Humans ; Diverticulum, Colon ; Fecal Impaction ; Hydrodynamics

Objective: To analyze the spatial and temporal distributions of bacillary dysentery in Chongqing, Yichang and Enshi (the Three Gorges Area) from 2005 to 2016, and provide evidence for the disease prevention and control. Methods: The incidence data of bacillary dysentery in the Three Gorges Area during this period were collected from National Notifiable Infectious Disease Reporting System. The spatial-temporal scan statistic was conducted with software SaTScan 9.4 and bacillary dysentery clusters were visualized with software ArcGIS 10.3. Results: A total of 126 196 cases were reported in the Three Gorges Area during 2005-2016, with an average incidence rate of 29.67/100 000. The overall incidence was in a downward trend, with an average annual decline rate of 4.74%. Cases occurred all the year round but with an obvious seasonal increase between May and October. Among the reported cases, 44.71% (56 421/126 196) were children under 5-year-old, the cases in children outside child care settings accounted for 41.93% (52 918/126 196) of the total. The incidence rates in districts of Yuzhong, Dadukou, Jiangbei, Shapingba, Jiulongpo, Nanan, Yubei, Chengkou of Chongqing and districts of Xiling and Wujiagang of Yichang city of Hubei province were high, ranging from 60.20/100 000 to 114.81/100 000. Spatial-temporal scan statistic for the spatial and temporal distributions of bacillary dysentery during this period revealed that the temporal distribution was during May-October, and there were 12 class Ⅰ clusters, 35 class Ⅱ clusters, and 9 clusters without statistical significance in counties with high incidence. All the class Ⅰ clusters were in urban area of Chongqing (Yuzhong, Dadukou, Jiangbei, Shapingba, Jiulongpo, Nanan, Beibei, Yubei, Banan) and surrounding counties, and the class Ⅱ clusters transformed from concentrated distribution to scattered distribution. Conclusions: Temporal and spatial cluster of bacillary dysentery incidence existed in the three gorges area during 2005-2016. It is necessary to strengthen the bacillary dysentery prevention and control in urban areas of Chongqing and Yichang.
Adolescent ; Adult ; Child ; Child, Preschool ; China/epidemiology* ; Cities ; Dysentery, Bacillary/epidemiology* ; Environment ; Female ; Humans ; Incidence ; Male ; Seasons ; Spatio-Temporal Analysis ; Young Adult

Objective: To investigate the infection pattern and etiological characteristics of a case of human infection with highly pathogenic avian influenza A (H7N9) virus and provide evidence for the prevention and control of human infection with highly pathogenic avian influenza virus. Methods: Epidemiological investigation was conducted to explore the case's exposure history, infection route and disease progression. Samples collected from the patient, environments and poultry were tested by using real time reverse transcriptase-polymerase chain reaction (RT-PCR). Virus isolation, genome sequencing and phylogenetic analysis were conducted for positive samples. Results: The case had no live poultry contact history, but had a history of pulled chicken processing without taking protection measure in an unventilated kitchen before the onset. Samples collected from the patient's lower respiratory tract, the remaining frozen chicken meat and the live poultry market were all influenza A (H7N9) virus positive. The isolated viruses from these positive samples were highly homogenous. An insertion which lead to the addition of multiple basic amino acid residues (PEVPKRKRTAR/GL) was found at the HA cleavage site, suggesting that this virus might be highly pathogenic. Conclusions: Live poultry processing without protection measure is an important infection mode of "poultry to human" transmission of avian influenza viruses. Due to the limitation of protection measures in live poultry markets in Guangzhou, it is necessary to promote the standardized large scale poultry farming, the complete restriction of live poultry sales and centralized poultry slaughtering as well as ice fresh sale.
Animals ; Chickens ; China ; Commerce ; Humans ; Influenza A Virus, H7N9 Subtype/pathogenicity* ; Influenza in Birds/virology* ; Influenza, Human/virology* ; Phylogeny ; Poultry/virology* ; Real-Time Polymerase Chain Reaction ; Zoonoses

