Objective To analyze the epidemiological characteristics of mountain-type zoonotic visceral leishmaniasis (MT-ZVL) in China for references for the prevention and control of this infection. Methods Case information of MT-ZVL reported from 2011 to 2023 was obtained through the Chinese Disease Prevention and Control Information System to establish the database. Descriptive epidemiological method was used to analyze the characteristics of MT-ZVL in temporal, spatial and population distribution. Results From 2011 to 2023, a total of 1 849 MT-ZVL cases were reported across China. The cases were distributed in Gansu (n=791), Shanxi (n=570), Shaanxi (n=179), Sichuan (n=138), Henan (n=107), Hebei (n=59) and Beijing (n=5). The high-incidence counties (cities, districts) included Wudu District of Longnan City (n=286), Zhouqu County (n=215), Pingding County (n=139), Tanchang County (n=117) and Jiaoqu District of Yangquan City (n=116). The overall number of cases tended to decline initially, followed by a resurgence. In terms of temporal distribution, more cases were reported between March and July (n=948; 51.27%), indicating a certain seasonality. By population distribution, the cases were dominated in the 1-year-old group (n=239; 12.93%), followed by the age groups of 50-59 (n=231; 12.49%), 60-69 (n=224; 12.11%). The majority of cases were males (n=1 195; 64.63%). Occupational distribution showed that farmers accounted for the highest proportion (n=740; 40.02%), followed by children living at home (n=587; 31.75%). Conclusion From 2011 to 2023, MT-ZVL in China remained at a low endemic level, with case numbers declining initially and rising thereafter, during which the epidemic area appeared gradually expanded. Gansu and Shanxi provinces were major hotspots, with cases concentrated in mountainous areas of Longnan, the southern part of Taihang Mountains and its extended hills areas. In recent years, the infection showed an increase trend in farmers and middle-aged and eldly population. Therefore, it is recommended to strengthen multi-sectoral collaboration under the One Health framework, and to carry out precise control strategies such as dog management, vector control, active surveillance, and scientific research innovation.

Objective To analyze the epidemiological characteristics and spatiotemporal clustering of hepatitis E in Jilin Province for scientific evidences to precisely prevent and control this entity. Methods The data on hepatitis E cases reported in Jilin Province from 2005 to 2024 were collected through the Chinese Disease Prevention and Control Information System. Descriptive epidemiological methods were used to analyze the epidemiological characteristics of hepatitis E. Spatial autocorrelation analysis was conducted using ArcGIS software to determine the spatial clustering and hotspots of hepatitis E incidence, and spatio-temporal scan analysis was performed using SaTScan software. Results A total of 5 098 hepatitis E cases were reported in Jilin Province from 2005 to 2024, with an average annual reported incidence rate of 0.96/100 000. The reported incidence rate was the highest in 2007 (1.58/100 000), yet the lowest in 2020 (0.40/100 000). By the population genders, the average annual reported incidence rate was 1.40/100 000 in males (n=3 765), and 0.51/100 000 in females (n=1 333). The reported incidence rate was generally increased with age, peaking at the 60-64 age group (2.01/100 000). By occupation distribution, farmers were dominant (n=1 598; 31.35%). The reported cases showed a slight increase from November to May of the following year, totaling 3 209 cases (62.95%). The highest number of cases were seen in March (n=501; 9.83%). Spatial autocorrelation analysis revealed that “High-High” clustering areas and hotspots of hepatitis E were primarily found in Liaoyuan City, Tonghua City, Siping City, and the Yanbian Korean Autonomous Prefecture. Spatio-temporal scan analysis identified a total of 9 high-risk clusters of hepatitis E. Conclusion The incidence of hepatitis E in Jilin Province showed an overall declining trend from 2005 to 2024, yet exhibited a significant spatio-temporal clustering. Our findings suggest that it is essential to strengthen surveillance on hepatitis E in southern Jilin Province and border cities, as well as to implement prevention and control measures such as health education and vaccination programs for the key populations.

