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Objective@#To understand the characteristics of different pulmonary function grades and comprehensive assessment groups among patients with chronic obstructive pulmonary disease (COPD) from community survey, so as to provide the evidence for the comprehensive community management of COPD. @*Methods@#The survey data of five monitoring sites in Zhejiang Province during 2014-2015 in the COPD surveillance of Chinese residents aged 40 years and above was collected. The patients with COPD were classified by pulmonary function according to the percentage of forced expiratory volume in the first second (FEV1) in the predicted value, and by comprehensive assessment according to modified British Medical Research Council (mMRC) score, COPD Assessment Test (CAT) score and acute exacerbation in the past year. The characteristics of different pulmonary function grading and comprehensive assessment groups were compared. @*Results@#A total of 355 patients with COPD were found, with an average age of (63.00±9.63) years. The male-to-female ratio was 3.18:1. There were 243 patients with an education level of primary school or below, accounting for 68.45%. The awareness rate of COPD related knowledge was only 1.69%. There were 257 (72.39%) patients with mild, 86 (24.23%) patients with moderate, and 12 (3.38%) patients with severe pulmonary function. The proportions of patients with childhood history of severe respiratory infection, self-reported respiratory system diseases, chronic cough, chronic sputum, acute exacerbation in the past year, CAT score ≥10 points, and inhaled medication were lower in the patients with mild pulmonary function than with moderate and severe pulmonary function; the body mass index and waist circumference were higher in the patients with mild pulmonary function than in the patients with moderate and severe pulmonary function (all P<0.05). The comprehensive assessment resulted in 158 (44.51%) patients of Group A, 134 (37.75%) patients of Group B, 1 (0.28%) patient of Group C, and 7 (1.97%) patients of Group D. The average age and systolic pressure were lower in Group A than in Group B, C and D; the proportions of patients with self-reported respiratory system diseases, family history of respiratory diseases, chronic cough, chronic sputum, dyspnea, acute exacerbation in the past year and CAT score ≥10 points were lower in Group A than in Group B, C and D (all P<0.05). @*Conclusion@#The community patients with COPD are mainly classified to mild pulmonary function and Group A in the comprehensive assessment; thus they need different levels of management.
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Objective@#To understand the underreporting rate of death among residents in Zhejiang Province from 2016 to 2018, so as to provide a basis for improvement of death surveillance measures. @*Methods@#Multi-stage random cluster sampling was used to select residents in 30 public health surveillance areas of Zhejiang Province and all the residents were investigated the general information and death conditions that occurred during the period 2016-2018 by door to door visit. The underreporting rate of death was calculated and descriptive methods were used to analyze the causes of underreporting deaths.@*Results@#A total of 358 992 residents were investigated in 30 public health surveillance areas of Zhejiang Province. There were 63 underreporting deaths among 5 896 deaths, with an underreporting rate of 1.07%. The underreporting rate in men was 1.30%, which was higher than 0.75% in women ( P<0.05 ). The underreporting rate of residents aged 20 to <40 years was 6.74%, the highest among all the age groups ( P<0.05 ). The underreporting rate was 4.46% on the way to the hospital, the highest among all the places of death ( P<0.05 ). The underreporting rate in Wuxing District of Huzhou was 5.80%, the highest among all the surveillance areas. There were 25 cases of "late report or untimely review", accounting for 39.68%; 38 cases of "not report", accounting for 60.32%, of which 14 cases were caused by doctors forgetting to report, accounting for 22.22%. @*Conclusion@#The underreporting rate of death in Zhejiang Province from 2016 to 2018 is generally low. In response to underreporting deaths, multi-departmental collaboration should be promoted to effectively strengthen the reporting and management of routine death surveillance.
