中华流行病学杂志最新文献

To introduce the recent progress in the research of gene polymorphisms and differences in vaccine immune responses, this paper systematically summarizes current findings of the associations between human leukocyte antigen (HLA) polymorphisms and other key immunoregulatory gene variations with vaccine responses across different domains, including COVID-19 and influenza vaccines. Furthermore, it discusses the impact of different genotypes on antibody production, immune protection, and the risk for breakthrough infections. To address the challenges posed by genetic polymorphisms, this paper further summarizes several key strategies for vaccine optimization, including conserved epitope targeting, multivalent vaccine design, and peptide-carrier conjugation approaches. Although genomics has laid a theoretical foundation for precise vaccine design, multiple challenges still persist in current research, such as the complexity of gene-environment interactions and ethical concerns regarding data sharing and privacy protection. Future investigations should further evaluate the effects of specific gene polymorphisms, such as detailed HLA subtypes, on the variations in vaccine immune responses, and elucidate underlying mechanisms by integrating functional studies Exploring and establishing genomics and multi-omics-based precise immunization strategies will provide more effective solutions for vaccine-preventable diseases.

Objective: To evaluate the immunity persistence of different enterovirus A71 (EV-A71) vaccines in healthy infants and young children aged 6-35 months. Methods: In this study, volunteers who were eligible in a phase Ⅳ clinical trial to receive different EV-A71 vaccines. Venous blood samples were collected from them 3 and 5 years later after receiving two doses of EV-A71 vaccines. Sero positive rate and GMT of the neutralizing antibody was calculated to evaluate the dynamic profiles of EV-A71 vaccine-induced immunogenicity. Results: A total of 169 subjects with full series of blood samples (at all the sampling points) were included in the immune persistence analysis. The positive rates of EV-A71 neutralizing antibody in four groups were all 100.00% 3 years later after full immunization, while the positive rates of neutralizing antibody in the four groups were 93.18%, 97.62%, 97.44%, and 100.00%, respectively, 5 years later after full immunization, the difference was not significant. The neutralizing antibody GMTs of EV-A71 neutralizing antibody in the study participants were 74.69 and 67.20, respectively, 3 and 5 years later after immunization, which decreased compared with that 30 days later after full immunization. There was no significant difference in neutralizing antibody GMT among the four groups 3 years later, but there was significant difference in neutralizing antibody GMT 5 years later (P<0.001). Conclusion: The immunity induced by different EV-A71 vaccines has good persistence within 5 years after full vaccination.

The field of global public health is undergoing multiple complex challenges, including emerging and re-emerging infectious diseases, increasing burden of chronic diseases, climate change, and demographic transitions. This article systematically reviews the latest developments and challenges in key public health areas. In infectious disease prevention and control, the "One Health" approach has become the core framework for addressing zoonotic diseases, while intelligent multi-point trigger and multi-pathogen surveillance and early warning systems continue to enhance early response capabilities. The paradigm of chronic disease prevention and control is gradually shifting toward precision, with large-scale population cohorts and systems epidemiology providing scientific evidence for transitioning from population-based prevention to individualized intervention. Environmental health research is becoming more refined and in-depth, evolving from macro-level exposure associations to analyses of toxicity mechanisms and specific health effects. Meanwhile, China's new demographic normal-characterized by deep aging and low fertility-coupled with rapid advancements in innovative biologics and digital technologies, is reshaping public health intervention models and service demands. Looking ahead, building a more resilient, equitable, and intelligent global health governance system requires strengthened interdisciplinary collaboration, innovative financing mechanisms, optimized collaborative governance, and the efficient translation of scientific research into policy practice.

