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Zhu Y, Jiao X, Meng W, Yu X, Cheng H, Shen G, Wang X, Tao S. Drinking Water in Rural China: Water Sources, Treatment, and Boiling Energy. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:6465-6473. [PMID: 37040484 DOI: 10.1021/acs.est.2c09344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Access to safe drinking water is a major public concern in China. A national survey of 57 029 households was conducted to fill major knowledge gaps on drinking water sources, end-of-use treatment methods, and energy used to boil water. Herein, we show that surface water and well water were frequently used by >147 million rural residents living in low-income inland and mountainous areas. Driven by socioeconomic development and government intervention, the level of access to tap water in rural China increased to 70% by 2017. Nevertheless, the rate was considerably lower than that in cities and unevenly distributed across the country. Approximately 90% of drinking water was boiled, an increase from 85% a decade ago. The contribution of electricity, mainly electric kettles, to the boiling of water was 69%. Similar to cooking, living conditions and heating requirements are the main influencing indicators of energy used to boil water. In addition to socioeconomic development, government intervention is a key factor driving the transition to safe water sources, universal access to tap water, and clean energy. Further improvement in drinking water safety in poor and remote rural areas remains challenging, and more intervention and more investment are needed.
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Affiliation(s)
- Yaqi Zhu
- College of Urban and Environmental Sciences, Laboratory for Earth Surface Processes, Sino-French Institute for Earth System Science, Peking University, Beijing 100871, China
| | - Xiaoqiao Jiao
- College of Urban and Environmental Sciences, Laboratory for Earth Surface Processes, Sino-French Institute for Earth System Science, Peking University, Beijing 100871, China
| | - Wenjun Meng
- College of Urban and Environmental Sciences, Laboratory for Earth Surface Processes, Sino-French Institute for Earth System Science, Peking University, Beijing 100871, China
| | - Xinyuan Yu
- College of Urban and Environmental Sciences, Laboratory for Earth Surface Processes, Sino-French Institute for Earth System Science, Peking University, Beijing 100871, China
| | - Hefa Cheng
- College of Urban and Environmental Sciences, Laboratory for Earth Surface Processes, Sino-French Institute for Earth System Science, Peking University, Beijing 100871, China
| | - Guofeng Shen
- College of Urban and Environmental Sciences, Laboratory for Earth Surface Processes, Sino-French Institute for Earth System Science, Peking University, Beijing 100871, China
| | - Xuejun Wang
- College of Urban and Environmental Sciences, Laboratory for Earth Surface Processes, Sino-French Institute for Earth System Science, Peking University, Beijing 100871, China
| | - Shu Tao
- College of Urban and Environmental Sciences, Laboratory for Earth Surface Processes, Sino-French Institute for Earth System Science, Peking University, Beijing 100871, China
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Fang J, Li R, Ye D, Chen L, Zhuo Ma LB, Zhang Y, Zhu J, Gao X, Xu P, Zheng Y, Li X, You J, Jiang C, Qing K, Yue F, Li J, Wang Dui PB, Xue K. The clinical characteristics of anemia in native adults living at different altitudes of the Tibetan Plateau. Sci Rep 2023; 13:3208. [PMID: 36828825 PMCID: PMC9958083 DOI: 10.1038/s41598-022-26868-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 12/21/2022] [Indexed: 02/26/2023] Open
Abstract
To provide evidence-based medicine references for formulating prevention and control policies in plateau areas, we explore the characteristics of anemia patients in Tibet (the plateau areas of China), especially those located at an altitude above 4500 m. We collected clinical data from 379 Tibetan anemia patients over the age of 18 years. We found those female patients accounted for the majority of Tibetan anemia patients. Almost half of the anemia patients aged from 28 to 47 years. The percentage of severe anemia and extremely severe anemia was 45.4% and 2.4%, respectively. 88.7% of patients are engaged in agriculture and animal husbandry, and 81.5% of patients just graduated from primary school or below. The most common causes of anemia were nutritional anemia, especially iron-deficiency anemia. At high-altitude localities, folic acid-deficiency anemia needs more attention. Overall, this study showed that altitude influences the incidence, severity, and cause of anemia. Peasants and herdsmen, low education levels, young and middle-aged women, and nutrition status should be paid attention to in future anemia control.
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Affiliation(s)
- Jie Fang
- Department of Hematology, Shigatse People's Hospital, Tibet Autonomous Region, China
| | - Ran Li
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dongdong Ye
- Department of Medical Oncology, Ruijin Hospital Wuxi Branch, Shanghai Jiao Tong University School of Medicine, Wuxi, China
| | - Liang Chen
- Department of Hematology, Shigatse People's Hospital, Tibet Autonomous Region, China
- Department of Emergency Medicine, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Luo Bu Zhuo Ma
- Department of Hematology, Shigatse People's Hospital, Tibet Autonomous Region, China
| | - Yinyin Zhang
- Department of Hematology, Shigatse People's Hospital, Tibet Autonomous Region, China
| | - Jun Zhu
- Department of Hematology, Shigatse People's Hospital, Tibet Autonomous Region, China
| | - Xiaodong Gao
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Pengpeng Xu
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Zheng
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoyang Li
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianhua You
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chuanhe Jiang
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kai Qing
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fei Yue
- Department of Hematology, Shigatse People's Hospital, Tibet Autonomous Region, China
| | - Junmin Li
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Pu Bu Wang Dui
- Department of Hematology, Shigatse People's Hospital, Tibet Autonomous Region, China.
| | - Kai Xue
- Department of Hematology, Shigatse People's Hospital, Tibet Autonomous Region, China.
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Bhattacharya S, Tripathi S, Gupta P, Varshney S, Vallabh V. Integration of communicable and non-communicable diseases within the health system of India: A window of opportunity? Front Public Health 2023; 10:1079827. [PMID: 36699928 PMCID: PMC9870306 DOI: 10.3389/fpubh.2022.1079827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/09/2022] [Indexed: 01/11/2023] Open
Affiliation(s)
- Sudip Bhattacharya
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Deoghar, India,*Correspondence: Sudip Bhattacharya ✉
| | | | - Pratima Gupta
- Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Deoghar, India
| | - Saurabh Varshney
- Department of ENT (Otorhinolaryngology), All India Institute of Medical Sciences (AIIMS), Deoghar, India
| | - Vidisha Vallabh
- Department of Community Medicine, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
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Mujumbusi L, Nalwadda E, Ssali A, Pickering L, Seeley J, Meginnis K, Lamberton PHL. Understanding perceptions of schistosomiasis and its control among highly endemic lakeshore communities in Mayuge, Uganda. PLoS Negl Trop Dis 2023; 17:e0010687. [PMID: 36656869 PMCID: PMC9888691 DOI: 10.1371/journal.pntd.0010687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 01/31/2023] [Accepted: 12/15/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Schistosomiasis is a neglected tropical disease and a serious global-health problem with over 230 million people requiring treatment, of which the majority live in Africa. In Uganda, over 4 million people are infected. Extensive parasitological data exist on infection prevalence, intensities and the impact of repeated praziquantel mass drug administration (MDA). However, how perceptions of schistosomiasis shape prevention and treatment practices and their implications for control measures are much less well understood. METHODS Rapid ethnographic appraisals were performed for six weeks in each of three Schistosoma mansoni high endemicity communities on the shores of Lake Victoria, Mayuge District, Uganda. Data were collected between September 2017 and April 2018. Data were collected through structured observations, transect walks, and participant observation, and sixty in-depth interviews and 19 focus group discussions with purposively recruited participants. Data were analyzed thematically using iterative categorization, looking at five key areas: perceptions of 1) the symptoms of schistosomiasis; 2) the treatment of schistosomiasis; 3) how schistosomiasis is contracted; 4) how schistosomiasis is transmitted onwards and responsibilities associated with this; and 5) how people can prevent infection and/or onward transmission. RESULTS Observations revealed open defecation is a common practice in all communities, low latrine coverage compared to the population, and all communities largely depend on lake water and contact it on a daily basis. Perceptions that a swollen stomach was a sign/symptom of 'ekidada' (caused by witchcraft) resulted in some people rejecting free praziquantel in favour of herbal treatment from traditional healers at a fee. Others rejected praziquantel because of its perceived side effects. People who perceived that schistosomiasis is caught from drinking unboiled lake water did not seek to minimize skin contact with infected water sources. Community members had varied perceptions about how one can catch and transmit schistosomiasis and these perceptions affect prevention and treatment practices. Open defecation and urinating in the lake were considered the main route of transmission, all communities attributed blame for transmission to the fishermen which was acknowledged by some fishermen. And, lastly, schistosomiasis was considered hard to prevent due to lack of access to safe water. CONCLUSION Despite over 15 years of MDA and associated education, common misconceptions surrounding schistosomiasis exist. Perceptions people have about schistosomiasis profoundly shape not only prevention but also treatment practices, greatly reducing intervention uptake. Therefore, we advocate for a contextualized health education programme, alongside MDA, implementation of improved access to safe-water and sanitation and continued research.
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Affiliation(s)
- Lazaaro Mujumbusi
- Medical Research Council/Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- * E-mail: (LM); (PHLL)
| | - Edith Nalwadda
- Medical Research Council/Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
| | - Agnes Ssali
- Medical Research Council/Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
| | - Lucy Pickering
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Janet Seeley
- Medical Research Council/Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Keila Meginnis
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- School of Biodiversity, One Health & Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Poppy H. L. Lamberton
- School of Biodiversity, One Health & Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom
- Wellcome Centre for Integrative Parasitology, University of Glasgow, Glasgow, United Kingdom
- * E-mail: (LM); (PHLL)
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Chen Q, Zhao K, Li G, Luo J, Li X, Zeng Y, Wang XM. Highly Permeable Polylactic Acid Membrane Grafted with Quaternary Ammonium Salt for Effective and Durable Water Disinfection. ACS APPLIED MATERIALS & INTERFACES 2022; 14:43741-43748. [PMID: 36099237 DOI: 10.1021/acsami.2c11551] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Given the increasing usage of drinking water purifiers, highly permeable membranes with strong antimicrobial functions are desperately desirable for effective and durable water disinfection. Hereby, we prepared such antimicrobial membranes by chemical grafting of quaternary ammonium salt (QAS) molecules, 3-(trimethoxysilyl)propyldimethyloctadecyl ammonium chloride (TPMMC), onto air plasma pretreated biodegradable polylactic acid (PLA) substrates. The high chemical grafting density promoted very strong and positive zeta potential charge of the resulted PLA-QAS membrane, contributing to effective and broad-spectrum antimicrobial efficiencies (>99.99%) against different microbes, including fungi and conventional and drug-resistant bacteria. The solid grafting of QAS molecules produced a durable antimicrobial performance of the PLA-QAS membrane. In addition, the pleated filter (0.45 m2) of PLA-QAS membrane showed outstanding bacteria rejection properties (>99.99%) and excellent washing durability (up to 20 m3 water) even at very high water filtration rates (up to 4 L/min). The disinfection mechanism was clarified that negatively charged bacteria could be rapidly adsorbed to positively charged PLA-QAS spinnings, followed by devastating cell membrane damage to bacterial debris, leaving a clean environment without significant biofilm and biofouling formation.
