2009-2016年南京市重症手足口病流行特征和时空聚集性分析

目的 了解南京市重症手足口病（hand-foot-mouth disease,HFMD）的流行特征,并分析时空聚集性,为HFMD的重点防控工作提供依据。方法 采用描述流行病学方法,分析2009-2016年南京市报告的重症HFMD流行病学和病原学特征,采用时空重排扫描分析时空聚集性特征。结果 2009-2016年南京市共报告重症病例1 526例,年均报告191例（93~284例）;重症病例占HFMD比例为11‰（6‰~20‰）,无趋势变化（Z=1.5,P=0.125）,5岁及以下儿童重症病例报告发病率为53/10万（21/10万~76/10万）。4~7月报告病例占54%;病例中男性占64%,年龄中位数为2岁（0~13岁）,5岁及以下占97%,1~3岁占75%;散居儿童占67%,幼托儿童占31%。除2013年外,其他各年均探测到时空聚集区域（均有P<0.001）,聚集地区由中心城区向南部江宁、雨花台和溧水转移,聚集时间多为3~7月。重症病例肠道病毒阳性检出率为39%（17%~70%）,阳性标本中75%（54%~89%）为EV71,5%（0~17%）为CoXA16。结论 南京市重症HFMD流行特征与普通病例一致,但病原以EV71为主,应加强重点地区和人群监测,宣传接种EV71疫苗。     

Economic evaluation of vaccination against influenza in the elderly: an experience from a population-based influenza vaccination program in Taiwan

Due to viral strains, influenza season, and consultations and admission rates varying from country to country, the continued economic evaluation of influenza vaccination for the elderly people aged 65 years and above is paramount, particularly in areas with dense population. Efficacy and cost-effective analysis of influenza vaccination in reducing all-cause mortality and hospitalization was therefore elucidated based on a prospective and population-based study targeted to 226,997 elderly people aged 65 years and above residing in Taipei county, Taiwan between 1 October 2000 and 31 March 2001. Vaccination against influenza for the elderly persons can lead to a 29% (95% CI: 23-35%) significant reduction of all-cause deaths. Approximately, 20% (95% CI: 9-30%) significant reduction in hospitalization was observed for average-risk group but 4% (95% CI: -4-11%) non-significant reduction for high-risk group. Community-based influenza vaccination program for elderly people aged 65 years and above was demonstrated to be effective in reducing mortality in all elderly people but not significantly in reducing hospitalization. Universal vaccination program for the elderly people seems cost-effective in averting death or gaining life years.     

Influenza and pneumococcal vaccination levels among persons aged > or = 65 years--United States, 2001

Two vaccine-preventable diseases, influenza and pneumococcal disease, contribute to the mortality of older persons in the United States. Influenza caused an average of 20,000 deaths per year during influenza epidemics in the United States from 1969 to 1996; persons aged > or = 65 years accounted for approximately 90% of these deaths. Pneumococcal disease caused approximately 3,400 deaths among persons aged > or = 65 years in the United States in 1998. National health objectives for 2010 include increasing influenza and pneumococcal vaccination levels to > or = 90% among persons aged > or = 65 years (objective nos. 14.29a and 14.29b, respectively). To assess progress toward achieving these objectives, CDC analyzed data from the 2001 Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the results, which indicate that the estimated point prevalences of influenza and pneumococcal vaccination were <80% among persons aged > or = 65 years in all reporting areas. Influenza vaccination levels during 2000-2001 decreased from 1998-1999 levels in 27 of 52 reporting areas; pneumococcal vaccination prevalence increased a median of 7 percentage points from 1999 to 2001. Continued efforts are needed to increase the proportion of older adults who receive influenza and pneumococcal vaccines; health-care providers should offer pneumococcal vaccine all year and should continue to offer influenza vaccine during December and throughout the influenza season, even after influenza activity has been documented in the community.     

