1.Management programs on diabetes among Chinese adults in the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases.
R R JIN ; J J LI ; J ZHANG ; J L LI ; F BIAN ; G J DENG ; S MA ; X W SU ; J ZHAO ; Y JIANG
Chinese Journal of Epidemiology 2018;39(4):407-411
Objective: To understand the current situation on management of diabetes mellitus patients aged 35 and above in the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases, in China. Methods: Local residents, aged 18 years and above were randomly selected by a complex, multistage, probability sampling method. Face-to-face questionnaire survey was carried out between November and December 2016. Rates regarding prevalence, treatment and management of diabetes were calculated, and influencing factors of diabetes were analyzed by using the non-conditional logistic regression model. Results: A total of 3 213 residents aged ≥35 years were included in this study, of which 11.48% (369/3 213) reported that they had ever been informed by a doctor or other health worker that their blood sugar level was high or being diabetic. The rate of self-reported treatment among the diabetic patients was 83.20% (307/369). Rates on overall management and standardized management were 69.92% (258/369) and 53.66% (198/369), respectively. Higher rates were seen in residents aged 55 to 64 years, 76.32% for overall management and 59.65% for standardized management. Through multiple logistic regression analysis, we found that standardized management for diabetes was much higher in the Demonstration Areas located in the eastern areas (OR=2.942, 95%CI: 1.547-5.594), or patients with characteristics including high implementation score (OR=3.499, 95%CI: 1.865-6.563), already signed family doctors (OR=5.661, 95%CI: 3.237-9.899), or without hypertension (OR=1.717, 95%CI: 1.010- 2.920). Residents who were living in the first and second batch areas of implementation or responding to the NCDs with positive attitude were more likely to accept standardized management. Conclusion: Prevention and management programs on diabetes had met the requirements set for the Demonstration Areas which had promoted the specific implementation and further development of standardized management on diabetes.
Adult
;
Aged
;
Asian People/statistics & numerical data*
;
China/epidemiology*
;
Diabetes Mellitus/therapy*
;
Humans
;
Hypertension/epidemiology*
;
Logistic Models
;
Middle Aged
;
Noncommunicable Diseases/prevention & control*
;
Population Surveillance
;
Prevalence
;
Risk Factors
;
Self Care
;
Surveys and Questionnaires
2.Genetic characteristics of hemagglutinin and neuraminidase of avian influenza A (H7N9) virus in Guizhou province, 2014-2017.
Y H WAN ; L ZHUANG ; Q N ZHENG ; L J REN ; L FU ; W J JIANG ; G P TANG ; D Z ZHANG ; S J LI
Chinese Journal of Epidemiology 2018;39(11):1465-1471
Objective: To understand the molecular characteristics of hemagglutinin (HA) and neuraminidase (NA) as well as the disease risk of influenza virus A H7N9 in Guizhou province. Methods: RNAs were extracted and sequenced from HA and NA genes of H7N9 virus strains obtained from 18 cases of human infection with H7N9 virus and 6 environmental swabs in Guizhou province during 2014-2017. Then the variation and the genetic evolution of the virus were analyzed by using a series of bioinformatics software package. Results: Homology analysis of HA and NA genes revealed that 2 strains detected during 2014-2015 shared 98.8%-99.2% and 99.2% similarities with vaccine strains A/Shanghai/2/2013 and A/Anhui/1/2013 recommended by WHO, respectively. Two strains detected in 2016 and 14 strains detected in 2017 shared 98.2%-99.3% and 97.6%-98.8% similarities with vaccine strain A/Hunan/02650/2016, respectively. Other 6 stains detected in 2017 shared 99.1%-99.4% and 98.9%-99.3% similarities with strain A/Guangdong/17SF003/2016, respectively. Phylogenetic analysis showed that all the strains were directly evolved in the Yangtze River Delta evolution branch, but they were derived from different small branch. PEVPKRKRTAR↓GLF was found in 6 of 24 strains cleavage site sequences of HA protein, indicating the characteristic of highly pathogenic avian influenza virus. Mutations A134V, G186V and Q226L at the receptor binding sites were found in the HA. All the strains had a stalk deletion of 5 amino acid residue "QISNT" in NA protein, and drug resistance mutation R294K occurred in strain A/Guizhou-Danzhai/18980/2017. In addition, potential glycosylation motifs mutations NCS42NCT were found in the NA of 9 of 24 strains. Conclusions: HA and NA genes of avian influenza A (H7N9) virus showed genetic divergence in Guizhou province during 2014-2017. The mutations of key sites might enhance the virulence of the virus, human beings are more susceptible to it. Hence, the risk of infection is increasing.
