Spatiotemporal analysis of imported and local dengue virus and cases in a metropolis in Southwestern China, 2013-2022.

Dengue fever is a viral illness, mainly transmitted by Aedes aegypti and Aedes albopictus. With climate change and urbanisation, more urbanised areas are becoming suitable for the survival and reproduction of dengue vector, consequently are becoming suitable for dengue transmission in China. Chongqing, a metropolis in southwestern China, has recently been hit by imported and local dengue fever, experiencing its first local outbreak in 2019. However, the genetic evolution dynamics of dengue viruses and the spatiotemporal patterns of imported and local dengue cases have not yet been elucidated. Hence, this study implemented phylogenetic analyses using genomic data of dengue viruses in 2019 and 2023 and a spatiotemporal analysis of dengue cases collected from 2013 to 2022. We sequenced a total of 15 nucleotide sequences of E genes. The dengue viruses formed separate clusters and were genetically related to those from Guangdong Province, China, and countries in Southeast Asia, including Laos, Thailand, Myanmar and Cambodia. Chongqing experienced a dengue outbreak in 2019 when 168 imported and 1,243 local cases were reported, mainly in September and October. Few cases were reported in 2013-2018, and only six were imported from 2020 to 2022 due to the COVID-19 lockdowns. Our findings suggest that dengue prevention in Chongqing should focus on domestic and overseas population mobility, especially in the Yubei and Wanzhou districts, where airports and railway stations are located, and the period between August and October when dengue outbreaks occur in endemic regions. Moreover, continuous vector monitoring should be implemented, especially during August-October, which would be useful for controlling the Aedes mosquitoes. This study is significant for defining Chongqing's appropriate dengue prevention and control strategies.

Temporal relationship between hepatic steatosis and blood pressure elevation and the mediation effect in the development of cardiovascular disease.

The temporal relationship between non-alcoholic fatty liver disease (NAFLD) and hypertension remains highly controversial, with ongoing debates on whether NAFLD induces hypertension or vice versa. We employed cross-lagged panel models to investigate the temporal relationship between hepatic steatosis (assessed by Fatty Liver Index [FLI] in the main analysis, and by Proton Density Fat Fraction [PDFF] in the validation study) and blood pressure (systolic and diastolic blood pressure [SBP/ DBP]). Subsequently, we employed causal mediation models to explore the mediation effect in CVD development, including ischemic heart disease and stroke. The main analysis incorporated repeated measurement data of 5,047 participants from the China Multi-Ethnic Cohort (CMEC) and 5,685 participants from the UK Biobank (UKB). In both cohorts, the path coefficients from FLI to blood pressure were significant and greater than the path from blood pressure to FLI, with ßFLI→SBP = 0.081, P < 0.001 versus ßSBP→FLI = 0.020, P = 0.031; ßFLI→DBP = 0.082, P < 0.001 versus ßDBP→FLI = -0.006, P = 0.480 for CEMC, and ßFLI→SBP = 0.057, P < 0.001 versus ßSBP→FLI = -0.001, P = 0.727; ßFLI→DBP = 0.061, P < 0.001, versus ßDBP→FLI = -0.006, P = 0.263 for UKB. The validation study with 962 UKB participants using PDFF consistently supported these findings. In the mediation analyses encompassing 11,108 UKB participants, SBP and DBP mediated 12.2% and 5.2% of the hepatic steatosis-CVD association, respectively. The proportions were lower for ischemic heart disease (SBP: 6.1%, DBP: non-statistically significant -6.8%), and relatively stronger for stroke (SBP: 19.4%, DBP: 26.1%). In conclusion, hepatic steatosis more strongly contributes to elevated blood pressure than vice versa. Blood pressure elevation positively mediates the hepatic steatosis-CVD association, particularly in stroke compared to ischemic heart disease.

Immunogenicity evaluation of primary polio vaccination schedule with inactivated poliovirus vaccines and bivalent oral poliovirus vaccine.

BACKGROUND: To assess the immunogenicity of the current primary polio vaccination schedule in China and compare it with alternative schedules using Sabin or Salk-strain IPV (sIPV, wIPV). METHODS: A cross-sectional investigation was conducted at four sites in Chongqing, China, healthy infants aged 60-89 days were conveniently recruited and divided into four groups according to their received primary polio vaccination schedules (2sIPV + bOPV, 2wIPV + bOPV, 3sIPV, and 3wIPV). The sero-protection and neutralizing antibody titers against poliovirus serotypes (type 1, 2, and 3) were compared after the last dose. RESULTS: There were 408 infants completed the protocol. The observed seropositivity was more than 96% against poliovirus types 1, 2, and 3 in all groups. IPV-only groups induced higher antibody titers(GMT) against poliovirus type 2 (Median:192, QR: 96-384, P<0.05) than the "2IPV + bOPV" group. While the "2IPV + bOPV" group induced significantly higher antibody titers against poliovirus type 1 (Median:2048, QR: 768-2048, P<0.05)and type 3 (Median:2048, QR: 512-2048, P<0.05) than the IPV-only group. CONCLUSIONS: Our findings have proved that the two doses of IPV with one dose of bOPV is currently the best polio routine immunization schedule in China.

