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20 February 2023, Volume 21 Issue 1 Previous Issue    Next Issue

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SPECIALARTICLES FOR OTHER INFECTIOUS DIARRHEA

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Epidemiological characteristics of public health emergencies caused by other infectious diarrhea in China from 2017 to 2021 REN Jing-huan, WANG Rui 2023, 21 (1):  1-6.  doi: 10.3969/j.issn.1672-2302.2023.01.001 Abstract ( 1260 )   HTML ( 127 )   PDF (1213KB) ( 1191 )   Objective To understand the occurrence and epidemiological characteristics of public health emergencies caused by other infectious diarrhea in China, so far as to provide evidence for early warning and effective control of such events. Methods The data on other infectious diarrhea were retrieved through National Report Management Information System of Public Health Emergency reported from 2017 to 2021, and analyzed for the epidemiological characteristics using descriptive epidemiology. Results In total, 2 360 other infectious diarrhea events were reported between 2017 and 2021 in 28 provinces (autonomous regions and municipalities directly under the central government), which involved 90 689 cases and 5 deaths. Other infectious diarrhea was highly prevalent in winter and spring season, and respectively peaked during November and December and following March. Most incidents and cases were reported in Zhejiang, Guangdong, Jiangsu, Chongqing, Fujian, Shandong, Anhui, Guangxi, Hunan and Hubei provinces. The pathogen responsible for other infectious diarrhea was clearly identified in 2 269 events, which accounted for 95.7% (2 171/2 269) of the events caused by virus infection. 3.7% (84/2 269) and 0.6% (14/2 269) were caused by bacterial infection and mixed virus/bacteria infection, respectively. Norovirus infection accounted for 93.5% (2 122/2 269) of all other infectious diarrhea with definite pathogens. Contact transmission via daily activities, intake of the contaminated food and drinking water were mainly responsible for other infectious diarrhea events, and the events caused by life-contact transmission account for the highest proportion (51.0%, 1 204/2 360). Schools as well as kindergartens, were the main places where other infectious diarrhea occurred, with a total of 2 163 cases reported. Conclusion Other infectious diarrhea events tends to be upward trend in China in recent years. The major pathogen is associated with norovirus, schools and kindergartens are the main places where it occurs. Implementation of health supervision in key places such as schools and health education for the key population, strengthening the management of food safety and drinking water hygiene, improving the epidemiological investigation and etiological diagnosis of other infectious diarrhea as well as the level of event monitoring report can effectively prevent and control the occurrence of such events. Figures and Tables | References | Related Articles | Metrics

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Epidemiological characteristics of other infectious diarrhea in Sichuan Province from 2017 to 2021 HAO Cai-xia, LIU Ya-qiong, LIAO Xue-chun, YUAN Heng 2023, 21 (1):  7-12.  doi: 10.3969/j.issn.1672-2302.2023.01.002 Abstract ( 692 )   HTML ( 62 )   PDF (1005KB) ( 639 )   Objective To analyze the epidemic characteristics and the pathogen of other infectious diarrhea in Sichuan Province from 2017 to 2021 for scientific basis for epidemic prevention and control of the infection. Methods The data on the reported cases of other infectious diarrhea for Sichuan Province were collected through the Infectious Disease Surveillance System under the Chinese Disease Prevention and Control Information System from 2017 to 2021, and analyzed using descriptive epidemiology. Results In total, 210 677 cases of other infectious diarrhea were reported in Sichuan Province from 2017 to 2021, with an average annual reported incidence of 50.60/100 000. The annual reported incidence rate was between 42.87/100 000 and 67.71/100 000, and the reported incidence rate showed an overall upward trend (χ2trend=4 926.705, P<0.001). The number of cases reported was 113 661 for men and 97 016 for women, and the average annual reported incidence was 53.49/100 000 and 46.76/100 000, respectively. For all age groups, children under 2 years old were most reported, accounting for 51.52% of the total cases (108 537/210 677). By different occupational group, the number of cases was the largest in children living in diaspora, accounting for 63.15% of the total cases (133 037/210 677). Other infectious diarrhea peaked in winter and in summer in Sichuan Province, with climax from July to September and from December to January of the next year. The infections were reported in all 21 cities (prefectures) in Sichuan Province. Average annual reported incidence was between 22.60/100 000 and 70.16/100 000 for each city (prefecture). There were 22 541 cases with definite etiological diagnosis, including 20 901 cases of viral diarrhea, 1 625 of bacterial diarrhea and 15 of fungal diarrhea. In the cases of viral diarrhea, rotavirus infection accounted for 88.64% (18 526/20 901). A total of 20 outbreaks were reported in Sichuan Province from 2017 to 2021, in which 19 cases were associated with norovirus infection and 1 with rotavirus and norovirus co-infection. Conclusion The reported incidence rate of other infectious diarrhea in Sichuan Province is increasing year by year. Scattered children under 2 years old should be the key population for prevention and control, and rotavirus is the main pathogen. The findings suggest that attention should be paid to active surveillance, prevention and control of other infectious diarrhea. Figures and Tables | References | Related Articles | Metrics

