1.Analysis on 10 year survival of HIV/AIDS patients receiving antiretroviral therapy during 2003-2005 in Henan province.
Y SUN ; Q X ZHAO ; C F LI ; X YANG ; X ZHANG ; C L LIU ; Z Y CHEN
Chinese Journal of Epidemiology 2018;39(7):966-970
Objective: To understand the survival of HIV/AIDS patients after receiving antiretroviral therapy for 10 year in Henan province and related factors. Methods: The database of national integrated management system of HIV/AIDS was used to collect the basic information and follow-up information of HIV/AIDS patients who received antiretroviral therapy between 2003 and 2005 in Henan province. Software SPSS 23.0 was used to analyze the patients' survival and related factors based on the life-table method and Cox proportional hazards model. Results: Among the 2 448 HIV/AIDS patients who started antiretroviral therapy during 2003-2005, the men accounted for 53.5%, and women accounted for 46.5%. Up to 70.1% of the patients were aged 40-59 years and 95.5% of the patients had blood borne infections. The patients were observed for 10 years after antiviral treatment, and 719 cases died from AIDS related diseases, with a mortality rate of 3.78/100 per year (719/19 010 per year). The cumulative survival rates of patients within 1-year, 3 years, 5 years and 10 years were 0.94, 0.86, 0.78, 0.69 respectively. Compared with the patients aged <40 years, the HRs of the patients aged 40-, 50-, 60- and ≥70 years were 1.417 (95%CI: 0.903-2.222), 1.834 (95%CI: 1.174-2.866), 2.422 (95%CI: 1.539-3.810) and 3.424 (95%CI: 2.053-5.709) respectively. Compared with patients with baseline CD(4+)T lymphocyte >350 unit/ul, the HRs of the patients with CD(4+)T lymphocyte <50 unit/μl, 50-199 unit/ul and 200-350 unit/ul were 7.105 (95%CI: 5.449-9.264), 4.175 (95%CI: 3.249-5.366) and 2.214 (95%CI: 1.691-2.900) respectively. Compared with the women, the HR of the men was 1.480 (95%CI: 1.273-1.172). Compared with the patients who received second line ART therapy, the HR of patients receiving no second line therapy was 11.923 (95%CI: 9.410-15.104). Conclusions: The cumulative survival rate the HIV/AIDS patients after 10 years of antiretroviral therapy reached 0.69 in Henan. Male, old age, low basic CD(4+)T lymphocyte count and receiving no second line therapy were the risk factors for long-term survival of AIDS patients.
Acquired Immunodeficiency Syndrome
;
Adult
;
Aged
;
Antiretroviral Therapy, Highly Active
;
CD4 Lymphocyte Count
;
China/epidemiology*
;
Female
;
HIV/drug effects*
;
HIV Infections/mortality*
;
Humans
;
Male
;
Middle Aged
;
Proportional Hazards Models
;
Risk Factors
;
Survival Analysis
;
Survival Rate
2.Study on early warning threshold values for 7 common communicable diseases in Gansu province, 2016.
Y CHENG ; X F LIU ; L MENG ; X T YANG ; D P LIU ; K F WEI ; X J JIANG ; H X LIU ; Y H ZHENG
Chinese Journal of Epidemiology 2018;39(3):352-356
Objective: To optimize the warning threshold values of common communicable diseases in Gansu province, and improve the early warning effect. Method: An early warning model was set up for influenza, scarlet fever, other infectious diarrheal diseases, dysentery, typhoid and paratyphoid, viral hepatitis type E and hand foot and mouth disease (HFMD) respectively in Gansu by using the moving percentile method and cumulative sum method. By calculating the sensitivity, specificity, predictive value of positive test, predictive value of negative test, Youden' index and receiver-operating characteristic curve, the optimum early warning threshold values for communicable diseases in Gansu were selected. Results: The optimum early warning boundary values of influenza, scarlet fever, other infectious diarrheal diseases, dysentery, typhoid and paratyphoid, and viral hepatitis type E were P(90), P(80), P(95), P(90), P(80) and P(90) respectively. The optimum early warning parameters of HFMD were k=1.2, H=5σ. Under the optimum early warning boundary values/parameters, the early warning sensitivities of influenza, scarlet fever, other infectious diarrheal diseases, dysentery, typhoid and paratyphoid, viral hepatitis type E and HFMD were 86.67%, 100.00%, 91.67%, 100.00%, 100.00%, 100.00% and 100.00%, the specificities were 86.49%, 62.22%, 75.00%, 100.00%, 97.92%, 89.13% and 74.47%. The predictive values of positive test were 72.22%, 29.17%, 52.38%, 100.00%, 80.00%, 54.55% and 29.41%, and the predictive values of negative test were 94.12%, 100.00%, 96.77%, 100.00%, 100.00%, 100.00% and 100.00%, and the Youden' indexes were 0.73, 0.62, 0.67, 1.00, 0.98,0.89 and 0.74. Receiver-operating characteristic curve showed that the values/parameters of this warning boundary were the points closest to the upper left of the coordinate diagram. Conclusion: The early warning thresholds of influenza, other infectious diarrheal diseases, dysentery and hepatitis E in Gansu may be raised appropriately and the early warning parameters of HFMD need to be adjusted to improve the effectiveness of early warning.