Associations between residential greenness and obesity phenotypes among adults in Southwest China.

BACKGROUND: Although exposure to greenness has generally benefited human metabolic health, the association between greenness exposure and metabolic obesity remains poorly studied. We aimed to investigate the associations between residential greenness and obesity phenotypes and the mediation effects of air pollutants and physical activity (PA) level on the associations. METHODS: We used the baseline of the China Multi-Ethnic Cohort (CMEC) study, which enrolled 87,613 adults. Obesity phenotypes were defined based on obesity and metabolic status, including metabolically unhealthy obesity (MUO), non-obesity (MUNO), metabolically healthy obesity (MHO), and non-obesity (MHNO). Greenness exposure was measured as the 3-year mean values of the normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI) within the 500-m buffer zones around the participants' residence. Multivariable logistic regression was used to estimate the associations between greenness and obesity phenotypes. Stratified analyses by age, sex, educational level, and urbanicity were performed to identify how the effect varies across different subgroups. Causal mediation analysis was used to examine the mediation effects of air pollutants and PA level. RESULTS: Compared with MHNO, each interquartile range (IQR) increase in greenness exposure was associated with reduced risks of MHO (ORNDVI [95% CI] = 0.87 [0.81, 0.93]; OREVI = 0.91 [0.86, 0.97]), MUO (ORNDVI = 0.83 [0.78, 0.88]; OREVI = 0.86 [0.81, 0.91]), and MUNO (ORNDVI = 0.88 [0.84, 0.91]; OREVI = 0.89 [0.86, 0.92]). For each IQR increase in both NDVI and EVI, the risks of MHO, MUO, and MUNO were reduced more in men, participants over 60 years, those with a higher level of education, and those living in urban areas, compared to their counterparts. Concentrations of particulate matter (PM) and PA level partially mediated the associations between greenness exposure and obesity phenotypes. CONCLUSIONS: Exposure to residential greenness was associated with decreased risks of MHO, MUO, and MUNO, which was mediated by concentrations of PM and PA level, and modified by sex, age, educational level, and urbanicity.

Healthcare-seeking behaviours of patients with acute respiratory infection: a cross-sectional survey in a rural area of southwest China.

OBJECTIVES: This study aimed to assess the healthcare-seeking behaviour and related factors of people with acute respiratory symptoms in the rural areas of central and western China to estimate the disease burden of influenza more accurately. DESIGN: Cross-sectional survey. SETTINGS: Fifty-two communities/villages in the Wanzhou District, Chongqing, China, a rural area in southwest China, from May 2022 to July 2022. PARTICIPANTS: The participants were those who had been living in Wanzhou District continuously for more than 6 months and consented to participate. OUTCOME MEASURES: A semistructured questionnaire was used to determine the healthcare-seeking behaviour of participants, and the dichotomous response of 'yes' or 'no' was used to assess whether participants had acute respiratory symptoms and their healthcare-seeking behaviour. RESULTS: Only 50.92% (360 of 707) of the patients with acute respiratory infection visited medical and health institutions for treatment, whereas 49.08% (347 of 707) avoided treatment or opted for self-medication. The primary reason for not seeing a doctor was that patients felt their condition was not serious and visiting a medical facility for treatment was unnecessary. Short distance (87.54%) and reasonable charges (49.48%) were ranked as the most important reasons for choosing treatment at primary medical and health facilities (80.27%). The primary reasons for which patients visited secondary and tertiary hospitals (7.78% and 8.61%, respectively) were that doctors in such facilities were better at diagnosis (57.14%) and at treatment (87.10%). CONCLUSION: The findings provided in this study indicated that regular healthcare-seeking behaviour investigations should be conducted. The disease burden of influenza can be calculated more accurately when healthcare-seeking behaviour investigations are combined with surveillance in the hospitals.

Role of metabolic risk factors in the relationship between ambient fine particulate matter and depressive symptoms: Evidence from a longitudinal population study.