Objective: To analyze the longitudinal association between feeding pattern before age 2 years and dietary quality in preschool-aged children, and provide the oretical evidence for targeted dietary guidance and nutritional interventions. Methods: Based on Shanghai Maternal-Child Pairs Cohort, the information about the feeding pattern before age 2 years and dietary intake during preschool period were collected through questionnaires. The dietary balance index for preschool children was used to evaluate the overall dietary quality, with specific metrics including the high bound score (HBS), low bound score (LBS), and diet quality distance (DQD). Higher scores on these indices indicate poorer dietary quality. Multiple linear regression analyses were conducted to evaluate the association between feeding pattern before age 2 years and subsequent dietary quality during preschool period. Results: Compared with children who had breastfeeding within 1 hour after birth, preschool children who started breastfeeding after >1 hour had higher DQD scores (β=0.96, 95%CI: 0.03-1.88). Mixed feeding at 4 months of age was associated with elevated LBS (β=1.33, 95%CI: 0.23-2.44) and DQD (β=1.24, 95%CI: 0.25-2.23) scores during preschool years compared with exclusive breastfeeding. Preschool children who did not meet the Minimum Dietary Diversity (MDD) at 12 months had LBS and DQD scores that were 2.17 points (β=2.17, 95%CI: 0.66-3.68) and 1.69 points (β=1.69, 95%CI: 0.35-3.02) higher, respectively, than those who met the MDD requirement. For each 1-point increase in pressure-to-eat, the LBS and DQD scores of preschool children increased by an average of 1.59 points (β=1.59, 95%CI: 0.90-2.29) and 1.58 points (β=1.58, 95%CI: 0.97-2.19), respectively. Conversely, each 1-point increase in parental monitoring of children's eating behaviors was associated with a reduction of 0.97 points (β=-0.97, 95%CI: -1.55 - -0.38) and 0.69 points (β=-0.69, 95%CI: -1.21 - -0.18) in LBS and DQD scores, respectively. The impact of feeding pattern before age 2 years on the diet quality of preschool children was more pronounced in boys and children whose mothers perceived that their families had common economic status. Conclusion: Feeding pattern before age 2 years significantly influence dietary quality in preschool children.

Objective: To analyze the changing trends and development strategies of research hotspots in domestic and foreign epidemiological journals in the past decade, in order to promote the capacity building of the Chinese Journal of Epidemiology, enhance its academic influence, and improve its ability to serve authors. Methods: By searching the China National Knowledge Infrastructure and PubMed databases from 2015 to 2024, and using CiteSpace literature quantification analysis software, keyword co-occurrence analysis and cluster analysis were conducted on the Chinese Journal of Epidemiology (3 146 articles) and International Journal of Epidemiology, European Journal of Epidemiology, and American Journal of Epidemiology (4 988 articles) (3 international epidemiological journals) to explore the differences in research focus and hotspots between domestic and foreign journals, and to conduct keyword emergence knowledge graph analysis on the research progress and trends of epidemiological journals. Results: The annual average number of articles published in the Chinese Journal of Epidemiology from 2015 to 2024 is 320.4, with 26 authors having published ≥30 articles. The Chinese Journal of Epidemiology extracted a total of 436 keywords, and 3 international epidemiological journals extracted a total of 449 keywords, forming 13 and 11 clusters respectively. Both domestic and international journals focus on chronic non-communicable diseases and related influencing factors, but the Chinese Journal of Epidemiology places greater emphasis on locally adapted content and applied research. Keyword burst analysis reveals that the emerging intelligent methods theme appeared earlier in three international epidemiology journals compared to the Chinese Journal of Epidemiology, and in recent years, there has been increased attention to macro health policy topics such as "health disparities" and "health equity". Conclusions: The Chinese Journal of Epidemiology has developed distinctive features in localized adaptive content and applied research. In the future, it can enhance international alignment by advancing methodological frontiers and focusing on macro health policy themes, thereby elevating academic influence.

Objective: To analyze the referral time interval and related factors of antiretroviral treatment for newly confirmed HIV-infected cases and to provide a reference basis for optimizing the connection mechanism of AIDS referral treatment in Shandong Province. Methods: A cross-sectional study design was adopted. From September 2024 to March 2025, 10 cities in Shandong Province with a relatively high rate of new HIV infection were selected. The subjects were recruited through local designated hospitals, and face-to-face questionnaire surveys were conducted to collect information on the sociodemographic characteristics of the research subjects, knowledge of AIDS diagnosis and treatment, perceived discrimination against HIV, HIV testing and intervention situations, and ART. The generalized linear mixed-effects model (GLMM) was used to analyze the related factors of the referral time interval for antiviral treatment in newly confirmed HIV-infected individuals. Statistical analysis was performed using R 4.3.3 software. Results: Among the 447 newly confirmed HIV-infected cases, the average age was (36.92±12.31) years. The majority were male (93.27%, 416/446), had a high school education or below (51.90%, 232/447), were unmarried (49.22%, 220/447), and had a homosexual sexual orientation (40.99%, 182/444). The median (Q₁, Q₃) interval for referring new HIV-infected individuals for antiviral treatment was 6 (4, 13) days. There was a statistically significant difference in the referral interval among different cities (P<0.001). The results of the generalized linear mixed-effects model analysis showed that the related factors of the referral interval included age, gender, sexual orientation, diagnosis knowledge score, number of active tests, baseline CD4⁺T lymphocyte count, and distance to the designated hospital. Conclusions: Overall, the referral time intervals for antiretroviral treatment of newly confirmed HIV-infected cases were relatively short in 10 cities of Shandong Province. There were differences in the referral time intervals among different cities. There were many factors influencing the referral time intervals. It is necessary to strengthen health education, promote active testing for HIV, optimize medical resource allocation, and formulate differentiated intervention strategies for different infected groups.