Objective To understand the epidemiological characteristics of acute hepatitis B in Anhui Province and the vaccination status of the vaccine for evidences in prevention and control of this condition. Methods The data on acute hepatitis B cases reported in Anhui Province from 2012 to 2024 were retrieved through the Chinese Disease Prevention and Control Information System, and the reported vaccination rates of hepatitis B vaccine were collected through the National Immunization Program Information System. Descriptive epidemiology was used to analyze the characteristics of temporal, regional and population distribution as well as the vaccination status in population. The Joinpoint regression model was used to analyze the temporal trend of incidence rates, and the annual percent change (APC) and average annual percent change (AAPC) were calculated. Results From 2012 to 2024, a total of 18 019 cases of acute hepatitis B were reported in Anhui Province, with an average annual incidence rate of 2.23 per 100 000 population. Joinpoint regression analysis indicated that the incidence rate of acute hepatitis B showed an overall downward trend during 2012-2024 (AAPC= -10.52%, t=-8.13, P<0.01), and the decline was particularly significant from 2018 to 2024 (APC=-16.20%, t=-6.05, P<0.01). Cases were reported throughout the year, with the highest number of reports in March (n=1 639; 9.10%). The top three regions with the highest average annual incidence rates were Suzhou City (7.87/100 000), Xuancheng City (2.56/100 000), and Huangshan City (2.12/100 000). Of the reported cases, 11 404 were males and 6 615 were females. The age of onset was mainly concentrated among individuals aged 30~44 (n=5 318; 29.51%). The farmers were dominant by occupation (n=13 303; 73.83%). The full vaccination rate of hepatitis B vaccine in Anhui Province from 2012 to 2024 was all above 99.00%, and the timely first-dose vaccination rate within 24 hours, except for 2021 (89.78%) and 2022 (89.88%), remained above 90.00%. Conclusion The incidence of acute hepatitis B in Anhui Province is on a downward trend, and the hepatitis B vaccine is maintained at a high level of inoculation. The findings suggest that the prevention and control of hepatitis B should be strengthened in high-incidence areas (Suzhou) and high-risk groups (farmers) across the whole province, as well as enhance the inoculation of hepatitis B vaccine.

Objective To analyze the epidemiological trends of viral hepatitis in Ningxia Hui Autonomous Region for evidences to optimize the prevention and control strategies. Methods The data on viral hepatitis cases reported in Ningxia area between 2008 and 2024 were retrieved from the Chinese Disease Prevention and Control Information System. Descriptive epidemiology and JoinPoint regression model were used to analyze the trend of the incidence. Results From 2008 to 2024, a total of 82 180 viral hepatitis cases were reported in Ningxia area, with an annual average incidence rate of 72.19 per 100 000 population. Hepatitis B predominated among all types of viral hepatitis (n=66 438; 80.84%), and the incidence of hepatitis A and hepatitis B showed overall declining trends (AAPC=-18.56% and -11.24%, t =-4.83 and -13.22, both P<0.05). The incidence of hepatitis C was increased from 2008 to 2011 (APC=26.24%, t=3.29, P<0.05), yet showed slower growth from 2011 to 2019 (APC=5.25%, t=3.89, P<0.05), and declined rapidly from 2019 to 2024 (APC=-23.26%, t=-9.08, P<0.05). The trend of hepatitis E incidence indicated no significant change. The cumulative reported cases were 49 779 (60.57%) in males and 32 401 (39.43%) in females, with an annual average incidence rate of 85.71 per 100 000 and 58.11 per 100 000 population, respectively. The incidence of all types of viral hepatitis was higher in males than in females, and population aged 20-49 years were most affected (n=47 607; 57.93%). The incidence was generally increased with age. By occupation distribution, farmers accounted for the majority of reported cases (n=42 821; 52.11%), representing the highest proportion in all types of viral hepatitis. By regional distribution, the reported cases were the highest in Yinchuan City (n=25 226), and the annual average incidence rate was the highest in Wuzhong City (84.62 per 100 000). Conclusion The incidence rate of viral hepatitis in Ningxia area showed an overall declining trend, with middle-aged and elderly males and farmers being the key populations. Future prevention and control efforts should focus on strengthening screening and treatment of the middle-aged and elderly rural populations to reduce disease burden and incidence rates.

