中华流行病学杂志最新文献

Objective: To analysis the HIV infection status and correlated factors in men who have sex with men (MSM) in young students in Tianjin based on social network peer mobilization testing model, and provide evidence for the development of AIDS prevention and control strategies for this population. Methods: From January 2020 to December 2024, Tianjin CDC and social organizations collaborated to recruit and train peer volunteers, then MSM in young students aged 16-24 years were mobilized to conduct one-on-one assisted HIV testing through social volunteer networks, and the information about their social demographic characteristics, awareness of knowledge about AIDS prevention and control and related behavioral characteristics were collected and analyzed. Results: A total of 234 peer volunteers were recruited, and 3 240 MSM in young students were mobilized, and 4 461 tests were conducted. The overall HIV infection rate was 1.20% (39/3 240). The HIV infection rates in the MSM from urban, periurban, and rural areas were 0.92% (8/869), 1.51% (24/1 594), and 0.90% (7/777), respectively. The differences in behavioral characteristics of the MSM from different areas were significant (all P<0.05). The results of multivariate logistic regression analysis showed that the positive correlation factor of HIV infection risk among young student MSM was the lack of knowledge about post-exposure prophylaxis (aOR=2.39, 95%CI: 1.21-4.73). The negatively correlated factor was a college degree or above (aOR=0.33, 95%CI: 0.11-0.95). Conclusions: The HIV infection rate in the MSM in young students was relatively low in the survey in Tianjin based on social network peer mobilization testing model, but the HIV infection rate was slightly higher in those from periurban area than in those from other areas. In the future, it is necessary to strengthen the prevention and control of HIV infection in periurban area.

Objective: To understand the quality of life and its influencing factors in pregnant and postpartum women hospitalized due to influenza in Suzhou and provide evidence for the development of intervention measures. Methods: Pregnant and postpartum women hospitalized due to influenza in Suzhou between 2018 and 2024 were enrolled as the study participants for a survey with self-designed questionnaire and the EuroQol Five-Dimensional Health Questionnaire to evaluate their quality of life. Influencing factors for health across the five dimensions were analyzed using χ² tests and binary logistic regression, combining regression tree analysis to explore the factors affecting Visual Analogue Scale scores. Results: A total of 901 pregnant and postpartum women hospitalized due to influenza were included. In the five dimensions, pain/discomfort had the highest proportionin in reported health problems (20.4%), followed by anxiety/depression (8.4%), daily life activity (8.2%), movement (7.7%), and self-care (5.7%). Comprehensive analysis revealed that pre-pregnancy low BMI, third trimester, underlying diseases, antiviral drug use, antiviral drug use within 48 hours of symptom onset, and frequency of influenza-like illness in the past year significantly influenced self-reporting of health problems, the differences were all significant (all P<0.05). Conclusions: Interventions should target the pregnant women with underweight before pregnancy, late pregnancy, underlying diseases, or frequent onset of influenza-like illness in the past year, with attention to the impact of side effects of antiviral drug on health status. Developing more effective interventions is crucial to improve the quality of life of this population.

Objective: To investigate the impact of sleep duration on the risk for all-cause mortality and cardiovascular disease (CVD) mortality in adults in China and evaluate the modifying effect of physical activity levels. Methods: A nationwide retrospective cohort was established by using data from 172 692 participants aged ≥18 years in 2015 China Chronic Disease and Risk Factors Surveillance, and the mortality data as of December 31, 2021 were collected from National Mortality Surveillance Database. Weighted Cox proportional hazards regression models were used to analyze associations between sleep duration and all-cause mortality or CVD mortality. Restricted cubic spline models were used to describe dose-response relationships. Additive interaction indices relative excess risk of interaction (RERI) and multiplicative interaction terms were used to evaluate the joint effects of sleep duration and physical activity. Results: A total of 172 692 participants were included in the study, in whom 21.0% had short sleep duration (<7 hours/day) and 10.9% had long sleep duration (>9 hours/day). After adjusting for confounders, compared with the participants with normal sleep duration (7- hours/day), those with short and long sleep durations exhibited 12% (HR=1.12, 95%CI: 1.02-1.23) and 36% (HR=1.36, 95%CI: 1.22-1.53) higher risks for all-cause mortality, respectively. Long sleep duration was associated with a 44% increased risk for CVD mortality (HR=1.44, 95%CI: 1.21-1.71). Dose-response curves showed non-linear relationships between sleep duration and risks for all-cause mortality and CVD mortality (non-linear P<0.001). Significant additive interactions were observed between physical inactivity level and abnormal sleep duration (<7 hours/day or >9 hours/day) for all-cause mortality (RERI=0.23, 95%CI: 0.09-0.37) and CVD mortality (RERI=0.24, 95%CI: 0.01-0.47). Conclusions: Deviations from normal sleep duration significantly increase mortality risks in adults in China, especially in those with long sleep duration. Physical inactivity synergistically amplifies mortality risk associated with abnormal sleep duration, suggesting the importance of multidimensional behavioral interventions for primary prevention.

