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1.
BMC Infect Dis ; 21(1): 514, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34074256

RESUMO

BACKGROUND: Talaromyces marneffei (TM) bloodstream infection is common in Acquired Immunodeficiency Syndrome (AIDS) patients with extreme immunodeficiency in Southeast Asia and South China, however, clinical case study on TM bloodstream infection is scarce. We retrospectively analyzed the clinical characteristics of TM bloodstream infection in hospitalized AIDS patients and determined the outcomes of hospitalization after diagnosis in our hospital over the past 5 years. METHODS: From January 2015 to July 2020, 87 cases of TM detected by blood culture in patients admitted to our center were collected. The admission complaints, blood cells, biochemistry, CD4 and CD8 cell counts and 1,3-ß-D-glucan (BDG), procalcitonin (PCT), CRP level on the day of blood culture test, and outcomes during hospitalization were analyzed. Logistic regression analysis was performed for the risk factors for poor prognosis (60 cases). Spearman correlation analysis was used to analyze the correlation between peripheral blood cells, albumin and the time required for TM turnaround in blood culture. The difference was statistically significant when the P value was < 0.05. RESULTS: A total of 87 patients were collected, with a median age of 34 years, a median hemoglobin of 94 g/L and CD4 count of 7/µl. The rate of TM bloodstream infection among all in-hospital patients increased from 0.99% in 2015 to 2.09% in 2020(half year). Patients with TM bloodstream infection with CD8 count < 200/µl had a 12.6-fold higher risk of poor prognosis than those with CD8 count > 200/µl (p = 0.04), and those with BDG < 100 pg/mL had a 34.9-fold higher risk of poor prognosis than those with BDG > 100 pg/mL (p = 0.01). CONCLUSIONS: TM bloodstream infection is becoming more common in advanced AIDS patients in endemic areas. For those patients with extremely low CD4 and CD8 cell counts below 200/µl is with an increased risk of poor prognosis.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Fungemia/epidemiologia , Micoses/epidemiologia , Talaromyces/isolamento & purificação , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Adulto , China/epidemiologia , Feminino , Fungemia/diagnóstico , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Micoses/diagnóstico , Prognóstico , Estudos Retrospectivos , Fatores de Risco
2.
BMJ Open ; 11(6): e045317, 2021 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-34083336

RESUMO

OBJECTIVE: We aimed to ascertain the trends of injury mortality during the COVID-19 period in southern China. METHODS: We conducted a population-based retrospective analysis to compare the mortality changes of all-cause injury and transport injuries, poisoning, falls, fire/heat/hot substances, drowning, self-harm and interpersonal violence, which were further stratified by sex and age. Comparisons were made between the COVID-19 period (between January 2020 and June 2020) and control period (between January 2019 and June 2019) in Guangdong province. We used the negative binomial models to explore the associations of deaths during the COVID-19 period, according to the different sex and age strata. RESULTS: The all-cause injury mortality in Guangdong province decreased significantly from 28.65 per 100 000 population during the control period to 23.24 per 100 000 population during COVID-19 pandemic period. Similar results were found in specific injury categories. Mortality of self-harm increased by 139.26% in the 10-14 year group during the COVID-19 period as compared with the control period. Although mortality changes in some groups were not statistically significant, some increases were noteworthy during the COVID-19 period (ie, self-harm, transport injury and falls) in the 70-79 year group. The corresponding increase in mortality rate was 16.83%, 3.32% and 4.92%, respectively. CONCLUSION: The mortality of all-cause injury, transport injury and drowning during the COVID-19 pandemic was consistently decreased. However, the increase in mortality associated with falls, fire/heat/hot substance injury and self-harm in specific age populations warrant the targeted control and prevention measures for the population at risk.


Assuntos
COVID-19 , Suicídio , Ferimentos e Lesões , China/epidemiologia , Humanos , Pandemias , Estudos Retrospectivos , SARS-CoV-2
3.
BMC Public Health ; 21(1): 1063, 2021 06 04.
Artigo em Inglês | MEDLINE | ID: mdl-34088290

RESUMO

BACKGROUND: Coronavirus Disease 2019 (COVID-19) is a global pandemic and an anxiety-provoking event. There are few studies to identify potential risk and protective factors related to anxiety during COVID-19 pandemic. METHODS: We collected information on demographic data and lifestyles by a web-based survey of 19,802 participants from 34 provinces in China during COVID-19 pandemic. Level of anxiety was evaluated using the Self-Rating Anxiety Scale. We used ordinal multivariable logistic regression to estimate the associations of anxiety level with potential risk and protective factors. We further developed a new score to simplify the assessment of anxiety during COVID-19 crisis. RESULTS: Among 19,802 participants, we found that those who were front-line medical personnel, suffered from chronic disease, with present symptoms of SARS-CoV-2 infection or contact history had 112, 93, 40 and 15% increased risk of higher anxiety level; while those with knowledge about personal protective measures or wore masks had 75 and 29% lower risk of higher anxiety level respectively. We developed a risk score by calculating the sum of single score of 17 factors. Each one increase of the risk score was associated with a 297% increase in anxiety index score. In categorical analysis, low risk (the risk score between 1 to 2), the moderate risk group (the risk score of 3) and high risk group (the risk score ≥ 4) had - 0.40 (95% CI: - 1.55, 0.76), 1.44 (95% CI: 0.27, 2.61) and 9.18 (95% CI: 8.04, 10.33) increase in anxiety index score, and 26% (95% CI: - 7, 72%), 172% (95% CI: 100, 270%), and 733% (95% CI: 516, 1026%) higher risk of anxiety respectively, when compared with the very low risk group (the risk score of 0). The AUC was 0.73 (95% CI, 0.72, 0.74) for the model fitted the developed risk score, with the cut-off point of 3.5. CONCLUSIONS: These findings revealed protective and risk factors associated with anxiety, and developed a simple method of identifying people who are at an increased risk of anxiety during COVID-19 pandemic.