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

Objective: To analyze the distribution characteristics of bacillary dysentery in Beijing during 2004-2015 and evaluate the influence of meteorological factors on the temporal and spatial distribution of bacillary dysentery. Methods: The incidence data of bacterial dysentery and meteorological data in Beijing from 2004 to 2015 were collected. Descriptive epidemiological analysis was conducted to study the distribution characteristics of bacterial dysentery. Linear correlation analysis and multiple linear regression analysis were carried out to investigate the relationship between the incidence of bacillary dysentery and average precipitation, average air temperature, sunshine hours, average wind speed, average air pressure, gale and rain days. Results: A total of 280 704 cases of bacterial dysentery, including 36 deaths, were reported from 2004 to 2015 in Beijing, the average annual incidence was 130.15/100 000. The annual incidence peak was mainly between May and October, the cases occurred during this period accounted for 80.75% of the total, and the incidence was highest in age group 0 year. The population distribution showed that most cases were children outside child care settings and students, and the sex ratio of the cases was 1.22∶1. The reported incidence of bacillary dysentery was positively associated with average precipitation, average air temperature and rain days with the correlation coefficients of 0.931, 0.878 and 0.888, but it was negatively associated with the average pressure, the correlation coefficient was -0.820. Multiple linear regression equation for fitting analysis of bacillary dysentery and meteorological factors was Y=3.792+0.162X(1). Conclusion: The reported incidence of bacillary dysentery in Beijing was much higher than national level. The annual incidence peak was during July to August, and the average precipitation was an important meteorological factor influencing the incidence of bacillary dysentery.
Beijing/epidemiology* ; Child ; China/epidemiology* ; Dysentery, Bacillary/epidemiology* ; Humans ; Incidence ; Linear Models ; Meteorological Concepts ; Multivariate Analysis ; Regression Analysis ; Sex Ratio ; Temperature

Objective: To understand the influence of diurnal temperature range (DTR) on influenza incidence in the elderly in Beijing and to conduct a subgroup analysis. Methods: The incidence data of daily influenza cases in the elderly and daily meteorological data from 2014 to 2016 in Beijing were collected for this study. A generalized additive model (GAM) was used to explore whether the relationship between daily influenza cases and DTR is a linear one. A distributed lag non-linear model (DLNM) was established to quantify the lagged effect of DTR on daily influenza incidence in the elderly. The model was also used to estimate the effects of DTR on daily influenza incidence among various subgroups. Results: A total of 4 097 influenza cases in the elderly were notified during study period. The mean DTR was 10.153 ℃. A linear relationship between daily influenza incidence and DTR was detected by using GAM. DTR was significantly associated with daily influenza incidence between lag0 and lag5 with a maximal effect at lag0. An 1 ℃ increase of DTR was associated with a 2.0% increase in daily influenza incidence in the elderly (95%CI: 0.9%-3.0%). The RR values of males, females, people aged 60-69 years, people aged ≥70 years were 1.018 (95%CI: 1.005-1.032), 1.021(95%CI: 1.007-1.035), 1.012 (95%CI: 1.002-1.022), 1.025 (95%CI: 1.012-1.039), respectively. The influencing time of DTR on females (lag6) was longer than males (lag2). Conclusions: DTR was associated with increased risk of influenza in the elderly in Beijing. It is necessary to take targeted measures in the elderly to control the incidence of influenza when DTR becomes greater.
Aged ; Beijing ; China/epidemiology* ; Female ; Humans ; Incidence ; Influenza, Human/epidemiology* ; Male ; Middle Aged ; Temperature