In real-world clinical settings, the combination of traditional Chinese medicine (TCM) and western medicine is widely used, and the clinical efficacy of the combination of TCM and western medicine is attracting increasing attention from clinical researchers. In view of the insufficient evidence for evaluating the efficacy of the combination of TCM and western medicine based on real-world data, this study describes the specific implementation process and key methodological considerations in the clinical scenarios of the combination of TCM and western medicine based on the methodological framework of target trial emulation provide clinical researchers with references and suggestions for the feasible pathway, which is of great significance for making the full use of the advantages of the combination of TCM and western medicine and realizing the clinical value of TCM.

Objective: To understand the prevalence of cardiometabolic multimorbidity (CMM) and influencing factors in adults in Jilin Province, and provide data support and theoretical basis for the development of chronic disease prevention and control strategies and measures. Methods: In 2023, a multi-stage stratified cluster random sampling was conducted to select local residents aged ≥18 years from 8 surveillance areas in Jilin as the study participants. Intergroup comparisons were conducted by using χ² test, and multivariate logistic regression models were employed to analyze the influencing factors of CMM. Results: In 4 717 study participants, the weighted prevalence of CMM was 34.56%. Multivariate logistic regression analysis revealed that the risk factors of CMM included being aged 45-59 years (aOR=1.87, 95%CI: 1.50-2.32), being aged ≥60 years (aOR=3.38, 95%CI: 2.71-4.20), being man (aOR=1.31, 95%CI: 1.13-1.52), being married/cohabiting (aOR=1.74, 95%CI: 1.05-2.87), being widowed/divorced/separated (aOR=1.94, 95%CI: 1.12-3.36), having sleep problems (aOR=1.67, 95%CI: 1.45-1.93), physical inactivity (aOR=1.26, 95%CI: 1.11-1.44), being overweight/obese (aOR=2.10, 95%CI: 1.79-2.46), suffering from central obesity (aOR=1.85, 95%CI: 1.61-2.14), having depressive symptoms (aOR=1.52, 95%CI: 1.23-1.87), and having lower education levels (primary/junior high school: aOR=0.81, 95%CI: 0.67-0.99; senior high school: aOR=0.68, 95%CI: 0.53-0.86; college/university or above: aOR=0.67, 95%CI: 0.51-0.87). Conclusions: The challenge of CMM is serious in Jilin. In the future, special attention should be paid to the following high-risk groups: middle-aged and elderly populations, men, those who are married/cohabiting or widowed/divorced/separated, individuals with unhealthy behaviors such as sleep problems or physical inactivity, populations with metabolic disorders, including overweight/obesity and central obesity, individuals with depressive symptoms, and those with low education levels. By implementing precise and stratified prevention and control strategies, it is expected to effectively reduce the health risks and social burden caused by CMM.

Objective: To investigate the association between serum uric acid/high-density lipoprotein cholesterol ratio (UHR) and chronic kidney disease (CKD). Methods: This cross-sectional study enrolled participants who underwent comprehensive health evaluations in the Health Management Center of Sichuan Provincial People's Hospital between January 2020 and December 2024. Data were collected through standardized questionnaire survey, physical examinations, and biochemical assessments. Multivariate logistic regression model was used to evaluate the independent association between UHR and CKD. Restricted cubic spline (RCS) analysis with four knots was conducted to evaluate potential nonlinear dose-response relationships. Results: A total of 54 040 participants with age (51.79±13.35) years were included in this study, including 5 708 CKD cases (prevalence 10.56%) and 48 332 controls. Multivariable-adjusted logistic regression analysis revealed a progressive increase in CKD risk across increased UHR quartiles (Q₁ as reference). Adjusted OR for Q₃ and Q₄ were 1.24 (95%CI: 1.13-1.37) and 1.83 (95%CI: 1.64-2.03), respectively (all P<0.001). RCS analysis demonstrated a nonlinear association between UHR and CKD risk (nonlinear P=0.001), with significantly increased risk observed when UHR ≥247.59 (inflection point). Subgroup analyses stratified by sex, age, BMI categories, and alcohol consumption status consistently showed increased CKD risk across UHR quartiles. Conclusion: The level of UHR is significantly associated with an increased risk for CKD, and this association exhibits a nonlinear increasing trend.

