Seroprevalence of Bartonella in Eastern China and analysis of risk factors

<p>Abstract</p> <p>Background</p> <p><it>Bartonella </it>infections are emerging in the Zhejiang Province of China. However, there has been no effort to date to explore the epidemiology of these infections in this region, nor to identify risk factors associated with exposure to <it>Bartonella</it>. The aim of this study was to investigate the seroprevalence of <it>Bartonella </it>in both patients bitten by dogs and blood donors (for control) in Eastern China, and to identify risk factors associated with exposure to <it>Bartonella</it>. As no previous data for this region have been published, this study will provide baseline data useful for <it>Bartonella </it>infection surveillance, control, and prevention.</p> <p>Methods</p> <p>Blood samples were collected from industrial rabies clinic attendees and blood donors living in eight areas of the Zhejiang Province of China, between December 2005 and November 2006. An indirect immunofluorescent antibody test was used to determine the presence of <it>Bartonella </it>in these samples. Risk factors associated with <it>Bartonella </it>exposure were explored using Chi-square tests and logistic regression analysis of epidemiological data relating to the study's participants.</p> <p>Results</p> <p><it>Bartonella </it>antibodies were detected in 19.60% (109/556) of blood samples. Seroprevalence varied among the eight areas surveys, ranging from over 32% in Hangzhou to only 2% in Jiangshan (X²= 28.22, P < 0.001). We detected a significantly higher prevalence of <it>Bartonella </it>antibodies in people who had been bitten by dogs than in blood donors (X²= 13.86, P < 0.001). Seroprevalence of <it>Bartonella </it>was similar among males (18.61%, n = 317) and females (20.92%, n = 239).</p> <p>Conclusions</p> <p><it>Bartonella </it>antibodies were encountered in people living across Zhejiang Province and the seropositivity rate among those exposed to dog bites was significantly higher than that among blood donors, indicating that dog bites may be a risk factor for <it>Bartonella </it>infection.</p

Risk Factors for Severe Cases of 2009 Influenza A (H1N1): A Case Control Study in Zhejiang Province, China

Few case control studies were conducted to explore risk factors for severe cases of 2009 influenza A (H1N1) with the mild cases as controls. Mild and severe cases of 2009 influenza A (H1N1), 230 cases each, were randomly selected from nine cities in Zhejiang Province, China, and unmatched case control study was conducted. This study found that it averagely took 5 days for the severe cases of 2009 influenza A (H1N1) to start antiviral therapy away from onset, 2 days later than mild cases. Having chronic underlying diseases and bad psychological health combined with chronic underlying diseases were two important risk factors for severe cases, and their OR values were 2.39 and 5.85 respectively. Timely anti-viral therapy was a protective factor for severe cases (OR = 0.35, 95% CI: [0.18–0.67]). In conclusion, psychological health education and intervention, as well as timely anti-viral therapy, could not be ignored in the prevention, control and treatment of 2009 influenza A (H1N1)

Theories-based determinants analysis of Hib-combined vaccine hesitancy in China: A multi-group structural equation modeling

Objectives To explore determinants of Hib-combined vaccine hesitancy in Chinese parents, and to provide scientific intervention measures to tackle vaccine hesitancy. Methods 2,531 parents were recruited from local healthcare centers in Zhejiang Province by accidental sampling, and completed the self-developed online questionnaire with voluntary participation. Health Belief Model and Model of Determinants of Vaccine Hesitancy were applied to construct the framework of research. Multi-group Structural Equation Modeling was performed to explore the effects of determinants of vaccine hesitancy across various socio-economic status (SES). Results Hib-combined vaccine hesitancy for total sample was 2.184 ± 0.777 (95%CI: 2.153–2.214), and most of them were in low (n = 1436, 56.7%) level. Low SES group (2.335 ± 0.763, 95%CI: 2.271–2.400) had significantly highest vaccine hesitancy. For total sample, Self-Efficacy and Cues to Action presented −0.517 and −0.437 of standard total effect on Vaccine Hesitancy, respectively. The Multi-group Structural Equation Model with satisfying goodness of fit in SES groups ($${\chi ^2}$$ = 1616.074, df = 314, $${\chi ^2}$$/df = 5.147, CFI = 0.973, TLI = 0.966, SRMR = 0.027, RMSEA = 0.041) showed that Cues to Action imposed −0.621 (95%CI: −0.867–0.389, p < .001) of major standard total effect on Vaccine Hesitancy in low SES group, while Self-Efficacy imposed −0.560 (95%CI: −0.668–0.444, p < .001) and −0.685 (95%CI: −0.841–0.454, p < .001) of principal standard total effect on Vaccine Hesitancy in middle and high SES groups, respectively. Conclusions Hib-combined vaccine hesitancy in Chinese parents was low, and the lower the SES, the higher the vaccine hesitancy. Cues to Action and Self-Efficacy played primary role in declining vaccine hesitancy for parents at low SES, and at middle and high SES, respectively