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Affiliation(s)
- Qingyan Chen
- Shenzhen Angel Drinking Water Industrial Group Corporation, Angel Industrial Park, Baoan District, Shenzhen, Guangdong 518108, China
| | - Kai Zhao
- Shenzhen Angel Drinking Water Industrial Group Corporation, Angel Industrial Park, Baoan District, Shenzhen, Guangdong 518108, China
| | - Guoping Li
- Shenzhen Angel Drinking Water Industrial Group Corporation, Angel Industrial Park, Baoan District, Shenzhen, Guangdong 518108, China
| | - Jiyue Luo
- Shenzhen Angel Drinking Water Industrial Group Corporation, Angel Industrial Park, Baoan District, Shenzhen, Guangdong 518108, China
| | - Xin Li
- Shenzhen Angel Drinking Water Industrial Group Corporation, Angel Industrial Park, Baoan District, Shenzhen, Guangdong 518108, China
| | - Yingjie Zeng
- Shenzhen Angel Drinking Water Industrial Group Corporation, Angel Industrial Park, Baoan District, Shenzhen, Guangdong 518108, China
| | - Xiao-Mao Wang
- State Key Joint Laboratory of Environment Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, China
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Grau-Pujol B, Cano J, Marti-Soler H, Casellas A, Giorgi E, Nhacolo A, Saute F, Giné R, Quintó L, Sacoor C, Muñoz J. Neighbors' use of water and sanitation facilities can affect children's health: a cohort study in Mozambique using a spatial approach. BMC Public Health 2022; 22:983. [PMID: 35578273 PMCID: PMC9109333 DOI: 10.1186/s12889-022-13373-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 05/05/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Impact evaluation of most water, sanitation and hygiene (WASH) interventions in health are user-centered. However, recent research discussed WASH herd protection - community WASH coverage could protect neighboring households. We evaluated the effect of water and sanitation used in the household and by household neighbors in children's morbidity and mortality using recorded health data. METHODS We conducted a retrospective cohort including 61,333 children from a district in Mozambique during 2012-2015. We obtained water and sanitation household data and morbidity data from Manhiça Health Research Centre surveillance system. To evaluate herd protection, we estimated the density of household neighbors with improved facilities using a Kernel Density Estimator. We fitted negative binomial adjusted regression models to assess the minimum children-based incidence rates for every morbidity indicator, and Cox regression models for mortality. RESULTS Household use of unimproved water and sanitation displayed a higher rate of outpatient visit, diarrhea, malaria, and anemia. Households with unimproved water and sanitation surrounded by neighbors with improved water and sanitation high coverage were associated with a lower rate of outpatient visit, malaria, anemia, and malnutrition. CONCLUSION Household and neighbors' access to improve water and sanitation can affect children's health. Accounting for household WASH and herd protection in interventions' evaluation could foster stakeholders' investment and improve WASH related diseases control. Distribution of main water and sanitation facilities used during study period.
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Affiliation(s)
- Berta Grau-Pujol
- grid.410458.c0000 0000 9635 9413Barcelona Institute for Global Health, Hospital Clínic - Universitat de Barcelona, C/Rosselló 132 4°1ª, 08036 Barcelona, Spain ,grid.452366.00000 0000 9638 9567Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique ,Mundo Sano Foundation, Buenos Aires, Argentina
| | - Jorge Cano
- grid.463718.f0000 0004 0639 2906Expanded Special Project for Elimination of NTDs, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Helena Marti-Soler
- grid.410458.c0000 0000 9635 9413Barcelona Institute for Global Health, Hospital Clínic - Universitat de Barcelona, C/Rosselló 132 4°1ª, 08036 Barcelona, Spain
| | - Aina Casellas
- grid.410458.c0000 0000 9635 9413Barcelona Institute for Global Health, Hospital Clínic - Universitat de Barcelona, C/Rosselló 132 4°1ª, 08036 Barcelona, Spain ,grid.5841.80000 0004 1937 0247Departament de Fonaments Clínics, Facultat de Medicina, Universitat de Barcelona (UB), Casanova 143, 08036 Barcelona, Spain
| | - Emanuele Giorgi
- grid.9835.70000 0000 8190 6402Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Bailrigg, Lancaster, LA1 4YW UK
| | - Ariel Nhacolo
- grid.452366.00000 0000 9638 9567Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Francisco Saute
- grid.452366.00000 0000 9638 9567Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Ricard Giné
- grid.454010.40000 0001 1009 1661Stockholm International Water Institute, Stockholm, Sweden
| | - Llorenç Quintó
- grid.410458.c0000 0000 9635 9413Barcelona Institute for Global Health, Hospital Clínic - Universitat de Barcelona, C/Rosselló 132 4°1ª, 08036 Barcelona, Spain ,grid.452366.00000 0000 9638 9567Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Charfudin Sacoor
- grid.452366.00000 0000 9638 9567Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Jose Muñoz
- grid.410458.c0000 0000 9635 9413Barcelona Institute for Global Health, Hospital Clínic - Universitat de Barcelona, C/Rosselló 132 4°1ª, 08036 Barcelona, Spain
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Guan X, Lan T, Liao W, Wu X, Pan J. Exploring the effect of the primary care health workers number on infectious diarrhea morbidity and where the health resources should go. Sci Rep 2022; 12:6060. [PMID: 35411117 PMCID: PMC9001693 DOI: 10.1038/s41598-022-10060-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 03/21/2022] [Indexed: 11/09/2022] Open
Abstract
We aimed to explore the association between the number of primary healthcare workers and infectious diarrhea morbidity at community levels and to provide evidence-based implications for optimizing primary healthcare manpower resource allocations. We collected annual infectious diarrhea morbidity and relevant data of 4321 communities in Sichuan Province, China, from 2017 to 2019. Global and local Moran’s I were calculated to detect the spatial clustering of infectious diarrhea morbidity and to identify areas where increased primary healthcare manpower resources should be allocated. The spatial lag fixed effects panel data model was adopted to explore the association between the number of primary healthcare workers per 1000 residents and infectious diarrhea morbidity. Significantly high–high and low–low clusters of infectious diarrhea cases were found to be mainly distributed in underdeveloped and developed areas during the studied period years, respectively. The infectious diarrhea morbidity was found to be statistically negatively associated with the number of primary healthcare workers per 1000 residents with a coefficient of − 0.172, indicating that a 0.172 reduction of infectious diarrhea morbidity (1/10,000) was associated with doubled amounts of primary healthcare workers per 1000 residents. Our findings highlighted the role of primary healthcare in the process of infectious diarrhea prevention and control, and implied that constant efforts should be addressed to facilitate infectious diarrhea prevention and control, especially in the underdeveloped areas.
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Wang Q, Cao H, Zhang S. Trends of and factors associated with access to residential toilets among the middle-aged and elderly in rural China from 2011 to 2018. BMC Public Health 2022; 22:421. [PMID: 35236327 PMCID: PMC8889666 DOI: 10.1186/s12889-022-12739-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 02/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND At the global and country levels, several important sanitation improvement initiatives were launched in the last decade. This study aimed to explore the temporal trend of and factors associated with access to residential toilets among the middle-aged and elderly in rural China from 2011 to 2018. METHODS This study used the 2011, 2013, 2015, and 2018 data of China Health and Retirement Longitudinal Study (CHARLS). CHARLS was conducted among adults aged ≥ 45 years in 28 provinces of China. We used descriptive statistics and logistic regressions for data analysis. RESULTS We found that residential toilet coverage increased by about 6% among population aged ≥ 45 years in rural China from 2011 to 2018. The coverage of flushable toilets and toilets with seats among this sector of the population increased by more than 10% during this period. We also found that being female, higher levels of education, higher annual per capita household consumption, having running water in the residence, larger household size, and better health status were significantly associated with an increased likelihood of residential toilet ownership among population aged ≥ 45 years in rural China. CONCLUSIONS China made progress in sanitation improvement in rural areas from 2011 to 2018. However, considering the current coverage levels of residential toilets and the vulnerable subgroups who are more prone to toilet deprivation in rural areas, we suggest to the government to implement further targeted toilet improvement interventions to ensure universal coverage of sanitation facilities for the whole of the Chinese population.
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Affiliation(s)
- Qun Wang
- Faculty of Humanities and Social Sciences, Dalian University of Technology, Dalian, China
| | - Huiyuan Cao
- Faculty of Humanities and Social Sciences, Dalian University of Technology, Dalian, China.,School of Public Administration, College of Management and Economics, Tianjin University, Tianjin, China
| | - Shuo Zhang
- Institute of Complex Systems On Decision and Control, Dalian University of Technology, Dalian, China.
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Wei N, Zhou L, Huang W. Does an upward intergenerational educational spillover effect exist? The effect of children's education on Chinese parents' health. INTERNATIONAL JOURNAL OF HEALTH ECONOMICS AND MANAGEMENT 2022; 22:69-89. [PMID: 34415455 DOI: 10.1007/s10754-021-09308-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 05/10/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Research on the presence of an upward spillover effect of children's education on parental health is rapidly developing. However, there are certain differences in the conclusions of relevant studies, and no consistent viewpoint has been reached. METHODS Using the exogenous differences in education generated by the expansion of higher education enrollment that China implemented as a reform in 1999, we analyze this issue by studying the effect of children's higher education on their parents' health. RESULTS The instrumental variable (IV) estimation results show that children who received higher education have a significant and positive effect on the physical health of their parents. Compared with the ordinary least squares (OLS) estimation results, the coefficient of the effect of children receiving higher education is larger in the IV estimation. CONCLUSIONS Children's education can generate a significant active effect on parental health, affecting parental physical health via its effect on parental health cognition and health behaviors. Based on heterogeneity analyses, the effect of a son's education on parental health is more significant than the effect of a daughter's education, and among rural children, higher education has a more significant effect on parental health.
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Affiliation(s)
- Ning Wei
- School of Management, Jiangsu University, 301 Xuefu Road, Zhenjiang, Jiangsu Province, China
| | - Lülin Zhou
- School of Management, Jiangsu University, 301 Xuefu Road, Zhenjiang, Jiangsu Province, China
| | - Wenhao Huang
- School of Management, Xuzhou Medical University, 209 Tongshan Road, Xuzhou, Jiangsu Province, China.
