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Epidemic characteristics of measles and efforts to control measles infections in Zhejiang Province, China
Rui Yan, Mengya Yang, Hanqing He, Yan Feng, Yang Zhou, Xuewen Tang, Xuan Deng, Yao Zhu, Yuxia Du, Can Chen, Cao Kexin, Shigui Yang, RIDPHE Group
Epidemiol Health. 2024;46:e2024075.   Published online September 11, 2024
DOI: https://doi.org/10.4178/epih.e2024075
  • 1,909 View
  • 63 Download
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Several countries have successfully eliminated measles, and China is making significant strides toward achieving this goal. This study focused on investigating the patterns of measles infections in Zhejiang Province, China, as well as control measures. The objective was to provide valuable insights that could contribute to the development of nationwide elimination strategies.
METHODS
We analyzed measles surveillance data from 2005 to 2022 in Zhejiang Province. We utilized a joinpoint regression model to examine trends in measles. Additionally, we employed SaTScan version 9.5 to identify spatial-temporal clusters. Finally, we used an age-period-cohort model to assess the effects of age, period, and cohort.
RESULTS
The age-standardized incidence rate (ASIR) of measles infection in Zhejiang Province from 2005 to 2022 was 5.24 per 100,000, showing a consistent and significant downward trend with an annual percentage change of -24.93% (p<0.05). After 2020, the ASIR for measles infection fell to below 0.1 per 100,000. The majority of measles cases occurred in individuals either without an immunization history or with an unknown immunization status, representing 41.06% and 41.40% of the cases from 2010 to 2022, respectively. According to data from the National Measles Surveillance System, the annual rate of discarded measles cases from 2009 to 2014, and the annual rate of discarded measles and rubella cases from 2015 to 2022, were both above 2 per 100,000, indicating the high sensitivity of the measles surveillance system.
CONCLUSIONS
The significant reduction in measles incidence from 2005 to 2022 demonstrates substantial progress in Zhejiang Province towards the elimination of measles.
Summary
Key Message
Measles incidence in Zhejiang Province has been declining since 2008, with a particularly notable decrease from 2020 to 2022. Adults remain the primary population susceptible to measles in Zhejiang Province. Therefore, it is essential to enhance prevention and control measures for measles, especially among individuals who have not received the MCV immunization. The reduced incidence of measles during the COVID-19 pandemic presents Zhejiang Province with a unique opportunity to leverage the lowest recorded measles incidence in its history and accelerate efforts in measles elimination.