Animals
;
Base Sequence
;
Birds
;
China/epidemiology*
;
Genome, Viral
;
Hemagglutinin Glycoproteins, Influenza Virus/immunology*
;
Hemagglutinins/genetics*
;
Humans
;
Influenza A Virus, H7N9 Subtype/isolation & purification*
;
Influenza in Birds
;
Influenza, Human/virology*
;
Neuraminidase/genetics*
;
Phylogeny
;
RNA, Viral/genetics*
;
Sequence Analysis, DNA
3.Study on the effectiveness of implementation: the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases.
J ZHANG ; R R JIN ; J J LI ; J L LI ; X W SU ; G J DENG ; S MA ; J ZHAO ; Y P WANG ; F BIAN ; Y M QU ; Z Z SHEN ; Y JIANG ; Y L LIU
Chinese Journal of Epidemiology 2018;39(4):394-400
Objective: To assess the implementation and impact of programs carried out by the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases. Methods: Both sociological and epidemiological methods were used to collect qualitative and quantitative data in November and December, 2016 in order to conduct on process and outcome evaluation of the above mentioned objective. In the meantime, case study was also conducted. Results: All the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases were found well implemented across the country, with health education and health promotion, surveillance and safeguard measures in particular. A government-led and inter-sector coordination and communication mechanism had been well established, with more than 16 non-health departments actively involved. 28.7% of the residents living in the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases were aware of the key messages related to chronic diseases. Among the residents, 72.1% of them consumed vegetables and 53.6% consumed fruits daily, with another 86.9% walked at least 10 minutes per day. Over 70% of the patients with hypertension or diabetes reported that they were taken care of by the Community Health Centers, and above 50% of them were under standardized management. Residents, living in the National Demonstration Areas under higher ranking of implementation scores, were more likely to be aware of relevant knowledge on chronic disease control and prevention (OR=6.591, 95%CI: 5.188-8.373), salt reduction (OR=1.352, 95%CI: 1.151-1.589), oil reduction (OR=1.477, 95%CI: 1.249-1.746) and recommendation on physical activities (OR=1.975, 95%CI: 1.623- 2.403). Conclusion: The implementation of programs carried out by the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases had served a local platform for the control and prevention of non-communicable diseases, and thus become an important 'carrier' for chronic disease prevention and control programs in China.
China/epidemiology*
;
Chronic Disease/epidemiology*
;
Delivery of Health Care
;
Health Promotion/organization & administration*
;
Humans
;
National Health Programs
;
Noncommunicable Diseases/prevention & control*
;
Outcome Assessment, Health Care
;
Population Surveillance
;
Preventive Health Services/organization & administration*
;
Program Evaluation
;
Public Health
4.Current status on prevalence, treatment and management of hypertension among Chinese adults in the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases.