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Chang Q, Wang K, Zhang H, Li C, Wang Y, Jing H, Li S, Guo Y, Cui Z, Zhang W. Effects of daily mean temperature and other meteorological variables on bacillary dysentery in Beijing-Tianjin-Hebei region, China. Environ Health Prev Med 2022; 27:13. [PMID: 35314583 PMCID: PMC9251629 DOI: 10.1265/ehpm.21-00005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Although previous studies have shown that meteorological factors such as temperature are related to the incidence of bacillary dysentery (BD), researches about the non-linear and interaction effect among meteorological variables remain limited. The objective of this study was to analyze the effects of temperature and other meteorological variables on BD in Beijing-Tianjin-Hebei region, which is a high-risk area for BD distribution. Methods Our study was based on the daily-scale data of BD cases and meteorological variables from 2014 to 2019, using generalized additive model (GAM) to explore the relationship between meteorological variables and BD cases and distributed lag non-linear model (DLNM) to analyze the lag and cumulative effects. The interaction effects and stratified analysis were developed by the GAM. Results A total of 147,001 cases were reported from 2014 to 2019. The relationship between temperature and BD was approximately liner above 0 °C, but the turning point of total temperature effect was 10 °C. Results of DLNM indicated that the effect of high temperature was significant on lag 5d and lag 6d, and the lag effect showed that each 5 °C rise caused a 3% [Relative risk (RR) = 1.03, 95% Confidence interval (CI): 1.02–1.05] increase in BD cases. The cumulative BD cases delayed by 7 days increased by 31% for each 5 °C rise in temperature above 10 °C (RR = 1.31, 95% CI: 1.30–1.33). The interaction effects and stratified analysis manifested that the incidence of BD was highest in hot and humid climates. Conclusions This study suggests that temperature can significantly affect the incidence of BD, and its effect can be enhanced by humidity and precipitation, which means that the hot and humid environment positively increases the incidence of BD. Supplementary information The online version contains supplementary material available at https://doi.org/10.1265/ehpm.21-00005.
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Affiliation(s)
- Qinxue Chang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University
| | - Keyun Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University
| | - Honglu Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University
| | - Changping Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University
| | - Yong Wang
- Chinese PLA Center for Disease Control and Prevention
| | - Huaiqi Jing
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University
| | - Zhuang Cui
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University
| | - Wenyi Zhang
- Chinese PLA Center for Disease Control and Prevention
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Tunali M, Radin AA, Başıbüyük S, Musah A, Borges IVG, Yenigun O, Aldosery A, Kostkova P, dos Santos WP, Massoni T, Dutra LMM, Moreno GMM, de Lima CL, da Silva ACG, Ambrizzi T, da Rocha RP, Jones KE, Campos LC. A review exploring the overarching burden of Zika virus with emphasis on epidemiological case studies from Brazil. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:55952-55966. [PMID: 34495471 PMCID: PMC8500866 DOI: 10.1007/s11356-021-15984-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 08/11/2021] [Indexed: 05/13/2023]
Abstract
This paper explores the main factors for mosquito-borne transmission of the Zika virus by focusing on environmental, anthropogenic, and social risks. A literature review was conducted bringing together related information from this genre of research from peer-reviewed publications. It was observed that environmental conditions, especially precipitation, humidity, and temperature, played a role in the transmission. Furthermore, anthropogenic factors including sanitation, urbanization, and environmental pollution promote the transmission by affecting the mosquito density. In addition, socioeconomic factors such as poverty as well as social inequality and low-quality housing have also an impact since these are social factors that limit access to certain facilities or infrastructure which, in turn, promote transmission when absent (e.g., piped water and screened windows). Finally, the paper presents short-, mid-, and long-term preventative solutions together with future perspectives. This is the first review exploring the effects of anthropogenic aspects on Zika transmission with a special emphasis in Brazil.
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Affiliation(s)
- Merve Tunali
- Institute of Environmental Sciences, Boğaziçi University, Bebek, 34342 Istanbul, Turkey
| | | | - Selma Başıbüyük
- Institute of Environmental Sciences, Boğaziçi University, Bebek, 34342 Istanbul, Turkey
| | - Anwar Musah
- UCL Centre for Digital Public Health in Emergencies, Institute for Risk and Disaster Reduction, University College London, London, WC1E 6BT, London, UK
| | - Iuri Valerio Graciano Borges
- Departamento de Ciências Atmosféricas, Instituto de Astronomia, Geofísica e Ciências Atmosféricas, Universidade de São Paulo, São Paulo, SP 05508-090 Brazil
| | - Orhan Yenigun
- Institute of Environmental Sciences, Boğaziçi University, Bebek, 34342 Istanbul, Turkey
- School of Engineering, European University of Lefke, Lefke, North Cyprus, Turkey
| | - Aisha Aldosery
- UCL Centre for Digital Public Health in Emergencies, Institute for Risk and Disaster Reduction, University College London, London, WC1E 6BT, London, UK
| | - Patty Kostkova
- UCL Centre for Digital Public Health in Emergencies, Institute for Risk and Disaster Reduction, University College London, London, WC1E 6BT, London, UK
| | - Wellington P. dos Santos
- Department of Biomedical Engineering, Federal University of Pernambuco, Recife, PE 50740-550 Brazil
| | - Tiago Massoni
- Department Systems and Computing, Federal University of Campina Grande, Campina Grande, PB 58429-900 Brazil
| | - Livia Marcia Mosso Dutra
- Departamento de Ciências Atmosféricas, Instituto de Astronomia, Geofísica e Ciências Atmosféricas, Universidade de São Paulo, São Paulo, SP 05508-090 Brazil
| | - Giselle Machado Magalhaes Moreno
- Departamento de Ciências Atmosféricas, Instituto de Astronomia, Geofísica e Ciências Atmosféricas, Universidade de São Paulo, São Paulo, SP 05508-090 Brazil
| | - Clarisse Lins de Lima
- Polytechnic School of Pernambuco, University of Pernambuco (Poli-UPE), Recife, PE 50720-001 Brazil
| | - Ana Clara Gomes da Silva
- Department of Biomedical Engineering, Federal University of Pernambuco, Recife, PE 50740-550 Brazil
| | - Tércio Ambrizzi
- Departamento de Ciências Atmosféricas, Instituto de Astronomia, Geofísica e Ciências Atmosféricas, Universidade de São Paulo, São Paulo, SP 05508-090 Brazil
| | - Rosmeri Porfirio da Rocha
- Departamento de Ciências Atmosféricas, Instituto de Astronomia, Geofísica e Ciências Atmosféricas, Universidade de São Paulo, São Paulo, SP 05508-090 Brazil
| | - Kate E. Jones
- Department of Genetics, Evolution and Environment, Centre for Biodiversity and Environment Research, University College London, WC1E 6BT, London, UK
| | - Luiza C. Campos
- Department of Civil, Environmental and Geomatic Engineering, University College London, WC1E 6BT, London, UK
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12
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Zhao Z, Chen Q, Wang Y, Chu M, Hu Q, Hannah MN, Rui J, Liu X, Yu Y, Zhao F, Ren Z, Yu S, An R, Pan L, Chiang YC, Zhao B, Su Y, Zhao B, Chen T. Relative transmissibility of shigellosis among different age groups: A modeling study in Hubei Province, China. PLoS Negl Trop Dis 2021; 15:e0009501. [PMID: 34111124 PMCID: PMC8219151 DOI: 10.1371/journal.pntd.0009501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 06/22/2021] [Accepted: 05/24/2021] [Indexed: 11/24/2022] Open
Abstract
Shigellosis is a heavy disease burden in China especially in children aged under 5 years. However, the age-related factors involved in transmission of shigellosis are unclear. An age-specific Susceptible-Exposed-Infectious/Asymptomatic-Recovered (SEIAR) model was applied to shigellosis surveillance data maintained by Hubei Province Centers for Disease Control and Prevention from 2005 to 2017. The individuals were divided into four age groups (≤ 5 years, 6-24 years, 25-59 years, and ≥ 60 years). The effective reproduction number (Reff), including infectivity (RI) and susceptibility (RS) was calculated to assess the transmissibility of different age groups. From 2005 to 2017, 130,768 shigellosis cases were reported in Hubei Province. The SEIAR model fitted well with the reported data (P < 0.001). The highest transmissibility (Reff) was from ≤ 5 years to the 25-59 years (mean: 0.76, 95% confidence interval [CI]: 0.34-1.17), followed by from the 6-24 years to the 25-59 years (mean: 0.69, 95% CI: 0.35-1.02), from the ≥ 60 years to the 25-59 years (mean: 0.58, 95% CI: 0.29-0.86), and from the 25-59 years to 25-59 years (mean: 0.50, 95% CI: 0.21-0.78). The highest infectivity was in ≤ 5 years (RI = 1.71), and was most commonly transmitted to the 25-59 years (45.11%). The highest susceptibility was in the 25-59 years (RS = 2.51), and their most common source was the ≤ 5 years (30.15%). Furthermore, "knock out" simulation predicted the greatest reduction in the number of cases occurred by when cutting off transmission routes among ≤ 5 years and from 25-59 years to ≤ 5 years. Transmission in ≤ 5 years occurred mainly within the group, but infections were most commonly introduced by individuals in the 25-59 years. Infectivity was highest in the ≤ 5 years and susceptibility was highest in the 25-59 years. Interventions to stop transmission should be directed at these age groups.
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Affiliation(s)
- Zeyu Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People’s Republic of China
| | - Qi Chen
- Hubei Provincial Center for Disease Control and Prevention, Wuhan City, Hubei Province, People’s Republic of China
| | - Yao Wang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People’s Republic of China
| | - Meijie Chu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People’s Republic of China
| | - Qingqing Hu
- Division of Public Health, School of Medicine, University of Utah, Presidents Circle, Salt Lake City, Utah, United States of America
| | - Mikah Ngwanguong Hannah
- Medical College, Xiamen University, Xiamen City, Fujian Province, People’s Republic of China
| | - Jia Rui
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People’s Republic of China
| | - Xingchun Liu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People’s Republic of China
| | - Yunhan Yu
- School of Statistics, Beijing Normal University, Beijing City, People’s Republic of China
| | - Fuwei Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People’s Republic of China
| | - Zhengyun Ren
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People’s Republic of China
| | - Shanshan Yu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People’s Republic of China
| | - Ran An
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People’s Republic of China
| | - Lili Pan
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People’s Republic of China
| | - Yi-Chen Chiang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People’s Republic of China
| | - Benhua Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People’s Republic of China
| | - Yanhua Su
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People’s Republic of China
| | - Bin Zhao
- Medical Insurance Office, Xiang’an Hospital of Xiamen University, Xiamen City, Fujian Province, People’s Republic of China
| | - Tianmu Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People’s Republic of China
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13
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Nexus between Water Security Framework and Public Health: A Comprehensive Scientific Review. WATER 2021. [DOI: 10.3390/w13101365] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Water scarcity, together with the projected impacts of water stress worldwide, has led to a rapid increase in research on measuring water security. However, water security has been conceptualized under different perspectives, including various aspects and dimensions. Since public health is also an integral part of water security, it is necessary to understand how health has been incorporated as a dimension in the existing water security frameworks. While supply–demand and governance narratives dominated several popular water security frameworks, studies that are specifically designed for public health purposes are generally lacking. This research aims to address this gap, firstly by assessing the multiple thematic dimensions of water security frameworks in scientific disclosure; and secondly by looking into the public health dimensions and evaluating their importance and integration in the existing water security frameworks. For this, a systematic review of the Scopus database was undertaken using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A detailed review analysis of 77 relevant papers was performed. The result shows that 11 distinct dimensions have been used to design the existing water security framework. Although public health aspects were mentioned in 51% of the papers, direct health impacts were considered only by 18%, and indirect health impacts or mediators were considered by 33% of the papers. Among direct health impacts, diarrhea is the most prevalent one considered for developing a water security framework. Among different indirect or mediating factors, poor accessibility and availability of water resources in terms of time and distance is a big determinant for causing mental illnesses, such as stress or anxiety, which are being considered when framing water security framework, particularly in developing nations. Water quantity is more of a common issue for both developed and developing countries, water quality and mismanagement of water supply-related infrastructure is the main concern for developing nations, which proved to be the biggest hurdle for achieving water security. It is also necessary to consider how people treat and consume the water available to them. The result of this study sheds light on existing gaps for different water security frameworks and provides policy-relevant guidelines for its betterment. Also, it stressed that a more wide and holistic approach must be considered when framing a water security framework to result in sustainable water management and human well-being.
