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1.
N Engl J Med ; 2020 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-31995857

RESUMO

BACKGROUND: The initial cases of novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the first 425 confirmed cases in Wuhan to determine the epidemiologic characteristics of NCIP. METHODS: We collected information on demographic characteristics, exposure history, and illness timelines of laboratory-confirmed cases of NCIP that had been reported by January 22, 2020. We described characteristics of the cases and estimated the key epidemiologic time-delay distributions. In the early period of exponential growth, we estimated the epidemic doubling time and the basic reproductive number. RESULTS: Among the first 425 patients with confirmed NCIP, the median age was 59 years and 56% were male. The majority of cases (55%) with onset before January 1, 2020, were linked to the Huanan Seafood Wholesale Market, as compared with 8.6% of the subsequent cases. The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days. In its early stages, the epidemic doubled in size every 7.4 days. With a mean serial interval of 7.5 days (95% CI, 5.3 to 19), the basic reproductive number was estimated to be 2.2 (95% CI, 1.4 to 3.9). CONCLUSIONS: On the basis of this information, there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019. Considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere. Measures to prevent or reduce transmission should be implemented in populations at risk. (Funded by the Ministry of Science and Technology of China and others.).

2.
Brain Topogr ; 33(1): 123-134, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31691912

RESUMO

Both functional magnetic resonance imaging (fMRI) and transcranial magnetic stimulation (TMS) have been used to non-invasively localize the human motor functional area. These locations can be clinically used as stimulation target of TMS treatment. However, it has been reported that the finger tapping fMRI activation and TMS hotspot were not well-overlapped. The aim of the current study was to measure the distance between the finger tapping fMRI activation and the TMS hotspot, and more importantly, to compare the network difference by using resting-state fMRI. Thirty healthy participants underwent resting-state fMRI, task fMRI, and then TMS hotspot localization. We found significant difference of locations between finger tapping fMRI activation and TMS hotspot. Specifically, the finger tapping fMRI activation was more lateral than the TMS hotspot in the premotor area. The fMRI activation peak and TMS hotspot were taken as seeds for resting-state functional connectivity analyses. Compared with TMS hotspot, finger tapping fMRI activation peak showed more intensive functional connectivity with, e.g., the bilateral premotor, insula, putamen, and right globus pallidus. The findings more intensive networks of finger tapping activation than TMS hotspot suggest that TMS treatment targeting on the fMRI activation area might result in more remote effects and would be more helpful for TMS treatment on movement disorders.

3.
MMWR Morb Mortal Wkly Rep ; 68(48): 1112-1116, 2019 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-31805034

RESUMO

In 2005, the World Health Organization (WHO) Western Pacific Region countries, including China, resolved to eliminate measles by 2012 or as soon as feasible thereafter (1). As of 2018, nine* of the 37 Western Pacific Region countries or areas† had eliminated§ measles. China's Measles Elimination Action Plan 2006-2012 included strengthening routine immunization; conducting measles risk assessments, followed by supplementary immunization activities (SIAs) with measles-containing vaccine (MCV) at national and subnational levels; strengthening surveillance and laboratory capacity; and investigating and responding to measles outbreaks. Most recently, progress toward measles elimination in China was described in a 2014 report documenting measles elimination efforts in China during 2008-2012 and a resurgence in 2013 (2). This report describes progress toward measles elimination in China during January 2013-June 2019.¶ Measles incidence per million persons decreased from 20.4 in 2013 to 2.8 in 2018; reported measles-related deaths decreased from 32 in 2015 to one in 2018 and no deaths in 2019 through June. Measles elimination in China can be achieved through strengthening the immunization program's existing strategy by ensuring sufficient vaccine supply; continuing to improve laboratory-supported surveillance, outbreak investigation and response; strengthening school entry vaccination record checks; vaccinating students who do not have documentation of receipt of 2 doses of measles-rubella vaccine; and vaccinating health care professionals and other adults at risk for measles.


