Epidemiological Characteristics and Risk Factors of Obstetric Infection After the Universal Two-child Policy in North China: A 5-year Retrospective Study Based on 268, 311 Cases

Abstract PurposeObstetrical infection is one of the causes of maternal death and a difficult problem for many clinicians. Changes in the demographic and obstetric background of pregnant women following the Universal Two-Child Policy may have an impact on some fertility phenomena. Therefore, more studies based on the change of fertility policy are needed. We try to analyze the epidemiological characteristics and risk factors of obstetric infection before and after the Universal Two-Child Policy, with a view to providing reference for the prevention and control of obstetric infection in regions after the change of fertility policy. MethodsThe subjects of the survey were 268,311 pregnant women from Hebei Province Maternal Near Miss Surveillance System (HBMNMSS) of Hebei Women and Children's Health Center from January 1, 2013 to December 31, 2017. We analyzed the region , time and population distribution characteristics of obstetric infection, compared the epidemiological factors of obstetric infection before and after the Universal Two-Child Policy , and analyzed the relevant risk factors of obstetric infection. ResultsThe incidence of obstetric infection increased nearly twice after the Universal Two-Child Policy. The incidence of obstetric infection was highest in Chengde(1.9%), a city with a northward geographical distribution, Baoding (1.6%), Cangzhou (1.5%) followed; The higher the hospital grade, the higher the incidence; The incidence of obstetric infections in hospitals at all levels has increased; The age of onset before the Universal Two-Child Policy was (27.82±5.047) years old, and the age after the Universal Two-Child Policy was (28.97±4.880) years old; The incidence of obstetric infections is higher in winter. The rate of abortion-related infection (increased from 0.61% to 1.65%) and the rate of pregnant women with high school education (increased from 0.35% to 0.74%) increased significantly. The results of multivariate Logistic regression analysis after the Universal Two-Child Policy showed that anemia (OR=1.249, 95%CI: 1.071-1.458), chronic hypertension (OR=1.934, 95%CI: 1.375-2.722), mild preeclampsia (OR=2.103, 95%CI: 1.323-3.344) and severe preeclampsia (OR=2.228, 95%CI: 1.703-2.916) were independent risk factors for obstetric infection. Gestational age ≥37 weeks was a protective factor. ConclusionsAfter the Universal Two-Child Policy, the prevention and control of obstetric infections should be strengthened, especially for abortion-related infections and elderly maternal with obstetric complications and complication in high-grade hospitals in winter. Educational background is also one of the factors that should be considered in the prevention of obstetric sensation. Prolonging gestational age is helpful to reduce the incidence of obstetric infection.

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Prevention and control measures of the major cold-region diseases (hypertension) in China

Frigid Zone Medicine ◽

10.2478/fzm-2021-0002 ◽

2021 ◽

Vol 1 (1) ◽

pp. 3-8

Author(s):

Zhenwei Pan ◽

Yong Zhang ◽

Tengfei Pan ◽

Haihai Liang ◽

Baofeng Yang

Keyword(s):

Risk Factors ◽

Cardiovascular Events ◽

Prevention And Control ◽

Control Measures ◽

Effective Management ◽

Cold Region ◽

Low Latitude ◽

Prevention And Control Measures ◽

And Control ◽

Epidemiological Characteristics

Abstract Hypertension is the most common cardiovascular condition in clinical practice and a major risk factor for stroke and cardiovascular events. There are more than 270 million hypertension patients in China, and the prevalence of hypertension in the high-latitude cold areas is significantly higher than in the low-latitude warm areas. The unique epidemiological characteristics and risk factors of hypertension in the cold regions of China urge for establishment of the prevention and control system for targeted and more effective management of the condition.

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Study of Risk Factors for Total Attack Rate and Transmission Dynamics of Norovirus Outbreaks, Jiangsu Province, China, From 2012 to 2018

Frontiers in Medicine ◽

10.3389/fmed.2021.786096 ◽

2022 ◽

Vol 8 ◽

Author(s):

Jing Ai ◽

Yuanzhao Zhu ◽

Jianguang Fu ◽

Xiaoqing Cheng ◽

Xuefeng Zhang ◽

...