Analysis of Epidemiological Characteristics of Notifiable Diseases Reported in Children Aged 0–14 Years from 2008 to 2017 in Zhejiang Province, China

This study aims to learn the characteristics of morbidity and mortality of notifiable diseases reported in children aged 0&ndash;14 years in Zhejiang Province in 2008&ndash;2017. We collated data from the China Information System for Disease Control and Prevention in Zhejiang province between 1 January 2008 and 31 December 2017 of children aged 0&ndash;14 years. From 2008 to 2017, a total of 32 types and 1,994,740 cases of notifiable diseases were reported in children aged 0&ndash;14 years, including 266 deaths in Zhejiang Province. The annual average morbidity was 2502.87/100,000, and the annual average mortality was 0.33/100,000. Male morbidity was 2886.98/100,000, and female morbidity was 2072.16/100,000, with the male morbidity rate higher than the female morbidity rate (&chi;2 = 54,033.12, p &lt; 0.01). No Class A infectious diseases were reported. The morbidity of Class B infectious diseases showed a downward trend, but that of Class C infectious diseases showed an upward trend. There were 72,041 cases in 22 kinds of Class B infectious disease and 138 death cases, with a morbidity rate of 90.39/100,000, and a mortality rate of 0.17/100,000. There were 1,922,699 cases in 10 kinds of Class C infectious disease and 128 death cases, with a morbidity rate of 2412.47/100,000, and a mortality rate of 0.16/100,000. The main high-prevalence diseases included hand-foot-and-mouth disease (1430.38/100,000), other infectious diarrheal diseases (721.40/100,000), mumps (168.83/100,000), and influenza (47.40/100,000). We should focus on the prevention and control of hand-foot and mouth disease, other infectious diarrheal diseases, mumps and influenza in children aged 0&ndash;14 years in Zhejiang Province. It is recommended to strengthen epidemic surveillance and undertake early prevention and control measures in order to reduce the younger children incidence rate of infectious diseases. Immunization planning vaccines can help achieve a significant preventive decline of infectious diseases

Spatial-temporal characteristics of severe fever with thrombocytopenia syndrome and the relationship with meteorological factors from 2011 to 2018 in Zhejiang Province, China.

BACKGROUND:Zhejiang Province has the fifth-highest incidence of severe fever with thrombocytopenia syndrome (SFTS) in China. While the top four provinces are all located in northern and central China, only Zhejiang Province is located in the Yangtze River Delta region of southeast China. This study was undertaken to identify the epidemiological characteristics of SFTS in Zhejiang from 2011 to 2018. METHODS:The epidemic data from SFTS cases in Zhejiang Province from January 2011 to December 2018 were obtained from the China Information Network System of Disease Prevention and Control. Meteorological data were collected from the China Meteorological Data Sharing Service System. A multivariate time series model was used to analyze the heterogeneity of spatial-temporal transmission of the disease. Random forest analysis was performed to detect the importance of meteorological factors and the dose-response association of the incidence of SFTS with these factors. RESULTS:In total, 412 SFTS cases (49 fatal) were reported from January 2011 to December 2018 in Zhejiang Province, China. The number of SFTS cases and the number of affected counties increased year by year. The case fatality rate in Zhejiang Province was 11.89%, which was the highest in China. Elderly patients and farmers were the most affected. The total effect values of the autoregressive component, spatiotemporal component and endemic component of the model in all ranges were 0.4580, 0.0377 and 0.0137, respectively. There was obvious heterogeneity across counties for the mean values of the spatiotemporal component and the autoregressive component. The autoregressive component was obviously the main factor driving the occurrence of SFTS, followed by the spatiotemporal component. The importance scores of the monthly mean pressure, mean temperature, mean relative humidity, mean two-minute wind speed, duration of sunshine and precipitation were 10.64, 8.34, 8.16, 6.37, 5.35 and 2.81, respectively. The relationship between these factors and the incidence of SFTS is complicated and nonlinear. A suitable range of meteorological factors for this disease was also detected. CONCLUSIONS:The autoregressive and spatiotemporal components played an important role in driving the transmission of SFTS. Targeted preventive efforts should be made in different areas based on the main component contributing to the epidemic. For most areas, early measures several months ahead of the suitable season for the occurrence of SFTS should be implemented. The level of reporting and diagnosis of this disease should be further improved

Effects of cigarette smoking associated with sarcopenia in persons 60 years and older: a cross-sectional study in Zhejiang province