Citations

Citations to this article as recorded by  
  • Application of the age-period-cohort model in tuberculosis
    Dan Luo, Fengying Wang, Songhua Chen, Yu Zhang, Wei Wang, Qian Wu, Yuxiao Ling, Yiqing Zhou, Yang Li, Kui Liu, Bin Chen
    Frontiers in Public Health.2025;[Epub]     CrossRef
Unraveling trends in schistosomiasis: deep learning insights into national control programs in China
Qing Su, Cici Xi Chen Bauer, Robert Bergquist, Zhiguo Cao, Fenghua Gao, Zhijie Zhang, Yi Hu
Epidemiol Health. 2024;46:e2024039.   Published online March 13, 2024
DOI: https://doi.org/10.4178/epih.e2024039
  • 4,218 View
  • 73 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
To achieve the ambitious goal of eliminating schistosome infections, the Chinese government has implemented diverse control strategies. This study explored the progress of the 2 most recent national schistosomiasis control programs in an endemic area along the Yangtze River in China.
METHODS
We obtained village-level parasitological data from cross-sectional surveys combined with environmental data in Anhui Province, China from 1997 to 2015. A convolutional neural network (CNN) based on a hierarchical integro-difference equation (IDE) framework (i.e., CNN-IDE) was used to model spatio-temporal variations in schistosomiasis. Two traditional models were also constructed for comparison with 2 evaluation indicators: the mean-squared prediction error (MSPE) and continuous ranked probability score (CRPS).
RESULTS
The CNN-IDE model was the optimal model, with the lowest overall average MSPE of 0.04 and the CRPS of 0.19. From 1997 to 2011, the prevalence exhibited a notable trend: it increased steadily until peaking at 1.6 per 1,000 in 2005, then gradually declined, stabilizing at a lower rate of approximately 0.6 per 1,000 in 2006, and approaching zero by 2011. During this period, noticeable geographic disparities in schistosomiasis prevalence were observed; high-risk areas were initially dispersed, followed by contraction. Predictions for the period 2012 to 2015 demonstrated a consistent and uniform decrease.
CONCLUSIONS
The proposed CNN-IDE model captured the intricate and evolving dynamics of schistosomiasis prevalence, offering a promising alternative for future risk modeling of the disease. The comprehensive strategy is expected to help diminish schistosomiasis infection, emphasizing the necessity to continue implementing this strategy.
Summary
Key Message
Our research found that CNN-IDE model effectively captured the complex dynamic process of schistosomiasis prevalence. The comprehensive strategy is expected to help diminish schistosomiasis infection.
The association between glaucoma and all-cause mortality in middle-aged and elderly Chinese people: results from the China Health and Retirement Longitudinal Study
Xiaoxu Huang, Mengqiao Xu, Minwen Zhou, Wenjia Liu, Xiaohuan Zhao, Xiaodong Sun
Epidemiol Health. 2023;45:e2023066.   Published online July 21, 2023
DOI: https://doi.org/10.4178/epih.e2023066
  • 6,833 View
  • 127 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This population-based, prospective cohort study investigated the association between glaucoma and mortality in older adults.
METHODS
Participants aged 45 years or older at baseline (47.9% male) were enrolled in 2011 for the China Health and Retirement Longitudinal Study (CHARLS). All-cause mortality was observed during 7 years of follow-up. The baseline data were collected in the 2011 CHARLS, and participants were followed up for 7 years (until 2018). The risk of all-cause mortality was investigated using Cox proportional-hazards regression with age as the time scale, adjusting for significant risk factors and comorbid conditions.
RESULTS
Among the 14,803 participants included, the risk of all-cause death was significantly higher among people with glaucoma than among those without glaucoma, after adjustment for other confounders (hazard ratio [HR], 1.46; 95% confidence interval [CI], 1.04 to 2.03). In a subgroup analysis based on the mean age of death, among those who were 75 years and older (n=1,231), the risk of all-cause death was significantly higher in patients with glaucoma than in those without glaucoma (HR, 1.89; 95% CI, 1.24 to 1.89).
CONCLUSIONS
Participants with glaucoma had a higher risk of all-cause mortality, especially those aged 75 years and above. Our findings revealed potential mechanisms underlying an association between glaucoma and all-cause mortality. They also highlighted the importance of glaucoma management to prevent premature death in middle-aged and older adults.
Summary
Key Message
The present study suggests that glaucoma is associated with a higher rate of mortality in middle-aged and elderly people in China, especially for those aged 75 years and older. This study provides an important reference for the design and evaluation of clinical glaucoma treatment and the management of patients of different ages.
Exploring cognitive trajectories and their association with physical performance: evidence from the China Health and Retirement Longitudinal Study
Jingdong Suo, Xianlei Shen, Jinyu He, Haoran Sun, Yu Shi, Rongxin He, Xiao Zhang, Xijie Wang, Yuandi Xi, Wannian Liang
Epidemiol Health. 2023;45:e2023064.   Published online July 9, 2023
DOI: https://doi.org/10.4178/epih.e2023064
  • 6,554 View
  • 443 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The long-term trends of cognitive function and its associations with physical performance remain unclear, particularly in Asian populations. The study objectives were to determine cognitive trajectories in middle-aged and elderly Chinese individuals, as well as to examine differences in physical performance across cognitive trajectory groups.
METHODS
Data were extracted from the China Health and Retirement Longitudinal Study. A total of 5,701 participants (47.7% male) with a mean age of 57.8 (standard deviation, 8.4) years at enrollment were included. A group-based trajectory model was used to identify cognitive trajectory groups for each sex. Grip strength, repeated chair stand, and standing balance tests were used to evaluate physical performance. An ordered logistic regression model was employed to analyze differences in physical performance across cognitive trajectory groups.
RESULTS
Three cognitive trajectory groups were identified for each sex: low, middle, and high. For both sexes, higher cognitive trajectory groups exhibited smaller declines with age. In the fully adjusted model, relative to the low trajectory group, the odds ratios (ORs) of better physical performance in the middle cognitive group were 1.37 (95% confidence interval [CI], 1.17 to 1.59; p<0.001) during follow-up and 1.40 (95% CI, 1.20 to 1.64; p<0.001) at the endpoint. The ORs in the high trajectory group were 1.94 (95% CI, 1.61 to 2.32; p<0.001) during follow-up and 2.04 (95% CI, 1.69 to 2.45; p<0.001) at the endpoint.
CONCLUSIONS
Cognitive function was better preserved in male participants and individuals with higher baseline cognitive function. A higher cognitive trajectory was associated with better physical performance over time.
Summary
Key Message
Three cognitive trajectory groups were identified for each sex in middle-aged and elderly Chinese people. Cognitive function was found to be better preserved in male participants and individuals with higher baseline cognitive function. Better cognitive trajectory was associated with better physical performance over time.

