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Colorectal cancer (CRC) risk is influenced by dietary patterns and gut microbiota enterotypes. However, the interaction between these factors remains unclear. This study examines this relationship, hypothesizing that different diets may affect colorectal tumor risk in individuals with varied gut microbiota enterotypes. We conducted a case-control study involving 410 Han Chinese individuals, using exploratory structural equation modeling to identify two dietary patterns, and a Dirichlet multinomial mixture model to classify 250 colorectal neoplasm cases into three gut microbiota enterotypes. We assessed the association between dietary patterns and the risk of each tumor subtype using logistic regression analysis. We found that a healthy diet, rich in vegetables, fruits, milk, and yogurt, lowers CRC risk, particularly in individuals with type I (dominated by Bacteroides and Lachnoclostridium) and type II (dominated by Bacteroides and Faecalibacterium) gut microbiota enterotypes, with adjusted odds ratios (ORs) of 0.66 (95% confidence interval [CI] = 0.48-0.89) and 0.42 (95% CI = 0.29-0.62), respectively. Fruit consumption was the main contributor to this protective effect. No association was found between a healthy dietary pattern and colorectal adenoma risk or between a high-fat diet and colorectal neoplasm risk. Different CRC subtypes associated with gut microbiota enterotypes displayed unique microbial compositions and functions. Our study suggests that specific gut microbiota enterotypes can modulate the effects of diet on CRC risk, offering new perspectives on the relationship between diet, gut microbiota, and colorectal neoplasm risk.
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Neoplasias Colorretais , Microbioma Gastrointestinal , Humanos , Estudos de Casos e Controles , Neoplasias Colorretais/patologia , Dieta Hiperlipídica , População do Leste Asiático , Dieta SaudávelRESUMO
Malaria is a parasitic disease caused by Plasmodium, and Anopheles sinensis is a vector of malaria. Although malaria is no longer indigenous to China, a high risk remains for local transmission of imported malaria. This study aimed to identify the risk distribution of vector An. sinensis and malaria transmission. Using data collected from routine monitoring in Shanghai from 2010 to 2020, online databases for An. sinensis and malaria, and environmental variables including climate, geography, vegetation, and hosts, we constructed 10 algorithms and developed ensemble models. The ensemble models combining multiple algorithms (An. sinensis: area under the curve [AUC] = 0.981, kappa = 0.920; malaria: AUC = 0.959, kappa = 0.800), with the best out-of-sample performance, were used to identify important environmental predictors for the risk distributions of An. sinensis and malaria transmission. For An. sinensis, the most important predictor in the ensemble model was moisture index, which reflected degree of wetness; the risk of An. sinensis decreased with higher degrees of wetness. For malaria transmission, the most important predictor in the ensemble model was the normalized differential vegetation index, which reflected vegetation cover; the risk of malaria transmission decreased with more vegetation cover. Risk levels for An. sinensis and malaria transmission for each district of Shanghai were presented; however, there was a mismatch between the risk classification maps of An. sinensis and malaria transmission. Facing the challenge of malaria transmission in Shanghai, in addition to precise An. sinensis monitoring in risk areas of malaria transmission, malaria surveillance should occur even in low-risk areas for An. sinensis.
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Anopheles , Malária , Plasmodium , Animais , Humanos , Anopheles/parasitologia , Mosquitos Vetores/parasitologia , China/epidemiologia , Malária/epidemiologiaRESUMO
BACKGROUND: Shanghai had a local outbreak of COVID-19 from January 21 to 24. Timely and precise strategies were taken to prevent further spread of the disease. We discussed and shared the experience of COVID-19 containment in Shanghai. PROCESS: The first two patients worked at two hospitals but no staff from the two hospitals were infected. The suspected case and his two close contacts were confirmed to be infected within 12 h. The testing rate of individuals was low. The scope of screening was minimized to two related districts and the close contact tracing was completed within 12 h, which were precise and cost-effective. CONCLUSIONS: Active monitoring, precise epidemiological investigation and timely nucleic acid testing help discover new cases, minimize the scope of screening, and interrupt the transmission.
