目的 了解2016-2020年广东省华支睾吸虫病高流行地区的人群感染状况,为制订防控策略提供依据.方法 2016-2020年,将广东省江门市新会区按地理方位划分为东、西、南、北、中5个片区,每个片区随机选择1个乡(镇)(大鳌镇、三江镇、沙堆镇、司前镇、崖门镇)为固定监测点,每年每个乡(镇)整群抽取一个行政村中的3周岁以上常住居民200人以上,采集人群粪样,采用改良加藤厚涂片法检查华支睾吸虫虫卵(一粪两检).采用X2检验比较组间率的差异.结果 2016-2020年,新会区5个监测点共检测人群粪样5 116份,总感染率为14.6％(749/5 116).2016-2020年监测人群华支睾吸虫感染率分别为23.1％(237/1 025)、15.5％(156/1 005)、13.1％(134/1 021)、13.8％(142/1 031)、7.7％(80/1 034),年感染率呈下降趋势,不同年份间感染率差异有统计学意义(x2=101.56,P＜0.01).5个固定监测点的人群感染率分别为大鳌38.7％(404/1 045),司前 13.9％(142/1 025),三江 10.5％(105/1 003),沙堆 6.0％(61/1 017)和崖门 3.6％(37/1 026),不同地区间感染率差异有统计学意义(x2=657.67,P＜0.01).感染者平均年龄为43.1岁,＜18岁组感染率最低,为5.6％(79/1 415);61～70岁组感染率最高,为20.6％(97/470);不同年龄组间感染率差异有统计学意义(x2=137.0,P＜0.01).不同职业人群以公职人员感染率最高,为24.7％(36/146),不同职业人群感染率差异有统计学意义(x2=156.44,P＜0.01).不同文化程度人群以文盲、半文盲人群感染率最高,为16.8％(17/101),不同文化程度人群感染率差异无统计学意义(x2=9.33,P＞0.05).男性感染率为16.5％(412/2 492),高于女性的12.8％(337/2 624)(x2=13.93,P＜0.01).感染者中,轻度占 97.2％(728/749)、中度占 2.8％(21/749),无重度感染.结论 2016-2020年广东省华支睾吸虫病高流行地区监测人群华支睾吸虫感染率仍然较高,但总体呈现下降趋势,以轻度感染为主,今后需要重点监测18岁以上的男性人群.

目的 构建基层医疗卫生机构突发急性传染病防控职责,为开展防控工作提供借鉴指导.方法 通过查阅文献初步拟定职责指标,按Likert 5级评分法设计咨询问卷;采用德尔菲法进行两轮专家咨询,依据指标重要性得分筛选职责指标.结果 构建了 38项防控职责,排在第一位的防控职责为"预检分诊",排在第二位的依次为"协助疾病预防控制中心开展相关样本采集与送检""协助疾病预防控制中心开展密切接触者追踪查找""医务人员个人防护"等,排在第三位的依次为"协助疾病预防控制中心进行流行病学调查""发热患者的报告与管理""密切接触者的隔离管理""对全体基层医务人员进行防控知识和院内感染知识培训".两轮咨询的统计指标均满足相关要求.结论 基层医疗卫生机构突发急性传染病防控职责客观可信,可为政策制定者提供科学参考和依据.

The conronavirus disease 2019 (COVID-19) pandemic exerts a major impact on the world. Understanding the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can help public health personnel to define the prevention and control priorities in practical work. This study summarized the existing literature (update to May 2, 2022) and analyzed and classified the main transmission routes of SARS-CoV-2 based on typical cases and laboratory studies, and proposed relevant prevention and personal protection strategies to provide a basis for more accurate and effective control of SARS-CoV-2 transmission.

