BACKGROUND:Whether the impact of vision impairment (VI)/hearing impairment (HI) on depressive symptoms changes over time has not been investigated. This study aimed to examine the complex dynamic associations between VI/HI and depressive symptoms to design effective prevention strategies for older Chinese adults. METHODS:Data were from the China Health and Retirement Longitudinal Study (CHARLS). The study identified self-reported VI, HI, depressive symptoms, and other covariates (including social isolation). Logistic regression models were used to analyze the dynamic associations across three waves, with the assessment of multiplicative and additive interactions. RESULTS:Of the 8519 participants in wave 1 (mean [SD] age, 62.0 [8.0] years, 49.5 % male), 38.5 % had depressive symptoms. After adjusting for covariates including social isolation, VI and HI were significantly associated with depressive symptoms across all three waves. Specifically, the adjusted odds ratio (AOR) of VI increased from 2.08 (95 % CI: 1.89 to 2.29) in wave 1 to 2.15 (95 % CI: 1.90 to 2.44) in wave 3; while the AOR of HI increased from 1.80 (95 % CI: 1.58 to 2.04) in wave 1 to 2.11 (95 % CI: 1.75 to 2.51) in wave 3. The additive interactions between VI and HI on depressive symptoms in each wave (e.g., RERI [95 % CI]: 7.90 [2.51 to 12.30] in wave 1) were significant without adjusting for social isolation. CONCLUSION:The study suggests that VI and HI are consistently associated with depressive symptoms among older adults in China over a four-year period, and their influences on mental health deserve more attention.

Objective To understand the change of incidence of notifiable communicable diseases in Guangzhou during the epidemic of COVID-19 in 2020. Methods The data in this study were collected from the National Communicable Disease Reporting Information System. We applied descriptive analysis to compare the incidence of reported notifiable communicable diseases in Guangzhou for COVID-19 in four different time stages in 2020 and 2015-2019. R 3.5.0 software was used for statistical analysis. Results The incidence rate of reported notifiable communicable diseases in four different time stages in Guangzhou was 272.38/10~5, 51.16/10~5, 130.34/10~5 and 664.25/10~5 in 2020, respectively. The incidence rates increased by 187.76%,-30.37%,-57.64% and-41.85% respectively, compared with the average level in 2015-2019, especially the incidence rate of class C communicable diseases. All kinds of different transmission communicable diseases of class A and B decreased significantly after starting the first-level response. However, it decreased slowly in the second and third level response except for natural focal communicable diseases and vector-borne diseases. The incidence rate of acute communicable diseases such as influenza decreased significantly after the first-level response and decreased faster after the second-level response. However, the incidence rate of chronic communicable diseases such as HIV/AIDS, syphilis and hepatitis B decreased after the first-level response, but declined narrowed after the second and third level response. Conclusions The incidence rate of reported notifiable communicable diseases has changed significantly before and after the epidemic of COVID-19, especially that of acute communicable diseases such as influenza, and even in the late stage of the epidemic.

ObjectiveTo assess epidemiological features of imported and indigenous dengue fever cases and phylogenetic features of dengue virus prevalent in the cases in Guangzhou, Guangdong province in 2019 and to explore the impact of imported cases on dengue fever epidemics in the city. MethodsThe data on all dengue fever cases registered in Guangzhou city in 2019 were extracted from the National Notifiable Infectious Disease Reporting System. The demographic and epidemiological features of the reported cases were statistically analyzed. The envelope (E) gene of the dengue viruses isolated from the cases was sequenced and analyzed to construct maximum likelihood phylogenetic trees. ResultsAmong 1655 dengue fever incidents yearly registered in the city, 273 and 1 382 were imported and local cases. Of the imported cases with a male to female ratio of 2.85 : 1, 86.45% were aged 20 to 49 years, mainly being engaged in commercial service, housework and general industries. The imported cases occurred in every month of the year but more cases were reported during June and August. The most (90.38%) of the imported cases were from Southeast Asia. For the reported local dengue fever cases, the male to female ratio was 1.07 : 1 and 89.87% were at ages of 20 – 69 years; main occupations of the local cases included houseworker, unemployee, commercial service worker and retiree; the local cases were reported during June – December and more cases were reported during August – October of the year. E gene sequences of the virus isolated from the local cases displayed close associations with sequences from imported cases and with those of prevalent virus in Southeast Asia. ConclusionThe epidemic of dengue fever in Guangzhou city was affected by the imported dengue fever cases and the local prevalence of dengue fever in 2019 was likely being induced by the imported cases.