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COVID-19/epidemiologia , COVID-19/transmissão , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , COVID-19/complicações , COVID-19/prevenção & controle , China/epidemiologia , Busca de Comunicante , Complicações do Diabetes , Surtos de Doenças , Feminino , Humanos , Hipertensão/complicações , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Quarentena/normasRESUMO
INTRODUCTION: The objective of this study was to examine the association between type 2 diabetes mellitus (T2DM) and genes identified in previous genome-wide association studies (GWASs) in rural Han Chinese adults. METHODS: This prospective study included 1,832 adults aged ≥18 years in Deqing without diabetes at baseline. The subjects were followed up for 8.7 years on average. We selected 45 susceptible tag single-nucleotide polymorphisms (SNPs) for T2DM that have been identified in GWASs and genotyped. A Cox model was constructed to calculate the adjusted hazard ratios (aHRs) for the association between SNPs and incident T2DM. RESULTS: The incidence rate of T2DM was 12.0 per 1,000 person-years. After adjustment for covariates and a Bonferroni correction, rs17584499 of protein tyrosine phosphatase, receptor-type D (PTPRD), rs11257655 and rs10906115 of cell division cycle 123 gene (CDC123), and rs12970134 of melanocortin-4 receptor (MC4R) were significantly associated with incident T2DM. The aHRs for incident T2DM were 1.75 (95% confidence interval [CI]: 1.28-2.40) and 1.61 (95% CI: 1.27-2.04) in association with an increasing number of T alleles in rs17584499 and rs11257655 under an additive genetic model, and the aHR was 1.72 (95% CI: 1.33-2.22) with an increasing number of A alleles in rs10906115. The aHRs under the dominant model were 1.82 (95% CI: 1.25-2.66) for TT + CT versus CC of rs17584499 and 2.04 (95% CI: 1.47-2.86) for AA + AG versus GG of rs10966115. The aHRs under the recessive model were 2.99 (95% CI: 1.30-6.89) for TT versus CT + CC of rs17584499, 1.92 (95% CI: 1.39-2.70) for TT versus CT + CC of rs11257655, and 2.54 (95% CI:1.22-5.29) for AA versus AG + GG of rs12970134. In addition, an increased incidence of T2DM was significantly associated with the TA haplotype of rs11257655 and rs10906115 (aHR = 1.81, 95% CI: 1.12-2.92), while a decreased incidence was associated with the CG haplotype (aHR = 0.49, 95% CI: 0.35-0.68) and the CT haplotype of rs1111875 and rs5015480 (aHR = 0.61, 95% CI: 0.37-0.98). CONCLUSION: Variants of the PTPRD, CDC123, and MC4R genes were associated with the T2DM incidence in a rural Han Chinese population.
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Diabetes Mellitus Tipo 2 , Polimorfismo de Nucleotídeo Único , Adolescente , Adulto , Alelos , Povo Asiático/genética , Estudos de Casos e Controles , China , Diabetes Mellitus Tipo 2/genética , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Genótipo , Humanos , Estudos ProspectivosRESUMO
In recent years, it has been demonstrated that some susceptible gene loci of type 2 diabetes mellitus (T2DM) are not only associated with the susceptibility risk of T2DM, but also the modifying effects of lifestyle interventions. To further explore the modifying effects of the single nucleotide polymorphism (SNP) on the onset of T2DM and the reduction of blood glucose in response to lifestyle interventions among the high-risk population, we performed a lifestyle intervention study in two Deqing rural communities during the period from June to December in 2017. The intensive lifestyle interventions were conducted among the study subjects of the intervention group while those in the control group only received conventional and general health education. All participants were genotyped by the MassARRY system. This study showed that for SNP rs9502570, fasting blood glucose showed a significantly greater reduction for individuals with CC + CT genotype than those with TT genotype (P=0.031). In the intervention group, the glycated hemoglobin A1C (HbA1C) decreased by 0.03% for those with CC+CT genotype, while HbA1C increased by 0.27% for those with TT genotype (P=0.012). The difference in the reduction of fasting blood glucose and HbA1c between the intervention and control groups was also statistically significant between individuals with TT and those with CC+CT genotype. For SNP rs10811661, the reduction of fasting blood glucose was significantly higher in people with TT genotype than those with CC + CT genotype (0.44 mmol/L vs 0.12 mmol/L, P=0.021). The difference in reduction of fasting blood glucose between the intervention group and control group was also statistically significant between TT and CC+CT genotype (P<0.001). In summary, the SNP genotypes of both rs9502570 and rs10811661 could modify the effects of lifestyle interventions on reducing fasting blood glucose and HbA1C among the high risk rural population for T2DM. The present study has provided supporting evidence for future development of individualized intervention measures for high-risk population of T2DM.