BACKGROUND: There is growing evidence indicating a connection between fine particulate matter (PM2.5) and depressive symptoms. Metabolic risk factors are critical determinants of depressive symptoms. However, the mediating role of these factors on the association between PM2.5 and depressive symptoms remains elusive. We aimed to investigate whether and to what extent metabolic risk factors mediated the link between long-term PM2.5 exposure and depressive symptoms. METHODS: This study comprised 7794 individuals aged between 30 and 79 years who participated in two waves of the on-site surveys in the China Multi-Ethnic Cohort. Ambient PM2.5 concentrations were assessed utilizing a random forest method based on satellite data. We employed the Patient Health Questionnaire-9 to assess depressive symptoms at wave 2, and the overall as well as three sub-domain symptom scores (emotional, neurovegetative, and neurocognitive symptoms) were calculated. Three metabolic risk factors, including hypertension, diabetes, and dyslipidemia, were considered. Mediation analyses were conducted to assess the indirect effects of PM2.5 on depressive symptoms through metabolic risk factors. RESULTS: We found a positive association between chronic exposure to ambient PM2.5 and overall depressive symptoms as well as the three sub-domains. In mediation analyses, metabolic risk factors partially mediated the associations of PM2.5 on depressive symptoms. The natural indirect effects (RR, 95% CI) of PM2.5 on overall, emotional, neurovegetative, and neurocognitive symptoms mediated through metabolic risk factors were 1.004(1.001, 1.007), 1.004 (1.001, 1.008), 1.004 (1.001, 1.007), and 1.003(0.999, 1.007), respectively. Larger indirect effects were found in elderly participants (mediated proportion, 29.3%), females (13.3%), and people who did not consume alcohol (19.6%). CONCLUSIONS: Metabolic risk factors may act as mediators in the relationship between chronic PM2.5 exposure and depression. Treatment of metabolic risk factors may be an opportunity to reduce the burden of depression caused by long-term exposure to PM2.5.

A foodborne outbreak linked to Bacillus cereus at two middle schools in a rural area of Chongqing, China, 2021.

Bacillus cereus (B. cereus) is a common cause of foodborne illness. An outbreak of acute gastrointestinal illness occurred at two middle schools in a rural region of Chongqing, China, in 2021. This study aimed to elucidate the outbreak's characteristics, identify risk factors, and determine the source of contamination. A retrospective cohort study and an environmental investigation were conducted. Vomit samples, anal swabs, and food samples were collected and tested by RT-PCR for 18 species of bacteria and viruses, including B. cereus. Positive samples of B. cereus underwent biochemical experiments and bacterial quantification. A total of 198 cases were reported in this outbreak, with an attack rate of 24.63%. The main symptoms were vomiting (100%), bellyache (83.33%), and dizziness (62.63%). The retrospective cohort study showed a significant association between the outbreak and rice noodles provided by a nearby food manufacturer (RR = 39.63, p < 0.001). B. cereus was detected in 20 vomit samples, three anal swabs, and seven rice noodles samples, with a count exceeding 103 CFU/g. These findings strongly suggested that the outbreak was linked to B. cereus-contaminated rice noodles. Enhancing food safety surveillance and promoting health measures among schools and food manufacturers in rural areas is crucial to prevent similar incidents in the future in Chongqing, China.

Association between alcohol consumption and risk of stroke among adults: results from a prospective cohort study in Chongqing, China.

BACKGROUND: The incidence of stroke in China is increasing, along with a clear trend in the prevalence of risk factors. Alcohol consumption is also a risk factor for stroke. Many cohort studies have explored the relationship between alcohol consumption and stroke risk. However, findings have been inconsistent. METHODS: We used cluster sampling to select 13 districts and counties (at the same level) in Chongqing, China. Then, we used stratified random sampling to distribute the number of people in each district and county. 23,308 adults aged 30-79 were recruited between October 2018 and February 2019. Follow-up was conducted through a monitoring system and questionnaires until September 2022. Information on alcohol consumption and other covariates was collected using a standardized questionnaire. Participants were asked to report their weekly frequency of drinking over the past year and weekly intake of various alcoholic beverages in general. The frequency of drinking was divided into three categories: 1-2 d/week, 3-5 d/week, and 6-7 d/week. The average daily alcohol consumption is calculated based on the amount of alcohol contained in different alcoholic beverages. It is classified as nondrinker (0 g/day), light (0 to 12 g/day), moderate (13 to 36 g/day), and high (> 36 g/day). Cox proportional hazard regression models were used to estimate the association between alcohol consumption and stroke risk. Results are shown as multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs). RESULTS: With an average follow-up of 3.80 years, there were 310 new stroke events. The incidence of total stroke was 368.69 per 100,000 person-years. Overall, after adjusting for covariates, moderate alcohol consumption (average daily alcohol consumption 13-36 g/d) was associated with a lower risk of total stroke (HR: 0.48; 95% CI: 0.25-0.92) compared with nondrinkers. The adjusted HR and 95% CI for total stroke and ischemic stroke for those who drank alcohol 6-7 days per week were 0.60(0.37, 0.96) and 0.53(0.30, 0.94), respectively. The risk of total stroke (HR: 0.39; 95% CI: 0.17-0.89) was reduced in a pattern of drinking 6-7 days per week but with a mean alcohol consumption of less than 36 g/d. There was no significant association between alcohol consumption and hemorrhagic stroke. CONCLUSION: This study suggests moderate alcohol consumption is associated with a lower risk of total stroke. And healthy drinking patterns should be of more significant concern.

