中国疾病预防控制中心周报最新文献

Background: This study aimed to develop and validate test-based physical literacy scales (PLSs) for primary school students across different grades.

Methods: Data were collected through a field survey conducted from June 1 to July 31, 2022, involving 3,275 primary school students from four provinces in China. The questionnaires assessed four domains: physical knowledge, physical competence, physical motivation, and physical behavior. The Rasch model was employed for psychometric analysis.

Results: The variance explained by measures for the PLSs was 53.1%, 50.3%, and 54.7%, all exceeding the 50% threshold, confirming unidimensionality and robust internal consistency. This enabled effective differentiation among students with varying proficiency levels. The item-person map demonstrated optimal alignment between item difficulty and participant ability levels. Most items showed favorable fit statistics, with Infit mean square (MNSQ) and Outfit MNSQ values ranging between 0.5 and 1.5.

Conclusions: The PLSs demonstrate validity and reliability in measuring physical literacy among Chinese primary school students across four components: physical knowledge, physical competence, physical motivation, and physical behavior. The scales measure a unidimensional construct, supporting the use of summed total scores for assessment.

Universal newborn hearing screening (UNHS) is recognized as the most effective strategy for early detection of congenital hearing loss; however, screening coverage remains inadequate in many countries. In China, newborn hearing screening has been implemented for over two decades. To evaluate our policies and practices during this period and assess resource equity, health impacts, and future challenges, we conducted a nationwide survey focusing on newborn hearing screening coverage, the number of special schools for deaf-mutes, and the proportion of hearing-impaired students in mainstream education. From 2001 to 2020, China's UNHS program coverage increased from 10.9% to 94.3%, while the proportion of hearing-impaired students in mainstream education rose from 24.8% to 57.5%. Concurrently, the number of hearing-impaired students in special schools decreased from 76,554 to 34,945, and the number of special schools for deaf-mutes declined from 639 to 389. Through the implementation of the UNHS program, China has made substantial progress in improving newborn hearing health, yielding long-term benefits for those with congenital hearing loss. However, targeted resource allocation and the establishment of a national platform remain priorities for future development. Our experience may provide valuable insights for similar settings.

What is already known about this topic?: Between 50% and 85% of children experience at least one episode of acute otitis media (AOM) by age three. Since the coronavirus disease 2019 (COVID-19) pandemic, numerous hospitals across China have integrated telehealth solutions into their pediatric care services.

What is added by this report?: Our study found patients with ear pain relief was 84% in the telehealth follow-up group compared to 81% in the in-person follow-up group, showing no statistically significant difference (P=0.57). Hearing loss was documented in 21 cases from the telehealth group and 23 cases from the in-person follow-up group (P=0.73). Patient satisfaction scores were comparable between groups, with mean scores of 4.47 for telehealth and 4.49 for in-person follow-up (P=0.87). Multivariate regression revealed no significant difference in patient satisfaction between telehealth and in-person follow-up (P=0.21).

What are the implications for public health practice?: Telehealth services can effectively bridge geographical healthcare disparities while optimizing pediatric care delivery systems.

Introduction: Non-cycloplegic refraction is widely utilized in vision screening. However, interpreting non-cycloplegic refraction results remains a significant challenge in both clinical practice and public health settings. This study aimed to establish grade- and sex-specific reference values for non-cycloplegic spherical equivalent (SE) to enhance myopia screening and risk prediction among Chinese students.

Methods: A comprehensive study was conducted between 2020 and 2024, involving 67,260 students from kindergarten through high school across 10 provincial-level administrative divisions (PLADs) in China. The Lambda-Mu-Sigma method was employed to model non-cycloplegic SE. Reference values were established by calculating SE centiles corresponding to myopia and high myopia prevalence across grades 0 through 12.

Results: Among boys, the estimated prevalence of myopia and high myopia increased from 1.2% and <0.1% in grade 0 (senior kindergarten) to 82.4% and 11.6% in grade 12 (third year of high school), respectively. For twelfth-grade boys, the 82.4th and 11.6th percentiles of SE (-0.99 D and -6.16 D) were established as reference values for screening myopia and high myopia, respectively. The corresponding percentiles in lower grades served as predictive reference values for grade 12 outcomes. For instance, a grade-0 boy with non-cycloplegic SE>0.70 D (82.4th percentile) was predicted to remain free of myopia before grade 12. Similarly, SE>-0.73 D (11.6th percentile) indicated a low likelihood of developing high myopia before grade 12.

Conclusions: This study established comprehensive non-cycloplegic SE reference values for screening and predicting myopia among Chinese students. The methodology developed here may be applicable to other regions where student myopia prevalence patterns demonstrate relative stability.

What is already known about this topic?: Preexposure prophylaxis (PrEP) and postexposure prophylaxis (PEP) have been proven effective in preventing human immunodeficiency virus (HIV) transmission.

What is added by this report?: Men who have sex with men (MSM) who incorrectly used PrEP/PEP demonstrated higher HIV positivity rates compared to both correct users and non-users. Since PrEP/PEP users are more likely to engage in unprotected anal intercourse (UAI), incorrect use of these prophylactic measures may constitute a significant risk factor for HIV transmission among MSM.

