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Objective:To learn about the current situation of prevention and control of coal-burning-borne endemic fluorosis (coal burning fluorosis for short) in Yunnan Province, and comprehensively evaluate the implementation effect of prevention and control measures.Methods:From August to November 2020, according to the requirements of the Monitoring Program of Yunnan Province for Coal-burning-borne Endemic Fluorosis (2019 edition), monitoring was carried out in all natural villages in the disease areas of 13 counties (cities and districts, hereinafter referred to as counties) of the province, and 30 households were selected from each natural village to monitor the use of stoves and the formation of related healthy living behaviors. At the same time, children aged 8 - 12 years in the natural villages in the disease areas were examined for the prevalence of dental fluorosis. The evaluation for control and elimination of disease areas was carried out in accordance with the Evaluation Approach for Control and Elimination of Priority Endemic Diseases (2019 edition).Results:A total of 392 244 households were investigated, and the rates of qualified improved stoves, the correct utilization of qualified improved stoves and correct drying of corn and pepper were 99.42% (389 982/392 244), 99.70% (388 796/389 982) and 99.07% (388 579/392 244), respectively. A total of 227 057 children aged 8 - 12 years were examined, 9 413 children of dental fluorosis were detected, the detection rate of dental fluorosis was 4.15%, the dental fluorosis index was 0.10, and the prevalence intensity was negative. Taking the county as a unit, except Fuyuan and Zhenxiong, which reached the control standard of the disease area, the remaining 11 counties reached the elimination standard.Conclusion:The prevention and control measures on coal burning fluorosis are implemented well in Yunnan Province and healthy lifestyle has gradually taken shape, with the overall condition of the disease reduced.
ABSTRACT
Objective To understand the current situation on coal-burning-borne endemic fluorosis control and prevention in Yunnan Province,timely discover problems in prevention and control of the disease,and achieve the "13th Five-Year Plan" objectives as scheduled.Methods Simple random sampling method was adopted to conduct investigations in Weixin County,Daguan County of Zhaotong City,and Fuyuan County of Qujing City in the key diseased areas of Yunnan Province in 2017.Three townships from each endemic fluorosis area were randomly selected,and 2 villages of each township were randomly selected.The use of improved stoves (types of stoves,integrity rate and correct use),knowledge and behavior changes of endemic fluorosis prevention among local grade five pupils and housewives or household heads and the condition of endemic fluorosis (dental fluorosis and urinary fluoride situation in children) were investigated in above mentioned villages.Results A total of 532 households were investigated.The consumption rate of self-produced corn and pepper were 53.4% (284/532) and 44.7% (238/532),respectively.Totally 81.0% (431/532) of households burned coal,the average annual coal burning time per household was 6.3 months.Totally 44.5% (237/532) of the households used the improved iron stove,89.5% (476/532) used the electric cooker to cook rice,84.2% (448/532) used the induction cooker to cook,and 36.7% (195/532)used the portable open stove.The integrity rate of improved stoves and the correct usage rate were 86.9% (206/237) and 84.0% (199/237),respectively,among the 237 households using improved stoves.The awareness rate of the prevention and control of coal-burning-borne fluorosis in grade five pupils and housewives or household heads were 85.8% (921/1 074) and 17.7% (283/1 596),respectively.The correct drying rates of edible corn and peppers were 66.5% (189/284) and 52.9% (126/238),respectively.A total of 3 333 children aged 8-12 years old were examined and the dental fluorosis positive rate was 11.28% (376/3 333).Totally 377 samples of immediate urine samples were detected,the geometric mean of urinary fluoride content of children was 0.37 (0.06-2.14) mg/L.Conclusions The situation of coal-burning-borne endemic fluorosis in Yunnan Province is effectively controlled,but the correct use rate of improved stoves,the correct drying rate of edible com and peppers are low,and do not meet the requirements of the "13th Five-Year Plan".
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Objectives To grasp the situation and fluctuation tendency of Keshan disease in Qujing City,and to scientifically evaluate the control effect of Keshan disease.To provide scientific basis for elimination of Keshan disease in the 12th Five-Year Plan.Methods Cardiomyopathy cases of the past three years were searched,screening suspected cases of Keshan disease.And according to the National Surveillance Program of Keshan Disease (Trial),In Qujing City,2 Keshan disease counties (Huize,Qilin) were selected to carried out focused monitoring,1-2 endemic townships with more patients were selected based on total numbers of cases in each county,1 village with more patients was selected in each township as a monitoring site,the residents of the monitoring sites were examined clinically and electrocardiographic (ECG) tracings recorded and suspicious patients were taken chest radiograph and color Doppler ultrasound echocardiography.Diagnosis was based on the Diagnostic Standard for Keshan Disease.Results Totally 300 cases of cardiomyopathy were found,10 cases were suspected Keshan disease,0 cases of Keshan disease was diagnosed in 2009-2012.In the three villages of the two counties monitored,3 cases of potential Keshan disease were detected of the 1 505 villagers,the detection rate was 0.20%;62 abnormal ECG were found,the abnormal rate was 4.12%.Chest X-ray examination was done in 3 people,cardiothoracic ratio of 0.50 or less were 2 people,and 0.51-0.55 was 1 person.Conclusion The prevalence of Keshan disease in Qujing City is low,but the pathogenesis of Keshan disease remains,therefore,monitoring and intervention of children Keshan disease should be strengthened.