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

OBJECTIVETo evaluate the integrated effects of tobacco control programs through comparing the pre- and post-implementation of the Tianjin Tobacco Control Act (Act), in 4 successive years.

METHODSCase-related data on myocardial infarction was collected by Tianjin Surveillance System, New Case Registry. Both the representative sample size of indoor working places and public places for observation and PM2.5 monitored were selected through the calculation of Survey System, while the representative sample size of people involved in the survey for interview was under the Door to Door and Intercept.

RESULTSThrough comparing the pre- and post-implementation programs on Act, the posting of "No Smoking Sign" had become much more visible in hospitals, schools, governmental buildings and the waiting areas of public transportation. People smoked much less in the main public places, excepting for hotels and public bath rooms (P < 0.05). Exposure to secondhand smoking (SHS) had a 26.5% (P < 0.01) decline, than the Act was implemented in workplace and public place. Despite the number of cases increased in the entire population in Tianjin (β = -0.061, P = 0.00; β = 0.059, P = 0.00), cases with myocardial infarction presented at the hospitals were declining annually, among the indoor workers.

CONCLUSIONAct showed a positive effect in decreasing the number of smokers in public places thus protecting people from the negative effects on SHS. Message on health effect and social benefits on tobacco control should be disseminated to facilitate the comprehensive implementation of the Act.

China ; Hospitals ; Humans ; Schools ; Smoking ; legislation & jurisprudence ; Smoking Prevention ; Tobacco Smoke Pollution ; prevention & control ; Workplace

OBJECTIVETo establish a comprehensive evaluation index system for the China Public Health Emergency Events Surveillance System (CPHEESS).

METHODSA draft index system was built through literature review and under the consideration of the characteristics on CPHEESS. Delphi method was adapted to determine the final index system.

RESULTSThe index system was divided into primary, secondary and tertiary levels. There were 4 primary indicators: System structure, Network platform, Surveillance implementation reports with Data analysis and utilization. There were 16 secondary and 70 tertiary indicators being set, with System structure including 14 tertiary indicators (accounted for 20.00%), 21 Network platforms (accounted for 30.00%). Twenty-four Surveillance implementation reports (accounted for 34.29%), 11 Data analysis and utilization (accounted for 15.71%). The average score of importance of each indicators was 4.29 (3.77-4.94), with an average coefficient variation as 0.14 (0.12-0.16). The mean Chronbach's α index was 0.84 (0.81-0.89). The adaptability of each related facilities indicator was specified.

CONCLUSIONThe primary indicators were set in accordance with the characteristics and goals of the surveillance systems. Secondary indicators provided key elements in the management and control of the system while the tertiary indicators were available and operative. The agreement rate of experts was high with good validity and reliability. This index system could be used for CPHEESS in future.

China ; epidemiology ; Delphi Technique ; Emergencies ; Forecasting ; Humans ; Public Health Surveillance ; methods ; Reproducibility of Results

Animals ; Borrelia burgdorferi ; genetics ; isolation & purification ; China ; Genotype ; Ixodidae ; microbiology

China ; epidemiology ; Hepatitis A ; epidemiology ; Hepatitis E ; epidemiology ; Humans

OBJECTIVETo understand the current status of HBV infection among patients receiving maintenance hemodialysis (MHD) and related influencing factors.

METHODSA questionnaire survey was conducted among 1,524 MHD patients selected from hemodialysis units in 16 hospitals in Shanxi province from 1 November 2012 to 30 December 2014 to collect their demographic information and learn about their risk behaviors. Serological detection was conducted for them. Statistical software package SAS 9.3 was used for fitting a two level logistic regression model to identify the independent risk factors for HBV infection.

RESULTSAmong the 1 524 MHD patients, the positive rate of HBsAg was 5.25% and the HBV infection rate was 38.85%. The HBV infection rate varied with hospital (t=2.33, P=0.034). The two-level logistic regression empty model showed that intra-class correlation coefficient was 0.106 4, indicating that about 10.64% of the total variation was caused by the differences in hospitals. After introducing explaining variables, the results showed that the HBV infection rate in age group 50-65 years group was higher than that in age group 0-35 years (OR=1.560, 95% CI: 1.061-2.293). Family history of HBV infection and dental surgery were the risk factors for HBV infection (OR=2.052 and 1.267, 95% CI: 1.176-3.582 and 1.009-1.591). Receiving HepB vaccination was a protective factor for HBV infection (OR=0.734, 95% CI: 0.541-0.996).

CONCLUSIONThe HBV infection rates were different among MHD patients in different hospitals. Old age (50-65 years), family history of HBV infection and dental surgery were the risk factors and receiving HepB vaccination was a protective factor for HBV infection among MHD patients.

Aged ; China ; epidemiology ; Hepatitis B ; epidemiology ; Hepatitis B Surface Antigens ; blood ; Humans ; Middle Aged ; Models, Statistical ; Multilevel Analysis ; Renal Dialysis ; adverse effects ; Risk Factors

OBJECTIVETo identify the complete genome sequence of an echovirus 20 isolate (KM/EV20/2010) and understand its genetic variation and evolution characteristics.