China
;
Communicable Disease Control/methods*
;
Communicable Diseases/epidemiology*
;
Disease Notification
;
Disease Outbreaks/prevention & control*
;
Humans
;
Models, Theoretical
;
Population Surveillance/methods*
3.Characteristics of HIV-infected persons without long term disease progress and related factors in Guangxi Zhuang Autonomous Region.
X J ZHOU ; Q Y ZHU ; J J LI ; G H LAN ; S S LIANG ; S F LIU ; X H LIU ; Q MENG ; C X ZHOU ; Z Y SHEN
Chinese Journal of Epidemiology 2019;40(1):70-73
Objective: To understand the characteristics of HIV infected persons without long term disease progress [also known as long term non-progressors (LTNPs)], and related factors in Guangxi Zhuang Autonomous Region (Guangxi). Methods: Data of persons living with HIV and receiving no antiretroviral therapy in Guangxi by the end of 2016 were collected from the national HIV/AIDS comprehensive control and prevention information system of China. Results: By the end of 2016, there were 313 LTNPs in Guangxi, accounting for 2.3% of those being reported for more than 10 years, 5.4% of those being reported for more than 10 years and surviving, and 26.6% of those being reported for more than 10 years, surviving and receiving no antiretroviral therapy. Among the LTNPs, 87.2%(273) were men, 94.9% (297) were aged ≤ 40 years, 32.3% (101) were farmers, 55.6% (174) were single, divorced or widowed, 69.3% (217) were of Han ethnic group, 68.1% (213) were injecting drug users, and 52.1% (163) were from custody facilities. Multiple logistic regression analysis indicated that factors associated with delayed disease progression included age ≤40 years (compared with age >40 years, aOR=1.55, 95%CI: 1.31-3.12) and injection drug use (compared with sexual transmission, aOR=1.23, 95%CI: 1.10-1.74). Conclusions: A number of LTNPs existed in HIV-infected individuals in Guangxi. Further research are needed to identify the related factors, and it is necessary to conduct large sample size studies on host immunology, genetics and the virology of HIV to explore the related mechanism.
Adolescent
;
Adult
;
Age Distribution
;
China/epidemiology*
;
Drug Users/statistics & numerical data*
;
Ethnicity/statistics & numerical data*
;
HIV Infections/ethnology*
;
Humans
;
Male
;
Socioeconomic Factors
4.Prevalence, awareness, treatment and control of hypertension in population older than 15 years of age in Beijing, 2013-2014.