Assuntos
Erradicação de Doenças , Surtos de Doenças/prevenção & controle , Sarampo/prevenção & controle , Vigilância da População , Adolescente , Criança , Pré-Escolar , China/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Feminino , Humanos , Programas de Imunização , Incidência , Lactente , Masculino , Sarampo/epidemiologia , Sarampo/mortalidade , Vacina contra Sarampo/administração & dosagem
4.
BMC Infect Dis ; 19(1): 770, 2019 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-31481020

RESUMO

BACKGROUND: We sought to assess reporting in China's Pneumonia of Unknown Etiology (PUE) passive surveillance system for emerging respiratory infections and to identify ways to improve the PUE surveillance system's detection of respiratory infections of public health significance. METHODS: From February 29-May 29, 2016, we actively identified and enrolled patients in two hospitals with acute respiratory infections (ARI) that met all PUE case criteria. We reviewed medical records for documented exposure history associated with respiratory infectious diseases, collected throat samples that were tested for seasonal and avian influenza, and interviewed clinicians regarding reasons for reporting or not reporting PUE cases. We described and analyzed the proportion of PUE cases reported and clinician awareness of and practices related to the PUE system. RESULTS: Of 2619 ARI admissions in two hospitals, 335(13%) met the PUE case definition; none were reported. Of 311 specimens tested, 18(6%) were seasonal influenza virus-positive; none were avian influenza-positive. < 10% PUE case medical records documented whether or not there were exposures to animals or others with respiratory illness. Most commonly cited reasons for not reporting cases were no awareness of the PUE system (76%) and not understanding the case definition (53%). CONCLUSIONS: Most clinicians have limited awareness of and are not reporting to the PUE system. Exposures related to respiratory infections are rarely documented in medical records. Increasing clinicians' awareness of the PUE system and including relevant exposure items in standard medical records may increase reporting.


Assuntos
Notificação de Doenças , Necessidades e Demandas de Serviços de Saúde , Pneumonia/epidemiologia , Pneumonia/etiologia , Vigilância da População , Adulto , China/epidemiologia , Doenças Transmissíveis Emergentes/diagnóstico , Doenças Transmissíveis Emergentes/epidemiologia , Diagnóstico Diferencial , Notificação de Doenças/métodos , Notificação de Doenças/normas , Feminino , Necessidades e Demandas de Serviços de Saúde/organização & administração , Necessidades e Demandas de Serviços de Saúde/normas , Hospitalização , Humanos , Influenza Humana/epidemiologia , Masculino , Notificação de Abuso , Testes Obrigatórios/normas , Pessoa de Meia-Idade , Projetos Piloto , Pneumonia/diagnóstico , Vigilância da População/métodos , Padrões de Prática Médica/organização & administração , Padrões de Prática Médica/normas , Avaliação de Programas e Projetos de Saúde , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/etiologia , Engajamento no Trabalho
5.
BMC Cancer ; 19(1): 622, 2019 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-31238891

RESUMO

BACKGROUNDS: The aim of this study is to investigate the risk factors for the cervical lymph node metastasis in papillary thyroid carcinoma (PTC). METHODS: The clinicopathological data from the 966 PTC patients who underwent thyroid operation between January 2013 and December 2015 in the general surgery department of Shengjing Hospital of China Medical University were collected. The risk factors of predicting cervical lymph node metastasis were analyzed. RESULTS: Male, age ≤ 45 years old, tumor size> 1.0 cm, extrathyroidal extension (ETE), US features as microcalcification, were independent risk factors for central lymph node metastasis (CLNM) (P < 0.05). Only CLNM was independent risk factors for lateral lymph node metastasis (LLNM) (P < 0.05). The ROC curve showed that the cutoff value of the number of CLNM for predicting lateral lymph node metastasis was defined as 2.5 (Sensitivity = 0.535, Specificity = 0.722, AUC = 0.669, P < 0.05). When the number of CLNM > 3, OR value was significantly higher, suggesting that the risk of LLNM increased significantly. The incidence of LLNM in level III (66.8%) and level IV (67.3%) were significantly higher than level II (42.2%) and level V (21.3%) (P < 0.05). The incidence of LLNM and skip metastasis in tumor located in the upper 1/3 of the lobe was the highest (P < 0.05). CONCLUSIONS: Prophylactic central lymph node dissection should be performed in patients with risk factors as male, age ≤ 45 years old, tumor size> 1.0 cm, ETE and US features as microcalcification. Lateral lymph node dissection (LLND) should be more actively performed in patients with the number of CLNM> 3. Extent of LLND should include levels II, III, IV and V. Tumor located in the upper 1/3 of the lobe was vulnerable for LLNM and skip metastasis, so lymph node in lateral compartment should be noticed when lymph node status was preoperatively evaluated by imaging examination.