Currently, people all over the world have been affected by coronavirus disease 2019 (COVID-19). Fighting against COVID-19 is the top priority for all the countries and nations. The development of a safe and effective COVID-19 vaccine is considered the optimal way of ending the pandemic. Three hundred and 44 vaccines were in development, with 149 undergoing clinical research and 35 authorized for emergency use as to March 15 of 2022. Many studies have shown the effective role of COVID-19 vaccines in preventing SARS-CoV-2 infections as well as serious and fatal COVID-19 cases. However, tough challenges have arisen regarding COVID-19 vaccines, including long-term immunity, emerging COVID-19 variants, and vaccine inequalities. A systematic review was performed of recent COVID-19 vaccine studies, with a focus on vaccine type, efficacy and effectiveness, and protection against SARS-CoV-2 variants, breakthrough infections, safety, deployment and vaccine strategies used in the real-world. Ultimately, there is a need to establish a unified evaluation standard of vaccine effectiveness, monitor vaccine safety and effectiveness, along with the virological characteristics of SARS-CoV-2 variants; and determine the most useful booster schedule. These aspects must be coordinated to ensure timely responses to beneficial or detrimental situations. In the future, global efforts should be directed toward effective and immediate vaccine allocations, improving vaccine coverage, SARS-CoV-2 new variants tracking, and vaccine booster development.

Background Quantitative point-of-care testing assay for detecting antibodies is critical to COVID-19 control. In this study, we established an up-conversion phosphor technology-based point-of-care testing (UPT-POCT), a lateral flow assay, for rapid COVID-19 diagnosis, as well as prediction of seral neutralizing antibody (NAb) activity and protective effects. Methods UPT-POCT was developed targeting total antibodies against the receptor-binding domain (RBD) of SARS-CoV-2 spike protein. Using ELISA as a contrast method, we evaluated the quantitation accuracy with NAb and serum samples. Cutoff for serum samples was determined through 70 healthy and 140 COVID-19 patients. We evaluated the cross-reactions with antibodies against other viruses. Then, we performed multi-center clinical trials of UPT-POCT, including 782 patients with 387 clinically confirmed COVID-19 cases. Furthermore, RBD-specific antibody levels were detected using UPT-POCT and microneutralization assay for samples from both patients and vaccinees. Specifically, the antibodies of recovered patients with recurrent positive (RP) reverse transcriptase-polymerase chain reaction test results were discussed. Results The ratios of signal intensities between the test and control bands on the lateral flow strip, namely, T/C ratios, was defined as the results of UPT-POCT. T/C ratios had excellent correlations with concentrations of NAb, as well as OD values of ELISA for serum samples. The sensitivity and specificity of UPT-POCT were 89.15% and 99.75% for 782 cases in seven hospitals in China, respectively. We evaluated RBD-specific antibodies for 528 seral samples from 213 recovered and 99 RP COVID-19 patients, along with 35 seral samples from inactivated SARS-CoV-2 vaccinees, and we discovered that the total RBD-specific antibody level indicated by T/C ratios of UPT-POCT was significantly related to the NAb titers in both COVID-19 patients ( r = 0.9404, n = 527; ρ = 0.6836, n = 528) and the vaccinees ( r = 0.9063, ρ = 0.7642, n = 35), and it was highly relevant to the protection rate against RP ( r = 0.9886, n = 312). Conclusion This study reveals that the UPT-POCT for quantitative detection of total RBD-specific antibody could be employed as a surrogate method for rapid COVID-19 diagnosis and prediction of protective effects.

作为基础性制度安排的基本公共卫生服务项目已实施十余年,虽然取得了一定成效,但也面临服务质量不高、服务不规范、专业服务人员不足等挑战.随着基本公共卫生服务经费的增长,工作任务不断加重,工作要求不断提高,医防割裂的工作模式和激励机制不完善,人员短缺的难题加剧.后疫情时代推动基本公共卫生服务有利于医联体、医共体的改革.整合医保、基本公共卫生服务财政补助资金,统一支配,重视家庭医生团队建设,提供医防融合的整合型医疗卫生服务,特别是落实"公益一类财政供给、公益二类绩效管理"的激励政策,有利于促进基本公共卫生服务项目工作再上新台阶.