2008—2010年天津市流行性感冒流行特征分析

目的了解2008年4月—2010年3月天津市流行性感冒(流感)流行特征。方法通过"中国流感监测信息系统"收集天津市国家级哨点医院流感样病例(ILI)监测数据及病原学检测结果进行分析。结果 2008年4月—2010年3月天津市国家级哨点医院上报ILI 483 941例,流感样病例占门诊病例比例(ILI%)为12.79%,病例以15岁以下儿童为主。共采集ILI咽拭子标本5 816例,分离出流感病毒1 393株,阳性率为26.86%。2008—2009年流感优势毒株为季H1,2009—2010年以甲型H1N1为主。结论 2009年甲型H1N1流感全球大流行,天津市流感流行高峰提前,且ILI发病数和病毒分离阳性率有所增多。天津市非监测期ILI%较高,需进一步开展非监测期ILI病原学监测。     

Prevalence of stroke and transient ischaemic attack in the elderly population of an Italian rural community

Objectives: To evaluate the prevalence of stroke and transient ischaemic attack in the elderly population, including the oldest residents, of a rural Italian community. Methods: A door-to-door survey was performed between April and October 2001 in 2390 subjects aged 65 years and over. A symptom questionnaire validated by medical records and neurological examination was employed. Results: Complete information was available for 2260 subjects. The overall prevalence of stroke was 8.2% in males and 5.1% in females. In the very elderly, this increased to 10.7% in males and 10% in females and decreased only in males aged 90 years or over. The overall prevalence of transient ischaemic attack was 7% in males and 4.9% in females. This, too, increased with age, reaching 10.2% in males and 7.4% in females and decreased only in subjects of both sexes aged 85 years or over. Conclusions: An actual estimate of the high prevalence of cerebrovascular disease in the elderly population, even in very old subjects, was thus achieved. Appropriate health care services consequently need to be planned.     

合肥市2009～2010年麻疹流行病学特征分析

目的 分析2009～2010年合肥市麻疹流行病学特征,为消除麻疹策略的制定与实施提供科学依据.方法 利用麻疹专病监测数据资料进行描述性统计.结果 2009年麻疹发病率为10.00/10万,2010年大幅度下降至0.81/10万.3～6月份为发病高峰.以小年龄组发病为主,＜1岁病例构成比最高超过35％,2009、2010年＜1岁组发病率分别为287.41/10万、24.02/10万.暴发病例以散居儿童和小学生为主,流动人口病例构成比＞30％.麻疹病例无免疫史者占半数,1剂次和≥2剂次免疫史者构成比低.结论 完善麻疹病例监测体系,强化免疫规划管理,确保小年龄组人群初次和2剂次疫苗及时接种,适时开展重点人群强化免疫,控制流动人口发病,获得良好持续的防控效果是消除麻疹的关键.     

Nonfatal traumatic brain injuries related to sports and recreation activities among persons aged ≤19 years--United States, 2001-2009

Traumatic brain injuries (TBIs) from participation in sports and recreation activities have received increased public awareness, with many states and the federal government considering or implementing laws directing the response to suspected brain injury. Whereas public health programs promote the many benefits of sports and recreation activities, those benefits are tempered by the risk for injury. During 2001--2005, an estimated 207,830 emergency department (ED) visits for concussions and other TBIs related to sports and recreation activities were reported annually, with 65% of TBIs occurring among children aged 5--18 years. Compared with adults, younger persons are at increased risk for TBIs with increased severity and prolonged recovery. To assess and characterize TBIs from sports and recreation activities among children and adolescents, CDC analyzed data from the National Electronic Injury Surveillance System--All Injury Program (NEISS-AIP) for the period 2001--2009. This report summarizes the results of that analysis, which indicated that an estimated 173,285 persons aged ≤19 years were treated in EDs annually for nonfatal TBIs related to sports and recreation activities. From 2001 to 2009, the number of annual TBI-related ED visits increased significantly, from 153,375 to 248,418, with the highest rates among males aged 10--19 years. By increasing awareness of TBI risks from sports and recreation, employing proper technique and protective equipment, and quickly responding to injuries, the incidence, severity, and long-term negative health effects of TBIs among children and adolescents can be reduced.     