R R JIN ; J ZHANG ; J L LI ; J J LI ; S MA ; F BIAN ; G J DENG ; X W SU ; Z Z SHEN ; Y P WANG ; Y JIANG
Chinese Journal of Epidemiology 2018;39(4):401-406
Objective: To investigate the current status of prevalence, treatment, and management on hypertension among Chinese adults from the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases. Methods: We selected a total of 4 000 residents aged ≥18 years for this questionnaire-based survey by multi-stage clustering sampling in 10 National Demonstration Areas between November and December, 2016. Results: There were 3 891 effective questionnaires. The self-reported prevalence of hypertension among aged ≥35 years was 31.47% (1 011/3 213). For the past two weeks, the self-reported treatment of hypertension was 86.75%(877/1 011), with the rates of guidance as 56.87% (575/1 011) on physical activity, 40.95% (414/1 011) on diet, 38.33% (385/1 011) on weight management, and 22.75% (228/1 011) on smoking cessation. For the past 12 months, 74.68% (755/1 011) of the residents aged ≥35 years were under the proper management and 62.12% (628/1 011) of them were under the standardized management programs. The follow-up program lasted for 4 (P(25)-P(75): 4-12) times per year, with 15 (P(25)-P(75): 10-20) minutes per each visit. Hypertensive patients would mainly visit the outpatient clinics (53.51%), followed by home visits (22.91%) and telephone calls (13.64%). Rate of satisfaction on management services was 94.83% (716/755) from the hypertensive patients. Multivariate analysis showed that the rate of self-reported treatment (OR=1.986, 95%CI: 1.222-3.228) and self-reported standardized management (OR=2.204, 95%CI: 1.519-3.199) on hypertension were higher in the Demonstration Areas with higher implementation scores of self-reported non-communicable diseases management. Conclusions: Prevention and management on hypertension in the Demonstration Areas had met the requirement set for the Demonstration Areas during the "12th Five-Year Plan" . Projects on setting up the National Non-communicable Diseases Demonstration Areas had played an active role in promoting the standardized management program on hypertension.
Adult
;
Asian People/statistics & numerical data*
;
Diet
;
Exercise
;
Humans
;
Hypertension/therapy*
;
Noncommunicable Diseases/prevention & control*
;
Population Surveillance
;
Prevalence
;
Risk Factors
;
Surveys and Questionnaires
5.Study on consumption of vegetables and fruits and related influencing factors among residents from the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases.
J J LI ; R R JIN ; J ZHANG ; J L LI ; S MA ; X W SU ; G J DENG ; F BIAN ; Y M QU ; Y R HAN ; Y JIANG
Chinese Journal of Epidemiology 2018;39(4):412-416
Objective: To investigate the consumption of vegetables and fruits and related influencing factors among residents from the National Demonstration Areas of Comprehensive Prevention and Control of Non-communicable Diseases. Methods: From November to December, 2016, a total of 4 000 residents, aged 18 or above, from ten Demonstration Areas, were selected as participants for this study by multi-stage cluster random sampling method. Information on vegetables, fruits consumption and related influencing factors was collected via questionnaire. Results: A total of 3 891 residents were involved in the final analysis. Daily consumption of vegetables and fruits accounted for 72.1% and 53.6% of the residents under study. The residents who were aware of the National Demonstration Areas activities were more willing to have adequate intake of vegetables (OR=3.017, 95%CI: 2.426-3.753) and fruits (OR=1.261, 95%CI: 1.007-1.580). Residents with higher degree of participation activities of the demonstration areas were more likely to have adequate fruits intake (high degree: OR=1.431, 95%CI: 1.210-1.694; medium degree: OR=1.573, 95%CI: 1.315- 1.882). Conclusions: The implementation of the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases has improved the adequate vegetables and fruits intake among residents. Relevant activities carried out in the Demonstration Areas appeared conducive to the healthy lifestyle of the residents.
Diet/statistics & numerical data*
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Fruit
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Humans
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Middle Aged
;
Noncommunicable Diseases/prevention & control*
;
Population Surveillance
;
Surveys and Questionnaires
;
Vegetables
6.Study on the overall implementation status of the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases.