Assuntos
Linfonodos/patologia , Metástase Linfática/patologia , Câncer Papilífero da Tireoide/secundário , Neoplasias da Glândula Tireoide/patologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Calcinose/diagnóstico por imagem , Criança , Feminino , Humanos , Modelos Logísticos , Linfonodos/cirurgia , Masculino , Pessoa de Meia-Idade , Pescoço , Esvaziamento Cervical/métodos , Curva ROC , Estudos Retrospectivos , Sensibilidade e Especificidade , Fatores Sexuais , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/cirurgia , Nódulo da Glândula Tireoide/diagnóstico por imagem , Carga Tumoral , Adulto Jovem
7.
Int J Epidemiol ; 48(4): 1240-1251, 2019 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-30977801

RESUMO

BACKGROUND: Measles is among the most highly infectious human diseases. By virtue of increasingly effective childhood vaccination, together with targeted supplemental immunization activities (SIAs), health authorities in the People's Republic of China have reduced measles' reproduction number from about 18 to 2.3. Despite substantial residual susceptibility among young adults, more in some locales than others, sustained routine childhood immunization likely would eliminate measles eventually. To support global eradication efforts, as well as expedite morbidity and mortality reductions in China, we evaluated alternative SIAs via mechanistic mathematical modelling. METHODS: Our model Chinese population is stratified by immune status (susceptible to measles infection; infected, but not yet infectious; infectious; and recovered or immunized), age (0, 1-4, 5-9, …, 65+ years) and location (31 provinces). Contacts between sub-populations are either empirical or a mixture of preferential and proportionate with respect to age and decline exponentially with distance between locations at age-dependent rates. We estimated initial conditions and most parameters from recent cross-sectional serological surveys, disease surveillance and demographic observations. Then we calculated the reproduction numbers and gradient of the effective number with respect to age- and location-specific immunization rates. We corroborated these analytical results by simulating adolescent and young adult SIAs using a version of our model in which the age-specific contact rates vary seasonally. RESULTS: Whereas the gradient indicates that vaccinating young adults generally is the optimal strategy, simulations indicate that a catch-up campaign among susceptible adolescent schoolchildren would accelerate elimination, with timing dependent on uptake. CONCLUSIONS: These results are largely due to indirect effects (i.e. fewer infections than immunized people might otherwise cause), which meta-population models with realistic mixing are uniquely capable of reproducing accurately.