Keyword(s):

Risk Factors ◽

Statistical Analysis ◽

Attack Rate ◽

Primary Schools ◽

Prevention And Control ◽

Jiangsu Province ◽

Factors Associated ◽

The Mean ◽

And Control ◽

Epidemiological Characteristics

Objective: To describe the epidemiological characteristics of norovirus outbreaks in Jiangsu Province, utilize the total attack rate (TAR) and transmissibility (Runc) as the measurement indicators of the outbreak, and a statistical difference in risk factors associated with TAR and transmissibility was compared. Ultimately, this study aimed to provide scientific suggestions to develop the most appropriate prevention and control measures.Method: We collected epidemiological data from investigation reports of all norovirus outbreaks in Jiangsu Province from 2012 to 2018 and performed epidemiological descriptions, sequenced the genes of the positive specimens collected that were eligible for sequencing, created a database and calculated the TAR, constructed SEIAR and SEIARW transmission dynamic models to calculate Runc, and performed statistical analyses of risk factors associated with the TAR and Runc.Results: We collected a total of 206 reported outbreaks, of which 145 could be used to calculate transmissibility. The mean TAR in was 2.6% and the mean Runc was 12.2. The epidemiological characteristics of norovirus outbreaks showed an overall increasing trend in the number of norovirus outbreaks from 2012 to 2018; more outbreaks in southern Jiangsu than northern Jiangsu; more outbreaks in urban areas than in rural areas; outbreaks occurred mostly in autumn and winter. Most of the sites where outbreaks occurred were schools, especially primary schools. Interpersonal transmission accounted for the majority. Analysis of the genotypes of noroviruses revealed that the major genotypes of the viruses changed every 3 years, with the GII.2 [P16] type of norovirus dominating from 2016 to 2018. Statistical analysis of TAR associated with risk factors found statistical differences in all risk factors, including time (year, month, season), location (geographic location, type of settlement, type of premises), population (total number of susceptible people at the outbreak site), transmission route, and genotype (P < 0.05). Statistical analysis of transmissibility associated with risk factors revealed that only transmissibility was statistically different between sites.Conclusions: The number of norovirus outbreaks in Jiangsu Province continues to increase during the follow-up period. Our findings highlight the impact of different factors on norovirus outbreaks and identify the key points of prevention and control in Jiangsu Province.

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Prevalence, Risk Factors, and Approach to Control of Comorbidities Among Hospitalized Patients: Evidence From A 4-Year Longitudinal Study in China

10.21203/rs.3.rs-534443/v1 ◽

2021 ◽

Author(s):

Mengzhu Liu ◽

Meng Shi ◽

Jianqin Gu ◽

Liuyi Wang ◽

Clifford Silver Tarimo ◽

...

Keyword(s):