2001—2010年上海市宝山区肺结核疫情分析

目的通过分析上海市宝山区肺结核的发病规律及流行特征,为进一步控制宝山区肺结核发病水平及实施有效管理肺结核患者提供科学的依据。方法将2001—2010年宝山区新登记肺结核病例的相关资料进行描述性统计分析。结果 2001—2010年宝山区新登记肺结核年平均发病率该市人口为32.87/10万,流动人口为56.32/10万。发病时间分布呈现出4—9月相对集中的特征,该区居民与流动人口发病高峰基本一致。地区分布该区居民以通河街道发病数居首,占19.0%;流动人口以大场镇病例数居多,占24.34%。发病年龄构成该区居民以老年为主,其中65岁及以上年龄组占25.12%;流动人口以青壮年为主,25～34岁年龄组占36.60%。病例中男女性别比该区居民为2.5:1,流动人口为1.5∶1。职业分布该区居民以离退人员为主,占29.13%;流动人口以农民为主,占27.49%。该区人口新登记肺结核患者在市级定点医院就诊的比例较高,为73.85%,但在该辖区定点医院就诊的比例较低。流动人口肺结核患者在该辖区定点医院就诊的比例较高,为46.72%。结论提示应加强流动人口肺结核病的发现和管理工作;做好老年人群肺结核因症推荐及因症就诊发现肺结核的工作;努力提高该辖区定点医院的诊疗水平,发挥定点门诊的功能。     

Attendance in the second phase (2004-2005) of the Hungarian organized breast cancer screening program

AIM: Organised, nationwide screening for breast cancer with mammography in the age group of 45-65 years with a 2-year screening interval started in Hungary in January 2002. The aim of this study is to analyze the attendance rate of breast screening programme, including the analysis of the ratio of screening and diagnostic mammography examinations. DATA AND METHODS: The data derive from the financial database of the National Health Insurance Fund Administration (NHIFA) covering the 6-year period between 2000-2006. The ratio of women in the age group of 45-65 years was calculated having either a screening mammography or a diagnostic mammography. The analysis was carried out for the years 2000-2001 before and 2002-2003, 2004-2005 after the implementation of nationwide organised programme. RESULTS: In the years 2000-2001 7.26% of the women aged 45-65 had an opportunistic screening mammography, while in 2002-2003 34% and in 2004-2005 29.5% of the target population had screening mammography within the organised programme. During the same periods 19.8% (2000-2001), 22.1% (2002-2003) and 23.2% (2004-2005) of women aged 45-65 had a diagnostic mammography. Thus the total (screening and diagnostic) coverage of mammography increased from 26.2% (2000-2001) to 53.5% (2002-2003) and 50.8% (2004-2005). CONCLUSIONS: The attendance of the Hungarian organised breast cancer screening programme slightly declined in 2004-2005, and to achieve the expected results in mortality decrease a further improvement of the uptake is necessary.     

The attendance of the first screening round (2002-2003) of the Hungarian organized breast cancer screening program and its effect on the number of diagnostic and screening mammography

AIM: Organised, nationwide screening for breast cancer with mammography in the age group 45-65 years with 2 years screening interval started in Hungary in January 2002. The aim of this study is to analyze the attendance rate of breast screening programme, including the analysis of the ratio of screening and diagnostic mammography examinations. DATA AND METHODS: The data derive from the financial database of the National Health Insurance Fund Administration (NHIFA) covering the period 2000-2003. The ratio of women was calculated in the age group 45-65 years having either a screening mammography or a diagnostic mammography. The analysis was carried out for the years 2000-2001 (mainly opportunistic screening) before and 2002-2003 after the implementation of nationwide organized programme. RESULTS: In the years 2000-2001 7,26% of the women aged 45-65 had an opportunistic screening mammography while in 2002-2003 33,95% of the target population had screening mammography within the organized programme. During the same periods 19,67% (2000-2001) and 22,05% (2002-2003) of women aged 45-65 had a diagnostic mammography. Thus the total (screening and diagnostic) coverage of mammography increased from 25,85% (2000-2001) to 53,46% (2002-2003). CONCLUSIONS: The attendance of the Hungarian organized breast cancer screening programme - compared to the previous period before the implementation of the organized screening programme - is promising, although to achieve the expected results in mortality decrease a further improvement of the uptake is necessary.     