目的 评价广东省广州市新型冠状病毒肺炎(COVID-19)网络直报质量,总结经验,发现存在问题,分析影响因素,提出改进措施.方法 通过中国疾病信息报告管理系统中获取COVID-19报告卡,收集汇总广州市各疾病预防控制中心现场流行病学调查资料,应用漏报率、迟报率、报告卡填写不完整率、报告卡填写不准确率、报告卡与流行病学调查资料不一致率、重复报告率等评价指标体系,运用SPSS 16.0软件对广州市COVID-19的网络直报质量进行评价.结果 COVID-19漏报率为0,迟报率0.05％、报告卡填写不完整率1.62％、报告卡填写不准确率3.97％、报告卡与流行病学调查资料不一致率3.88％,报告卡重复报告率13.25％.结论 广州市COVID-19报告时效性良好,报告卡填写质量有待提高,在今后的工作中应针对薄弱环节制定行之有效的措施.并继续完善系统,为及时研判COVID-19疫情发生发展趋势提供重要支撑.

目的 了解新型冠状病毒肺炎疫点终末消毒工作情况.方法 采用电子调查表方式收集广州市新型冠状病毒肺炎确诊病例疫点终末消毒工作信息,对消毒前准备、现场消毒操作和重点部位消毒情况进行分析.结果 截至2020年3月14日,广州市11个区针对新型冠状病毒肺炎确诊病例疫点累计开展终末消毒351次,疫点终末消毒执行率为100％,现场消毒操作流程基本符合疫源地终末消毒工作程序.中心城区执行消毒次数较多,占76.6％;消毒环境以病例家居为主,占76.6％;执行单位中区疾病预防控制中心消毒次数最多,占45.9％;累计消毒面积达26.1万平方米,消毒容积为69.7万立方米.结论 广州市新型冠状病毒肺炎确诊病例疫点终末消毒工作基本符合规范程序.

蚊媒传染病对我国公共卫生造成了巨大的威胁,蚊媒监测是掌握蚊虫种群分布、季节消长和抗药性的主要方法.本文对广州市蚊媒监测的现状和存在问题进行了回顾分析,提出了加大蚊媒监测经费投入、提高专业技术人员种类鉴定能力、建立蚊媒监测电子化平台、加强监测结果的深入挖掘和资源整合等建议.

Objective: Analyze epidemiological situation of dengue fever,and survey impacts of four serotypes dengue viruses in Guangzhou, 2019. Methods: Information of patients was collected in Notifiable Infectious Disease Report System (NIDRS). Spatial autocorrelation of dengue cases was evaluated using ArcGIS version 10.2. Serum samples were tested by real-time PCR. Virus strains were isolated from positive sera. Then E gene was sequenced. Phylogenetic trees were including PhyMLsoftwarev 3.1. Results: A total of 1 655 dengue cases, consisted of 1 382 local cases and 273 imported cases, was confirmed in 2019. The incidence was 11.10 per 100 000 dengue cases were autocorrelated in Guangzhou. There were 18 high-high clusters. Most of the imported dengue cases were imported from Southeast Asian countries (86.08%,235/273) and African countries (2.56%,7/273). Of 749 serum samples detected by real-time PCR, the positive rate was 93.06% (697/749). Four hundred and sixty-four dengue virus strains had been isolated in 2019. Compared with data from the genotype tree of the former years, no genotype shift was discovered. Serotype 1 was still predominant. Serotype 2 was the significant strain in Baiyun district and Liwan district. Conclusions: Dengue fever was spreading all over Guangzhou in 2019. The suburban areas, which played a more critical role in causing the spread and outbreak of dengue fever, should be given more prominence. Inspection at ports should be enforced to prevent importing cases from African countries and Southeast Asian countries. The risk of serotype 2 cannot be overlooked. Four serotypes dengue viruses prevailed simultaneously in Guangzhou, which warns us to take precaution of severe dengue outbreaks.