Risk Factors ◽

General Practice ◽

Quality Improvement ◽

Prevention And Control ◽

Circulatory System ◽

Central China ◽

Female Ratio ◽

Metabolic Systems ◽

And Control ◽

Epidemiological Characteristics

Abstract Background: The disease burden of comorbidity is growing steadily in many developing countries, affecting residents' physical and mental health. General Practitioners are considered as the suitable service providers for the prevention and control of comorbidity. However, the current knowledge on the clinical and epidemiological characteristics of comorbidity among inpatients in the general practice departments of hospital is limited, which hinders the precise promotion of the service capacity and quality of GPs. Objective: The current study aimed to analyze the clinical prevalence of comorbidities in central China and to provide evidence-based policy recommendations for quality improvement in general medical services. Methods: The study was conducted at the general practice departments of all 27 tertiary grade-A hospitals of Henan Province, China. 3 registered GPs of each hospital were selected by random, and all direct admissions of the 81 GPs from December 2016 to November 2020 were followed up. The clinical epidemiological characteristics and influencing factors of comorbidity were evaluated using descriptive statistical analysis and logistic regression models. Results: Comorbidity was present in 93.1 percent of the 2385 direct admitted patients, with a male-to-female ratio of 1: 1. Comorbidity was significantly more prevalent in patients aged 45-59 years (OR=3.018, 95% CI=1.945-4.683), 60-74 years (OR=4.349, 95% CI=2.574-7.349), ≥75 years (OR=7.804, 95% CI=3.665-16.616), and those with body mass index (BMI) ≥28 kg/m2 (OR=3.770, 95% CI =1.453-9.785). The circulatory system is the most commonly involved human body system in comorbidity, accounting for 79% of all cases. The endocrine, nutritional, and metabolic systems, as well as the digestive and respiratory systems, were all significantly affected, with prevalence rates of 62 percent, 48 percent, and 37 percent, respectively. Conclusion: Comorbidity is common among the inpatients attending the provincial tertiary grade-A hospitals. Since old age and obesity are independent risk factors for comorbidity, healthy lifestyle interventions should be strengthened, as should the implementation of the patient-centered prevention and control model. Meanwhile, quality improvement priorities should be given to improving GPs' clinical diagnosis and treatment of the circulatory system, endocrine system, metabolic system, digestive system, and respiratory system.

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Evaluating the effectiveness of measures to control the novel coronavirus disease 2019 in Jilin Province, China

BMC Infectious Diseases ◽

10.1186/s12879-021-05936-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Qinglong Zhao ◽

Yao Wang ◽

Meng Yang ◽

Meina Li ◽

Zeyu Zhao ◽

...

Keyword(s):

Prevention And Control ◽

Good Control ◽

Asymptomatic Infection ◽

Jilin Province ◽

Control Measures ◽

First Case ◽

Before And After ◽

Novel Coronavirus ◽

Reported Data ◽

And Control

Abstract Background Based on differences in populations and prevention and control measures, the spread of new coronary pneumonia in different countries and regions also differs. This study aimed to calculate the transmissibility of coronavirus disease 2019 (COVID-19), and to evaluate the effectiveness of measures to control the disease in Jilin Province, China. Methods The data of reported COVID-19 cases were collected, including imported and local cases from Jilin Province as of March 14, 2019. A Susceptible–Exposed–Infectious–Asymptomatic–Recovered/Removed (SEIAR) model was developed to fit the data, and the effective reproduction number (Reff) was calculated at different stages in the province. Finally, the effectiveness of the measures was assessed. Results A total of 97 COVID-19 infections were reported in Jilin Province, among which 45 were imported infections (including one asymptomatic infection) and 52 were local infections (including three asymptomatic infections). The model fit the reported data well (R2 = 0.593, P < 0.001). The Reff of COVID-19 before and after February 1, 2020 was 1.64 and 0.05, respectively. Without the intervention taken on February 1, 2020, the predicted cases would have reached a peak of 177,011 on October 22, 2020 (284 days from the first case). The projected number of cases until the end of the outbreak (on October 9, 2021) would have been 17,129,367, with a total attack rate of 63.66%. Based on the comparison between the predicted incidence of the model and the actual incidence, the comprehensive intervention measures implemented in Jilin Province on February 1 reduced the incidence of cases by 99.99%. Therefore, according to the current measures and implementation efforts, Jilin Province can achieve good control of the virus’s spread. Conclusions COVID-19 has a moderate transmissibility in Jilin Province, China. The interventions implemented in the province had proven effective; increasing social distancing and a rapid response by the prevention and control system will help control the spread of the disease.

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Risk factors of dengue fever in an urban area in Vietnam: a case-control study

BMC Public Health ◽

10.1186/s12889-021-10687-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Thang Nguyen-Tien ◽

Duy Cuong Do ◽

Xuan Luat Le ◽

Thi Hai Dinh ◽

Mats Lindeborg ◽

...

