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Objective To study the epidemiological characteristics and the effects of control measurements in Guangxi by comparing the results from diarrhea-household-surveys conducted in the three different periods of time and to develop control strategies. Methods Data on the incidence, health care seeking and treatment of diarrhea from three household surveys conducted in 1988, 1995 and 2007 was analyzed using SPSS (version 13.0). Results The incidence rates of diarrhea over the three periods of time were 0.562, 0.456 and 0.221 per person-year, respectively (P<0.001). No significant difference was found in the incidence between males and females. The disease mainly attacked young age groups and those with lower educational levels. In recent years, longer durations of disease but less severe were observed in patients with diarrhea. The patients mainly visited first line health services with a health care seeking rate of 28.3%. Antibiotics were used by most of the patients (49.8%-90.2%), while the rate of using oral rehydrathon salts(ORS) was only 1.4%-11.5% but the use of traditional Chinese medicines has increased. Intake of untreated water, contaminated foods and contact with patients were important risk factors on diarrhea. Conclusion The prevalence of diarrhea in Guangxi had declined and the health seeking rate was low in the past two decades. It is necessary to further regulate the treatment, in order to strengthen the health education programs to the general population, in order to improve the accessibility of health services and to increase both the health care seeking rate and effective diagnosis rate.
RESUMO
<p><b>OBJECTIVE</b>To characterize the incidence, epidemiologic features, etiologic agents and sequelae of bacterial meningitis in children under 5 years of age in Nanning, Guangxi.</p><p><b>METHODS</b>A population-based surveillance was conducted to evaluate children with signs and symptoms of meningitis. All hospitals, township health centers and village clinics in the surveillance area were structured to participate in the case referral and evaluation. Cerebrospinal fluid (CSF) and blood specimens were obtained and processed using standardized microbiologic methods.</p><p><b>RESULTS</b>During the 26-month surveillance period, among the children under 5 years old, a total of 1272 cases who met the screening criteria of meningitis were studied. 265 of 1272 cases were identified as clinically diagnosed meningitis, with an incidence rate of 86.36 per 100 000 population. The annual incidence rate under the 38 cases of confirmed bacterial meningitis appeared to be 12.38/100 000. Staphylococcus species accounted for the largest proportion of laboratory-confirmed bacterial meningitis, followed by E. coli and S. pneumoniae. The highest attack rate occurred in neonates < 1 month, followed by children aged 1 - 12 months in the confirmed patients. Meningitis caused by Sp and Hi mainly occurred in children aged 1 - 12 months. All cases of meningitis due to Hi and Sp were children aged 1 - 24 months. 13.16% and 0.00% of the cases survived with complications and sequelae, and the case-fatality rate was 18.42%. 40 bacterial isolates were identified from 1193 blood cultures and 23 from 1211 cerebrospinal fluid samples, but no Neisseria meningitidis was found.</p><p><b>CONCLUSION</b>Meningitis due to Hi was first confirmed in Guangxi with the incidence of 0.98 per 100 000 population. The annual incidence rate of confirmed bacterial meningitis was 12.38 per 100 000, which was considered an important public health problem in children. Staphylococci was the predominant pathogen in confirmed bacterial meningitis.</p>