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Glicemia , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/terapia , Estilo de Vida , Polimorfismo de Nucleotídeo Único , China , Genótipo , Hemoglobinas Glicadas/análise , Humanos , População RuralRESUMO
Internationally, vaccine pricing is relatively opaque, although many low- or lower-middle-income countries belong to international consortiums that jointly procure vaccines. China procures vaccines domestically, and vaccines that require payment from the public ("category 2 vaccines"), have undergone several regulatory changes over the past 15 years. This study aims to describe the vaccine procurement method changes in China since 2005 and to analyze how the procurement method impacted vaccine price. This review of vaccine procurement reforms found that a shift to provincial-level Group Purchasing Organizations after 2016 was accompanied by an increase in most prices. There was more variability in vaccine prices across provinces for vaccines with only one supplier, and these vaccines have a higher price than what is found in United Nations Children's Fund (UNICEF)-supported countries. China's current procurement system for non-mandatory vaccines leaves these vaccines costing several-fold more than in other countries, and in particular those supported by Gavi, the Vaccine Alliance. Exploring a variety of methods to reduce vaccine purchase prices will not only directly benefit the general population, but also the government, as they aim to implement more programs to benefit public health in a cost-effective manner.
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BACKGROUND: Biomphalaria straminea is an invasive vector in China, posing a significant threat to public health. Understanding the factors affecting the establishment of this snail is crucial to improve our ability to manage its dispersal and potential risk of schistosomiasis transmission. This study sought to determine the spatial distribution of B. straminea in mainland China and whether environmental factors were divergent between places with and without B. straminea. METHODS: A malacological survey of B. straminea was conducted in Guangdong Province, China. Snails were identified using anatomical keys. Water and sediment samples were taken, and their physicochemical properties were analyzed using national standard methods. Landscape and climatic variables were also collected for each site. We compared the environmental characteristics between sites with and without B. straminea using Mann-Whitney U test. We further used generalized linear mixed models to account for seasonal effects. RESULTS: B. straminea was found at six sites, including one in Dongguan and five in Shenzhen. Probability map found a hot spot of B. straminea distribution at Shenzhen and Hong Kong. Sites occupied by B. straminea were characterized by higher median altitude, mean annual precipitation and moderate temperature. Water with snails had higher median concentrations of total nitrogen, nitrate and nitrites, ammoniacal nitrogen, calcium, zinc and manganese but lower dissolved oxygen and magnesium. Sediments with snails had higher median copper, zinc and manganese. B. straminea was associated with maximum temperature of the warmest month (pMCMC < 0.001) and sediment zinc (pMCMC < 0.001). CONCLUSIONS: B. straminea is distributed in Shenzhen and its surrounding areas in Guangdong, China. Sites with and without B. straminea differed in the maximum temperature of the warmest month and sediment zinc. Surveillance should be continued to monitor the dispersal of this snail in China.
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Biomphalaria/parasitologia , Schistosoma mansoni/isolamento & purificação , Animais , China/epidemiologia , Vetores de Doenças , Ecossistema , Meio Ambiente , Sedimentos Geológicos/análise , Chuva , Esquistossomose mansoni/epidemiologia , Análise Espacial , TemperaturaRESUMO
OBJECTIVE: To explore the association between infections with HIV and Schistosoma japonicum, and to determine the influences of the HIV-S. japonicum coinfections on the immune system of Yi people. METHODS: A block design study was conducted in a Yi county in southwestern China, one of the endemic areas of both HIV/AIDS and S. japonicum in China. All participants were screened for HIV antibodies and S. japonicum antibodies (SjAb) and were classified into four groups: HIV(+)/S. japonicum(-), HIV(-)/S. japonicum (+), HIV(+)/S. japonicum(+), and HIV(-)/S. japonicum(-). RESULTS: There were significant differences among the four groups in both CD4+ T lymphocytes and CD8+ T lymphocytes, but no significant difference in CD3+ T lymphocytes. Both the CD4+ T lymphocyte counts and the ratio of CD4+/CD8+ were lower in HIV-infected people compared with those uninfected. People infected with S. japonicum had increased CD4+ T lymphocyte counts but reduced CD8+ T lymphocyte counts. Similarly, the ratio of CD4+/CD8+ was higher in S. japonicum-infected people compared with those uninfected. People coinfected with HIV and S. japonicum had lower CD4+ T lymphocyte counts, lower ratio of CD4+/CD8+, and higher CD8+ T lymphocyte counts compared with those infected with HIV only or S. japonicum only. People infected with HIV only and those coinfected with HIV and S. japonicum had a higher level of IFN-γ compared with people with no infection. There were no significant differences between people infected with HIV only and with S. japonicum only in the levels of IFN-γ and IL-10. CONCLUSIONS: People coinfected with HIV and S. japonicum might have a suppressed immune function because of a decrease in CD4+ T lymphocyte counts, a lowered ratio of CD4+/CD8+, and an increase in CD8+ T lymphocyte counts. Coinfection with HIV and S. japonicum would alter the level of IFN-γ in plasma.