Objective To analyze the factors influencing the immune efficacy of hepatitis B virus (HBV) during mother-to-child blockade in newborns for evidence to improve the measures in interrupting HBV transmission from mother to an infant. Methods We conducted a study on the newborns in Fuzhou City, who had completed full HBV vaccination schedule to interrupt the transmission from August 2023 to October 2024, and the mothers’ hepatitis B virus surface antigen (HBsAg) was positive. The case group comprised newborns with failure of immune response after vaccination, and the control group were infants with immune response after vaccination. Multivariate logistic regression model was used to analyze factors affecting the immune efficacy. Results A total of 1 256 HBsAg-positive mother and their newborn were investigated (419 cases, 837 controls). The newborns who were born to mothers aged≥36 years (OR=0.54, 95% CI: 0.32-0.92) or received antiviral therapy during pregnancy (OR=0.58, 95% CI: 0.41-0.82) had a lower risk of immune response failure following HBV vaccination, whereas the incidence of immunological unresponsiveness was higher in the newborns with family members with HBV or HBsAg carriers (OR=1.44, 95% CI: 1.09-1.92) or if the Bacille Calmette-Guérin (BCG) vaccine and HBV vaccine were administered at the same site (OR=1.48, 95% CI: 1.12-1.95). Conclusion The immune efficacy of HBV mother-to-child blockade in newborns in Fuzhou City is influenced by maternal age, status of maternal antiviral therapy during pregnancy, presence of HBV patients or HBsAg carriers in the family, and vaccination site, for which strengthening prenatal screening and antiviral therapy, implementation of targeted health education and immunization management, and timely revaccination of the vaccine non-responder children are recommended.

Objective To assess the value of spatial zero-inflated Poisson model applied to the spatial analysis of Brucellosis cases with high zero values in Yunnan Province for methodological references in analysis of the similar data in the field of public health. Methods The data on Brucellosis cases reported in Yunnan Province from January to December of 2022 were collected through the Chinese Disease Prevention and Control Information System. The global Moran’s I, local Moran’s I, and spatial scan statistics were used to analyze global and local spatial autocorrelation and detection of spatial clustering of Brucellosis cases. Traditional Poisson, zero-inflated Poisson, and spatial zero-inflated Poisson models were employed for data fitting, with the optimal model determined based on deviance information criterion (DIC) and Watanabe-Akaike information criterion (WAIC). Results In total, 1 015 cases of Brucellosis were reported in Yunnan Province from January to December of 2022. The number of cases at county-level showed a significant global spatial autocorrelation (Moran’s I=0.40, Z=8.80, P<0.01), and exhibited a serious outbreak in the eastern region of Yunnan, where a high-risk cluster was identified (RR=18.53, LLR=694.21, P<0.01). The spatial zero-inflated Poisson model demonstrated the best fit (DIC=556.055, WAIC=740.752), followed by the non-spatial zero-inflated Poisson model (DIC=815.527, WAIC=1 564.548), both outperforming the traditional Poisson model (DIC=975.799, WAIC=1 613.696). The latter two models showed biased results, leading to inaccurate parameter estimates. The posterior mean of the spatial structure random effects in the optimal model revealed significant spatial autocorrelation (Moran’s I=0.32, Z=5.92, P<0.01), whereas the non-spatial random effects indicated no significant spatial autocorrelation (Moran’s I=0.08, Z=1.52, P>0.05). Conclusion The spatial zero-inflated Poisson model, which incorporates spatial effects, can better address zero-inflated count data with spatial autocorrelation features, and reveal potential spatial structures in disease data, which may provide effective methodological support for the spatial epidemiological analysis of low-prevalence infectious diseases.

