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Zhang B.-Y.,Institute of Endemic Disease | Li D.-S.,Institute of Endemic Disease | He P.,Institute of Endemic Disease | Liang Y.,Institute of Endemic Disease
Chinese Journal of Endemiology | Year: 2013

Objective: To observe the effect of health education and installation of improved stove in control of coal-burning-borne endemic fluorosis in Pingba County of Guizhou Province. Methods: Two towns (Shizi and Qibo) of Pingba County that had implemented the health education and installed the improved stoves for control of coal-burning-borne endemic fluorosis were selected as the investigation sites. Two villages in each selected town and 30 householders as well as all students of grade 4 - 6 were investigated. Questionnaires were made by survey of the fluorosis control knowledge, household investigations were used to know the use of household stoves, corn and peppers drying method, and the dental fluorosis of children aged 8 - 12 were examined by Dean methods before the intervention (2006) and after implementation (2009) of health education and improvement of stoves. Results: The awareness of fluorosis control among students and households after the intervention was 97.36% (405/416) and 86.46%(415/480), respectively, and the difference was statistically significant(χ2 = 658.86, 163.10, all P < 0.01) compared with that before the intervention[32.19%(1083/3364), 43.33%(130/300)]. Correct using rate of the household stoves was 95.42%(229/240) after the intervention and 45.85%(3976/8672) before the intervention, the difference was statistically significant (χ2 = 230.25, P < 0.01). The correct rates of drying corn and chili were 91.67%(110/120) and 97.50%(117/120) before the intervention, and 20.00%(12/60), 26.67%(16/60) after the intervention, the difference was statistically significant(χ2 = 94.07, 104.02, all P < 0.01). The incidences of dental fluorosis of children aged 8 - 12 were 31.21%(1305/4182) after the intervention and 87.71%(2856/3256) before the intervention, the difference was statistically significant(χ2 = 2371.91, P < 0.01). Conclusions: The measures of health education and intervention of stove improvement in Pingba County of Guizhou Province for prevention and control of coal-burning-borne endemic fluorosis is effective.


Zhang B.-Y.,Institute of Endemic Disease | Li D.-S.,Institute of Endemic Disease | Liang Y.,Institute of Endemic Disease | Hu X.-Q.,Institute of Endemic Disease | Zhang R.-Z.,Institute of Endemic Disease
Chinese Journal of Endemiology | Year: 2011

Objective: To study the follow-up management strategies after improving stoves for controlling coal-burning type endemic fluorosis in Guizhou and to provide a scientific basis for exploring the follow-up management measures. Methods: In 2006-2009, three counties of Puding, Bijie and Liuzhi with improved stoves in 2005 and implemented follow-up management measures for subsequent three years were chosen, 3 towns were chosen randomly in each chosen county, 2 villages were selected randomly in each chosen town, 10 households were investigated randomly in each chosen village, and 20 students were investigated of the knowledge of fluorosis control. The investigation included also the usage of the stoves, dehydration methods of grain and related conditions. Results: &circled digit oneThe head of the family and student awareness of fluorosis control were 82.6% (743/900) and 91.7%(1650/1800), respectively, and 35.0%(385/1100) and 61.0%(6605/10835), respectively, before the test, and the difference was statistically significant (χ 2 = 33.04, 1189.12, all P < 0.01). &circled digit twoThe rates of chimney out of the house were 88.5%(69/78) and 100.0%(102/102), respectively, compared with those before the trial[74.4% (2125/2856) and 2.1% (104/4984), respectively], the difference was statistically significant (χ 2 = 720.56, 4295.38, all P < 0.01). The iron stove and the table stove's airtight utilization rates were 85.9% (67/78) and 100.0% (102/102), respectively. Circled digit threeThe corn and the hot pepper's correct drying rates were 100.0%(180/180). Compared with those[27.2%(49/180) and 32.2%(58/180), respectively]before the trial, the difference was statistically significant (χ 2 = 26.68, 37.38, all P < 0.01). The corn and the hot pepper's washing rates before eating were 95.0% (57/60) and 98.3% (177/180), respectively. Compared with those [85.0% (153/180) and 77.8% (140/180)] before the trial, the difference was statistically significant (χ 2 = 135.00, 490.82, all P < 0.01). Conclusions: The target population ' s awareness and knowledge of fluorosis prevention and related behavior are significantly elevated and enhanced after implementation of the three years post-management, which has reached the desired goal. The strategies of the follow-up management suits Guizhou province and widespread application is suggested.