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Linfócitos T CD4-Positivos/patologia , Linfócitos T CD8-Positivos/patologia , Infecções por HIV/imunologia , HIV/imunologia , Schistosoma japonicum/imunologia , Esquistossomose Japônica/imunologia , Adolescente , Adulto , Animais , Anticorpos Anti-Helmínticos/sangue , Anticorpos Antivirais/sangue , China , Coinfecção , Feminino , Humanos , Interferon gama/metabolismo , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
BACKGROUND: Schistosomiasis is one of the most devastating tropical diseases in the world. Oncomelania hupensis is the only intermediate host of Schistosoma japonicum, and its growth and development are sensitive to environmental factors. The Three Gorges Dam has substantially altered the water level in the Yangtze River. This study focused on the impact of the flooding time on the occurrence of Oncomelania snails in Hunan Province, China. METHODS: The data regarding Oncomelania snails were collected from the Schistosomiasis Atlas of the People's Republic of China. Air temperature, hours of daylight and relative humidity from 1995 to 2002 were collected from the China Meteorological Data Sharing Service System. The data for rainfall and days inundated with water were collected from the Hunan flood control information system and hydrological stations in Hunan Province. A generalized additive model was used to estimate the impact of these factors on the presence or absence of snails. RESULTS: The number of days inundated with water in the areas with snails ranged from 56 to 212 days. However, 82 percent of the areas without snails were inundated with water less than 60 days. The lowest air temperature in a year in the areas without snails ranges from -2.88 °C to -2.10 °C, and the range was from -2.88 °C to -2.34 °C for areas with snails. Annual rainfall in the areas with snails ranged from 989 to 1565 mm, and the range was from 1230 mm to 1647 mm for the areas without snails. The results from the generalized additive model showed that the number of days inundated with water, lowest air temperature in a year, annual rainfall, days of daily rainfall greater than 0.1 mm, and hours of daylight were the factors that significantly affect the occurrence of snails in Hunan Province, China. CONCLUSIONS: The number of days inundated with water may be a key factor determining the geographical distribution of Oncomelania snails in Hunan Province and the favorable number of days inundated with water for the survival of snails ranges from about 2 to 7 months.
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Reservatórios de Doenças/parasitologia , Inundações , Rios/parasitologia , Esquistossomose Japônica/epidemiologia , Esquistossomose Japônica/transmissão , Caramujos/parasitologia , Animais , China/epidemiologia , Caramujos/crescimento & desenvolvimentoRESUMO
In 2013, two episodes of influenza emerged in China and caused worldwide concern. A new H7N9 avian influenza virus (AIV) first appeared in China on February 19, 2013. By August 31, 2013, the virus had spread to ten provinces and two metropolitan cities. Of 134 patients with H7N9 influenza, 45 died. From then on, epidemics emerged sporadically in China and resulted in several victims. On November 30, 2013, a 73-year-old woman presented with an influenza-like illness. She developed multiple organ failure and died 9 d after the onset of disease. A novel reassortant AIV, H10N8, was isolated from a tracheal aspirate specimen that was obtained from the patient 7 d after onset. This case was the first human case of influenza A subtype H10N8. On 4 February, 2014, another death due to H10N8 avian influenza was reported in Jiangxi Province, China.