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Objective @#To explore the relationship between alcohol consumption and hypertension in adults of Zhejiang Province, so as to provide scientific evidence for the prevention and control of hypertension. @*Methods@#Data were collected from 10 national surveillance sites in Zhejiang Province in the 2018 China Chronic Disease and Risk Factors Surveillance. The multivariate logistic regression model was used to explore the relationship between alcohol consumption and hypertension in adults of Zhejiang Province. @*Results @#Among 5 908 people included, 2 641 were males, accounting for 50.38%; and 3 267 were females, accounting for 49.62%. There were 2 721 cases of hypertension ( 28.54% ). The number of the cases with no, light and excessive alcohol consumption was 3 945, 1 117 and 846, accounting for 66.28%, 23.65% and 10.07%, respectively, after complex sampling weighting. The results of the multivariate logistic regression model showed that compared with those with no alcohol consumption, the adults with excessive alcohol consumption had higher risk of hypertension ( OR=2.126, 95%CI: 1.649-2.741 ); men with light ( OR=1.875, 95%CI: 1.075-3.270 ) and excessive alcohol consumption ( OR=2.752, 95%CI: 2.021-3.748 ) had higher risk of hypertension; the 18-<45-year-old adults with light ( OR=2.441, 95%CI: 1.171-5.087 ) and excessive alcohol consumption ( OR=3.368, 95%CI: 1.609-7.049 ), and the ≥60-year-old adults with excessive alcohol consumption ( OR=1.632, 95%CI: 1.174-2.269 ) had higher risk of hypertension. @*Conclusions @#Light and excessive alcohol consumption are associated with hypertension in Zhejiang adults. The association is stronger between excessive alcohol consumption and hypertension than between light alcohol consumption and hypertension.
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Objective @#To optimize the primary prevention strategies of birth defects in Zhejiang Province by Delphi method, so as to promote the capacity of birth defects prevention. @*Methods@#The expert consultation questionnaire was developed based on the relevant policies of Zhejiang Province and literature. Ten experts from medical institutions and health administrative departments were employed for one round Delphi expert consultation. The weighted scores and priorities of ten measures for the primary prevention of birth defects in Zhejiang Province were determined, as well as the suggestions of optimizing the current policies. @*Results @# The response rate of the experts was 90.91%; the coefficient of authority was 0.92; the coefficients of variation of ten measures were all less than 0.25; the coefficient of coordination was 0.31 ( P<0.05 ) , which indicated the opinions of the experts tended to be consistent. In the order of priority, ten primary prevention measures of birth defects were the improvement of birth defects surveillance network ( province, city and county level ) , the training of birth defects prevention talents, the construction of genetic consultation clinics, health education and publicity, the reproduction outpatient service construction for older people, free premarital medical examination, free pre-pregnancy eugenics test, the construction of drug consultation clinics, career planning and training of birth defect prevention and control consultants and free folic acid supplement to the whole population. Nine experts suggested that the following policies need to be optimized: birth defects surveillance system, free premarital medical examination, and health education and publicity.@*Conclusion@#In the primary prevention of birth defects in Zhejiang Province, the most urgent problem to be solved is the improvement of the three-level birth defects surveillance network.
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Objective@#To learn the prevalence of dyslipidemia and its influencing factors among patients with type 2 diabetes mellitus (T2DM) in rural areas of Zhejiang Province, and to provide evidence for dyslipidemia control.@* Methods@#A sample of 10 343 patients with T2DM managed by communities from three counties (Jiashan,Suichang and Yongkang) were recruited. Through the residents’ health record system and specific investigation, demographic features,physical examination results of blood pressure,height, weight, waist circumstance (WC), glycated hemoglobin (HbA1c),total cholesterol (TC),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were collected to analyze the spectrum of dyslipidemia. A logistic regression model was established to explore the associated factors of dyslipidemia. @*Results @#The prevalence rate of dyslipidemia among the patients with T2DM in rural communities was 66.91%. The prevalence rates of higher level of TC, TG, LDL-C were 41.76%, 41.28%, 15.89%, respectively, while the prevalence rateof lower level of HDL-C was 16.92%. The prevalence rates of purely high TC,high TC with TG and purely high TG were 11.84%,11.75% and 11.47%,respectively. Higher level of TG with lower level of HDL-C was common in males (11.32%) and higher level of TC with TG was common in females (14.60%). The results from multivariate logistic regression analysis indicated that females(OR=1.499,95%CI:1.352-1.663),age(OR=0.992,95%CI:0.988-0.996),poor control of HbA1c(OR=1.241,95%CI:1.141-1.351), abdominal obesity(OR=1.169,95%CI:1.064-1.285),overweight(OR=1.384,95%CI:1.257-1.524)and obesity(OR=1.582,95%CI:1.352-1.852)were associated with dyslipidemia. @*Conclusions@#The prevalence of dyslipidemia is relatively higher among the patients with T2DM in rural communities of Zhejiang Province. Higher level of TC and TG contributed to most dyslipidemia. The patients with T2DM who are females,have poor control of plasma glucose and suffer from obesity should be under surveillance.