Ambient PM2.5 and its components associated with 10-year atherosclerotic cardiovascular disease risk in Chinese adults.

BACKGROUND: Exposure to particulate matter with aerodynamic diameters less than 2.5 µm (PM2.5) may increase the risk of 10-year atherosclerotic cardiovascular disease (ASCVD) risk. While PM2.5 is comprised of various components, the evidence on the correlation of its components with 10-year ASCVD risk and which component contributes most remains limited. METHODS: Data were derived from the baseline assessments of China Multi-Ethnic Cohort (CMEC). In total, 69,722 individuals aged 35-74 years were included into this study. The annual average concentration of PM2.5 and its components (black carbon, ammonium, nitrate, sulfate, organic matter, soil particles, and sea salt) were estimated by satellite remote sensing and chemical transport models. The ASCVD risk of individuals was calculated by the equations from the China-PAR Project (prediction for ASCVD risk in China). The relationship between single exposure to PM2.5 and its components and predicted 10-year ASCVD risk was assessed using the logistic regression model. The effect of joint exposure was estimated, and the most significant contributor was identified using the weighted quantile sum approach. RESULTS: Totally 69,722 participants were included, of which 95.8 % and 4.2 % had low and high 10-year ASCVD risk, respectively. Per standard deviation increases in the 3-year average concentration of PM2.5 mass (odds ratio [OR] 1.23, 95 % confidence interval [CI]: 1.12-1.35), black carbon (1.21, 1.11-1.33), ammonium (1.21, 1.10-1.32), nitrate (1.25, 1.14-1.38), organic matter (1.29, 1.18-1.42), sulfate (1.17, 1.07-1.28), and soil particles (1.15, 1.04-1.26) were related to high 10-year ASCVD risk. The overall effect (1.19, 1.11-1.28) of the PM2.5 components was positively associated with 10-year ASCVD risk, and organic matter had the most contribution to this relationship. Female participants were more significantly impacted by PM2.5, black carbon, ammonium, nitrate, organic matter, sulfate, and soil particles compared to others. CONCLUSION: Long-term exposure to PM2.5 mass, black carbon, ammonium, nitrate, organic matter, sulfate, and soil particles were positively associated with high 10-year ASCVD risk, while sea salt exhibited a protective effect. Moreover, the organic matter might take primary responsibility for the relationship between PM2.5 and 10-year ASCVD risk. Females were more susceptible to the adverse effect.

Association between spicy food and hypertension among Han Chinese aged 30-79 years in Sichuan Basin: a population-based cross-sectional study.