8.
Lancet Infect Dis ; 19(4): 402-409, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30833160

RESUMO

BACKGROUND: In China, measles-rubella vaccine and live attenuated SA 14-14-2 Japanese encephalitis vaccine (LJEV) are recommended for simultaneous administration at 8 months of age, which is the youngest recommended age for these vaccines worldwide. We aimed to assess the effect of the co-administration of these vaccines at 8 months of age on the immunogenicity of measles-rubella vaccine. METHODS: We did a multicentre, open-label, non-inferiority, two-group randomised controlled trial in eight counties or districts in China. We recruited healthy infants aged 8 months who had received all scheduled vaccinations according to the national immunisation recommendations and who lived in the county of the study site. Enrolled infants were randomly assigned (1:1) to receive either measles-rubella vaccine and LJEV simultaneously (measles-rubella plus LJEV group) or measles-rubella vaccine alone (measles-rubella group). The primary outcome was the proportion of infants with IgG antibody seroconversion for measles 6 weeks after vaccination, and a secondary outcome was the proportion of infants with IgG antibody seroconversion for rubella 6 weeks after vaccination. Analyses included all infants who completed the study. We used a 5% margin to establish non-inferiority. This trial was registered at ClinicalTrials.gov (NCT02643433). FINDINGS: 1173 infants were assessed for eligibility between Aug 13, 2015, and June 10, 2016. Of 1093 (93%) enrolled infants, 545 were randomly assigned to the measles-rubella plus LJEV group and 548 to the measles-rubella group. Of the infants assigned to each group, 507 in the measles-rubella plus LJEV group and 506 in the measles-rubella group completed the study. Before vaccination, six (1%) of 507 infants in the measles-rubella plus LJEV group and one (<1%) of 506 in the measles-rubella group were seropositive for measles; eight (2%) infants in the measles-rubella plus LJEV group and two (<1%) in the measles-rubella group were seropositive for rubella. 6 weeks after vaccination, measles seroconversion in the measles-rubella plus LJEV group (496 [98%] of 507) was non-inferior to that in the measles-rubella group (499 [99%] of 506; difference -0·8% [90% CI -2·6 to 1·1]) and rubella seroconversion in the measles-rubella plus LJEV group (478 [94%] of 507) was non-inferior to that in the measles-rubella group (473 [94%] of 506 infants; difference 0·8% [90% CI -1·8 to 3·4]). There were no serious adverse events in either group and no evidence of a difference between the two groups in the prevalence of any local adverse event (redness, rashes, and pain) or systemic adverse event (fever, allergy, respiratory infections, diarrhoea, and vomiting). Fever was the most common adverse event (97 [19%] of 507 infants in the measles-rubella plus LJEV group; 108 [21%] of 506 infants in the measles-rubella group). INTERPRETATION: The evidence of similar seroconversion and safety with co-administered LJEV and measles-rubella vaccines supports the co-administration of these vaccines to infants aged 8 months. These results will be important for measles and rubella elimination and the expansion of Japanese encephalitis vaccination in countries where it is endemic. FUNDING: US Centers for Disease Control and Prevention, US Department of Health and Human Services; China-US Collaborative Program on Emerging and Re-emerging Infectious Diseases.

9.
World J Surg Oncol ; 17(1): 25, 2019 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-30704487

RESUMO

BACKGROUND: The abnormal expression of activator protein-1(AP-1) has recently been investigated in a variety of tumors. While the relationship between AP-1 and thyroid cancer is poorly studied, our study was to evaluate the protein expression and clinical value of AP-1 in papillary thyroid carcinoma (PTC). METHODS: The expression of AP-1 was examined by immunohistochemistry on paraffin-embedded tissues obtained from PTC and correspondent paracancerous tissues of 82 patients. RESULTS: Compared with paracancerous tissues, AP-1 expression was significantly elevated in PTC tissues and the positive rate was 79.3% (65/82). Our study found a linear trend relationship between the expression of AP-1 and tumor size. However, the differences in AP-1 expression among gender, age, lymph node metastasis, number of lesions, location of the lesion, and extrathyroid invasion are not statistically significant. CONCLUSIONS: The expression of AP-1 plays an important role in the proliferation process of PTC.


Assuntos
Câncer Papilífero da Tireoide/química , Neoplasias da Glândula Tireoide/química , Fator de Transcrição AP-1/análise , Adolescente , Adulto , Idoso , Feminino , Humanos , Imuno-Histoquímica , Proteínas Quinases JNK Ativadas por Mitógeno/fisiologia , Masculino , Metaloproteinase 9 da Matriz/análise , Pessoa de Meia-Idade , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia , Fator de Transcrição AP-1/fisiologia , Adulto Jovem
10.
Emerg Infect Dis ; 25(1): 33-41, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-30560778

RESUMO

Imported infectious diseases are becoming a serious public health threat in China. However, limited information concerning the epidemiologic characteristics of imported infectious diseases is available. In this study, we collected data related to imported infectious diseases in mainland China from the National Information Reporting System of Infectious Diseases and analyzed demographic, temporal, and spatial distributions. The number of types of imported infectious diseases reported increased from 2 in 2005 to 11 in 2016. A total of 31,740 cases of infectious disease were imported to mainland China during 2005-2016; most of them were found in Yunnan Province. The cases were imported mainly from Africa and Asia. As a key and effective measure, pretravel education should be strengthened for all migrant workers and tourists in China, and border screening, cross-border international cooperation, and early warning should be further improved.