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Morgan J, Strode C, Salcedo-Sora JE. Climatic and socio-economic factors supporting the co-circulation of dengue, Zika and chikungunya in three different ecosystems in Colombia. PLoS Negl Trop Dis 2021; 15:e0009259. [PMID: 33705409 PMCID: PMC7987142 DOI: 10.1371/journal.pntd.0009259] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 03/23/2021] [Accepted: 02/20/2021] [Indexed: 02/06/2023] Open
Abstract
Dengue, Zika and chikungunya are diseases of global health significance caused by arboviruses and transmitted by the mosquito Aedes aegypti, which is of worldwide circulation. The arrival of the Zika and chikungunya viruses to South America increased the complexity of transmission and morbidity caused by these viruses co-circulating in the same vector mosquito species. Here we present an integrated analysis of the reported arbovirus cases between 2007 and 2017 and local climate and socio-economic profiles of three distinct Colombian municipalities (Bello, Cúcuta and Moniquirá). These locations were confirmed as three different ecosystems given their contrasted geographic, climatic and socio-economic profiles. Correlational analyses were conducted with both generalised linear models and generalised additive models for the geographical data. Average temperature, minimum temperature and wind speed were strongly correlated with disease incidence. The transmission of Zika during the 2016 epidemic appeared to decrease circulation of dengue in Cúcuta, an area of sustained high incidence of dengue. Socio-economic factors such as barriers to health and childhood services, inadequate sanitation and poor water supply suggested an unfavourable impact on the transmission of dengue, Zika and chikungunya in all three ecosystems. Socio-demographic influencers were also discussed including the influx of people to Cúcuta, fleeing political and economic instability from neighbouring Venezuela. Aedes aegypti is expanding its range and increasing the global threat of these diseases. It is therefore vital that we learn from the epidemiology of these arboviruses and translate it into an actionable local knowledge base. This is even more acute given the recent historical high of dengue cases in the Americas in 2019, preceding the COVID-19 pandemic, which is itself hampering mosquito control efforts.
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Affiliation(s)
- Jasmine Morgan
- Department of Biology, Edge Hill University, Lancashire, United Kingdom
| | - Clare Strode
- Department of Biology, Edge Hill University, Lancashire, United Kingdom
- * E-mail: (CS); (JES-S)
| | - J. Enrique Salcedo-Sora
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
- * E-mail: (CS); (JES-S)
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15
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Abstract
The article aims to estimate and forecast the transmissibility of shigellosis and explore the association of meteorological factors with shigellosis. The mathematical model named Susceptible–Exposed–Symptomatic/Asymptomatic–Recovered–Water/Food (SEIARW) was used to explore the feature of shigellosis transmission based on the data of Wuhan City, China, from 2005 to 2017. The study applied effective reproduction number (Reff) to estimate the transmissibility. Daily meteorological data from 2008 to 2017 were used to determine Spearman's correlation with reported new cases and Reff. The SEIARW model fit the data well (χ2 = 0.00046, p > 0.999). The simulation results showed that the reservoir-to-person transmission of the shigellosis route has been interrupted. The Reff would be reduced to a transmission threshold of 1.00 (95% confidence interval (CI) 0.82–1.19) in 2035. Reducing the infectious period to 11.25 days would also decrease the value of Reff to 0.99. There was a significant correlation between new cases of shigellosis and atmospheric pressure, temperature, wind speed and sun hours per day. The correlation coefficients, although statistically significant, were very low (<0.3). In Wuhan, China, the main transmission pattern of shigellosis is person-to-person. Meteorological factors, especially daily atmospheric pressure and temperature, may influence the epidemic of shigellosis.
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16
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Epidemiologic trends of hepatitis A in different age groups and regions of China from 1990 to 2018: observational population-based study. Epidemiol Infect 2021. [PMCID: PMC8365862 DOI: 10.1017/s0950268821001552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
This study characterises changes in the incidence and mortality of hepatitis A in different age groups and provinces of China from 1990 to 2018, and evaluates the effect of the nation-wide expanded programme on immunisation (EPI). A mathematical model was used to estimate the relative change in incidence and mortality in different provinces and age groups. Interrupted time series regression was applied to evaluate the impacts of the inclusion of vaccination in the EPI during 2007–2018. The geographic clustering of hepatitis A incidence was assessed using global Moran's I and changing trends over time were estimated using joinpoint regression analysis. Both the incidence (odds ratio (OR) for overall relative change: 0.86; 95% confidence interval (CI): 0.85–0.87; P < 0.0001) and the mortality rate (OR for overall relative change: 0.84; 95% CI: 0.83–0.85; P < 0.0001) decreased. Most age groups had significant declines in reported incidence over time. The incidence and mortality of hepatitis A significantly reduced after inclusion of hepatitis A vaccine in EPI, showing that the EPI strategy had a continuous effect on the decreasing trend of hepatitis A burden. Increasing the coverage rate of the vaccine and improving hygiene conditions are the key measures for the control of hepatitis A in China.
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Zhao ZY, Chen Q, Zhao B, Hannah MN, Wang N, Wang YX, Xuan XF, Rui J, Chu MJ, Yu SS, Wang Y, Liu XC, An R, Pan LL, Chiang YC, Su YH, Zhao BH, Chen TM. Relative transmissibility of shigellosis among male and female individuals: a modeling study in Hubei Province, China. Infect Dis Poverty 2020; 9:39. [PMID: 32299485 PMCID: PMC7162736 DOI: 10.1186/s40249-020-00654-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 03/30/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Developing countries exhibit a high disease burden from shigellosis. Owing to the different incidences in males and females, this study aims to analyze the features involved in the transmission of shigellosis among male (subscript m) and female (subscript f) individuals using a newly developed sex-based model. METHODS The data of reported shigellosis cases were collected from the China Information System for Disease Control and Prevention in Hubei Province from 2005 to 2017. A sex-based Susceptible-Exposed-Infectious/Asymptomatic-Recovered (SEIAR) model was applied to explore the dataset, and a sex-age-based SEIAR model was applied in 2010 to explore the sex- and age-specific transmissions. RESULTS From 2005 to 2017, 130 770 shigellosis cases (including 73 981 male and 56 789 female cases) were reported in Hubei Province. The SEIAR model exhibited a significant fitting effect with the shigellosis data (P < 0.001). The median values of the shigellosis transmission were 2.3225 × 108 for SARmm (secondary attack rate from male to male), 2.5729 × 108 for SARmf, 2.7630 × 10-8 for SARfm, and 2.1061 × 10-8 for SARff. The top five mean values of the transmission relative rate in 2010 (where the subscript 1 was defined as male and age ≤ 5 years, 2 was male and age 6 to 59 years, 3 was male and age ≥ 60 years, 4 was female and age ≤ 5 years, 5 was female and age 6 to 59 years, and 6 was male and age ≥ 60 years) were 5.76 × 10-8 for β61, 5.32 × 10-8 for β31, 4.01 × 10-8 for β34, 7.52 × 10-9 for β62, and 6.04 × 10-9 for β64. CONCLUSIONS The transmissibility of shigellosis differed among male and female individuals. The transmissibility between the genders was higher than that within the genders, particularly female-to-male transmission. The most important route in children (age ≤ 5 years) was transmission from the elderly (age ≥ 60 years). Therefore, the greatest interventions should be applied in females and the elderly.
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Affiliation(s)
- Ze-Yu Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen, Fujian Province, People's Republic of China
| | - Qi Chen
- Hubei Provincial Center for Disease Control and Prevention, Wuhan City, Hubei Province, People's Republic of China
| | - Bin Zhao
- Laboratory Department, Xiang'an Hospital of Xiamen University, State Key Laboratory of Molecular Vaccinology and Molecular Diagnosis, Xiamen, Fujian, People's Republic of China
| | - Mikah Ngwanguong Hannah
- Medical College, Xiamen University, Xiamen City, Fujian Province, People's Republic of China
| | - Ning Wang
- Respiratory Department, Shanghai General Hospital, Shanghai, People's Republic of China
| | - Yu-Xin Wang
- Department of Nephrology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, Fujian, People's Republic of China
| | - Xian-Fa Xuan
- Department of Nephrology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, Fujian, People's Republic of China
| | - Jia Rui
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen, Fujian Province, People's Republic of China
| | - Mei-Jie Chu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen, Fujian Province, People's Republic of China
| | - Shan-Shan Yu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen, Fujian Province, People's Republic of China
| | - Yao Wang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen, Fujian Province, People's Republic of China
| | - Xing-Chun Liu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen, Fujian Province, People's Republic of China
| | - Ran An
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen, Fujian Province, People's Republic of China
| | - Li-Li Pan
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen, Fujian Province, People's Republic of China
| | - Yi-Chen Chiang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen, Fujian Province, People's Republic of China
| | - Yan-Hua Su
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen, Fujian Province, People's Republic of China.
| | - Ben-Hua Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen, Fujian Province, People's Republic of China.
| | - Tian-Mu Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen, Fujian Province, People's Republic of China.
