microg/dl and the breastfed children (27.60 +/- 0.56) microg/dl was significantly different (P < 0.01). The corresponding figures were (31.82 +/- 0.98) microg/dl and (29.46 +/- 0.96) microg/dl after adjustment for confounders, which also showed significant difference (P < 0.01). After stratified by age groups, the breastfeeding rates in the 0-, 6-, 12- and 18-months groups were 92.1%, 70.1%, 32.0% and 17.1%, respectively. We calculated the difference in means of the serum retinol level between the bottle-fed and breastfed children for each of four age groups, and the 95% confidence limits of the differences. The differences in means and the 95% confidence limits for 0-, 6-, 12- and 18-months group were 4.70 microg/dl (-2.52-1.92), 0.82 microg/dl (-2.32-3.95), 2.95 microg/dl (-0.68-6.58) and 6.05 microg/dl (2.34-9.77), respectively. After adjustment for confounders and covariates, the adjusted figures were 0.00 microg/dl (-7.18-7.19), 1.35 microg/dl (-1.76-4.45), 2.92 microg/dl (-0.82-6.65) and 4.26 microg/dl (0.71-7.81), respectively. The significant difference in means of serum retinol level was only found in the 18-months group before or after adjustments (P < 0.01 for both). The Cochrane-Atmitage chi square trend test showed that the breastfed children tended to have lower frequencies of complementary dietary intakes than that of the bottle-fed aged 12 months and above.</p><p><b>CONCLUSIONS</b>The breastfed children aged 0 to 23 months had relative low serum retinol level while compared with the bottle-fed. However, the significant differences seemed to be only confined to those aged 18 months and above. Low level of vitamin A in breast milk and low frequent complimentary food supplements might have served as the potential for the differences.</p>