The Enterovirus A71 (EV-A71) vaccine was introduced in China in December 2015 as a preventive measure against hand, foot, and mouth disease (HFMD) caused by EV-A71. However, the effectiveness of the vaccine (VE) in real-world settings needs to be evaluated. We conducted a test-negative case-control study to assess the effectiveness of EV-A71 vaccines in preventing EV-A71-associated HFMD. Children aged 6-71 months with HFMD were enrolled as participants. The case group comprised those who tested positive for EV-A71, while the control group comprised those who tested negative for EV-A71. To estimate VE, a logistic regression model was employed, adjusting for potential confounders including age, gender, and clinical severity. In total, 3223 children aged 6 to 71 months were included in the study, with 162 in the case group and 3061 in the control group. The proportion of children who received EV-A71 vaccination was significantly lower in the case group compared to the control group (p < .001). The overall VEadj was estimated to be 90.8%. The VEadj estimates for partially and fully vaccinated children were 90.1% and 90.9%, respectively. Stratified by age group, the VEadj estimates were 88.7% for 6 to 35-month-olds and 95.5% for 36 to 71-month-olds. Regarding disease severity, the VEadj estimates were 86.3% for mild cases and 100% for severe cases. Sensitivity analysis showed minimal changes in the VE point estimates, with most changing by no more than 1% point. Our study demonstrates a high level of vaccine effectiveness against EV-A71-HFMD, especially in severe cases. Active promotion of EV-A71 vaccination is an effective strategy in preventing EV-A71 infections.
Background and Objective: Early and routine detection of HPV which is responsible for most cervical cancers in women infected with HIV could not only improve their prognosis but can help in reducing the mortality and morbidity associated with such populations.The HPV infections are caused by a variety of HPV types including HPV-16.This study investigated the prevalence of HPV-16 in HIV-infected women in Abakaliki, Nigeria.Materials and Methods: Whole blood samples (aliquots of 10 mL) were aseptically collected from HIV-positive women (n = 100) who attended a tertiary hospital in Abakaliki, Nigeria for antiretroviral therapy and counselling.Also, 60 HIV-negative women were included as a control group.All samples were investigated by ELISA and PCR for the detection of HPV-16.Results: A high prevalence of HPV antibodies (HPV IgG) in the HIV-1 positive women was reported.It was observed that there was a significant association of HPV-16 infection with age and sexual activity among the HIV-1 infected women.The prevalence of high risk HPV-16 (8.8%) in the patientʼs blood samples was reported in HIV-positive women.Conclusion: Given the prevalence of HPV-16 and HPV antibodies reported in this study, it could be concluded that HIV-1 infection could increase the susceptibility of women to HPV-16 infection, particularly among those already living with the immunodeficiency disease (HIV-1).
Objective:To investigate the genome characteristics of imported severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) omicron XBB.1.5 variant, so as to provide the evidence to trace the source of the virus and for the prevention and control of epidemics.Methods:The whole genome sequences of SARS-CoV-2 were obtained by the next generation sequencing. The genotypes were obtained by using sequence assembler software and online analysis websites. MEGA X software was used for multiple sequence alignment and analysis of point mutations in the virus as well as for the construction of phylogenetic tree.Results:The genome sequences of 6 imported cases of SARS-CoV-2 omicron XBB.1.5 variant identified by Beijing Customs during the period from early February to mid-March, 2023 were successfully obtained. The whole genomic nucleotide mutation analysis indicated that the genomes of 6 XBB.1.5 variant had significantly increased mutations comparing to the Wuhan reference strain (NC_045512.2) and the number of mutations ranged 120–127. The distribution of the mutations in various genes of SARS-CoV-2 was inconsistent. More mutations were observed in S, ORF1a, N and ORF1b gene. Amino acid mutation analysis indicated that there were 38 XBB characteristic amino acid mutation sites and 1 non-characteristic mutation site in the spike protein of the 6 strains In the receptor binding domains (RBDs), the XBB.1.5 variant had F486P mutation while the XBB variant had the F486S mutation. The maximum likelihood phylogenetic tree showed the sequences of imported viruses were similar to the circulating strains in the regions of origin or neighborhood of the origin.Conclusions:It was necessary to continuously perform whole genomic surveillance of SARS-CoV-2 to understand the molecular characteristics of the imported virus strains and provide evidence for tracing the potential source of the virus and the prevention and control of the epidemics.