Zhang B.,Institute of Endemic Disease | An D.,Institute of Endemic Disease | Li D.,Institute of Endemic Disease | Yao D.,Institute of Endemic Disease | And 5 more authors.
Chinese Journal of Endemiology | Year: 2015

Objective To evaluate the effects of prevention and control measures on coal-burning-borne endemic fluorosis in the 11 historic mild illness counties of Guizhou Province and to provide a basis for further prevention and control of the disease. Methods In 2014, the resident households life behavior related to health was investigated in 11 counties. At the same time, according to the "Diagnosis of Dental Fluorosis (WS/T 208- 2011)", dental fluorosis of all children aged 8-12 was examined in the 11 counties' historic diseased areas. Results were determined using the standards for "Control Criteria for Endemic Fluorosis Areas" and "Elimination of Coal- burning-borne Endemic Fluorosis". Results A total of 1 449 villages of 11 counties were investigated. The detection rate of dental fluorosis of children aged 8-12 was ≤ 15% in each county. The qualified rate of improved stoves, the correct usage rate of qualified stoves, and the correct drying rate of chili were all > 95%. All households no longer took corn as staple food. In administrative villages, the prevalence of dental fluorosis of children aged 8 - 12 was 15% or less in all the villages with the exception of 32 villages of Pingba County; the qualified rate of improved stoves, qualified stoves correct usage, dry chili correct rate of all vallages were higher than 95%, except the 15 villages of Pingba County. Conclusions The effects of comprehensive control measures on coal-burning- borne endemic fluorosis in the 11 historic mild illness counties in Guizhou are good. Besides Pingba County, other counties have reached elimination standards. In the future, a comprehensive assessment should be done in areas which has already reached control or elimination standards. At the same time, in areas at risk of fluorine pollution, risk assessment should be carried out to find countermeasures.


Xiang Y.,Institute of Endemic Disease | Tan W.,Institute of Endemic Disease | Liu Y.,Institute of Endemic Disease | Wang X.,Institute of Endemic Disease | And 3 more authors.
Chinese Journal of Endemiology | Year: 2015

Objective To investigate the clinical diagnostic value and pathogenesis of serum protein identification in Keshan disease (KD). Methods A total of 65 chronic KD patients were selected as the patient group in KD endemic areas, while 29 cases of dilated cardiomyopathy (the DCM group), 62 healthy cases from KD endemic areas (control 1 group) and 28 healthy cases from non-endemic areas (control 2 group) were selected as controls. Liquid chip time of flight mass spectrometry (ClinProt™ MALDI-TOF-MS) was used to determine the expression of proteins/ peptide peaks. ClinProTools 2.2 software was used to analyze the protein profiles to determine differentially expressed proteins/peptide peaks. The Genetic Algorithm (GA), QuickClassifer Algorithm (QC) and Supervised Neural Network Algorithm (SNN) methods were used to screen marker proteins. Matrix-assisted laser desorption/ionization time-of-flight Mass Spectrometry technique (MALDI-TOF/TOF) was also used as a secondary mass spectrometry to identify differentially expressed peptides. Results Between the KD and control 1 groups, 34 differentially expressed proteins/peptides and 5 marker proteins were identified, while 52 differentially expressed proteins/peptides and 5 marker proteins were identified between the KD and control 2 groups, and there were 67 differentially expressed proteins/peptides and 5 marker proteins between the KD and DCM groups. During secondary mass spectrometry, two peptides for mass-to-charge ratio (m/z) 2 079 and 1 465 were obtained, peptide of matching β-globin showed low expression while peptide of matching fibrinogen showed high expression in the KD patients. Conclusions Serum marker proteins can be used as biomarkers for diagnosis and differentiation of KD. β -globin and fibrinogen play an important role in the development of KD myocardial injury.


Zhong W.,Institute of Endemic Disease | Liu L.-P.,Institute of Endemic Disease | Yang T.,Institute of Endemic Disease | Lin L.-F.,Institute of Endemic Disease | And 2 more authors.
Chinese Journal of Endemiology | Year: 2013

