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Surveillance on the dynamics of leptospirosis epidemics in the Chongqing Section of the Three Gorges dam area.

Jiang LONG ; Xin-li WANG ; Qing-liang JIA ; Qin LI ; De-qiang MAO ; Guo-hui WU ; Li-su HAN ; Heng-qing JI

Chinese Journal of Epidemiology.2007;28(4):366-369.

OBJECTIVETo analyze the changes of leptospirosis epidemic characteristics before and after the Phase 2 'reservoir store water project' in Chongqing section of the Three Gorges dam area and to provide prevention, control and intervention measures to prevent the spread of leptospirosis from infectious focus to the Three Gorges dam area and downstream region of Changjiang River.

METHODSChangshou district and Fengdu county were selected as surveillance sites. We monitored the source of infection through examining the serum antibody of patients, healthy groups together with farm cattle measured by micro agglutination test (MAT).

RESULTSporadic cases were reported before and after the storage of water in the reservoir. There was no significant difference found between mouse density before and after the Phase 2 reservoir project (chi2 = 1.00, P > 0.05). The main species of rat were Sewer rat before and Insectivorea after the storage of water. The germ-carrying rate of rats was 1.72% (10/583) and positive carrying rate of rats was 16.51% (18/109) when using PCR. Results showed a significant difference when comparing it to culture method (chi2 = 51.80, P < 0.01). Positive rate of leoptopirosis appeared in the serum of patients was 73.33% (33/45) with the major serum group as the Australia group. The rate of infection among the healthy group was 26.84% (233/868). There was significant difference seen between the serum antibody positive rate of epidemic prophase (23.85%) and epidemic anaphase (29.86%) of the healthy group (chi2 = 3.99, P < 0.05). The GMRT of ox serum antibody of leoptopirosis was 29.97 with Bailen group as the predominant microbial population.

CONCLUSIONThere was no epidemics of leptopirosis occurred in the Three Gorges dam area. There was no significant difference between mouse density before and after the storage of water in the reservoir. However, the major species of rats had a change. The natural infection level of people living in the dam area was low, but there existed potential of leoptopirosis outbreak.

Animals ; China ; Humans ; Leptospira ; genetics ; isolation & purification ; Leptospirosis ; epidemiology ; Polymerase Chain Reaction ; Population Surveillance ; Rats ; microbiology ; Rivers ; Water Supply

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Study on the determinants of 'signing agreements' to establish smoke-free homes among 2019 parents of the secondary school students.

Quan QIU ; Wei-qing CHEN ; Xiao-zhong WEN ; Yong-jun OU ; Wen-hua LING

Chinese Journal of Epidemiology.2007;28(4):362-365.

OBJECTIVETo explore the determinants of 'signing a agreement for establishing smoke-free homes' among the parents of secondary school students.

METHODS2019 parents were surveyed with self-administered questionnaires on their socio-demographic characteristics, smoking behaviors, attitude toward tobacco control at home and related data of their children. At the same time, parents were asked to sign an agreement for making the 'home as smoking-free'. 'Parents signing the agreement' was defined as dependent variable (0=no, 1=yes), and parent's age, gender, educational level, etc. were defined as independent ones. Multi-variant logistic regression analysis was conducted for identifying the determinants of the parents to sign an agreement for establishing 'smoking-free homes'.

RESULTSOf the 2019 surveyed parents, 1047 (51.86%) had signed the agreement including 49.25% of the fathers and 55.73% of the mothers. The results from multi-variant logistic regression analysis indicated that father's 'signing action' was significantly associated with (a) their intention of carrying out the agreements (OR = 3.37), (b) to teach their children about the consequence between smoking and health (OR = 2.10), (c) knowing tobacco control program at school (OR = 1.38), (d) reading tobacco control material provided by school (OR = 1.38), (e) being current smoker (OR = 0.53) compare to that the mother's 'signing action' was significantly associated to (a) intention to carrying out agreements (OR = 2.36), (b) teaching children not to smoke (OR = 2.22), (c) reading tobacco control material provided by school (OR = 1.57).