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Epidemiological characteristics and spatiotemporal clustering of other infectious diarrhea in Chengdu City from 2011 to 2021 XU Kai, DAI Ying-xue, WANG Yao, WANG Liang, XIAO Chong-kun 2023, 21 (1):  13-19.  doi: 10.3969/j.issn.1672-2302.2023.01.003 Abstract ( 575 )   HTML ( 58 )   PDF (1045KB) ( 634 )   Objective To describe the epidemic characteristics of other infectious diarrhea in Chengdu area from 2011 to 2021, and analyze the temporal and spatial aggregation so as to provide scientific basis for prevention and control of these intestinal infectious diseases. Methods The data of other infectious diarrhea diseases reported in Chengdu area were retrieved through the Infectious Disease Surveillance System under the Chinese Disease Prevention and Control Information System from 2011 to 2021. The incidence profile and the distribution characteristics in different region, population and time were described. The spatial autocorrelation analysis and spatial and temporal scanning were used to analyze the characteristics of spatial and temporal aggregation. Results A total of 94 955 cases of other infectious diarrhea were reported with an average annual incidence of 53.46/100 000 in Chengdu area from 2011 to 2021. The annual reported incidence was 36.86/100 000-78.64/100 000, showing an overall upward trend (χ2Trend=34.13, P<0.001). The highest number of reported cases was mainly seen in summer and winter. In the reported cases, 52 125 were males, and 42 830 females, with a sex ratio being 1.22∶1. By age distribution, incidence of the infections was the highest in children under 6 years old (74.00%, 70 268/94 955). By occupational distribution, the proportion of scattered children was the largest (67.21%, 63 821/94 955). Global spatial autocorrelation analysis showed that there was spatial clustering of other infectious diarrhea during 2011 to 2019. Local spatial autocorrelation analysis found that the Hi-tech Zone, Qingyang District, Chenghua District, Wuhou District, Jinjiang District and Jinniu District were the "hot spots" of the disease, while Qionglai City, Pujiang County and Dayi County were the "cold spots". Spatial-temporal scanning analysis also shows that there is obvious spatial-temporal clustering. In addition to the Hi-tech Zone, Qingyang District, Chenghua District, Wuhou District, Jinjiang District and Jinniu District, the main cluster also involves Qingbaijiang District, Jintang County, Chongzhou City, Xinjin District, Tianfu New District and other areas. The clustering time is mostly summer and winter. Conclusion In recent years, prevalence of other infectious diarrhea in Chengdu represents an overall upward trend, and primarily peaks in summer and winter. The reported cases are mainly scattered children under 6 years old. These findings suggest that monitoring of key areas and key populations as well as health education should be strengthened during the prevalent season. Figures and Tables | References | Related Articles | Metrics