Objectives. To describe the epidemiological characteristics and medication overview of HFMD in Guangzhou and analyze the factors of length of stay (LOS) based on TCM usage. Method. From January 1, 2014, to June 30, 2019, clinical data of HFMD (ICD-10 B08.401) as the initial diagnosis, based on HIS of five medical institutions for outpatient and inpatient cases, was collected. The inpatient cases of the five hospitals in Guangzhou were utilized for hospitalization analysis. Information extracted from the warehouse was standardized. Descriptive analysis was used for baseline characteristics, medication usage, and inpatient characteristics. Potential factors were analyzed by bivariate analysis. COX regression analysis and Kaplan–Meier analysis for calculating HRs and 95% CIs were adopted to determine the predictors of LOS. Stratified COX regression was applied to analyze the relationship between predictors and LOS and to calculate interaction. Results. A total of 14172 patients with HFMD were included. It showed that HFMD would occur in males, infants, and summer. Cause and symptoms are the two aspects of conventional Western medicine treatments, while TCM treatment of HFMD took clearing heat and detoxification as the basic principle. Inpatients with HFMD were divided into two groups by the use ratio of TCM. Age, season, and disease severity were possible correlated factors of LOS, extrapolating from their disparity in distribution. By stratified Cox regression, three factors following presented as possible contributions to shortening LOS, including TCM ≥ 0.1 (HR = 1.79, 95% CI (1.67–1.92), P < 0.01 ), winter (HR = 1.28, 95% CI (1.12–1.47)), P < 0.01 ), mild HFMD (HR = 1.93, 95% CI (1.69–2.22), P < 0.01 ). Additive interaction of TCM use and disease severity was significant (RERI = 1.014 (0.493–1.534), P < 0.01 ). Conclusion. Young children and high temperature were the risk factors of HFMD infection, which suggests that increasing surveillance for susceptible particular-age individuals and season is indispensable. Favorable factors to decrease LOS included a higher proportion of TCM use, mild HFMD, and onset in winter. The proportion of TCM use had additive interaction with disease severity, indicating that TCM may have antiviral and other biological effects on HFMD. Increasing the proportion of TCM use was probably beneficial to shortening LOS.

目的 分析2008-2019年广东省新报告HIV/AIDS病例随访检测随时间变化趋势及相关影响因素.方法 通过AIDS综合防治信息系统中历年的报告卡以及随访数据库,采用Joinpoint回归分析模型了解HIV感染者随访检测指标的年度变化情况,用Logistic回归分析模型分析相关影响因素.结果 2012年为新报告HIV/AIDS病例随访与CD4+T淋巴细胞检测比例趋势变化转折点,2008-2012年间呈快速上升趋势(β=0.3,P＜0.001),2012-2019年呈小幅上升趋势;不同地区、不同年龄组的随访检测比例随时间变化的趋势不同.控制其他因素后,发现时间、地区、社会人口学特征、传播途径、发现途径及流动情况,为新报告HIV/AIDS病例完成随访检测的影响因素.结论 2008-2019年广东省AIDS感染者和病人随访管理工作取得了显著进展,但2013年后随访管理工作进展较缓慢.非珠三角地区、高年龄组人群应引起关注.下一步应因地制宜,根据人群特征制定有针对性的工作策略,进一步加强各随访单位的业务能力,做好异地流动的转介工作.

Risk assessment of the intra-city spatio-temporal spreading of COVID-19 is important for providing location-based precise intervention measures, especially when the epidemic occurred in the densely populated and high mobile public places. The individual-based simulation has been proven to be an effective method for the risk assessment. However, the acquisition of individual-level mobility data is limited. This study used publicly available datasets to approximate dynamic intra-city travel flows by a spatio-temporal gravity model. On this basis, an individual-based epidemic model integrating agent-based model with the susceptible-exposed-infectious-removed (SEIR) model was proposed and the intra-city spatio-temporal spreading process of COVID-19 in eleven public places in Guangzhou China were explored. The results indicated that the accuracy of dynamic intra-city travel flows estimated by available big data and gravity model is acceptable. The spatio-temporal simulation method well presented the process of COVID-19 epidemic. Four kinds of spatial-temporal transmission patterns were identified and the pattern was highly dependent on the urban spatial structure and location. It indicated that location-based precise intervention measures should be implemented according to different regions. The approach of this research can be used by policy-makers to make rapid and accurate risk assessments and to implement intervention measures ahead of epidemic outbreaks.