Keyword(s):

Risk Factors ◽

Dengue Fever ◽

Prevention And Control ◽

Case Control Study ◽

Case Control ◽

Younger Adults ◽

The Mean ◽

Dengue Prevention ◽

And Control ◽

Control Study

Abstract Background Dengue is a mosquito-borne flavivirus present in many metropolitan cities of tropical countries. Methods During and after the dengue season (September 2018 to January 2019), we conducted a case-control study in order to determine the risk factors for dengue fever in Hanoi city, Vietnam. 98 dengue patients and 99 patients with other acute infections, such as Hepatitis B virus infection, were recruited at Department of Infectious Disease of Bach Mai national hospital in Hanoi. Patients were interviewed using a structured questionnaire covering demographic, housing, environmental factors and knowledge, attitude, and practice on dengue prevention and control. Univariate analysis and multivariable logistic regression were used to determine the risk factors of dengue status. Results The mean score of knowledge items and practice items was only 7.9 out of total 19 points and 3.9 out of total 17 points, respectively. While the mean score of attitude items was 4.8 out of total 6 points. Multivariable logistic regression indicated that older patients had lesser risk of getting dengue infection as compared to younger adults aged 16–30, and patients living in peri-urban districts were less likely to suffer of dengue fever than patients living in central urban districts (OR = 0.31; 95% CI 0.13–0.75). This study could not find any association with occupation, water storage habit, knowledge, attitude, or practice on dengue prevention. Conclusions All patients had a relatively low level of knowledge and practice on dengue prevention and control. However, the attitude of the participants was good. We found that age group and living district were the risk factors correlated with the dengue status. Communication programs on raising dengue awareness should be repeated all year round and target particular groups of adolescents, younger adults, landlords and migrants from other provinces to improve their knowledge and encourage them to implement preventive measures against dengue fever.

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Components of a risk assessment tool for prevention and control of bovine respiratory disease in preweaned dairy calves

Animal Health Research Reviews ◽

10.1017/s1466252320000201 ◽

2020 ◽

pp. 1-7

Author(s):

Sharif S. Aly ◽

Betsy M. Karle ◽

Deniece R. Williams ◽

Gabriele U. Maier ◽

Sasha Dubrovsky

Keyword(s):

Risk Factors ◽

Risk Assessment ◽

Risk Factor ◽

Respiratory Disease ◽

Scoring System ◽

Prevention And Control ◽

Assessment Tool ◽

Bovine Respiratory Disease ◽

And Control ◽

Management Changes

Abstract Bovine respiratory disease (BRD) is the leading natural cause of death in US beef and dairy cattle, causing the annual loss of more than 1 million animals and financial losses in excess of $700 million. The multiple etiologies of BRD and its complex web of risk factors necessitate a herd-specific intervention plan for its prevention and control on dairies. Hence, a risk assessment is an important tool that producers and veterinarians can utilize for a comprehensive assessment of the management and host factors that predispose calves to BRD. The current study identifies the steps taken to develop the first BRD risk assessment tool and its components, namely the BRD risk factor questionnaire, the BRD scoring system, and a herd-specific BRD control and prevention plan. The risk factor questionnaire was designed to inquire on aspects of calf-rearing including management practices that affect calf health generally, and BRD specifically. The risk scores associated with each risk factor investigated in the questionnaire were estimated based on data from two observational studies. Producers can also estimate the prevalence of BRD in their calf herds using a smart phone or tablet application that facilitates selection of a true random sample of calves for scoring using the California BRD scoring system. Based on the risk factors identified, producers and herd veterinarians can then decide the management changes needed to mitigate the calf herd's risk for BRD. A follow-up risk assessment after a duration of time sufficient for exposure of a new cohort of calves to the management changes introduced in response to the risk assessment is recommended to monitor the prevalence of BRD.

