Objective:To analyze the epidemiological characteristics, spatial clustering, and correlation between dental fluorosis detection rates and meteorological factors in children aged 8 - 12 years old in 37 counties (cities, districts, hereinafter referred to as counties) affected by coal-burning-borne endemic fluorosis in Guizhou Province, and to provide a scientific basis for prevention and control of the disease.Methods:Monitoring data on dental fluorosis in children aged 8 - 12 years old from 2019 to 2022 were collected from the National Health Security Information System for Endemic Diseases. Meteorological data, including annual average temperature, annual average precipitation, annual sunshine hours, and annual average relative humidity, were obtained from the Guizhou Provincial Bureau of Statistics. Descriptive epidemiology, analytical epidemiology, and spatial correlation analysis methods were used to analyze the data. Visual maps were created based on the clustering levels of annual dental fluorosis detection rates (high-high, low-low, high-low, low-high). Spatial autocorrelation and meteorological factors were used to analyze the epidemiological characteristics, spatial clustering, and the impact of meteorological factors on dental fluorosis.Results:From 2019 to 2022, a total of 3 649 161 children aged 8 - 12 in the counties affected by coal-burning-borne endemic fluorosis were monitored, and 115 793 children were diagnosed with dental fluorosis, with a detection rate of 3.17%. The detection rates were 4.73% (45 093/954 338) in 2019, 3.35% (31 424/938 445) in 2020, 2.86% (21 727/760 195) in 2021, and 1.76% (17 549/996 183) in 2022, respectively. The dental fluorosis indices were 0.09, 0.07, 0.06, and 0.03, respectively. The number of counties with detection rates > 6% was 7, 5, 5, and 0 in 2019 - 2022, respectively. Dafang County consistently had the highest detection rates, with rates of 10.06% (6 783/67 408), 10.07% (1 955/19 421), 13.54% (4 017/29 667), and 4.83% (3 284/76 206) in 2019 - 2022, respectively. The Moran's I indices for dental fluorosis detection rates were 0.45, 0.53, 0.53, and 0.53 in 2019 - 2022, with Z = 4.29, 5.07, 5.31, and 5.10, respectively ( P < 0.05), indicating global spatial autocorrelation (positive) and spatial clustering of dental fluorosis detection rates. The number of counties with "high-high" clustering of detection rates was 7, 7, 6, and 7 in 2019 - 2022, mainly concentrated in the northwestern region, including Qixingguan District, Nayong County, Dafang County, Zhijin County, and Jinsha County of Bijie City. "Low-high" clustering areas were distributed in Zhongshan District of Liupanshui City in 2019, 2020, and 2022. The detection rate of dental fluorosis was associated with local annual average temperature (°C) and annual precipitation (mm) ( r = - 0.393, - 0.337, P = 0.016, 0.041). Conclusions:From 2019 to 2022, the detection rate of dental fluorosis in children aged 8 - 12 in coal-burning-borne endemic fluorosis areas in Guizhou Province has been decreasing year by year, and it shows spatial clustering. The high clustering area is in the northwest of Guizhou Province, which should be regarded as a key prevention and control area for coal-burning-borne fluorosis in the future. At the same time, areas with lower temperatures and precipitation should also strengthen prevention and control efforts.