CONCLUSIONChanging parental cognition and attitude toward smoking was beneficial to promote parental participation in tobacco control campaign and to establish 'smoking-free homes'.

China ; Data Collection ; Female ; Housing ; Humans ; Male ; Parents ; Smoking ; Tobacco Smoke Pollution ; prevention & control

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An epidemiological study on carotid atherosclerosis among veterans in Beijing.

Li LIU ; Yu-sheng ZHAO ; Shi-wen WANG ; Yao HE ; Rui CHEN ; Yan-hua LI ; Qiang XU ; Guang-yong HUANG

Chinese Journal of Epidemiology.2007;28(4):358-361.

OBJECTIVETo investigate the prevalence and risk factors of carotid atherosclerosis (CAS) among veterans in Beijing.

METHODS820 individuals, aged 60 or above, were randomly selected out from 8202 individuals, 21 military cadre retirement centers in Beijing. Each individual answered a questionnaire and received Doppler ultrasonic examination for an observation of the Internal-Media Thickness and structure of the carotid. A logistic regression analysis was also made to identify possible risk factors and their powers on the prevalence of CAS.

RESULTSThe prevalence of carotid atherosclerosis by ultrasonic examinations among the veterans in Beijing was 44.0%, of which males taked 53.8% and females taked 33.5%. The prevalence rised with the increase of age. Among them, the prevalence ratio of CAS for ages of 60-69, 70-79, and 80 or above were 30.4%, 51.8%, 65.27%, respectively. Logistic regression was done to provide the following results: CAS risk factors include the age, sex, obesity, smoking, hypertention and diabetes mellitus.

CONCLUSIONThe prevalence of CAS among the veterans in Beijing rises with the increase of age. CAS risk factors include age, sex, obesity, smoking, hypertention and diabetes mellitus.

Aged ; Carotid Artery Diseases ; epidemiology ; China ; epidemiology ; Humans ; Male ; Middle Aged ; Prevalence ; Risk ; Veterans

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Study on the relations between concentration of endotoxin in dwelling and atopic asthma in school-age children.

Dong HU ; Rong-bo ZHANG ; Jing WU

Chinese Journal of Epidemiology.2007;28(4):354-357.

OBJECTIVETo explore the effect of endotoxin concentration in dwellings on the prevalence of atopic asthma in children.

METHODSStandardized questionnaires of asthma were distributed to the parents of 2986 school children aged between 8 and 12 years and endotoxin content in children's mattress was measured by a kinetic limulus assay. A radioallergosorbent technique--fluorescence enzyme immunoassay (RAST-FEIA) was used to measure the level of specific IgE in serum.

RESULTSComplete data was available for 904 children with males more than females. There were both negative associations seen between endotoxin levels and both atopic asthma (OR = 0.48, 95% CI: 0.32-0.72, P < 0.05) and atopic sensitization (OR = 0.65, 95% CI: 0.49-0.94, P < 0.05) but not with non-atopic asthma and wheeze. Comparing with normal people, patients with atopic sensitization, atopic wheeze and atopic asthma had a higher levels of endotoxin (M-W U: 15 138.0, P < 0.01, M-W U: 4858.0, P < 0.01, M-W U: 4041.0, P < 0.01).

CONCLUSIONExposure to endotoxin in early lives of children might have a protective effect on atopic asthma and sensitization.

Asthma ; epidemiology ; prevention & control ; Child ; China ; epidemiology ; Data Collection ; Endotoxins ; blood ; Environmental Exposure ; Humans ; Hypersensitivity, Immediate ; epidemiology ; Immunoglobulin E ; blood ; Respiratory Sounds

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Correlates of and willingness to participate in HIV voluntary counseling and testing among migrants in a city of Shanxi province.

Jin-ling ZHANG ; Na HE ; Xue-wu SHEN ; Shi-xiong QIN ; Mei-yang GAO ; Jian-guo WEI ; Qing-wu JIANG

Chinese Journal of Epidemiology.2007;28(4):350-353.