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Vírus da Influenza A Subtipo H9N2/classificação , Influenza Humana/virologia , Vírus Reordenados/classificação , Idoso , China/epidemiologia , Feminino , Humanos , Vírus da Influenza A Subtipo H10N8/classificação , Subtipo H7N9 do Vírus da Influenza A/classificação , Influenza Humana/epidemiologia , FilogeniaRESUMO
BACKGROUND: Communication for Development (C4D) is a strategy promoted by the United Nations Children's Fund to foster positive and measurable changes at the individual, family, community, social, and policy levels of society. In western China, C4D activities have previously been conducted as part of province-level immunization programs. In this study, we evaluated the association of C4D with changes in parental knowledge of immunization services, measles disease, and measles vaccine, and changes in their children's measles vaccine coverage. METHODS: From April 2013 to April 2014, C4D activities were implemented as part of provincial immunization programs in the Inner Mongolia, Guangxi, Chongqing, Guizhou, Tibet, Shaanxi, Gansu, Ningxia, and Qinghai provinces. We used a before-and-after study design and employed face-to-face interviews to assess changes in parental knowledge and vaccination coverage. RESULTS: We surveyed 2 107 households at baseline and 2 070 households after 1 year of C4D activities. Following C4D, 95% of caregivers were aware of the vaccination record check requirement for entry into kindergarten and primary school; 80% of caregivers were aware that migrant children were eligible for free vaccination; more than 70% of caregivers knew that measles is a respiratory infectious disease; and 90% of caregivers knew the symptoms of measles. Caregivers' willingness to take their children to the clinic for vaccination increased from 51.3% at baseline to 67.4% in the post-C4D survey. Coverage of one-dose measles-containing vaccine (MCV) increased from 83.8% at baseline to 90.1% after C4D. One-dose MCV coverage was greater than 95% in the Guangxi, Shaanxi, and Gansu provinces. Two-dose MCV coverage increased from 68.5 to 77.6%. House-to-house communication was the most popular C4D activity among caregivers (91.6% favoring), followed by posters and educational talks (64.8 and 49.9% favoring). CONCLUSIONS: C4D is associated with increased caregiver knowledge about measles, increased willingness to seek immunization services for their children, and increased measles vaccination coverage. Tailored communication strategies based on insights gained from these analyses may be able to increase vaccination coverage in hard-to-reach areas. C4D should be considered for larger scale implementation in China.
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Conhecimentos, Atitudes e Prática em Saúde , Programas de Imunização , Vacina contra Sarampo , China/epidemiologia , Seguimentos , Humanos , Imunização/métodos , Imunização/psicologia , Imunização/estatística & dados numéricos , Sarampo/prevenção & controle , PobrezaRESUMO
BACKGROUND: Cryptosporidium spp. is an important intestinal protozoan causing diarrhea in humans, livestock, and wild animals. Cryptosporidium infection remains a major public health issue, but its epidemiology in humans is still unclear, particularly in rural China. This study was designed to determine the prevalence of and risk factors associated with Cryptosporidium infection in a rural southwestern Chinese community. METHODS: A community-based cross-sectional survey was conducted among 687 residents of a small town in a Yi autonomous prefecture of southwest China in 2014. Blood samples were examined using a broad set of quality-controlled diagnostic methods for hepatitis B virus (HBV) and human immunodeficiency virus (HIV). Stool specimens were processed using the modified acid-fast staining method, and microscopically examined for Cryptosporidium infection. Univariable and multivariable analyses were performed to determine the risk factors associated with Cryptosporidium infection. RESULTS: The majority of the participants were Yi people with poor living conditions and unsatisfactory hygiene habits, and the study area was of very low socioeconomic status. Of the 615 individuals included in the analysis, 14 (2.3%) were HIV positive, 51 (8.3%) were infected with HBV, and 74 (12.0%) had Cryptosporidium infection. The prevalences of HIV/HBV, HIV/Cryptosporidium, and HBV/Cryptosporidium co-infections were 0.3%, 0.3%, and 1.8%, respectively. The prevalence of HBV infection was higher in individuals with Cryptosporidium infection (χ 2 = 5.00, P = 0.03). Owning livestock or poultry was an important risk factor for Cryptosporidium infection (aOR = 2.27, 95% CI: 1.01-5.08, P < 0.05). Cryptosporidium infection was significantly associated with HBV infection (aOR = 3.42, 95% CI: 1.47-7.92, P < 0.01), but not with HIV infection (aOR = 0.57, 95% CI: 0.07-4.39, P = 0.59). CONCLUSIONS: The prevalence of Cryptosporidium infection was high in the rural area of southwestern China that was investigated, and there was a significant association between HBV infection and Cryptosporidium infection. Further investigations are needed to determine the significance of Cryptosporidium infection in patients infected with HBV.