1997—2009年我国9省区18～49岁成年居民身体活动状况及变化趋势研究

目的研究1997—2009年我国9省区18~49岁成年居民身体活动状况及变化趋势。方法利用＂中国健康与营养调查＂资料中选取1997、2000、2004、2006和2009年5轮调查有完整身体活动数据的18~49岁健康成年居民25 507人作为研究对象,计算该人群每周身体活动量。结果男、女性成年居民身体活动量从1997年的358.7 metabolic equivalent-hours（MET-hrs）/周和403.1 MET-hrs/周分别下降至2009年的255.8 METhrs/周和249.0 MET-hrs/周;城市、农村成年居民身体活动量从1997年的311.1 MET-hrs/周和416.9 MET-hrs/周分别下降至2009年的181.4 MET-hrs/周和285.3 MET-hrs/周,男性、女性、城市、农村成年居民身体活动量在不同调查年间比较差异均有统计学意义（P〈0.01）。成年居民以静态活动为主要休闲方式的人群比例从1997年的89.0%升高至2009年的91.2%;以步行和骑自行车为主要出行方式的人群比例从1997年的70.0%下降至2009年的47.1%,成年居民休闲方式及出行方式的人群比例在不同调查年间比较差异均有统计学意义（P〈0.01）。结论我国9省区18~49岁成年居民身体活动量发生显著变化,该人群身体活动量的大幅度下降值得关注。     

西藏自治区长寿人口的时空分布特点

目的探讨西藏地区长寿人口时空分布的特点。方法以2000年和2010年全国人口普查资料为依据,以75岁以上人口定义为长寿人口,并以65岁以上人口数为基数计算长寿人口比例;结合与西藏人口有关数据,探讨西藏长寿人口时空分布,利用统计方法研究比较2次人口普查中西藏长寿人口的分布。结果 10年中西藏长寿人口显著增加,人口平均寿命提升至68岁,男性长寿人口数量较女性低;昌都地区长寿人口最多,占65岁以上比例长寿人口比例最高,一些经济较落后地区近10年增长率高于其他地区。结论西藏地区长寿人口大量增加,长寿人口数与地区医疗卫生机构数量呈正相关,与GDP增长率呈负相关,分布呈区域性特点,艰苦偏远地区长寿人口比例的增长超过一般地区。     

Notes from the field: risk factors for hepatitis C virus infections among young adults--Massachusetts, 2010

During 2002-2009, rates of newly diagnosed hepatitis C virus (HCV) infection increased from 65 to 113 cases per 100,000 population among persons aged 15-24 years in Massachusetts. Accordingly, the Massachusetts Department of Public Health (MDPH) and CDC interviewed persons aged 18-24 years with HCV infection reported to MDPH during July 1-December 31, 2010, to elicit detailed information regarding demographic, clinical, and risk characteristics.     

吸烟对牙周组织及其龈沟液中天冬氨酸转氨酶活性水平的影响

目的 了解吸烟对牙周组织及其龈沟液中天冬氨酸转氨酶(GcF-AST)水平的影响。方法 1999年5月至2001年3月对体检人群、大学生及门诊病人进行基本等比的筛选,选择115名吸烟者,年龄23～65岁,男102名,女13名;90名非吸烟者,年龄25—70岁,男80名,女10名。测定软垢指数(DI)、牙石指数(CI)、牙周病指数(PDI)和GCF—AST水平。结果 吸烟组DI(0级区数125个,27．2％;5级区数23个,5．0％)与非吸烟组(0级区数100个,27．8％;5级区数15,4．2％)比较,差异无显著性;吸烟组CI与非吸烟组比较,差异有非常显著性,吸烟组无牙石区数(0级区数45个,9．8％)低于非吸烟组(0级区数72个,20．0％),重度牙石区数吸烟组(3级区数117个,25．4％)高于非吸烟组(3级区数46个,12．8％);吸烟组PDI值明显高于非吸烟组,牙周健康区数吸烟组(0级区数44个,9．6％)低于非吸烟组(0级区数75个,20．8％),牙龈炎区数两者相近(239,51．9％;192,53．3％),牙周炎区数吸烟组(117,38．5％)高于非吸烟组(93,25．8％);吸烟指数与PDI区数有非常显著的正相关关系;在PDI相同的情况下两组GCF-AST水平差异无显著性。结论 吸烟对牙周病的发生、发展有促进作用,是牙周病的高危因素之一,而对GCF—AST水平无直接影响。     

Interim results: state-specific influenza vaccination coverage--United States, August 2010-February 2011