Objective:To analyze the course of disease and epidemiological parameters of COVID-19 and provide evidence for making prevention and control strategies.Methods:To display the distribution of course of disease of the infectors who had close contacts with COVID-19 cases from January 1 to March 15, 2020 in Guangdong Provincial, the models of Lognormal, Weibull and gamma distribution were applied. A descriptive analysis was conducted on the basic characteristics and epidemiological parameters of course of disease.Results:In total, 515 of 11 580 close contacts were infected, with an attack rate about 4.4%, including 449 confirmed cases and 66 asymptomatic cases. Lognormal distribution was fitting best for latent period, incubation period, pre-symptomatic infection period of confirmed cases and infection period of asymptomatic cases; Gamma distribution was fitting best for infectious period and clinical symptom period of confirmed cases; Weibull distribution was fitting best for latent period of asymptomatic cases. The latent period, incubation period, pre-symptomatic infection period, infectious period and clinical symptoms period of confirmed cases were 4.50 (95% CI:3.86-5.13) days, 5.12 (95% CI:4.63-5.62) days, 0.87 (95% CI:0.67-1.07) days, 11.89 (95% CI:9.81-13.98) days and 22.00 (95% CI:21.24-22.77) days, respectively. The latent period and infectious period of asymptomatic cases were 8.88 (95% CI:6.89-10.86) days and 6.18 (95% CI:1.89-10.47) days, respectively. Conclusion:The estimated course of COVID-19 and related epidemiological parameters are similar to the existing data.

Objective: To analyze the epidemiological characteristics and influencing factors of COVID-19 confirmed cases with viral nucleic acid re-positive in anal and/or throat swabs after discharge during the domestic imported epidemic stage in Guangdong Province in early 2020. Methods: The COVID-19 confirmed cases with the onset time before March 1, 2020 in Guangdong Province were collected to analyze the demographic data, epidemiological characteristics, and specimen collection and testing data after discharge. Logistic regression model was used for influencing factors analysis of re-positive cases. Results: A total of 1 286 COVID-19 confirmed cases were included, the M(Q1,Q3) of age was 44(32,58)years, 617 cases were male, 224 cases were re-positive in anal and/or throat swabs with the re-positive rate 17.42%. The M(Q1,Q3) of age of re-positive cases was 35(23, 50) years, which was younger than that of re-negative cases age was those 46(33, 59) years (P<0.001). With the increase of age, re-positive rate decreased (χ2trend=52.73, P<0.001). 85.27% (191/224) of re-positive cases were found in 14 d after discharge, the duration time of re-positive status was 13(7, 24) d, and 81.69% (183/224) of re-positive cases were re-tested negative in 28 d after re-positive date. No fever and other symptoms had been observed among re-positive cases during the whole follow-up. No secondary infectious cases had been found among close contacts after 14 d of centralized isolation and sampling screening. Univariate logistic regression model analysis revealed that the influencing factors of the re-positive cases included age, occupation, clusters, clinical types, and admission time. Multivariate logistic regression model analysis revealed that age was an independent risk factor. Conclusions: SARS-CoV-2 viral nucleic acid re-positive is found in COVID-19 confirmed cases after discharge in Guangdong Province. Most re-positive cases are confirmed among 14 d after discharge and re-test to negative among 28 d after re-positive date. Age is an risk factor for re-positive cases after discharge.

Nipah virus disease (NVD) is a newly emerged zoonosis with a case fatality rate of 40%-75%. NVD is a severe threat to human health and the development of livestock farming. NVD has become one of the emerging infectious diseases with great concern globally during more than 20 years. Nipah virus (NiV) is a pathogen for NVD, the natural host of which is Fruit bats of the Pteropodidae family. The clinical spectrum of NiV infection is broad, including asymptomatic infection, acute respiratory infection, fatal encephalitis, and even death. Since NiV was first identified in Malaysia in 1999, it has been prevalent mainly in Southeast Asia and South Asia. NiV is primarily transmitted to humans through bat-pig-human, contaminated food. Currently, there are no specific therapeutic drugs and vaccines for NVD. Although there are no cases of NVD reported in China, which has close personnel and trade exchanges with major NVD-endemic countries, and NiV antibody has also been detected in relevant bats. There is a potential risk of importing NVD and domestic outbreaks in the future in this country. This paper provides a systematic review of the research progress in the prevention and control of NVD etiology, epidemiology, clinical manifestations and laboratory diagnosis to help relevant staff to understand NVD more comprehensively and systematically.