Abstract Purpose Smoking is a risk factor for sarcopenia. Nevertheless, few studies analyzed the independent effects of various smoking dimensions (duration, intensity, cumulative dose) on sarcopenia risk. This is a cross-sectional study based on an older population in Zhejiang Province to determine which smoking dimensions are mainly important for sarcopenia risk and to explore the dose–response relationship between them. Methods Our study included 783 patients with sarcopenia and 4918 non-sarcopenic individuals. Logistic regression and restricted cubic with logistic regression (for nonlinear dose effects) were used to obtain odds ratios (ORs) and 95% confidence intervals as well as restricted cubic splines (RCS) curves. Results Compared with never-smokers, current smokers had an increased risk of sarcopenia (OR = 1.786; 95% CI 1.387–2.301) after adjusting for confounders such as age, sex, education, alcohol consumption, disease history, etc. There was no significant association between smoking intensity and sarcopenia after more than 20 cigarettes per day (OR = 1.484; 95% CI 0.886–2.487), whereas the risk of sarcopenia increased significantly with increasing duration of smoking after more than 40 years (OR = 1.733; 95% CI 1.214–2.473). Meanwhile, there was a significant non-linear dose–response relationship between smoking duration or intensity and the risk of sarcopenia. However, the risk of sarcopenia increased linearly with the number of pack-years of smoking, which is not a significant nonlinear dose–response relationship. Conclusions This study indicated the association between smoking and sarcopenia. Both smoking duration and cumulative dose were significantly and positively associated with sarcopenia. These findings reflect the important role of the number of years of smoking in increasing the risk of sarcopenia and provide scientific evidence that different smoking dimensions may influence the risk of the sarcopenia

Evaluating the effects of control interventions and estimating the inapparent infections for dengue outbreak in Hangzhou, China.

BackgroundThe number of dengue fever (DF) cases and the number of dengue outbreaks have increased in recent years in Zhejiang Province, China. An unexpected dengue outbreak was reported in Hangzhou in 2017 and caused more than one thousand dengue cases. This study was undertaken to evaluate the effectiveness of the actual control measures, estimate the proportion of inapparent infections during this outbreak and simulate epidemic development based on different levels of control measures taking inapparent infections into consideration.MethodsThe epidemic data of dengue cases in Hangzhou, Zhejiang Province, in 2017 and the number of the people exposed to the outbreaks were obtained from the China Information Network System of Disease Prevention and Control. The epidemic without intervention measures was used to estimate the unknown parameters. A susceptible-exposed-infectious/inapparent-recovered (SEIAR) model was used to estimate the effectiveness of the control interventions. The inapparent infections were also evaluated at the same time.ResultsIn total, 1137 indigenous dengue cases were reported in Hangzhou in 2017. The number of indigenous dengue cases was estimated by the SEIAR model. This number was predicted to reach 6090 by the end of November 2, 2017, if no control measures were implemented. The total number of reported cases was reduced by 81.33% in contrast to the estimated incidence without intervention. The number of average daily inapparent cases was 10.18 times higher than the number of symptomatic cases. The earlier and more rigorously the vector control interventions were implemented, the more effective they were. The results showed that implementing vector control continuously for more than twenty days was more effective than every few days of implementation. Case isolation is not sufficient enough for epidemic control and only reduced the incidence by 38.10% in contrast to the estimated incidence without intervention, even if case isolation began seven days after the onset of the first case.ConclusionsThe practical control interventions in the outbreaks that occurred in Hangzhou City were highly effective. The proportion of inapparent infections was large, and it played an important role in transmitting the disease during this epidemic. Early, continuous and high efficacy vector control interventions are necessary to limit the development of a dengue epidemic. Timely diagnosis and case reporting are important in the intervention at an early stage of the epidemic

Pyroptosis, inflammasome, and gasdermins in tumor immunity

The gasdermins (GSDM), a family of pore-forming proteins, consist of gasdermin A (GSDMA), gasdermin B (GSDMB), gasdermin C (GSDMC), gasdermin D (GSDMD), gasdermin E (GSDME) and DFNB59 (Pejvakin (PJVK)) in humans. These proteins play an important role in pyroptosis. Among them, GSDMD is the most extensively studied protein and is identified as the executioner of pyroptosis. Other family members have also been implicated in certain cancers. As a unique form of programmed cell death, pyroptosis is closely related to tumor progression, and the inflammasome, an innate immune mechanism that induces inflammation and pyroptosis. In this review, we explore the current developments of pyroptosis, the inflammasome, and especially we review the gasdermin family members and their role in inducing pyroptosis and the possible therapeutic values in antitumor effects