中华流行病学杂志最新文献

Objective: To analyze the distribution and epidemiological characteristics of anthrax in China from 2014 to 2024 to provide a scientific basis for identifying key prevention and control areas, detecting new epidemic areas, and formulating targeted prevention and control strategies. Methods: Spatial autocorrelation analysis and epidemiological analysis of anthrax data in China from 2014 to 2024 were applied with ArcGIS 10.8 and RStudio 4.2 software. Results: A total of 3 722 anthrax cases were reported in China from 2014 to 2024, with an overall fluctuating upward trend, including 25 fatal cases, with a case-fatality rate of 0.67%. Anthrosis cases primarily occurred between July and September, totaling 1 855 cases, which accounted for 49.84% of all reported cases. Among the cases, 2 731 were male and 991 were female, with a male-to-female ratio of 2.76∶1, showing a statistically significant difference in incidence (χ²=34.89, P<0.001). The majority of cases were concentrated in the 30-49 age group, with a cumulative total of 2 632 cases, representing 70.71% of all cases. In terms of occupational distribution, herders and farmers were the most affected groups, accounting for 51.40% and 37.99% of total cases, respectively. From 2014 to 2024, the top three provinces with the highest cumulative reported cases were Gansu (821 cases), Qinghai (784 cases), and Sichuan (640 cases). Newly reported cases have shown a trend of spreading to North China, northern Heilongjiang Province, and southwestern Xizang Autonomous Region. Spatial autocorrelation analysis indicated clustering in anthrax distribution from 2014 to 2024 (the Moran's I values ranged from 0.271 1 to 0.395 8, P<0.001). Highly clustered areas were mainly located in Qinghai Province and the Xizang Autonomous Region, with a scattered distribution in northwestern Inner Mongolia. A total of 73 clustering events were recorded, involving 421 cases, with an attack rate of 0.89%, accounting for 11.31% of all cases. These clustering events exhibited periodic fluctuations. Conclusions: From 2014 to 2024, human anthrax cases in China showed an overall increasing trend, primarily concentrated in Gansu Province, Qinghai Province and Sichuan Province. The epidemic season was predominantly summer and autumn, with the most affected demographic being males aged 30-49 years. Strengthening prevention and control guidance in these regions and among high-risk populations is essential to reduce the occurrence and spread of anthrax.

In light of the growing trend of global population ageing, chronic diseases have become a major challenge for global public health, and promoting healthy lifestyles has emerged as a critical strategy for reducing the disease burden and enhancing health benefits. There has been a surge in research on healthy lifestyles and health outcomes. However, there are significant variations in the healthy lifestyle scores of different studies, limiting the comparability of findings and a notable absence of reviews on the in-depth integration of the components of healthy lifestyle scores. This study provides a comprehensive review of healthy lifestyle scores, their components, and calculation methods, to provide more references for the construction of healthy lifestyle scores.

Objective: To assess the long-term risk of atherosclerotic cardiovascular disease (ASCVD) in patients with type 2 diabetes mellitus (T2DM) managed under the National Essential Public Health Services Program and explore the relationship between behavioral/metabolic factor control and ASCVD risk. Methods: This retrospective study included patients with T2DM who were enrolled in the National Essential Public Health Services Program. Baseline data from follow-up visits and physical examinations in 2018 were collected to evaluate 10-year ASCVD risk using the Prediction for Atherosclerotic Cardiovascular Disease Risk in China model. Follow-up continued until December 31, 2024, with ASCVD occurrence as the primary outcome. A competing-risk Cox proportional hazards regression model was used to analyze the impact of metabolic and behavioral factors on the risk of ASCVD. The "averisk" package in R 4.4.2 software was employed to estimate the population attributable risk (PAR) of ASCVD associated with these factors. Results: A total of 27 877 T2DM patients were included in 2018. Over a median (Q₁, Q₃) follow-up of 75 (60, 77) months, 4 115 ASCVD events and 1 602 non-ASCVD deaths occurred, with a cumulative ASCVD incidence of 17.18%. Baseline ASCVD risk stratification (low-, medium-, and high-risk groups) revealed cumulative incidence rates of 4.24%, 11.91%, and 22.26%, respectively (P<0.001). Achieving control targets for FPG, blood pressure, non-HDL-C, waist circumference, smoking, and physical activity reduced ASCVD risk by 15% (HR=0.85, 95%CI: 0.80-0.91), 11% (HR=0.89, 95%CI: 0.84-0.95), 23% (HR=0.77, 95%CI: 0.72-0.83), 10% (HR=0.90, 95%CI: 0.85-0.96), 17% (HR=0.83, 95%CI: 0.76-0.91), and 5% (HR=0.95, 95%CI: 0.89-1.03), respectively. Simultaneous control of all six factors could prevent 60% (HR=0.40, 95%CI: 0.31-0.53) of ASCVD events. The PAR for ASCVD attributed to these six factors was 33.21% (95%CI: 27.52%-38.91%). Conclusions: For T2DM patients managed under the National Essential Public Health Services Program, early achievement of metabolic and behavioral factor control targets significantly reduces ASCVD risk at both individual and population levels. Future efforts should focus on optimizing community-based health management strategies tailored to T2DM patients, with an emphasis on metabolic and behavioral interventions, to further reduce ASCVD risk in this population.