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18
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Chen Q, Rui J, Hu Q, Peng Y, Zhang H, Zhao Z, Tong Y, Wu Y, Su Y, Zhao B, Guan X, Chen T. Epidemiological characteristics and transmissibility of shigellosis in Hubei Province, China, 2005 - 2017. BMC Infect Dis 2020; 20:272. [PMID: 32264846 PMCID: PMC7136996 DOI: 10.1186/s12879-020-04976-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 03/13/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Shigellosis is one of the main diarrhea diseases in developing countries. However, the transmissibility of shigellosis remains unclear. METHODS We used the dataset of shigellosis cases reported between January 2005 and December 2017, from Hubei Province, China. A mathematical model was developed based on the natural history and the transmission mechanism of the disease. By fitting the data using the model, transmission relative rate from person to person (b) and from reservoir to person (bw), and the effective reproduction number (Reff) were estimated. To simulate the contribution of b and bw during the transmission, we performed a "knock-out" simulation in four scenarios: A) b = 0 and bw = 0; B) b = 0; C) bw = 0; D) control (no intervention). RESULTS A total of 130,770 shigellosis cases were reported in Hubei province, among which 13 cases were dead. The median annual incidence was 19.96 per 100,000 persons (range: 5.99 per 100,000 persons - 29.47 per 100,000 persons) with a decreased trend (trend χ2 = 25,470.27, P < 0.001). The mean values of b and bw were 0.0898 (95% confidence interval [CI]: 0.0851-0.0946) and 1.1264 × 10- 9 (95% CI: 4.1123 × 10- 10-1.8416 × 10- 9), respectively. The "knock-out" simulation showed that the number of cases simulated by scenario A was almost the same as scenario B, and scenario C was almost the same as scenario D. The mean value of Reff of shigellosis was 1.19 (95% CI: 1.13-1.25) and decreased slightly with a Linear model until it decreased to an epidemic threshold of 0.99 (95% CI: 0.65-1.34) in 2029. CONCLUSIONS The incidence of shigellosis is still in high level. The transmissibility of the disease is low in Hubei Province. The transmission would be interrupted in the year of 2029.
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Affiliation(s)
- Qi Chen
- Hubei Provincial Center for Disease Control and Prevention, NO.6 Zhuodaoquan North Road, Hongshan District, Wuhan City, Hubei Province People’s Republic of China
| | - Jia Rui
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 4221-117 South Xiang’an Road, Xiang’an District, Xiamen City, Fujian Province People’s Republic of China
| | - Qingqing Hu
- Division of Public Health, School of Medicine, University of Utah, 201 Presidents Circle, Salt Lake City, UT 84112 USA
| | - Ying Peng
- Wuhan Center for Disease Control and Prevention, Wuhan City, Hubei Province People’s Republic of China
| | - Hao Zhang
- Yichang Center for Disease Control and Prevention, Yichang City, Hubei Province People’s Republic of China
| | - Zeyu Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 4221-117 South Xiang’an Road, Xiang’an District, Xiamen City, Fujian Province People’s Republic of China
| | - Yeqing Tong
- Hubei Provincial Center for Disease Control and Prevention, NO.6 Zhuodaoquan North Road, Hongshan District, Wuhan City, Hubei Province People’s Republic of China
| | - Yang Wu
- Hubei Provincial Center for Disease Control and Prevention, NO.6 Zhuodaoquan North Road, Hongshan District, Wuhan City, Hubei Province People’s Republic of China
| | - Yanhua Su
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 4221-117 South Xiang’an Road, Xiang’an District, Xiamen City, Fujian Province People’s Republic of China
| | - Benhua Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 4221-117 South Xiang’an Road, Xiang’an District, Xiamen City, Fujian Province People’s Republic of China
| | - Xuhua Guan
- Hubei Provincial Center for Disease Control and Prevention, NO.6 Zhuodaoquan North Road, Hongshan District, Wuhan City, Hubei Province People’s Republic of China
| | - Tianmu Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 4221-117 South Xiang’an Road, Xiang’an District, Xiamen City, Fujian Province People’s Republic of China
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Queiroz JTMD, Silva PN, Heller L. Novos pressupostos para o saneamento no controle de arboviroses no Brasil. CAD SAUDE PUBLICA 2020; 36:e00223719. [DOI: 10.1590/0102-311x00223719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 02/14/2020] [Indexed: 11/22/2022] Open
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20
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Ma M. Does children's education matter for parents' health and cognition? Evidence from China. JOURNAL OF HEALTH ECONOMICS 2019; 66:222-240. [PMID: 31265950 DOI: 10.1016/j.jhealeco.2019.06.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 06/11/2019] [Accepted: 06/12/2019] [Indexed: 06/09/2023]
Abstract
Intergenerational transmission of human capital from parents to offspring is widely documented. However, whether there are upward spillovers from children to parents remains understudied. This paper uses data from the China Health and Retirement Longitudinal Study to estimate the causal impact of educational attainment of children on various health and cognition outcomes of older parents. Identification is achieved by using the exposure of children to the compulsory education law in China and its interaction with local schooling level before law enforcement as instruments for children's years of schooling. IV estimation results demonstrate that increasing years of education of children lead to better cognitive functions, higher survival expectations and improved lung function of Chinese older parents. Further evidence suggests that children's education might shape health of older parents by providing financial support, affecting the access to resources and influencing the labor supply and psychological well-being of parents.
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Affiliation(s)
- Mingming Ma
- School of Economics, Shanghai University of Finance and Economics, 111 Wuchuan Road, Shanghai 200433, China.
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21
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Zhang N, Song D, Zhang J, Liao W, Miao K, Zhong S, Lin S, Hajat S, Yang L, Huang C. The impact of the 2016 flood event in Anhui Province, China on infectious diarrhea disease: An interrupted time-series study. ENVIRONMENT INTERNATIONAL 2019; 127:801-809. [PMID: 31051323 DOI: 10.1016/j.envint.2019.03.063] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/26/2019] [Accepted: 03/26/2019] [Indexed: 06/09/2023]
Abstract
Climate change may bring more frequent and severe floods which will heighten public health problems, including an increased risk of infectious diarrhea in susceptible populations. Affected by heavy rainfall and an El Niño event, a destructive flood occurred in Anhui province, China on 18th June 2016. This study investigates the impact of this severe flood on infectious diarrhea at both city-level and provincial level, and further to identify modifying factor. We obtained information on infectious diarrheal cases during 2013-2017 from the National Disease Surveillance System. An interrupted time-series design was used to estimate effects of the flood event on diarrhea in 16 cities. Then we applied a meta-analysis to estimate the area-level pooled effects of the flood in both flooded areas and non-flooded areas. Finally, a meta-regression was applied to determine whether proximity to flood was a predictor of city-level risks. Stratified analyses by gender and age group were also conducted for flooded areas. A significant increase in infectious diarrhea risk (RR = 1.11, 95% CI: 1.01, 1.23) after the flood event was found in flooded area with variation in risks across cities, while there was no increase in non-flooded areas. Diarrheal risks post-flood was progressively higher in cities with greater proximity to the Yangtze River. Children aged 5-14 were at highest risk of diarrhea post-flood in the flooded areas. Our study provides strong evidence that the 2016 severe flood significantly increased infectious diarrheal risk in exposed populations. Local public health agencies are advised to develop intervention programs to prevent and control infectious diarrhea risk when a major flood occurs, especially in areas close to water bodies and among vulnerable populations.
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Affiliation(s)
- Na Zhang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Dandan Song
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Jin Zhang
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Wenmin Liao
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Kaichao Miao
- Public Meteorological Service Center of Anhui Province, Hefei, China
| | - Shuang Zhong
- School of Government, Sun Yat-sen University, Guangzhou, China
| | - Shao Lin
- School of Public Health, University at Albany, State University of New York, Albany, USA
| | - Shakoor Hajat
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Lianping Yang
- School of Public Health, Sun Yat-sen University, Guangzhou, China.
| | - Cunrui Huang
- School of Public Health, Sun Yat-sen University, Guangzhou, China.
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Spatiotemporal Characteristics of Bacillary Dysentery from 2005 to 2017 in Zhejiang Province, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091826. [PMID: 30149494 PMCID: PMC6163953 DOI: 10.3390/ijerph15091826] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 08/10/2018] [Accepted: 08/17/2018] [Indexed: 11/24/2022]
Abstract
Background: This study aimed to analyze the epidemiological and spatiotemporal characteristics of bacillary dysentery in Zhejiang Province and to provide the basis for its monitoring, prevention and control. Methods: This study included cases registered in China Information System for Diseases Control and Prevention from 1 January 2005 to 31 December 2017 in Zhejiang. Descriptive methods were employed to investigate the long trend of this disease: gender distribution, high-risk population, seasonality, and circular distribution was explored to detect the peak period; incidence maps were made to show the incidence trend of disease at county level; spatial autocorrelation was explored and the regions with autocorrelation were detected; and spatiotemporal scan was conducted to map out the high-risk regions of disease and how long they lasted. Statistical significance was assumed at p value of <0.05. Results: A total of 105,577 cases of bacillary dysentery were included, the incidence declining sharply from 45.84/100,000 to 3.44/100,000 with an obvious seasonal peak from July to October. Males were more predisposed to the infection than females. Pre-education children had the highest proportion among all occupation categories. Incidence in all age groups were negatively correlated with the year (p < 0.001), and the incidences were negatively correlated with the age groups in 2005–2008 (p = 0.022, 0.025, 0.044, and 0.047, respectively). Local autocorrelation showed that counties in Hangzhou were high-risk regions of bacillary dysentery. The spatiotemporal scan indicated that all clusters occurred before 2011, and the most likely cluster for disease was found in Hangzhou, Jiaxing and Huzhou. Conclusions: The incidence of bacillary dysentery in Zhejiang from 2005 to 2017 featured spatiotemporal clustering, and remained high in some areas and among the young population. Findings in this study serve as a panorama of bacillary dysentery in Zhejiang and provide useful information for better interventions and public health planning.
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Low Transmission to Elimination: Rural Development as a Key Determinant of the End-Game Dynamics of Schistosoma japonicum in China. Trop Med Infect Dis 2017; 2:tropicalmed2030035. [PMID: 30270892 PMCID: PMC6082087 DOI: 10.3390/tropicalmed2030035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 07/30/2017] [Accepted: 07/31/2017] [Indexed: 01/07/2023] Open
Abstract
Rural development has been a critical component of China’s economic miracle since the start of economic reform in the early 1980s, both benefiting from and contributing to the nation’s rapid economic growth. This development has yielded substantial improvements of public health relevance, including contributing to major reductions in schistosomiasis prevalence. The history of schistosomiasis elimination in Japan suggests that development played a dominant causal role in that nation. We argue that it is highly probable that a similar story is playing out in at least some large regions of China. In particular, we summarize evidence from Sichuan Province which supports the case that economic development has led to improvements in rural irrigation and water supply which, together with changes in crop selection and agricultural mechanization, have all contributed to sustainable reductions in the prevalence of Schistosoma japonicum. The two major factors that have experienced major reductions are the area of snail habitat and the degree of human exposure, both through a variety of mechanisms which differ by region and economic circumstance. However, hotspots of transmission remain. Overall, however, economic development in traditionally endemic areas has provided the resources to carry out projects that have had major beneficial impacts on disease transmission that are likely to be sustainable.