METHODSSeven overlapping clones covering the whole viral genome (excluding the poly-A tail) were obtained by RT-PCR and sequenced, and their nucleotide and amino acid sequences were aligned with other echovirus 20 isolates. Phylogenetic and pairwise alignment analyses based on genome and complete VP1 regions were conducted with software Mega 4.1, RDP3 and SimPlot 3.5.1.

RESULTSThe genome of the echovirus strain was 7 395 nucleotides in length, and contained a 744-nt non-translated region (NTR) at the 5' end and a 96-nt NTR at the 3' end. The entire open reading frame contained 6 549 nt, encoding a 2 183-aa polyprotein. In the coding region, there was no nucleotide deletion or insertion. Based on the complete genome sequence alignments, the echovirus strain showed 80.1% nucleotide and 96.7% amino acid homology to echovirus 20 prototype JV-1 strain. The phylogenetic trees constructed on the genome and complete VP1 regions all indicated that the echovirus strain was not in one cluster with echovirus 20 prototype JV-1 strain, while had a closer relationship with echovirus 30 prototype Bastianni. Genotyping results from phylogenetic analysis showed that echovirus 20 has six genotypes. The strain used in this study belonged to genotype IV. The nucleotide divergence was 9.4%-21.7% among the 6 genotypes. The possible putative recombination was detected in its non-coding sequence of the echovirus 20 strain used in this study.

CONCLUSIONBased on the bioinformatics analysis. The echovirus 20 strains isolated in China could be divided into six genotypes, and the echovirus 20 in this study belonged to genotype IV.

Amino Acid Sequence ; Base Sequence ; China ; Computational Biology ; Enterovirus B, Human ; genetics ; isolation & purification ; Genome, Viral ; Genomics ; Genotype ; Humans ; Open Reading Frames ; Phylogeny ; Sequence Alignment

OBJECTIVETo establish a gene identification method of Yersinia pestis and Yersinia pseudotuberculosis for plague surveillance.

METHODSAccording to the specific genomic sequences of Y. pestis and Y. pseudotuberculosis, i.e. "pestis Island (PeI)" and "pseudotuberculosis Island (PsI)" and the published genomic sequences of 12 strains of Y. pestis and 4 strains of Y. pseudotuberculosis, the specific identification primers of these sequences were designed.

RESULTSA total of 52 strains of Y. pestis and 57 strains of Y. pseudotuberculosis and other intestinal bacteria strains were tested with PCR. Of the 5 pairs of Y. pestis identification primers, PeI2 and PeI11 were specific for Y. pestis. Besides Y. pestis, the primers PeI1, PeI3 and PeI12 could detect part of 57 Y. pseudotuberculosis strains. Of the 5 pairs of Y. pseudotuberculosis identification primers, PsI1 could detect all the 52 strains of Y. pestis and 57 strains of Y. pseudotuberculosis. PsI7, PsI16, PsI18 and PsI19 were specific for Y. pseudotuberculosis.

CONCLUSIONThe primers PsI1, PeI 2 and PeI11, PsI7, PsI16, PsI18 and PsI19 can be used in the rapid identification of Y. pestis and Y. pseudotuberculosis, which can be also used to explore the circulation of atypical Y. pestis in quiescent plague foci.

Base Sequence ; China ; epidemiology ; DNA Primers ; Genomics ; Humans ; Plague ; diagnosis ; epidemiology ; Polymerase Chain Reaction ; Population Surveillance ; methods ; Yersinia pestis ; genetics ; Yersinia pseudotuberculosis ; genetics

OBJECTIVETo understand the species, genotypes and mating types of Cryptococcus neoformans and Cryptococcus gattii isolated from clinical samples in Guigang, Guangxi Zhuang Autonomous Region.

METHODSA total of 20 Cryptococcus strains were isolated from clinical samples in Guigang from 2009 to 2012. The biological identification was conducted by polymerase chain reaction (PCR) to amplify internal transcribed spacer (ITS) sequences. The serotypes and mating types of C. neoformans and C. gattii were identified by PCR with serotype-specific and mating type-specific primers. The genotype was characterized by PCR fingerprinting and URA5 gene restriction fragment length polymorphism (URA5-RFLP). Phenotype study included growth test at 37 °C, melanin production test and urease test.

RESULTSAmong the 20 strains, 19 (95%) were identified as C. neoformans varieties (var.) grubii (serotype A, mating type α, genotype VN I), and only 1 was identified as C. gattii (mating type α, genotype VG I). The results of virulence test showed that all the strains grew well at 37 °C and positive in both urease test and melanin production test.

CONCLUSIONC. neoformans var. grubii (serotype A, genotype VN I and mating type α) was the predominant pathogen causing cryptococcosis in Guigang, and C. gattii strain was also detected.

China ; Cryptococcus gattii ; genetics ; isolation & purification ; pathogenicity ; Cryptococcus neoformans ; genetics ; isolation & purification ; pathogenicity ; Genotype ; Humans ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Virulence