Assuntos
Doenças Transmissíveis Importadas/epidemiologia , China/epidemiologia , Doenças Transmissíveis Importadas/etiologia , Doenças Transmissíveis Importadas/prevenção & controle , Monitoramento Epidemiológico , Feminino , Humanos , Masculino
11.
Vaccine ; 36(16): 2079-2085, 2018 04 12.
Artigo em Inglês | MEDLINE | ID: mdl-29550193

RESUMO

BACKGROUND: Rubella-containing vaccine (RCV) became available in China in 1993 and was introduced nationwide into the Expanded Immunization Program (EPI) in 2008. We evaluated implementation and impact of RCV from 2 years prior to nationwide introduction through the 10 years after nationwide introduction. METHODS: We analyzed RCV lot-release (doses distributed) data, 1- and 2-dose RCV coverage, and rubella data from China's nationwide disease surveillance system to describe the current status and changes in rubella epidemiology between 2005 and 2017. RESULTS: While the vaccine was included into the routine immunization program in 2008, its full implementation required 4 years due to sporadic vaccine supply constraints. RCV1 and RCV2 coverage increased from 51.5% and 39.0% in 2008 to >95% during 2012 through 2016. From 2005 to 2017, the annual incidences (per million) of rubella ranged from 91.09 in 2008 down to 1.16 in 2017; reductions occurred in all age groups. The proportion of cases among individuals ≥20 years old increased from 0.97% in 2005 to 31.2% in 2017. In the better-developed eastern China, most cases were among adults; in central and western China, most cases were among children or adolescents. CONCLUSIONS: The marked decrease rubella was a result of inclusion of RCVs into EPI targeting children less than 2 years of age and achieving high level of 2-dose coverage. Rubella was reduced in absolute terms, and its epidemiology was changed to older cases with substantial inter-province variation. Ensuring full vaccination of school children and identifying strategies to reach adults with measles and rubella combined vaccines will be important to hasten elimination of rubella and prevent CRS outbreaks.


Assuntos
Erradicação de Doenças , Vacina contra Rubéola/imunologia , Rubéola (Sarampo Alemão)/epidemiologia , Rubéola (Sarampo Alemão)/prevenção & controle , Vacinação , China/epidemiologia , Feminino , História do Século XXI , Humanos , Programas de Imunização , Masculino , Vigilância da População , Rubéola (Sarampo Alemão)/história , Vacina contra Rubéola/administração & dosagem , Cobertura Vacinal
12.
Emerg Infect Dis ; 24(2)2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29165238

RESUMO

To detect changes in human-to-human transmission of influenza A(H7N9) virus, we analyzed characteristics of 40 clusters of case-patients during 5 epidemics in China in 2013-2017. Similarities in number and size of clusters and proportion of clusters with probable human-to-human transmission across all epidemics suggest no change in human-to-human transmission risk.


Assuntos
Epidemias , Subtipo H7N9 do Vírus da Influenza A , Influenza Humana/epidemiologia , Influenza Humana/transmissão , Análise por Conglomerados , Humanos , Influenza Humana/virologia , Estudos Retrospectivos
13.
J Infect Dis ; 216(suppl_4): S548-S554, 2017 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-28934462

RESUMO

Multiple clusters of human infections with novel avian influenza A(H7N9) virus have occurred since the virus was first identified in spring 2013. However, in many situations it is unclear whether these clusters result from person-to-person transmission or exposure to a common infectious source. We analyzed the possibility of person-to-person transmission in each cluster and developed a framework to assess the likelihood that person-to-person transmission had occurred. We described 21 clusters with 22 infected contact cases that were identified by the Chinese Center for Disease Control and Prevention from March 2013 through June 2015. Based on detailed epidemiological information and the timing of the contact case patients' exposures to infected persons and to poultry during their potential incubation period, we graded the likelihood of person-to-person transmission as probable, possible, or unlikely. We found that person-to-person transmission probably occurred 12 times and possibly occurred 4 times; it was unlikely in 6 clusters. Probable nosocomial transmission is likely to have occurred in 2 clusters. Limited person-to-person transmission is likely to have occurred on multiple occasions since the H7N9 virus was first identified. However, these transmission events represented a small fraction of all identified cases of H7N9 human infection, and sustained person-to-person transmission was not documented.


