Whole-course management of chronic obstructive pulmonary disease in primary healthcare: an internet of things-enabled prospective cohort study in China.

BACKGROUND: Despite substantial progress in reducing the global burden of chronic obstructive pulmonary disease (COPD), traditional methods to promote understanding and management of COPD are insufficient. We developed an innovative model based on the internet of things (IoT) for screening and management of COPD in primary healthcare (PHC). METHODS: Electronic questionnaire and IoT-based spirometer were used to screen residents. We defined individuals with a questionnaire score of 16 or higher as high-risk population, COPD was diagnosed according to 2021 Global Initiative for COPD (Global Initiative for Chronic Obstructive Lung Disease) criteria. High-risk individuals and COPD identified through the screening were included in the COPD PHC cohort study, which is a prospective, longitudinal observational study. We provide an overall description of the study's design framework and baseline data of participants. RESULTS: Between November 2021 and March 2023, 162 263 individuals aged over 18 from 18 cities in China were screened, of those 43 279 high-risk individuals and 6902 patients with COPD were enrolled in the cohort study. In the high-risk population, the proportion of smokers was higher than that in the screened population (57.6% vs 31.4%), the proportion of males was higher than females (71.1% vs 28.9%) and in people underweight than normal weight (57.1% vs 32.0%). The number of high-risk individuals increased with age, particularly after 50 years old (χ2=37 239.9, p<0.001). Female patients are more common exposed to household biofuels (χ2=72.684, p<0.05). The majority of patients have severe respiratory symptoms, indicated by a CAT score of ≥10 (85.8%) or an Modified Medical Research Council Dyspnoea Scale score of ≥2 (65.5%). CONCLUSION: Strategy based on IoT model help improve the detection rate of COPD in PHC. This cohort study has established a large clinical database that encompasses a wide range of demographic and relevant data of COPD and will provide invaluable resources for future research.

[Study on the epidemiological characteristics of measles in Henan province during 2004-2006].

OBJECTIVE: To understand the epidemiological characteristics of measles in Henan province during 2004-2006 and to evaluate the quality of measles special report system (MSS) in order to provide evidence for strategies and measures development for measles prevention and control. METHODS: Data were collected from the National Notifiable Disease Report System (NNDRS) and MSS on epidemiological characteristics of measles in Henan province during 2004-2006. RESULTS: The sensitivity of MSS was lower than that of NNDRS in Henan province during 2004-2006. The incidence of measles appeared to be 2.54/100 000 in 2004 increased to 8/100 000 during 2005-2006. The incidence of measles was higher in the central part of the province during the recent years with cases concentrated in March to May every year. The percentage of cases from age groups < 8 months and 8 months to 1 year olds increased yearly. All the cases with no or unclear vaccination record took up 77.13%, with 18.23% of the measles cases fell into the floating population. CONCLUSION: Improving the 2 doses and timely coverage rate of the first dose of measles vaccine strategy was essential for measles control and prevention. In order to improve the quality of measles surveillance program, the advantage of MSS and NNDRS should be integrated.

[Analysis on the proportion of reported hepatitis B cases through pilot surveillance in China during 2006].

OBJECTIVE: To better understand the proportions of reported hepatitis B cases in pilot surveillance cites through investigation and laboratory testing. METHODS: To confirm the reported cases of hepatitis B by collecting blood specimen and laboratory testing on HBsAg, IgM of Anti-HBc, Anti-HAV in 18 pilot surveillance counties. RESULTS: Among 2858 cases of hepatitis B reported in 2006, 23.97% of them were reported as suspected acute cases, 14.87% as acute cases, 20.33% as suspected chronic cases, 34.67% as chronic cases, 4.09% as cirrhosis and 2.06% as HCC. Among 1681 reported hepatitis B cases confirmed by laboratory testing, results showed that 24.16% of them were diagnosed as acute hepatitis B, but only 15.37% were confirmed as acute hepatitis B. Although the proportion confirmed as hepatitis B kept consistent as before, misclassification was found. CONCLUSION: In current surveillance system, reported hepatitis B cases were mainly chronic, only up to one third belonged to acute hepatitis B. The reported incidence of hepatitis B did not reflect the real incidence due to misclassification. To better define the burden on hepatitis B disease, it was necessary and urgent to revise the diagnostic criteria and to conduct surveillance on hepatitis B, under separate reporting categories which including acute and chronic cases of the disease.

[Study on the authenticity of parents' memory on their children's immunization status].

OBJECTIVE: To evaluate the authenticity of the parents' memory on their children's immunization status. METHODS: Two counties and 1 district in each of the 18 prefectures were selected, and parents of the children 1 - 2 years old, residents in counties or floating in district, were studied on the authenticity of their memory regarding their children's immunization status. RESULTS: The rates of inoculation with all the four expanded programme on immunization (EPI) vaccines were 89.7% in the whole province, and 77.9% among floating children. The authenticity of the reply from parents on their children, inoculation status with vaccines was above 96%. However, less than 50% of the parents could remember what specific vaccines that their children had received. The authenticity of parents' memory was higher in the parents with high school or college education than those who were illiterates or only having had elementary school education. Mothers had better memory than the fathers. Of the children whose parents could not remember the vaccination status, 97% of them had been inoculated. CONCLUSION: The definite answer of parents to children's immunization status had high creditability, especially when the mothers having had more schooling. Those children whose parents failed to remember whether vaccination had been received should not be ranked as unimmuned.