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Epidemiological characteristics of other infectious diarrhea in Kunming City from 2017 to 2021 ZHA Zhi-yan, ZHOU Yong-ming, ZHOU Yang, MAO Zhi-peng 2023, 21 (1):  20-24.  doi: 10.3969/j.issn.1672-2302.2023.01.004 Abstract ( 565 )   HTML ( 36 )   PDF (1161KB) ( 636 )   Objective To analyze the epidemic pattern and characteristics of other infectious diarrhea in Kunming area, and propose targeted prevention and control measures according to the epidemic regularity and characteristics, so as to provide theoretical support for adjusting prevention and control strategies by the health administration sections. Methods The data on the reported cases of other infectious diarrhea and public health emergencies in Kunming were collected through the Chinese Disease Prevention and Control Information System from 2017 to 2021, and described in accordance with the three-distribution and pathogenic classification. Results In total, 58 909 cases of other infectious diarrhea were reported in Kunming area from 2017 through 2021. No deaths were reported. Annual average reported incidence was 156.90/100 000, and annual reported incidence rate was 123.66/100 000-194.03/100 000. The number of reported cases showed seasonal peaks, primarily occurring in winter (December-January). The top 5 areas by average annual reported incidence were Anning City (226.65/100 000), Wuhua District (210.63/100 000), Jinning District (185.68/100 000), Shilin County (180.08/100 000) and Panlong District (174.33/100 000). Of the reported cases, 31 559 were males (53.57%), and 27 350 females (46.43%). By different age group, the population under 5 years of age was the highest in the cases reported, which accounted for 68.02% (40 067/58 909). Among different occupations, the number of cases reported was the highest 65.47% (38 566/58 909) for children of scattered living. The incidence of viral diarrhea was 99.38% (10 205/10 269) in the diseases with clear etiology, in which rotavirus infection accounted for 94.06% (9 659/10 269). Eight other infectious diarrhea events were reported in the city from 2017 to 2021, of which 7 occurred in schools and nurseries. The total attack rate was 0.86%. Of the 7 events with clear etiology, 6 were caused by norovirus. Conclusion The prevention and control of other infectious diarrhea is one of the important tasks in the prevention and control of infectious diseases in Kunming area. Children are recommended to be vaccinated with rotavirus vaccine before the epidemic season, and the epidemic monitoring and control work in key areas and institutions should be strengthened during the peak period. Figures and Tables | References | Related Articles | Metrics

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Epidemiological characteristics of other infectious diarrhea in Zigong City from 2015 to 2022 ZHOU Min, ZHANG Jie, ZHANG Zheng-dong, WANG Hong, ZOU Nian-li, PU Yang-yang, CHEN Xi 2023, 21 (1):  25-29.  doi: 10.3969/j.issn.1672-2302.2023.01.005 Abstract ( 487 )   HTML ( 35 )   PDF (1100KB) ( 583 )   Objective To analyze the epidemiological characteristics of other infectious diarrhea in Zigong City for scientific evidence to formulate corresponding prevention and control measures. Methods The data on other infectious diarrhea in Zigong City was retrieved through Infectious Disease Surveillance System under the Chinese Disease Prevention and Control Information System, and analyzed by using descriptive epidemiological methods. Results A total of 13 628 cases of other infectious diarrhea were reported in Zigong City from 2015 to 2022, with an average incidence of 62.97/100 000 and an annual incidence of 43.77/100 000-94.62/100 000. The incidence showing an increasing trend from 2015 to 2022 (Z=2.35，P<0.05). There were 2 waves for the reported cases, which peaked in spring and sub-peaked in summer. Children aged from 0 to 2 years were dominant in the reported cases, accounting for 63.84% (8 700/13 628) of the total reported cases. The reported cases were 7 444 for males, and 6 184 for females, with an average reported incidence of 69.37/100 000 and 56.69/100 000, and the incidence was higher in males than in females. The pathogen was clearly identified in 22.36% (3 047/13 628) of all reported cases, in which 95.31% (2 904/3 047) were associated with viral infection. Rotavirus was most seen, accounting for 97.35% (2 827/2 904) of the total infections. Virus infection mainly occurred in winter and spring, and bacterial infection mainly occurred in summer. A total of 7 outbreaks were reported, all of which were caused by norovirus. Conclusion Infectious diarrhea prevention and control in Zigong area should focus on children, and diverse pathogens should be monitored in different seasons. In addition, medical institutions shall further improve the level of testing for other infectious diarrhea and the standardization and sensitivity in reporting the infectious diseases. Figures and Tables | References | Related Articles | Metrics