C X WANG ; X G WU ; H J LIU ; S C GUAN ; C B HOU ; H H LI ; X GU ; Z Y ZHANG ; X H FANG
Chinese Journal of Epidemiology 2018;39(2):179-183
Objective: To investigate the rates on prevalence, awareness, treatment and control of hypertension in population older than 15 years of age in Beijing, 2013-2014. Methods: A cross-sectional survey was conducted in Beijing between 2013-2014. Stratified multistage random sampling method was used to select representative sample of 13 057 Chinese individuals aged over 15 years, from the general population. Blood pressure was measured for three readings at sitting position after resting for at least five minutes with an average reading recorded. A standardized structured questionnaire was developed to collect history of hypertension and antihypertensive treatment. Results: A total of 4 663 community residents aged over 15 years were hypertensive among the 13 057 individuals, with the standardized prevalence rate as 32.7%, in Beijing area. The age-standardized prevalence rates of hypertension appeared 34.6% in men and 30.8% in women. The age-and sexstandardized prevalence of hypertension rates were 33.3% in urban and 24.6% in rural areas. The prevalence of hypertension increased with age and appeared higher in men than in women, in urban than in rural residents. Among the hypertensive patients, rates of awareness, treatment and control were 66.8%, 64.6% and 31.6%, respectively. Conclusion: High prevalence of hypertension with low rates on awareness and treatment and control, appeared in the general population of Beijing. Related strategies should be developed regarding prevention, control and management of hypertension, to reduce the burden of this disease.
Adolescent
;
Adult
;
Age Distribution
;
Aged
;
Antihypertensive Agents/therapeutic use*
;
Asian People/statistics & numerical data*
;
Awareness
;
Blood Pressure
;
Blood Pressure Determination
;
China/epidemiology*
;
Cross-Sectional Studies
;
Female
;
Health Knowledge, Attitudes, Practice
;
Humans
;
Hypertension/epidemiology*
;
Male
;
Middle Aged
;
Prevalence
;
Rural Population
;
Sex Distribution
;
Surveys and Questionnaires
;
Urban Population
;
Young Adult
5.Sampling methods and errors appearing in the China National Human Biomonitoring Program.
Z J CAO ; Y L QU ; F ZHAO ; L LIU ; S X SONG ; Y C LIU ; J Y CAI ; X M SHI
Chinese Journal of Epidemiology 2018;39(12):1642-1647
Objective: To explore the sampling method in China National Human Biomonitoring Program (HBP) and the related errors, so as to calculate and evaluate the study design in sampling. Methods: The sampling method of HBP is of multistage nature. Taking the results of sampling method from Guizhou province as an example, results related to sampling error and variation coefficient were calculated, using the multistage unequal probability sampling error method. Results: The HBP covered 152 monitoring sites in 31 provinces (autonomous regions and municipalities) and with 21 888 residents selected. The replacement rates at various stages were 5.26%, 6.35% and 40.6% respectively. The sampling error in Guizhou province was 3 207 594, and the coefficient of variation was 0.097. Conclusions: According to the multi-stage unequal probability sampling method, the sampling coefficient variability appeared small with high precision, in Guizhou province. However, this method did not consider the weight adjustment of non-sampling errors such as population missing rate and response rate. Methods related to the calculation on multi-stage sampling error among large-scale public health monitoring projects need to be further studied.
China
;
Cities
;
Environmental Monitoring
;
Humans
;
Research Design
6.Using the sequenced sample cluster analysis to study the body mass index distribution characteristics of adults in different age groups and genders.
Y N CAI ; X T PEI ; P P SUN ; Y P XU ; L LIU ; Z G PING
Chinese Journal of Epidemiology 2018;39(6):821-825
Objective: To explore the characteristics of distribution on Chinese adult body mass index (BMI) in different age groups and genders and to provide reference related to obesity and related chronic diseases. Methods: Data from the China Health and Nutrition Survey in 2009 were used. Sequential sample cluster method was used to analyze the characteristics of BMI distribution in different age groups and genders by SAS. Results: Our results showed that the adult BMI in China should be divided into 3 groups according to their age, as 20 to 40 years old, 40 to 65 years old, and> 65 years old, in females or in total when grouped by difference of 5 years. For groupings in male, the three groups should be as 20 to 40, 40 to 60 years old and>60 years old. There were differences on distribution between the male and female groups. When grouped by difference of 10 years, all of the clusters for male, female and total groups as 20-40, 40-60 and>60 years old, became similar for the three classes, respectively, with no differences of distribution between gender, suggesting that the 5-years grouping was more accurate than the 10-years one, and BMI showing gender differences. Conclusions: BMI of the Chinese adults should be divided into 3 categories according to the characteristics of their age. Our results showed that BMI was increasing with age in youths and adolescents, remained unchanged in the middle-aged but decreasing in the elderly.