J J LI ; J L LI ; J ZHANG ; R R JIN ; S MA ; G J DENG ; X W SU ; F BIAN ; Y M QU ; L L HU ; Y JIANG
Chinese Journal of Epidemiology 2018;39(4):417-421
Objective: To understand the current overall status of implementation on the National Demonstration Areas of Comprehensive Prevention and Control of Non-communicable Diseases. Methods: According to the scheme design of the questionnaires, all the National Demonstration Areas were involved in this study. For each National Demonstration Areas, eight departments were selected to complete a total of 12 questionnaires. Results: Scores related to the implementation of the National Demonstration Areas accounted for 71.8% of the total 170 points. Based on the scores gathered from this study, the 23-items-index-system that represented the status of project implementation was classified into seven categories. Categories with higher percentile scores would include: monitoring (88.0%), safeguard measures (75.0%), health education and health promotion (75.0%). Categories with lower percentile scores would include: the national health lifestyle actions (67.7%), community diagnosis (66.7%), discovery and intervention of high-risk groups (64.7%), and patient management (60.9%). There were significant differences noticed among the eastern, central and western areas on items as safeguard measures, health education/promotion, discovery and intervention of high-risk groups. In all, the implementation programs in the eastern Demonstration Areas seemed better than in the central or western regions. As for the 23 items, five of the highest scores appeared on policy support, mortality surveillance, tumor registration, reporting system on cardiovascular/cerebrovascular events, and on tobacco control, respectively. However, the lowest five scores fell on healthy diet, patient self-management program, oral hygiene, setting up the demonstration units and promotion on basic public health services, respectively. The overall scores in the eastern region was higher than that in the central or the western regions. The scores in the central and western regions showed basically the same. Conclusions: The overall status of implementation on the National Demonstration Areas was satisfactory. Future attention should be focusing on patient management as well as discovery and intervention of high-risk groups, which also presented the lowest scores, in this survey.
China/epidemiology*
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Chronic Disease/epidemiology*
;
Delivery of Health Care
;
Health Promotion/organization & administration*
;
Humans
;
National Health Programs
;
Noncommunicable Diseases/prevention & control*
;
Outcome Assessment, Health Care
;
Population Surveillance
;
Preventive Health Services/organization & administration*
;
Program Evaluation
;
Public Health
;
United States
7.Impact of multidisciplinary team working on the management of colorectal cancer.
Ying-Jiang YE ; Zhan-Long SHEN ; Xian-Tao SUN ; Zhi-Feng WANG ; Dan-Hua SHEN ; Hui-Jun LIU ; Wan-Lei ZHANG ; Ya-Lin CHEN ; Jing ZHOU ; G J POSTON ; Shan WANG
Chinese Medical Journal 2012;125(2):172-177
BACKGROUNDThe continual and rapid development of techniques which are used for diagnosis and treatment makes management of colorectal cancer more difficult depending on single discipline. Colorectal cancer multidisciplinary team (MDT) working model is recommended by UK and other countries, but there is little information on the impact of MDT working on management of colorectal cancer in China. The aim of this study was to assess the effect on management of colorectal cancer after the inception of an MDT.
METHODSA total of 595 consecutive colorectal cancer patients were referred to the Department of Gastroenterological Surgery, the pre-MDT cohort include 297 patients, recruited from January 1999 to November 2002, and the MDT cohort had 298 patients enrolled from December 2002 to September 2006. Information recorded included: TNM stage from histological reports, degree of differentiation, the number of examined lymph nodes and CT TNM staging performed or not, and its accuracy, including local and distant recurrence.
RESULTSThe number of examined lymph nodes and the accuracy of TNM staging by CT in the MDT group were significantly more than those in pre-MDT group. CT TNM staging was more accurate in the MDT group compared to the pre-MDT group (P = 0.044). The rate of tumor recurrence in the MDT group was lower than pre-MDT group (log-rank test, P < 0.001). Multivariate analysis revealed that age (P = 0.001), management after inception of the MDT (P = 0.002), degree of differentiation (P = 0.003), number of examined lymph nodes (P = 0.002), and TNM stage (P = 0.000) were important factors that independently influence overall survival.
CONCLUSIONSThe inception of MDT working improved the diagnostic accuracy and overall survival of colorectal cancer patients. MDT working promoted communication and cooperation between disciplines and ensured high-quality diagnosis, evidence-based decision making, and optimal treatment planning.