Assuntos
COVID-19 , Pandemias , Ansiedade/epidemiologia , China/epidemiologia , Estudos Transversais , Depressão , Humanos , Pandemias/prevenção & controle , Fatores de Proteção , Fatores de Risco , SARS-CoV-2 , Inquéritos e Questionários
4.
BMJ Open ; 11(6): e044262, 2021 06 04.
Artigo em Inglês | MEDLINE | ID: mdl-34088706

RESUMO

OBJECTIVES: This research investigated whether certain population segments might be more psychologically vulnerable in different phases of a pandemic. Specifically, the research examined how disparities in wealth might be associated with differences in emotional well-being before, during, versus after the nationwide COVID-19 outbreak in China. SETTING, PARTICIPANTS AND OUTCOME MEASURES: In this large-scale cross-sectional study, three rounds of nationally representative data collection (N=27 760) were conducted immediately before (December 2019), in the midst of (February 2020), versus immediately after (April 2020) the countrywide COVID-19 outbreak in China. Participants' emotional well-being, wealth (income, property ownership) and demographic information were measured using established instruments. Statistical analyses examined relationships between disparities in different types of wealth and emotional well-being across the pandemic phases. RESULTS: Although the onset of the coronavirus outbreak substantially degraded emotional well-being, having a higher income was associated with better emotional well-being during the outbreak. Property owners experienced a larger drop in emotional well-being during the outbreak than non-owners; however, the former was not emotionally worse off than the latter during the outbreak. After the nationwide COVID-19 outbreak had been contained and the economy reopened, those with more wealth of either type again became better off in emotional well-being than those with less. The highest income segment even experienced better emotional well-being after the end of the nationwide outbreak than prior to the outbreak. In contrast, the lowest income segment became worse off in emotional well-being after the nationwide outbreak ended than before the outbreak began. CONCLUSION: People with less wealth tend to be emotionally worse off throughout the different phases of a disease outbreak. In particular, even after an outbreak has been contained, the poor are less able to restore their psychological well-being. Policies and interventions are needed to address disparities in mental health in the age of pandemics.


Assuntos
COVID-19 , Pandemias , Ansiedade , China/epidemiologia , Estudos Transversais , Surtos de Doenças , Humanos , Saúde Mental , SARS-CoV-2 , Inquéritos e Questionários
5.
Front Public Health ; 9: 603331, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34095044

RESUMO

Background: The 2019 coronavirus disease (COVID-19) pandemic is a public health emergency of international concern. This study aimed to assess the psychological outcomes and their influencing factors among medical and non-medical University students during the COVID-19 pandemic in China. Methods: A cross-sectional online survey using structured questionnaires was conducted from February 20 to March 20, 2020. Psychological outcomes were assessed according to the Depression, Anxiety, and Stress Scale (DASS-21). Influencing factors were assessed by COVID-19 knowledge, mindful coping scale, and sense of control scale. Results: Our sample is comprised of 563 University students (male = 172, mean age = 21.52). Among them, 382 are medical students. Among the participants, 12.26, 18.47, and 8.53% have moderate to severe levels of depression, anxiety, and stress symptoms, respectively. Compared with the non-medical students, the medical students had a higher knowledge level of COVID-19, a higher sense of awareness, and fewer mental health symptoms. After controlling the covariance, perceived constraints of sense of control were negatively associated with depression, anxiety, and stress among both medical and non-medical students. Prevention of negative emotions by mindful coping was negatively associated with depression and anxiety among non-medical students. Knowledge of COVID-19 is not associated with mental distress among medical and non-medical students. Conclusions: During the COVID-19 pandemic in China, the mental health of University students was affected. Our findings suggested that a sense of control is a protective factor for both medical and non-medical students, while mindful coping is a protective factor for only non-medical students.


