Sick individuals and sick populations: Yunnan unexplained sudden death from the perspective of population medicine / 中华地方病学杂志

Individuals and populations affected by Yunnan unexplained sudden death have different causes, so different research methods and control strategies should be adopted for these two different causes. By reviewing relevant research literature on Yunnan unexplained sudden death, we reinterpret some characteristics of the disease from the perspective of population medicine. At the same time, it is found that some studies have shown that residents in areas where sudden death occurs have a higher proportion of myocardial damage compared to control areas, making them a population with basic sickness. Population medicine methods can be used to conduct etiology research and disease prevention and control.

Effect of the comprehensive intervention measures on Yunnan unexplained sudden death in Dali Prefecture / 中华地方病学杂志

Objective:To evaluate the effect of comprehensive intervention measures on Yunnan unexplained sudden death (YUSD) in Dali Prefecture, Yunnan Province, and to provide scientific basis for improving the prevention and control measures.Methods:Since 2010, Yunnan Province had implemented comprehensive intervention measures in ward areas according to the etiological pattern of YUSD. In July 2019, 47 families with YUSD were selected as case families and 23 families without YUSD were selected as control families in 31 natural villages of Heqing, Xiangyun, Yunlong, Eryuan, Jianchuan, Binchuan and Nanjian counties of Dali Prefecture. A unified questionnaire was used to investigate the basic information, economic status, dietary structure, and health literacy of the families during the two periods of "the first sudden death case" and "the present".Results:The annual household income of the case families at present (median, 20 492.6 yuan) was significantly higher than that of the first sudden death case (3 883.4 yuan), and the difference was statistically significant ( Z = - 5.27, P < 0.001). At present, rice (76.6%, 36/47) was the main diet of the case families; at the time of the first sudden death case, 23.4% (11/47) of the case families could not eat enough, and there was no such situation in the case families at present. Compared with the time of the first sudden death case, the dietary habits of the case families at present were as follows: the proportion of eating Trogia venenata decreased from 19.0% (39/205) to 0 (0/190), the proportion of eating wild fruit decreased from 17.1% (35/205) to 9.5% (18/190), and the proportion of drinking raw water decreased from 55.1% (113/205) to 42.1% (80/190), and the differences were statistically significant (χ 2 = 22.37, 4.90, 6.86, P < 0.05). Lifestyle and health awareness: the proportion of those who washed their hands before meals and after using the toilet increased from 9.8% (20/205) to 41.6% (79/190), those who did not overwork increased from 16.6% (34/205) to 34.2% (65/190), and those who took good protection when spraying pesticides increased from 7.3% (15/205) to 21.6% (41/190), and the differences were statistically significant (χ 2 = 53.17, 33.94, 16.48, P < 0.001). Toilet habits: the proportion of using outdoor toilet decreased from 75.6% (155/205) to 9.5% (18/190), the difference was statistically significant (χ 2 = 175.21, P < 0.001). When the first sudden death case occurred, the proportions of eating Trogia venenata and using outdoor toilet in the case families were higher than those in the control families (χ 2 = 22.37, 23.70, P < 0.001), the proportions of those who washed their hands before meals and after using the toilet and those who did not overwork in the case families were lower than those in the control families (χ 2 = 7.38, 4.93, P < 0.05). Conclusions:The economic conditions, production and living conditions of YUSD areas in Dali Prefecture have been significantly improved, and the health literacy and health prevention awareness of the population have been greatly improved. Economic conditions and living standard, dietary structure and health literacy may be related factors of YUSD.

Research Progress of Yunnan Unexplained Sudden Death / 法医学杂志

Yunnan unexplained sudden death (YUSD) has obvious spatial and temporal aggregations.With the features of sudden onset and rapid death,its causes remain unclear.However,the onset of YUSD is related to the geological and climatic conditions in specific range of altitude of incidence area,which is also influenced by the existed susceptibility gene loci or several multiple mutations in SNP loci,long-term fatigue,low dietary nutrition,trace element deficiency,poor living condition and hygienic habit,and infection by etiologic microorganism or virus among the residents live in the incidence area of YUSD.Under the continuous influence of factors above,the crowd of incidence area finally occurred unexplained sudden death that prominently shown by myocardial injury.Improvements of public health administration,living conditions,villagers' health,living habits and enhancement of indicator measurement of myocardial enzyme and electrocardiogram for the residents in the incidence area of YUSD are effective measures for prevention of YUSD.Timely identification of cause of death and in-depth genetic research are important ways to explore the causes of YUSD,enhance the effectiveness of treatment and reduce the death rate.