The burden of skin diseases in China: global burden of Disease Study 2019.

Skin diseases continue to affect human health and cause a significant disease burden on the healthcare system.We aimed to report the changing trends in the burden of skin disease in China from 1990 to 2019, Which has an important role in developing targeted prevention strategies. We applied Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2019 analytical tools to calculate the age-standardized Prevalence and Incidence in 2019, number of years lived with disability (YLDs) and age-standardized YLDs from 1990 to 2019 of skin and subcutaneous diseases, notifiable infectious skin diseases and skin tumors in China. Among the skin and subcutaneous diseases in China in 2019, dermatitis contributed to the greatest YLD (2.17 million, 95% uncertainty interval[UI]: 1.28-3.36). Age-standardized YLD rates for leprosy decreased from 0.09 (95%UI: 0.06-0.13) in 1990 to 0.04 (95%UI: 0.03-0.06) in 2019; the proportional decrease was 55.56% over 30 years. Age-standardized YLDs for HIV and sexually transmitted infections increased by 26% during the same time period. Age-standardized YLDs for non-melanoma skin cancer increased at a much higher rate than melanoma between 1990 and 2019. Dermatitis and scabies continue to have an important role in the burden of skin and subcutaneous disease burden in China. The burden of non-melanoma cell cancer has increased most significantly over the past three decades.

Prevalence, risk factors, and medical costs of Chlamydia trachomatis infections in Shandong Province, China: a population-based, cross-sectional study.

BACKGROUND: A population-based study of Chlamydia trachomatis (CT) infections is essential in designing a specific control program; however, no large investigation of CT infections among the general population in mainland China has been conducted since 2000. We aimed to determine the prevalence, risk factors, and associated medical costs of CT among residents, 18-49 years of age, in Shandong, China. METHODS: From May to August 2016, a multistage probability sampling survey involving 8074 individuals was distributed. Data were collected via face-to-face interviews, followed by self-administered questionnaire surveys. First-void urines were collected and tested for CT and Neisseria gonorrhoeae (NG) using nucleic acid amplification. RESULTS: The weighted prevalence of CT infection was 2.3% (95% confidence interval [CI], 1.5-3.2) in females and 2.7% (1.6-3.8) in males. Women, 30-34 years of age, had the highest prevalence of CT infections (3.5%, 2.6-4.4), while the highest prevalence of CT infections in males was in those 18-24 years of age (4.3%, 0.0-8.8). Neisseria gonorrhoeae infection had a prevalence of 0.1% (0.0-0.3) in women and 0.03% (0.0-0.1) in men. Risk factors for CT infections among females included being unmarried, divorced, or widowed (odds ratio [OR], 95% CI 3.57, 1.54-8.24) and having two or more lifetime sex partners (3.72, 1.14-12.16). Among males, first intercourse before 20 years of age (1.83, 1.10-3.02) and having two or more lifetime sex partners (1.85, 1.14-3.02) were associated with CT infections. The estimated lifetime cost of CT infections in patients 18-49 years of age in Shandong was 273 million (range, 172-374 million) China Renminbi in 2016. CONCLUSIONS: This study demonstrated a high burden of CT infections among females < 35 years of age and males < 25 years of age in Shandong. Thus, a CT infection control program should focus on this population, as well as others with identified risk factors.

Healthcare seeking behaviour and delay in diagnosis of leprosy in a low endemic area of China.

Delay in diagnosis of leprosy can increase the risk of nerve function impairments and promote the transmission of the infection in a community. In order to understand the factors associated with the delays in diagnosis of leprosy, a questionnaire-based interview was conducted to collect information on the delays among 88 newly diagnosed leprosy patients. The results showed that delay was common and associated with the high rate of disability in the study population. The total mean delay was 50.18 months (median 36 months). The mean patient delay was 24-4 months (median 9.5 months) and the mean health service delay was 257 months (median 12 months). Patients with leprosy reported a variety of symptoms/signs at an early stage of the disease, particularly numbness and tingling. Ignorance of the illness was reported to be the main reason for the patient's delay. Health seeking actions ranged from 1 to 50 with a mean of 7.2 after becoming aware of the first symptom/sign. The effectiveness of early diagnosis of leprosy through health promotion in the population needs to be validated and continuous training on leprosy among healthcare providers is needed.