Real-world national trends and socio-economic factors preference of sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists in China.

Backgrounds: Robust evidence have demonstrated the beneficial effect of Sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) in T2D patients with cardiovascular diseases and chronic kidney disease. Multiple studies analyzed patterns and predictors of SGLT2i and GLP-1RA in the US, Europe and worldwide. However, there is no study about the utilization of these two classes of drugs in real-world in China. Method: A total of 181743 prescriptions of SGLT2i and 59720 GLP-1RA were retrospectively pooled from Hospital Prescription Analysis Cooperation Project from 2018 to 2021. The social-economic characteristics of patients and prescribers, including age, gender, residency, hospital level, insurance type, department visited, and payment amount, were collected and analyzed to study trends and risk factors associated with preference among two antidiabetics. Results: Annual number of prescriptions of SGLT2i significantly increased to approximately 140 folds, while GLP-1RA increased to about 6.5 folds. After adjustment for socio-economic information, several patients or physician characteristics were positively associated with the preference of GLP-1RA, including female gender (OR 1.581, 95% CI 1.528-1.635), residents in second-tier cities (OR 1.194, 95% CI 1.148-1.142), visiting primary or secondary hospital level (OR 2.387, 95% CI 2.268-2.512); while other factors were associated with the preference of SGLT2i, including older adults (OR 0.713, 95% CI 0.688-0.739), uncovered by insurance (OR 0.310, 95% CI 0.293-0.329), visiting other departments compared with endocrinology. In addition, the share of SGLT2i and GLP-1RA was low but in an increasing tendency. Conclusions: SGLT2i and GLP-1RA prescription significantly increased from 2018 to 2021. The socio-economic risk factors in choosing SGLT2i or GLP-1RA highlight an effort required to reduce disparities and improve health outcomes.

[Assessment of ability of professionals in parasitic disease control and prevention techniques in China, 2017].

OBJECTIVE: To understand the professional theory, prevention and control practice, experimental diagnosis and other technical skills of parasitic diseases among technicians of all levels of disease control and prevention institutions, so as to provide the evidence for strengthening the capacity building of Chinese professional personnel. METHODS: According to the method of recommendation at all levels, the subjects from disease control and prevention institutions at province, prefecture or county levels were chosen to assess the theory of parasitic diseases and test operation skills by using the method of answering the questions together with on-site operations in China. A database was built consisting of subjects' basic information and assessment scores. By using the method of hierarchical classification, the scores by gender, age, professional title, institutions and places of participants were analyzed. RESULTS: A total of 124 professions in prevention and treatment of parasitic diseases in 31 provinces (cities and regions) were evaluated in China. The average total score of all the subjects was 125.0 ± 35.2, with a passing rate of 54.8%. The average scores of male subjects and female subjects were 120.8 ± 34.2 and 126.6 ± 35.4 respectively; the average scores of the subjects aged under 30 years, between 30 and 40 years, and above 40 years were 125.6 ± 33.6, 124.9 ± 35.8, and 119.3 ± 45.9 respectively; the average scores of persons with junior, intermediate and senior professional titles were 119.8 ± 35.8, 136.0 ± 32.5 and 127.1 ± 40.9 respectively. The average theoretical assessment score of all the subjects was 67.4 ± 15.6, with a passing rate of 68.5%. The average practical skill assessment score of all the subjects was 57.6 ± 21.8, with a passing rate of 46.0%. The average detection rates of Plasmodium falciparum, P. vivax, P. ovale and P. malariae in endemic and non-endemic areas were 64.1%, 72.8%, 57.0%, 58.3% and 35.9%, 46.9%, 33.3%, 43.8%, respectively. The detection ability of professionals in endemic areas was significantly higher than that in non-endemic areas (χ2 = 767.10, 462.12, 134.97 and 360.80, respectively, all P < 0.01). The total detection rate of schistosome eggs was 48.7%, and the detection rates of schistosome eggs were 67.4% and 36.8% in endemic and non-endemic areas, respectively. The detection ability of professionals in endemic areas was significantly higher than that in non-endemic areas (χ2 = 817.74, P < 0.01). The detection rates of Ascaris lumbricoides, Trichuris trichiura, and Enterobius vermicularis were 85.7%, 78.6%, 91.7%, and 61.8%, 23.5% and 74.4% in the technicians in southern region and northern region of China, showing significant differences (χ2 = 622.58, 301.70 and 588.71, respectively, all P < 0.01). CONCLUSIONS: The overall results of the subjects are good, but the technical operation capability of them is relatively low. Therefore, the specific training based on daily work needs should be enhanced. In addition, we should attach importance to talent cultivation and technical reserve, and strengthen the construction of the team, so as to meet the needs of the prevention and control of parasitic diseases.

[Transmission risk matrix assessment of imported leishmaniasis in China].

OBJECTIVE: To assess the risk of imported leishmaniasis in China, offering scientific evidences for leishmaniasis prevention and control. METHODS: The expert consultation method was used to establish a risk index system, and the risk matrix was used to evaluate the risk scales of leishmaniasis. RESULTS: This risk assessment indicator system included 3 first-grade indexes and 13 second-grade indexes to the aspect of risk probability. Five indexes were also included on the aspect of the risk hazard severity in this system. The transmission risk matrix assessment showed that the risk of imported leishmaniasis transmission in China was in low risk level. CONCLUSIONS: This risk matrix assessment is applied for the transmission of imported leishmaniasis in China in the first time, indicating the potential risk of imported leishmaniasis in China.