Citations

Citations to this article as recorded by  
  • Longitudinal trajectories of cognitive aging
    Elena Lobo, Patricia Gracia-GarcĂ­a, Antonio Lobo
    Current Opinion in Psychiatry.2024; 37(2): 123.     CrossRef
  • Mediation role of DNA methylation in association between handgrip strength and cognitive function in monozygotic twins
    Jin Liu, Weijing Wang, Jia Luo, Haiping Duan, Chunsheng Xu, Xiaocao Tian, Shumin Chen, Lin Ge, Dongfeng Zhang
    Journal of Human Genetics.2024; 69(8): 357.     CrossRef
The association between obesity and glaucoma in older adults: evidence from the China Health and Retirement Longitudinal Study
Xiaohuan Zhao, Qiyu Bo, Junran Sun, Jieqiong Chen, Tong Li, Xiaoxu Huang, Minwen Zhou, Jing Wang, Wenjia Liu, Xiaodong Sun
Epidemiol Health. 2023;45:e2023034.   Published online March 9, 2023
DOI: https://doi.org/10.4178/epih.e2023034
  • 6,118 View
  • 165 Download
  • 2 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
This study evaluated the association between obesity and glaucoma in middle-aged and older people. A population-based retrospective cohort study was conducted using data from the China Health and Retirement Longitudinal Study.
METHODS
Glaucoma was assessed via self-reports. Multivariate logistic regression analysis and a Cox proportional hazards model were used to assess the relationship between obesity and glaucoma risk.
RESULTS
Older males living in urban areas who were single, smokers, and non-drinkers were found to have a significantly higher incidence of glaucoma (all p<0.05). Diabetes, hypertension, and kidney disease were also associated with higher glaucoma risk, while dyslipidemia was associated with lower risk (all p<0.05). After the model was adjusted for demographic, socioeconomic, and health-related variables, obesity was significantly associated with a 10.2% decrease in glaucoma risk according to the Cox proportional hazards model (hazard ratio, 0.90; 95% confidence interval [CI], 0.83 to 0.97) and an 11.8% risk reduction in the multivariate logistic regression analysis (odds ratio, 0.88; 95% CI, 0.80 to 0.97). A further subgroup analysis showed that obesity was associated with a reduced risk of glaucoma in people living in rural areas, in smokers, and in those with kidney disease (all p<0.05). Obesity also reduced glaucoma risk in people with diabetes, hypertension, or dyslipidemia more than in healthy controls (all p<0.05).
CONCLUSIONS
This cohort study suggests that obesity was associated with a reduced risk of glaucoma, especially in rural residents, smokers, and people with kidney disease. Obesity exerted a stronger protective effect in people with diabetes, hypertension, or dyslipidemia than in healthy people.
Summary
Key Message
Glaucoma is a neurodegenerative disease and the leading cause of irreversible vision loss worldwide. The diagnosis of glaucoma is frequently delayed, as it may be asymptomatic until a relatively late stage. Thus, there is a need to identify protective and risk factors for glaucoma. Glaucoma is a multifactorial disease, and the impact of obesity on glaucoma risk remains uncertain. This study evaluated the association between obesity and glaucoma in middle-aged and older people. This cohort study suggests that obesity was associated with a reduced risk of glaucoma, especially in rural residents, smokers, and people with kidney disease.