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Risk factors and biofilm formation analyses of hospital-acquired infection of Candida pelliculosa in a neonatal intensive care unit

BMC Infectious Diseases ◽

10.1186/s12879-021-06295-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zhijie Zhang ◽

Yu Cao ◽

Yanjian Li ◽

Xufang Chen ◽

Chen Ding ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Biofilm Formation ◽

Prevention And Control ◽

Neonatal Intensive Care ◽

Infection Prevention ◽

Infection Prevention And Control ◽

Anti Fungal ◽

Hospital Acquired ◽

And Control

Abstract Background Candida pelliculosa is an ecological fungal species that can cause infections in immunocompromised individuals. Numerous studies globally have shown that C. pelliculosa infects neonates. An outbreak recently occurred in our neonatal intensive care unit; therefore, we aimed to evaluate the risk factors in this hospital-acquired fungal infection. Methods We performed a case-control study, analysing the potential risk factors for neonatal infections of C. pelliculosa so that infection prevention and control could be implemented in our units. Isolated strains were tested for drug resistance and biofilm formation, important factors for fungal transmission that give rise to hospital-acquired infections. Results The use of three or more broad-spectrum antimicrobials or long hospital stays were associated with higher likelihoods of infection with C. pelliculosa. The fungus was not identified on the hands of healthcare workers or in the environment. All fungal isolates were susceptible to anti-fungal medications, and after anti-fungal treatment, all infected patients recovered. Strict infection prevention and control procedures efficiently suppressed infection transmission. Intact adhesin-encoding genes, shown by genome analysis, indicated possible routes for fungal transmission. Conclusions The use of three or more broad-spectrum antimicrobials or a lengthy hospital stay is theoretically associated with the risk of infection with C. pelliculosa. Strains that we isolated are susceptible to anti-fungal medications, and these were eliminated by treating all patients with an antifungal. Transmission is likely via adhesion to the cell surface and biofilm formation.

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High Rates of Streptococcus Agalactiae Clindamycin and Erythromycin Resistance in Vietnamese Pregnant Women

10.21203/rs.3.rs-196314/v1 ◽

2021 ◽

Author(s):

Vu Du ◽

Pham Thai Dung ◽

Nguyen Linh Toan ◽

Can Mao ◽

Nguyen Thanh Bac ◽

...

Keyword(s):

Pregnant Women ◽

Antimicrobial Susceptibility ◽

Prevention And Control ◽

Control Strategies ◽

Geographic Area ◽

Resistance Rate ◽

Antibiotics Resistance ◽

Erythromycin Resistance ◽

Antimicrobial Susceptibility Pattern ◽

And Control

Abstract Background Group B streptococcus (GBS) is a leading cause of morbidity and mortality in newborns. Maternal GBS colonization rates vary depending on geographic area, ethnic and social conditions worldwide. Many studies suggested the continuous surveillance of GBS to provide data to guide decision-making and planning prevention and control strategies. Here, we report the rate and the antimicrobial susceptibility pattern of GBS from Vietnamese pregnant women over 5 year period. Methods We worked with 3863 Vietnamese pregnant women at < 37 weeks of gestation at the National Hospital of Obstetrics and Gynecology, Hanoi, Vietnam from Jan 2016 to Dec 2020. The data were recorded and retrieved from the computerized laboratory database. GBS was identified according to the American Society for Microbiology’s guidelines. Antimicrobial susceptibility was tested by the VITEK 2 system or E-test strips. The results were calculated according to the MIC breakpoints recommended by the Clinical and Laboratory Standards Institute. Results The positivity for GBS was 8.02% (310/3863) and the highest resistance rate was to tetracycline 89.66% (234/261), followed by 76.23% (202/265) for erythromycin, 58.21% (156/268) for clindamycin. The multidrug-resistance rate was 59.19% (161/272), and 8.46% (23/272) of isolates were resistant to 6 to 7 of the 12 antibiotics. Resistance to clindamycin in the absence of erythromycin resistance was found in 6/272 (2.2%) samples. The resistance rate to clindamycin was significantly increased (p < 0.01) over the time study period. Nevertheless, all isolates were sensitive to penicillin, ampicillin, ceftriaxone, cefotaxime, quinupristin/dalfopristin, and vancomycin. Conclusion Our results indicate that penicillin and ampicillin are currently the drugs of choice for the prevention and treatment of GBS-related diseases for Vietnamese pregnant women. However, antibiotic resistance to erythromycin and clindamycin was high. Thus, it reinforces the need for continuous surveillance of GBS to provide data to guide planning prevention and control strategies.

