China CDC Weekly最新文献

What is already known about this topic?: In China, patients with echinococcosis receive complimentary healthcare services, such as medical treatment, diagnostic examinations, and follow-up care. Despite this, no studies have been conducted to assess the quality of patient management to date.

What is added by this report?: This study reviewed the medical records of 899 patients who underwent albendazole treatment across 10 endemic counties. Out of 634 evaluable patient files, the proportion of patients with a ratio of actual follow-up and reexamination times to theoretical follow-up and reexamination times ≥0.8 were both low (21.92% and 23.19%, respectively).

What are the implications for public health practices?: This study identified weaknesses and specific issues in patient management and proposed feasible recommendations to enhance patient file documentation, follow-up, and reexamination.

What is already known on this topic?: Chronic obstructive pulmonary disease (COPD) exacerbations increase household economic burden, but there is limited evidence from prospective cohort studies in China about the impact of vaccination on economic burden.

What is added by this report?: This study demonstrated the economic burden of COPD exacerbations, pneumonia, and hospitalization in COPD patients in China is substantial. Influenza vaccine and 23-valent pneumococcal polysaccharide vaccine (PPSV23), separately or together, were significantly associated with decreased economic burden.

What are the implications for public health practice?: Our study supports evidence on recommendations that COPD patients in China are offered both influenza vaccine and PPSV23.

Introduction: Campylobacter jejuni (C. jejuni) is the leading cause of human bacterial gastroenteritis worldwide and has a major impact on global public health. The objective of the present study was to conduct whole genome sequencing (WGS) to determine the genetic diversity, virulence factors, and determinants of antimicrobial resistance of C. jejuni during a 3-year surveillance period in Beijing, China.

Methods: A total of 184 clinical isolates were obtained from sentinel hospital surveillance between 2019 and 2021. Antimicrobial susceptibility testing was conducted using the agar dilution method. WGS was employed to characterize the 184 C. jejuni strains.

Results: Multilocus sequence typing analysis revealed high genetic diversity among the 184 C. jejuni strains, identifying 71 sequence types (STs) and 19 clonal complexes (CCs). The most prevalent ST was ST760 (6.5%), and the most common CC was CC21 (24.5%), consisting of 11 STs. High resistance rates were observed for ciprofloxacin (76.6%), nalidixic acid (76.1%), and tetracycline (71.2%). A total of 77 C. jejuni isolates (41.8%) exhibited multidrug resistance with 43 resistance patterns. Virulome analysis disclosed the differential distribution of virulence factors related to adherence, colonization, chemotaxis, as well as lipo-oligosaccharide and capsular polysaccharide biosynthesis. Resistome analysis demonstrated widespread resistance to quinolones and tetracycline, but low rates of macrolides resistance. The phylogeny, based on whole genome single nucleotide polymorphisms, indicated a high degree of clonality and grouped the C. jejuni strains into six clades. Closely related isolates that were part of a genetic cluster mostly shared a homogenous clonal complex.

Conclusions: The present study emphasizes the rising resistance to quinolones and tetracycline, as well as the virulence potential and diverse genotypes identified among C. jejuni strains isolated from diarrheal patients in Beijing.

What is already known about this topic?: Children with medical conditions frequently experience under-immunization. Ensuring high-quality immunization services is crucial for enhancing vaccination coverage levels; nevertheless, the state of immunization service provision for children with medical conditions in China remains unclear.

What is added by this report?: Immunization support for children with medical conditions in China demonstrates considerable variability and may be inadequate. Primary obstacles to the provision of immunization services include an absence of comprehensive vaccination recommendations and assessment guidelines for specific medical conditions, as well as inconsistencies among vaccine recommendations, package inserts, and expert consensus statements pertaining to the vaccination of children with medical conditions.

What are the implications for public health practice?: The examination of provincial practices in providing immunization services for children with medical conditions, as well as understanding the barriers faced by National Immunization Program providers in administering vaccinations, can contribute to the improvement of immunization services for this population in China.

What is already known about this topic?: Limited evidence exists regarding the relationship between pregnancy loss and female-specific cancers within the Chinese population from prospective cohort studies.

