OBJECTIVETo identify the cause of an outbreak of foot pain syndrome among students from a senior high school in Foshan.

METHODSWe defined a suspect case as onset of foot pain/numbness with unknown reason among students and teachers in a school of Foshan city, from February 10 to March 16, 2014. A suspect case was noticed as having both food pain and numbness. All the cases were searched through reviewing medical records in the nearby hospitals and school's clinic, also the records of absenteeism in school. Clinical information was collected from all the students, using a standardized questionnaire. Daily temperature was collected from all the students, between January 1 and March 31, 2014. A 1 : 2 individual matched case-control study was conducted to identify related risk factors on this epidemic. We interviewed all the cases and controls on their diet, physical activities and measures used for warming.

RESULTSA total of 407 case-students were identified, with an attack rate (AR) as 26.5%. The AR was 37.3% in girls, compared to 12.9% in boys. The difference was statistically significant (χ² = 115.1, P < 0.01). Boarding students had a higher AR (31.8%) than the commuting students (16.2%). The difference was statistically significant (χ² = 43.2, P < 0.01). In girls, boarding students had higher AR (46.1%) than those commuting students (18.5%). The difference was statistically significant (χ² = 61.4, P < 0.01). No statistically significant difference was found between boarding or commuting students in boys. Outdoor temperature was coming down from 23 °C on February 6 to 6 °C on February 13, but gradually rose to 23 °C on February 28. There was a positive relationship (r = 0.65, P = 0.002) noticed between daily maximum temperature and the number of cases during February 13-28. Results from this case-control study showed that factors as lacking physical activities (OR = 2.8, 95% CI: 1.5-5.6), feeling cold in bed (OR = 3.0, 95% CI: 1.3-7.0) and having experienced similar symptoms (OR = 3.4, 95% CI: 1.1-11.0) could increase the risk of this disease.

CONCLUSIONThis outbreak was possibly caused by the abrupt fluctuation of temperature within a short period.

Case-Control Studies ; China ; epidemiology ; Disease Outbreaks ; Female ; Foot Diseases ; epidemiology ; Humans ; Male ; Pain ; epidemiology ; Residence Characteristics ; statistics & numerical data ; Risk Factors ; Schools ; Students ; statistics & numerical data ; Surveys and Questionnaires ; Syndrome ; Temperature ; Time Factors ; Transportation ; statistics & numerical data

OBJECTIVETo observe the trends on prevalence of early syphilis and HIV infection among men who had sex with men in the last six years from a HIV/AIDS counseling and testing clinic in Nanjing, and to develop relative strategies.

METHODSMen who have sex with men involved in AIDS/HIV and syphilis voluntary counseling and testing services were recruited and investigated from 2008 to 2013 in this clinic. Clients whose syphilis serologic test showed positive were determined the diagnosis by physician within the referral network from sexually transmitted diseases clinics. Demographic information on early syphilis, HIV infection or co-infection with HIV and early syphilis was described while related epidemic trend analysis was performed.

RESULTSThe annual numbers of men having sex with men under survey were 1 004 in 2008, 1 218 in 2009, 1 236 in 2010, 748 in 2011, 1 019 in 2012 and 1 420 in 2013. The prevalence rates of early syphilis appeared to be: 2.19% in 2008, 2.71% in 2009, 2.43% in 2010, 1.74% in 2011, 3.04% in 2012 and 2.32% in 2013, with the trend as: P > 0.05. The prevalence rates of HIV infection were 1.29% in 2008, 2.63% in 2009, 5.42% in 2010, 8.82% in 2011, 11.97% in 2012 and 10.42% in 2013, with trend as: P < 0.01. The prevalence rates of early syphilis with HIV infection increased from 0.20% in 2008 to 1.06% in 2013 (trend: P < 0.01). The proportion of HIV co-infection among men having sex with men with early syphilis infection, increased from 9.09% in 2008 to 45.45% in 2013, with trend: P < 0.01.

CONCLUSIONEarly syphilis infection among men who having sex with men showed a stable trend but the number of HIV and co-infections with early syphilis and HIV increased rapidly in the last six years in Nanjing. Continued intervention strategies should target on men who have sex with men to slow down the epidemic of syphilis and HIV infection.

China ; epidemiology ; Coinfection ; Counseling ; HIV Infections ; epidemiology ; Homosexuality, Male ; statistics & numerical data ; Humans ; Male ; Prevalence ; Surveys and Questionnaires ; Syphilis ; epidemiology ; Syphilis Serodiagnosis

OBJECTIVEThe purpose of this study was to explore the spatial distribution and spatial clustering of hand-foot-mouth disease (HFMD) in Gansu, 2012.

METHODSSpatial autocorrelation and Spatial scanning analysis were used to conduct spatial statistical analyses for the HFMD at the county/district level.

