Mental health and related influencing factors among rural elderly in 14 poverty state counties of Chongqing, Southwest China: a cross-sectional study.

BACKGROUND: China has the largest elderly population in the world; little attention has been paid to the mental health of elderly in areas of extreme poverty. This is the first study to investigate the mental health of the rural elderly in poverty state counties in Chongqing and was part of the Chongqing 2018 health literacy promotion project. METHODS: In 2019, a cross-sectional study was conducted to investigate the mental health status of the rural elderly in fourteen poverty state counties of Chongqing, in which a total of 1400 elderly aged ≥ 65 years were interviewed, where mental health status was measured by the ten-item Kessler10 (K10) scale. Ordered multivariate logistic regression was performed to evaluate the influencing factors related to mental health of the elderly in these areas. RESULTS: The average score of K10 in 14 poverty state counties was 17.40 ± 6.31, 47.6% was labeled as good, 30.2% was moderate, 17.0% was poor, and lastly 5.1% was bad, and the mental health status of the elderly in the northeastern wing of Chongqing was better than the one in the southeastern wing of Chongqing. A worse self-rated health was the risk factor for mental health both in the northeastern and southeastern wings of Chongqing (all P < 0.001). Lower education level (OR (95% CI) = 1.45 (1.12-1.87), P = 0.004) was a risk factor in the northeastern wing, whereas older age (OR (95% CI) = 1.33 (1.13-1.56), P = 0.001) was a risk factors in the southeastern wing. CONCLUSIONS: The results showed that mental health of the elderly in poverty state counties was poor, especially in the southeastern wing of Chongqing. Particular attention needs to be paid to the males who were less educated, older, and single; female with lower annual per capital income; and especially the elderly with poor self-rated health.

Influenza A(H7N9) virus emerged and resulted in human infections in Chongqing, southwestern China since 2017.

OBJECTIVES: Influenza A(H7N9) virus has emerged and resulted in human infections in Chongqing, southwestern China since 2017. This study aimed to describe the epidemiological characteristics of the first epidemic in this region. METHODS: The epidemiological data of patients were collected. Live poultry markets (LPMs), commercial poultry farms (CPFs) and backyard poultry farms (BPFs) were monitored, and poultry sources were registered. Samples derived from the patients, their close contacts, and the environments were tested for influenza A(H7N9) virus by real-time reverse transcriptase polymerase chain reaction. Genetic sequencing and phylogenetic analysis were also conducted. RESULTS: Since the confirmation of the first patient infected with influenza A(H7N9) virus on March 5, 2017, nine patients had been identified within four months in Chongqing. Their mean age was 45 years, 77.8% were male, 66.7% were urban residents and 55.6% were of poultry related occupation. All patients became infected after exposure to live chickens. The median time interval from initial detection of influenza A(H7N9) virus in Chongqing to the patients' onset was 75 days. Since initial detection in February 2017, influenza A(H7N9) virus was detected in 21 (53.8%) counties within four months. The proportion of positive samples was 2.94% (337/11,451) from February 2017 to May 2018, and was higher (χ2=75.78, P<0.001) in LPMs (3.66%, 329/8979) than that in CPFs (0.41%, 5/1229) and BPFs (0.24%, 3/1243). The proportion of positive samples (34.4%, 22/64) at the premises to which the patients were exposed was significantly higher than that (5.7%, 257/4474) in premises with no patients. Phylogenetic analysis indicated that the viruses isolated in Chongqing belonged to the Yangtze River Delta lineage and resembled those circulated in Jiangsu and Anhui provinces between late 2016 and early 2017. CONCLUSION: Influenza A(H7N9) virus was newly introduced into Chongqing most likely between late 2016 and early 2017, which swept across half of Chongqing territory and resulted in human infections within months. The most impacted premises and population were LPMs and poultry related workers respectively in the epidemic.

Assessment of thyroid function in children, adults and pregnant and lactating women after long-term salt iodisation measurements.

Universal salt iodisation (USI) has been successfully implemented in China for more than 15 years. Recent evidence suggests that the definition of 'adequate iodine' (100-199 µg/l) be revised to 'sufficient iodine' (100-299 µg/l) based on the median urinary iodine concentration (MUI) in school-age children. The objective of this study was to determine the prevalence of thyroid dysfunction in populations after long-term salt iodisation and examine whether the definition of adequate iodine can be broadened to sufficient iodine based on the thyroid function in four population groups. A cross-sectional survey was conducted in six provinces in the northern, central and southern regions of China. Four population groups consisting of 657 children, 755 adults, 347 pregnant women and 348 lactating women were recruited. Three spot urinary samples were collected over a 10-d period and blood samples were collected on the 1st day. In the study, among the adults, pregnant women and lactating women, the prevalence rates of elevated thyroglobulin antibody and thyroid microsomal antibody levels were 12·4, 8·5 and 7·8 %, and 12·1, 9·1 and 9·1 %, respectively. Abnormally high thyroid dysfunction prevalence was not observed after more than 15 years of USI in China because the thyroid dysfunction rates were all <5 %. The recommended range should be cautiously broadened from adequate iodine to sufficient iodine according to the MUI of school-age children considering the high levels of hormones and antibodies in the other populations. Adults, particularly pregnant women positive for thyroid antibodies, should be closely monitored.