BACKGROUND: While spicy food is believed to have cardiovascular-protective effects, its impact on hypertension remains uncertain due to conflicting findings from previous studies. This study aimed to explore the association between spicy food and hypertension in Sichuan Basin, China. METHODS: The baseline data of 43,657 residents aged 30-79 in the Sichuan Basin were analyzed including a questionnaire survey (e.g., sociodemographics, diet and lifestyle, medical history), medical examinations (e.g., height, body weight, and blood pressure), and clinical laboratory tests (e.g., blood and urine specimens). Participants were recruited by multi-stage, stratified cluster sampling in consideration of both sex ratio and age ratio between June 2018 and February 2019. Multivariable logistic regression was performed to explore the effect of spicy food on hypertension and multivariable linear regression was applied to estimate the effect of spicy food on systolic and diastolic blood pressure (SBP/DBP). RESULTS: Concerning hypertension, negative associations with spicy food consumption were observed only in females: compared to those who do not eat spicy food, the odds ratios of consuming spicy food 6-7 days/week, consuming spicy food with strong strength, and years of eating spicy food-to-age ratio were 0.886 (0.799, 0.982), 0.757 (0.587, 0.977), 0.632 (0.505, 0.792), respectively. No significant association was found in males (All P trends > 0.05). In the stratified analyses, participants in the subgroup who were 50 to 79 years old (OR, 95%CI: 0.814, 0.763, 0.869), habitually snored (OR, 95%CI: 0.899, 0.829, 0.976), had a BMI < 24 kg/m2 (OR, 95%CI: 0.886, 0.810, 0.969), had a normal waist circumference (OR, 95%CI: 0.898, 0.810, 0.997), and had no dyslipidemia (OR, 95%CI: 0.897, 0.835, 0.964) showed a significantly stronger association. For SBP, consuming spicy food had negative effects in both genders, but the effect was smaller in males compared to females: among males, the ß coefficients for consuming spicy food 1-2 days/week, weak strength, and years of eating spicy food-to-age ratio were 0.931 (-1.832, -0.030), -0.639 (-1.247, -0.032), and - 2.952 (-4.413, -1.492), respectively; among females, the ß coefficients for consuming spicy food 3-5 days/week, 6-7 days/week, weak strength, moderate strength, and years of eating spicy food-to-age ratio were - 1.251 (-2.115, -0.388), -1.215 (-1.897, -0.534), -0.788 (-1.313, -0.263), -1.807 (-2.542, -1.072), and - 5.853 (-7.195, -4.512), respectively. For DBP, only a positive association between the years of eating spicy food-to-age ratio and DBP was found in males with ß coefficient (95%CI ) of 1.300 (0.338, 2.263); Little association was found in females (all P trends > 0.05), except for a decrease of 0.591 mmHg ( 95%CI: -1.078, -0.105) in DBP among participants who consumed spicy food 1-2 days/week, compared to those who did not consume spicy food. CONCLUSION: Spicy food may lower SBP and has an antihypertensive effect, particularly beneficial for women and individuals with fewer risk factors in the Sichuan Basin. Spicy food consumption may decrease DBP in women but increase it in men. Further multicenter prospective cohort studies are needed to confirm these findings.

Ambient PM2.5 Components Are Associated With Bone Strength: Evidence From a China Multi-Ethnic Study.

CONTEXT: The relationship between the components of particulate matter with an aerodynamic diameter of 2.5 or less (PM2.5) and bone strength remains unclear. OBJECTIVE: Based on a large-scale epidemiologic survey, we investigated the individual and combined associations of PM2.5 and its components with bone strength. METHODS: A total of 65 906 individuals aged 30 to 79 years were derived from the China Multi-Ethnic Cohort Annual average concentrations of PM2.5 and its components were estimated using satellite remote sensing and chemical transport models. Bone strength was expressed by the calcaneus quantitative ultrasound index (QUI) measured by quantitative ultrasound. The logistic regression model and weighted quantile sum method were used to estimate the associations of single and joint exposure to PM2.5 and its components with QUI, respectively. RESULTS: Our analysis shows that per-SD increase (µg/m3) in 3-year average concentrations of PM2.5 (mean difference [MD] -7.38; 95% CI, -8.35 to -6.41), black carbon (-7.91; -8.90 to -6.92), ammonium (-8.35; -9.37 to -7.34), nitrate (-8.73; -9.80 to -7.66), organic matter (-4.70; -5.77 to -3.64), and soil particles (-5.12; -6.10 to -4.15) were negatively associated with QUI. In addition, these associations were more pronounced in men, and people older than 65 years with a history of smoking and chronic alcohol consumption. CONCLUSION: We found that long-term exposure to PM2.5 and its components may lead to reduced bone strength, suggesting that PM2.5 and its components may potentially increase the risk of osteoporosis and even fracture. Nitrate may be responsible for increasing its risk to a greater extent.

Eating Spicy Food, Dietary Approaches to Stop Hypertension (DASH) Score, and Their Interaction on Incident Stroke in Southwestern Chinese Aged 30-79: A Prospective Cohort Study.

Little is known about the association between spicy food intake, dietary approaches to stop hypertension (DASH) score, and incident stroke. This study aimed to explore the association of eating spicy food, DASH score, and their interaction with stroke incidence. We included 22,160 Han residents aged 30-79 in southwest China from the China Multi-Ethnic Cohort. Three hundred and twelve cases were newly diagnosed with stroke by October 8, 2022, during a mean of 45.5 months of follow-up. Cox regression analyses showed that eating spicy food reduced stroke risk by 34% among people with low DASH scores (HR 0.66, 95%CI 0.45-0.97), while individuals with high DASH scores versus low DASH scores had a 46% lower stroke incidence among spicy food nonconsumers (HR 0.54, 95%CI 0.36-0.82). The HR of the multiplicative interactive term was 2.02 (95%CI 1.24-3.30) and the overall estimates of relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and the synergy index (S) were 0.54 (95%CI 0.24-0.83), 0.68 (95%CI 0.23-1.14), and 0.29 (95%CI 0.12-0.70), respectively. Consuming spicy food seems to be associated with lower stroke risk only in people who have a lower DASH score, while the beneficial effect of higher DASH scores seems to be found only among nonconsumers of spicy food, and a negative interaction may exist between them in southwestern Chinese aged 30-79. This study could provide scientific evidence for dietary guidance to reduce stroke risk.