目的 探讨应用差分自回归移动平均(autoregressive intergrated moving average,ARI-MA)乘积季节模型预测广州市肺结核月发病数的可行性,为制定防控措施提供参考依据.方法 利用2010年1月至2019年6月广州市肺结核月发病数据建立ARIMA模型,并以2019年7-12月数据对模型的预测效果进行验证.结果 2010-2019年广州市共报告肺结核124 311例,总体呈下降趋势.2月发病数最少,3-4月发病数最多.拟合出的最佳模型ARIMA(0,1,1)(0,1,1)12对广州市2019年7-12月肺结核月发病数预测结果 显示实际值和预测值相对误差范围介于0.08％?11.33％,平均相对误差为1.46％.结论 ARIMA(0,1,1)(0,1,1)12模型可用于广州市肺结核月发病数的短期预测.

目的 分析广州市儿童肺结核流行特征及变化趋势,为制定科学防控措施提供参考依据.方法 收集2006—2020年广州市0～14岁儿童肺结核发病报告数据,分析疾病的三间分布,同时采用Joinpoint回归模型进行发病率趋势分析.结果 共报告0～14岁儿童肺结核1397例,占全人口肺结核报告发病例数的0.66％,报告发病率由2006年的7.31/10万降至2020年的2.90/10万,总体呈下降趋势,年均下降3.90％(AAPC=-3.90,95％CI:-5.64～-2.13),男性年均下降速度(AAPC=-4.74,95％CI:-6.77～-2.66,P<0.01)较女性年均下降速度(AAPC=-2.86,95％CI:-4.78～-0.91,P<0.01)更快;城区儿童肺结核报告发病率年均下降4.14％(AAPC=-4.14,95％CI:-5.99～-2.24,P<0.01),农村儿童发病率无明显变化趋势(β=-0.02,t=1.00,P=0.34),但总体报告发生率略低于城区儿童;0～2岁组和10～14岁组儿童肺结核报告发生率相对较高,除10～14岁组儿童肺结核报告发病率无明显变化趋势外,其他年龄组儿童均呈下降趋势.结论 广州市0～14岁儿童肺结核报告发生率总体呈下降趋势,农村儿童以及10～14岁组儿童下降趋势不明显,需重点加强此类儿童结核病防控工作.

Objective: To analyze the sensitivity and specificity of SARS-CoV-2 nucleic acid testing in 20 348 close contacts of COVID-19 cases in different prevention and control stages in Guangzhou and to provide scientific evidence for optimizing epidemic response strategies. Methods: A total of 20 348 close contacts of COVID-19 cases in Guangzhou were traced between February 21 and September 22,2020. All the close contacts were tested for the nucleic acid of SARS-CoV-2. The sensitivity and specificity of nucleic acid testing and diagnosis in the different prevention and control stages were compared. Results: In 20 348 close contacts, 12 462 were males (61.24%), the median (P25,P75) of age of them was 31.0 years (23.0,43.0), the median number (P25,P75) of nucleic acid testing for them was 2.0 (1.0,3.0), and the median (P25,P75) of their quarantine days was 12.0 (8.0,13.0) days, respectively. A total of 256 COVID-19 cases were confirmed in the close contacts after seven nucleic acid tests. In the 1st, 2nd, 3rd and 7th nucleic acid testing, the sensitivity and specificity were 69.14% and 99.99% (177 cases confirmed), 89.84% and 99.99% (230 cases confirmed), 97.27% and 99.99% (249 cases confirmed), and 100.00% and 99.98%, respectively. In the three stages of COVID-19 prevention and control in China: domestic case stage, imported case stage, and imported case associated local epidemic stage, the sensitivity of the 1st nucleic acid testing was 70.68%, 68.00% and 67.35%, and the specificity was 99.98%, 100.00% and 100.00%, respectively. Conclusions: The sensitivity of nucleic acid testing in the close contacts at the different stages were consistent with slight decrease, which might be related to the increased proportion of asymptomatic infections in the late stage of epidemic prevention and control with COVID-19 in Guangzhou. It is suggested to give three nucleic acid tests to improve the sensitivity and reduce false negative risk.

