2.Assessment on the Effects of Hepatitis B Prevention and Control Measures in Western China: A Comparison of Three Population-based Serosurveys.
Hui CHEN ; Nan LIU ; Zhao Hua JI ; Zhong Shu PU ; Zhi Wen GUO ; Jie GAO ; Zhong Jun SHAO ; Yi Wen LIU ; Yong Ping YAN
Biomedical and Environmental Sciences 2020;33(10):735-744
Objective:
Despite the remarkable progress in efforts to control disease spread, the nationwide elimination of hepatitis B in China is still hindered by the persistently high rate of hepatitis B virus (HBV) infection in Western China. This study aimed to evaluate the strategy of hepatitis B prevention and control in Western China and identify potential areas and strategies for improvement.
Methods:
Susceptible population vaccination, health education, professional training of doctors, and other prevention and control measures have been implemented in Wuwei city since 2010. Data were obtained from three representative cross-sectional serosurveys conducted in 2010, 2013, and 2015. The serum samples were subjected to enzyme-linked immunosorbent assays to detect the following seromarkers: HBV surface antigen (HBsAg), antibody against hepatitis B surface antigen (anti-HBs), and antibody against hepatitis B core antigen (anti-HBc). Estimates of variance were determined using Taylor series linearization methods.
Results:
The three serosurveys revealed decreases in the prevalence of HBsAg (7.19% in 2010
Conclusion
Although vaccine-based prevention and control measures reduced the rate of HBV infection in Wuwei City over time, the hepatitis B infection rate in children younger than 10 years was still higher than the national average level. Therefore, the prevention and control of mother-to-child transmission and the management of the infected should be the focus of future prevention and control work.
Adolescent
;
Adult
;
Aged
;
Aged, 80 and over
;
Child
;
Child, Preschool
;
China/epidemiology*
;
Communicable Disease Control/statistics & numerical data*
;
Cross-Sectional Studies
;
Female
;
Hepatitis B/prevention & control*
;
Hepatitis B virus/isolation & purification*
;
Humans
;
Infant
;
Infant, Newborn
;
Male
;
Middle Aged
;
Prevalence
;
Seroepidemiologic Studies
;
Young Adult
3.The Disease and Treatment of the Frontline Soldiers in Han Dynasty.
Korean Journal of Medical History 2015;24(1):67-109
This paper purports to identify and analyze the medical information of the frontline soldiers in the Northwest borderland provinces of Han Dynasty, especially Juyan and Dunhuang region, through an heuristic reading of the Juyan Bamboo Slips and the Dunhuang Bamboo Slips of the Han Dynasty. My findings are as follows. The most frequent disease found in the bamboo slips was the external injury. The injury of the frontline soldiers mainly occurred from the quarrels among armed soldiers using weapons. The bamboo slips also demonstrate that the quarrels usually arose due to the fierce tension caused by the frontier line service such as heavy guard activity and labour duty. Undernourishment and chronic stress the soldiers suffered might be another reasons. The second most common disease harassing the soldiers was exogenous febrile disease. In most cases reviewed in this paper, the exogenous febrile disease was usually concurrent with complex symptoms such as chills, fever, headache, etc. The bamboo slips show that the exogenous febrile disease was related to the harsh climate of the Northwest provinces, featuring extremely dry weather and the large magnitude of diurnal temperature fluctuations. In addition, the annual temperature range in the Northwest province was huge, fluctuating between very cold and dry winter and very hot and dry summer. The third most common disease this study identified was the disorder of the digestive system and respiratory system. However, these two types of disease were virtually indistinguishable in the bamboo slips, because the ancient Chinese chroniclers did not distinguish them, usually dubbing both diseases simply 'abdominal pain.' It should be mentioned that a few slips mention contagious disease such as dysentery and dermatolosis, and sudden death, as well. Overall, the bamboo slips demonstrate extremely poor status of the soldiers' heath condition and poor medical environment surrounding the soldiers stationing in the Northwest borderland military camps. The records also show that acupuncture, applying a plaster, drugs were the most common medical treatment. Drugs among them was the most frequently used. Whereas Acupuncture, applying a plaster were very rarely used. Medication has been used in three ways: powdered medicine, medicinal decoction and pill. Medicinal decoction was the most commonly used way.