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Zhang H, Si Y, Wang X, Gong P. Environmental Drivers and Predicted Risk of Bacillary Dysentery in Southwest China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14070782. [PMID: 28708077 PMCID: PMC5551220 DOI: 10.3390/ijerph14070782] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 07/02/2017] [Accepted: 07/11/2017] [Indexed: 11/26/2022]
Abstract
Bacillary dysentery has long been a considerable health problem in southwest China, however, the quantitative relationship between anthropogenic and physical environmental factors and the disease is not fully understand. It is also not clear where exactly the bacillary dysentery risk is potentially high. Based on the result of hotspot analysis, we generated training samples to build a spatial distribution model. Univariate analyses, autocorrelation and multi-collinearity examinations and stepwise selection were then applied to screen the potential causative factors. Multiple logistic regressions were finally applied to quantify the effects of key factors. A bootstrapping strategy was adopted while fitting models. The model was evaluated by area under the receiver operating characteristic curve (AUC), Kappa and independent validation samples. Hotspot counties were mainly mountainous lands in southwest China. Higher risk of bacillary dysentery was found associated with underdeveloped socio-economy, proximity to farmland or water bodies, higher environmental temperature, medium relative humidity and the distribution of the Tibeto-Burman ethnicity. A predictive risk map with high accuracy (88.19%) was generated. The high-risk areas are mainly located in the mountainous lands where the Tibeto-Burman people live, especially in the basins, river valleys or other flat places in the mountains with relatively lower elevation and a warmer climate. In the high-risk areas predicted by this study, improving the economic development, investment in health care and the construction of infrastructures for safe water supply, waste treatment and sewage disposal, and improving health related education could reduce the disease risk.
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Affiliation(s)
- Han Zhang
- Ministry of Education Key Laboratory for Earth System Modeling, Department of Earth System Science, Tsinghua University, Beijing 100084, China.
| | - Yali Si
- Ministry of Education Key Laboratory for Earth System Modeling, Department of Earth System Science, Tsinghua University, Beijing 100084, China.
- Joint Center for Global Change Studies, Beijing 100875, China.
| | - Xiaofeng Wang
- Center for Public Health Surveillance and Information Services, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
| | - Peng Gong
- Ministry of Education Key Laboratory for Earth System Modeling, Department of Earth System Science, Tsinghua University, Beijing 100084, China.
- Joint Center for Global Change Studies, Beijing 100875, China.
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Infectious diarrheal disease caused by contaminated well water in Chinese schools: A systematic review and meta-analysis. J Epidemiol 2017; 27:274-281. [PMID: 28457602 PMCID: PMC5463023 DOI: 10.1016/j.je.2016.07.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 07/06/2016] [Indexed: 11/21/2022] Open
Abstract
Background In China, waterborne outbreaks of infectious diarrheal disease mainly occur in schools, and contaminated well water is a common source of pathogens. The objective of this review was to present the attack rates, durations of outbreak, pathogens of infectious diarrheal disease, and sanitary conditions of wells in primary and secondary schools in China, and to analyze risk factors and susceptibility of school children. Methods Relevant articles and reports were identified by searching PubMed, Web of Science, China National Knowledge Infrastructure, China Information System for Disease Control and Prevention, and the Chinese Field Epidemiology Training Program. Essential information, including urban/rural areas, school types, attack rates, pathogens, durations of outbreak, report intervals, and interventions were extracted from the eligible articles. Wilcoxon signed-rank test, Kruskal–Wallis H test, and Spearman correlation test were conducted in statistical analyses. Sex- and age-specific attack rate ratios were calculated as pooled effect sizes. Results We screened 2188 articles and retrieved data of 85 outbreaks from 1987 to 2014. Attack rates of outbreaks in rural areas (median, 12.63 cases/100 persons) and in primary schools (median, 14.54 cases/100 persons) were higher than those in urban areas (median, 5.62 cases/100 persons) and in secondary schools (median, 8.74 cases/100 persons) (P = 0.004 and P = 0.013, respectively). Shigella, pathogenic Escherichia coli, and norovirus were the most common pathogens. Boys tended toward higher attack rates than girls (sex-specific attack rate ratio, 1.13; 95% CI, 1.00–1.29, P = 0.05). Unsanitary conditions of water wells were reported frequently, and unhealthy behavior habits were common in students. Conclusion School children were susceptible to waterborne disease in China. Chinese government should make efforts to improve access to safe water in schools. Health education promotion and conscientiousness of school leaders and teachers should be enhanced. School children were susceptible to waterborne disease in China. Attack rates of rural or primary schools were high. Boys trended toward higher risk than girls. Unsanitary conditions of water wells were reported frequently.
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de Oliveira AF, Leite IDC, Valente JG. Global burden of diarrheal disease attributable to the water supply and sanitation system in the State of Minas Gerais, Brazil: 2005. CIENCIA & SAUDE COLETIVA 2017; 20:1027-36. [PMID: 25923615 DOI: 10.1590/1413-81232015204.00372014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 09/17/2014] [Indexed: 11/21/2022] Open
Abstract
Advances have occurred in relation to the coverage of water supply and sanitation in Brazil, however inequalities are still observed in relation to the coverage of these services, reflecting the importance of diarrheal disease in the Brazilian epidemiological context. The aim of this study was to measure the impact of the water supply and sanitation system on diarrheal diseases among children aged under five. The global burden of diarrhea was calculated based on the attributable population fraction, using information on prevalence and relative risks from the 2000/2010 censuses and a study by Pruss et al. The north of the State of Minas Gerais, the Northeast and Jequitinhonha regions had the highest disability-adjusted life year (DALY) rates and ratios. The fraction of diarrhea attributable to the water supply and sanitation system was 83%, decreasing to 78.3% where sanitation had 100% coverage. An inverse relationship was found between DALY rates and attributable fractions and per capita GDP. Broadening the scope and coverage of services and improving the quality of water available in homes is an urgent requirement. These measures will bring economic and social benefits related to the reduction of diarrheal diseases and consequent improvement of the quality of life of children aged under five.
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Affiliation(s)
| | - Iuri da Costa Leite
- Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Fiocruz, Rio de Janeiro, RJ, Brasil,
| | - Joaquin Gonçalves Valente
- Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Fiocruz, Rio de Janeiro, RJ, Brasil,
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Ebrahimi A, Mahdavi M, Ghasemian A, Poursafa P, Sharifi F, Mohammadi R, Nejatifar M, Amin MM, Asayesh H, Safiri S, Ansari H, Qorbani M. Trends in health burden of untreated water and insanitary environments in Iran, 1990-2010: Findings from the global burden of disease study 2010. Med J Islam Repub Iran 2016; 30:424. [PMID: 28210589 PMCID: PMC5307626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Accepted: 09/25/2016] [Indexed: 12/03/2022] Open
Abstract
Background: Water, sanitation and hygiene have a very important role in public health. Poor sanitation is the cause of water contamination, which causes many types of diseases. The aim of this paper was to present the attributable death and disability adjusted life year (DALYs) of untreated water and insanitary environments from 1990 to 2010 in Iran. Methods: In the Global Burden of Disease 2010 study, using the comparative risk assessment, the proportion of death and DALYs attributable to untreated water source and insanitary environment has been calculated in 1990 to 2010. The certain outcomes were intestinal infectious diseases for both untreated water source and insanitary environments. Estimated attributable deaths and DALYs were reported with 95% uncertainty interval (UI). Results: DALY number for untreated water source and insanitary environments was 5838 (95% UI: 198- 14837) in 1990, which decreased to 326 (95% UI: 9-863) in 2010 and the percent of decrease was 94.42%. In addition, DALY rate was 5667 (95% UI: 192-14402) DALY per 100,000 in 1990, which decreased to 453 (95% UI: 13-1199) DALY per 100,000 in 2010 and the percent of the reduction was 92.01%. The greatest percentage of decrease in the attributed number of deaths was also found in the late neonatal age group (95.45%). Conclusion: A significant decrease has occurred in a number of DALYs and deaths between 1990 and 2010, which was attributed to the development of new water systems and environmental sanitations in Iran.
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Affiliation(s)
- Afshin Ebrahimi
- PhD, Associate Professor, Environment Research Center, Research Institute for Primordial Prevention of Non-communicable disease, Isfahan University of Medical Sciences, Isfahan, Iran, & Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Mokhtar Mahdavi
- PhD Candidate, Environment Research Center, Isfahan University of Medical Sciences, Isfahan, Iran, & Student Research Committee and Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Anoosheh Ghasemian
- MD, Research Assistant, Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Parinaz Poursafa
- PhD Candidate, Environment Research Center, Research Institute for Primordial Prevention of Non-communicable disease, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Farshad Sharifi
- PhD Candidate, Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Rasool Mohammadi
- PhD Candidate, Department of Epidmioligy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Masoumeh Nejatifar
- MSc, Department of Epidmioligy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mohammad Mehdi Amin
- PhD, Professor, Environment Research Center, Research Institute for Primordial Prevention of Non-communicable disease, Isfahan University of Medical Sciences, Isfahan, Iran, & Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Hamid Asayesh
- MSc, Instructor, Department of Medical Emergency, Qom University of Medical Sciences, Qom, Iran.
| | - Saeid Safiri
- PhD, Assistant Professor, Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran.
| | - Hossain Ansari
- PhD, Assistant Professor, Department of Epidemiology and Biostatistics, Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
| | - Mostafa Qorbani
- PhD, Assistant Professor, Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran, & Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Abstract
At the beginning of the new millennium, helminth infections continue to be prevalent, particularly among impoverished populations. This study attempts to create the first health informatics model of helminthiasis in Thailand. The authors investigate how a health informatics model could be used to predict the control and eradication in a national control campaign. Fish-borne helminthiasis caused by Opisthorchis viverrini remains a major public health problem in many parts of South-East Asia, including Thailand, Lao PDR, Vietnam and Cambodia. The epicentre of this disease is located in north-east Thailand, where high prevalence coexists with a high incidence of cholangiocarcinoma (CHCA). The current report was conducted to determine a mathematical model of surveillance for helminthiasis while also using a geographic information system. The fish-borne helminthiasis model or the predicted equation was Y1 = 3.028 + 0.020 (elevation) - 2.098 (clay). For soil-transmitted helminthiasis, the mathematical model or the predicted equation was Y2 = -1.559 + 0.005 (rainfall) + 0.004 (elevation) - 2.198 (clay). The Ministry of Public Health has concluded that mass treatment for helminthiasis in the Thai population, targeting high-risk individuals, may be a cost-effective way to allocate limited funds. This type of approach, as well as further study on the correlation of clinical symptoms with environmental and geographic information, may offer a novel strategy to the helminth crisis.