Objective To analyze the epidemiological characteristics and spatiotemporal clustering of hemorrhagic fever with renal syndrome (HFRS) in Jilin Province from 2011 to 2023 for a reference to develop prevention and control measures in areas with higher incidence of HFRS. Methods HFRS case data reported in Jilin Province from 2011 to 2023 were retrieved from the Chinese Disease Control and Prevention Information System. Descriptive epidemiological methods were used to analyze temporal, spatial, and population distribution. Global and local spatial autocorrelation analyses were performed using software ArcGIS. Results A total of 6 557 cases of HFRS, including 22 deaths, were reported in Jilin Province from 2011 to 2023, with an incidence rate of 1.87 per 100 000 population and the case fatality rate of 0.32%. The incidence rate was highest in 2014 (2.71/100 000), and the lowest in 2023 (0.66/100 000). HFRS cases were reported in each city (prefecture) of the Province. Meihekou City had the highest incidence (4.87/100 000). There were two epidemic peaks (March to June, and October to December), during which 2 660 (40.57%) and 1 918 cases (29.25%) were reported, respectively. The incidence rate was higher in males (2.87/100 000) than in females (0.82/100 000). The 50-59 age group had the highest incidence rate (2.76/100 000). Farmers constituted the majority of the cases (n=4 140, 63.14%). The spatial agglomeration analysis showed that the “high-high” agglomeration areas were mainly distributed in the eastern mountainous/semi-mountainous regions (Yanbian Korean Autonomous Prefecture, Baishan City, Tonghua City, Changbai Mountain Administrative Committee, Meihekou City) and western meadow-wetland areas (Baicheng City). Conclusion From 2011 to 2023, HFRS incidence in Jilin Province showed a declining trend, yet exhibited a distinct seasonality and spatial clustering. High-risk areas were concentrated in the eastern mountainous/semi-mountainous regions and western meadow-wetland ecosystems. Middle-aged/elderly, males and farmers were the most affected demographic, warranting prioritized interventions.

Objective To investigate the epidemiological characteristics and spatiotemporal clustering of scarlet fever in Chengdu area for evidences to formulate scientific prevention and control measures for this acute respiratory infection. Methods Surveillance data of scarlet fever reported at each subdistrict/township of urban areas, counties, communities in Chengdu City from 2017 to 2023 were obtained from the Chinese Disease Prevention and Control Information System. The epidemiological profile and temporal, spatial and population distribution were characterized, and spatial autocorrelation and spatiotemporal scan analyses were performed to identify clustering patterns. Results Between 2017 and 2023, a total of 4 433 scarlet fever cases were reported in Chengdu area. The annual incidence ranged from 1.41/100 000 to 7.50/100 000, and overall, the prevalence tended to decline (χ²_trend=1 089.79, P<0.01). Seasonal peaks occurred in April-June (n=1 655; 37.33%) and November-January (n=1 336; 30.14%). The incidence was dominated by children aged 3-8 years (n=3 837; 86.56%). The reported cases were 2 669 for males and 1 764 for females, and the annually reported cases were higher in males than in females (n=2 669; 2.08/100 000 vs. n=1 764; 1.38/100 000). Qionglai City had the highest average annual incidence (13.68/100 000), whereas the most cases were from Xindu District (n=1 034; 23.33%). Spatial autocorrelation analysis revealed a significant spatial positive correlation in 2017-2019 and 2021-2023 (Moran’s I>0, Z>1.960, P<0.05), and that the hotspots were involved in the subdistricts/townships of Xindu, Qionglai, Shuangliu, and Longquanyi. Spatiotemporal scan analysis identified one primary cluster (Xindu District, January 2017-January 2019) and six secondary clusters. Conclusion The incidence of scarlet fever in Chengdu City exhibited a fluctuating downward trend with notable spatiotemporal clustering. Our findings suggest that surveillance, early warning, publicity and education should be intensified in key areas and key populations during the higher prevalence seasons to mitigate the disease burden.

Objective To investigate the potential cuticular protein adaptation mechanisms of Culex pipiens pallens resistance to propoxur for characterizing the functional roles of differentially expressed proteins (DEPs) in conferring the resistance between resistant and susceptible strains. Methods A propoxur-resistant strain was generated through 20 generations of selective pressure from a laboratory-maintained susceptible strain. Samples spanning multiple developmental stages from both strains were subjected to quantitative proteomic profiling using isobaric tags for relative and absolute quantification (iTRAQ). Subsequent functional annotation and pathway enrichment analyses were performed by means of COG, GO, and KEGG databases, followed by targeted validation of pivotal proteins via parallel reaction monitoring (PRM). Results A total of 156 DEPs, comprising 59 upregulated and 97 downregulated proteins, were identified. Cuticular structural components (B0WIY4, B0W0L1), chitin-binding proteins, and larval cuticular proteins exhibited marked upregulation in the resistant strain, whereas cytoskeleton-associated proteins (B0WY76), energy metabolism regulators (pyruvate dehydrogenase B0XA87), and ribosomal proteins (B0WQU6) were significantly downregulated. PRM analysis confirmed the expression trends of 11 representative proteins, including actin (B0WY76). Conclusion The resistance of Culex pipiens pallens to propoxur is closely related to the structural alterations of the cuticle caused by differential expression of cuticular proteins and cytoskeletal remodeling. These alterations likely impede insecticide penetration through the cuticle, thereby enhancing propoxur resistance.