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Criptosporidiose/epidemiologia , Cryptosporidium/isolamento & purificação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , China/epidemiologia , Estudos Transversais , Criptosporidiose/parasitologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Pobreza , Prevalência , Fatores de Risco , População Rural/estatística & dados numéricos , Adulto JovemRESUMO
Schistosomiasis remains a serious public health issue in many tropical countries, with more than 700 million people at risk of infection. In China, a national integrated control strategy, aiming at blocking its transmission, has been carried out throughout endemic areas since 2005. A longitudinal study was conducted to determine the effects of different intervention measures on the transmission dynamics of S. japonicum in three study areas and the data were analyzed using a multi-host model. The multi-host model was also used to estimate the threshold of Oncomelania snail density for interrupting schistosomiasis transmission based on the longitudinal data as well as data from the national surveillance system for schistosomiasis. The data showed a continuous decline in the risk of human infection and the multi-host model fit the data well. The 25th, 50th and 75th percentiles, and the mean of estimated thresholds of Oncomelania snail density below which the schistosomiasis transmission cannot be sustained were 0.006, 0.009, 0.028 and 0.020 snails/0.11 m(2), respectively. The study results could help develop specific strategies of schistosomiasis control and elimination tailored to the local situation for each endemic area.
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Transmissão de Doença Infecciosa/prevenção & controle , Vetores de Doenças , Schistosoma/isolamento & purificação , Esquistossomose/transmissão , Caramujos/crescimento & desenvolvimento , Caramujos/parasitologia , Animais , China/epidemiologia , Humanos , Estudos Longitudinais , Densidade Demográfica , Medição de Risco , Esquistossomose/epidemiologiaRESUMO
The elimination of Oncomelania hupensis snails is important to schistosomiasis control. Recently, the application of molluscicidal organisms is considered as a safe and efficient method for snail elimination. In order to provide scientific evidences for effective control of O. hupensis and schistosomiasis, this paper summarizes the researches of molluscicidal microorganisms against O. hupensis.
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Moluscocidas/farmacologia , Esquistossomose/prevenção & controle , Caramujos/efeitos dos fármacos , Microbiologia do Solo , Animais , Caramujos/microbiologiaRESUMO
The Three Gorges Dam, located in the largest endemic area of schistosomiasis in China, is one of the world's largest hydroelectric projects to date. Some large-scale hydro projects have resulted in schistosomiasis emergence or re-emergence. Therefore, the dam's potential impact on the transmission of Schistosoma japonicum has raised concerns from medical researchers worldwide. A systematic literature review, coupled with an analysis of data on the water level and snail density in the Yangtze River was conducted to assess the impact of the dam on schistosomiasis transmission after more than 10 years of operation. The dam has significantly altered the water levels in the Yangtze River according to different seasons. These changes directly impact the ecology of the schistosome snail host. Due to the dam, there has been a reduction in the density of Oncomelania snails and/or changes in the distribution of snails. The prevalence of infection with S. japonicum has decreased in the downstream areas of the dam, including in the Dongting and Poyang Lakes. The prevalence of infection with S. japonicum in humans has decreased from 6.80 % in 2002 (before the dam began operating) to 0.50 % in 2012, and the number of people infected with S. japonicum have decreased from 94 208 in 2002 to 59 200 in 2011 in the Poyang Lake region. The presence of the dam does not seem to affect snail breeding or the prevalence of schistosomiasis in the Three Gorges Reservoir. Overall, the Three Gorges Dam has significantly contributed to changes in hydrology after more than 10 years of the dam operating. The changes caused by the dam, together with integrated control of schistosomiasis, might be accelerating the progress towards eliminating the transmission of S. japonicum in the middle and lower reaches of the Yangtze River. Despite the positive effect the dam is having in controlling S. japonicum transmission, continued surveillance is required to monitor the future ecological impacts of the dam over the long term.