Objective:To analyze the epidemiological characteristics, spatial clustering, and correlation between dental fluorosis detection rates and meteorological factors in children aged 8 - 12 years old in 37 counties (cities, districts, hereinafter referred to as counties) affected by coal-burning-borne endemic fluorosis in Guizhou Province, and to provide a scientific basis for prevention and control of the disease.Methods:Monitoring data on dental fluorosis in children aged 8 - 12 years old from 2019 to 2022 were collected from the National Health Security Information System for Endemic Diseases. Meteorological data, including annual average temperature, annual average precipitation, annual sunshine hours, and annual average relative humidity, were obtained from the Guizhou Provincial Bureau of Statistics. Descriptive epidemiology, analytical epidemiology, and spatial correlation analysis methods were used to analyze the data. Visual maps were created based on the clustering levels of annual dental fluorosis detection rates (high-high, low-low, high-low, low-high). Spatial autocorrelation and meteorological factors were used to analyze the epidemiological characteristics, spatial clustering, and the impact of meteorological factors on dental fluorosis.Results:From 2019 to 2022, a total of 3 649 161 children aged 8 - 12 in the counties affected by coal-burning-borne endemic fluorosis were monitored, and 115 793 children were diagnosed with dental fluorosis, with a detection rate of 3.17%. The detection rates were 4.73% (45 093/954 338) in 2019, 3.35% (31 424/938 445) in 2020, 2.86% (21 727/760 195) in 2021, and 1.76% (17 549/996 183) in 2022, respectively. The dental fluorosis indices were 0.09, 0.07, 0.06, and 0.03, respectively. The number of counties with detection rates > 6% was 7, 5, 5, and 0 in 2019 - 2022, respectively. Dafang County consistently had the highest detection rates, with rates of 10.06% (6 783/67 408), 10.07% (1 955/19 421), 13.54% (4 017/29 667), and 4.83% (3 284/76 206) in 2019 - 2022, respectively. The Moran's I indices for dental fluorosis detection rates were 0.45, 0.53, 0.53, and 0.53 in 2019 - 2022, with Z = 4.29, 5.07, 5.31, and 5.10, respectively ( P < 0.05), indicating global spatial autocorrelation (positive) and spatial clustering of dental fluorosis detection rates. The number of counties with "high-high" clustering of detection rates was 7, 7, 6, and 7 in 2019 - 2022, mainly concentrated in the northwestern region, including Qixingguan District, Nayong County, Dafang County, Zhijin County, and Jinsha County of Bijie City. "Low-high" clustering areas were distributed in Zhongshan District of Liupanshui City in 2019, 2020, and 2022. The detection rate of dental fluorosis was associated with local annual average temperature (°C) and annual precipitation (mm) ( r = - 0.393, - 0.337, P = 0.016, 0.041). Conclusions:From 2019 to 2022, the detection rate of dental fluorosis in children aged 8 - 12 in coal-burning-borne endemic fluorosis areas in Guizhou Province has been decreasing year by year, and it shows spatial clustering. The high clustering area is in the northwest of Guizhou Province, which should be regarded as a key prevention and control area for coal-burning-borne fluorosis in the future. At the same time, areas with lower temperatures and precipitation should also strengthen prevention and control efforts.

Objective:To investigate the oral health knowledge awareness, attitude and behavior of children in endemic fluorosis areas of Guizhou Province, and evaluate the effectiveness of health education, so as to provide a scientific basis for improving oral health.Methods:In September 2020, 6 counties (cities and districts) were selected as survey sites from the historical fluorosis medium and severe areas in Guizhou Province. One township/village primary school was selected from each survey site to carry out health education activities for one school year. A questionnaire survey was conducted among students from grades 1 to 6 to analyze the changes in children's oral health knowledge, attitude, and behavior before and after health education and their influencing factors.Results:Before and after health education, the awareness rate of children's oral health knowledge increased from 79.22% (7 744/9 775) to 94.38% (9 169/9 715), the recognition rate of children's importance of oral health increased from 89.26% (3 490/3 910) to 95.88% (3 726/3 886), and the formation rate of children's oral health behavior increased from 62.59% (6 118/9 775) to 80.38% (7 809/9 715), with an increase of 15.16, 6.62 and 17.79 percentage points, respectively, the differences were statistically significant (χ 2 = 975.62, 15.17, 756.29, P < 0.001). The analysis of influencing factors showed that whether to stay, gender, and ethnic characteristics could significantly affect the overall score ( t = - 3.94, - 3.86, - 3.62, P < 0.001). Conclusion:The implementation of oral health education in endemic fluorosis areas in Guizhou Province has significantly improved the health knowledge, attitude and behavior of oral health among children in endemic fluorosis areas.