Objective To understand the diagnosis and treatment costs for patients with rifampicin-resistant pulmonary tuberculosis in order to provide references for development or adjustment of the policies for this population group. Methods By stratified sampling and convenience sampling methods, we initially selected 6, 3 and 5 provinces from the eastern, central and western regions of China, respectively. Then one or two cities with higher degree of work cooperation was/were singled out from each province, and one designated medical institution with effective work cooperation was selected from each city for the survey. A questionnaire survey was conducted among rifampicin-resistant pulmonary tuberculosis patients who were treated from January to June 2021, and the economic burden of disease was analyzed. Results In this study, 162 patients underwent the survey. The mean total cost from the onset of symptoms to the completion of treatment was 109 452 (69 530, 182 365) yuan, of which the direct medical cost was 88 681 (58 967, 160 611) yuan, and the direct non-medical cost was 10 299 (4 710, 19 029) yuan. The mean indirect cost was 974 (0, 4 380) yuan. Self-paid expense was 68 052 (44 597, 93 761) yuan, with the proportion of individual payment being 63.78% (43.79%, 81.07%). The proportion of individual payment for direct medical expenses was 54.88% (36.10%, 78.21%), and the proportion was higher in western region [71.35% (48.78%, 96.10%)] and non-hospitalized patients [90.23% (65.90%, 100.00%)] (H=35.061, Z=38.650; all P <0.01). The incidence of catastrophic health expenditure of patients’ families was 96.25%. There were significant differences in the proportion of total out-of-pocket expenses in annual household income among patients with different education levels, occupations, regions, whether they were from families with the highest household income, or whether they were floating population (H=21.536, 38.579, 11.439; Z=2.931, -3.830; all P <0.01). The results of multivariate analysis showed that farmers (b=2.395, 95%CI: 1.249-3.541) and housework and unemployment (b=2.324, 95%CI: 0.753-3.894) were the risk factors for increased economic burden of patients compared with students and teachers. Conclusion The economic burden of patients with rifampicin-resistant pulmonary tuberculosis in China is relatively heavy, especially the direct medical expenses are relatively high. Meanwhile, special attention should be paid to the economic burden of such tuberculosis victims as farmers, domestic workers and the unemployed.

Objective To understand the research progress of schistosome circulating antigen studies globally and domestically for reference for schistosomiasis diagnosis in China. Methods Literature on schistosome circulating antigen published between 1990 and 2024 was retrieved from the China National Knowledge Infrastructure (CNKI) and Web of Science (WoS). CiteSpace was used for visual co-occurrence, clustering and burst analysis of authors, institutions and keywords. Results In total, 264 Chinese and 498 English articles were retrieved. Chinese publications showed an initial increase followed by a decline, whereas English literature demonstrated a steady upward trend. In the Chinese publications, Lou Wenxian was the most prolific author (14 articles), and Deelder AM contributed 108 articles in English literature. Keyword analysis revealed that Chinese research clusters focused on “antigen”, “erythrocyte”, and “praziquantel” with the strongest burst term being “circulating antigen” and the longest-lasting burst term being “antibody”. Burst terms shifted from “circulating antigen”, “erythrocyte”, and “therapeutic efficacy evaluation” to “gold nanorods”, “combined detection”, and “schistosomiasis”. For English publications, major clusters included “chemotherapy”, “anodic antigen”, and “intensity”, with the highest burst intensity for “monoclonal antibody” and the longest burst duration for “individuals”. Burst terms transitioned from “monoclonal antibodies”, “individuals”, and “neglected tropical diseases” to “prevalence” and “Schistosoma mansoni”. Conclusion Current research on schistosome circulating antigen by Chinese scholars remains limited, for which we recommend that interdisciplinary and multi-institutional collaboration should be strengthened to advance schistosome circulating antigen studies, thereby supporting China’s goal of schistosomiasis elimination.