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Distribuição Animal , Gastrópodes/fisiologia , Gastrópodes/parasitologia , Schistosoma japonicum/fisiologia , Esquistossomose Japônica/prevenção & controle , Esquistossomose Japônica/transmissão , Animais , China/epidemiologia , Humanos , Lagos , Rios , Esquistossomose Japônica/epidemiologia , Esquistossomose Japônica/parasitologia , Estações do Ano , Movimentos da ÁguaRESUMO
BACKGROUND: Intestinal helminths do not cause severe diseases in general, however, when combined with other diseases such as immunodeficiency diseases, there would be massive complications. Infections with Hepatitis B Virus (HBV) may lead to immunological disturbances and defects of cellular immunity and there is a need of clarification whether HBV infections are associated with infections with intestinal helminths. METHODS: A community-based cross sectional study was conducted in Tezi town, Puge County of the Liangshan Prefecture, southwestern China from October 23rd to November 3rd, 2014. Four hundred and thirty eight people (median age = 37 years, IQR = 22-49) were enrolled in this study. Modified Kato-Katz thick smear was used to detect intestinal helminths. HBV DNA was quantified to confirm HBV infection. RESULTS: Among the 438 participants, 9.1%, 13.5% and 30.6% were infected with HBV, A. lumbricoides (L., 1758) and T. trichiura (L., 1771), respectively; 7.1% (30/438) were infected with both A. lumbricoides and T. trichiura and 2.3% (10/438) were co-infected with HBV and A. lumbricoides. The multivariate logistic regression analysis showed that age (21-30 years versus >50 years: OR = 6.66, 95% CI = 2.15-20.68), drug abuse (OR = 6.96, 95% CI = 1.11-43.90), A. lumbricoides infection (OR = 3.60, 95% CI = 1.48-8.75), fertilization with faeces after disposal (OR = 0.15, 95% CI = 0.04-0.47) and working on a farm (OR = 4.59, 95% CI = 1.44-14.63) were significantly associated with HBV infection. Having toilets at home was negatively related to A. lumbricoides infection (OR = 0.52, 95% CI = 0.27-0.98) and T. trichiura infection (OR = 0.48, 95% CI = 0.28-0.80). CONCLUSIONS: Ascaris lumbricoides was independently associated with HBV infection, and faeces might be the medium of HBV transmission. Improving hygiene conditions and habits are essential to reduce the risks of A. lumbricoides and T. trichiura infections.
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Ascaríase/epidemiologia , Hepatite B/epidemiologia , Tricuríase/epidemiologia , Animais , Ascaris lumbricoides/isolamento & purificação , China/epidemiologia , Estudos Transversais , DNA Viral/isolamento & purificação , Vírus da Hepatite B/isolamento & purificação , Humanos , Prevalência , Fatores de Risco , Trichuris/isolamento & purificaçãoRESUMO
BACKGROUND: To assess the association between maternal human immunodeficiency virus (HIV) infection and low birth weight (LBW)/prematurity (PTD), we conducted a meta-analysis of cohort studies of HIV infected and uninfected women. METHODS: Several English and Chinese databases were searched (updated to May 2015) to find the studies reporting infant outcomes associated with exposure to maternal HIV infection during pregnancy. Relevant articles were manually selected based on several inclusion and exclusion criteria. RESULTS: Fifty-two cohort studies including 15,538 (for LBW) and 200,896 (for PTD) HIV infected women met the inclusion criteria. There was significant heterogeneity among studies for maternal HIV infection associated with LBW/PTD (I(2) = 71.7%, P < 0.05, and I(2) = 51.8%, P < 0.05 for LBW and PTD, respectively). The meta-analysis demonstrated that the maternal HIV infection was significantly associated with both LBW (pooled odds ratio (OR): 1.73, 95% confidence interval (CI): 1.64, 1.82, P < 0.001) and PTD (pooled OR: 1.56, 95% CI: 1.49, 1.63, P < 0.001). No significant difference in the relationship between maternal HIV infection and adverse pregnancy outcomes was detected among the groups of different study periods. HIV infected women were at slightly higher risk of LBW in developing countries compared with women in developed countries (OR: 2.12 (95% CI: 1.81, 2.48) vs. 1.75 (95% CI: 1.44, 2.12)). Antiretroviral drugs usage did not significantly change the associations of maternal HIV exposure with LBW and PTD. CONCLUSIONS: HIV infected women were at higher risk of having a low birth weight infant or a preterm delivery infant compared with uninfected women. Such associations did not change significantly over time or were not significantly affected by the usage of antiretroviral drugs.
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Peso ao Nascer , Países Desenvolvidos/estatística & dados numéricos , Países em Desenvolvimento/estatística & dados numéricos , Infecções por HIV/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Nascimento Prematuro/epidemiologia , China/epidemiologia , Inglaterra/epidemiologia , Feminino , Humanos , Recém-Nascido de Baixo Peso , GravidezRESUMO
OBJECTIVE: To study the reasons of natural death of Oncomelania hupensis snails by comparing the differences of the indicator days covered with water (DCW) in snail marshland and non-snail marshland around the build of Three Gorges Dam in Eastern Dongting Lake areas. METHODS: Two marshlands were selected, one was a non-snail marshland (Qianliang Lake) and another was a snail marshland (Junshan Park). The measuring points were set through the mechanical sampling. The snails and elevation of the points were surveyed, and the data of the water levels from the hydrological station were collected, and then DCWs were calculated. RESULTS: From 1995 to 2013, DCWs of the marshland of natural death of snails were all more than that of the snail marshland (P < 0.01). In Qianliang Lake marshland, the difference between DCW before natural death and DCW from natural death until the dam was not significant (P = 0.23), while DCWs of the two stages both were more than that after the dam (P1 = 0.045, P2 = 0.002). Before the build of the dam, DCW of the Qianliang Lake marshland of natural death of snails was more than that after the build of the dam (P = 0.013), and there was the same situation in Junshan Park marshland (P = 0.005). The relationship between snail density and DCW was not significant in Junshan Park marshland (r(s) = 0.008, P = 0.914), and the reference range of DCW of all the measuring points was 76-251 days. CONCLUSION: In the eastern Dongting Lake district, the build of Three Gorges Dam and DCW may be not the direct factors affecting the natural death of snails and the latter may change the distribution of snails.