RESULTSHFMD cases did not show a random distribution but with significant spatial aggregation. When Local Autocorrelation analysis was applied at the county/district level, with nine hot spot areas as Jiayuguan, Yumen, Dunhuang, Jinta, Suzhou, Chengguan, Anning, Xigu and Gaolan, were discovered. Four statistically significant HFMD clusters were identified by spatial scan statistics.

CONCLUSIONHFMD was noticed geographically clustered in Gansu in 2012. Results from this study indicated that the spatial autocorrelation and spatial scanning analysis could effectively detect the areas which presenting significant clusters. Cluster Detection System (CDS) could provide evidence for the development of an effective measure concerning the prevention and control of HFMD.

China ; epidemiology ; Cluster Analysis ; Hand, Foot and Mouth Disease ; epidemiology ; Humans ; Spatial Analysis

OBJECTIVETo analyze the information obtained through Internet-based media surveillance in 2013 on domestic public health emergencies and to compare with the related data reported through Chinese Public Health Emergency Management Information System (PHEMIS), and to study the role of Internet-based Media Surveillance Program (IBMSP) in the detection of public health emergencies.

METHODSA descriptive analysis was conducted based on the database of the information on domestic public health emergencies. Information was obtained through the Internet-based media surveillance in 2013.

RESULTSA total of 752 pieces of information regarding domestic public health emergencies in 31 provinces were obtained, through the IBMSP, run by the China CDC in 2013. 53.46% of all the information were categorized as initial ones on public health emergency while another 22.07% were considered as updated ones. 41.62% of the information were related to infectious diseases with another 24.73% to food poisoning. 27.53% of the information were from official websites of governments and professional organizations, with the rest 72.47% were from media. As for corresponding public health emergencies, 41.79% were food poisoning and 18.66% were infectious diseases. 22.39% of them occurred in schools, 18.16% in other organizations and 16.92% in households. 28.86% were reported through Chinese PHEMIS. For the 116 public health emergencies that both related to information obtained through Internet-based media surveillance in 2013 and reported through PHEMIS, the median days of interval between illness onset of the first case as well as reported by media, interval between onset of the first case as well as reported through PHEMIS, were 2.5 days and 2.0 days respectively. 19.83% of the emergencies were first reported by media than through PHEMIS.

CONCLUSIONInternet-based media surveillance programs had become an important way to detect public health emergencies and could serve as the supplement to the classic surveillance programs on public health emergencies.

China ; epidemiology ; Communicable Diseases ; epidemiology ; Databases, Factual ; Emergencies ; Humans ; Internet ; Public Health Surveillance ; methods

OBJECTIVETo explore the association between dietary cholesterol intake and hypercholesterolemia among Chinese adults.

METHODSIn 2009, 4 244 adults aged 25-65 years old who participated in both 2004 and 2009 China Health and Nutrition Surveys, and with complete biochemical and dietary data were selected. Hypercholesterolemia were defined as with total cholesterol ≥ 6.22 mmol/L, according to 2007 Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults. Non-conditional logistic regression was used to investigate association between dietary cholesterol intake and hypercholesterolemia.

RESULTSThe average total cholesterol was 4.9 mmol/L, with prevalence of hypercholesterolemia as 9.6%, in 2009. During 2004 to 2009, dietary cholesterol showed a dramatical increase, with lower intake groups the most. Males who consumed middle or lower dietary cholesterol in 2004 and high intake in 2009 had significantly higher risk of having hypercholesterolemia. However, similar findings did not appear in females.

CONCLUSIONThe associations between dietary cholesterol intake and hypercholesterolemia were different among Chinese males and females. Dramatic increase of dietary cholesterol intake was related to higher risk of hypercholesterolemia in males.

Adult ; Aged ; China ; epidemiology ; Cholesterol ; Cholesterol, Dietary ; administration & dosage ; Cohort Studies ; Female ; Humans ; Hypercholesterolemia ; epidemiology ; Male ; Middle Aged ; Nutrition Surveys ; Prevalence ; Risk Factors ; Sex Distribution

OBJECTIVETo study the HIV-1 genotypes and transmitted drug resistance (TDR) in Dehong prefecture of Yunnan province in 2013.

METHODSReferring to the guidelines for HIV drug resistance threshold survey (HIVDR-TS), 54 plasma samples of recently reported HIV-infected individuals, aged between 16 and 25 years, were collected in Dehong prefecture from January to August 2013. Genotyping of partial pol gene was performed by using reverse transcriptional PCR. HIV-1 genotype. Prevalent levels of HIV-1 drug resistance transmission were analyzed.

