Prevalence and distribution of acute gastrointestinal illness in the community of China: a population-based face-to-face survey, 2014-2015.

BACKGROUND: The true incidence of acute gastrointestinal illness in China is underrecognized by surveillance systems. The aims of this study were to estimate the incidence and prevalence of self-reported AGI in the community of China, and to investigate sociodemographic and epidemiological determinants of AGI. METHODS: We conducted a 12-months cross-sectional population-based survey in eight provinces of China during 2014-2015. The survey determined the prevalence and incidence of acute gastrointestinal illness (AGI) in the total permanent resident population in China according to the census of the population in 2010. The random multilevel population sample was stratified by geographic, population, and socioeconomic status. We used a recommended case definition of AGI, with diarrhea (three loose or watery stools) and/or any vomiting in a four-week recall. A face-to-face survey was conducted by selecting the member in the household with the most recent birthday. RESULTS: Among 56,704 sampled individuals, 948 (1,134 person-time) fulfilled the case definition; 98.5% reported diarrhea. This corresponds to 2.3% (95% CI:1.9%-2.8%) of an overall standardized four-week prevalence and 0.3 (95% CI: 0.23-0.34) episodes per person-year of annual adjusted incidence rate. There was no significant difference between males and females. The incidence rates were higher among urban residents, and in the spring and summer. In the whole study period, 50% of the cases sought medical care, of which 3.9% were hospitalized and 14.3% provided a biological sample for laboratory identification of the causative agent. Children aged 0-4 and young adults aged 15-24, people living in rural areas and people who traveled frequently had higher prevalence of AGI. CONCLUSION: Results showed that AGI represents a substantial burden in China, and will contribute to the estimation of the global burden of AGI. Complemented with data on the etiologies of AGI, these estimates will form the basis to estimate the burden of foodborne diseases in China.

Correlation between Frequency of Eating Out of Home and Dietary Intake, Sleep, and Physical Activity: A Survey of Young CDC Employees in China.

OBJECTIVES: We aimed to investigate the correlation between the frequency of eating out of home and dietary intake, sleep, and physical activity among young employees from the Center for Disease Control and Prevention in China. METHODS: Using the cluster sampling method, 6099 employees aged 40 years or below from the Center for Disease Control and Prevention (CDC) from 32 provinces in China were interviewed using an online questionnaire survey. The frequency of eating out of home, dietary intake, sleep, and physical activity of all participants was described, and correlation analysis was used to study the relationships between eating out of home frequency and related indicators. RESULTS: A total of 5353 valid questionnaires were collected with the recovery rate of 87.77%. The results show that 85.8% of participants eat out of home one to five times per week, 10.1% eat out of home more than six times, and 4.1% never eat out. Correlation analysis showed that eating out of home is negatively correlated with a daily vegetable and fruit intake. The lower the intake of vegetables and fruits, the more obvious this tendency. Eating out of home is positively correlated with a daily intake of meat as well as a weekly intake of aquatic products. The higher the intake of meat and aquatic products, the more obvious this tendency. There was a negative correlation between eating out of home and sleep duration and physical activity. The lower the duration of sleep and physical activity, the more obvious this tendency. CONCLUSIONS: Based on existing survey data, young employees from the CDC eat out of home regularly, which may affect dietary intake, sleep, and physical activity. Targeted health education programs are urgently needed to assist in the promotion of a healthy lifestyle and reduce the potential risk of chronic disease.

Estimating the burden of acute gastrointestinal illness in the community in Gansu Province, northwest China, 2012-2013.

BACKGROUND: Acute gastrointestinal illness (AGI) imposes considerable social and economic burden on low and middle-income countries. This study aimed to estimate the occurrence, distribution, and burden of self-reported AGI in Gansu Province of northwest China, where economic growth rates have lagged far behind those of other regions in China and systematic studies to investigate the burden of AGI are still lacking. METHODS: Twelve-month, retrospective face-to-face surveys were conducted in three sentinel sites between June 2012 and May 2013. Respondents were asked if they had experienced diarrhoea or vomiting in the 28 days prior to the interview. RESULTS: In total, 2094 interviews were completed. The adjusted monthly prevalence was 8.5% with an incidence rate of 1.16 episodes of AGI per person-year. Healthcare was sought by 73.8% of those reporting illness. Of the cases who visited a doctor, 50.5% submitted a stool sample. The use of antibiotics was reported by 65.6% of the cases and 53.3% took antidiarrhoeals. In the multivariable model, age, household income and sentinel site were significant risk factors of being a case of AGI. CONCLUSIONS: The burden of AGI was considerable in Gansu Province of northwest China. Ongoing research to identify the main causes of AGI is needed for more accurate estimate of the burden of AGI in this region.