Meteorological factors and its association with hand, foot and mouth disease in Southeast and East Asia areas: a meta-analysis.

Since the late 1990s, hand, foot and mouth disease (HFMD) has become a common health problem that mostly affects children and infants in Southeast and East Asia. Global climate change is considered to be one of the major risk factors for HFMD. This study aimed to assess the correlation between meteorological factors and HFMD in the Asia-Pacific region. PubMed, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang Data and Weipu Database were searched to identify relevant articles published before May 2018. Data were collected and analysed using R software. We searched 2397 articles and identified 51 eligible papers in this study. The present study included eight meteorological factors; mean temperature, mean highest temperature, mean lowest temperature, rainfall, relative humidity and hours of sunshine were positively correlated with HFMD, with correlation coefficients (CORs) of 0.52 (95% confidence interval (CI) 0.42-0.60), 0.43 (95% CI 0.23-0.59), 0.43 (95% CI 0.23-0.60), 0.27 (95% CI 0.19-0.35), 0.19 (95% CI 0.02-0.35) and 0.19 (95% CI 0.11-0.27), respectively. There were sufficient data to support a negative correlation between mean pressure and HFMD (COR = -0.51, 95% CI -0.63 to -0.36). There was no notable correlation with wind speed (COR = 0.10, 95% CI -0.03 to 0.23). Our findings suggest that meteorological factors affect the incidence of HFMD to a certain extent.

The relationship between health literacy and quality of life: a systematic review and meta-analysis.

BACKGROUND: Low health literacy often has an association with poor health outcomes such as low levels of self-efficacy, increased mortality, poor health status and reduced quality of life (QOL). The aim of the study was to quantitatively evaluate the relationship between health literacy (HL) and QOL based on a systematic review and meta-analysis. METHODS: EMBASE, PubMed, Web of Science, Elsevier, Cochrane Library, and Chinese electronic databases such as CNKI, and Wanfang were searched from 1970 until February 1, 2018. The pooled correlation coefficient (PCOR) and its 95% confidence interval (CI) between HL and QOL were estimated using R software. Potential sources of heterogeneity were explored using subgroup analysis, sensitivity analysis, and meta-regression. RESULTS: Twenty-three studies, with a total of 12,303 subjects,were included. The PCOR between HL and QOL was 0.35 (95%CI: 0.25-0.44). Considering different dimensions of HL, the PCOR between QOL and health knowledge, health behavior, health belief, and health skill were 0.36 (95% CI: 0.04-0.61), 0.36 (95%CI: 0.13-0.55), 0.39 (95%CI: 0.10-0.62), and 0.42 (95%CI: 0.03-0.69), respectively. The PCOR between HL and the two dimensions of QOL was lower than the total PCOR between HL and QOL. In subgroup analysis, the PCOR between HL and QOL was 0.46 (95%CI: 0.13, 0.69) among community residents, 0.45 (95%CI: 0.27, 0.61) in China, and 0.45 (95%CI: 0.24, 0.62) based on cohort studies. Sensitivity analyses showed that the stability of results had no significant after excluding the study (p < 0.001). Meta-regression showed that cohort study design, studies conducted in China, and publication before 2012 may be important influencing factors. CONCLUSIONS: Health literacy was moderately correlated with quality of life, but this finding needs to be supported by more evidence.

Disease burden in patients with severe hand, foot, and mouth disease in Jiangsu Province: a cross-sectional study.

This study aimed to estimate the disease burden and health-related quality of life (HRQOL) among patients with severe hand, foot, and mouth disease (HFMD) in Jiangsu Province, China. We analyzed the surveillance data of HFMD cases in Jiangsu Province from 2009 to 2020. Moreover, a cross-sectional study was conducted in Nanjing and Suzhou, China, between January 2017 and May 2018. Patients with severe HFMD and their parents were recruited from selected hospitals. Questionnaires and hospital management systems were used to collect data on direct economic burden. The HRQOL of children was assessed using the TNO-AZL Preschool Quality of Life (TAPQOL) scale. A total of 1,348,737 confirmed cases of HFMD were reported to the NNDRS in Jiangsu province during 2009-2020. Of these, 9,622 were severe cases, with 62 (.64%) of these being fatal. From January 2017 to May 2018, data was collected from 362 severe HFMD cases using a structured questionnaire. The median per capita direct economic burden was RMB 16142.88, and was associated with the region and length of hospital stay (P < .05). The direct economic burden for all cases of severe HFMD in Jiangsu province between 2017 and 2018 was approximately RMB 16.64 million. Finally, the median (IQR) of the TAPQOL scale for children with severe HFMD was 69.23 (56.20, 82.27). Severe HFMD infection is a relatively large burden for individuals, and the burden of EV-A71 infection was seen to be even greater for the population. Prevention of severe HFMD should strengthen hygiene habits and targeted measures for EV-A71 vaccination.

Disease burden concerning hepatitis E-infected inpatients in Jiangsu province, China.