Objective:To analyze the epidemiological characteristics of clustered epidemics of hand, foot, and mouth disease (HFMD) in Changping district of Beijing from 2018 to 2021.Methods:The epidemiological and etiological data of HFMD cluster epidemics in Changping district of Beijing from 2018 to 2021 were collected, and the descriptive epidemiological methods were used to analyze the distributions and pathogen constituents.Results:A total of 271 epidemics (including 266 clusters and 5 outbreaks) were reported from 2018 to 2021 and the average incidence rate was 11.04%. The median values of were both 2 d. The number of patients were positively correlated to the interval between epidemic on-set and reporting and to the duration of epidemics, with the correlation coefficients of 0.682 and 0.145, respectively (all P<0.05). The cases were mainly in the age group ≤ 5 years old, accounting for 77.67% (619/797). The epidemic mainly occurred in kindergartens, accounting for 78.97% (214/271). The top three number of epidemics occurred in Beiqijia town (51 epidemics), Huilongguan region (43 epidemics) and Dongxiaokou town (37 epidemics). The trend of epidemics reported was consistent with that of sporadic cases with the peak from May to July, and the second peak in September and November in some years. The main pathogens were coxsackievirus A 16 (CV-A16) and CV-A6. Conclusions:Clustered epidemic was the dominant type of epidemics in Changping District. Children under 5 years, kindergartens, the urban and rural fringe with dense population and large floating population are the key populations, places and areas for HFMD epidemic prevention and control. respectively. Early detection and reporting of the epidemic are the keys for prevention and control.
Objective:To describe the clinical and epidemiological characteristics of mpox cases reported in Beijing, so as to provide reference for the prevention and control of mpox epidemics.Methods:A total of 203 confirmed mpox cases were selected from the cases reported by active reporting by medical institutions and screening of close contacts in Beijing from May 31 to September 6, 2023. Epidemiological investigation was carried out to analyze the disease distribution, disease onset and hospital visits as well as the clinical characteristics of the cases.Results:For the 203 confirmed mpox cases, the age ranged from 17 to 56 years old while male patients accounted 99.51% (202/203). The patients were mainly unemployees/job-waiting persons (50, 24.63%). Fourteen cases were self-employees (6.90%) and 6 were school students (2.96%). There were 183 cases (90.15%) in men who have sex with men (MSM). There were 86 cases with definite exposure time, and the average incubation period was 8.85 d. The main detection method of the cases was voluntary treatment, accounting for 95.07% (193/203). Two hundred and one cases had symptoms, mainly rash (97.54%), fever (67.98%) and lymph node enlargement (33.00%). The skin lesion involved multiple sites of whole body, and there was no obvious order of rash occurrence. There were 198 patients with definite medical records, and the interval from onset to first visit to hospital was 0-38 d, with median value of 4 d and an average of 4.71 d. The detection rate in the first visit was 52.53% (104/198) and HIV infected patients accounted for 44.33%.Conclusions:The mpox cases occurred mainly in MSM and transmitted by man-man sexual contact with an average incubation period of 8.85 d. The main symptoms were fever and rash and most patients were mild case. The rate of diagnosis at the first visit was low. Frequently change of sexual partners and several partners at the same time lead to difficulties in defining risk population and in the prevention and control of epidemics.
