Perinatal prevalence of birth defects in the Mainland of China, 2000-2021: a systematic review and meta-analysis.

BACKGROUND: Although birth defects are of great concern globally, the latest national prevalence has not yet been quantified in China. We conducted a systematic review and meta-analysis to estimate the perinatal prevalence of birth defects in the Mainland of China between 2000 and 2021. METHODS: We performed a systematic literature search of six databases for relevant articles published between January 1, 2000, and March 1, 2023. We included published studies that reported data on the perinatal prevalence of birth defects in the Mainland of China. The DerSimonian and Laird random-effects models were used to estimate the pooled prevalence and its 95% confidence interval (CI). We also conducted subgroup analyses and univariable meta-regressions to explore differences in prevalence by time period, geographic region, and other characteristics. RESULTS: We included 254 studies reporting the perinatal prevalence of birth defects and 86 studies reporting only the prevalence of specific types of birth defects. Based on 254 studies covering 74,307,037 perinatal births and 985,115 cases with birth defects, the pooled perinatal prevalence of birth defects was 122.54 (95% CI 116.20-128.89) per 10,000 perinatal births in the Mainland of China during 2000-2021. Overall, the perinatal prevalence of birth defects increased from 95.60 (86.51-104.69) per 10,000 in 2000-2004 to 208.94 (175.67-242.22) per 10,000 in 2020-2021. There were also significant disparities among different geographical regions. Congenital heart defects (33.35 per 10,000), clefts of the lip and/or palate (13.52 per 10,000), polydactyly (12.82 per 10,000), neural tube defects (12.82 per 10,000), and inborn errors of metabolism (11.41 per 10,000) were the five most common types of birth defects. The perinatal prevalence among males was significantly higher than that among females (ß = 2.44 × 10-3, P = 0.003); a higher perinatal prevalence of birth defects was observed among perinatal births whose mothers were ≥ 35 years (ß = 4.34 × 10-3, P < 0.001). CONCLUSION: Comprehensive and sustained efforts are needed to strengthen surveillance and detection of birth defects, improve prenatal and postnatal healthcare, and promote rehabilitation, especially in underdeveloped areas.

Global Epidemic of Ebola Virus Disease and the Importation Risk into China: An Assessment Based on the Risk Matrix Method.

Objective: To analyze the global epidemic status of the Ebola virus disease (EVD) and assess the importation risk into China. Methods: Data from World Health Organization reports were used. We described the global epidemic status of EVD from 1976-2021, and assessed and ranked the importation risk of EVD from the disease-outbreaking countries into China using the risk matrix and Borda count methods, respectively. Results: From 1976-2021, EVD mainly occurred in western and central Africa, with the highest cumulative number of cases (14,124 cases) in Sierra Leone, and the highest cumulative fatality rate (85%) in the Congo. Outbreaks of EVD have occurred in the Democratic Republic of the Congo and Guinea since 2018. The importation risk into China varies across countries with outbreaks of disease. The Democratic Republic of the Congo had an extremely high risk (23 Borda points), followed by Guinea and Liberia. Countries with a moderate importation risk were Nigeria, Uganda, Congo, Sierra Leone, Mali, and Gabon, while countries with a low importation risk included Sudan, Senegal, and Co^te d'Ivoire. Conclusion: China is under the risk of EVD importation with the globalization and severe epidemic status of EVD. Key attention need to be paid to the Democratic Republic of the Congo, Guinea, and Liberia. Therefore, it is necessary to prevent and prepare in advance for importation risk in China.

2022 Multiple-country Monkeypox Outbreak and Its Importation Risk into China: An Assessment Based on the Risk Matrix Method.

Objective: To analyze the 2022 multiple-country monkeypox outbreak and assess its importation risk into China. Methods: Data was from United States Centers for Disease Control and Prevention. We described the global epidemic and calculated concentration index to measure economic-related inequality. Importation risk into China was evaluated and ranked by using risk matrix method and Borda count method, respectively. Results: As of July 29, 2022, of 79 countries or territories, 39 (49.37%, 39/79), 17 (21.52%, 17/79), 6 (7.59%, 6/79), 12 (15.19%, 12/79), and 5 (6.33%, 5/79) country or territories identified cases < 10, 10-, 51-, 101-, and > 1,000. There were economic-related health disparities exist in the distribution of cases (the concentration index = 0.42, P = 0.027), and the inequality disadvantageous to the rich (pro-poor). There were 12 (15.38%, 12/78), 15 (19.23%, 15/78), 6 (7.69%, 6/78), and 45 (57.69%, 45/78) countries or territories with extremely high, high, moderate, and low importation risk. United States and France ranked first with the highest Borda points of 156, and counts of zero. Conclusion: Of 78 countries or territories, the key attention need be paid to the United States and France, relatively. As the epidemic progresses, preparing prevention and control measures to further reduce importation risk was crucial.

Long-term effectiveness of group-based diabetes self-management on glycosylated haemoglobin for people with type 2 diabetes in community: a protocol of systematic review and meta-analysis.

INTRODUCTION: The rapid rise in the prevalence of diabetes has a negative impact on patients' quality of life. Diabetes self-management group education is cost-effective and efficient for patients to control blood glucose. However, there are no consistent standards for self-management group education, and its long-term effects (≥12 months) are unclear. Although a few systematic reviews evaluated the long-term effects, they did not make clear provisions on the content of self-management, and the number and sample size of included studies were small, which may lead to misclassification bias and reporting bias. Therefore, we plan to conduct this systematic review to evaluate the long-term effects of self-management group education and determine the effects of different self-management characteristics on glycosylated haemoglobin (HbA1c). METHODS AND ANALYSIS: We will retrieve Chinese databases (Wanfang, Chinese Hospital Knowledge Warehouse) and English databases (PubMed, ScienceDirect, EMBASE, Web of Science, Bailian Platform, Cochrane Central Register of Controlled Trials, Google Scholar) for randomly controlled trials and cluster randomly controlled trials of which participants are adults with type 2 diabetes mellitus. We will manually search citation lists and trial registries, and consult authors to obtain relevant articles. The retrieval time range will be from the establishment of the database to July 2020 to avoid omitting relevant studies. The primary outcome will be HbA1c. The secondary outcomes will be fasting plasma glucose, postprandial blood glucose, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, systolic blood pressure, diastolic blood pressure, body mass index, waist circumference and death event. Two reviewers will independently conduct article screening and assessment of risk of bias, with a third reviewer arbitrating if necessary. We will give priority to the use of meta-analysis to evaluate the pooled effects of all outcomes. For the outcomes of unrecognised sources of heterogeneity, missing data and less than three related studies, narrative synthesis approach will be used. ETHICS AND DISSEMINATION: Ethical approval is not required for this systematic review. We plan to present the findings in a peer-reviewed scientific journal, relevant and responsible organisations, and training meetings. PROSPERO REGISTRATION NUMBER: CRD42020209011.