Assuntos
COVID-19 , Estudantes de Medicina , Adulto , China/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Humanos , Masculino , Saúde Mental , Pandemias , SARS-CoV-2 , Estresse Psicológico/epidemiologia , Adulto Jovem
6.
Front Public Health ; 9: 644536, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34095053

RESUMO

Background: To contain the pandemic of COVID-19, China has implemented a series of public health interventions that impacted the tuberculosis control substantially, but these impacts may vary greatly depending on the severity of the local COVID-19 epidemic. The impact of COVID-19 on TB control in Ningxia Hui Autonomous Region is little known. Methods: Based on the national TB Information Management System (TBIMS), this study accessed the actual impact of COVID-19 on TB by comparing TB notifications, pre-treatment delays, and clinical characteristics of TB cases between 2020 COVID-19 period and 2017-2019 baseline. The data were divided into three periods based on the response started to fight against COVID-19 in Ningxia Hui Autonomous Region, including the control period (10 weeks before the pandemic), intensive period (10 weeks during the Ningxia Hui Autonomous Region lockdown), and regular (10 additional weeks after Ningxia Hui Autonomous Region reopen). Results: TB notification dropped sharply in the first week of the intensive period but took significantly longer to return to the previous level in 2020 compared with the 2017-2019 baseline. Totally, the TB notification rates decreased by more than 60% in the intensive period of COVID-19 compared with the average level of 2017-2019. The sputum smear-positive rate of TB patients diagnosed in intensive period of COVID-19 was significantly higher than that in the corresponding periods of 2017-2019 (P < 0.001). The rate of cavity on X-ray inspection of TB cases diagnosed in the intensive period of COVID-19 was significantly higher than that in period 2 of 2017-2019 (23.5 vs. 15.4%, P = 0.004). The patients' delay in the intensive period was significantly longer than that before the pandemic (P = 0.047). Conclusions: The TB notification in Ningxia was impacted dramatically by the pandemic of COVID-19. To compensate for the large numbers of missed diagnosis as well as delayed diagnosis during the intensive period of COVID-19, an urgent restoration of normal TB services, and further emphasis on enhanced active case finding and scale-up of household contact tracing and screening for TB-related symptoms or manifestation, will be essential.


Assuntos
COVID-19 , Tuberculose , China/epidemiologia , Controle de Doenças Transmissíveis , Humanos , Pandemias , SARS-CoV-2 , Tempo para o Tratamento , Tuberculose/diagnóstico
7.
Front Public Health ; 9: 672568, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34095074

RESUMO

A series of public health interventions have been implemented to prevent the transmission of SARS-CoV-2 in China. However, the effect of non-pharmaceutical interventions to COVID-19 on the incidence of the influenza virus and Mycobacterium tuberculosis infections is not clear. In current study, we analyzed surveillance data on influenza and Mycobacterium tuberculosis from Henan Provincial People's Hospital in Zhengzhou, Henan province, China from 2019 to 2020. The monthly positive test rate for influenza and Mycobacterium tuberculosis to estimate transmissibility changes was calculated. The positive detection rate of influenza A declined significantly during the implementation of inventions in 2020, from a total positive rate of 17.69% in 2019 to 5.77% in 2020. Similarly, a 2.15% reduction in positive detective rate was seen for influenza B, from a total positive rate of 5.15% in 2019 to 3% in 2020. The positive rate curve of Mycobacterium tuberculosis measured by x-pert in 2020 remained above the curve in 2019 from March to June, and August, showing the rising trend under these precautions. Our study suggests that non-pharmaceutical public health interventions likely reduced influenza transmission significantly and have less effect on Mycobacterium tuberculosis transmission in 2020.


Assuntos
COVID-19 , Influenza Humana , Tuberculose , China/epidemiologia , Humanos , Influenza Humana/epidemiologia , SARS-CoV-2 , Tuberculose/epidemiologia
8.
Front Public Health ; 9: 650493, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34095057

RESUMO

Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is a highly infectious virus that is transmitted primarily through droplets or by coming in close contact with an infected person. In 2020, there was a global outbreak of COVID-19, resulting in an unprecedented global burden of disease, health care costs, and had a significant economic impact. Recently, SARS-CoV-2 was detected on the outer packaging of imported cold chain items in China and has led to virus transmission events, causing great concern. This paper analyses the factors of SARS-CoV-2 survival and transmission in different places and environments, especially the characteristics of low temperatures and object surfaces. It was found that SARS-CoV-2 could survive on surfaces of cold and moist objects in the cold chain for more than 3 weeks, potentially causing COVID-19 transmission. We believe that the low-temperature environment in winter may accelerate the spread of the outbreak and new outbreaks may occur. Overall, SARS-CoV-2 transmission that is susceptible to low winter temperatures is critical for predicting winter pandemics, allowing for the appropriate action to be taken in advance.


Assuntos
COVID-19 , SARS-CoV-2 , China/epidemiologia , Surtos de Doenças , Embalagem de Alimentos , Humanos , Refrigeração
9.
Front Public Health ; 9: 659797, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34095063