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Evaluation of malaria risk factors prevention and control program in Kulon Progo Regency

Berita Kedokteran Masyarakat ◽

10.22146/bkm.26891 ◽

2017 ◽

Vol 33 (12) ◽

pp. 565

Author(s):

Husni Husni ◽

Th. B Rahayujati ◽

S Supargiyono

Keyword(s):

Public Health ◽

Risk Factors ◽

Health Center ◽

Prevention And Control ◽

Larval Fish ◽

Control Program ◽

Malaria Risk ◽

District Health ◽

And Control ◽

Malaria Risk Factors

Evaluation of malaria risk factors prevention and control program in Kulon Progo RegencyPurposeThe purpose of this research was to evaluate the program of prevention and control of malaria risk factors in Kulon Progo District in 2016 based on system approach.MethodThis research was evaluation program used mixed methods (sequential explanatory design). Data collected from 7 public health center of active focus malaria and district health office. Respondents were program managers and head of public health center, district program managers, head of control and eradication of communicable diseases, and head of district health offices. The instruments used structured questionnaires and in-depth interview guides. Quantitative data analysis was descriptive and qualitative data used Miles and Huberman model.Results Most of the availability of human resources, funds, facilities, materials, and methods already meet implementation needs except entomologists, allocation of funds activities other than IRS, time of the implementation of larval fish deployment. Most of the processes that started from the planning, implementation, monitoring, and evaluation have gone well except for planning other than IRS, preparation vector control without entomology database, implementation of environmental management, larviciding, and larval fish deployment. Coverage of LLINs, coverage of IRS, control of LLINs efficacy, and test of vector resistance have met the target, except coverage of larviciding and larval fish deployment was not available.ConclusionPrevention and control program of malaria risk factors has implemented but wasn’t based on entomological data. District health offices should recruit entomologist to support vector control activities.

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Integrated approach to prevention and control of cardiovascular diseases

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1106304r ◽

2011 ◽

Vol 139 (5-6) ◽

pp. 304-310

Author(s):

Dusica Rakic ◽

Djordje Jakovljevic

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Prevention And Control ◽

Integrated Approach ◽

Noncommunicable Disease ◽

Intervention Programme ◽

Cerebrovascular Events ◽

International Projects ◽

Novi Sad ◽

And Control

Introduction. From 1984 to 2004, the city of Novi Sad participated in the international MONICA (Multinational MONItoring of trends and determinants in CArdiovascular disease) project, as one of the 38 research centres form 21 countries around the world and in CINDI (Countrywide Integrated Noncommunicable Disease Intervention Programme) programme. Objective. Objective was to indicate the advantages of the integrated approach to prevention and control of the cardiovascular disease (CVD) over mono-programmes and still present curative approach. Additional objective was the assessment of the vulnerability from the leading risk factors of the population of Novi Sad, based on the results and experience gained in realization of international projects. Methods. We analyzed the results obtained in the countries where MONICA project and CINDI programme have been applied. The results of their application in Novi Sad are analyzed (the trend of the prevalence of risk factors, the incidence of coronary and cerebrovascular events). Results. The prevalence of risk factors (except smoking), the incidence of coronary and cerebrovascular events are significantly increasing and are in positive correlation with the values of the linear trend. The decrease was only recorded in 1987 (the implementation of the intervention programme). Conclusion. The review of results and experiences in international projects and programs, clearly indicate the advantage of an integrated approach to prevention and control of CVD in relation to monoprograme. The great vulnerability of the population of Novi Sad of the risk factors of CVD points out the necessity of their reductions by the principles of integrated programmes of prevention and control.

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