目的 了解医院洁净手术部空气消毒现况和日常管理情况,揭示洁净技术维护与空气消毒质量之间的关联,为规范开展洁净手术室维护提供依据.方法 通过问卷调查与现场采样检测相结合的方式对广州市12家三甲医院进行研究,通过关联规则分析探讨空气检测质量与消毒技术配备和维护之间的关系,通过聚类分析对调查医院进行风险分类.结果 12家医院共抽检洁净手术室19间,中心区平均合格率75.2％;周边区平均合格率64.2％;关联规则发现最终确定14条规则,院感人员配备充足、洁净技术按照规范标准进行维护与中心手术区浮游菌检测合格存在关联.层次聚类结果显示,在距离为4的情况下可将12家医院分类三类.结论 洁净手术室中心区和周边区均存在不同程度的污染,日常运行维护与手术室空气污染之间存在关联.

登革热对我国公共卫生造成了巨大的威胁,广州市登革热防控面临重大挑战.本文对广州市的登革热流行情况和传播风险进行了分析,探讨了广州市的登革热防控策略及其优势和局限性,并提出建立奖惩制度、落实属地责任、重视日常防控、加强输入性病例的监测和处置以及深入开展科学防控相关基础性研究等具体建议.

目的 对我国30个省份医疗资源配备情况进行对比,以了解不同医疗资源配置对新型冠状病毒肺炎疫情发展及规模的影响.方法 收集2019年中国卫生健康统计年鉴中卫生资源数据和国家卫生健康委公布新型冠状病毒肺炎疫情数据,采用相关分析卫生资源配置和疫情之间关联性,采用广义线性回归方法分析卫生资源配制对疫情规模的影响.结果 卫生资源和疫情控制指标Pearson相关性分析显示,每万人公共卫生医师数与峰值天数、新增开始下降天数、开始首次0新增天数呈负相关,相关系数分别为-0.402、-0.387和-0.604,差异有统计学意义(f=2.318、2.216、3.935,均P＜0.05),卫生总费用占GDP比例与累计确诊、峰值天数和开始首次0新增天数呈负相关,相关系数r分别为-0.522、-0.478和-0.637,差异有统计学意义(￡=3.250,2.856,4.675,均P＜0.05).卫生总费用占GDP比例和卫生技术人员数量对峰值天数的影响有意义,B及95％CI分别为-0.931(95％ CI:-1.740～0.122)和-0.413(95％CI:-0.734 ～0.092);每万人公共卫生医师配制数量对新增开始下降天数有影响,B及95％CI为-5.661(95％ CI:-10.665～0.657);卫生总费用占GDP比例、每万人公共卫生医师人数对开始首次0新增的天数有影响,B及95％ CI分别为-1.772(95％CI:-2.654 ～0.890)和-10.127(95％ CI:-14.408 ～5.846).结论 我国卫生资源投入仍然呈现各地发展不平衡的状况,公共卫生人员队伍配备以及经费投入不足与疫情发展有关.

目的 对2006—2018年广州市乙型病毒性肝炎流行特征进行分析.方法 数据来源于全国法定传染病疾病监测信息报告管理系统,采用描述性分析对数据进行描述,分类资料采用卡方检验,年份趋势分析采用Joinpoint软件进行年度变化百分比及趋势检验.结果 2006—2018年广州市共报告乙肝病例292674例,年平均报告发病率为182.2/10万,以慢性乙肝为主,占89.9％.男性(241.6/10万)高于女性(117.9/10万),性别比为2.0:1.2006—2018年期间,广州市乙肝报告发病率先上升,到2008年达到最高,然后逐年下降.全年月份之间并无明显差异.广州市乙肝报告平均发病年龄为39.3岁,2006—2018年平均发病年龄逐年增加.结论 广州市乙肝报告发病率在2008年后逐年下降,但报告发病率依然高于全国发病率,乙肝防控形势依然严峻,需进一步在保持儿童乙肝防控的基础上,加大成人乙肝防控工作力度,从而降低全市乙肝水平.