China/epidemiology
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Climate
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Communicable Disease Control/history
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Communicable Diseases/epidemiology/etiology/history
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Digestive System Diseases/epidemiology/etiology/history/prevention & control
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History, Ancient
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Humans
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Military Medicine/*history/statistics & numerical data
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Military Personnel/*history
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Wounds and Injuries/epidemiology/etiology/history/prevention & control
4.Outbreak of acute norovirus gastroenteritis in a military facility in Singapore: a public health perspective.
Jonathan YAP ; Abdul QADIR ; Isaac LIU ; Jimmy LOH ; Boon Huan TAN ; Vernon J LEE
Singapore medical journal 2012;53(4):249-254
INTRODUCTIONNorovirus gastrointestinal disease (GID) outbreaks occur frequently in closed settings, with high attack rates. On October 16, 2008, a norovirus GID outbreak occurred at a Singapore military camp. This study describes the epidemiological investigations conducted to determine the cause of outbreak and the efficacy of the public health measures implemented.
METHODSEpidemiologic investigations included a case-control study of exposure to different food items and an environmental exposure survey. Stool samplings of patients and food handlers for common pathogens, and microbiologic testing of food and water samples were performed. Inspection of dining facilities and health screening of all food-handlers were also conducted.
RESULTSA total of 156 GID cases were reported on October 15-31, 2008. 24 (15.4%) personnel were positive for norovirus. The predominant symptoms were diarrhoea (76.3%) and abdominal pain (69.2%). There was no clinical correlation between any food item and the affected personnel. Testing of food and water samples, dining facility inspections and health screening of food handlers showed satisfactory results. The environmental exposure survey indicated possible transmission due to environmental contamination by vomitus in common areas. Comprehensive environmental decontamination was performed with hypochlorite solution, and personal hygiene measures were enforced. The outbreak lasted 17 days, with a decline in cases post intervention.
CONCLUSIONTimely notification and prompt response can curtail disease transmission. Swift implementation of public health measures, such as emphasis on personal hygiene, isolation of affected cases and comprehensive disinfection of the environment, effectively stopped norovirus transmission and may be adapted for future GID outbreaks.
Acute Disease ; Adolescent ; Caliciviridae Infections ; diagnosis ; epidemiology ; Case-Control Studies ; Communicable Disease Control ; methods ; Diarrhea ; virology ; Disease Outbreaks ; statistics & numerical data ; Feces ; virology ; Food Handling ; Gastroenteritis ; epidemiology ; virology ; Humans ; Male ; Military Facilities ; Norovirus ; isolation & purification ; Singapore ; epidemiology ; Water Microbiology ; Young Adult
5.Evaluation on the effectiveness of the national childhood immunisation programme in Singapore, 1982-2007.
Fereen LIEW ; Li Wei ANG ; Jeffery CUTTER ; Lyn JAMES ; Kee Tai GOH
Annals of the Academy of Medicine, Singapore 2010;39(7):532-510
INTRODUCTIONWe undertook a study to evaluate the effectiveness of the National Childhood Immunisation Programme (NCIP) over the past 26 years by reviewing the epidemiological trends of the diseases protected, the immunisation coverage and the changing herd immunity of the population during the period of 1982 to 2007.
MATERIALS AND METHODSThe epidemiological data of all cases of diphtheria, pertussis, poliomyelitis, measles, mumps, rubella and acute hepatitis B notified to the Communicable Diseases Division, Ministry of Health (MOH) from 1982 to 2007 were collated and analysed. Data on tuberculosis (TB) cases were obtained from the TB Control Unit, Tan Tock Seng Hospital. Cases of neonatal tetanus and congenital rubella syndrome (CRS) among infants born in Singapore were identified from the Central Claims Processing System. The number of therapeutic abortions performed for rubella infections was retrieved from the national abortion registry. Coverage of the childhood immunisation programme was based on the immunisation data maintained by the National Immunisation Registry, Health Promotion Board. To assess the herd immunity of the population against the various vaccine-preventable diseases protected, the findings of several serological surveys conducted from 1982 to 2005 were reviewed.