Aged ; Colorectal Neoplasms ; diagnostic imaging ; pathology ; surgery ; Disease Management ; Female ; Humans ; Interdisciplinary Communication ; Male ; Middle Aged ; Neoplasm Staging ; Radiography ; Treatment Outcome
8.Evaluation on follow-up intervention program in men who have sex with men in Tianjin.
N ZHOU ; M N ZHENG ; H H LI ; M H YU ; H GONG ; J YANG ; G H JIANG
Chinese Journal of Epidemiology 2018;39(9):1228-1233
Objective: To evaluate the behavior intervention program on men who have sex with men (MSM) in Tianjin. Methods: From April 2013 to September 2017, MSM were enrolled from MSM gathering places and through mobile internet to establish an open prospective cohort. Interventions were conducted in every follow-up meeting, while the changes of behaviors and HIV infection and syphilis incidences in the MSM before and after intervention were compared. Results: A total of 1 822 MSM were interviewed at baseline survey, with 1 007 eligible MSM were enrolled in the cohort. A total of 39 new cases of HIV infection were reported, and the cumulative observation time on cohort follow-up was 2 216.96 person-year, with the HIV incidence rate as 1.76 per 100 person-years. Among them, 934 MSM were sero-negative for syphilis in baseline survey. A total of 100 new cases of syphilis were reported, and the cumulative observation time of cohort follow-up was 1 959.94 person-year, the syphilis incidence rate was 5.10 per 100 person-years. With health education and intervention conducted, the awareness rate of AIDS related knowledge for MSM increased. Though the rate of anal sex increased after intervention, the rate of condom use in anal sex increased, too. The rate of condom use decreased after receiving more than 3 interventions. Data from the multivariate GEE analysis indicated that protective factors might be as follows: education level of college and above (aOR=0.81, 95%CI: 0.68-0.98), awareness of AIDS related knowledge (aOR=0.52, 95%CI: 0.36-0.75), ever receiving condom promotion and distribution in the past six months (aOR=0.60, 95%CI: 0.49-0.74), being recruited from mobile internet (aOR=0.85, 95%CI: 0.73-1.00) and times of cumulative intervention: one time (aOR=0.55, 95%CI: 0.45-0.66), two times (aOR=0.38, 95%CI: 0.30-0.49), three times (aOR=0.26, 95%CI: 0.20-0.35), four times and above (aOR=0.24, 95%CI: 0.17-0.33). Diagnoses of STDs in the past six months (aOR=1.43, 95%CI: 1.06-1.96), using rush-poppers (aOR=1.22, 95%CI: 1.02-1.47) might be risk factors. Conclusions: After continuous behavior intervention, the incidence of HIV infection and syphilis were at a low level in the MSM cohort in Tianjin. Their awareness rate of AIDS related knowledge and the rate of condom use increased. But there are still many risk factors influencing the unprotected anal sex in MSM. We should continuously carry out behavioral intervention programs to prevent unprotected anal sex among MSM.
Behavior Therapy
;
China/epidemiology*
;
Follow-Up Studies
;
HIV Infections/transmission*
;
Homosexuality, Male/statistics & numerical data*
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Humans
;
Incidence
;
Male
;
Prospective Studies
;
Risk Factors
;
Safe Sex
9.Recent transmission of pulmonary tuberculosis and its influencing factors in Jing'an district, Shanghai, 2010-2015.