Objective:To analyze the pathogen spectrum and genetic characteristics of the main pathogens of hand, foot, and mouth disease (HFMD) in Chongqing from 2017 to 2018.Methods:Chongqing Children's Hospital was selected as the study object. Nucleic acid detection information of 1 071 patients diagnosed with HFMD from 2017 to 2018 was collected. The enterovirus serotypes of 810 samples were identified. There were 175 samples remaining unidentified for serotypes. Eighty-six samples were enterovirus-negative. Through virus isolation, nucleic acid concentration and gene sequencing, the above 261 samples were tested to obtain a complete pathogen spectrum of HFMD in this area. MEGA 7.0 software was used to construct phylogenetic trees of the four major pathogens for the study of genetic characteristics.Results:Except for 3 samples that were identified as Human parechovirus (HPeV), 258 samples were positive for enterovirus by the improved identification method. Among them, coxsackievirus A6 (CVA6) was the dominant serotype, followed by enterovirus A71 (EV-A71). There were also 13 serotypes of CVA16, CVA10 and other enteroviruses. The phylogenetic analysis results showed that the serotypes of CVA6 in Chongqing were all D3a sub-genotype, while the dominant gene subtypes of EV-A71, CVA10 and CVA16 were C4a, C2b and B1b, respectively. These four dominant genotypes co-evolved with the genotypes in other areas of China.Conclusions:This study improved the detection rate of enterovirus by optimizing the identification method, and further defined the pathogen spectrum of HFMD in Chongqing. The dominant pathogen of HFMD was CVA6 in Chongqing from 2017 to 2018, followed by EV-A71, and both serotypes were also the main pathogen causing severe HFMD in Chongqing area.
Objective:To explore the factors influencing behaviors among patients with coronavirus disease 2019 (COVID-19) in seeking medical care and medication, so as to provide a reference basis for scientific planning of medical resources and for science promotion on health.Methods:The general information of COVID-19 patients from October 30, 2022 to January 8, 2023 were collected by self-filling electronic questionnaire. The patients were divided into seeking for medical care group (n=77) and no-seeking group (n=973) according to information of the hospital-visiting. The infected patients were divided into the medication group (n=803) and no-medication group (n=247) according to information of using drugs. The population characteristics of the two patient groups were compared separately, and the influences of population characteristics on behaviors of seeking medical care and medication were analyzed using multifactorial logistic regression.Results:For 1 050 patient, the age range from 2 to 70 years old, with median value of 36 (32, 44) years old. The male to female ratio was 1:3.41. The top five clinical symptoms were fever, cough, fatigue, sore throat, and coughing with sputum. The occurrence of shortness of breath, heart discomfort, duration of fever and underlying diseases were the influencing factors for behavior of seeking medical care among patients ( P<0.05). The occurrence of fever, cough and fatigue were the influencing factors for behavior of medication among the patients ( P<0.05). Conclusions:The relevant guidelines on medication and seeking for medical care should be issued, especially for key populations combined with underlying disease. This would provide guidance for COVID-19 patients to identify the high-risk factors and early warning indicators of COVID-19 correctly, to take medicine rationally and to reduce unnecessary behaviors of seeking medical care.
Objective:To investigate the levels of serum interleukin-37(IL-37), cardiac troponin I (cTnI), B lymphoblastoma-2 gene (Bcl-2) in patients with viral myocarditis (VMC) and their relationship with prognosis.Methods:A total of 200 VMC patients admitted to our hospital from June 2018 to June 2021 were selected as the study group, and 100 healthy people who underwent physical examination during the same period were selected as the control group. The serum levels of IL-37, cTnI and Bcl-2 in the two groups were measured and compared. Receiver operating characteristic curve (ROC) was used to analyze the diagnostic efficacy of serum IL-37 and other indicators for VMC. The relationship between serum indicators and prognosis was analyzed by logistic regression.Results:The levels of serum IL-37 and cTnI in the study group were significantly higher than those in the control group ( t=17.187 and 19.452, P <0.01), and the level of Bcl-2 was significantly lower than that in the control group ( t=17.145, P < 0.001). After treatment, the levels of serum IL-37 and cTnI in VMC patients significantly decreased compared with the results before treatment ( t=30.521, 42.426, P<0.01), while the level of Bcl-2 significantly increased ( t=25.227, P<0.01). The area under curve (AUC) of serum IL-37, cTnI and Bcl-2 in the diagnosis of VMC was 0.945, 0.961 and 0.911, respectively. The AUC for combined diagnosis was 0.998 and the sensitivity and specificity were 98.50% and 97.00%, respectively. Logistic regression analysis showed that the levels of IL-37, cTnI and Bcl-2 were respectively associated with poor prognosis of VMC patients ( OR=1.041, P<0.01; OR=90.740, P=0.01, OR=0.007, P<0.01). Conclusions:The serum levels of IL-37 and cTnI increased while Bcl-2 decreased in patients with VMC. The three criteria were of significant values in the diagnosis and prognosis evaluation of VMC.