As a typical emerging pollutant, microplastic exposure has become a great concern for human health. Pregnant women, fetuses, and infants are in critical life stages and are highly sensitive to environmental exposures. This paper introduces the literature in the field of microplastic research, and the definition and classification of microplastics, exposure pathways in pregnant women and their offspring, summarizes the current status of epidemiological and toxicological research in the health impacts of microplastic exposure, discusses the potential biological mechanisms and the limitations of existing studies, and suggests investigation focus to provide reference for the future research.

In the context of accelerated globalization and frequent emergence of new infectious diseases, the establishment of a sensitive and efficient surveillance system has become crucial in the early warning and precise prevention and control of infectious diseases. Traditional hospital-based passive surveillance systems are significantly influenced by factors such as healthcare-seeking behavior and reporting biases. In contrast, community-based surveillance (CBS), which expands the surveillance network to communities to effectively identify un-visited cases and mild infections, can be a vital approach to break the "iceberg phenomenon" and improve the infectious disease surveillance system. This paper systematically summarizes the global progress, application scenarios, and technical frameworks of CBS to provide a theoretical foundation to construct multi-dimensional infectious disease surveillance. It is suggested to conduct technological innovation, community empowerment, and the integration of multi-source data to improve the application of CBS in the early warning of diseases, disease burden estimation, and health policy development.

Objective: To explore the antimicrobial resistance phenotypes and whole genome characteristics of toxigenic Vibrio cholerae O139 strains in Henan Province, elucidate the evolving epidemiological trends of cholera outbreaks, and decipher molecular genetic variation patterns of the pathogen, thereby providing a reference for cholera prevention and control in the region. Methods: Drug susceptibility assay, whole genome sequencing assay, and bioinformatics analysis of 11 toxigenic Vibrio cholerae O139 strains isolated in Henan Province from 2001 to 2024. Results: All 11 strains were multi-drug resistant strains, resistant to all three antimicrobial drugs, polymyxin, nalidixic acid, and streptomycin, and all of them carried multi-drug resistant genes; all strains were ST69-type, and all of them carried the ctxA/B genes, sequence of CTXΦ phage, the VSP-Ⅰ gene island, VSP-Ⅱ gene island, the VPI-1 pathogenicity island, and the virulence genes ctxB, tcpA, and rstR carried by the strain are all of the El Tor type; the analysis of single-nucleotide polymorphisms (SNP) evolutionary tree revealed that 11 Vibrio cholerae strains were most closely related to Vibrio cholerae O139 strains in Taiwan. Conclusions: Using whole genome sequencing technology, it was revealed that all the outbreak strains of cholera in different regions of Henan Province carry multiple drug resistance and virulence genes, with highly similar genomic features and minor SNP differences between strains. It suggests that strengthened surveillance and early warning mechanisms targeting these strains are critically warranted.

This paper provides a comprehensive review of the 70-year evolution of field epidemiology, examines its current state, and critically analyzes contemporary challenges and strategic responses. In Europe and the United States, the discipline has progressed from its conceptual inception to the publication of foundational academic works over nearly five decades, yet formal degree programs in field epidemiology remain relatively scarce. Over the past 50 years, the Field Epidemiology Training Program (FETP), modeled after the United States Epidemic Intelligence Service, has been adopted in more than 100 countries and regions. These programs primarily focus on investigating and mitigating public health emergencies to strengthen national health security. In China, field epidemiology has undergone a dynamic 25-year development, with FETPs established at national, provincial, municipal, and county levels earning international recognition and demonstrating robust expansion. The discipline has become an integral component of applied public health education in academic institutions, and several authoritative textbooks on field epidemiology have been published domestically. However, for field epidemiology to transition from an emerging concept to a well-established discipline, key challenges-including standardization, interdisciplinary integration, and global cooperation-must be addressed. Further theoretical research is essential to enhance preparedness and response capabilities for public health crises.