RESUMO

Background: The coronavirus disease 2019 (COVID-19) pandemic in China is essentially under control. Under global scrutiny, China has started reviving the social, cultural, and working lives of its inhabitants. However, localized outbreaks of COVID-19 are occurring, indicating that the country still needs to follow disease prevention and control measures. Previous studies have assessed the knowledge, attitudes, and behaviors of the general public in China regarding COVID-19 during the pandemic. However, little is known about knowledge, attitudes, and practices (KAP) of Chinese residents regarding COVID-19 after periods of lockdown. Therefore, this study was conducted to identify the KAP and other factors among the residents of Shaanxi Province during the post-lockdown period. Methods: A cross-sectional, network questionnaire survey was conducted in Shaanxi Province from October 1-30, 2020. A total of 1,175 urban residents were interviewed via Wen Juan Xing, an online questionnaire tool. A self-developed online KAP COVID-19 questionnaire was developed in this study. The questionnaire consisted of four parts: general information, knowledge, attitude, and practice. Descriptive statistics and binomial logistic regression analysis were used in the statistical analysis. Results: The majority of the participants were knowledgeable about COVID-19. They had optimistic attitudes and behaved appropriately toward COVID-19. Education was an associated factor for the knowledge of residents and the knowledge of COVID-19 was high among people with high academic qualifications. Attitudes were more positive in residents who lived with elderly people, women, and children. The score of practice was higher in residents with positive attitudes and high academic qualifications. There was a positive correlation between age and practice. Conclusion: We found that the KAP of residents in Shaanxi was at a relatively high level during the post-lockdown period. Although the lockdown was lifted, the epidemic is not over. Thus, it is necessary to develop targeted health education programs for residents with different demographic characteristics in Shaanxi.


Assuntos
COVID-19 , Conhecimentos, Atitudes e Prática em Saúde , Idoso , Criança , China/epidemiologia , Controle de Doenças Transmissíveis , Estudos Transversais , Feminino , Humanos , SARS-CoV-2 , População Urbana
10.
Front Public Health ; 9: 664905, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34095068

RESUMO

Objective: The Coronavirus disease 2019 (COVID-19) vaccine is currently available. This timely survey was conducted to provide insight into on the willingness of healthcare workers (HCWs)to receive the vaccine and determine the influencing factors. Methods: This was a cross-sectional online survey. An online questionnaire was provided to all participants and they were asked if they would accept a free vaccine. The questionnaire gathered general demographic information, and included the General Health Questionnaire (GHQ-12); Myers-Briggs Type Indicator questionnaire (MBTI); Depression, Anxiety, and Stress Scales (DASS-21); and the 12-item Short Form Health Survey (SF-12). The data were collected automatically and electronically. Univariate analysis was done between all the variables and our dependent variable. Multivariable logistic regression models were employed to examine and identify the associations between the acceptance of the COVID-19 vaccine with the associated variables. Results: We collected 505 complete answers. The participants included 269 nurses (53.27%), 206 clinicians (40.79%), 15 administrative staff (2.97%), and 15 other staff (2.97%). Of these, 76.63% declared they would accept the vaccine. The major barriers were concerns about safety, effectiveness, and the rapid mutation in the virus. Moreover, four factors were significantly associated with the willingness to receive the vaccine: (a) "understanding of the vaccine" (odds ratio (OR):2.322; 95% confidence interval [CI]: 1.355 to 3.979); (b) "worried about experiencing COVID-19" (OR 1.987; 95% CI: 1.197-3.298); (c) "flu vaccination in 2020" (OR 4.730; 95% CI: 2.285 to 9.794); and (d) "living with elderly individuals" (OR 1.928; 95% CI: 1.074-3.462). Conclusions: During the vaccination period, there was still hesitation in receiving the vaccine. The results will provide a rationale for the design of future vaccination campaigns and education efforts concerning the vaccine.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Idoso , China/epidemiologia , Estudos Transversais , Pessoal de Saúde , Humanos , Aceitação pelo Paciente de Cuidados de Saúde , SARS-CoV-2
11.
Zhonghua Yi Xue Za Zhi ; 101(21): 1583-1591, 2021 Jun 08.
Artigo em Chinês | MEDLINE | ID: mdl-34098685

RESUMO

Objective: Investigate the current situation of lung cancer cough diagnosis and treatment and the awareness of related issues among Chinese medical providers. Methods: Doctors, nurses, pharmacists from the oncology department, respiratory department, or general department were investigated using an electronic questionnaire from January 29 to March 29, 2021. There were 25 questions about lung cancer in the questionnaire. The questionnaire was including the most common accompanying symptoms in patients with lung cancer, the incidence of lung cancer-related cough, the assessment of the proportion of central antitussive drugs, and the commonly used central antitussives. Results: Questionnaires from 2 424 medical providers were collected from 402 hospitals in 21 provincial administrative units. Cough was the most common symptom in lung cancer. Most physicians believed that the incidence of lung cancer-related cough was 51%~75%, while the proportion of patients satisfied with the treatment was only 11%~20%. The evaluation of lung cancer-related cough was seriously insufficient. The leading cause of lung cancer-related cough was tumors. And the main problem was the inadequate antitussive effect of drugs in lung cancer-related cough management. The proportion of central antitussive medication usage in the secondary and tertiary hospitals was 93.9% and 92.0%, significantly higher than 75.0% in Primary hospitals (χ²=8.390, P=0.015). The proportion of the physicians who underhanded that codeine is at risk of addiction was 76.6% and 72.0% in the secondary and tertiary hospitals, which were significantly higher than 53.9% in Primary hospitals (χ²=9.240, P=0.010). In different occupations, the proportions of doctors and pharmacists who knew the risk of addicting to codeine were 73.0% and 82.6%, which were significantly higher than the 66.4% of nurses (χ²=21.200, P<0.001). The Chinese medical providers were lack of training about the basic knowledge of using central antitussive medication. Conclusions: The proportion of patients who were satisfied with the effect of cough treatment is low. The medical staff did not have enough awareness of this. There was an urgent need to develop a consensus and standardize lung cancer cough diagnosis and treatment in China.