目的 评估政府购买病媒生物防制服务在登革热疫情防控中的效果,完善政府购买有害生物防制(PCO)服务参与登革热疫情应急处置的防控模式.方法 系统收集2019年广州市登革热病例发病、疫点评估和市级蚊媒应急队处置和评估数据,通过疫情处置持续时间和疫点累计病例数评估市级蚊媒应急控制队处置效果,采用非参数秩和检验比较政府购买服务市级蚊媒应急队参与处置与否、不同处置之间疫情发展的不同.结果 2019年广州市共报告本地病例1 478例,分布在680个疫点,其中暴发疫点143个(21.03％),市级蚊媒应急队共处置疫点28个,占总疫点数的4.12％,市级蚊媒应急队应急处置前后成蚊密度差异有统计学意义(t=6.909,P＜0.001),市级蚊媒应急队介入时疫点发生时间＜8d和处置次数≥2次的疫点,疫情持续时间和疫点病例数均少于未介入处置组(Z=3.984、2.345、2.048、3.586,均P＜0.05).结论 以政府购买服务形式成立的市级蚊媒应急队早期、充分介入疫点灭蚊,能够达到控制登革热社区传播的效果.在今后的防控中应进一步增加人员配置,建立与其他防控力量有效的监测评估和应急处置机制.

目的 对我国新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)境外输入性病例地区分布和全球病例分布进行关联性分析,为精准防控提供政策依据.方法 收集中国COVID-19境外输入性病例和全球其他国家地区病例数据,通过描述性流行病学和Spearman相关分析方法分析境外输入性病例分布及其与全球病例分布的关联性.结果 截至4月9日,中国共报告境外输入病例995例,主要分布在上海(20.20％)、广东(17.59％)、北京(17.19％)和黑龙江(8.74％);主要输入国为英国(27.74％)、美国(14.87％)、俄罗斯(12.16％)和西班牙(8.74％).使用世界卫生组织各成员国(及地区)区域划分进行地区关联性Spearman相关分析,除西太平洋和东南亚区域外,其他4个区域均有统计学意义(均有P＜0.05).结论 中国输入病例与输入国本土病例间总体相关;部分卫生体系和资源相对薄弱的国家地区疫情存在低估;中国在输入性疫情防控上,应特别关注卫生体系和资源较差的非洲、东南亚、南美等国家地区,各省可依据输入病例分布情况开展风险评估,制定和实施精准防控和分类管理措施.

Objective:To analyze the epidemic characteristics and spatio-temporal distribution of hemorrhagic fever with renal syndrome (HFRS) in Guangzhou from 2010 to 2019 and provide a basis for prevention and control strategies.Methods:The data of HFRS was from National Disease Reporting Information System and the epidemic investigation. A descriptive analysis was used. OpenGeoDa 1.2.0 software was used for global spatial autocorrelation and local spatial autocorrelation analysis. SatScan 9.6 software was used for detecting the hot spot area in time and space. ArcGIS 10.2 software was used for map visualization.Results:1 298 cases of HFRS were reported, and three patients died in Guangzhou in 2010-2019. The annual incidence rate was 0.99/100 000. The proportion of 21-50 years old cases accounted for 70.88% and the male to female ratio was 2.98∶1. Most patients were house workers or unemployed, accounting for 31.28%, followed by business servants (accounting for 17.33%). The incidence peak in spring and winter accounted for 33.74% and 26.35% of the year. All districts reported cases in recent ten years. A total of 407 cases had been reported in Haizhu district, accounting for 31.36% of the total number of cases in the whole city. The annual incidence rate was 2.52/100 000. The number of reported cases and the annual incidence rate were the highest in Guangzhou. The clustered area showed that there was spatio-temporal clustering in Guangzhou. The aggregation area was mainly concentrated in the urban villages adjacent to Wan-mu orchard and the Haizhu Lake Wetland Park in Haizhu district (logarithmic likelihood ratio was 44.08, P<0.001). Conclusions:The prevalence and concentration of HFRS in winter and spring Guangzhou city from 2010 to 2019, showed a high incidence. Young and middle-aged men engaged in domestic and unemployed, and commercial services appeared the main risk groups. The urban-rural junction with many immigrants and low health environment, streets adjacent to Wan-mu orchard, and the Haizhu Lake Wetland Park in Haizhu district were the important regions for preventing and controlling HFRS. The government should formulate prevention and control measures to curb the rise and spread of the HFRS epidemic.