Interaction of Harmful Alcohol Use and Tea Consumption on Hyperuricemia Among Han Residents Aged 30-79 in Chongqing, China.

Objective: The prevalence of hyperuricemia appears to be high worldwide. We aimed to explore the interaction between harmful alcohol use and tea consumption on hyperuricemia. Methods: This study recruited 22,449 Han residents based on the data from the China Multi-Ethnic Cohort (CMEC) study, Chongqing province, to have a face-to-face electronic questionnaire, physical examination, and clinical laboratory tests. The difference in hyperuricemia between the different populations was compared by the Chi-square test. The interaction between harmful alcohol use and tea consumption was analyzed by the multivariate logistic regression model. Results: Amongst 22,449 participants, the mean age was 51.5±11.8 years, and 46.83% of them were males. The proportion of harmful alcohol use, tea consumption, and harmful alcohol use and tea consumption were 14.01%, 21.01%, and 6.54%, respectively. Multivariate logistic regression showed that the odds ratio (OR) of harmful alcohol use and tea consumption (OR=2.21, 95% CI: 1.58-3.10) was greater than that of harmful alcohol use (OR=1.63, 95% CI:1.17-2.27) and tea consumption (OR=1.34, 95% CI:1.10-1.63). Among males, the results were similar (harmful alcohol use and tea consumption: OR=2.02, 95% CI: 1.43-2.84; harmful alcohol use: OR=1.61, 95% CI: 1.14-2.27; tea consumption: OR=1.28, 95% CI: 1.05-1.57). However, among females, the odds ratio of harmful alcohol use and tea consumption (OR=15.50, 95% CI: 1.36-176.50) was more than 10 times than that of only harmful alcohol use (OR=1.55, 95% CI: 0.42-5.69) or tea consumption (OR=1.22, 95% CI: 0.52-2.82). Conclusion: The interaction of harmful alcohol use and tea consumption was a positive risk for hyperuricemia in Han residents aged 30-79 years in China.

The association between tea consumption and blood pressure in the adult population in Southwest China.

OBJECTIVES: Prior research on the effect of tea consumption on blood pressure (BP) generated inconsistent findings. The objective of this study was to explore the effects of different types of tea consumption on BP. METHODS: We included 76,673 participants aged 30-79 from the baseline data of the China Multi-Ethnic Cohort (CMEC) study. Binary logistic regression was used to analyze the influences of different types of tea consumption on the risk of hypertensive BP. Moreover, multiple linear regression was used to examine the association between tea drinking and BP. RESULTS: Tea consumption was associated with a reduced risk of hypertensive BP by 10% (AOR: 0.90, 95%CI: 0.86-0.94). While dark tea was related to a 1.79-5.31 mmHg reduction in systolic blood pressure (SBP) and a 0.47-1.02 mmHg reduction in diastolic blood pressure (DBP), sweet tea, regardless of the duration, frequency, or amount of consumption, significantly was associated with a reduced SBP by 3.19-7.18 mmHg. Green tea also was associated with a reduced SBP by 1.21-2.98 mmHg. Although scented tea was related to reduced SBP by 1.26-2.48 mmHg, the greatest effect came from the long duration (> 40 years:ß=-2.17 mmHg, 95%CI=-3.47 mmHg --0.87 mmHg), low frequency (1-2 d/w: ß = -2.48 mmHg, 95%CI=-3.76 mmHg--1.20 mmHg), and low amount (≤ 2 g/d: ß=-2.21 mmHg, 95%CI=-3.01 mmHg--1.40 mmHg). Additionally, scented tea was correlated to a decrease in DBP at the frequency of 1-2 d/w (ß=-0.84 mmHg, 95%CI=-1.65 mmHg--0.02 mmHg). Drinking black tea only was associated with lowered SBP. The protective effect of black tea on SBP was characterized by the long-duration (> 15 years, -2.63--5.76 mmHg), high frequency (6-7 d/w, -2.43 mmHg), and medium amount (2.1-4.0 g/d, -3.06 mmHg). CONCLUSION: Tea consumption was associated with lower SBP and a reduced risk of hypertensive BP. The antihypertensive effect varies across types of tea consumed.

Association between Nocturnal Sleep Duration and Insomnia symptoms with depressive symptoms among 44,900 Chinese Han adults aged 30-79 in Southwest China.