Objective: To understand the syphilis infection rate, changing trend and related factors of syphilis infection among men who have sex with men (MSM) in Yunnan Province from 2019 to 2024. Methods: From 2019 to 2024, a cross-sectional survey was conducted at monitoring sentinel sites in Yunnan Province from April to July each year. Recruitment methods such as snowball sampling, activity venues, and social software were adopted to recruit men who aged 16 and above, and engaged in homosexual behavior (anal or oral sex) in the past year as subjects. The χ² trend test was used to analyze the changing trend of syphilis infection, and a multinomial logistic regression model was used to analyze the related factors of syphilis infection among MSM. Statistical analysis was performed using SPSS 19.0 software. Results: From 2019 to 2024, a total of 15 998 MSM were involved in sentinel surveillance of Yunnan, and among them, 15 987 participated in serological test. The syphilis infection rates from 2019 to 2024 were 4.3% (116/2 729), 3.6% (93/2 608), 2.7% (70/2 608), 3.7% (97/2 610), 3.5% (91/2 607), and 3.4% (95/2 825), respectively. Overall, there was no statistically significant trend in the syphilis infection rate (trend χ²=1.59, P=0.207). However, the downward trend of syphilis infection rate among divorced/widowed individuals, those with a high school education or above, and MSM in the central Yunnan region was statistically significant (all P<0.05). The syphilis infection rates of MSM in the central Yunnan region in 2019 and 2022 (6.6% and 4.9%) were higher than those in the western Yunnan region (2.8% and 2.3%) (all P<0.05). In the past six months, the proportion of MSM who consistently used condoms when having sex with different types of sexual partners has all shown an upward trend (all P<0.05).The proportion of sexually transmitted disease cases in the past year showed a downward trend (all P<0.05). The results of multinomial and multivariate logistic regression analysis showed that being under 30 years old, unmarried, married/cohabiting, and having a household registration in Yunnan Province were positive related factors for syphilis infection among MSM, while having a junior high school education or below and having a homosexual orientation were negative related factors. Conclusions: From 2019 to 2024, the syphilis infection rate among MSM in Yunnan Province was relatively high. However, the overall changing trend was stable. The syphilis infection rate among MSM with a high school education or above and in the central Yunnan region showed a downward trend. Sexual health education, comprehensive intervention, sexually transmitted diseases screening, referral and standardized diagnosis and treatment should be strengthened for MSM to further reduce the risk of syphilis infection among MSM.

Artificial intelligence (AI) has been widely utilised in infectious disease surveillance and early warning. Artificial intelligence technology can rapidly collect, analyze, and process large-scale data from multiple sources, identify complex patterns in the data using efficient algorithms, accurately simulate and predict the development trend of epidemics, and assist in making optimal decisions. This paper summarizes the application of AI technology in infectious disease surveillance and early warning, describes its advantages, and discusses the challenges it will face in the future, aiming to provide a reliable reference for more effective monitoring and control of infectious disease epidemics.

Objective: This study employed a Meta analysis to evaluate the factors influencing nutritional anemia among children and adolescents aged 6-17 years in China, in order to provide a scientific basis for the prevention and control of anemia. Methods: This study utilized databases including CNKI, Wanfang database, VIP, PubMed, and Web of Science to retrieve literature reporting on the influencing factors of nutritional anemia among children and adolescents aged 6-17 years in China. Meta analysis was conducted using Stata 16.0 software. Results: A total of 30 articles were ultimately included, including 105 018 children with anemia and 849 069 normal children. The results of Meta analysis showed that the risk of anemia was significantly higher in children with the following characteristics compared to their respective control groups: wasting (OR=1.67, 95%CI: 1.24-2.24), stunted growth (OR=1.30, 95%CI: 1.05-1.59), ethnic minority (OR=1.17, 95%CI: 1.09-1.25), fewer than two physical examinations per year (OR=2.14, 95%CI: 1.54-2.98), rural residence (OR=1.42, 95%CI: 1.16-1.74), being raised by someone other than parents (OR=1.22, 95%CI: 1.12-1.33), female (OR=1.42, 95%CI: 1.28-1.57), poor appetite (OR=2.18, 95%CI: 1.52-3.13), and consuming eggs fewer than four times per week (OR=2.30, 95%CI: 1.90-2.77). Conversely, the risk of anemia was lower in children with obesity (OR=0.73, 95%CI: 0.57-0.93), and 8-14 years old (OR=0.59, 95%CI:0.49-0.72). Sensitivity analysis indicated that the Meta analysis results for the most influential factors in this study were relatively stable, and publication bias assessment suggested that there might be publication bias for the gender factors. Conclusions: The main influencing factors of anemia among children and adolescents (6-17 years old) in China include nutritional status, age, ethnicity, frequency of annual health check-ups, residence, caregiver, gender, appetite, and frequency of egg consumption per week.