The 2010--11 influenza season was unusual because it followed the 2009 influenza A pandemic (H1N1) season and it was the first season the Advisory Committee on Immunization Practices (ACIP) recommended influenza vaccination of all persons aged ≥6 months. The season also was notable because a record number of seasonal influenza vaccine doses (approximately 163 million) were distributed in the United States. To provide preliminary state-specific influenza vaccination coverage estimates, CDC analyzed Behavioral Risk Factor Surveillance System (BRFSS) data for adults aged ≥18 years and National Immunization Survey (NIS) data for children aged 6 months-17 years collected September 2010 through March 2011. By February 28, the preliminary national vaccination coverage estimate was 49.0% for children aged 6 months-17 years; among 43 states and the District of Columbia (DC), coverage ranged from 30.2% for adults aged 18-49 years to 68.6% for adults aged ≥65 years. The record high seasonal vaccination coverage achieved during 2009-10 (41.3%) among persons aged ≥6 months in 43 states and DC was sustained during the 2010--11 season (42.8%). Coverage for Hispanic and non-Hispanic black children increased by 11-12 percentage points from 2009-10 levels. Opportunity exists to improve coverage in all age groups, particularly among adults. To accomplish that, health departments and other nonoffice-based vaccination providers can increase access to vaccination at work and school locations, pharmacies and stores, and other nonmedical sites. In addition, physicians and clinics should implement proven strategies for improving vaccination coverage (e.g., office-based protocols, including reminder/recall notification and standing orders).     

湖北省麻城市1 984--2008年自杀死亡水平长期趋势分析

目的 探讨1984-2008年湖北省农村人口自杀死亡水平的特征及其长期变化趋势.方法 利用湖北省麻城市1984-2008年居民死因监测资料,回顾性分析不同性别、不同年龄人群的自杀死亡水平、自杀死亡占伤害的死因构成比及其变化趋势.结果 1984-2008年间该地人群的自杀死亡率呈下降趋势,自杀标化死亡率由1984年的113.29/10万降至2008年的20.11/10万,下降幅度为82.25%.自杀死亡占伤害死亡的构成比下降幅度不明显,自杀仍是该地人群伤害死亡的首要死因.自杀死亡者中,女性人数始终多于男性,女性所占的构成比在50%～60%之间波动;≥65岁老年人口所比例近年来明显增加,2008年老年人的构成比达46.81%.结论 自杀仍居该地人群,特别是女性人群伤害死因谱的首位.农村地区自杀预防的重点人群是女性和≥65岁老年人.

Abstract：

Objective To explore the characteristics and the long-term trend of suicidal deaths among the rural population in Hubei province. Methods Data on suicide deaths from 1984 through 2008 were released from Macheng Death Registration System and analyzed by year, gender and age. Results The suicidal death rates were decreasing during the last 25 years in Macheng city, with the standardized suicide mortality rapidly decreasing from 113.29/100 000 in 1984 to 20.11/100 000 in 2008. The proportion of suicide deaths in the total deaths caused by injuries were declining but not obviously. Suicide was still the leading cause of deaths among all the deaths due to injuries.Number of suicidal deaths among females was outnumbered the males during the last 25 years,representing 50%-60% in total suicide deaths annually. The proportion of suicide deaths among the elderly aged 65 and over had significantly increased in the recent years, which accounting for 46.81% of all the suicidal deaths in 2008. Conclusion Suicide remained the leading cause of injury deaths among the population in this area, especially in females. Attention should be paid to the females and the elderly aged 65 and over,in the rural areas.     

Seasonal influenza vaccination coverage in France during two influenza seasons (2007 and 2008) and during a context of pandemic influenza A(H1N1) in 2009

Objectives

To measure the seasonal influenza vaccination coverage rate (VCR) in France in 2009, year of the A(H1N1) influenza pandemic, by age and target disease and compare it with the VCR for the 2007 and 2008 influenza seasons.

Method

At the beginning of each annual seasonal vaccination campaign, the National Health Insurance, covering 86% of the French population, sends free influenza vaccination vouchers to at-risk beneficiaries aged under 65 suffering from diverse chronic diseases and to all individuals aged 65 and over (around 11 million). Vaccination is estimated from refund claims registered in the National Health Insurance Information System.