Assuntos
Antitussígenos , Neoplasias Pulmonares , Antitussígenos/uso terapêutico , China/epidemiologia , Tosse/tratamento farmacológico , Tosse/etiologia , Humanos , Neoplasias Pulmonares/complicações , Inquéritos e Questionários
12.
J Orthop Surg Res ; 16(1): 356, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34074300

RESUMO

BACKGROUND: The coronavirus disease (COVID-19) pandemic has had a massive impact on individuals globally. The Chinese government has formulated effective response measures, and medical personnel have been actively responding to challenges associated with the epidemic prevention and control strategies. This study aimed to evaluate the effect of the implementation of a care transition pathway on patients that underwent joint replacement during the COVID-19 pandemic. METHODS: A quasi-experimental study was designed to evaluate the effect of implementing a care transition pathway for patients who underwent joint replacement during the COVID-19 pandemic in the orthopedic department of a tertiary care hospital in Beijing, China. Using a convenient sampling method, a total of 96 patients were selected. Of these, 51 patients who had undergone joint replacement in 2019 and received treatment via the routine nursing path were included in the control group. The remaining 45 patients who underwent joint replacement during the COVID-19 epidemic in 2020 and received therapy via the care transition pathway due to the implementation of epidemic prevention and control measures were included in the observation group. The quality of care transition was assessed by the Care Transition Measure (CTM), and patients were followed up 1 week after discharge. RESULTS: The observation group was determined to have better general self-care preparation, written planning materials, doctor-patient communication, health monitoring, and quality of care transition than the control group. CONCLUSIONS: A care transition pathway was developed to provide patients with care while transitioning through periods of treatment. It improved the patient perceptions of nursing quality. The COVID-19 pandemic is a huge challenge for health professionals, but we have the ability to improve features of workflows to provide the best possible patient care.


Assuntos
Artroplastia de Substituição/tendências , COVID-19/epidemiologia , Ensaios Clínicos Controlados não Aleatórios como Assunto/tendências , Procedimentos Ortopédicos/tendências , Centros de Atenção Terciária/tendências , Cuidado Transicional/tendências , Idoso , Artroplastia de Substituição/métodos , Artroplastia de Substituição/reabilitação , Pequim/epidemiologia , COVID-19/prevenção & controle , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados não Aleatórios como Assunto/métodos , Procedimentos Ortopédicos/métodos , Procedimentos Ortopédicos/reabilitação , Pandemias , Resultado do Tratamento
13.
Wei Sheng Yan Jiu ; 50(3): 377-381, 2021 May.
Artigo em Chinês | MEDLINE | ID: mdl-34074359

RESUMO

OBJECTIVE: To describe the hemoglobin and prevalence of anemia among 6-23 months infants at different elevations in poor rural areas in China. METHODS: The monitoring data in the year 2018 from the Children Nutrition Improvement Project in Poor Areas of China was used for the analysis, which covered 19 provinces and 42 938 infants of 6-23 months. Hemoglobin was tested by Hemoque method with blood drop from finger tips. The altitude of the residence regions was divided into eight parts. Analysis of variance was used to compare the mean values among the altitude groups, and chi-square test was used to compare the prevalence of anaemia. RESULTS: The data from 42 938 6-23 months infants was under analysis, among them 22 207(51.7%)were boys and 20 731(48.4%)girls. 27 208(63.4%)infants and children were located in the areas under 1000 meters whose average hemoglobin was 11.8 g/dL and the prevalence of anemia was 18.7%. There were 15 730(36.6%)infants living in areas higher than 1000 meters. The anemia rate ranged from 31.3% to 83.6% in all aged groups when altitude& gt; 2500 m that were noticeable higher than that of lower altitude regions. With the increase of altitude, the adjusted anemic rate showed an obvious upward trend. 6-11 months infants showed higher anemia rate compared with other groups. CONCLUSION: The incidence of anemia among children aged 6 to 23 months in poor areas of China is severe, among which infants living at an altitude of more than 2500 meters have a higher prevalence of anemia.


Assuntos
Altitude , Anemia , Pobreza , Anemia/epidemiologia , China/epidemiologia , Feminino , Hemoglobinas/análise , Humanos , Lactente , Masculino , Prevalência , População Rural
14.
BMC Pediatr ; 21(1): 255, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-34074254