OBJECTIVETo determine the correlates of and willingness to participate(WTP) in HIV voluntary counseling and testing (VCT) among migrants in Shanxi province.

METHODSThrough quota sampling, a total of 1280 migrants were recruited from 6 different venues where migrants were most likely employed to administer a face-to-face anonymous interview.

RESULTSKnowledge of VCT among migrants was low. Only 56.6% of migrants had heard of HIV voluntary counseling and testing. 64.5% reported willingness to accept VCT after participants were informed that HIV counseling and testing was offered free of charge Centers for Disease Prevention and Control (48.7%), hospital (27.0%) and home (18.5%) were most preferred places for VCT service. Logistic regression analysis indicated that the willingness was associated with having a history of HIV test, having better knowledge of HIV, no discrimination against people with HIV, and high HIV/AIDS perception.

CONCLUSIONCommunity-based health education programs for improving HIV/AIDS knowledge, promoting acceptance of VCT and eliminating discrimination to HIV-infected persons were called for.

China ; Counseling ; utilization ; Emigrants and Immigrants ; HIV Infections ; diagnosis ; Health Education ; Health Knowledge, Attitudes, Practice ; Humans ; Patient Participation

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Study on the molecular typing and epidemiology of non-polio enteroviruses isolated from Yunnan province, China.

Bing-jun TIAN ; Yan WU ; Dong-hua ZHANG ; Li-fang HE ; Zheng-rong DING ; Lin LU

Chinese Journal of Epidemiology.2007;28(4):346-349.

OBJECTIVEThis report presented an overview on the epidemiology of enterovirus in Yunnan province, the People's Republic of China.

METHODSA total of 210 strains of non-polioviruses isolated under acute flaccid paralysis surveillance during a 5-year study period from 1997 to 2000 and 2004 were examined. Of the 210 non-polioviruses strains, a total of 12 strains of adenoviruses were serologically identified. The remaining 198 isolates were used for molecular typing, and the viral genomes of 195 nonpolio enteroviruses (NPEVs) were translated to corresponding amino acid sequences and compared with those of the prototype strains.

RESULTSBased on molecular typing, 5 isolates were classified into 5 serotypes of human enterovirus A species while 158 isolates into 34 serotypes of B and 32 isolates into 6 serotypes of C species. However, we did not isolate any viruses which belonged to human enterovirus D species. Thus, under acute flaccid paralysis surveillance, human enterovirus B species accounted for 75.2% of the 210 isolates and was considered as the predominant one, followed by human enterovirus C (12.2%), adenovirus (5.7%), and human enterovirus A (2.4%).

CONCLUSIONAlthough the epidemiological characteristics of NPEVs from Yunnan province remained "unknown", the molecular typing method had provided us a breakthrough to understand the epidemiology of these viruses.

China ; epidemiology ; Enterovirus ; classification ; genetics ; isolation & purification ; Enterovirus Infections ; epidemiology ; Genes, Viral ; Humans ; Molecular Epidemiology ; Serotyping

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A three-year follow-up study on sera specific antibody in severe acute respiratory syndrome cases after the onset of illness.

Shu-yun XIE ; Guang ZENG ; Shi-chang XIA ; Pan-he ZHANG ; Wei-dong YIN ; Bi-yao LIU ; Shi-gui YANG ; Wu-chun CAO

Chinese Journal of Epidemiology.2007;28(4):343-345.

OBJECTIVETo study the variation of specific antibody among convalescent of severe acute respiratory syndrome (SARS) patients through a three-year program.

METHODSSera samples were collected from SARS cases in the 5th, 20th and 35th month after onset of the illness. The SARS-CoV specific antibody was detected for all of them by ELISA and neutralized test simultaneously. The titer of neutralizing antibodies was calculated using Reed-Muench method, and the comparison between different time groups was analyzed regarding the variance of data on repeated measures after logarithm conversion.