Assuntos
Caramujos , Animais , China , Demografia , Lagos , Densidade DemográficaRESUMO
BACKGROUND: Previous studies have shown inconsistent or even contradictory results for some risk factors associated with HIV infection among drug users, and these may be partially explained by geographical variations. METHODS: Data were collected from 11 methadone clinics in the Liangshan Yi Autonomous Prefecture from 2004 to 2012. A non-spatial logistical regression model and a geographically weighted logistic regression model were fitted to analyze the association between HIV infection and specific factors at the individual level. RESULTS: This study enrolled 6,458 patients. The prevalence of HIV infection was 25.1 %. The non-spatial model indicated that being divorced was positively associated with HIV infection. The spatial model also showed that being divorced was positively associated with HIV infection, but only for 49.4 % of individuals residing in some northern counties. The non-spatial model suggested that service sector work was negatively associated with HIV infection. However, the spatial model indicated that service work was associated with HIV infection, but only for 23.0 % of patients living in some western counties. The non-spatial model did not show that being married was associated with HIV infection in our study field, but the spatial model indicated that being married was negatively associated with HIV infection for 12.0 % of individuals living in some western counties. For other factors, the non-spatial and spatial models showed similar results. CONCLUSION: The spatial model may be useful for improving understanding of geographical heterogeneity in the relationship between HIV infection and individual factors. Spatial heterogeneity may be useful for tailoring intervention strategies for local regions, which can consequently result in a more efficient allocation of limited resources toward the control of HIV transmission.
Assuntos
Usuários de Drogas , Infecções por HIV/epidemiologia , China/epidemiologia , Feminino , Geografia Médica , Infecções por HIV/transmissão , Humanos , Masculino , Modelos Estatísticos , Prevalência , Fatores de RiscoRESUMO
BACKGROUND: Schistosomiasis remains an important public health issue in China and worldwide. Oncomelania hupensis is the unique intermediate host of schistosoma japonicum, and its change influences the distribution of S. japonica. The Three Gorges Dam (TGD) has substantially changed the ecology and environment in the Dongting Lake region. This study investigated the impact of water level and elevation on the survival and habitat of the snails. METHODS: Data were collected for 16 bottomlands around 4 hydrological stations, which included water, density of living snails (form the Anxiang Station for Schistosomiasis Control) and elevation (from Google Earth). Based on the elevation, sixteen bottomlands were divided into 3 groups. ARIMA models were built to predict the density of living snails in different elevation areas. RESULTS: Before closure of TGD, 7 out of 9 years had a water level beyond the warning level at least once at Anxiang hydrological station, compared with only 3 out of 10 years after closure of TGD. There were two severe droughts that happened in 2006 and 2011, with much fewer number of flooding per year compared with other study years. Overall, there was a correlation between water level changing and density of living snails variation in all the elevations areas. The density of living snails in all elevations areas was decreasing after the TGD was built. The relationship between number of flooding per year and the density of living snails was more pronounced in the medium and high elevation areas; the density of living snails kept decreasing from 2003 to 2014. In low elevation area however, the density of living snails decreased after 2003 first and turned to increase after 2011. Our ARIMA prediction models indicated that the snails would not disappear in the Dongting Lake region in the next 7 years. In the low elevation area, the density of living snails would increase slightly, and then stabilize after the year 2017. In the medium elevation region, the change of the density of living snails would be more obvious and would increase till the year 2020. In the high elevation area, the density of living snails would remain stable after the year 2015. CONCLUSION: The TGD influenced water levels and reduced the risk of flooding and the density of living snails in the study region. Based on our prediction models, the density of living snails in all elevations tends to be stabilized. Control of S. japonica would continue to be an important task in the study area in the coming decade.