Citations

Citations to this article as recorded by  
  • Evaluating the impact of caloric restriction, body mass index and exercise on primary open-angle glaucoma: A review
    Jonathan YM Lai, Patrick Mclarnon, Carl Sheridan, Neeru A Vallabh
    European Journal of Ophthalmology.2024;[Epub]     CrossRef
  • The relationship between weight-adjusted-waist index, body mass index and diabetic retinopathy among American adults: a population-based analysis
    Songtao Wang, Hecong Qin, Yu Zhang, Ning Yang, Jinsong Zhao
    Scientific Reports.2024;[Epub]     CrossRef
  • The Weight on Sight: Exploring the Links Between Obesity and Ocular Diseases
    Ahmed Bilal, Muslim Bilal, Alia Hathaf, Danyal Usman, Nadim Haboubi
    Cureus.2024;[Epub]     CrossRef
Spatial analysis of tuberculosis treatment outcomes in Shanghai: implications for tuberculosis control
Jing Zhang, Xin Shen, Chongguang Yang, Yue Chen, Juntao Guo, Decheng Wang, Jun Zhang, Henry Lynn, Yi Hu, Qichao Pan, Zhijie Zhang
Epidemiol Health. 2022;44:e2022045.   Published online May 1, 2022
DOI: https://doi.org/10.4178/epih.e2022045
  • 10,297 View
  • 386 Download
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Tuberculosis (TB) treatment outcomes are a key indicator in the assessment of TB control programs. We aimed to identify spatial factors associated with TB treatment outcomes, and to provide additional insights into TB control from a geographical perspective.
METHODS
We collected data from the electronic TB surveillance system in Shanghai, China and included pulmonary TB patients registered from January 1, 2009 to December 31, 2016. We examined the associations of physical accessibility to hospitals, an autoregression term, and random hospital effects with treatment outcomes in logistic regression models after adjusting for demographic, clinical, and treatment factors.
RESULTS
Of the 53,475 pulmonary TB patients, 49,002 (91.6%) had successful treatment outcomes. The success rate increased from 89.3% in 2009 to 94.4% in 2016. The successful treatment outcome rate varied among hospitals from 78.6% to 97.8%, and there were 12 spatial clusters of poor treatment outcomes during the 8-year study period. The best-fit model incorporated spatial factors. Both the random hospital effects and autoregression terms had significant impacts on TB treatment outcomes, ranking 6th and 10th, respectively, in terms of statistical importance among 14 factors. The number of bus stations around the home was the least important variable in the model.
CONCLUSIONS
Spatial autocorrelation and hospital effects were associated with TB treatment outcomes in Shanghai. In highly-integrated cities like Shanghai, physical accessibility was not related to treatment outcomes. Governments need to pay more attention to the mobility of patients and different success rates of treatment among hospitals.
Summary
Key Message
Tuberculosis treatment outcomes, a key indicator in the assessment of TB control programs, were associated with spatial autocorrelation and hospital effects in Shanghai; however, they were not associated with physical accessibility to hospitals.

Citations

Citations to this article as recorded by  
  • Tuberculosis treatment outcomes and associated factors among patients treated at Bosaso TB Hospital, Bosaso, Somalia: A five-year retrospective study
    Saaid Said Jama, Mohamed Mohamud Abdi, Rodney Adam
    PLOS ONE.2025; 20(1): e0314693.     CrossRef

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