RESUMO

BACKGROUND: Antibiotic resistance poses a significant threat to public health globally. Irrational utilization of antibiotics being one of the main reasons of antibiotic resistant. Children as a special group, there's more chance of getting infected. Although most of the infection is viral in etiology, antibiotics still are the most frequently prescribed medications for children. Therefore, high use of antibiotics among children raises concern about the appropriateness of antibiotic prescribing. This systematic review aims to measuring prevalence and risk factors for antibiotic utilization in children in China. METHODS: English and Chinese databases were searched to identify relevant studies evaluating the prevalence and risk factors for antibiotic utilization in Chinese children (0-18 years), which were published between 2010 and July 2020. A Meta-analysis of prevalence was performed using random effect model. The Agency for Healthcare Research and Quality (AHRQ) and modified Jadad score was used to assess risk of bias of studies. In addition, we explored the risk factors of antibiotic utilization in Chinese children using qualitative analysis. RESULTS: Of 10,075 studies identified, 98 eligible studies were included after excluded duplicated studies. A total of 79 studies reported prevalence and 42 studies reported risk factors for antibiotic utilization in children. The overall prevalence of antibiotic utilization among outpatients and inpatients were 63.8% (35 studies, 95% confidence interval (CI): 55.1-72.4%), and 81.3% (41 studies, 95% CI: 77.3-85.2%), respectively. In addition, the overall prevalence of caregiver's self-medicating of antibiotics for children at home was 37.8% (4 studies, 95% CI: 7.9-67.6%). The high prevalence of antibiotics was associated with multiple factors, while lacking of skills and knowledge in both physicians and caregivers was the most recognized risk factor, caregivers put pressure on physicians to get antibiotics and self-medicating with antibiotics at home for children also were the main factors attributed to this issue. CONCLUSION: The prevalence of antibiotic utilization in Chinese children is heavy both in hospitals and home. It is important for government to develop more effective strategies to improve the irrational use of antibiotic, especially in rural setting.


Assuntos
Antibacterianos , Uso de Medicamentos , Antibacterianos/uso terapêutico , Criança , China/epidemiologia , Resistência Microbiana a Medicamentos , Humanos , Prevalência , Fatores de Risco
15.
BMC Pediatr ; 21(1): 261, 2021 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-34090355

RESUMO

BACKGROUND: Neonatal hypoxic-ischemic encephalopathy (HIE) affects as many as 100,000 infants each year in China. Therapeutic hypothermia reduces HIE related mortality and long-term neurodevelopmental disabilities. National guidelines for HIE management were published a decade ago. This study aimed to investigate the current status of HIE diagnosis and treatment in China. METHOD: This prospective cross-sectional national survey used a questionnaire evaluating practices related to HIE management. Descriptive statistics and Chi-square or Fisher's exact test were used, and a p-value of < 0.05 was considered significant. RESULTS: The 273 hospitals that completed the survey were located in 31 of the 34 provincial districts in China. Eighty-eight percent of the hospitals were Level III hospitals, and 74% treated 10 or more HIE cases annually. Awareness rates of the national guidelines for HIE diagnosis, HIE treatment, and therapeutic hypothermia protocol were 85, 63, and 78%, respectively. Neurological manifestations and blood gas were used as HIE diagnostic criteria by 96% (263/273) and 68% (186/273) of the hospitals, respectively. Therapeutic hypothermia was used in 54% (147/273) of hospitals. The percentage of general hospitals that implemented therapeutic hypothermia (43%, 71/165) was significantly lower than that in maternity and infant hospitals (67%, 49/73) (χ2 = 11.752, p = 0.001) and children's hospitals (77%, 27/35) (χ2 = 13.446, p < 0.001). Reasons for not providing therapeutic hypothermia included reduction of HIE cases in recent years (39%), high cost of cooling devices and treatment (31%), lack of training (26%), and safety concerns (4%). Among the hospitals that provided therapeutic hypothermia, 27% (39/147) were in full compliance with the recommended protocol. Eighty-one percent (222/273) of the hospitals treated HIE infants with putative neuroprotective agents alone or in combination with cooling. Ninety-one percent of the hospitals had long-term neurodevelopmental follow-up programs for infants with HIE. CONCLUSIONS: There is significant heterogeneity in HIE diagnosis and treatment in China. Therapeutic hypothermia has not become a standard of care for neonatal HIE nationwide. Unproven agents are widely used for HIE treatment. Nationwide standardization of HIE management and dissemination of therapeutic hypothermia represent the opportunities to reduce mortality and improve long-term neurodevelopmental outcomes of children affected by HIE.


Assuntos
Hipotermia Induzida , Hipóxia-Isquemia Encefálica , Criança , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Hipóxia-Isquemia Encefálica/diagnóstico , Hipóxia-Isquemia Encefálica/terapia , Lactente , Recém-Nascido , Gravidez , Estudos Prospectivos
16.
Zhonghua Er Ke Za Zhi ; 59(6): 466-470, 2021 Jun 02.
Artigo em Chinês | MEDLINE | ID: mdl-34102819