Public health decision-making may have great uncertainty especially in dealing with emerging infectious diseases, so it is necessary to establish a collaborative mechanism among modelers, epidemiologists, and public health decision-makers to reduce the uncertainty as much as possible. We searched the relevant studies on transmission dynamics modeling of infectious diseases, SARS, MERS, and COVID-19 as of March 1, 2021 based on PubMed. We compared the key health decision-making time points of SARS, MERS, and COVID-19 prevention and control, and the publication time points of modeling research, to reveal the collaboration between infectious disease modeling and public health decision-making in the context of the COVID-19 pandemic. Searching with infectious disease and mathematical model as keywords, there were 166, 81 and 1 289 studies on the modeling of infectious disease transmission dynamics of SARS, MERS, and COVID-19 were retrieved respectively. Based on the modeling application framework of public health practice proposed in the current study, the collaboration among modelers, epidemiologists and public health decision-makers should be strengthened in the future.

目的 于2020年3月调查广东省居民新型冠状病毒肺炎(COVID-19)相关知识知晓情况,为提高COVID-19预防意识和采取预防措施提供依据.方法 自行设计调查问卷,采用"问卷星"制作电子问卷并通过"广东疾控"微信公众号推送调查;采用方便抽样方法收集居民基本情况,分析COVID-19一般知识、预防措施、消毒措施和口罩使用的认知情况.结果 回收有效问卷2 743份,不同学历、年龄、职业居民COVID-19相关知识得分差异均有统计学意义(P＜0.05);其中硕士学历、年龄≥60岁和公务员/其他事业单位人员得分较高,分别为(8.28±0.98)分、(8.35±1.06)分和(7.86±1.07)分.COVID-19预防措施正确率较高,为84.18％;口罩使用、一般知识正确率分别为63.49％和72.68％;消毒措施相关知识正确率较低,仅为58.17％.结论 2020年3月,广东省居民COVID-19一般知识知晓水平较高,但消毒措施知识比较欠缺.

Background: It is much valuable to evaluate the comparative effectiveness of the coronavirus disease 2019 (COVID-19) prevention and control in the non-pharmacological intervention phase of the pandemic across countries and identify useful experiences that could be generalized worldwide. Methods: In this study, we developed a susceptible–exposure–infectious–asymptomatic–removed (SEIAR) model to fit the daily reported COVID-19 cases in 160 countries. The time-varying reproduction number (Rt) that was estimated through fitting the mathematical model was adopted to quantify the transmissibility. We defined a synthetic index (IAC) based on the value of Rt to reflect the national capability to control COVID-19. Results: The goodness-of-fit tests showed that the SEIAR model fitted the data of the 160 countries well. At the beginning of the epidemic, the values of Rt of countries in the European region were generally higher than those in other regions. Among the 160 countries included in the study, all European countries had the ability to control the COVID-19 epidemic. The Western Pacific Region did best in continuous control of the epidemic, with a total of 73.76% of countries that can continuously control the COVID-19 epidemic, while only 43.63% of the countries in the European Region continuously controlled the epidemic, followed by the Region of Americas with 52.53% of countries, the Southeast Asian Region with 48% of countries, the African Region with 46.81% of countries, and the Eastern Mediterranean Region with 40.48% of countries. Conclusion: Large variations in controlling the COVID-19 epidemic existed across countries. The world could benefit from the experience of some countries that demonstrated the highest containment capabilities.