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Epidemiological characteristics of other infectious diarrhea in Weifang City from 2017 to 2021 FAN Jun-jie, WANG Yi, WANG Ye-ping, WANG Da-peng, LIU Hui-hui, WANG Rui 2023, 21 (1):  30-34.  doi: 10.3969/j.issn.1672-2302.2023.01.006 Abstract ( 492 )   HTML ( 38 )   PDF (1238KB) ( 669 )   Objective To investigate the characteristics of other infectious diarrhea in Weifang City for evidence to optimize the prevention and control measures. Method The cases of other infectious diarrhea reported in Weifang area in the Chinese Disease Prevention and Control Information System were cumulatively collected from 2017 to 2021, and analyzed using descriptive epidemiology for the distribution characteristics of other infectious diarrhea in different region, population and time in Weifang. Results A total of 43 089 cases of other infectious diarrhea were reported in Weifang from 2017 to 2021, with an average 8 618 cases annually reported, and no deaths occurred. Average annual incidence was 92.01/100 000. The distribution of reported cases had a certain seasonal, with two peaks in July and December. Counties (cities and districts) with the largest number of cases reported were Kuiwen District (n=1 428), Linqu County (n=993), Zhucheng City (n=914) and Shouguang City (n=903). The annual number of reported cases and incidence in males were 4 765 and 99.62/100 000, and those in females were 3 853 cases and 84.07/100 000, both of which were higher in males than in females. Children aged 0 to 3 years had the highest number of reported cases and incidence. By occupation, the proportion was relatively higher in scattered children (3 786 cases, 43.93%) and farmers (2 927 cases, 33.96%). Rotavirus was mostly detected in children aged from 0 to 9 years, which accounted for 88.53% (1 705/1 926), yet rotavirus and norovirus were more seen in those over 10 years old, which accounted for 42.24% (98/218) and 34.48% (80/218), respectively. Rotavirus showed certain seasonal characteristics, while other viruses did not show obvious seasonal trend. Conclusion Incidence of other infectious diarrhea in Weifang had obvious seasonal characteristics. The findings suggest that scattered children and farmers should be the important population for prevention and control of the infection. Figures and Tables | References | Related Articles | Metrics

ARTICLE

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Effect of dietary structures on intestinal flora in population infected with Trichuris trichura ZHANG Yi-xin, WANG Long-jiang, LIU Jian-cheng, LIU Ping-ping, WANG Yong-bin, XU Yan, YAN Ge, BU Xiu-qin, ZHANG Dian-bo, LI Yue-jin, ZHANG Ben-guang 2023, 21 (1):  35-43.  doi: 10.3969/j.issn.1672-2302.2023.01.007 Abstract ( 695 )   HTML ( 26 )   PDF (4420KB) ( 1749 )   Objective To investigate the effects of different dietary structures on the intestinal flora in population infected by Trichuris trichura (T. trichura) so as to lay a foundation for studying the relationship between intestinal diseases and diet in patients with T. trichura infection. Methods Thirty-four patients infected by T. trichura were recruited from five towns in Lanshan District, Rizhao City, Shandong Province, and their dietary information was collected and analyzed by 16S rDNA high-throughput sequencing to determine the differences in intestinal flora diversity and species composition among T. trichura infected populations with different dietary structures. Results No association was found between high dietary intake and gut flora Alpha diversity or Beta diversity. The three dietary structures of vegetables, dairy products and meat products were significantly associated with the abundance and composition of intestinal flora.There were three species with significant differences in the intake of different vegetables at the genus level. The relative abundance of Clostridium sensu stricto 1 in the PDV3 group with a daily intake of <300 g was higher than that in PDV1 group with a daily intake of >500 g, and the difference was statistically significant (t=2.211, P<0.05). The relative abundance of Ruminococcus in PDV3 group was significantly lower than that in PDV1 group (t=2.246, P<0.05), whereas the relative abundance of Bifidobacterium was lower in PDV3 group than in PDV2 group with daily intake of 300-500 g. The difference was significant (t=2.610, P<0.05). Three species were significantly different in the intake of different dairy products at the genus level. The abundance of Clostridium sensu stricto 1 in PDD2 group with daily intake of 300 g-500 g was higher than that in PDD1 group with daily intake of >500 g(t=3.025, P<0.05), contrarily, the abundance of the Alistipes in PDD3 group with daily intake <300 g was lower than that in PDD1 group (t=3.234, P<0.05). The abundance of Ruminococcaceae UCG-014 was significantly lower in PDD3 group than in PDD2 group (t=2.255, P<0.05). Three species with significant differences in the intake of different meat products at the genus level were observed. The abundance of the genus pair of Phascolarctobacterium and Ruminococcus 2 in PDM2 group with a daily intake of 120-200 g was lower than that in the PDM1 group, with significant difference between groups (t=2.672, P<0.05; t=2.731, P<0.05), yet the relative abundance of Dialister in PDM3 group with daily intake <120 g was lower than that in PDM2 group (t=2.402, P<0.05). Conclusion Different dietary structures affected the composition of intestinal flora in whipworm-infected populations. By supplementing the diet with vegetables, dairy products and meat products to reduce harmful bacteria such as Clostridium sensu stricto 1 and increasing beneficial bacteria such as Bifidobacterium and Alistipes can improve the immunity of the body and reduce or avoid the development of intestinal inflammatory diseases in people with T. trichura infection. Figures and Tables | References | Related Articles | Metrics