在评价疫苗上市后保护效果的研究中，与随机对照试验、传统病例对照试验和队列研究等相比，检测阴性设计具有降低组织难度、节约花费、减少偏倚等诸多优势。本文系统介绍了检测阴性设计的基本原理、实施步骤、主要优势和应用中需要注意的问题。
呼吸道合胞病毒（RSV）引起的感染是造成婴儿与老年人呼吸道疾病的主要原因之一。当机体免疫力低下时，RSV可引起机体上呼吸道感染，严重者可导致支气管炎和肺炎，甚至死亡，严重威胁婴幼儿及老年人的生命和健康。治疗上，主要以对症支持治疗为主。接种疫苗是最有效的预防RSV感染的手段，目前，国外已有两款RSV疫苗于今年上市；但国内至今无RSV疫苗上市。随着研究的深入以及新技术的应用，很多候选RSV疫苗已经做到临床晚期研究并且已经显示出很好的安全性和有效性，本文对呼吸道合胞病毒病原体的生物学特征、致病机制、预防与治疗、以及疫苗的研究进展进行了综述。
Objective:To explore the the detection patterns of mpox virus in different types of clinical specimen, so as to provide evidence for the diagnosis of mpox cases and the formulation of public health policies.Methods:The throat swabs, skin lesion swabs, blood and anal swabs from the cases were collected. Real-time quantitative PCR method was used to detect monkeypox virus DNA in the samples. The differences in the positive detection rate of different sample types were analyzed the Prism software was used to analyze the differences in the viral loads (Ct values) in different types of samples and in different sampling time of the same sample type.Results:The positive detection rates of throat swabs, skin lesion swabs, blood, and anal swabs in the 210 confirmed cases were 70.95%, 98.97%, 75.26% and 88.89%, respectively. The median Ct values for the throat swab group, skin lesion swab group, blood group, and anal swab group were 31, 17, 34, and 26, respectively. The difference in viral loads (Ct values) among patient groups with different sampling intervals for skin lesion swab group and anal swab group were statistically significant.Conclusions:Skin lesions should be the optimal specimen type for detecting mpox virus, while other types of specimens can be used as alternatives or supplements.
Objective:To determine the efficacy and safety of elbasvir/grazoprevir (EBR/GZR) treatment in Chinese patients with genotype 1b (GT1b) chronic hepatitis virus C (HCV) infections.Methods:In this retrospective study, 49 treatment-naive patients with chronic GT1b HCV infection were treated with GZR (100 mg) plus EBR (50 mg) for 12 weeks. The viral response was the primary endpoint and fibrosis stage changes during and after treatment, as well as the incidence of treatment-emergent adverse events (TEAE) were secondary endpoints.Results:After 2-week EBR/GZR treatment, the virologic response rate was 85.1% (80/94) and reached 100% after 8 and 12 weeks of therapy. Sustained virologic response rates were 100% at the 12, 24 and 48-week follow-ups. Multivariate analysis revealed that the baseline viral load of HCV RNA may affect the rapid 2-week virologic response ( OR: 0.36, 95% CI: 0.14-0.92, P=0.034), but did not influence efficacy during further treatment or follow-ups. Fifteen patients with ≥1 TEAE (16.0%) were observed and 7 (7.4%) and 8 (8.5%) patients had mild alanine aminotransferase (ALT) or aspartate aminotransferase (AST) elevations (1.1-2.5× BL), but no serious drug-related adverse events occurred. Liver stiffness measurement, the AST to platelet ratio index and the fibrosis index based on age, ALT, AST and platelet 4 factor scores were consistently reduced, especially in patients with high baseline assessments after 12 weeks’ treatment and during follow-ups. Conclusions:A 12-week EBR/GZR regimen shows high efficacy and safety in Chinese patients with GT1b HCV infections.