RESULTSThe incidence of vaccine-preventable diseases covered under the NCIP had declined over the last 26 years with diphtheria, neonatal tetanus, poliomyelitis and congenital rubella virtually eliminated. The last case of childhood TB meningitis and the last case of acute hepatitis B in children below 15 years were reported in 2002 and 1996, respectively.
CONCLUSIONThe NCIP has been successfully implemented as evidenced by the disappearance of most childhood diseases, excellent immunisation coverage rate in infants, preschool and school children, and high level of herd immunity of the childhood population protected.
Adolescent ; Adult ; Child ; Child, Preschool ; Communicable Disease Control ; statistics & numerical data ; trends ; Communicable Diseases ; epidemiology ; Disease Notification ; statistics & numerical data ; Humans ; Immunity, Herd ; Immunization Programs ; statistics & numerical data ; Incidence ; Infant ; Population Surveillance ; Prevalence ; Singapore ; epidemiology
6.Mumps Transmission Control Status and Inapparent Infection Rate among Middle and High School Students during the 2007-2008 Mumps Outbreak in Daegu.
Kyo Hyun KIM ; Chang Hwi KIM ; Bo Youl CHOI ; Un Yeong GO ; Dong Han LEE ; Moran KI
Journal of Preventive Medicine and Public Health 2009;42(6):408-415
OBJECTIVES: This study was performed to investigate the mumps transmission control status and inapparent infection rate among middle and high school students in Daegu City during a mumps outbreak. METHODS: Nine schools (two middle schools and seven high schools), which reported a number of mumps cases between 2007 and 2008 were selected for investigation. During March-May 2008, a standard questionnaire was distributed to gather information about case identification, instructed isolation measure, isolation status of mumps cases and related factors, and outdoor activities of non-isolated mumps case. Inapparent infection rate was estimated by serum mumps IgM and IgG antibodies status and self-reported mumps symptoms in three of the nine schools. RESULTS: Among 2,560 respondents, more than half of students answered that they did not receive instructions in mumps transmission control measures during the outbreak. Among the 327 mumps cases identified by the questionnaire, 131 cases (40.1%) were considered as isolated and the isolation rates were significantly different among schools, grades, and gender. Of the non-isolated cases, 88.3% continued attending school. Inapparent mumps infection rates were between 56.3% and 70.2%. CONCLUSIONS: Mumps transmission control was inadequate to control the mumps outbreak. Although high inapparent infection rate would mitigate the transmission control effect of case isolation, this measure is fundamental for infection control. The reasons of this inadequate status need to be explored to develop an effective intervention strategy.
Adolescent
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Child
;
Communicable Disease Control/*methods
;
Disease Outbreaks/*statistics & numerical data
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Female
;
Humans
;
Immunoglobulin G/blood
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Immunoglobulin M/blood
;
Male
;
Mumps/epidemiology/*prevention & control/transmission
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Patient Isolation
;
Questionnaires
;
Republic of Korea/epidemiology
;
Schools/*statistics & numerical data
;
Students
7.Epidemiology and control of hand, foot and mouth disease in Singapore, 2001-2007.
Li Wei ANG ; Benjamin Kw KOH ; Kwai Peng CHAN ; Lian Tee CHUA ; Lyn JAMES ; Kee Tai GOH
Annals of the Academy of Medicine, Singapore 2009;38(2):106-112
INTRODUCTIONWe reviewed the epidemiology of hand, foot and mouth disease (HFMD) in Singapore after the 2000 epidemic caused by Enterovirus 71 (EV71), with particular reference to the cyclical pattern, predominant circulating enteroviruses and impact of prevention and control measures in preschool centres.
MATERIALS AND METHODSWe analysed the epidemiological data from all clinical cases and deaths of HFMD diagnosed by medical practitioners and notified to the Ministry of Health, as well as laboratory data on enteroviruses detected among HFMD patients maintained by the Department of Pathology, Singapore General Hospital, and the Microbiology Laboratory, KK Women's and Children's Hospital from 2001 to 2007.