What are the implications for public health practice?: It is crucial to implement strategies that guide MSM toward correct PrEP/PEP utilization while emphasizing that these prophylactic measures should not be considered substitutes for condom use.

Introduction: The genetic diversity of human immunodeficiency virus-1 (HIV-1) in China is characterized by multiple subtypes, circulating recombinant forms (CRFs) and unique recombinant forms (URFs) across the country. Through timely molecular surveillance, over 65 distinct CRFs have been identified in China to date. In this study, we identified five novel URFs among newly reported HIV-1 infected individuals in Anhui Province, China.

Methods: Near-full length HIV genome sequences were obtained using two-half molecule amplification methods from five samples containing potential URFs. The sequences were subsequently subjected to phylogenetic and recombination analyses.

Results: Phylogenetic and recombination analyses of the five near-full length genome sequences confirmed their classification as novel URFs. Among these, three sequences were recombinants of CRF01_AE and CRF07_BC, one sequence was a recombinant of CRF01_AE, CRF07_BC and B, and one sequence resulted from CRF07_BC and CRF08_BC recombination.

Conclusions: The identification of URFs in newly infected individuals indicates ongoing transmission of multiple HIV-1 clades in Anhui Province, with superinfection occurring at notable frequencies. These findings emphasize the importance of enhancing long-term surveillance of circulating HIV-1 clades using near-full length sequence analysis in Anhui, China.

Introduction: This study assessed the impact of antiretroviral therapy (ART) on stillbirth and neonatal mortality and investigated associated risk factors among ‌Human immunodeficiency virus-positive (HIV-positive) pregnant women in Yunnan, China during 2013-2022.

Methods: Data from the National Information System of Integrated Prevention of Mother-to-Child Transmission of HIV, Syphilis, and Hepatitis B Program (PMTCT) were analyzed to determine stillbirth and neonatal mortality rates. Multivariate Poisson regression was employed to identify risk factors associated with stillbirth and neonatal outcomes.

Results: Among 9,563 HIV-positive women with singleton pregnancies in Yunnan Province during 2013-2022, 9,404 (98.34%) received ART during pregnancy, while 159 (1.66%) did not. There were 9,421 live births, 76 stillbirths, and 66 neonatal deaths, yielding a stillbirth rate (SBR) of 8.07‰ and neonatal mortality rate (NMR) of 7.01‰. The SBR was significantly lower in pregnancies where ART was used (P=0.033). Univariate analysis revealed that ART (P=0.009), ethnicity (P=0.012), and antenatal care utilization (P<0.001) were associated with stillbirth and newborn survival. Multivariate Poisson regression identified that six or more antenatal care visits as an independent predictor of survival.

Conclusions: Stillbirth and neonatal mortality rates were elevated among mothers who did not receive ART during pregnancy compared to those who did. These findings emphasize the importance of ART during pregnancy, particularly since several mortality risk factors are amenable to intervention.

What is already known about this topic?: Antiretroviral therapy (ART) is transforming human immunodeficiency virus (HIV) infection into a chronic condition, leading to an altered disease spectrum in patients. The risk of cardiovascular disease (CVD) in HIV-infected individuals are twice that of the general population.

What is added by this report?: This study demonstrates elevated cardiovascular risk among the HIV population. The findings reveal that traditional CVD risk factors are prevalent among people living with HIV but remain inadequately addressed in clinical practice.

What are the implications for public health practice?: These findings underscore both the necessity and urgency of implementing systematic CVD risk screening and intervention programs for HIV population. Furthermore, the study emphasizes the critical need to develop CVD screening tools specifically calibrated for the HIV population in China.

Introduction: Human respiratory syncytial virus (HRSV) is the predominant respiratory pathogen causing acute respiratory tract infection (ARTI). Globally, HRSV infection represents the leading cause of acute respiratory morbidity and hospitalization in children under 2 years of age. HRSV infection continues to pose a significant public health challenge worldwide. Through epidemiological surveillance of HRSV in children with ARTI, we can elucidate its incidence patterns and epidemic characteristics to inform evidence-based prevention and control strategies.

Methods: We collected upper and lower respiratory tract specimens and clinical data from children under 14 years of age with ARTI. HRSV was detected using Real-time Polymerase Chain Reaction to analyze its incidence and epidemic characteristics.

Results: Among 1,440 specimens, the overall HRSV detection rate was 7.8% (HRSVA and HRSVB detection rates were 4.0% and 3.8%, respectively). Detection rates peaked in spring (12.2%), followed by winter (10.3%), with the lowest rates in autumn (2.8%) (P<0.05). HRSVB was the dominant subtype throughout 2021, while HRSVA predominated during 2022 and the first half of 2023. Detection rates were significantly higher in children under 5 years compared to older children, with lower respiratory tract infections in the 0-2 years age group showing notably higher detection rates (18.1%) than upper respiratory tract infections (8.1%) (P<0.05).

Conclusions: HRSV exhibited consistent circulation among children with ARTI in the Shijiazhuang area from 2021 to 2023, characterized by winter and spring outbreaks and alternating predominance of subtypes A and B. Infections predominantly affected children under 5 years of age.