Assuntos
Subtipo H7N9 do Vírus da Influenza A/isolamento & purificação , Influenza Humana/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Criança , Pré-Escolar , China/epidemiologia , Análise por Conglomerados , Infecção Hospitalar , Feminino , Humanos , Influenza Aviária/epidemiologia , Masculino , Pessoa de Meia-Idade , Aves Domésticas/virologia , Adulto Jovem
14.
15.
Artigo em Inglês | MEDLINE | ID: mdl-28409054

RESUMO

Since the first outbreak of avian influenza A(H7N9) virus in humans was identified in 2013, there have been five seasonal epidemics observed in China. An earlier start and a steep increase in the number of humans infected with H7N9 virus was observed between September and December 2016, raising great public concern in domestic and international societies. The epidemiological characteristics of the recently reported confirmed H7N9 cases were analysed. The results suggested that although more cases were reported recently, most cases in the fifth epidemic were still highly sporadically distributed without any epidemiology links; the main characteristics remained unchanged and the genetic characteristics of virus strains that were isolated in this epidemic remained similar to earlier epidemics. Interventions included live poultry market closures in several cities that reported more H7N9 cases recently.


Assuntos
Epidemias , Subtipo H7N9 do Vírus da Influenza A , Influenza Aviária/virologia , Influenza Humana/epidemiologia , Influenza Humana/virologia , Aves Domésticas/virologia , Adolescente , Adulto , Idoso , Animais , Criança , Pré-Escolar , China/epidemiologia , Cidades , Controle de Doenças Transmissíveis , Surtos de Doenças , Feminino , Humanos , Lactente , Recém-Nascido , Subtipo H7N9 do Vírus da Influenza A/genética , Influenza Aviária/transmissão , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Zoonoses/epidemiologia , Zoonoses/etiologia , Zoonoses/prevenção & controle
16.
Hum Vaccin Immunother ; 13(7): 1688-1692, 2017 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-28362546

RESUMO

Objective This study aimed to understand the knowledge, attitudes and practices (KAP) on seasonal influenza among medical college students in a low-income multiethnic society. Methods A cross-sectional questionnaire survey collected information of KAP related to influenza. A knowledge score was calculated according to the total number of correct points out of 9 questions. Logistic regression was used to identify factors associated with influenza vaccine uptake. Results 856 valid questionnaires were obtained. The average knowledge score was 14.8 ± 3.1 out of 22 correct points. Han Chinese got higher score than minorities (p < 0.001). Knowledge score increased with grade (p < 0.001). Students majoring in pharmacy had lower score than others. Questions on mode of transmission, symptoms, precautions, high risk groups and vaccination schedule had a correct rate lower than 50%. Hand hygiene was practiced by less than 40% of students after touching objects in public areas or sneezing. The proportion of participants received influenza vaccine in the past 3 y was 4.1%, 9.2% and 6.1% respectively. Willingness to receive free vaccine (OR = 2.49, 95% CI 1.31∼4.28), and awareness of the vaccine effectiveness (OR = 1.67, 95% CI 1.08∼2.56) were significantly associated with vaccine uptake, while the general knowledge about influenza, perceived susceptibility and severity, and demographic factors were not. The top 3 reasons for not being vaccinated were poor knowledge of the vaccine (46%), no perceived need due to good health (45%) and worry about adverse reactions (33%). Conclusion Health education is needed to improve the awareness of basic facts about influenza and vaccine, and more attention should be paid to minority groups. The coverage of seasonal influenza vaccine is quite low. Besides individual level behavior change, social and structural factors should be considered to increase the uptake of influenza vaccine.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Estudantes de Medicina , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Vacinas contra Influenza/administração & dosagem , Masculino , Cobertura Vacinal , Adulto Jovem
17.
Emerg Infect Dis ; 23(5): 765-772, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-28418296

RESUMO

China's hepatitis B virus (HBV) prevention policy has been evaluated through nationally representative serologic surveys conducted in 1992 and 2006. We report results of a 2014 serologic survey and reanalysis of the 1992 and 2006 surveys in the context of program policy. The 2014 survey used a 2-stage sample strategy in which townships were selected from 160 longstanding, nationally representative, county-level disease surveillance points, and persons 1-29 years of age were invited to participate. The 2014 sample size was 31,713; the response rate was 83.3%. Compared with the 1992 pre-recombinant vaccine survey, HBV surface antigen prevalence declined 46% by 2006 and by 52% by 2014. Among children <5 years of age, the decline was 97%. China's HBV prevention program, targeted toward interrupting perinatal transmission, has been highly successful and increasingly effective. However, this progress must be sustained for decades to come, and elimination of HBV transmission will require augmented strategies.