Objectives: We aimed to estimate the time-varying transmission dynamics of COVID-19 in China, Wuhan City, and Guangdong province, and compare to that of severe acute respiratory syndrome (SARS). Methods: Data on COVID-19 cases in China up to 20 March 2020 was collected from epidemiological investigations or official websites. Data on SARS cases in Guangdong Province, Beijing, and Hong Kong during 2002-3 was also obtained. We estimated the doubling time, basic reproduction number (R-0), and time-varying reproduction number (R-t) of COVID-19 and SARS. Results: As of 20 March 2020, 80,739 locally acquired COVID-19 cases were identified in mainland China, with most cases reported between 20 January and 29 February 2020. The R-0 value of COVID-19 in China and Wuhan was 5.0 and 4.8, respectively, which was greater than the R-0 value of SARS in Guangdong (R-0 = 2.3), Hong Kong (R-0= 2.3), and Beijing (R-0 = 2.6). At the start of the COVID-19 epidemic, the R-t value in China peaked at 8.4 and then declined quickly to below 1.0 in one month. With SARS, the R-t curve saw fluctuations with more than one peak, the highest peak was lower than that for COVID-19. Conclusions: COVID-19 has much higher transmissibility than SARS, however, a series of prevention and control interventions to suppress the outbreak were effective. Sustained efforts are needed to prevent the rebound of the epidemic in the context of the global pandemic. (C) 2020 Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

Objectives: The moving epidemic method (MEM) has been well used for assessing seasonal influenza epidemics in temperate regions. This study used the MEM to establish epidemic threshold for influenza in Guangdong, a subtropical province in China. Methods: Influenza virology surveillance data from 2011/2012 to 2017/2018 seasons in Guangdong were used with the MEM to calculate the epidemic thresholds and timeously detect the 2018/2019 influenza season epidemic. The weekly positive proportion of influenza A(H1N1)pdm09, A(H3N2), B/Victoria-lineage and B/Yamagata-lineage were separately adapted to calculate the subtype-specific epidemic thresholds. The performance of MEM was evaluated using a cross-validation procedure. Results: For the 2018/2019 influenza season, the epidemic threshold of a weekly positive proportion was 15.08%. Epidemic detection for the 2018/2019 season was 1 week in advance. Influenza A(H1N1)pdm09, B/Yamagata-lineage and B/Victoria-lineage prevailed during winter and spring and their epidemic thresholds were 5.12%, 4.53% and 4.38%, respectively. Influenza A(H3N2) was active in the summer, with an epidemic threshold of 11.99%. Conclusions: Using influenza virology surveillance data stratified by types of influenza virus, the MEM was effectively used in Guangdong, China. This study provided a practical way for subtropical regions to establish local influenza epidemic thresholds.

Background: Nonpharmaceutical interventions (NPIs) are public health measures that aim to suppress the transmission of infectious diseases, including border restrictions, quarantine and isolation, community management, social distancing, face mask usage, and personal hygiene. This research aimed to assess the co-benefits of NPIs against COVID-19 on notifiable infectious diseases (NIDs) in Guangdong Province, China.Methods: Based on NID data from the Notifiable Infectious Diseases Surveillance System in Guangdong, we first compared the incidence of NIDs during the emergency response period (weeks 4–53 of 2020) with those in the same period of 2015–2019 and then compared that with the expected incidence during the synchronous period of 2020 for each city by using a Bayesian structural time series model.Findings: A total of 514,341 cases of 39 types of NIDs were reported in Guangdong during the emergency response period in 2020, which decreased by 50·7% compared with the synchronous period during 2015–2019. It was estimated that the number of 39 NIDs during the emergency response in 2020 was 65·6% (95% credible interval [CI]: 64·0% – 68·2%) lower than expected, which means that 982,356 (95% CI: 913,443 – 1,105,170) cases were averted. The largest reduction (82·1%) was found for children aged 0–14 years. For different categories of NIDs, natural focal diseases and insect-borne infectious diseases had the greatest reduction (89·4%), followed by respiratory infectious diseases (87·4%), intestinal infectious diseases (59·4%), and blood-borne and sexually transmitted infections (18·2%). Dengue, influenza, and hand-foot-and-mouth disease were reduced by 99·3%, 95·1%, and 76·2%, respectively. Larger reductions were found in the regions with developed economies and a higher number of COVID-19 cases.Interpretation: NPIs against COVID-19 may have a large co-benefit on the prevention of other infectious diseases in Guangdong, China, and the effects have heterogeneity in populations, diseases, time and space.Funding: Key-Area Research and Development Program of Guangdong Province