RESULTS13, 17 and 13 sera samples were collected in the 5th, 20th and 35th month after onset. Results showed that despite the fact that the positive rates of ELISA antibody were 100%, 82.4% and 84.6% respectively,the neutralizing antibody was still positive for all the samples. The average neutralizing antibody titers were 1:43 (1:16-1:203), 1:36 (1:17-1:59) and 1:21 (1:10-1:39) on the 5th, 20th and 35th month after onset, and the differences were statistically significant (F = 60.419, P < 0.001). On the 35th month after the onset, 30.8% (4/13) of the patients were still having the neutralizing antibody level of above 1:36, but the neutralizing antibody level in another 30.8% (4/13) of the patients had decreased to as low as 1:10, when the cut-off level was set as 1:8.

CONCLUSIONResults of the study indicated that the neutralizing antibody of SARS cases could last for at least three years, but the sera specific antibody in SARS cases decreased gradually when time went by. However, neutralizing antibody in some of the cases decreased to a lower level on the 35th month. Further follow-up study was worthwhile to observe the long-lasting profile of antibody existence on SARS cases.

Antibodies, Neutralizing ; analysis ; Enzyme-Linked Immunosorbent Assay ; Follow-Up Studies ; Humans ; Severe Acute Respiratory Syndrome ; immunology

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Study on the antiviral therapy program among people with human immunodeficiency virus in Guangxi Zhuang Authority.

Han-ping LI ; Wei LIU ; Hai-xia LIU ; Shu-jia LIANG ; Zuo-yi BAO ; Yong-Jian LIU ; Dao-min ZHUANG ; Si-yang LIU ; Lin LI ; Jing-yun LI

Chinese Journal of Epidemiology.2007;28(4):338-342.

OBJECTIVETo explore the reconstitution of immune function and viral suppression condition and to analyze the occurrence of drug resistance HIV-1 variants and its prevalence after using HAART in Guangxi Autonomy Region.

METHODSFrom July 2004 to October 2005, 133 HIV infected individuals who had received HAART for more than three months were recruited, and 58 infected persons with no antiviral therapy were selected as controls. Questionnaire was used to collect information about the adherence of HAART therapy. Immune reconstruction and viral suppress conditions were obtained by CD4+ counts and viral load and RT-PCR were used to amplify the PR and RT regions of HIV-1 genome while HIV-1 drug resistance rates were analyzed to show the occurrence and prevalence in both treated and naive patients.

RESULTSIn terms of CD4+ T cell counts: 70.69% of the treated patients showed obvious increase and 23.28% had no apparent change but 6.03% of them went down. 70.48% of the patients who had received antiviral therapy more than 3 months had their viral load lower than the low detectable limitation. When comparing the log of viral load between treated and untreated cohort, the mean value of the treated was obviously less than the untreated (P < 0.05). However,the result of drug resistance showed no obvious difference between the treated and untreated groups.

CONCLUSIONThe antiviral therapy being used in Guangxi region, had achieved obvious effect on the reconstruction of immune system and the suppression of viral replication in vivo under good adherence while the occurrence of drug-resistant HIV strain did not show obvious difference between treated and naive patient groups.

Antiretroviral Therapy, Highly Active ; CD4 Lymphocyte Count ; Case-Control Studies ; China ; HIV Infections ; drug therapy ; epidemiology ; virology ; HIV-1 ; Humans ; Patient Compliance ; Prevalence ; Reverse Transcriptase Polymerase Chain Reaction ; Viral Load

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Role of mutations on the "hepatitis B virus 'a' determinant hotpoint" to the efficacy of hepatitis B vaccine.

Rui ZHANG ; Rong-cheng LI ; Feng-cai ZHU ; Yan-ping LI ; She-lan LIU ; Xian-chen ZHANG ; Sheng-qi WANG ; Zheng-lun LIANG ; He-min LI ; Hui ZHUANG

Chinese Journal of Epidemiology.2007;28(4):334-337.

OBJECTIVETo study how hepatitis B virus(HBV) 'a' determinant hotpoint mutations were influecing the hepatitis B vaccine efficacy.