Z Y HAN ; J LI ; K K GU ; G M SUN ; Y JIANG ; Y Y ZHANG ; B XU
Chinese Journal of Epidemiology 2018;39(10):1339-1345
Objective: To understand the recent transmission of Mycobacterium tuberculosis (MTB), and to identify the influencing factors of recent transmission among pulmonary tuberculosis (TB) patients in Jing'an district, Shanghai. Methods: The genotypes and drug resistances of MTB isolated from TB patients registered in the TB designated hospitals in Jing'an district during 2010-2015 were analyzed through 12-loci Mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR)(QUB11b, QUB18, Mtub21, Miru26, QUB26, Mtub04, Miru31, Miru40, VNTR2372, VNTR3820, 3232, 4120), and tested for drug susceptibility as well. With the results of field epidemiological investigation, univariate and multivariate analyses were performed to analyze the distribution of the clusters and influencing factors on recent transmission. Results: This study enrolled 80 TB patients, 23 (28.75%) had a resistance to at least one anti-TB drug, and the prevalence of multidrug-resistant tuberculosis (MDR-TB) was 16.25%. A total of 65 genotypes were identified with 58 (72.50%, 58/80) being unique and 7 clusters with 2-10 isolated in each cluster. The proportion of clustering was 27.50% (22/80). Results from the multivariate analysis revealed that multidrug- resistance (OR=35.799, 95%CI: 4.239-302.346) and having comorbidity with TB (OR=7.695, 95%CI: 1.421-41.658) were independently associated with the clustering, which suggesting a recent transmission. The field investigation to the clustered cases proved that the patients in two clusters had epidemiological links, one was between family members, and the other contained 10 MDR-TB patients with 9 knowing each other which have a definite connection and 1 having the possible connection with them. Conclusion: Recent transmission of tuberculosis happened among TB patients in Jing'an district, with high risks among the MDR-TB patients.
China
;
Cluster Analysis
;
Genotype
;
Humans
;
Mycobacterium tuberculosis/isolation & purification*
;
Tuberculosis
;
Tuberculosis, Multidrug-Resistant/transmission*
;
Tuberculosis, Pulmonary/transmission*
10.Survey on extramarital sexual behaviors and HIV infection in middle-aged and elderly people aged 50 and above in selected areas of Chongqing.
G J JIANG ; W GUO ; Y X PEI ; C CAI ; G H WU ; C ZHOU ; R R LU ; Z L CHEN
Chinese Journal of Epidemiology 2018;39(11):1438-1442
Objective: To know the situation of extramarital sexual behaviors and HIV infection in middle-aged and elderly people in Chongqing, and provide reference for AIDS prevention and treatment. Methods: From October to December 2017, a multi-stage sampling method was used to recruit middleaged and elderly people aged ≥50 years who lived in Dazu and Hechuan districts of Chongqing for at least one year, with a sample size of 410. Face-to-face questionnaires survey and HIV antibody test were conducted. Results: A total of 408 people were surveyed, including 313 males and 95 females aged 50-88 (64.93±9.03) years. The HIV infection rate was 1.47% (6/408), with the rate of 1.28% (4/313) in males and 2.11% (2/95) in females. The awareness rate of AIDS related knowledge was 37.50% (153/408). And 18.87% (77/408) of subjects surveyed reported extramarital sexual behaviors, 7.60% (31/408) reported extramarital sexual behaviors in the past half year, the constant condom use rate was 19.35% (6/31). The results of multivariate logistics model analysis on extramarital sexual behaviors showed that the prevalence in males were 39.51 times higher than that in females (OR=39.51, 95%CI: 5.03-310.30), 4.60 times higher in those who were unmarried, divorced or widowed than that in the married or cohabitants (OR=4.60, 95%CI: 1.50-14.05), 2.03 times higher in those with outside activities than those with individual activities (OR=2.03, 95%CI: 1.08-3.81) and 3.94 times higher in those with self-evaluation of emptiness of living state than that in those with engaged life (OR=3.94, 95%CI: 1.86-8.36). Conclusions: The prevalence of extramarital sexual behavior in middle-aged and elderly people in some counties and districts in Chongqing is high. The factors such as gender, marital status, leisure activities, and self-evaluation of living state were related to the prevalence of extramarital sexual behaviors in this population. The condom use rate in extramarital sexual behavior was low. It is necessary to take effective interventions in this population.
Aged
;
Aged, 80 and over
;
China/epidemiology*
;
Condoms
;
Extramarital Relations
;
Female
;
HIV Infections/transmission*
;
Humans
;
Male
;
Marital Status
;
Middle Aged
;
Risk Factors
;
Sexual Behavior
;
Surveys and Questionnaires