What is added by this report?: Terminations were associated with a 13% lower risk of endometrial cancer, whereas stillbirths were related to an 18% higher risk of cervical cancer. Rural residents with a history of pregnancy loss experienced a 19% and 38% increased risk of breast and cervical cancers, respectively, compared to their urban counterparts. Moreover, a positive graded relationship between live births and pregnancy loss on cervical cancer was observed.

What are the implications for public health practice?: This study has significant implications for identifying women at an increased risk for breast and genital cancers and contributes to the development of effective public health strategies for female cancer prevention. Future research on reproductive history, particularly in rural areas, should be given priority in efforts to improve female cancer screening and early detection.

What is already known about this topic?: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection by variants is being reported commonly and has caused waves of epidemic in many countries. Because of dynamic zero policy, the SARS-CoV-2 reinfection was less reported in China.

What is added by this report?: SARS-CoV-2 reinfections were observed in Guangdong Province between December 2022 and January 2023. This study estimated that the reinfection incidence was 50.0% for the original strain primary infections, 35.2% for the Alpha or Delta variants, and 18.4% for the Omicron variant; The reinfection incidence within 3-6 months after primary infection by Omicron variant was 4.0%. Besides, 96.2% reinfection cases were symptomatic while only 7.7% sought medical attention.

What are the implications for public health practice?: These findings suggest a reduced likelihood of an Omicron-driven epidemic resurgence in the short term but emphasize the importance of maintaining vigilant surveillance of emerging SARS-CoV-2 variants and conducting population-based antibody level surveys to inform response preparedness.

What is already known about this topic?: Healthcare workers (HCWs) and previously infected patients (PIPs) may experience a wave of epidemic following the modification of the country's coronavirus disease (COVID)-zero policy in China.

What is added by this report?: As of early January 2023, the initial wave of the COVID-19 pandemic among HCWs had effectively subsided, with no statistically significant differences observed in infection rates compared to those of their co-occupants. The proportion of reinfections among PIPs was relatively low, particularly in those with recent infections.

What are the implications for public health practice?: Medical and health services have resumed normal operations. For patients who have recently experienced severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, appropriate relaxation of policies may be considered.

What is already known about this topic?: The first nationwide wave of coronavirus disease 2019 (COVID-19), driven by the Omicron variant, has largely subsided. However, subsequent epidemic waves are inevitable due to waning immunity and the ongoing evolution of the severe acute respiratory syndrome coronavirus 2.

What is added by this report?: Insights gleaned from other nations offer guidance regarding the timing and scale of potential subsequent waves of COVID-19 in China.

What are the implications for public health practice?: Understanding the timing and magnitude of subsequent waves of COVID-19 in China is crucial for forecasting and mitigating the spread of the infection.

Introduction: Coronavirus disease 2019 (COVID-19) has had profound disruptions worldwide. For a population or individual, it is critical to assess the risk of death for making preventative decisions.

Methods: In this study, clinical data from approximately 100 million cases were statistically analyzed. A software and an online assessment tool were developed in Python to evaluate the risk of mortality.

Results: Our analysis revealed that 76.51% of COVID-19-related fatalities occurred among individuals aged over 65 years, with frailty-associated deaths accounting for more than 80% of these cases. Furthermore, over 80% of the reported deaths involved unvaccinated individuals. A notable overlap was observed between aging and frailty-associated deaths, both of which were connected to underlying health conditions. For those with at least two comorbidities, the proportion of frailty and the proportion of COVID-19-related death were both close to 75 percent. Subsequently, we established a formula to calculate the number of deaths, which was validated using data from twenty countries and regions. Using this formula, we developed and verified an intelligent software designed to predict the death risk for a given population. To facilitate rapid risk screening on an individual level, we also introduced a six-question online assessment tool.

Conclusions: This study examined the impact of underlying diseases, frailty, age, and vaccination history on COVID-19-related mortality, resulting in a sophisticated software and a user-friendly online scale to assess mortality risk. These tools offer valuable assistance in informed decision-making.