[Challenge and strategy of prevention and control of important parasitic diseases under the Belt and Road Initiative].

China was once a country with the heaviest burden of parasitic diseases. Under the leadership of the Communist Party and national authority, after more than 60 years' efforts of prevention and control, the remarkable results have been achieved in China. However, affected by the social and economic development and environmental changes, the prevention and control of parasitic diseases, especially imported parasitic diseases, are facing new challenges, and the parasitic diseases, such as malaria, schistosomiasis, leishmaniasis, filariasis and trypanosomiasis, appear increasingly. With the development of the Belt and Road Initiative, the transmission risks of these diseases are more increased. The purpose of this paper is to describe the experience and results of parasitic disease prevention and control in China, understand the present parasitic disease epidemic situation of the Belt and Road Initiative related countries, analyze the transmission risks of important parasitic diseases, and present some relevant suggestions, so as to provide the evidence for the health administrative department formulating the prevention and control strategies of such parasitic diseases timely and effectively.

[Analysis of results of Assessment on National Parasitic Disease Control and Prevention Techniques in 2015].

OBJECTIVE: To assess the theoretical knowledge and practical skills of parasitic diseases among technicians from disease control and prevention institutions. METHODS: The Assessment on National Parasitic Disease Control and Prevention Techniques was organized in September, 2015. Together, 124 subjects from disease control and prevention institutions at province, prefecture or county levels in 31 provinces joined the assessment. A database was built consisting of subjects' basic information and assessment scores. Statistical analysis was used to analyze the scores by gender, age, professional title, institutions and places of participants. RESULTS: The average total score of all the subjects was 123.3, with a passing rate of 57.3%. The average scores of male subjects (48 subjects) and female subjects (76 subjects) were 125.9 and 121.7 respectively; the average scores of the subjects aged under 30 years (57 subjects), between 30 and 40 years (61 subjects) and above 40 years (6 subjects) were 119.6, 128.1 and 111.2 respectively; the average scores of persons with junior (94 subjects), intermediate (28 subjects) and senior (2 subjects) professional titles were 119.2, 135.9 and 140.5 respectively. The average theoretical assessment score of all the subjects was 61.9, with a passing rate of 62.9%. The average practical skill assessment score of all the subjects was 61.4, with a passing rate of 58.1%. CONCLUSIONS: The theoretical assessment results range widely. The theoretical knowledge results of technicians from disease control and prevention institutions are low in general. Therefore, the specific training based on daily work needs to be enhanced.

[Evaluation on human resource allocation in certain national institute of parasitic diseases in ten years].

OBJECTIVE: To evaluate the human resource in a national institute of parasitic diseases from 2007 to 2016, so as to provide a reference for the construction of a well-crafted human resource of national parasitic diseases control and prevention. METHODS: The basic information of the staff in the national institute of parasitic diseases was investigated and a related database was established to analyze the quantity and structure of the human resource allocation in 10 years through the annual statistics each year. RESULTS: The number of staff in the institute increased by 6.25% in 2016 compared with that in 2007, and 43.32% of the staff were under 35 years old. In 2016, 59.36% of the staff had a master degree or a higher level degree, and 37.97% of the staff had senior technical titles. The difference value of the inflows and outflows was 3.21%. CONCLUSIONS: The change of the structure and quality of human resource in this institute has a good tendency in the past ten years. The organization should optimize the human resource allocation and improve its capacity in disease control and prevention to broaden the methods of talent introduction and control the brain drain problem.

[GIS Spatial Distribution and Ecological Risk Assessment of Heavy Metals in Surface Sediments of Shallow Lakes in Jiangsu Province].

To understand pollution of heavy metals in surface sediments of shallow lakes, surface sediments samples of 11 lakes in Jiangsu province were collected to determine the content of six heavy metals including As, Cr, Cu, Pb, Zn and Ni. GIS was used to analyze the spatial distribution of heavy metals, and geological accumulation index (Igeo), modified contamination index (mCd) pollution load index (PLI) and potential ecological risk index (RI) were used to evaluate heavy metal contamination in the sediments. The results showed that: in the lakes' surface sediments, the average content of As, Cu, Zn, Cr, Pb, Ni in multiples of soil background of Jiangsu province were 1.74-3.85, 0.65-2.66, 0.48-3.56, 0.43-1.52, 0.02-1.49 and 0.12-1.42. According to the evaluation results of Igeo and RI, As, which had high degree of enrichment and great potential ecological risk, was the main pollutant, followed by Cu, and pollution of the rest of heavy metals was relatively light. Combining the results of several evaluation methods, in surface sediments of Sanjiu Lake, Gaoyou Lake and Shaobo Lake, these heavy metals had the most serious pollution, the maximum pollution loading and moderate potential ecological risk; in surface sediments of Gehu Lake, Baima Lake and Hongze Lake, some regions were polluted by certain metals, the overall trend of pollution was aggravating, the pollution loading was large, and the potential ecological risk reached moderate; in the other 5 lakes, the risk of sediments polluted by heavy metals, as well as the pollution loading, was small, and the overall was not polluted.