RESULTSForty-eight plasma samples were successfully sequenced and analyzed. Among them, 45.8% were Chinese and the rest 54.2% were all Burmese. Based on pol sequences, identified HIV genotypes included subtype C (41.7%), URF (31.3%), CRF01_AE (12.5%), CRF07_BC (10.4%), CRF08_BC (2.1%) and subtype B (2.1%), C subtype appeared dominated in Chinese while URF was dominated in Burmese. One drug resistant mutation to non-nucleoside reverse transcriptase inhibitors (NNRTIs) was detected in one sequence from Burmese. Based on the statistical method of HIVDR-TS, the prevalence of transmitted HIV-1 drug resistance was adjusted as < 5%.

CONCLUSIONDiverse HIV-1 genotypes were found in this study, and the current HIV-1 drug resistant strains transmission was catalogued as at low prevalence level, in Dehong. To prevent the increase of the prevalence of transmitted HIV-1 drug resistance, standard treatment and scientific management for people living with HIV/AIDS should be strictly followed. Meanwhile, relevant surveillance, including drug resistance surveillance should also be performed among cross-border migrant population.

Anti-HIV Agents ; pharmacology ; therapeutic use ; China ; Drug Resistance, Viral ; genetics ; Genes, pol ; Genotype ; HIV Infections ; drug therapy ; virology ; HIV-1 ; drug effects ; genetics ; Humans ; Mutation ; Polymerase Chain Reaction ; Prevalence ; Reverse Transcriptase Inhibitors

OBJECTIVETo analyze the cost effectiveness of HIV screening project in three Guangxi infectious disease special demonstration project countries in 2013.

METHODSTo calculate the funds used for the HIV screening project and to study the data on HIV/AIDS and HAART. A five-tree markov model was used to evaluate the quality adjusted life year (QALY) of this HIV screening project and to analyze the related cost effectiveness of the project.

RESULTSThe cost of HIV screening in Guangxi infectious disease special demonstration project areas was 19.205 million Yuan and having identified 1 218 HIV/AIDS patients. The average costs for HIV/AIDS positive detection in three project countries were 14.562, 18.424 and 14.042 thousand Yuan per case. The QALYs gained from finding a HIV/AIDS case were 12.736, 8.523 and 8.321 on average, with the total number of QALYs gained from the project as 5 973.184, 3 613.752 and 2 704.325. The overall cost effectiveness ratio of the project was 1.562 thousand Yuan per QALY, and 1.143, 2.162 and 1.688 thousand Yuan per QALY in these three project countries. Project country "A" showed better cost effectiveness index than country B and C.

CONCLUSIONThe HIV screening project in Guangxi seemed relatively cost-effective but the average cost of HIV/AIDS positive detection was expensive. To strengthen HAART work for HIV/AIDS could improve the cost-effective of the project.

Antiretroviral Therapy, Highly Active ; China ; Cost-Benefit Analysis ; HIV Infections ; diagnosis ; drug therapy ; Humans ; Mass Screening ; economics ; Program Evaluation ; Quality-Adjusted Life Years

OBJECTIVETo understand the one-year effect of HCV/HIV co-infected patients who had received AIDS second-line antiretroviral treatment after failure virologically, on the first-line therapy.

METHODSHCV and HIV antibody positive patients who had experienced virological failure but received at least one-year AIDS first-line treatment, were recruited from May to October 2012 in Xincai, Queshan and Weishi of Henan province. 6-months and 12-months follow-up programs were carried out after the regimen had been changed to AIDS second-line antiretroviral treatment, CD4⁺ T lymphocyte count, HIV-1 virus load and HIV-1 drug resistance were performed.

RESULTSEighty-one cases of eligible patients were selected and followed by an amelioration of CD4 median at 6-month and 12-month follow-up period. Data showed that the baseline, 6-months and 12-months CD4 medians were 266 cells/µl, 275 cells/µl and 299 cells/µl (χ² = 8.214, P = 0.009). The ratio of HIV virus load suppression patients at 6-months and 12-months follow-up increased to 46.84% and 50.00%, respectively. Frequencies of HIV drug resistance also decreased at the baseline, 6-months and 12-months, with ratios as 66.67%, 26.58% and 27.63% (χ² = 29.362, P = 0.000), respectively. Ratios of patients that holding NRTI and NNRTI drug resistance appeared coinstantaneous decrease at the baseline, 6-months and 12-months, as 51.85%, 18.99% and 17.11% (χ² = 14.230, P = 0.005). At the baseline, the ratios of patients resisted to 3TC, ABC and FTC were all more than 50%, with AZT, D4T and DDI between 41%-44% while TDF appeared as 33.33%, then all of them declined to 12%-18% at the 6-month and 12-month follow-up periods. 65.43% of the patients resisted to both NVP and EFV but declined to 24%-27% at 6 months and 12 months.

