Study of incidence and economic burden of herpes zoster based on community investigation among the aged in Laiwu district, Jinan city, Shandong Province of China / 中华预防医学杂志

Objective: To understand the incidence and economic burden of herpes zoster among the aged in Laiwu district, Jinan city. Methods: Retrospective cohort study was conducted in 5 communities in Laiwu District, Jinan City from July to September, 2019. A total of 8 300 residents born before July 1, 1959 and aged ≥60 years old were included in the investigation. At the same time, an economic burden survey was carried out among 220 cases who developed herpes zoster after July 1, 2017. A questionnaire was used to collect information on incidence and economic burden of HZ, and comparisons were carried out about the incidence and economic burden of herpes zoster among older people with different characteristics. Results: The age of 8 300 subjects was (71.46±6.71) years old. Male and female accounted for 44.10% and 55.90%, respectively. The cumulative incidence of disease after the age of 60 was 73.61‰ among population aged ≥60 years old. The cumulative incidence was 28.03‰, 71.26‰, 86.09‰, 93.48‰ and 88.10‰ among population aged 60-64, 65-69, 70-74, 75-79 and ≥80 years old,respectively. The average annual incidence of HZ was 9.49‰ and annual incidence was 7.59‰, 7.23‰, 8.43‰, 10.24‰ and 13.98‰ in 2014-2018, respectively. HZ cost was (2 626±667) RMB per patient with a median cost of 715 RMB (interquartile range 303-2 358) on 220 cases who developed disease after July 1, 2017. The cost of outpatient cases was (1 329±1 835) RMB per patient with a median cost of 560 RMB (interquartile range 300-1 320), and the cost of inpatient cases was (14 303±16 571) RMB per patient with a median cost of 8 190 RMB (interquartile range 4 368-15 160). Conclusion: The incidence of HZ is high among population aged≥60 years old, which could cause heavy economic burden for them.

Study of correlationship between congenital heart disease and 5, 10-methylenetetra hydrofolate reductase gene's polymorphism or folacin intakes / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the correlationship between congenital heart disease and 5, 10-methylenetetra hydrofolate reductase (MTHFR)'s C677T or folacin intakes, and to study the interaction of them in the occurring of congenital heart disease.</p><p><b>METHODS</b>We used case-control study (case = 104, control = 208) method. Cases and controls were chosen by age, sex and other conditions. The MTHFR C677T genotype distribution was analyzed by using polymerase chain reaction restricted fragment length polymorphism (PCR-RFLP), and non-conditional and multi-conditional logistic regression analysis were also used to analyze the correlationship and interaction of the factors.</p><p><b>RESULTS</b>In case group, the number of people in low folacin intake level was 38 (36.54%), which in control group was 21(10.10%). The intake level of folacin during pregnancy was related to congenital heart disease (chi(2) = 31.614, nu = 1, P < 0.0001). The value of OR was 1.417 with 95%CI 1.216 - 1.651, indicating that the low level of folacin intakes was a risk factor to the congenital heart disease. In case group, the number of TT genotype was 46 (44.24%), the number of CT genotype was 42 (40.38%), the number of CC genotype was 16 (15.38%). In control group, the number of TT genotype was 39 (18.75%), the number of CT genotype was 114 (54.81%), the number of CC genotype was 55 (26.44%). A significant genotype distribution difference was identified between case and control group (chi(2) = 23.13, nu = 2, P < 0.0001). Genotype MTHFR 677TT was a risk factor of congenital heart disease and the OR value was 3.437 (95%CI: 2.042 - 5.784). The interaction analysis suggested that the low level of folacin intakes and the MTHFR 677TT genotype had a positive adding effect in the occurring of congenital heart disease. After adjusted some factors such as the ages of parents, fetus age and sex, the effect values of interaction were 13.343 and 15.911 respectively, and the percentages of attributable interaction effects were 0.619 and 0.612. The percentages of effect values of interaction between pure factors were 0.649 and 0.637 and the population attributable risks were 25.26% and 27.82% according to the estimated exposure rate of population risk factors.</p><p><b>CONCLUSION</b>The low level of folacin intakes during pregancy should be a risk factor to congenital heart disease and the MTHFR 677TT genotype be correlated to congenital heart disease. There is interaction between folacin intakes and the MTHFR 677TT genotype. Increasing the intakes of folacin among MTHFR 677TT genotype people might decrease the incidence rate of congenital heart disease.</p>