Assuntos
Vacinas contra Hepatite B/imunologia , Vírus da Hepatite B , Hepatite B Crônica/epidemiologia , Hepatite B Crônica/prevenção & controle , Vacinação , Adolescente , Adulto , Biomarcadores , Criança , Pré-Escolar , China/epidemiologia , Feminino , Vacinas contra Hepatite B/administração & dosagem , Vírus da Hepatite B/imunologia , Hepatite B Crônica/história , Hepatite B Crônica/imunologia , História do Século XX , História do Século XXI , Humanos , Programas de Imunização , Lactente , Masculino , Pessoa de Meia-Idade , Vigilância da População , Prevalência , Adulto Jovem
18.
Malar J ; 16(1): 53, 2017 01 31.
Artigo em Inglês | MEDLINE | ID: mdl-28137250

RESUMO

BACKGROUND: When discussing the relationship between meteorological factors and malaria, previous studies mainly focus on the interaction between different climatic factors, while the possible interaction within one particular climatic predictor at different lag periods has been largely neglected. In this study, this issue was investigated by exploring the interaction of lagged rainfalls and its impact on malaria epidemics, which is a typical example of those meteorological variables. METHODS: The weekly data of malaria cases and three climatic variables of 30 counties in southwest China from 2004 to 2009 were analysed with the varying coefficient-distributed lag non-linear model. The correlation patterns of the 6th, 9th and 12th week lags would vary over different rainfall levels at the 4th-week lag. RESULTS: The non-linear patterns for rainfall at different rainfall levels are distinct from each other. In the low rainfall level at the 4th week lag, the increasing rainfall may promote the transmission of malaria. However, for the high rainfall level at the 4th week lag, evidence shows that the excessive rainfall decreases the risk of malaria. CONCLUSION: This study reports for the first time that the interaction effect between lagged rainfalls on malaria exists, and highlights the importance of integrating the interaction between lagged predictors in relevant studies, which could help to better understand and predict malaria transmission.


Assuntos
Malária/epidemiologia , Chuva , China/epidemiologia , Clima , Humanos , Incidência , Malária/parasitologia , Malária/transmissão , Dinâmica não Linear , Risco , Estações do Ano , Fatores de Tempo
19.
Hum Vaccin Immunother ; 13(1): 144-150, 2017 01 02.
Artigo em Inglês | MEDLINE | ID: mdl-28045585