INVESTIGATION STUDY

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Influence of personality traits on stress perception and mental health: based on a survey of carriers with SARS-CoV-2 YANG Jin-sun, ZHANG Ya-li, LI Hui-juan, LIU Zhen-jun, WANG Wen-jie, QUAN Bin, ZHANG Ting 2023, 21 (1):  44-47.  doi: 10.3969/j.issn.1672-2302.2023.01.008 Abstract ( 784 )   HTML ( 16 )   PDF (842KB) ( 1095 )   Objective To investigate the influence of personality traits on stress perception and mental health in population SARS-CoV-2 infection. Methods The subjects with SARS-CoV-2 infection treated in the designated hospitals of Wuhu City and Anqing City of Anhui Province were recruited from March to October of 2022, and undergone survey with general information questionnaire, NEO five factor inventory, symptom check list-90 (SCL-90) and Pressure Perception Scale. Linear regression analysis was performed to evaluate the influence of the score of personality traits on the scores of Symptom Checklist and Stress Perception Scale. Results A total of 130 copies of questionnaires were distributed, in which 118 valid copies were recovered, with an effective recovery rate of 90.8%. Of the participants, 85 were men, and 33 were women. The age ranged from 15 to 63 years, with an average being (34.85±10.99) years. One hundred and eight patients had been vaccinated with COVID-19 vaccine, and another 10 were not vaccinated. In addition, the 180 participants had no history of mental, neurological or psychological conditions. The average scoring on SCL-90 was 119.25±49.04, of which 22.03% (26/118) of the respondents were screened positive by SCL-90. The scoring on Pressure Perception Scale was 38.91±6.85 on average, of which 34.75% (41/118) respondents had higher pressure perception. Neurotic personality had statistical significance in positive prediction of SCL-90 and stress perception (β= 0.516 and 0.282, both P<0.01). Extraversion, openness and sense of responsibility had statistical significance in the negative prediction of stress perception (β=-0.371, -0.307, -0.477, all P<0.01). Conclusion The problems, including excessive pressure perception and poor mental health, may exist in population with SARS-CoV-2 infection, and their personality traits have a certain impact on pressure perception and mental health. Our findings suggest that medical staff should be paid with high attention to their personality traits in a timely manner, and provision with corresponding intervention measures. Figures and Tables | References | Related Articles | Metrics