目的 了解新型冠状病毒肺炎(corona virus disease 2019,COVID-19,简称新冠肺炎)疫情期间居民口罩和消毒产品使用情况及其影响因素,为进一步做好疫情防控提供科学依据.方法 采用Cronbach's仅系数和KMO值对问卷的信度和效度进行评价.2020年3月4日至5日,通过网络调查居民的人口学特征、口罩和消毒产品使用情况,并分析居民口罩和消毒产品使用的影响因素.结果 共回收有效问卷1 713份,其中男性492人(28.72％),有382人(24.12％)认为戴多层口罩会更安全,有269人(15.70％)认为口罩可以经过蒸煮后再用,有265人(15.47％)认为口罩可以经过喷酒精后再用.有1 529人(89.26％)近一个月使用消毒产品对门把手/开关/按钮(84.96％)、地面(71.88％)和马桶/便池(70.70％)进行消毒.多因素结果显示文化程度越高、年龄越大、月收入越高和企业人员更多使用口罩和消毒产品.结论 COVID-19流行期间,居民戴口罩和使用消毒产品的比例较高,但依旧存在误区,文化程度、年龄、职业和月收入对戴口罩和使用消毒产品有影响,应进行针对性的宣传教育.

目的 了解居民新型冠状病毒肺炎(新冠肺炎)消毒知识和消毒行为基本情况及其影响因素,为普及科学消毒知识,制定有效消毒措施,指导社区居民做好日常消毒工作提供科学依据.方法 2020年3月4-5日,采用自行设计问卷,通过网络调查方法调查居民的人口学特征、消毒知识和消毒行为情况.比较消毒知识得分情况,采用多因素logistic回归分析居民消毒知识得分和使用消毒产品的影响因素.结果 共收集问卷1 735份,有效问卷1 713份,问卷有效率为98.73％.居民消毒知识平均得分为(16.21±3.03).文化程度越高消毒知识得分越高(F=81.112,P＜0.001),家庭主妇消毒知识平均得分低于其它职业(F=13.562,P＜0.001),月收入越高消毒知识平均得分越高(F=28.090,P＜0.001);使用消毒产品的居民消毒知识平均得分高于不使用(F=4.207,P=0.040).多因素分析结果显示女性消毒知识得分低于男性0.777 (0.620 ～ 0.975);高中/中专/大专和本科及以上的消毒知识得分高于初中及以下,OR值和95％CI分别为2.679(1.849 ～ 3.884)和5.387(3.688 ～ 7.867);45 ～ 59岁和≥60岁的消毒知识得分高于≤29岁,OR值和95％CI分别为1.615(1.194～2.184)和1.644(1.078～2.508).对于消毒产品的使用方面,多因素分析结果显示女性、30 ～ 44岁、企业人员和其它人员更多使用消毒产品,OR值和95％CI分别为1.469(1.045 ～2.066)、1.635(1.101 ～ 2.427)、2.356(1.418 ～3.912)和2.102(1.279 ～ 3.454).另外,有93.87％的居民对消毒剂的选择、使用和安全性等知识有需求.结论 居民消毒知识水平整体较高,但依旧存在部分误区,应根据不同人群特征进行消毒知识、消毒产品使用和消毒需求方面有针对性的健康教育.

目的 分析2010-2019年广州市肺结核流行特征及时空聚集性,为制定精准防控措施提供参考依据.方法 收集2010-2019广州市肺结核发病数据,并以街镇为尺度分析肺结核发病的空间聚集性,同时采用时空扫描统计分析时空聚集性.结果 2010-2019年广州市共报告肺结核136 341例,年均发病率为103.48/10万,总体呈下降趋势(x2=712.46,P＜0.001).3～5月为发病高峰,69.59％的肺结核报告病例为男性.肺结核报告发病率全局空间自相关Moran'sI介于0.088 3～0.286 0之间(均有P＜0.05),高-高聚集区主要集中在广州市南部南沙区和西北部花都区部分街镇.时空扫描统计结果探测到2个高报告发病率聚集区和1个低报告发病率聚集区,最大可能的高报告发病率聚集区覆盖花都区的赤坭镇、炭步镇等5个街镇,低发病率主要聚集在越秀区、海珠区等中心城区.结论 2010-2019年广州市肺结核报告率总体呈下降趋势,存在时空聚集性,花都区和南沙区部分街镇应作为防控重点.