The anti-rabies virus monoclonal antibody (RmAb) is a novel passive immunization for rabies developed and produced through modern genetic engineering technologies. It specifically binds to the antigenic sites on the G protein of the rabies virus surface, thereby blocking the virus from binding to cellular receptors and exerting a preventive effect. Compared to traditional rabies immunoglobulin, RmAb demonstrates superior advantages in terms of controllable production yield, stable quality, high safety profile, and favorable specific activity. Currently, four RmAb products have been approved for marketing worldwide. In response to the relatively limited understanding of RmAb among clinical practitioners, the Rabies Prevention and Control Committee of the Chinese Preventive Medicine Association and the Animal Injury Treatment Branch of China Association for Disaster and Emergency Rescue Medicine have organized domestic experts to compile this consensus. This document synthesizes the latest evidence, references relevant domestic and international standards, guidelines, and consensus statements, and incorporates expert clinical experience to provide scientific and standardized recommendations for clinical practice.

Objective: To understand self-assessment of mpox virus infection risk, knowledge awareness, and vaccination intention and related factors of mpox among men who have sex with men (MSM) in 30 provinces of China. Methods: From January 18 to 25, 2024, in collaboration with MSM social organizations across 30 provinces in China, MSM aged 18 or above were recruited. The inclusion criteria for participants were men who had had at least one homosexual behavior in the past year. A cross-sectional study design was employed, and an online survey was conducted using an enterprise version of Questionnaire Star. A self-designed, self-administered, anonymous electronic questionnaire was used to collect information on the participants' sociodemographic data, behavioral patterns, HIV testing, awareness of mpox, knowledge of mpox, self-assessment of mpox virus infection risk, and vaccination intention. Logistic regression models were used to analyze the factors associated with the awareness of mpox knowledge and vaccination intention among the participants. Results: A total of 8 123 participants were surveyed among MSM, with a mean age of mean±SD (31.94±8.91) years. The awareness rate of mpox knowledge was 46.67% (3 791/8 123), while the percentage of individuals who occasionally paid attention to mpox information was 47.93% (3 893/8 123). Additionally, 67.64% (5 494/8 123) self-assessed their risk of mpox virus infection as low, and 91.23% (7 411/8 123) expressed an intention to be vaccinated. Multivariate logistic regression analysis showed that positive correlates of mpox knowledge awareness included being ≥26 years old, having a high school education or above, residing in urban or suburban areas, identifying as homosexual, engaging in same-sex behavior at least once/month in the past three months, having no history of sexually transmitted diseases in the past three months, being HIV-positive or HIV-negative, and paying attention to mpox information. Factors positively associated with mpox vaccination intention included being aged 18-25 years, engaging in same-sex behavior 1-4 times/month in the past three months, being HIV-positive, and paying attention to mpox information. Conclusions: MSM showed a certain level of awareness regarding mpox information and vaccination intentions in 30 provinces of China; however, the awareness rate of mpox knowledge and the self-perceived risk of mpox virus infection remained relatively low. There was a risk of mpox infection, and efforts should continue to strengthen the promotion and education related to mpox prevention and vaccination knowledge.

Objective: To understand epidemiological characteristics and spatial clustering of human brucellosis in Hunan Province from 2016 to 2024 and provide a scientific basis for its prevention and control. Methods: The surveillance data on human brucellosis in Hunan Province from 2016 to 2024 were collected through the Chinese Disease Prevention and Control Information System. The time, population, and geographical distribution characteristics of the human brucellosis epidemic in Hunan Province were analyzed using descriptive epidemiological methods. The GeoDa 1.16 software was used for global autocorrelation and local autocorrelation analyses. The source of infection, transmission route, and serological results of key populations were also analyzed. Results: From 2016 to 2024, Hunan Province reported 2 241 cases of human brucellosis, with no reported deaths, resulting in an average annual incidence rate of 0.37 per 100 000 population. The incidence was on a fluctuating rise (trend χ²=263.21, P<0.001). The peak incidence was concentrated from March to August (spring and summer). The male-to-female ratio of cases was 2.81∶1 (1 653∶588). The age distribution of the cases mainly concentrates in the range of 40-69 years. The occupations were mainly those of farmers. The cases involved 122 counties (cities, districts) in 14 cities (prefectures). The incidence areas showed an expanding trend, and the cities with the highest incidence rates were Chenzhou (0.84/100 000), Yongzhou (0.79/100 000), and Huaihua (0.60/100 000). There was a spatial positive correlation (Moran's I ranged from 0.095 to 0.341, all P<0.05) of incidence, high-high clustering areas were mainly distributed in the western and southern regions of Hunan Province. There was no correlation between the number of cattle/sheep and the incidence of human brucellosis (all P>0.05). The primary sources of infection were sheep and cattle, and the transmission route was mainly feeding and grazing. The positive rate of serologic surveillance in key populations was 1.71%. Conclusions: The annual incedence of human brucellosis in Hunan showed a fluctuating rise trend during 2016-2024. Spring and summer were the seasons with high incidence. The reported incidence of brucellos showed spatial clustering. The western and southern regions of Hunan are key areas, and monitoring should be strengthened, multiple departments should work together to carry out joint prevention and control.