BACKGROUND: Although there are several cross-sectional and prospective studies on the relationship between sleep duration /insomnia symptoms and depression symptoms, the results of these studies are still not conclusive, and few studies have further analyzed the association between sleep duration and depressive symptoms in adults by gender and age. Thus, this study aimed to investigate the relationship between nocturnal sleep duration and insomnia symptoms with depression symptoms, and further examine whether the association was impacted by age and gender in a large-scale Han Chinese population in southwest China. METHODS: A cross-sectional study was performed that included 44,900 participants from 18 districts in southwest China from September 2018 to January 2019. The study comprised 42,242 individuals in the final analysis. Depressive symptoms were investigated using the PHQ-2 questionnaires. Multivariate logistic regression analysis was performed to investigate the relationship between nocturnal sleep duration and insomnia symptoms with depression symptoms as well as the influence of age and gender. RESULTS: After adjusting for multiple variables, those with nocturnal sleep duration < 7 h had a higher odds ratio for depression (OR:1.47, 95%CI 1.31-1.65) compared to participants whose nocturnal sleep duration was in the range of 7-8 h. Notably, there is a higher association in those aged below 45 years (OR:1.91, 95%CI 1.52-2.41) and in female participants (OR:1.57, 95%CI 1.35-1.82). However, nocturnal sleep duration longer than 9 h was not associated with depression symptoms in either the whole population analysis or the subgroup analysis. Insomniacs had a higher odds ratio for depression(OR:1.87, 95%CI 1.84-2.36, respectively) compared to non-insomniacs. There is a higher association in those aged 45-60 years (OR:2.23, 95%CI 1.82-2.73) and in female participants (OR:2.17, 95%CI 1.84-2.56). Further subgroup analysis by age and gender at the same time showed the association between sleep deprivation and depression was highest among women aged below 45 years, while the association between insomnia and depression was the highest among men aged 45-59 years. CONCLUSION: Short nocturnal sleep duration and insomnia symptoms were positively associated with the risk of depressive symptoms among Chinese Han adults aged 30-79 in Southwest China, especially the middle-aged population and females should be more concerned.

Two a posteriori dietary patterns are associated with risks of hyperuricemia among adults in less-developed multiethnic regions in Southwest China.

Diet is a major determinant of hyperuricemia, but little is known about the association between diet and hyperuricemia in less-developed multiethnic regions (LMERs). This study aimed to assess the hypothesis that dietary patterns (including 2 a-priori and 3 a posteriori dietary patterns) are associated with hyperuricemia in LMERs. The 2 a priori dietary patterns were the Dietary Approaches to Stop Hypertension (DASH) and the alternative Mediterranean diet (aMED). We derived 3 a posteriori dietary patterns from the China Multi-Ethnic Cohort study by principal component factor analysis. Given that those dietary patterns had high geographic discrimination, they were named the Sichuan Basin (economically developed industrial region), Yunnan-Guizhou Plateau (agricultural region), and Qinghai-Tibet Plateau (nomadic region) dietary pattern, respectively. We performed a logistic regression model to investigate associations between dietary patterns and hyperuricemia with potential confounders identified by the directed acyclic graph. Comparing the highest with the lowest quintiles, the Sichuan Basin dietary pattern was positively associated with hyperuricemia, whereas the Yunnan-Guizhou Plateau dietary pattern showed an inverse association with hyperuricemia. For the Qinghai-Tibet Plateau dietary pattern, DASH, or aMED, our results did not show a significant association with hyperuricemia. The results were robust among stratified analyses and different analyzing strategies. The dietary patterns showed great diversity in Southwest China. Both DASH and aMED, which many studies widely recommended, did not show expected beneficial effects on preventing hyperuricemia. However, the plant-based protein dietary pattern in the Yunnan-Guizhou Plateau showed a beneficial association with the risk of hyperuricemia, which can provide insights for dietary guidance in LMERs.

Possible transmission of COVID-19 epidemic by a dog as a passive mechanical carrier of SARS-CoV-2, Chongqing, China, 2022.

An outbreak of coronavirus disease 2019 (COVID-19) was reported in Yongchuan district of Chongqing, China in March 2022, while the source was unknown. We aimed to investigate the origin and transmission route of the virus in the outbreak. We conducted field investigations for all cases and collected their epidemiological and clinical data. We performed gene sequencing and phylogenetic analysis for the cases, and draw the epidemic curve and the case relationship chart to analyze interactions and possible transmission mode of the outbreak. A total of 11 cases of COVID-19, including 5 patients and 6 asymptomatic cases were laboratory-confirmed in the outbreak. The branch of the virus was Omicron BA.2 which was introduced into Yongchuan district by a traveler in early March. Patient F and asymptomatic case G had never contact with other positive-infected individuals, but close contact with their pet dog that sniffed the discarded cigarette butts and stepped on the sputum of patient B. Laboratory test results showed that the dog hair and kennel were positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the 10 isolates were highly homologous to an epidemic strain in a province of China. The investigation suggested that the contaminated dog by SARS-CoV-2 can act as a passive mechanical carrier of the virus and might transmit the virus to humans through close contact. Our findings suggest that during the COVID-19 pandemic, increasing hygiene measures and hand washing after close contact with pets is essential to minimize the risk of community spread of the virus.