Objective: To assess the effectiveness of prevention program on iodine deficiency disorders and iodine nutritional status of residents in Guangdong Province. Methods: Probability proportionate to size sampling (PPS) was employed in surveillance of iodine deficiency disorders. Thirty counties (cities, districts) were selected in Guangdong Province. In each county (city, district) one township (street) was selected; in each township (street) one primary school was selected and in each primary school 40 children aged 8-10 were chosen to examine their thyroid and to collect salt samples at their home for determination of salt iodine. Out of the 40 children, 12 children were chosen to collect urine samples for determination of urinary iodine. From the primary schools chosen, 40 grade 5 students were selected for intelligence quotient (IQ) test. In the nearby of the primary schools, 3 townships (towns, street) were selected and in each township (town, street) 5 pregnant and 5 lactating women were selected to collect their urine samples for determination of urinary iodine. Type-B ultrasonic was used in measuring the thyroid volume. The iodine content of urine samples was measured by the method of arsenic and cerium catalysis spectrophotometry. The iodine content of salt was determined quantitatively with the titration method. IQ was tested by Chinese combined Raven's test. According to geographical location and the implementation of iodized salt, the effects of iodized salt on iodine deficiency disorders were analyzed in the plains and the Pearl River Delta Coastal region with mild iodine deficiency (iodized salt implementation region, referred to as the plains and the PRD), historical iodine deficiency areas (iodized implementation region) and the eastern and the western coastal areas of Guangdong (areas with non-iodized salt problem, referred to as the eastern and the western Guangdong). Results: A total of 1200 children aged 8 to 10 were examined by type-B ultrasonic test, and goiter rate was 3.5% (42/1200). The differences of goiter rate between the plains and the PRD, the historical iodine deficiency areas and the eastern and the western Guangdong were statistically significant (χ2 = 6.6, P < 0.05). The goiter rate (6.1%) in the eastern and the western Guangdong was significantly higher than that of the plains and the PRD and the historical iodine deficiency areas (3.3%, 2.0%, χ2 = 5.6, 7.1, all P < 0.05). A total of 1200 salt samples were examined. The median and coefficient of variation of iodine in the salt were 31.0 mg/kg and 23.2%, respectively. Coverage of iodized salt was 97.5% (1170/1200) while 96.1% (1153/1200) of consumed iodized salt was qualified. The median urinary iodine of 1200 children aged 8-10 was 186.5 μg/L, and the differences of median urinary iodine between the plains and the PRD, the historical iodine deficiency areas and the eastern and the western Guangdong were statistically significant (χ2 = 5.9, P < 0.05). The median urinary iodine of the eastern and the western Guangdong (162.4 μg/L) was significantly lower than that of the plains and the PRD (207.5 μg/L, &chi2 = 8.7, P < 0.01). The difference of median urinary iodine between the plains and the PRD, the historical iodine deficiency areas and the eastern and the western Guangdong was statistically significant (χ2 = 58.9, P < 0.01). The median urinary iodine of the eastern and the western Guangdong (109.6 μg/L) was significantly lower than that of the historical iodine deficiency areas and the plains and the PRD(152.9, 155.2 μg/L, &chi2 = 18.3, 20.6, all P < 0.05). The mean IQ of the 1208 grade 5 students was 102.8 ± 14.3. The IQ of the plains and the PRD (104.3 ± 13.9) and the historical iodine deficiency areas (102.7 ± 14.3) was significantly higher than that of the eastern and the western Guangdong (100.3 ± 14.7, t = 3.8, 2.1, P < 0.01 or P < 0.05). Conclusions: The goal of iodine deficiency disorders elimination is achieved as scheduled in Guangdong Province. The health level of general population has been improved significantly. Iodine nutrition is in the appropriate range (100-199 μg/L) in general population but low in pregnant women. The selling of non-iodized salt in the eastern and the western Guangdong Province should be followed closely.


Zhang B.,Institute of Endemic Disease | Li D.,Institute of Endemic Disease | Zhang R.,Institute of Endemic Disease
Chinese Journal of Endemiology | Year: 2014

Objective Through investigation of children fluorosis illness, family households improved stoves and related life styles, to provide a scientific basis for sustainable control of endemic fluorosis.Methods In 2013, in Huishui County and Baiyun District, 3 towns were selected in each county (district), and 3 villages were selected in each town. All 8-12 years old children in the school of these villages were checked dental fluorosis, which was diagnosed according to "Dental Fluorosis Diagnosis" (WS/T 208-2011 ) ; at the same time, 10 families were selected to survey the situation of improved stoves and related life styles.Results Dental fluorosis detection rate of 8 - 12 years old children in Huishui and Baiyun were 2.75% (23/836) and 2.26% (11/487), which were all lower than 30%. Qualified rate of improved stoves and qualified stoves correct utilization rate were all 100.0% (90/90). For human consumption, the correct rate of com drying was 100.0% (90/90) ; the correct rates of chili drying were 98.9% (89/90) and 100.0% (90/90). Conclusions The prevention effect is obvious, which has reached the control standards. We should continue to improve the long-term mechanism of comprehensive control measures, and to achieve substantial elimination of coal-burning endemic fluorosis. Fluorosis, dental ; Coal; Fluoride poisoning; Stoves improvement ; Data collection ; Outcome evaluation.