RESULTSThe incidence rate was highest in the 0 to 4 years old age group, with males being predominant. Three deaths were reported between January and February 2001. Nationwide epidemics occurred periodically; the predominating circulating virus was Coxsackievirus A16 (CA16) in the 2002, 2005 and 2007 epidemics, and EV71 in the 2006 epidemic. During the epidemic years between 2005 and 2007, 2 peaks were observed. The number of institutional outbreaks had increased 10-fold from 167 in 2001 to 1723 in 2007, although most of these outbreaks were rapidly brought under control with an attack rate of less than 10%.
CONCLUSIONHFMD remains an important public health problem in Singapore with the annual incidence rate per 100,000 population increasing from 125.5 in 2001 to 435.9 in 2007, despite stringent measures taken in preschool centres to prevent the transmission of infection. A high degree of vigilance should be maintained over the disease situation, in particular, surveillance of EV 71 which continues to cause severe complications and deaths in the region.
Adolescent ; Adult ; Child ; Child, Preschool ; Communicable Disease Control ; methods ; Disease Outbreaks ; prevention & control ; statistics & numerical data ; Female ; Hand, Foot and Mouth Disease ; epidemiology ; prevention & control ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Retrospective Studies ; Singapore ; epidemiology ; Young Adult
9.Analysis of the quality of notifiable infectious disease report in Beijing medical treatment organizations.
Xue-qin XIE ; Chen CHEN ; Xiao-ying YANG ; Zai-hua WEI ; Jing-long LIU
Chinese Journal of Preventive Medicine 2008;42(5):335-338
OBJECTIVETo evaluate the quality of the infectious diseases reporting via network in Beijing hospitals and to filtrate factors that affect the reporting quality.
METHODSWe collected 5536 infectious disease cases randomly and investigated 52 medical treatment organizations. Information was collected by field questionnaire survey, interview and gathering routine reporting data for analyzing the quality.
RESULTSThe result showed that the timeliness of the 52 medical treatment organizations was 94.18%, the consistency was 80.84%, the completeness was 88.47%, and the misreport was 13.73%. The reporting quality of the second level hospitals was higher than that of the first level hospitals, township health centers and the third level hospitals. The reporting quality of urban hospitals was higher than that of the suburb hospitals. The reporting quality of outpatient and inpatient departments was higher than that of the laboratory. The laboratory was the primary part of underreporting.
CONCLUSIONStrengthening guidance, training and paying attention to each weak portion would certainly ameliorate the quality of infectious diseases reporting via network.
China ; Communicable Disease Control ; organization & administration ; Communicable Diseases ; epidemiology ; Disease Notification ; statistics & numerical data ; Hospitals ; Humans ; Infection Control ; Public Health Informatics ; Quality Indicators, Health Care
10.Prevention and control of avian influenza in Singapore.
Hon Keong LEONG ; Cheryl S GOH ; Siang Thai CHEW ; Chee Wee LIM ; Yueh Nuo LIN ; Siow Foong CHANG ; Him Hoo YAP ; Sin Bin CHUA
Annals of the Academy of Medicine, Singapore 2008;37(6):504-509
The highly pathogenic avian influenza (HPAI) H5N1 virus was first detected in 1996 in Guangdong, China. Since 2003, H5N1 outbreaks have been reported in parts of Asia, Europe, the Middle East, and Africa. It is currently entrenched among poultry in parts of Asia and poses a major challenge to animal and human health. Singapore is free from HPAI. Given Singapore's need to import food, the Agri-Food and Veterinary Authority (AVA) has adopted a pro-active risk management system to prevent the introduction of HPAI. AVA's approach maybe described as a multi-layered control strategy for the prevention and control of HPAI. The strategy includes control measures at source, border control measures, local control measures and emergency preparedness.
Animals
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Birds
;
Communicable Disease Control
;
methods
;
Disease Outbreaks
;
prevention & control
;
statistics & numerical data
;
Global Health
;
Health Planning
;
Humans
;
Influenza A Virus, H5N1 Subtype
;
isolation & purification
;
Influenza in Birds
;
epidemiology
;
prevention & control
;
virology
;
Poultry
;
Singapore
;
epidemiology

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