CLINICAL STUDY

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Observation on the efficacy of different doses of tribendimidine for patients with clonorchiasis HUANG Xing-jiong, HUANG Xian-ze, BAN Gong-sheng, LU Li-yan, LIANG Mei-qun, LIN Shi-bao 2023, 21 (1):  48-51.  doi: 10.3969/j.issn.1672-2302.2023.01.009 Abstract ( 646 )   HTML ( 19 )   PDF (806KB) ( 743 )   Objective To observe the clinical efficacy of triphenylamidine against Clonorchis sinensis for evidence to screen the optimal drug in the treatment of clonorchiasis. Methods By stratified random sampling, patients infected with Clonorchis sinensis, treated in the outpatient department of Wuming District Disease Prevention and Control Center of Nanning City, were included from August 2020 to August 2022, and divided into observational group (treated with tribendimidine) and control group (treated with praziquantel). Then patients in the observational group were sub-grouped into group A (400 mg, single dose), group B (two doses of daily dose every other week), and group C (three doses for three consecutive days). Patients in the control group (group D) were was treated with praziquantel in dose of 800 mg/time, tid, for 3 days. After one month of medication, all patients underwent reexamination to observe the changes of worm eggs and adverse drug reactions before and after treatment, and treatment effect was evaluated. Results In total, 149 patients received medication with tribendimidine, including 45 patients in group A, 51 in group B, and 53 in group C. Ninety-nine patients were treated with praziquantel. Negative conversion rate in for the egg the observational group was 86.67%, 94.12% and 92.45% respectively, and 97.98% for the control group. There was no significant difference in the conversion rate among groups (χ2=7.146, P>0.05). The egg reduction rate was 79.27%, 88.47% and 82.11% in the three sub-groups, respectively, and 87.91% in the control group for patients with mild infection. For patients with moderate infection, the egg reduction rate was 78.86%, 97.43% and 98.65% in the tribendimidine group, and 99.15% in the praziquantel control group. The total incidence of adverse reaction and the average duration of adverse reaction were 5.37% and 3.9 h, and 13.13% and 50.9 h, respectively in the observational group and control group. The incidence and average duration of adverse reaction were lower in the tribendimidine group than in the praziquantel group, with statistical significance (χ2=4.624, t=6.423, both P<0.05). Conclusion Tribenzamidine can be used for clonorchiasis in clinic, because it shows better efficacy and has has lower incidence and duration of adverse reaction compared to praziquantel. Figures and Tables | References | Related Articles | Metrics

TEACHING EXPLORATION

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Current status of spatial epidemiology course construction and exploration of its teaching methods ZHANG Zhi-jie, JIANG Qing-wu 2023, 21 (1):  52-56.  doi: 10.3969/j.issn.1672-2302.2023.01.010 Abstract ( 543 )   HTML ( 20 )   PDF (769KB) ( 1367 )   Spatial epidemiology, as an interdisciplinary discipline, is in urgent need of corresponding curriculum construction, because it provides new opportunities for epidemiology by making full use of the characteristics of spatial geographic information, and generates a large number of talent demands. This paper systematically reviewed the course setting and reference books available for spatial epidemiology, summarized current status of the course construction at home and abroad, and briefly discussed the existing teaching methods for the course, so as to provide reference for better teaching of spatial epidemiology and training of diversified talents in the future. Figures and Tables | References | Related Articles | Metrics

REVIEW

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Research progress of tea tree oil in the treatment of eye diseases caused by Demodex ZHENG Xin-wu, XIE Si-jian, XIE Wen-jun 2023, 21 (1):  57-61.  doi: 10.3969/j.issn.1672-2302.2023.01.011 Abstract ( 706 )   HTML ( 28 )   PDF (838KB) ( 2091 )   Ocular Demodex infection can cause discomfort of the ocular surface and a variety of ocular conditions, and the incidence has been increasing in recent years. Tea tree oil and its derivatives not only have significant acaricidal effect, but also have antibacterial and anti-inflammatory activities, and are commonly used in the treatment of Demodex eye disease. Currently, various kinds of preparations from tea tree oil are available, yet the safety and optimal use of the related extract have not been fully clarified. This paper reviewed the mechanism, application, safety and efficacy of tea tree oil in the treatment of Demodex eye conditions, with an attempt to provide reference for clinical use of this extract for ocular Demodex infestation. References | Related Articles | Metrics