Epidemiological characteristics and post-exposure prophylaxis of human rabies in Chongqing, China, 2007-2016.

BACKGROUND: According to the global framework of eliminating human rabies, China is responding to achieve the target of zero human death from dog-mediated rabies by 2030. Chongqing is the largest municipality directly under central government in China. We described the epidemiological characteristics and post-exposure prophylaxis (PEP) of human rabies in this area, in order to provide a reliable epidemiology basis for further control and prevention of human rabies. METHODS: The most updated epidemiological data for human rabies cases from 2007 to 2016 in Chongqing were collected from the National Disease Reporting Information System. A standardized questionnaire was applied to the human rabies cases or family members of cases as proxy to investigate the PEP situation. RESULTS: A total of 809 fatal human rabies cases were reported in Chongqing from 2007 to 2016. There was a trend of gradual annual decline about number of cases from 2007 to 2013, followed by stable levels until 2016. Rabies was mostly reported in summer and autumn; a majority of cases were noted in farmers (71.8%), especially in males (65.3%). The cases aged 35-74 and 5-14 years old accounted for 83.8% of all the cases. We collected information of 548 human rabies cases' rabies exposure and PEP situation. Of those, 95.8% of human rabies cases were victims of dog bites or scratch, and 53.3% of these dogs were identified as stray dogs. Only 4.0% of the domestic dogs were reported to have been vaccinated previously. After exposure, 87.8% of the 548 human rabies cases did not seek any medical services. Further investigation showed that none of the 548 cases received timely and properly standardized PEP. CONCLUSION: Human rabies remains a major public health problem in Chongqing, China. Dogs are the main reservoir and source of human rabies infection. Unsuccessful control of canine rabies and inadequate PEP of cases might be the main factors leading to the serious human rabies epidemic in this area. An integrated "One Health" approach should be encouraged and strengthened in this area; with combined effort it would be possible to achieve the elimination of human rabies in the expected date.

Epidemiological and Virological Characteristics of Influenza in Chongqing, China, 2011-2015.

BACKGROUND: Chongqing is the largest municipality and located in Southwestern of China, with over 30 million registered inhabitants. There are few reports regarding the epidemiology of influenza in Chongqing. The objective of the paper is to explore the epidemiology of influenza in Chongqing, in order to provide scientific basis for prevention and control of influenza. METHODOLOGY /PRINCIPAL FINDINGS: From 2011 to 2015, we collected information on influenza-like illness (ILI) patients fulfilling the case definition, and took nasalpharyngeal or throat swabs specimens from ILI cases per week at the 7 sentinel hospitals. Specimens were tested by reverse transcription-polymerase chain reaction(RT-PCR) for influenza. Descriptive epidemiology was applied to analyze the epidemiology and etiology of influenza. A total of 9,696,212 cases were enrolled, of which 111,589 were ILI. Of those 24,868 samples from ILI cases, 13.3% (3,314/24,868) tested positive for influenza virus (65.7% influenza A, 34.1% influenza B, and 0.2% influenza A and B co-infection). Among the influenza A viruses, 71.3% were seasonal influenza A(H3N2) and 28.7% were influenza A(H1N1)pdm09. No cases of seasonal A(H1N1) were detected. The isolation rate was highest in children aged 5-14 years old. Influenza activity consistently peaked during January-March in 2011-2015, and June-July in 2012, 2014 and 2015. CONCLUSIONS: Influenza is an important public health problem among ILI patients in Chongqing, especially among school-aged children. It might be beneficial to prioritize influenza vaccination for school-aged children and implement the school-based intervention to prevent and mitigating influenza outbreaks in Chongqing, particularly during the seasonal peaks.

[Analysis on the frequency of urinary iodine in a population-based intervention study].

OBJECTIVE: Through a two-year follow up program, this study was to analyze the urinary iodine frequency of a cohort in the intervention trial, concerning different doses of salt ionization, so as to explore the selection of appropriate concentration of salt ionization. METHODS: A multistage cluster sampling method was used to select three townships in two countries for community intervention with different doses [(15±5) mg/kg, (25±5) mg/kg, (35±5) mg/kg] of salt ionization. RESULTS: After intervention, the median of urinary iodine was reduced among the population. The urinary iodine frequencies of (15±5) mg/kg and (25±5) mg/kg among groups of children were mainly concentrated in 100-200 µg/L and 200-300 µg/L paragraphs in A county. While the 300 µg/L paragraph had an overall decline in B county, the 100 µg/L and 200 µg/L paragraph ratio increased but the trend seemed to be slow. The 100-300 µg/L paragraph of the four treatment groups took a larger proportion and kept smooth in a more ideal state. However, the control group still maintained at above 250 µg/L level. CONCLUSION: The iodine supplementation should be gradually implemented in Chongqing. The doses of salt ionization should be reduced from the current (35±15) mg/kg to (25±5) mg/kg in the economically developed areas. At the same time, we need to continuously follow the changes of the condition.