Objective:To investigate the awareness of iodine deficiency disorders prevention and control knowledge among residents in Guiyang City, as well as the behavioral and attitude characteristics of iodized salt consumption, and to determine the focus and direction of future health education on iodine deficiency disorders.Methods:From 0 : 00 to 24 : 00 on May 15, 2021 (the National Day for Prevention and Control of Iodine Deficiency Disorders), through the "Guizhou Disease Control" WeChat official account, the questionnaire was randomly distributed to the residents of Guiyang City who paid attention to the official account in the form of award-winning contest and returned. The survey content included general demographic data, iodine deficiency disorders prevention and control knowledge among residents and the behaviors and attitudes towards iodized salt consumption. The awareness rate of iodine deficiency disorders prevention and control knowledge among residents and the correct rate of their behaviors and attitudes towards iodized salt consumption were calculated.Results:A total of 3 078 valid questionnaires were collected in this survey. The awareness rate of iodine deficiency disorders prevention and control knowledge among residents was 51.3% (9 467/18 468), with a score of (51.26 ± 14.30) points; the correct rate of behavior and attitude towards iodized salt consumption was 93.0% (11 446/12 312), with a score of (92.97 ± 13.13) points. There was a statistically significant difference in the awareness rate of iodine deficiency disorders prevention and control knowledge among residents of different age groups (χ 2 = 23.03, P < 0.001). There were statistically significant differences in the correct rates of behavior and attitude towards iodized salt consumption among residents of different ages, ethnic groups, and professions (χ 2 = 9.66, 4.88, 24.73, P < 0.05), with lower correct rates in the ≥61 years old group, Han minority people and students. The main channels for obtaining knowledge on iodine deficiency disorders prevention and control were promotional materials (59.3%, 1 825/3 078), newspapers and magazines (56.8%, 1 747/3 078), television (56.6%, 1 743/3 078), and the internet (56.2%, 1 731/3 078). Conclusions:The correct rate of behavior and attitude towards iodized salt consumption among residents in Guiyang City is relatively high, but the awareness rate of iodine deficiency disorders prevention and control knowledge is low. We should strengthen health education for residents, especially the elderly, ethnic minorities, and students, and attach importance to promoting the safety of iodized salt and the necessity of long-term iodine supplementation.

Objective:To understand the salt sales situation and salt iodine content in the market of Guizhou Province 3 years after the system reform of salt industry.Methods:From August to October 2020, in 9 cities (prefectures) of Guizhou Province, 2 counties (cities and districts) were selected from each city (prefecture), 1 urban area and 1 township were selected from each county (city and district), 1 large supermarket and 1 farmers' market were selected in the urban area, and 1 small supermarkets or convenience stores were selected in the township, to check the varieties, place of origin and iodine content label on the package of salt sold, and different brands of salt were collected and sent to the provincial and county salt iodine laboratories. The iodine content was determined and analyzed.Results:A total of 18 large supermarkets, 18 farmers' markets and 18 small supermarkets or convenience stores were investigated, and 70 salt samples of 23 brands, 3 types and origin from 11 provinces were collected. Among them, there were 56 samples with iodine content of 21 - 39 mg/kg on the package. The iodine content range of provincial detection was 19.23 - 37.41 mg/kg (two of them were lower than 21.0 mg/kg), and the median was 25.75 mg/kg. There were 12 samples of two iodine contents (18 - 33 and 21 - 39 mg/kg) marked on the package, and the salt iodine range of provincial detection was 23.52 - 32.90 mg/kg, with a median of 26.55 mg/kg. One sample was marked with 18 - 33 mg/kg, and the iodine content of provincial detection was 25.20 mg/kg; the iodine content of 1 sample of non-iodized salt was not detected. According to the actual test value, iodine contents of 68 samples were within the range of packaging marks, accounting for 97.14% of the total. Taking the provincial test results as a standard, the absolute value of the relative deviation of the provincial and county test results was 0 - 27.45%, the average deviation was 7.65%, and the coincidence rate was 91.43% (66/70). The county test results were acceptable.Conclusions:After the system reform of salt industry, there are many kinds of salt which come from many provinces, and more than 97% of the salt iodine content which is within the standard range of salt concentration in Guizhou Province.