METHODSPrimers were designed in HBV conservative region, and the degenerate probes for detecting 16 'a' determinant hotpoint mutations were developed for gene chips. Sensitivity and specificity of the gene chips were evaluated by clone sequencing. Sera of 47 pairs of mothers and infants with immune failure and 323 mothers of children with immune protection of HB vaccine were detected by the gene chips.

RESULTSResult from clone sequencing demonstrated that the gene chips were specific for the detection of 'a' determinant hotpoint mutations. The wild type of HBV was still dominant, with the prevalence of 78.66%, and the mutation frequencies of 126A, 145R, 126S-1, 126S-2, 129H, 144A, and 129R were 11.27%, 5.76%, 5.28%, 4.56%, 1.20%, 0.72% and 0.24%, respectively. The prevalence of 126A mutation was significantly higher than that of other mutations(P < 0.01). No significant differences were found in mother-infant transmission rates of 126A, 126S-1, 126S-2 and 145R variants.

CONCLUSIONThe currently available hepatitis B vaccine could block mother-infant transmission of 126A, 126S and 145R variants. It appears that there is no need to develop a new hepatitis B vaccine against 126 and 145 variants at present, but the consistent epidemiological surveillance on HBV mutants should be carried out.

Adult ; Female ; Genotype ; Hepatitis B ; prevention & control ; transmission ; Hepatitis B Vaccines ; immunology ; Hepatitis B virus ; genetics ; immunology ; Humans ; Infant, Newborn ; Infectious Disease Transmission, Vertical ; prevention & control ; Mutation ; Oligonucleotide Array Sequence Analysis ; Pregnancy ; Pregnancy Complications, Infectious ; prevention & control ; virology

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Interruption failure of heptitis B virus vaccination in mother-to-infant transmission and heptitis B virus genotypes and preC/BCP mutations.

Jia WANG ; Jie LI ; Hui ZHUANG ; She-lan LIU ; Rong-cheng LI ; Yan-ping LI ; Zheng-lun LIANG

Chinese Journal of Epidemiology.2007;28(4):331-333.

OBJECTIVETo investigate the association of heptitis B virus (HBV) genotypes and precore(PreC)/basal core promoter(BCP) mutation with interruption failure of HBV vaccination in mother-to-infant transmission.

METHODSA total number of 208 serum samples were collected from infants and mothers,including 16 infants who had become HBsAg-positive despite a complete and timely course of immunization and another 88 infants successfully protected from mother-to infant HBV transmission. HBV genotypes were determined by type-specific primers PCR method. PreC/BCP mutations were detected by direct sequencing of PCR products, and Clustal W 1.8 software was applied to analyzing the sequences.

RESULTSOf 16 mothers who were having vaccine failure infants, 15 (93.8%) were HBeAg positive and infected with genotype C (15/15, 100%). Among 88 mothers of having children being protected by vaccine, 51 (58.0%) were HBeAg positive, with 45.1% (23/51) of genotype C. The proportion of genotype C in HBeAg mothers of infants with vaccine failure, was significantly higher than that of mothers with vaccine protected infants (chi2 = 14.3, P = 0.003). However, the frequencies of T1762/A1764 mutations had no significant differences between genotype C HBeAg positive mothers with vaccine failure or protected infants (33.3% and 13.3%, respectively, P = 0.4). No A1896 mutation was found in these two groups.

CONCLUSIONHBV genotype C might contribute to the immune failure of HBV vaccination in mother-to-infant transmission, while PreC/BCP mutation might not have correlation with it.

Adult ; Female ; Genes, Viral ; Genotype ; Hepatitis B ; immunology ; prevention & control ; transmission ; Hepatitis B Vaccines ; immunology ; Hepatitis B virus ; genetics ; immunology ; Humans ; Infant, Newborn ; Infectious Disease Transmission, Vertical ; prevention & control ; Mutation ; Polymerase Chain Reaction ; Pregnancy ; Pregnancy Complications, Infectious ; immunology ; virology ; Promoter Regions, Genetic

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