CONCLUSIONHCV/HIV co-infected patients experienced virological failure of AIDS first-line therapy were ameliorated after changing to use second-line antiretroviral treatment for 6-months, but did not show constant positive effect at the 12-month end point.

Anti-HIV Agents ; pharmacology ; therapeutic use ; Antiretroviral Therapy, Highly Active ; CD4-Positive T-Lymphocytes ; China ; Coinfection ; Drug Resistance, Viral ; Follow-Up Studies ; HIV Infections ; complications ; drug therapy ; HIV-1 ; drug effects ; Hepatitis C ; complications ; drug therapy ; Humans ; Reverse Transcriptase Inhibitors ; pharmacology ; therapeutic use ; Treatment Outcome ; Viral Load

OBJECTIVETo investigate the survival time and affecting factors among AIDS patients under antiretroviral treatment, between 2008 and 2013 in Liangshan, Sichuan province.

METHODSObservational retrospective cohort study method was applied. AIDS patients were chosen from China's national comprehensive prevention and control management system of AIDS in Liangshan, during 2008-2013. Related information on demographics, source of infection, pathogenesis, treatment and death was collected. Cox proportional hazards model was applied to analyze the factors that might affect the survival on patients.

RESULTSAmong the 8 321 cases, ranging from 18 to 87.5 years old (mean age as 34.2 ± 9.8), 3 021 died and 3 721 patients had received HAART treatment. The total mortality rate dropped from 43.9/100 person-years to 20.7/100 person-years from 2008 to 2013. In the treatment group, mortality rate dropped from 27.3/100 person-years to 5.1/100 person-years, while in the untreated group it remained high-between 45.0/100-50.8/100 person-years. Proportion for the treatment coverage increased gradually, from 5.8% in 2008 to 54.5% in 2013. Median survival time of all the AIDS patients was 35.1 months, but 18.4 months in the untreated group. Survival of all the AIDS patients was associated with factors as: treatment, age when AIDS diagnosis was made and route of HIV infection (P < 0.05). The risk of death among untreated patients was 5.78 times to the treated ones, but did not seem to relate to gender or nationality (P > 0.05). Survival of the treated group was associated with factors as gender, age when AIDS diagnosis was made, nationality, route of HIV infection, CD4(+) T cell count when AIDS diagnosis was made, CD4(+) T cell count at treatment baseline, anemia at the treatment baseline (P < 0.05). Survival of the untreated group was mainly associated with age when AIDS was diagnosed (P < 0.05) while other factors did not seem to be significantly related (P > 0.05).

CONCLUSIONAntiretroviral therapy appeared an important factor that affecting the survival of AIDS patients, timely treatment and CD4(+) T cell count provided at the baseline for treatment, were two key factors that affecting the outcome of treatment. Our findings pointed out that tactic factors as: strengthening the detection, monitoring on CD4(+) T cell count, early diagnose and treatment, expanding the coverage of antiretroviral therapy, and appropriate timing for treatment etc., were important ways to enhance the effects of treatment, so as to reduce the mortality rate and prolong the time of survival.

Acquired Immunodeficiency Syndrome ; drug therapy ; mortality ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antiretroviral Therapy, Highly Active ; CD4 Lymphocyte Count ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate ; Time-to-Treatment ; Treatment Outcome ; Young Adult

OBJECTIVEThis study was aimed to investigate the ways of spousal notification and its associated factors among HIV discordant couples.

METHODSA face-to-face questionnaire survey was conducted in Henan, Yunnan, Sichuan provinces and Guangxi Zhuang Autonomous Region in China. Information including democratic characteristics, knowledge and behaviors correlated with HIV infections and ways of HIV infectious status notification was collected. 'Data information system' on AIDS prevention and control was used to collect information on the transmission route.

RESULTSA total of 770 pairs of HIV discordant couples were studied, among which 414 (53.77%) HIV positive respondents reported as self-notification, with another 44.68% were notified by medical staff. Factors associated with ways of notification included gender, nation, transmission route, and education level. HIV positive respondents who were female, under Han nationality, being paid blood donors, having had higher education level, were more likely to inform their HIV negative spouse by themselves.

CONCLUSIONNationality and HIV transmission route of the HIV positive individuals were found as significant factors associated with ways of spousal notification. Therefore, HIV discordant couples notification should be strengthened, especially in the Minority-living areas and areas where HIV transmission was predomint through sexual contact and/or via injected drug use.

China ; Female ; HIV Infections ; psychology ; transmission ; Humans ; Interpersonal Relations ; Male ; Minority Groups ; psychology ; statistics & numerical data ; Sexual Behavior ; Spouses ; psychology ; statistics & numerical data ; Substance Abuse, Intravenous ; Truth Disclosure