OBJECTIVE: This study aimed to determine the disease burden of hepatitis E virus (HEV)-infected inpatients in Jiangsu province, China. METHODS: Between July 1, 2016 and October 31, 2018, 1152 HEV-infected inpatients were identified from four cities in Jiangsu province, namely, Nanjing, Suzhou, Yancheng, and Zhenjiang. The disease burden comprised the economic burden and loss of health due to HEV infection. Factors influencing the disease burden were analyzed using univariate and multivariate analyses. RESULTS: The average direct, indirect, and total economic burden for 1152 HEV-infected inpatients was US$ 4,986.40, US$ 1,507.28, and US$ 6,493.68, respectively, accounting for 46.66%, 14.11%, and 60.77% of per capita disposable income (PCDI) in Jiangsu province, respectively. The disease burden for HEV-infected inpatients with hepatitis B was significantly higher than that for other inpatients. The average EQ-5D utility value of 1152 HEV-infected inpatients was 0.72 ±â€¯0.18 quality-adjusted life years (QALYs) and the average EQ-visual analogue score (EQ-VAS) was 0.66 ±â€¯0.17 points. Multivariate analysis showed that the direct economic burden and the total economic burden were influenced by variables such as hospitalization days, outcomes, past history of other diseases, and regions (P < 0.05). It was estimated the direct economic burden, the indirect economic burden, and the total economic burden for all HEV-infected inpatients in Jiangsu province in 2018 was approximately US$ 9.2 million, US$ 2.8 million and US$ 12.0 million, respectively. CONCLUSION: The disease burden of HEV infection in Jiangsu province is severe, and more attention should be paid to the prevention of hepatitis E and the treatment of comorbidities.

Prevalence of hepatitis E virus infection among people and swine in mainland China: A systematic review and meta-analysis.

Hepatitis E virus (HEV) infection remains an important public health problem, and it is endemic primarily in developing countries. This study aimed to evaluate the seroprevalence of HEV among the general population, occupational population and swine in mainland China and its risk factors based on a systematic review and meta-analysis. Systematic search from EMBASE, PubMed, Web of Science, Cochrane Library and several Chinese databases, such as Wanfang (WF) Data, China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP) and SINOMED, was searched from inception up to 25 April 2018. The overall seroprevalence of HEV and its corresponding 95% confidence interval (CI) as well as the correlation coefficients between different groups were estimated using stata 12.0 and r-3.4.1 software. Potential sources of heterogeneity were explored using subgroup and sensitivity analyses. Twenty-eight studies with 57,274 participants (including human and swine) were included. The seroprevalence of anti-HEV immunoglobulin G (IgG) among the general population, occupational population and swine was 27.3% (95% CI: 22.4-32.2), 47.4% (95% CI: 40.1-54.8) and 66.4% (95% CI: 61.7-71.1), respectively. The overall prevalence of IgM among the general population was 1.8% (95% CI: 0.7-2.9). The odds ratio for the occupational population, as compared to the general population, was 2.63. The highest anti-HEV IgG prevalence (59%) was observed in East China, whereas the lowest (34.8%) was noted in Northeast and North China. In the occupational population, the highest prevalence (77.0%) was observed among swine vendors. Seven studies included 30,392 participants (humans and swine); the correlation coefficient for the prevalence of anti-HEV IgG between the professional population and adult pigs was 0.88. Sensitivity analyses showed that the stability of results was not considered significant. This research found that HEV is common in China, and contact with pork or other pig products may be an important mode of HEV transmission.

Influenza vaccination coverage of population and the factors influencing influenza vaccination in mainland China: A meta-analysis.

INTRODUCTION: The best way to prevent influenza is receiving vaccination. However, the influenza vaccination coverage in mainland China was low. A meta-analysis was conducted to estimate the vaccination rates of the population and the factors influencing influenza vaccination in mainland China. METHODS: A systematic study was conducted on March 18, 2018, using Chinese language databases including China National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, WanFang Database, and English language databases including PubMed, Web of Science, and Cochrane Library. Based on the inclusion and exclusion criteria, the pooled coverage rate and estimated odds ratios (OR) of influencing factors were obtained using data abstraction. Subgroup analysis and meta-regression analysis were also employed to explore the heterogeneity. RESULTS: The pooled vaccination coverage rate in 126 included articles was 23.2% (95% confidence interval (CI): 22.8%, 23.7%), and the pooled vaccination rate among the general population was 9.4% (95% CI: 8.0%, 10.9%). The influenza vaccination rate fluctuated from 2005 to 2017. Vaccination rates in 2009-2010 were much higher than other years, pandemic influenza vaccination rate was 37.3% (95% CI: 28.4%, 46.1%) and seasonal influenza vaccination rate was 29.8% (95% CI: 24.6%, 34.9%). In the analysis of influencing factors, those recommended by healthcare workers was the most reported reasons for influenza vaccination with an OR = 5.2 (95% CI: 2.9, 9.4), and following as received influenza vaccination previously, perceived safety of vaccination, perceived effectiveness of vaccination, perceived severity of the disease. Meta-regression analysis indicate that the heterogeneity maybe significantly consistent with the sample size, study population, study region, and vaccination policy. CONCLUSION: Compared with other countries (the United States), vaccination rates were lower in mainland China. There were a few factors influencing the rate, which included vaccination policy, vaccination history and knowledge and attitudes toward influenza and vaccination.