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Molecular characterization and analysis of high-level multidrug-resistance of Shigella flexneri serotype 4s strains from China. Sci Rep 2016; 6:29124. [PMID: 27374009 PMCID: PMC4931504 DOI: 10.1038/srep29124] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 06/13/2016] [Indexed: 12/19/2022] Open
Abstract
To conduct the first comprehensive analysis of Shigella flexneri serotype 4s, a novel serotype found in 2010, we identified 24 serotype 4s isolates from 1973 shigellosis cases in China (2002–2014). The isolates were characterized by single nucleotide polymorphism (SNP) phylogenetic analysis, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) to determine their genetic relatedness, and analysed further for their antimicrobial susceptibilities and antimicrobial resistance determinants. The PFGE and SNP phylogenetic analyses suggest that S. flexneri serotype 4s strains are derived from multiple serotypes, including two predominant serotypes in China: serotype X variant and serotype II. Three new sequence types were identified by MLST. All isolates were resistant to ticarcillin, ampicillin and tetracycline, with high-level resistance to third-generation cephalosporins. Notably, all the isolates were multidrug resistant (MDR), with the highest levels of resistance observed for eight antimicrobials classes. Most isolates contain various antimicrobial resistance determinants. In conclusion, we found that serotype 4s isolates have multiple evolutionary sources, diverse biochemical characteristics and genomes, and highly prevalent multidrug resistance and antimicrobial-resistant determinants. With few clinical treatment options, continuous monitoring and timely intervention against this emerging MDR serotype is essential. The possibility that serotype 4s will become the next predominant serotype exists.
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Yang Y, Zhou YB, Song XX, Li SZ, Zhong B, Wang TP, Bergquist R, Zhou XN, Jiang QW. Integrated Control Strategy of Schistosomiasis in The People's Republic of China: Projects Involving Agriculture, Water Conservancy, Forestry, Sanitation and Environmental Modification. ADVANCES IN PARASITOLOGY 2016; 92:237-68. [PMID: 27137449 DOI: 10.1016/bs.apar.2016.02.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Among the three major schistosome species infecting human beings, Schistosoma japonicum is the only endemic species in The People's Republic of China. Schistosomiasis is endemic in 78 countries and regions and poses a severe threat to public health and socioeconomic development. Through more than 60years of hard work and endeavour, The People's Republic of China has made considerable achievements and reduced the morbidity and prevalence of this disease to the lowest level ever recorded, especially since the introduction of the new integrated control strategy in 2004. This review illustrates the strategies implemented by giving successful examples of schistosomiasis control from the different types of remaining endemic areas. The challenge to control or eliminate S. japonicum is analysed in order to provide useful information to policy makers and scientists.
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Affiliation(s)
- Y Yang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, The People's Republic of China; Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, The People's Republic of China; Center for Tropical Disease Research, Shanghai, The People's Republic of China
| | - Y-B Zhou
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, The People's Republic of China; Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, The People's Republic of China; Center for Tropical Disease Research, Shanghai, The People's Republic of China
| | - X-X Song
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, The People's Republic of China; Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, The People's Republic of China; Center for Tropical Disease Research, Shanghai, The People's Republic of China
| | - S-Z Li
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, The People's Republic of China; WHO Collaborating Centre for Tropical Diseases, Shanghai, The People's Republic of China; National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, The People's Republic of China
| | - B Zhong
- Sichuan Provincial Center for Disease Control and Prevention, Chengdu, The People's Republic of China
| | - T-P Wang
- Anhui Institute of Parasitic Disease, Hefei, The People's Republic of China; Anhui Provincial Institute of Schistosomiasis Control, Hefei, Anhui Province, The People's Republic of China
| | - R Bergquist
- Geospatial Health, University of Naples Federico II, Naples, Italy
| | - X-N Zhou
- WHO Collaborating Centre for Tropical Diseases, Shanghai, The People's Republic of China; National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, The People's Republic of China; Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, The People's Republic of China
| | - Q-W Jiang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, The People's Republic of China; Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, The People's Republic of China; Center for Tropical Disease Research, Shanghai, The People's Republic of China
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Zhang H, Si Y, Wang X, Gong P. Patterns of Bacillary Dysentery in China, 2005-2010. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:164. [PMID: 26828503 PMCID: PMC4772184 DOI: 10.3390/ijerph13020164] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 01/19/2016] [Accepted: 01/21/2016] [Indexed: 02/06/2023]
Abstract
Although the incidence of bacillary dysentery in China has been declining progressively, a considerable disease burden still exists. Few studies have analyzed bacillary dysentery across China and knowledge gaps still exist in the aspects of geographic distribution and ecological drivers, seasonality and its association with meteorological factors, urban-rural disparity, prevalence and distribution of Shigella species. Here, we performed nationwide analyses to fill the above gaps. Geographically, we found that incidence increased along an east-west gradient which was inversely related to the economic conditions of China. Two large endemically high-risk regions in western China and their ecological drivers were identified for the first time. We characterized seasonality of bacillary dysentery incidence and assessed its association with meteorological factors, and saw that it exhibits north-south differences in peak duration, relative amplitude and key meteorological factors. Urban and rural incidences among China’s cities were compared, and disparity associated with urbanization level was invariant in most cities. Balanced decrease of urban and rural incidence was observed for all provinces except Hunan. S. flexneri and S. sonnei were identified as major causative species. Increasing prevalence of S. sonnei and geographic distribution of Shigella species were associated with economic status. Findings and inferences from this study draw broader pictures of bacillary dysentery in mainland China and could provide useful information for better interventions and public health planning.
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Affiliation(s)
- Han Zhang
- Ministry of Education Key Laboratory for Earth System Modeling, Center for Earth System Science, Institute for Global Change Studies, Tsinghua University, Beijing 100084, China.
| | - Yali Si
- Ministry of Education Key Laboratory for Earth System Modeling, Center for Earth System Science, Institute for Global Change Studies, Tsinghua University, Beijing 100084, China.
- Joint Center for Global Change Studies, Beijing 100875, China.
| | - Xiaofeng Wang
- Center for Disease Surveillance and Information Services, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
| | - Peng Gong
- Ministry of Education Key Laboratory for Earth System Modeling, Center for Earth System Science, Institute for Global Change Studies, Tsinghua University, Beijing 100084, China.
- Joint Center for Global Change Studies, Beijing 100875, China.
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Lu Y, Song S, Wang R, Liu Z, Meng J, Sweetman AJ, Jenkins A, Ferrier RC, Li H, Luo W, Wang T. Impacts of soil and water pollution on food safety and health risks in China. ENVIRONMENT INTERNATIONAL 2015; 77:5-15. [PMID: 25603422 DOI: 10.1016/j.envint.2014.12.010] [Citation(s) in RCA: 407] [Impact Index Per Article: 45.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Revised: 12/25/2014] [Accepted: 12/31/2014] [Indexed: 05/21/2023]
Abstract
Environmental pollution and food safety are two of the most important issues of our time. Soil and water pollution, in particular, have historically impacted on food safety which represents an important threat to human health. Nowhere has that situation been more complex and challenging than in China, where a combination of pollution and an increasing food safety risk have affected a large part of the population. Water scarcity, pesticide over-application, and chemical pollutants are considered to be the most important factors impacting on food safety in China. Inadequate quantity and quality of surface water resources in China have led to the long-term use of waste-water irrigation to fulfill the water requirements for agricultural production. In some regions this has caused serious agricultural land and food pollution, especially for heavy metals. It is important, therefore, that issues threatening food safety such as combined pesticide residues and heavy metal pollution are addressed to reduce risks to human health. The increasing negative effects on food safety from water and soil pollution have put more people at risk of carcinogenic diseases, potentially contributing to 'cancer villages' which appear to correlate strongly with the main food producing areas. Currently in China, food safety policies are not integrated with soil and water pollution management policies. Here, a comprehensive map of both soil and water pollution threats to food safety in China is presented and integrated policies addressing soil and water pollution for achieving food safety are suggested to provide a holistic approach.
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Affiliation(s)
- Yonglong Lu
- State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China.
| | - Shuai Song
- State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Ruoshi Wang
- State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zhaoyang Liu
- State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jing Meng
- State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Andrew J Sweetman
- Lancaster Environment Centre, Lancaster University, Lancaster LA1 4YQ, UK; Centre for Ecology & Hydrology, Wallingford, OX10 8BB, UK
| | - Alan Jenkins
- Centre for Ecology & Hydrology, Wallingford, OX10 8BB, UK
| | | | - Hong Li
- Lancaster Environment Centre, Lancaster University, Lancaster LA1 4YQ, UK; Centre for Ecology & Hydrology, Wallingford, OX10 8BB, UK
| | - Wei Luo
- State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Tieyu Wang
- State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
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Doyle MP, Erickson MC, Alali W, Cannon J, Deng X, Ortega Y, Smith MA, Zhao T. The Food Industry's Current and Future Role in Preventing Microbial Foodborne Illness Within the United States. Clin Infect Dis 2015; 61:252-9. [DOI: 10.1093/cid/civ253] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 03/21/2015] [Indexed: 12/27/2022] Open
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Li X, Miao Y, Chen W. China's three-year health reform program and equity in sanitation improvement: a panel analysis. BMC Public Health 2015; 15:38. [PMID: 25638148 PMCID: PMC4323256 DOI: 10.1186/s12889-015-1364-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 01/06/2015] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Accessible improved sanitation is critical to child health, and inequities in improved sanitation can be interpreted as health inequities across socio-economic groups. From 2009 to 2011, the Chinese government invested 4.448 billion yuan for rural sanitation improvement through a 3-year health reform program. This study assesses the inequity of sanitation improvement in rural China from 2003 to 2011 and examines whether the 3-year health reform program promoted equity in sanitation improvement. METHODS Data from the China Health Statistics Yearbooks of 2004 to 2012 and the National Bureau of Statistics of China were used to create the concentration curve (CC), concentration index (CI), and absolute concentration index (ACI) of improved sanitation. Data of central investment for sanitation improvement in each province of China for 2009, 2010, and 2011 was gained through correspondence and used to create the CC and CI for investment. RESULTS Although the CIs of improved sanitation are lower than the CIs of the net income of rural residents, the latter have an obvious downtrend. The CIs of improved sanitation increased from 2003 until 2008 and started to drop in 2009. As a result, by 2011, the CIs of improved sanitation had reached their 2003 levels. The ACI of improved sanitation decreased slightly from 2003 to 2008, but declined sharply from 2009 to 2011. The CIs of central investment for 2009, 2010, and 2011 are negative and the CCs of central investment are above the line of absolute equality, indicating that investments had been concentrated more on poorer provinces and regions. CONCLUSIONS The equality of rural residents' net income has been improving each year, whereas equity in sanitation improvement deteriorated from 2003 to 2008. However, equity in sanitation improvement has increased since 2009 due to central investment in sanitation improvement during the 3-year health reform program that benefits low-income areas more. It is clear that the 3-year health reform program played an important role in promoting the level and equity of sanitation improvement.
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Affiliation(s)
- Xiaolong Li
- School of Economics and Management, Beijing University of Posts and Telecommunications, Beijing, 100876, China.
| | - Yanqing Miao
- China National Health Development Research Center, NHFPC, Beijing, 100083, China.
| | - Wenjing Chen
- School of Economics and Management, Beijing University of Posts and Telecommunications, Beijing, 100876, China.
