Inequalities in changing mortality and life expectancy in Jiading District, Shanghai, 2002-2018.

BACKGROUND: Improvements of population health in China have been unevenly distributed among different sexes and regions. Mortality Registration System provides an opportunity for timely assessments of mortality trend and inequalities. METHODS: Causes of death were reclassified following the method of Global Burden of Disease Study (GBD). Age-standardized mortality rate (ASMR) and ring-map of the rate by town were used to describe inequalities in changing mortality. Life expectancy (LE) and cause-deleted LE were calculated on the basis of life table technique. RESULTS: The burden of death from 2002 to 2018 was dominated by cardiovascular diseases (CVD), neoplasms, chronic respiratory diseases and injuries in Jiading district, accounting for almost 80% of total deaths. The overall ASMR dropped from 407.6/100000 to 227.1/100000, and LE increased from 77.86 years to 82.31 years. Women lived about 3.0-3.5 years longer than men. Besides, a cluster of lower LE was found for CVD in the southeast corner and one cluster for neoplasms in the southern corner of the district. The largest individual contributor to increment in LE was neoplasms, ranged from 2.41 to 3.63 years for males, and from 1.60 to 2.36 years for females. CONCLUSIONS: Improvement in health was mainly attributed to the decline of deaths caused by CVD and neoplasms, but was distributed with sex and town. This study served as a reflection of health inequality, is conducive to formulate localized health policies and measures.

Influence of coarse particulate matter on chickenpox in Jiading District, Shanghai, 2009-2018: A distributed lag non-linear time series analysis.

Although the link between ambient air pollution and some infectious diseases has been studied, few studies have explored so far, the relationship between chickenpox and particulate matter. Daily chickenpox counts in Jiading District, Shanghai, were collected from 2009 to 2018. Time series analysis was conducted to describe the trends of the daily number of chickenpox cases and the concentration of particulate matter 10 µm or less (PM10). The distributed lag non-linear model (DLNM) was developed to assess the lag and non-linear relationship between the number of chickenpox cases and PM10 concentration adjusting for meteorological factors and other pollutants. Spatiotemporal scanning was used to detect the clustering of chickenpox cases. There was a concomitant relationship between the number of chickenpox cases and PM10 concentration, especially in the period of high PM10 concentration. DLNM results showed a nonlinear relationship between the number of chickenpox cases and PM10 concentration with the maximum effect of PM10 being lagged for 13-14 days, which was consistent with the average incubation period of chickenpox. PM10 was significantly associated with the daily number of chickenpox cases when above 300 µg/m3. The risk of chickenpox increased with increasing PM10 concentration and the association was strongest at the lag of 14 day (RR = 1.13, 95% CI: 1.04-1.23) for PM10 concentration of 500 µg/m3 versus 50 µg/m3. The study provides evidence that high PM10 concentration increases the risk of chickenpox spreading.

[Practice and correlates of partner notification of HIV infection status among 307 HIV-infected individuals of Shanghai].

OBJECTIVE: To investigate the situation of notification and HIV antibody testing of sexual partners of people who lived with HIV, and to analyze the factors which could influence the rate of sexual partner notification of Shanghai. METHODS: HIV-positive people were recruited from Jiading, Jinan and Xuhui District in Shanghai, all of them were diagnosed with HIV from July 1, 1998 to July 30, 2014, and all of them were ≥ 16 years old, ruled out poor compliance, unwillingness to cooperate, mental disorders, deaf and other factors that could not properly answer questions. Face to face questionnaires were used to collect demographics, HIV related knowledge, testing of HIV, status of sexual partners before they have been diagnosed with HIV, notification of sexual partners. These questionnaires were self-designed. The differences of notification situation and the HIV-positive rate among different sexual partners were compared by chi-square tests. The factors which would influence the rate of sexual partner notification were analyzed by logistic regression, and the OR (95% CI) value was calculated. RESULTS: A total of 307 people living with HIV were surveyed, of these 276 (89.9%) were males and 31 (10.1%) were females. The rates of different sexual partner been notified from spouses, homosexual regular partners, heterosexual regular partners, heterosexual no-regular no-commercial partners, homosexual no-regular no-commercial partners to commercial sexual partners were 68.2% (105/154), 44.7% (119/266), 21.4% (22/103), 5.8% (3/52), 5.5% (43/787), and 0.4% (1/235) (χ(2) = 5.22, P < 0.001). Among these been notified sexual partners 277 of them have had HIV antibody tested, 90 persons was HIV-positive, the rate was 32.5%. Confirmed time (OR: 0.37, 95% CI: 0.16-0.86), whether inform staff allowed the HIV-positive people mobilize their sexual partners have HIV-antibody test (OR: 9.63, 95% CI: 3.77-24.55), whether someone else was present during notification (OR: 5.57, 95% CI: 1.96-15.78) and relationship stability (OR: 28.55, 95% CI: 7.93-102.75; OR: 14.13, 95% CI: 4.87-41.02) were associated with HIV-positive people disclosing their infected status to their sexual partners. CONCLUSIONS: The rate of notification to these partners was low, but the HIV antibody positive rate was high among the sexual partners in the three research districts of Shanghai. Shorter confirmed time, inform staff didn't allow the HIV-positive people mobilize their partners have HIV-antibody test, no other was present during people was told they were HIV-positive, and no fixed sexual relationship, all these could make lower rate of sexual partners to be notified.

Geographical Variation of COPD Mortality and Related Risk Factors in Jiading District, Shanghai.

Background: Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in China. Although numerous studies have been conducted to determine the risk factors for COPD mortality such as ambient air pollution, the results are not fully consistent. Methods: This study included mortality analysis and a case-control design by using the data extracted from the Mortality Registration System in Jiading District, Shanghai. Traditional logistic regression, geographically weighted logistic regression (GWLR), and spatial scan statistical analysis were performed to explore the geographic variation of COPD mortality and the possible influencing factors. Results: Traditional logistic regression showed that extreme lower temperature in the month prior to death, shorter distance to highway, lower GDP level were associated with increased COPD mortality. GWRL model further demonstrated obvious geographical discrepancies for the above associations. We additionally identified a significant cluster of low COPD mortality (OR = 0.36, P = 0.002) in the southwest region of Jiading District with a radius of 3.55 km by using the Bernoulli model. The geographical variation in age-standardized mortality rate for COPD in Jiading District was explained to a certain degree by these factors. Conclusion: The risk of COPD mortality in Jiading District showed obvious geographical variation, which were partially explained by the geographical variations in effects of the extreme low temperature in the month prior to death, residential proximity to highway, and GDP level.

[Survival and growth of Vibrio cholerae O139 inside Acanthamoeba].

OBJECTIVE: To study the survival and growth of Vibrio cholerae inside the Acanthamoeba polyphage. METHODS: Survival and growth of Vibro cholerae O139, co-cultured with Acanthamoeba polyphaga, was observed inside the trophozoites and cysts, using Gram stain and electron microscope. RESULTS: Viable O139 was observed inside the amoebal vacuoles in 24 hours. Vacuoles were filled with more bacteria along with the longer period of co-culture. The process of O139 infection with Amoebae would include uptake, formation of O139 vacuole, multiplication, trophozoites lysed and expel under electron microscopy. Some infected trophozoites could subsequently encyst and the surviving O139 could locate in the vesicles inside the cysts. CONCLUSION: O139 might survive and multiply in the trophozoites and reside inside the cysts of Amoebae, suggesting that Acanthamoebae might serve as one of the environmental hosts of Vibro cholerae.