RESUMO

Objective: To enhance the early recognition of Prader-Willi syndrome by summarizing the clinical characteristics of Prader-Willi syndrome (PWS) during perinatal period. Methods: Through a nationwide cross-sectional study in the Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences,226 children diagnosed as PWS by molecular genetics were recruited from September 2019 to March 2020. Clinical data including fetuses Age, birth weight, fetal movement, fetal position, amniotic fluid, mode of bith, crying, muscle tension, feeding, and cryptorchidism were collected to analyze the clinical characteristics of Chinese PWS patients in the perinatal period, and according to the mode of birty, birth weight and genotypes to perform subgroup analysis. The clinical manifestations of different subtypes were statistically analyzed by t test, χ2 test or Mann-Whitney U test. Results: Among the 226 PWS patients, 120 were males, and 106 were females. Among them, 100 (44.2%) patients were small for gestational age. Decreased fetal movement was the most common manifestation 202 cases (89.4%) during pregnancy, and other manifestations included polyhydramnios 71 cases (31.4%) and abnormal fetal position 58 cases (25.7%). One hundred and eighty-five (81.9%) patients were delivered by cesarean section and the frequency of abnormal fetal position was significantly higher (30.8%(57/185) vs. 2.4%(1/41),χ²=14.161,P<0.01). As for abnormal manifestations after birth included hypotonia 221 cases (97.8%),220 cases (97.3%) showing weak crying, 116 cases among the total 120 males patients (96.7%) wanifested with cryptordnildism and 206 feeding difficulties (91.2%). In terms of genetic subtype, most of them (184/226, 81.4%) had a paternal deletion, while maternal age (35±5 vs. 29±5, t=-6.591, P<0.01) and the frequency of polyhydramnios (47.6% (20/42) vs. 27.7% (51/185), χ²=6.286, P=0.012) were significantly higher in the non-deletion group. Conclusions: The main manifestations of PWS patients during the perinatal period are hypotonia, weak crying, feeding difficulties, decreased fetal movement, cryptorchidism and those patients are more likely to be born by cesarean section. In newborns with these characteristics, pediatricians should be aware of the possibility of PWS. In terms of the relationship between genotypes and phenotypes, polyhydramnios is more frequently observed in the non-deletion group.


Assuntos
Síndrome de Prader-Willi , Cesárea , Criança , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Recém-Nascido , Masculino , Hipotonia Muscular , Síndrome de Prader-Willi/epidemiologia , Síndrome de Prader-Willi/genética , Gravidez
17.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 29(3): 860-864, 2021 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-34105484

RESUMO

OBJECTIVE: To analyze the gene defect types and distribution characteristics of α- and ß-thalassemia in Lingui District of Guilin City, Guangxi, so as to provide scientific basis for genetic consultation and prevention measures. METHODS: A total of 6 496 suspected cases for screening the thalassemia during physical examination, premarital examination, pregnancy examination and hospitalization in the Second Affiliated Hospital of Guilin Medical University from May 2016 to October 2019 were analyzed. Gap-PCR, PCR-RDB and DNA sequencing techniques were used to detect the types and constituent ratios of gene defects in α- and ß-thalassemia positive cases. RESULTS: Among 6 496 suspected patients, 1 363 were thalassemia carriers, the total positive rate was 20.98%. There were 677 cases of single-gene deletion and 26 cases of double-gene detetion on the deletional α-thalassemia, 115 cases of non-deletion α-thalassemia mutation and 4 cases of deletion plus mutation. The positive rate of α-thalassemia was 12.66%. There were 11 gene abnormalities for α-thalassemia, of which --SEA/αα (50.36%) was the most common, followed by -α3.7/αα (23.84%); the main α-gene mutation was ααCS (6.93%). There were 514 ß-thalassemia gene carriers, with a positive rate of 7.93%. In 12 types of ß-gene mutations, CD41-42 (-TTCT) (55.64%) was the most common, followed by CD17 (A→T) (20.23%). There were 25 cases of double heterozygous α and ß thalassemia (0.39%), of which -α3.7/ßCD17 (24%) and --SEA/ß41-42 (16%) were numerically dominant. Two of rare thalassemia genotypes were identified by sequencing, which were heterozygous mutations of Chinese Hong Kong type α thalassemia (HKαα/αα or HKαα/-α3.7) and ß gene mutations IVS-I (-2) or codon30 (A→G) ß0, respectively. CONCLUSION: Lingui district of Guilin city is a high incidence area of thalassemia. The mutation rate of α-thalassemia --SEA/αα type deletion is relatively high, followed by that of the right deletion type (-α3.7/αα). CD41-42 (-TTCT) has the highest mutation rate in ß-thalassemia, followed by CD17(A→T). The results of this study provide reference data for the regional screening, diagnosis and treatment of thalassemia and eugenics.


Assuntos
Talassemia alfa , Talassemia beta , China/epidemiologia , Feminino , Genótipo , Heterozigoto , Humanos , Mutação , Gravidez , Talassemia alfa/epidemiologia , Talassemia alfa/genética , Talassemia beta/epidemiologia , Talassemia beta/genética
18.
BMJ Open ; 11(6): e042066, 2021 06 16.
Artigo em Inglês | MEDLINE | ID: mdl-34135029

RESUMO

OBJECTIVES: Systematic evaluation of the influence of occupation type on the association between sleep-glucose metabolism DESIGN: A cross-sectional study. SETTING: The Nantong Metabolic Syndrome Study is a Chinese population-based study. PARTICIPANTS: 20 502 participants aged 18-74 years old. INTERVENTION: No intervention. PRIMARY AND SECONDARY OUTCOME MEASURES: Impaired fasting glucose (IFG). RESULTS: A total of 1503 participants (7.33%) with a slightly longer sleep duration had IFG. After being stratified according to occupation, a sleep duration of ≥10 hours daily corresponded to a 1.321-fold risk of IFG (95% CI 1.071 to 1.628, p=0.0092) among moderate and heavy physical workers compared with those with a daily sleep duration of 7-9 hours. There was no significant relationship between sleep and IFG among other types of workers. Moreover, we discovered a gender difference in the influence of occupation on the sleep-IFG. A positive association among moderate and heavy physical men and a negative association among light or sedentary men were established, but not in unemployed men. However, a positive association was evident only in unemployed women; there was no significant association among other occupations. CONCLUSION: This study highlights the role of occupation in the relationship of sleep-glucose metabolism. A gender difference was found to have been influenced by occupational types on the sleep-metabolic association.