Results

The global VCR for the target population was 51% in 2007, 55.8% in 2008 and 56.9% in 2009. In 2009, the VCR for children under 10 years old was 24.3%, 28.1% in the 10-19 age range, 39.2% in the 20-64 age range and 63.3% for individuals aged 65 and over, of which 72.3% with a targeted chronic disease and 56.9% without. The inclusion of asthma as a target disease, lowered the global VCR for children under 10 years old (30.6% without asthma) but VCR increased proportionally with the number of annual refunds for drugs against asthma and chronic obstructive pulmonary disease. The 2009 vaccine uptake rates in target group children, adolescents, young adults and to a lesser extent the population aged 65 and over suffering from a chronic disease (particularly chronic respiratory disease), could have been positively impacted by the A(H1N1) influenza context.

Conclusion

The influenza VCR varies considerably according to age and target disease but globally remains inferior to the recommended 75% coverage rate. These results permit the detailed analysis of VCR distribution by disease and target group and highlights areas for reflection and action. Specific studies should be conducted in order to understand why the VCR is lower in certain target groups.     

Parity derived for pregnant women using historical administrative hospital data: Accuracy varied among patient groups

ObjectivesUnderstanding patterns of maternity care requires knowing which women have given birth previously, but this information is typically unavailable in administrative hospital data sets. We assessed how well parity can be derived using linked historical records.Study Design and SettingUsing Hospital Episode Statistics data, we identified records of women who gave birth between April 2009 and March 2010 in English National Health Service hospitals. The parity coded in these records was compared with an estimate derived from deliveries identified in previous hospital admissions between April 2000 and March 2009.ResultsWe identified 358,849 eligible deliveries with complete parity data in the 2009–10 birth records. The historical data classified 168,041 women as multiparous; of whom, 98% were coded as multiparous in their birth record. Among 190,798 women classified as primiparous using historical data, 72% were coded as primiparous in their birth record. The proportion of accurate predictions about primiparous status from historical data varied with age, ranging from 89% for 15–18 year olds to 50% for women aged more than 35 years.ConclusionHistorical records in administrative hospital data sets give accurate information on multiparous status of women. There is some misclassification of primiparous status, and error rates differ among subgroups of women.     

Public health and aging: projected prevalence of self-reported arthritis or chronic joint symptoms among persons aged >65 years--United States, 2005-2030

Arthritis and other rheumatic conditions are among the most common chronic diseases, affecting 70 million U.S. adults in 2001, and comprise the leading cause of disability among U.S. adults. Arthritis prevalence increases with age, affecting approximately 60% of the U.S. population aged >/= 65 years. As a result of better identification and treatment of other chronic diseases and lower mortality from infectious diseases, U.S. adults are living longer, and the U.S. population is aging. For this reason, the number of persons living with nonfatal but disabling conditions such as arthritis or chronic joint symptoms (CJS) might be increasing. To estimate the projected future burden of arthritis or CJS among persons aged >/= 65 years, CDC applied data from the 2001 Behavioral Risk Factor Surveillance System (BRFSS) to projected national population data for 2005-2030 and state population data for 2025. This report summarizes the results of that analysis, which indicate that if arthritis prevalence rates remain stable, the number of affected persons aged >/= 65 years will nearly double by 2030. Proven public health interventions should be applied and new interventions developed to improve function, decrease pain, and delay disability among persons with arthritis, particularly those at highest risk for functional impairment and disability.     

Disparities in premature deaths from heart disease--50 States and the District of Columbia, 2001

In 2001, heart disease accounted for approximately 29.0% of deaths among U.S. residents; 16.8% of those deaths occurred among persons aged <65 years. Although mortality rates from heart disease have decreased, the decline has not been uniform for all populations. One of the two overall national health objectives for 2010 is to eliminate health disparities among different segments of the U.S. population. To better understand these disparities, CDC analyzed death certificate data for premature deaths from heart disease occurring in 2001. This report summarizes the results of that analysis, which indicated that the proportion of premature heart disease deaths varied by state and was higher among blacks, American Indians/Alaska Natives (AI/ANs), Asians/Pacific Islanders (A/PIs), and Hispanics. Reducing premature death from heart disease and eliminating disparities will require preventing, detecting, treating, and controlling risk factors for heart disease in young and middle-aged adults.