RESUMO

BACKGROUND: Two kinds of regimens (2-1-1 and 1-1-1-1-1) can be selected after Zagreb regimen(2-1-1)of PVRV was officially approved in Beijing in January 2015. Up to now, the subjects for most studies about the comparison between Zagreb and Essen regimen are under 50 y old, rarely at and above. Aging of the immune system may result in decreasing efficacy of vaccination, especially for adults aged above 65-70 y. This study compared the safety and immunogenicity of the Zagreb and Essen regimen in Chinese adults aged 50 and above with the goal to provide a supplemental data for this age group. METHODS: A total of 114 cases were divided into 2 groups randomly, received PVRV under the Zagreb and Essen regimens respectively. Serum samples were collected at D0, D7, D14, D42, D180 and D365 to determine the rabies serum neutralizing antibody by rapid fluorescent focus inhibition test (RFFIT). Safety analyses were made by comparing the AEs in day-3, day-7, and day-(7 + 21) in Zagreb or day-(7 + 28) in Essen by gender and age cohorts. RESULTS: 617 blood samples were obtained. Two groups showed similar immunogenicity, the neutralizing antibody titer of all subjects at D14 and D42 showed >0.5 IU/ml. Under the same regimen, Subjects ≥65 y had lower GMC than those who <65 years from D7 to D365 within 2 groups. This difference was significantly shown on D7, D14, D180 in Zagreb group, and on D180 in Essen group (t = 2.38, p = 0.02; t = 3.78, p < 0.001; t = 2.30, p = 0.03; t = 4.42, p < 0.001). Subjects<65 years had higher seroconversion rate compared to ≥65 y on D7, D180 and D365 in both 2 groups, this difference was also significantly shown on D180, D365 in Zagreb group and on D180 in Essen group (χ2 = 20.66, p < 0.001; χ2 = 6.56, p = 0.02; χ2 = 10.96, p = 0.002). Two regimens all showed favorable performances with mildly or common adverse events (AEs). The incidence of local AEs after 3 d in Essen group was higher than Zagreb group (χ2 = 9.69, p = 0.002). The most common local AE was pain, the incidences (8.8%) in Zagreb group was higher than Essen group (8.4%, χ2 = 5.12, p = 0.02). All AEs for Zagreb group and 52.3% of AEs for Essen group occurred during the first 72 hours. During the first 72 hours, subjects aged <65 in Zagreb group (16.26%) had higher incidences of AEs than Essen group (8.57%, χ2 = 4.54, p = 0.03), males in Zagreb group (16.05%) had higher incidence of AEs than Essen group (5.71%, χ2 = 5.34, p = 0.02). The incidences of AEs close in during the first 7 d. CONCLUSION: The Zagreb and Essen regimens demonstrated the similar safety and efficacy of PVRV in Chinese adults aged 50 and above. People ≥65 y showed reduced immune response to both regimens. More AEs for the Zagreb regimen were observed within the first 72 hours, especially for male and people < 65 y.


Assuntos
Esquemas de Imunização , Vacinas Antirrábicas/efeitos adversos , Vacinas Antirrábicas/imunologia , Raiva/prevenção & controle , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Animais , Anticorpos Neutralizantes/sangue , Anticorpos Antivirais/sangue , China , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Vacinas Antirrábicas/administração & dosagem , Vacinas Antirrábicas/isolamento & purificação , Tecnologia Farmacêutica , Células Vero
20.
BMC Infect Dis ; 16(1): 734, 2016 12 05.
Artigo em Inglês | MEDLINE | ID: mdl-27919225

RESUMO

BACKGROUND: H7N9 human cases were first detected in mainland China in March 2013. Circulation of this virus has continued each year shifting to typical winter months. We compared the clinical and epidemiologic characteristics for the first three waves of virus circulation. METHODS: The first wave was defined as reported cases with onset dates between March 31-September 30, 2013, the second wave was defined as October 1, 2013-September 30, 2014 and the third wave was defined as October 1, 2014-September 30, 2015. We used simple descriptive statistics to compare characteristics of the three distinct waves of virus circulation. RESULTS: In mainland China, 134 cases, 306 cases and 219 cases were detected and reported in first three waves, respectively. The median age of cases was statistically significantly older in the first wave (61 years vs. 56 years, 56 years, p < 0.001) compared to the following two waves. Most reported cases were among men in all three waves. There was no statistically significant difference between case fatality proportions (33, 42 and 45%, respectively, p = 0.08). There were no significant statistical differences for time from illness onset to first seeking healthcare, hospitalization, lab confirmation, initiation antiviral treatment and death between the three waves. A similar percentage of cases in all waves reported exposure to poultry or live poultry markets (87%, 88%, 90%, respectively). There was no statistically significant difference in the occurrence of severe disease between the each of the first three waves of virus circulation. Twenty-one clusters were reported during these three waves (4, 11 and 6 clusters, respectively), of which, 14 were considered to be possible human-to-human transmission. CONCLUSION: Though our case investigation for the first three waves found few differences between the epidemiologic and clinical characteristics, there is continued international concern about the pandemic potential of this virus. Since the virus continues to circulate, causes more severe disease, has the ability to mutate and become transmissible from human-to-human, and there is limited natural protection from infection in communities, it is critical that surveillance systems in China and elsewhere are alert to the influenza H7N9 virus.


Assuntos
Subtipo H7N9 do Vírus da Influenza A/isolamento & purificação , Influenza Humana/virologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , China/epidemiologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Subtipo H7N9 do Vírus da Influenza A/classificação , Subtipo H7N9 do Vírus da Influenza A/genética , Influenza Humana/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Estações do Ano , Adulto Jovem
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