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

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

Objective: Through analyzing the epidemiological characteristics of hepatitis A and E and the situation of vaccination, to promote the recommendation profile on Hepatitis E vaccination program, in China. Methods: Three phases of time span were divided as 2004-2007, 2008-2011 and 2012-2015, with age groups divided as <20, 20-29, 30-39 and ≥40. Incidence rates in both different phases and age groups were compared. Numbers of Hepatitis A and E vaccines released and used, were described. Results: Between 2004 and 2015, a declining trend in the reported incidence of hepatitis A (t=-12.15, P<0.001), but an increasing trend in hepatitis E (t=6.63, P<0.001) were noticed. The mean number of hepatitis A cases declined from 6 515 to 1 986 between 2004 and 2007 while the number of hepatitis E cases increased from 1 491 to 2 277 between 2012 and 2015. The peaks of hepatitis E appeared persistent annually, in March. The incidence of hepatitis A declined in three regions, with the western region (3.46/100 000) much higher than the eastern (1.13/100 000) or central regions (1.14/100 000) (χ(2)=32 630, P<0.01). The incidence of hepatitis E increased both in the central (1.74/100 000) and western regions (1.58/100 000), but more in the eastern region (2.66/100 000) (χ(2)=6 009, P<0.01). Incidence of hepatitis A declined in all age groups and declined by 84.36% among the 0-19 group. However, the incidence of hepatitis E showed an increasing trend among the ≥20 group. Incidence rates appeared higher in the older age groups. The coverage of hepatitis A vaccine increased from 62.05% to 93.54%, but with a negative association seen between the coverage of Hepatitis A vaccine and the incidence (F=10.69, χ(2)<0.05). Conclusion: The incidence of Hepatitis A declined sharply in China while hepatitis E was still increasing from 2004 to 2015, calling for the expansion on the coverage of Hepatitis E vaccine in the whole population.
Adolescent ; Adult ; Aged ; China/epidemiology* ; Health Care Surveys ; Hepatitis A/epidemiology* ; Hepatitis A Vaccines/administration & dosage* ; Hepatitis E/epidemiology* ; Humans ; Immunization/statistics & numerical data* ; Immunization Programs ; Incidence ; Middle Aged ; Population Surveillance ; Vaccination/statistics & numerical data* ; Young Adult

Objective: To analyze the prevalence and co-prevalence of cardio metabolic (CM) risk factors in adults in China. Methods: The project data of 2015 Nutritional Status and Health Transition of Chinese Residents were used, and 5 456 adults aged 18-59 years with complete socio-demographic, anthropometric, and blood biochemical data were selected as the study subjects. The definition released by the International Diabetes Federation in 2005 were used to define each CM risk factors, including central obesity, elevated TG, reduced HDL-C, elevated blood pressure and elevated FPG. The co-prevalence of the risk factors was defined as adults having ≥2 risk factors. Multivariable logistic regression analysis was performed to evaluate the relationship between CM risk and socio-demographic factors. Results: About 80.8% of adults had at least 1 risk factor, and 54.0% had co-prevalence of risk factors. Gender, age, education level and living area were significantly associated with the prevalence of major metabolic risk factors. After adjusting for other factors, compared with men, women were more likely to have central obesity and reduced HDL-C, but not more likely to have elevated blood pressure, elevated FPG and elevated TG (P<0.01). Compared with adults aged 18-44 years, adults aged 45-59 years were more likely to have central obesity, elevated blood pressure, elevated FPG and elevated TG (P<0.01). The odds of having central obesity, elevated blood pressure and elevated fasting plasma glucose in the adults in eastern China were significantly higher than those in the central and western China. Conclusions: In 2015, less than 20% of the adults aged 18-59 years in China had no cardio metabolic risk factors, and more than half of them had two or more risk factors. Gender, age and living areas were the major influencing factors. It is necessary to take effective intervention measures targeting adults at high-risk for the early prevention of cardiovascular disease.
Adolescent ; Adult ; Alcohol Drinking/epidemiology* ; Cardiovascular Diseases/epidemiology* ; China/epidemiology* ; Female ; Humans ; Male ; Metabolic Syndrome/ethnology* ; Middle Aged ; Obesity/ethnology* ; Prevalence ; Risk Factors ; Smoking/epidemiology* ; Socioeconomic Factors ; Young Adult