Objective:To perform epidemiological investigation for the first confirmed locally acquired case of mpox in Chinese mainland, so as to analyze the source of infection.Methods:Epidemiological investigation and big data tracking technology were used to trace close contacts and key persons. Samples were collected from patients and were tested for mpox virus nucleic acid by fluorescent quantitative real-time polymerase chain reaction (PCR). High-throughput sequencing were used in the whole genome sequencing and alignment analysis to verify the route of transmission.Results:Oropharyngeal swabs, herpes fluid and serum specimens were all positive for mpox virus. The sequencing results indicated that the virus belonged to the B.1.3 branch of the West African lineage of mpox virus.Conclusions:The first confirmed locally acquired mpox case in Beijing may be the secondary case of the imported case who returned from Thailand. The case was detected timely and managed with standardized measures. This will lay a solid foundation for the prevention and control of mpox in China.
Objective:To describe the epidemiological characteristics of hepatitis B and related liver cancer in Yantai from 2018 to 2019, so as to understand the economic burden of hepatitis B and related liver cancer.Methods:The prevalence and mortality of hepatitis B and liver cancer in Yantai were analyzed by China Disease Control and Prevention Information System to summarize the epidemiological characteristics. The years of life lost (YLL) was calculated and the epidemiological burden was assessed. The economic burden of hepatitis B and related liver cancer were then estimated.Results:The reported incidence of hepatitis B in Yantai from 2018 to 2019 was 12.55/100 000 The annual YLL caused by hepatitis B related diseases was 1 313 person-years. The average total cost of hepatitis B related diseases was 16 535.0 yuan, and the costs from high to low were 24 201.4 yuan, 21 846.0 yuan, 18 040.3 yuan, 15 082.5 yuan and 12 808.2 yuan for liver cancer, decompensated stage of cirrhosis, acute hepatitis B, chronic hepatitis B and hepatitis B cirrhosis, respectively. The annual per capita economic burden of liver cancer, decompensated liver cirrhosis, compensatory liver cirrhosis, chronic hepatitis B and acute hepatitis B were 37 925.04 yuan, 28 506 yuan, 19 454.7 yuan, 20 635.15 yuan and 20 740.3 yuan, respectively. Among the costs, the proportion of direct medical expenses with an average of 13 288.9 yuan was the highest, accounting for 80.37%. The average indirect cost was 2 818.6 yuan, accounting for 17.05%. The average direct non-medical expenses was 427.5 yuan, accounting for 2.59%.Conclusions:The burden of hepatitis B-related liver cancer in Yantai from 2018 to 2019 was the highest, followed by cirrhosis, and burden by hepatitis B was the relatively low.
Objective:To describe the follow-up of a hepatitis C (HCV) related intervention study based on social software, and analyze the associated factors of the follow-up.Methods:The baseline data (including general demographic information, sexual behavior, HIV testing, and previous HCV knowledge) and follow-up of the intervention study were analyzed. Chi-square test was used to compare the difference of successful follow-up rate between different characteristics, and logistic regression was used to analyze the associated factors affecting successful follow-up.Results:A total of 1 180 subjects were included in this intervention study, and the age group was mainly 19-29 years old, accounting for 49.1% (579). The proportion of having both oral and anal sex in the past 6 months was 70.5% (832). Multiple sexual partners was common, accounting for 56.3% (664). Two hundred and thirty-seven participants were followed up successfully and rate of follow-up was 20.1%. Univariate analysis showed that the rate of follow-up among persons with older in age, heard about HCV and previous HIV testing were higher. The results of regression analysis showed that compared with the 19-29 years old group, the 40-49 years old group and the group of 50 years old and above were more likely to had successful follow-up, and the OR (95% CI) values were 1.7 (1.1-2.7) and 3.5 (2.0-6.2), respectively. Compared with those who had never heard of hepatitis C, those who had heard of hepatitis C were more likely to accept follow-up, with an OR (95% CI) value of 1.6 (1.2-2.3). Compared with those who had not been tested for HIV previously, those who had been tested for HIV were more likely to be successfully followed up, with an OR (95% CI) value of 1.9 (1.1-3.1). Conclusions:The follow-up rate in an online health intervention program of HCV should be improved and pay more attention to the younger people during the follow-up. HIV counseling and testing and other means should be fully applied to promote HCV knowledge, improve the awareness rate, for more effective follow-up.