[Prevalence of Enterobius vermicularis infection of children and its influencing factors in Chongqing City].

OBJECTIVE: To understand the infection status of Enterobius vermicularis of children aged 3-12 years and its influencing factors in Chongqing City. METHODS: One rural county and 1 urban county were selected as investigation areas. The children aged 3-12 years of 5 towns from 5 different directions of each county were investigated. About 150 children were investigated every town. The Enterobius vermicularis eggs of children were detected by the adhesive cellophane anal swab method. The children's parent education levels and personal circumstances of sanitation were investigated by the questionnaire survey. RESULTS: Among 1 592 children investigated, the total infection rate of Enterobius vermicularis was 6.85%. The infection rates of boys and girls were 6.29% and 7.40%, respectively. The infection rates of rural and urban areas were 12.13% and 2.14%, respectively. The infection rate in children aged 5-7 years was the highest (13.56%) among all the child aged groups. There were significant differences for the infection rates of Enterobius vermicularis among children of different aged groups, different areas, different education levels and occupations of parents, washing hand before meal or not, washing hand after WC or not, different classroom grounds, and lodging or not (P < 0.01 or P < 0.05). The multivariate logistic analysis indicated that aged group, different areas, classroom ground and lodging children were independent risk factors for Enterobius vermicularis infection. CONCLUSIONS: The infection rate of Enterobius vermicularis in rural area is higher than that in urban area. The control emphases should be the children of low group, rural area, poor classroom and lodging.

[Influence factors of Enterobius vermicularis infection among pupils in Chongqing City].

OBJECTIVE: To investigate Enterobius vermicularis infection among primary school students and its influence factors in Chongqing. METHODS: Beibei and Changshou were selected as investigated points from October to December 2011. One primary school was randomly chosen from each of the 5 different directions in every investigated point. Adhesive cellophane anal swab was used to examine pinworm eggs for 3 consecutive days. Information on children's family, hygiene habits and school environment was collected by questionnaire. RESULTS: The total infection rate of E. vermicularis was 6.7% (71/1 071). The infection rate in rural schools (7.9%, 60/755) was higher than that of urban schools (3.8%, 12/316) (chi2 = 6.1169, P < 0.05). The rate in males and females was 6.3% (34/536) and 7.1% (38/535), respectively (chi2 = 0.2463, P > 0.05). Among the investigated children aged 6-12 years, the infection rate in 6-year-old children (16.03%) was highest. There was a statistical significance among age groups (chi2 = 29.1492, P < 0.01). With the increase of age, the rate decreased. Multivariate logistic regression analysis showed that location (OR = 0.411), age groups (OR = 0.714), education level of mothers (OR = 0.568), materials of classroom-ground (OR = 0.116) and types of boarding (OR = 0.272) were the influence factors on E. vermicularis infection in primary schools (P < 0.05). CONCLUSIONS: Pinworm control should more focused on rural children, younger group, mothers with lower education, classroom with cement ground and lodging schools in Chongqing City.

[Construction and expression of recombinant plasmid pET28alpha-Sj26GST of Schistosoma japonicum in Escherichia coli BL21].

OBJECTIVE: To construct and express recombinant plasmid pET28a-Sj26GST of Schistosoma japonicum (Sj) in Escherichia coli BL21 (DE3). METHODS: The total RNA was extracted from Sj adult worms by ultrasound-breaking. The Sj26GST antigen gene was amplified by RT-PCR from the total RNA, and then cloned into prokaryotic expression plasmid pET28alpha and transformed into E. coli BL2 (DE3). The BL21(pET28a-Sj26GST) was induced with isopropyl-beta-D-thiogalactopyranosid (IPTG), and the expressed products were analyzed and identified with SDS-PAGE and Western blot. RESULTS: The 676 bp Sj26GST gene was successfully amplified by RT-PCR and cloned into pET28alpha. The recombinant plasmid pET28a-Sj26GST was successfully constructed, with a relative molecular weight of expressed recombinant protein at approximately 36 x 10(3) as determined by SDS-PAGE. The amount of the expressed protein comprised 26% of the total bacterial proteins. The fusion protein could be recognized by the sera of rabbits infected with Sj. CONCLUSION: The recombinant plasmid pET28alpha-Sj26GST is successfully constructed and highly expressed in E. coli in a fused form with His-tag. The expressed fusion protein shows specific antigenicity.