Hepatitis B virus (HBV) infection poses a significant threat to global public health. As disease control strategies evolve to encompass the entire lifespan, there is an urgent need to establish a new system for the prevention and control of HBV. The concept of "lifespan exploration of HBV transmission" involves studying HBV transmission pathways across the entire lifespan of an individual, focusing on key risk areas for prevention and control at different life stages. This approach is based on three population groups: HBsAg-positive reproductive populations, pregnant women and mothers, and community populations. From microscopic genetic and molecular immunological studies to macroscopic epidemiological investigations, this approach aims to generate comprehensive research findings on HBV transmission and outcomes across the entire lifespan of high-risk populations, identify weaknesses and challenges in current research, and explore new research perspectives. These efforts will provide new insights for HBV prevention and control strategies and play a crucial role in advancing HBV prevention and control efforts in China.

"Target trial emulation" has been formally established and widely applied as a new framework for real-world study in recent years, which can be used to guide observational causal inference research based on real-world data, including the evaluation of the effectiveness and safety of medical interventions. The framework aims to identify key factors in observational studies that align with a target clinical trial, utilizing causal inference methodology to establish causal associations between interventions and clinical outcomes. This paper summarizes the origin and conceptual definition of the framework, statistical design, implementation steps, research status and progress, application value classic cases, and the main challenges facing the framework.

Objective: To explore the impact of temperature on the incidence of hepatitis A and assess the incidence risk. Methods: We collected data on hepatitis A cases and meteorological factors in Liaoning, China, from January 2014 to December 2023. The time-stratified case-crossover design, a distributed lag nonlinear model, and the conditional logistic regression model were used to explore the exposure-response relationship between daily average temperature and the incidence of hepatitis A, and to calculate the excess incidence risk associated with temperature changes. Results: Between 2014 and 2023, 14 394 hepatitis A cases were reported in Liaoning, primarily in Dandong, Dalian, and Shenyang (71.86%). The median exposed temperature was 6.76 ℃. Temperature had a lag effect on the incidence of hepatitis A, with the maximum lag period reaching 28 days. The effect sizes were the greatest at a lag of 15 days under extremely low temperature and high temperature conditions (for low temperature, the peak OR=1.14, 95%CI: 1.09-1.19; for high temperature, OR=1.02, 95%CI: 1.01-1.04). The incidence risk increased with the decrease in temperature. For every 1.00 ℃ decrease in temperature, the excess incidence risk of hepatitis A was 5.64% (95%CI: 4.62%-6.64%). Subgroup analysis revealed that the excess incidence risk was higher in males (6.27%) than in females (4.66%), and higher in the cold season (6.87%) than in the warm season (4.43%). Gender and season have an effect modification. The excess incidence risks were 4.87% for those <30 years old and 5.94% for those 30-59 years old. In Dandong and Dalian, the rates were 9.26% and 7.34% respectively (all P<0.05). For individuals aged ≥60 years old (3.75%), in Shenyang (2.46%), and in other cities (1.24%), the impact of temperature on hepatitis A incidence was not statistically significant (all P>0.05). Conclusions: In Liaoning, the exposure-response relationship between temperature and the incidence of hepatitis A indicates that the incidence risk increases with decreasing temperature. The risks are particularly prominent during the cold season, affecting males and young populations, as well as in the regions of Dandong and Dalian. It is recommended to strengthen the monitoring and early warning of hepatitis A incidence by integrating meteorological data.