A survey of urolithiasis in young children fed infant formula contaminated with melamine in two townships of Gansu, China.

OBJECTIVE: To determine the prevalence of urolithiasis in young children fed infant formula (IF) contaminated with melamine, and the association between IF consumption and urolithiasis. DESIGN: A total of 2 733 children < or = 3 years of age on September 1, 2008 in two townships of Gansu Province, China were studied. Cases of urolithiasis were diagnosed by ultrasonography. Milk product consumption was determined by their caregivers. Remaining IF samples were tested for melamine and cyanuric acid. RESULTS: Of 2 733 eligible children in the two townships, 2 186 (80%) were enrolled in our study. Overall, 16.6% (362) of 2 186 children had urolithiasis. The prevalence was 24.6% in children exclusively fed Sanlu brand IF, 9.7% in those fed other IF, and 8.5% in those fed exclusively on other milk products. For children exclusively breast-fed, no urolithiasis was found (P < 0.05). The prevalence of urolithiasis was 11.4% in children fed 400 g of Sanlu IF, rising to 37.5% in children fed over 25 600 g. Of 48 Sanlu IF samples, 91.7% contained melamine (median = 1 800 ppm; range = 45-4 700) and 66.7% contained cyanuric acid (median = 1.2 ppm; range = 0.4-6.3). Melamine was also detected in 22.2% of 36 other brand IF (median = 27.5 ppm, range = 4-50). CONCLUSIONS: Urolithiasis was associated with melamine-contaminated IF. Although one product caused most morbidity, other milk products may have also contributed to the outbreak.

A preliminary cervical cancer screening cascade for eight provinces rural Chinese women: a descriptive analysis of cervical cancer screening cases in a 3-stage framework.

BACKGROUND: Cascade analysis is an effective method to analyze the processing data of an event, such as a provided service or a series of examinations. This study aimed to develop a primary cervical cancer screening cascade in China to promote the quality of the screening process. METHODS: We designed a cervical cancer screening cascade in China according to the program flow chart. It had three stages, each with two steps and one result. Data from 117,522 women aged 35 to 64 years in the Rural Cervical Cancer Surveillance Project from January 1, 2014, to December 31, 2014, were collected to analyze the main results of the cascade. The data and proportion are used to describe the follow-up of cervical cancer and pre-cancer detection rate. RESULTS: In 2014, 117,522 (80.94% of all cases reported by the Rural Cervical Cancer Surveillance Project) women aged 35 to 64 years had not received cervical cytology in the previous 3 years. The pre-cancer and cancer detection rates were 256.12/100,000 and 16.16/100,000, respectively. A total of 3031 cases failed to follow-up through the screening process, and 1189, 1555, and 287 cases were lost at cervical cytology, colposcopy, and histopathological screening stages, respectively. The estimated cases of pre-cancer and cancer cases would have been 544 and 34, respectively, and the estimated detection rates of pre-cancer and cancer would have been 462.89/100,000 and 28.93/100,000, respectively. CONCLUSION: In order to increase the detection rate of cervical cancer, cervical cancer screening staff should focus on increasing the rate of follow-up of those who are positive for cervical cancer screening (ie, those with positive cytology results), especially for the 40 to 44 years age range.

Risk assessment of human infection with a novel bunyavirus in China.

OBJECTIVE: To assess the public health risk of human infection from a novel bunyavirus - severe fever with thrombocytopenia syndrome virus (SFTSV) - in China. METHODS: The likelihood of disease spread and the magnitude of public health impact were assessed to clarify overall risk. Literature about hazard, exposure and contextual factors associated with SFTSV infection was collected and reviewed. Information on SFTSV cases and the population in six provinces under surveillance was compared. RESULTS: SFTSV is a member of the Phlebovirus genus of the Bunyaviridae family. A widely distributed tick species, Haemaphysalis longicornis, can act as the vector; thus the disease is likely to spread in China. Symptoms of SFTSV infection are nonspecific, but have led to multiorgan dysfunction in severe cases. High-risk populations include farmers and older females. Evidence of human-to-human transmission within family and hospital has been reported. The capacity for treatment and diagnosis of SFTSV are adequate in rural communities in China, and community awareness of the disease should be high. DISCUSSION: There is a low to moderate public health risk related to SFTSV human infection in China. There is potential for an increase in the number of cases reported as awareness increases and when surveillance is expanded.

[Study on the seasonal distribution of human rabies in different regions of China].

OBJECTIVE: Using simple quantitative methods to describe the seasonal distribution of rabies in different provinces of China and to analyze how it was influenced by geographical settings, to provide evidence for risk assessment and prediction of potential epidemics of rabies. METHODS: A total number of 17 800 clinical and laboratory confirmed rabies cases, reported by 29 provinces, from 2005 to 2011 and related data were collected from National Disease Reporting Information System. Data on related latitudes and longitudes of different provinces were obtained from the National Geographic Information Center. Excel 2003 was used to draw the national and provincial seasonal distribution curves while SPSS 18.0 was used to calculate parameters as P(25), P(50), P(75), inter-quartile range Q and kurtosis so as analyze the linear correlation between P(25), kurtosis and the latitude of different provinces respectively. RESULTS: The nation-wide incidence of rabies was low in February. The peaks fell in summer and autumn, especially in August. Seasonal distribution curves of P(25), P(50), P(75), inter-quartile range (Q) and kurtosis were different among provinces. Compared to the low latitude areas, high latitude areas had higher P(25), smaller Q and higher kurtosis. In 9 provinces where the annual reported number of cases more than 100, the related coefficients (r) between latitude and both P(25), kurtosis were 0.9342 and 0.8528 respectively (P < 0.05). CONCLUSION: There was a distinct seasonality of rabies occurrence in China which was correlated to the geographical settings which was more obvious in the higher latitude areas.

[A discussion on the strategy of evaluating the communicable disease surveillance systems in US Center for Disease Control and Prevention and World Health Organization].

OBJECTIVE: To compare the different surveillance system evaluation guidelines proposed by US Center for Disease Control and Prevention (CDC) and WHO, so as to develop an evaluation strategy suitable for communicable disease surveillance systems in China. METHODS: Systematic collection and review on the guidelines that were proposed by US CDC and WHO. Situation analysis together with feasibility analysis were linked to the analysis of evaluation strategy used in China. RESULTS: US CDC guidelines were more appropriate for evaluating those single or simple systems that focusing on those 'system characteristics' while the. WHO protocols were more appropriate for evaluating the multi-system or complicated system which focusing on data related to 'system functions'. The US CDC guidelines had been widely used in China and it was the right moment to start to evaluate the functions. CONCLUSION: More flexible and comprehensive strategy based on national conditions is needed when constitute the national communicable disease surveillance evaluation guidelines. The multi-step strategy described in this article could be used as reference.