Background: Different interventions targeting live poultry markets (LPMs) are applied in China for controlling avian influenza A (H7N9), including LPM closure and "1110" policy (i.e., daily cleaning, weekly disinfection, monthly rest day, zero poultry stock overnight). However, the interventions' effectiveness has not been comprehensively assessed. Methods: Based on the available data (including reported cases, domestic poultry volume, and climate) collected in Guangdong Province between October 2013 and June 2017, we developed a new compartmental model that enabled us to infer H7N9 transmission dynamics. The model incorporated the intrinsic interplay among humans and poultry as well as the impacts of absolute humidity and LPM intervention, in which intervention strategies were parameterized and estimated by Markov chain Monte Carlo method. Results: There were 258 confirmed human H7N9 cases in Guangdong during the study period. If without interventions, the number would reach 646 (95%CI, 575-718) cases. Temporal, seasonal and permanent closures of LPMs can substantially reduce transmission risk, which might respectively reduce human infections by 67.2% (95%CI, 64.3%-70.1%), 75.6% (95%CI, 73.8%-77.5%), 86.6% (95%CI, 85.7-87.6%) in total four epidemic seasons, and 81.9% (95%CI, 78.7%-85.2%), 91.5% (95%CI, 89.9%-93.1%), 99.0% (95%CI, 98.7%-99.3%) in the last two epidemic seasons. Moreover, implementing the "1110" policy from 2014 to 2017 would reduce the cases by 34.1% (95%CI, 20.1%-48.0%), suggesting its limited role in preventing H7N9 transmission. Conclusions: Our study quantified the effects of different interventions and execution time toward LPMs for controlling H7N9 transmission. The results highlighted the importance of closing LPMs during epidemic period, and supported permanent closure as a long-term plan.

目的 了解《登革热诊断标准(WS216-2018)》(《标准》)的实施情况、效果及其使用过程中遇到的问题,为《标准》修订和促进实施提供参考.方法 选择广东省、浙江省、重庆市的综合医院、社区卫生服务中心、疾病预防控制中心(CDC)、海关检疫部门的人员进行问卷调查和现场调研,采用EpiData 3.1软件建立数据库,用SPSS 22.0软件进行统计分析,采用x2检验、方差分析和Kruskal-Wallis H检验比较组间差异.结果 共调查61家机构,共收回637份问卷,其中广东省443份(69.54％)、重庆市102份(16.01％)、浙江省92份(14.44％).所属机构类型以综合医院(86.66％)为主,机构归属以区/县级(56.51％)为主.研究对象对《标准》的总掌握率为67.66％,其中广东省的掌握率(69.31％)高于重庆市(66.36％)和浙江省(61.14％),综合医院的掌握率(67.02％)总体低于社区卫生服务中心(69.05％)和CDC(74.43％).既往通过培训宣贯的途径知晓《标准》的比例最高,占76.61％.每次均使用该《标准》的临床医生占25.84％,28.50％经常使用,33.63％偶尔使用,12.03％几乎不使用.73.45％和64.25％的临床医生能分别正确回答发病5d内和7d后的疑似病例应开展的检测项目.仅42.48％的临床医生能全部正确回答所在医院开设的具体登革热诊断检测项目.96.55％的综合医院可以开展登革病毒NS1抗原筛查,所调查的广东省社区卫生服务中心中有87.50％可开展此筛查,浙江省2家社区卫生服务中心均可开展,重庆市的社区卫生服务中心均不能开展.调查的重庆市和浙江省3家CDC均可开展登革病毒核酸检测,调查的广东省的CDC中有58.33％可开展此检测,非珠三角地区的区级CDC尚不能开展.《标准》在实施过程中,与相关规范性文件保持了较好的一致性.结论 登革热诊断相关医务工作者对《标准》的掌握率和使用率较低,《标准》的培训宣贯工作需进一步加强.