Cost-of-illness of gastroenteritis caused by rotavirus in Chinese children less than 5 years.

Acute gastroenteritis (AGE) caused by rotavirus (RV) remains a public health issue in China. To accelerate the mass rotavirus vaccination, it is important to inform the policy maker, and the public of the economic burden caused by rotavirus infection. A meta-analysis was conducted applying standardized algorithms. Articles published before January 1, 2023, in English and Chinese were searched through PubMed, CNKI, and WanFang Data. Studies with cost analysis of RV AGE were included. A random-effects model was applied to synthesize the total cost of RV AGE from the societal perspective. A prospective survey aimed to measure the cost of RV AGE was conducted in 2021 and 2022 in Shaoxing city, Zhejiang province, that can represent the developed region. The cost data was applied as deviation indicator, in comparison with the pooled estimate generated from meta-analysis. Totally 286 articles were identified, and eventually 12 studies were included. The pooled total social cost of RV AGE was US$282.1 (95%CI: US$213.4-350.7). The pooled private cost of RV AGE was US$206.4 (95%CI: US$155.2-257.5). RV AGE hospitalized and RV AGE incurred in developed regions caused remarkable higher burden (US$631.2 [95%CI: US$512.6-749.8], and US$333.6 [95%CI: US$234.1-433.2] respectively), compared to RV AGE treated at outpatient, and incurred in less developed regions. Our study demonstrates that RV AGE causes a significant economic burden in China. Given the promising effectiveness and highly cost-effective, introduction of rotavirus vaccines in national immunization programs could substantially reduce the economic burden in China.

Burden of acute gastroenteritis caused by norovirus in China: A systematic review.

BACKGROUND: To understand the epidemiology and disease burden of norovirus (NoVs) gastroenteritis in China, a systematic review was conducted. METHODS: Studies on acute gastroenteritis (AGE) caused by NoVs from mainland China, published before 2017 were searched. All retrieved articles were screened and reviewed by a standardized algorithm. NoVs detection rates as well as strain variations by ages, seasonal variations and geographic locations were analyzed using random-effects model. RESULTS: A total of 225 articles were included in the final analysis. Similar detection rates at 21.0% and 19.8% were obtained from the North and the South, respectively. NoVs infection occurred year round, with a peak between October and January in the North and between August and November in the South. High detection rates (∼29%) of NoVs were found in adults and the elderly and in children aged 6-35 months (∼22%). The predominant strains were GII.4 (70.4%), followed by GII.3 (13.5%). CONCLUSION: NoVs cause significant disease burden in China which warrants development of vaccines against NoVs, particularly for children and the elderly who are vulnerable to gastroenteritis diseases. To achieve a broad protection, continual monitoring NoV epidemics and strain variations for selection of proper vaccine strains is critical.

Assessment of the Cadmium Exposure in the Blood, Diet, and Water of the Pumi People in Yunnan, China.

Cadmium (Cd) is considered as one of the most toxic and carcinogenic heavy metals. Accumulation of Cd in the human body can cause multiorgan dysfunction. Long-term irrational mining activities have led to serious Cd pollution in soil, water, and even agricultural products. Therefore, evaluating the Cd exposure levels of people living in mining areas is of great importance. In the current study, we chose the Pumi people who lived in Jinding and Tongdian towns of Lanping county in Yunnan province, China, to do the on-site nutritional epidemiology investigation and laboratory detection. We analyzed the content of the Cd in peripheral blood and mixed dietary, as well as water samples in the Pumi residents of the two towns. Results showed that the blood Cd levels of people in Jinding town, which is nearer the mining district, were statistically significantly higher than those in Tongdian town. The P 50 of blood Cd level of the two towns was 0.64 ng/mL. In addition, the P 50 of the mixed diet of the two towns was 8.32 µg/kg. There was a weak correlation between blood Cd levels and Cd exposure in the mixed diet, PTDI, and PTWI of the Pumi people. In addition, higher concentrations of Cd were observed in the water of Jinding town, indicating people in Jinding town risking more Cd exposure. These results indicated that diet and water are critical factors of Cd exposure for the residents and the nearer people living to mining district risking the more Cd exposure.

Assessment of the iodine status of the Wa national boarding school students in Southwest China.

Iodine deficiency disorder (IDD) has been recognized as a major public health problem worldwide and has serious detrimental effects on the growth and development of the children. Therefore, monitoring the iodine status of the school-aged children is of great importance. We randomly recruited 159 boarding school students (aged from 6 to 14) from 10 primary schools in Lincang County, Yunnan Province. The dietary iodine level of the students was measured by the new mixed meal method and chemical analysis. Fifty-seven daily water samples and 32 salt samples were collected from the same surveyed area to determine the iodine content using the sulfate cerium catalytic spectrophotometric method and the hyposulphite quantitative titration method, respectively. The iodine level of each water sample was ranged from 0.611 to 1.473 µg/L. The median and the mean value of the iodine content in water were 0.972 and 0.979 ± 0.189 µg/L. The average iodine intake of each age group was higher that the recommended nutrient intakes (RNI) but lower than the tolerable upper intake level (UL). The median and the mean value of the iodine content in salt were 25.53 and 25.62 ± 1.70 mg/kg. Taken together, the present study investigated the iodine intake status of Wa school-aged children through examination of their dietary iodine intake, the environment, and the salt iodine status. Results showed that the status of the iodine uptake of the Wa children were higher than the RNI, but lower than the UL.