The Epidemic Characteristics of Stroke Death from 2012 to 2021 in Chongqing, China

INTRODUCTION

Stroke has become a major disease that threatens the global population's health and is a major public health problem that needs to be solved in China. Therefore, it is essential to analyze the trend of the mortality of stroke and its epidemic characteristic of stroke death.

METHODS

Death cases of stroke were reported to the national death registry system by the medical staff of all medical institutions, and the population data every year were obtained from District or County's Statistic Bureau in Chongqing. They were analyzed to calculate the mortality, age-standardized mortality rate by Chinese standardization population (ASMRC), age-specific mortality, proportion, and annual percent of change (APC) according to the ICD-10 code. ASMRC was based on the standard population of the 6th census in China, 2010. The stroke mortality of each subgroup was compared using the χ2 test. Trend analysis was presented by APC.

RESULTS

The crude mortality of stroke increased from 96.29 per 100,000 in 2012 to 115.93 per 100,000 significantly, with the APC of 2.02% (t = 2.82, p = 0.022) in Chongqing. ASMRC of stroke was 56.47 per 100,000 in 2012 and 54.70 per 100,000 in 2021, and its trend change was stable (APC = -0.01, t = 0.07, p = 0.947). The crude mortality of stroke in males was higher than that in females every year (p < 0.05). The death proportion of intracerebral hemorrhage dwindled from 60.53% in 2012 to 49.88% in 2021, whereas the death proportion of ischemic stroke increased from 20.92% in 2012 to 39.96% in 2021. The average age of stroke death was delayed from 73.43 years old in 2012 to 76.52 years old in 2021 significantly (t = 18.12, p < 0.001). The percentage of stroke death at home increased from 75.23% in 2012 to 79.23% in 2021, while the percentage of stroke death at hospitals decreased from 17.89% in 2012 to 15.89% in 2021.

CONCLUSION

The crude mortality of stroke surged, and intracerebral hemorrhage was the main death cause of all subtypes. The mortality of stroke in males and rural residents was higher than that in females and urban residents. Most stroke deaths occurred at home. Male and rural residents were crucial populations for stroke prevention and control. There should be improved medical resources in rural areas and enhanced capability of stroke diagnosis and treatment.

[Epidemic trend and control progress of soil-transmitted nematodiasis in Jiangsu Province]

Soil-transmitted nematodiasis was once widely prevalent in Jiangsu Province, which seriously threatened human health and hindered socioeconomic development. The control efforts over decades resulted in a remarkable decline in the prevalence of soil-transmitted nematode human infections in Jiangsu Province, with a reduction from 59.32% in 1989 to 0.12% in 2019, and the human prevalence remains at < 0.5% since 2013. Since 1987, an integrated strategy has been adopted for the control of soil-transmitted nematodiasis in Jiangsu Province; however, the core interventions varies at different stages, which mainly include deworming, water and sanitation service improvement, health education, and monitoring and assessment. The criteria of effective soil-transmitted nematodiasis control had been achieved in all epidemic counties (districts) of Jiangsu Province by 2019. Further actions to strengthen health education and monitoring and implement precision control measures are required to consolidate the achievements of soil-transmitted nematodiasis control and eliminate the harm of soil-transmitted nematodiasis to humans. This review summarizes the epidemiology, control progress and evolution of control strategy of soil-transmitted nematodiasis in Jiangsu Province.

[Epidemiological analysis of malaria surveillance in Jinan City from 2012 to 2016]

OBJECTIVE

To analyze the epidemiological characteristics of malaria reported in the malaria surveillance system in Jinan City from 2012 to 2016, so as to provide the evidence for improving the ability of diagnosis, treatment, prevention and control of malaria.

METHODS

The data of all reported malaria cases in the malaria surveillance system were retrospectively analyzed.

RESULTS

From 2012 to 2016, 91 malaria cases were found in Jinan City, of which one patient died. All the cases were imported and 95.60% (87 cases) of them came from Africa (note：most of the people were Chinese residents who had been in Africa for the export of labor service and came back China). Falciparum malaria accounted for the most (82.42%, 75 cases). All the cases were adult males, and were mainly migrant workers. The median time from onset to being confirmedly diagnosed was 5 days, and the median time from seeing a doctor to being diagnosed was 1 day. The medical institutions where the patients first visited were mainly municipal medical institutions (42 cases, 46.15%). The misdiagnosis rate was 100% in village clinics and township health centers (8/8 and 2/2, respectively). The misdiagnosis rate was lowest in the municipal medical institutions (3/42, 7.14%). There were 41 malaria patients (45.05%) with complications.

CONCLUSIONS

The situation of overseas imported malaria in Jinan City is becoming more and more serious. It is necessary to further strengthen the related professional training for doctors and strengthen the multi-sectoral cooperation for health education, etc. in order to find the cases in time and conduct the active standardized treatment, so as to prevent the second generation cases.

[Epidemic characteristics of imported falciparum malaria in Huai'an City]

OBJECTIVE

To understand the situation and epidemic characteristics of imported falciparum malaria in Huai'an City from 2010 to 2016, so as to provide the evidence for formulating the prevention and control strategies of imported falciparum malaria in the city.

METHODS

The epidemic data of imported falciparum malaria in Huai'an City from 2010 to 2016 were analyzed by using the descriptive epidemiological method.

RESULTS

A total of 308 malaria cases were reported in Huai'an City from 2010 to 2016 with the average annual incidence of 0.88/10⁵. A total of 240 imported falciparum malaria cases were reported, of which 18 cases (7.50%) developed into severe illness, and 2 severe patients died. The cases were reported in every county (district), and the incidence rates of Qingpu District and Huai'an District were higher than the city average level. The cases occurred every month, so there was no significant seasonal variation in the reporting time of the cases. Most of the patients were young men and aged 30-49 years. The occupational distribution revealed that the patients were mainly farmers, workers and migrant workers. The main source of infection was from African countries. The median interval from symptom appearing to definite diagnosis was 1 day, and the longest interval was 236 days. Twenty-nine cases were diagnosed within 24 hours, accounting for 12.08%.

CONCLUSIONS

The epidemic situation of imported falciparum malaria in Huai'an City is grim. In order to consolidate the achievements of malaria eradication, it is necessary to further improve the multi-sectoral cooperation mechanism, strengthen the management of floating population and take effective measures to reduce the risk of imported falciparum malaria.