Adolescent
;
Adult
;
Age Distribution
;
Aged
;
Asian People/statistics & numerical data*
;
Body Mass Index
;
China/epidemiology*
;
Female
;
Humans
;
Male
;
Middle Aged
;
Nutrition Surveys
;
Obesity/ethnology*
;
Sex Distribution
;
Sex Factors
;
Young Adult
7.Transmission cluster and network of HIV-1 CRF01_AE strain in China, 1996-2014.
X L WANG ; L JIA ; H P LI ; Y J LIU ; J W HAN ; T Y LI ; J Y LI ; L LI
Chinese Journal of Epidemiology 2019;40(1):84-88
Objective: To understand the transmission patterns and risk factors of HIV-1 strain CRF01_AE subtypes in China, and to provide guidance for the implementation of precise intervention. Methods: A total of 2 094 CRF01_AE pol sequences were collected in 19 provinces in China between 1996 and 2014. Phylogenetic tree was constructed by PhyML 3.0 software to select the transmission clusters. Transmission network was constructed by Cytoscape 3.6.0, which was further used for exploring of the major risk factors. Results: Of the 2 094 sequences, 12.18% (255/2 094) were in clusters. A total of 82 transmission clusters were identified. The numbers of clusters and contained sequences in intra-provincial transmission (61, 173) were significantly more than those in inter-provincial transmission (21, 82). The ratio of transmission clustering in MSM increased over time from 2.41% (2/83) during 1996-2008 to 23.61% (72/305) during 2013-2014, showing a significant upward trend (χ(2)=27.800, df=1, P=0.000). The proportion of MSM with inter-provincial transmission clusters were higher than those with intra-provincial transmission clusters, which increased from 0.67% (2/297) during 1996-2008 to 6.36%(30/472) during 2013-2014, showing a significant upward trend (χ(2)=20.276, df=1, P=0.000). The transmission rate in homosexuals of the inter-transmission clusters (86.59%, 71/82) was higher than that of intra-provincial transmission clusters (56.65%, 98/173), and the difference was statistically significant (χ(2)=22.792, P=0.000). The proportion of inter-provincial transmission clusters with more than 2 transmission routes (33.33%, 7/21) was higher than that of intra-provincial clusters (13.11%, 8/61), and the difference was statistically significant (χ(2)=4.273, P=0.039). Results from the transmission network analysis indicated that the proportion of high risk population (degree≥4) with inter-provincial transmission clusters (51.22%, 42/82) was significantly higher than that with intra-provincial transmission clusters (26.59%, 46/173), and the difference was statistically significant (χ(2)=14.932, P=0.000). Inter-provincial clusters were mainly detected in and and MSM. Conclusions: Complex transmission networks were found for HIV-1 CRF01_AE strains in the mainland of China. Inter-provincial transmission clusters increased rapidly, MSM played an important role in the wide spread of the strain. More researches in transmission networks are needed to guide the precision intervention.
China/epidemiology*
;
HIV Infections/virology*
;
HIV-1/isolation & purification*
;
Homosexuality, Male/statistics & numerical data*
;
Humans
;
Male
;
Phylogeny
8.Study on the super-antigen genes of group A Streptococcus pyogenes strains isolated from patients with scarlet fever and pharyngeal infection, in Beijing, 2015-2017.