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Hodges M, Belle JH, Carlton EJ, Liang S, Li H, Luo W, Freeman MC, Liu Y, Gao Y, Hess JJ, Remais JV. Delays reducing waterborne and water-related infectious diseases in China under climate change. NATURE CLIMATE CHANGE 2014; 4:1109-1115. [PMID: 25530812 PMCID: PMC4266400 DOI: 10.1038/nclimate2428] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Despite China's rapid progress improving water, sanitation and hygiene (WSH) access, in 2011, 471 million people lacked access to improved sanitation and 401 million to household piped water. Because certain infectious diseases are sensitive to changes in both climate and WSH conditions, we projected impacts of climate change on WSH-attributable diseases in China in 2020 and 2030 by coupling estimates of the temperature sensitivity of diarrheal diseases and three vector-borne diseases, temperature projections from global climate models, WSH-infrastructure development scenarios, and projected demographic changes. By 2030, climate change is projected to delay China's rapid progress toward reducing WSH-attributable infectious disease burden by 8-85 months. This development delay summarizes the adverse impact of climate change on WSH-attributable infectious diseases in China, and can be used in other settings where a significant health burden may accompany future changes in climate even as the total burden of disease falls due to non-climate reasons.
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Affiliation(s)
- Maggie Hodges
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA
- Emory University School of Medicine, 1648 Pierce Dr NE, Atlanta, GA 30322, USA
| | - Jessica H. Belle
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA
| | - Elizabeth J. Carlton
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, 13001 E. 17th Place, Aurora, CO, 80045, USA
| | - Song Liang
- Department of Environmental and Global Health, College of Public Health and Health Professions, and Emerging Pathogens Institute, University of Florida, 2055 Mowry Road, Gainesville, FL, 32610, USA
| | - Huazhong Li
- Office of Disease Control and Emergency Response, China Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China
| | - Wei Luo
- Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, 18 Shuangqing Road, Haidian District, Beijing, 100085, China
| | - Matthew C. Freeman
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA
| | - Yang Liu
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA
| | - Yang Gao
- Atmospheric Science and Global Change Division, Pacific Northwest National Laboratory, 902 Battelle Boulevard, Richland, WA, 99352USA
| | - Jeremy J. Hess
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA
- Emory University School of Medicine, 1648 Pierce Dr NE, Atlanta, GA 30322, USA
| | - Justin V. Remais
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA
- Correspondence to: Dr. Justin V. Remais, Department of Environmental Health, Emory University; address: 1518 Clifton Road, Atlanta, Georgia, 30322; phone: 404-712-8908, fax: 404-727-8744;
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Liang S, Yang C, Zhong B, Guo J, Li H, Carlton EJ, Freeman MC, Remais JV. Surveillance systems for neglected tropical diseases: global lessons from China's evolving schistosomiasis reporting systems, 1949-2014. Emerg Themes Epidemiol 2014; 11:19. [PMID: 26265928 PMCID: PMC4531518 DOI: 10.1186/1742-7622-11-19] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 11/07/2014] [Indexed: 01/28/2023] Open
Abstract
Though it has been a focus of the country’s public health surveillance systems since the 1950s, schistosomiasis represents an ongoing public health challenge in China. Parallel, schistosomiasis-specific surveillance systems have been essential to China’s decades-long campaign to reduce the prevalence of the disease, and have contributed to the successful elimination in five of China’s twelve historically endemic provinces, and to the achievement of morbidity and transmission control in the other seven. More recently, an ambitious goal of achieving nation-wide transmission interruption by 2020 has been proposed. This paper details how schistosomiasis surveillance systems have been structured and restructured within China’s evolving public health system, and how parallel surveillance activities have provided an information system that has been integral to the characterization of, response to, and control of the disease. With the ongoing threat of re-emergence of schistosomiasis in areas previously considered to have achieved transmission control, a critical examination of China’s current surveillance capabilities is needed to direct future investments in health information systems and to enable improved coordination between systems in support of ongoing control. Lessons drawn from China’s experience are applied to the current global movement to reduce the burden of helminthiases, where surveillance capacity based on improved diagnostics is urgently needed.
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Affiliation(s)
- Song Liang
- Department of Environmental and Global Health, College of Public Health and Health Professions, and Emerging Pathogens Institute, University of Florida, 1225 Center Drive, Gainesville, FL 32611 USA
| | - Changhong Yang
- Sichuan Center for Disease Control and Prevention, Institute of Public Health Information, 6 Middle School Road, Chengdu, Sichuan, 610041 China
| | - Bo Zhong
- Sichuan Center for Disease Control and Prevention, Institute of Parasitic Diseases, 6 Middle School Road, Chengdu, Sichuan, 610041 China
| | - Jiagang Guo
- Department of Schistosomiasis, Institute of Parasitic Diseases. Chinese Center for Disease Control and Prevention, Shanghai, China ; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Huazhong Li
- Department of Emergence Response, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Elizabeth J Carlton
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, CO USA
| | - Matthew C Freeman
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA 30322 USA
| | - Justin V Remais
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA 30322 USA
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Akormedi M, Asampong E, Fobil JN. Working conditions and environmental exposures among electronic waste workers in Ghana. INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH 2014; 19:278-86. [PMID: 24588034 DOI: 10.1179/2049396713y.0000000034] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE To investigate and describe informal e-waste recycling and working conditions at Agbogbloshie, Accra, Ghana. METHODS We conducted in-depth interviews which were qualitatively analysed from a grounded theory perspective. RESULTS Workers obtained e-waste from the various residential areas in Accra, then dismantled and burned them in open air to recover copper, aluminum, steel, and other products for sale to customers on-site or at the nearby Agbogbloshie market. The processers worked under unhealthy conditions often surrounded by refuse and human excreta without any form of protective gear and were thus exposed to frequent burns, cuts, and inhalation of highly contaminated fumes. We observed no form of social security/support system for the workers, who formed informal associations to support one another in times of difficulty. CONCLUSIONS e-waste recycling working conditions were very challenging and presented serious hazards to worker health and wellbeing. Formalizing the e-waste processing activities requires developing a framework of sustainable financial and social security for the e-waste workers, including adoption of low-cost, socially acceptable, easy-to-operate, and cleaner technologies that would safeguard the health of the workers and the general public.
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Affiliation(s)
- Matthew Akormedi
- Department of Biological, Environmental & Occupational Health Sciences, School of Public Health, University of Ghana, Legon, Ghana
| | - Emmanuel Asampong
- Department of Social and Behavioural Health Sciences, School of Public Health, University of Ghana, Legon, Ghana
| | - Julius N Fobil
- Department of Biological, Environmental & Occupational Health Sciences, School of Public Health, University of Ghana, Legon, Ghana
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National Health Systems. THE NEW PUBLIC HEALTH 2014. [PMCID: PMC7170208 DOI: 10.1016/b978-0-12-415766-8.00013-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Health care systems ideally include universal access to comprehensive prepaid medical care along with health promotion and disease prevention. National health insurance and national health services of various models have evolved in the developed world and increasingly in developing countries as well. Some models, such as the Bismarckian social security model and the Bereidge National Health Service model, or National Health insurance such as in pioneered in Canada, are used by a number of countries. The common features are based on principles of national responsibility and solidarity for health, social solidarity for providing funding and searching for effective ways of providing care. Various universal systems of health coverage exist in all industrialized countries, except in the United States which has a mix of public and private insurance but with high percentages of uninsured and poorly insured. Health reform is a continuing process as all countries aspire to assure health care for all. Aging populations, increasing costs, advancing and increasing technology all require nations to modify and adapt organization and financing systems of health care, health protection and promotion.
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Abstract
Food supply and food safety are major global public health issues, and are particularly important in heavily populated countries such as China. Rapid industrialisation and modernisation in China are having profound effects on food supply and food safety. In this Review, we identified important factors limiting agricultural production in China, including conversion of agricultural land to other uses, freshwater deficits, and soil quality issues. Additionally, increased demand for some agricultural products is examined, particularly those needed to satisfy the increased consumption of animal products in the Chinese diet, which threatens to drive production towards crops used as animal feed. Major sources of food poisoning in China include pathogenic microorganisms, toxic animals and plants entering the food supply, and chemical contamination. Meanwhile, two growing food safety issues are illegal additives and contamination of the food supply by toxic industrial waste. China's connections to global agricultural markets are also having important effects on food supply and food safety within the country. Although the Chinese Government has shown determination to reform laws, establish monitoring systems, and strengthen food safety regulation, weak links in implementation remain.
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Affiliation(s)
- Hon-Ming Lam
- State Key Laboratory of Agrobiotechnology and School of Life Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, PRC
| | - Justin Remais
- Department of Environmental Health, Emory University, Atlanta, GA 30322, USA
| | - Ming-Chiu Fung
- State Key Laboratory of Agrobiotechnology and School of Life Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, PRC
| | - Liqing Xu
- School of Business, Jiangnan University, Jiangsu, PRC
| | - Samuel Sai-Ming Sun
- State Key Laboratory of Agrobiotechnology and School of Life Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, PRC
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Remais JV, Zeng G, Li G, Tian L, Engelgau MM. Convergence of non-communicable and infectious diseases in low- and middle-income countries. Int J Epidemiol 2012; 42:221-7. [PMID: 23064501 DOI: 10.1093/ije/dys135] [Citation(s) in RCA: 135] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The convergence of non-communicable disease (NCD) and infectious disease (ID) in low- and middle-income countries (LMICs) presents new challenges and new opportunities to enact responsive changes in policy and research. Most LMICs have significant dual disease burdens of NCDs such as cardiovascular disease, diabetes and cancer, and IDs including tuberculosis, HIV/AIDS and parasitic diseases. A combined strategy is needed in surveillance and disease control; yet, experts, institutions and policies that support prevention and control of these two overarching disease categories have limited interaction and alignment. NCDs and IDs share common features, such as long-term care needs and overlapping high-risk populations, and there are also notable direct interactions, such as the association between certain IDs and cancers, as well as evidence of increased susceptibility to IDs in individuals with NCDs. Enhanced simultaneous surveillance of NCD and ID comorbidity in LMIC populations would generate the empirical data needed to better understand the dual burden, and to target coordinated care. Where IDs and NCDs are endemic, focusing on vulnerable populations by strengthening social protections and improving access to health services is crucial, as is the re-alignment of efforts to combine NCD and ID screening, treatment programmes, and the assessment of their impact. Integrating public health activities for ID and NCD should extend beyond health care services to prevention, which is widely seen as crucial to successful NCD and ID control campaigns alike. The convergence of NCD and ID in LMICs has the potential to overstretch already strained health systems. With some LMICs now focused on major health system reforms, a unique opportunity is available to address NCD and ID challenges with newfound urgency and novel approaches.
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Affiliation(s)
- Justin V Remais
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
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