Assuntos
Glicemia , Jejum , Adolescente , Adulto , Idoso , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ocupações , Fatores de Risco , Sono , Adulto Jovem
19.
BMJ Open ; 11(6): e044349, 2021 06 16.
Artigo em Inglês | MEDLINE | ID: mdl-34135033

RESUMO

OBJECTIVE: This study was designed to identify the risk factors for drug-resistant tuberculosis (DR-TB) and the association between comorbidity and drug resistance among retreated pulmonary tuberculosis (PTB). DESIGN: A retrospective study was conducted among all the 36 monitoring sites in Shandong, China, over a 16-year period. Baseline characteristics were collected from the TB Surveillance System. Categorical variables were compared by Fisher's exact or Pearson's χ2 test. The risk factors for drug resistance were identified using univariable analysis and multivariable logistic models. The influence of comorbidity on different types of drug resistance was evaluated by performing multivariable logistic models with the covariates adjusted by age, sex, body mass index, drinking/smoking history and cavity. RESULTS: A total of 10 975 patients with PTB were recorded during 2004-2019, and of these 1924 retreated PTB were finally included. Among retreated PTB, 26.2% were DR-TB and 12.5% had comorbidity. Smoking (adjusted OR (aOR): 1.69, 95% CI 1.19 to 2.39), cavity (aOR: 1.55, 95% CI 1.22 to 1.97) and comorbidity (aOR: 1.44, 95% CI 1.02 to 2.02) were risk factors for DR-TB. Of 504 DR-TB, 9.5% had diabetes mellitus, followed by hypertension (2.0%) and chronic obstructive pulmonary disease (1.8%). Patients with retreated PTB with comorbidity were more likely to be older, have more bad habits (smoking, alcohol abuse) and have clinical symptoms (expectoration, haemoptysis, weight loss). Comorbidity was significantly associated with DR-TB (aOR: 1.44, 95% CI 1.02 to 2.02), overall rifampin resistance (aOR: 2.17, 95% CI 1.41 to 3.36), overall streptomycin resistance (aOR: 1.51, 95% CI 1.00 to 2.27) and multidrug resistance (aOR: 1.96, 95% CI 1.17 to 3.27) compared with pan-susceptible patients (p<0.05). CONCLUSION: Smoking, cavity and comorbidity lead to an increased risk of drug resistance among retreated PTB. Strategies to improve the host's health, including smoking cessation, screening and treatment of comorbidity, might contribute to the control of tuberculosis, especially DR-TB, in China.


Assuntos
Mycobacterium tuberculosis , Preparações Farmacêuticas , Tuberculose Resistente a Múltiplos Medicamentos , Tuberculose Pulmonar , Antituberculosos/uso terapêutico , China/epidemiologia , Comorbidade , Humanos , Estudos Retrospectivos , Fatores de Risco , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/epidemiologia
20.
BMJ Open ; 11(6): e044608, 2021 06 16.
Artigo em Inglês | MEDLINE | ID: mdl-34135035

RESUMO

OBJECTIVES: To assess the association between socioeconomic development and the myopia boom in China. DESIGN: Nationwide cross-sectional study. SETTING: We used data from the China Family Panel Study (CFPS 2010), and the Chinese National Survey on Students' Constitution and Health (CNSSCH 2010). PARTICIPANTS: Participants included 33 600 individuals and 14 226 families from the CFPS 2010, and 86 199 students aged 7-12 years from the CNSSCH 2010. MEASURES: The main measure was students' visual impairment (defined as Snellen visual acuity ≤20/25 (0.8) in the worse eye) rate of each province (or municipality or autonomous region); other measures included the Gini coefficient of property, logarithm of average property, Gini coefficient of education, average education duration and return-to-education rate of each province (or municipality or autonomous region). The visual impairment rate was calculated using students' data, aged 7-12 years, from the CNSSCH 2010. The Gini coefficient of property and logarithm of average property were calculated using the families' data from the CFPS 2010; the Gini coefficient of education, average education duration and return-to-education rate were calculated using individuals' data aged 18-44 years from the CFPS 2010. RESULTS: The urban environment (coefficient: 0.209; p<0.001), Gini coefficient of property (coefficient: 1.979; p=0.005), logarithm of average property (coefficient: 0.114; p<0.001), average education duration (coefficient: 0.041; p<0.001) and return-to-education rate (coefficient: 0.195; p<0.001) were positively associated with the logit function of visual impairment rate. CONCLUSIONS: Economic development may promote an increased desire to pursue wealth. Regarding high return to education and a fairly competitive education system, individuals are likely to pursue wealth through education, which is associated with a heavier education burden and higher prevalence rates of myopia.


Assuntos
Miopia , China/epidemiologia , Estudos Transversais , Humanos , Miopia/epidemiologia , Prevalência , Fatores Socioeconômicos , Acuidade Visual
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