C N MA ; X M PENG ; S S WU ; D T ZHANG ; J C ZHAO ; G L LU ; Y PAN ; S J CUI ; Y M LIU ; W X SHI ; M ZHANG ; Q Y WANG ; P YANG
Chinese Journal of Epidemiology 2018;39(10):1375-1380
Objective: To analyze the characteristics of super-antigen (SAg) of group A Streptococcus pyogenes (GAS), isolated from patients with scarlet fever or pharyngeal infections in Beijing between 2015-2017. Methods: Throat swab specimens from patients with scarlet fever or pharyngeal infections were collected and tested for GAS. Eleven currently known SAg genes including SpeA, speC, speG, speH, speI, speJ, speK, speL, speM, smeZ and ssa were tested by real-time PCR while M protein genes (emm genes) were amplified and sequenced by PCR. Results: A total of 377 GAS were isolated from 6 801 throat swab specimens, with the positive rate as 5.5%. There were obvious changes noticed among speC, speG, speH and speK in three years. A total of 45 SAg genes profiles were observed, according to the SAgs inclusion. There were significant differences appeared in the frequencies among two of the highest SAg genes profiles between emm1 and emm12 strains (χ(2)=38.196, P<0.001; χ(2)=72.310, P<0.001). There also appeared significant differences in the frequencies of speA, speH, speI and speJ between emm1 and emm12 strains (χ(2)=146.154, P<0.001; χ(2)=52.31, P<0.001; χ(2)=58.43, P<0.001; χ(2)=144.70, P<0.001). Conclusions: Obvious changes were noticed among SAg genes including speC, speG, speH and speK from patients with scarlet fever or pharyngeal infections in Beijing between 2015-2017. SAg genes including speA, speH, speI and speJ appeared to be associated with the emm 1 and emm 12 strains. More kinds of SAg genes profiles were isolated form GAS but with no significant differences seen in the main SAg genes profiles, during the epidemic period.
Antigens, Bacterial/genetics*
;
Bacterial Outer Membrane Proteins
;
Bacterial Proteins
;
Beijing/epidemiology*
;
China/epidemiology*
;
Exotoxins
;
Female
;
Humans
;
Membrane Proteins
;
Pharyngitis/microbiology*
;
Pharynx/microbiology*
;
Pregnancy
;
Pregnancy Complications, Infectious/microbiology*
;
Real-Time Polymerase Chain Reaction
;
Scarlet Fever/microbiology*
;
Streptococcal Infections
;
Streptococcus pyogenes/isolation & purification*
;
Superantigens/genetics*
9.Progress in research of relationship between heavy metal exposure and cardiovascular disease.
F LU ; F ZHAO ; J Y CAI ; L LIU ; X M SHI
Chinese Journal of Epidemiology 2018;39(1):102-106
Heavy metal is one of pollutants existed widely in the environment, its relationship with cardiovascular disease has attracted more and more attention. In this review, the concentrations of heavy metals, including lead, cadium and asenic, in the body from several national surveillance networks and the epidemiological studies on the effects of the exposure of three heavy metals on cardiovascular system were summarized. It is suggested to strengthen nationwide surveillance for body concentrations of heavy metals in general population in order to provide baseline data for quantitative evaluation of the risk of heavy metal exposure on cardiovascular disease.
Cadmium
;
Cardiovascular Diseases/chemically induced*
;
Environmental Exposure/adverse effects*
;
Environmental Pollutants/toxicity*
;
Epidemiologic Studies
;
Humans
;
Lead/toxicity*
;
Metals, Heavy/toxicity*
;
Neoplasms
;
Research/trends*
10.Trend on mortality/incidence ratio of acute myocardial infarction in Tianjin from 2007 to 2015.
Chinese Journal of Epidemiology 2018;39(4):510-513
Objective: To explore the variation for mortality/incidence (MI) ratio on acute myocardial infarction (AMI) in Tianjin from 2007 to 2015. Methods: Data from both disease and death surveillance systems on AMI in Tianjin from 2007 to 2015, were collected. Incidence and mortality for AMI of people over 35 years old were calculated and fitted by using the exponential model. Annual MI ratios by gender and different age groups were calculated. Join-point regression was used for sensitivity analysis of the ratio. Results: Other than 2007, 2010, 2014 and 2015, the ratios in rest of the years were all bigger than one. From 2007 to 2015, the ratios were ranging from 0.80 to 1.60, with 0.90 to 1.80 for females, and 0.80 to 1.40 for males, respectively. Conclusion: The MI ratio on AMI changed relatively stable in Tianjin from 2007 to 2015, but the AMI incidence data in Tianjin seemed underreported, especially for people over 75 years old, indicating that some elderly AMI cases were not reported to the disease surveillance system.
Aged
;
China/epidemiology*
;
Female
;
Hospital Mortality/trends*
;
Humans
;
Incidence
;
Male
;
Myocardial Infarction/mortality*