Investigation of two norovirus outbreaks linked to drinking water contaminated with multiple GII strains in a rural county-Chongqing, China, 2021.

Backgrounds: Norovirus is leading cause of non-bacterial gastroenteritis outbreaks globally, characterized by different strains prevalent in different countries and regions. Methods: Cases were defined as individuals experiencing diarrhea ≥3 times/24 h, and/or vomiting ≥2 times/24 h in two villages between January 28 and February 9, 2021. Investigations were conducted to identify causes. Cases were interviewed using a standardized in-person form to collect data on potential risk factors. A retrospective cohort study was conducted to investigate the role of the spring water supply as the outbreak source. Residents from neighboring villages with different water sources served as the unexposed population. Stool specimens, rectal swabs, and water samples were tested using quantitative real-time Polymerase Chain Reaction, with subsequent sequencing performed on pathogen-positive specimens. Results: Village-specific attack rates were 21.93% (123/561) and 26.99% (88/326), respectively. Evidence from both epidemiological and laboratory tests was consistent. Drinking spring water was statistically associated with the two outbreaks (RR = 41.8 and 79.2, respectively). In both outbreaks, stool specimens, rectal swabs, and water samples tested positive for norovirus. Specifically, GII.2 (P16) and GII.17 (P17) were identified in outbreak A, and GII.4 Sydney (P16) and GII.1 (P16) in outbreak B. Conclusion: These two independent gastroenteritis outbreaks share similarities, both being linked to norovirus GII strains. The contaminated spring drinking water was identified as the probable source and was promptly closed and subjected to disinfection procedures. These findings reinforce the importance of implementing sanitation and environmental disinfection measures in rural areas, especially during the periods of increased rainfall.

An Outbreak of SARS-CoV-2 Omicron Subvariant BA.2.76 in an Outdoor Park - Chongqing Municipality, China, August 2022.

What is already known about this topic?: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron subvariant has a stronger transmission capacity and faster transmission speed than the previous strain. What is added by this report?: The first coronavirus disease 2019 (COVID-19) case infected with the SARS-CoV-2 Omicron subvariant BA.2.76 who caused local transmission was reported in Chongqing Municipality on August 16, 2022. For 35 minutes, the Patient Zero jogged along a lake at a local park without wearing a mask. Among the 2,836 people potentially exposed at the time, 39 tested positive. Overall, 38 out of 39 cases did not wear a mask on the morning of August 16. All 39 cases lacked any previous exposure to the variant before testing positive on their nucleic acid test. What are the implications for public health practice?: It is essential to maintain personal wellbeing by ensuring one maintains personal protection and follows regulated guidelines such as maintaining safe distances from others both indoors and outdoors.

Effects of mobile APP for immunization on vaccination compliance of migrant children in southwest China: A community trial study.

With the advancement of the "internet plus" action plan in China, the electronic information system and the mobile phone applications (APPs) are widely used in the management of expanding national program of immunization (EPI). To estimate the use of childhood vaccination APP to improve migrants' vaccination knowledge, attitude and practice (KAP), a community trial toward migrant children was carried out in Chongqing, China. Migrant children were divided into two groups, one group was provided with health education and vaccination reminders in manual way and the other group was provided with online health education and vaccination reminders by mobile APP. After seven-month interventions, a total of 196 guardians of migrant children aged 2 months to 2 y participated in the questionnaire survey. There were significant differences between two groups in the awareness of vaccine policy, disposal of adverse reaction and attitude toward vaccination. Few significant differences in vaccination coverage of children ≤12 months between two groups, except 2ndbOPV and 2ndMenA. The timely vaccination rate of children >6 months in the APP group ranged from 37.5% to 68.2%, that was from 0% to 30.5% in the non-APP group (P < .05). Most migrant children above 6 months had vaccination within a month after due day in the APP group, while that was at least 3 months after due day in the non-APP group. The vaccination APP greatly improved migrants' KAP on vaccination. Continuous and systematic intervention by vaccination APP would play a more critical role in the vaccination behaviors of older migrant children.