Zhang B.,Institute of Endemic Disease | Li D.,Institute of Endemic Disease | Zhang N.,Institute of Endemic Disease | He P.,Institute of Endemic Disease | And 2 more authors.
Chinese Journal of Endemiology | Year: 2014

Objective: To explore the changes of children's dental fluorosis before and after implementation of comprehensive prevention and control intervention in coal-buming-bome endemic fluorosis areas of Guizhou Province, and to provide a scientific basis for making corresponding prevention and control measures. Methods: In 2010, according to a simple random cluster sampling method, 1/5 of the villages out of 1/5 of the towns of Zunyi, Kaiyang and Longli Counties, were selected as investigation sites for inspection of dental fluorosis in 8 - 12 years old children and a longitudinal comparison was done with historical related dental fluorosis (year 1986 and 2000). Dental fluorosis of children was diagnosed by Dean method. Results: In Zunyi, Kaiyang and Longli Counties,the detection rates of 8 - 12 years old children's dental fluorosis were 23.76%(202/850), 15.77% (79/501) and 11.17%(42/376), respectively. The detection rates of dental fluorosis in the 8, 9, 10, 11 and 12 years old age group of children were 11.52% (19/165), 17.19%(44/256), 20.20% (81/401), 18.61% (75/403) and 20.72%( 104/502), respectively, and there was no significant difference between groups(χ2 = 2.90, P > 0.05). The survey results of this investigation in the three counties in 2000 were 34.20%(7 805/22 821), 39.77%(1 782/ 4 481), 60.88%(2 806/4 609), and the differences were statistically significant between the results of 2010 and 2000(χ2 = 37.81, 110.91, 350.76, all P < 0.01). And compared with the results of 1986[34.29% (9 463/27 596), 36.30%(2 708/7 460), 35.72% (1 896/5 308)], the difference of Zunyi County was not statistically significant (χ2 = 0.045, P > 0.05), but for Kaiyang and Longli the differences were statistically significant (χ2 = 14.35, 626.39, all P < 0.01). Conclusions: The effect of comprehensive prevention and control intervention is very obvious. In the 3 countíes, the incidence rates of 8 - 12 years old children's dental fluorosis are already dropped to below 30% of the control standard. Subsequent management should be carried out and the state of disease should be evaluated for organization-assessment acceptance in accordance with relevant hygiene standards in a planned way.


Zhang N.-H.,Institute of Endemic Disease | Li D.-S.,Institute of Endemic Disease | Jin Z.-J.,Institute of Endemic Disease | An D.,Institute of Endemic Disease | And 5 more authors.
Chinese Journal of Endemiology | Year: 2013

Objective: To evaluate the influence of coal arsenic on food arsenic after implementing comprehensive control measures in coal-burning-borne epidemic arsenism areas of Guizhou province. Methods: In 2011, according to the history of arsenic disease of Guizhou province, 25 diseased villages from Xingyi, Xingren, Anlong counties that had carried out comprehensive prevention and control measures in 2005 were choosen. Because of the different sources of coal sample, 5 families, which used the same coal, were selected for the survey in each village. The levels of arsenic in coal, pepper and corn were measured. According to the provisions of "Define and Division Standard for Endemic Arsenism"(WS 277-2007), the residents surveyed were divided into two groups by the level of arsenic: low-risk group(≤40 mg/kg) and high-risk group(> 40 mg/kg). The risk of arsenic exposure between the two groups was analyzed. Arsenic in coal samples was determined by hydride-atomic absorption method and in corn and pepper by hydride atomic fluorescence spectrophotometry. Results: In 25 diseased villages, a total of 125 coal samples were tested, and the mean contents of arsenic was 30.54 mg/kg; 125 capsicum samples were tested, and the mean contents of arsenic was 0.25 mg/kg; 125 corn samples were tested, and the mean contents of arsenic was 0.20 mg/kg. Difference between low risk and high risk groups of capsicum arsenic was statistically significant(Z = -2.261, P < 0.05). Compared with 1991, the the mean contents of coal, pepper and corn arsenic(472.49, 5.28, 586.60 mg/kg) in arsenic diseased areas was significantly reduced(Z = -9.15, -11.93, -9.94, all P < 0.05). Conclusions: Comprehensive prevention and control measures have achieved the expected results in prevention and control of arsenic pollution. Food arsenic contamination is significantly reduced in diseased areas, and partially met the standard requirements of National Pollutant Limits. The work of prevention and control should be continued.


Zhang B.,Institute of Endemic Disease | Li D.,Institute of Endemic Disease | Gao J.,Institute of Endemic Disease | Zhang N.,Institute of Endemic Disease | And 5 more authors.
Chinese Journal of Endemiology | Year: 2015

Objective To investigate the prevalence of dental fluorosis of children aged 8-12 in coal-burning type of endemic fluorosis areas in Guizhou Province and to provide a scientific basis for assessment and acceptance of the diseased areas. Methods According to the "Diagnosis of Dental Fluorosis" (WS/T 208-2011), dental fluorosis of all children aged 8-12 were examined in historic diseased areas of 13 counties (districts) from 2013 to 2014. The date of dental fluorosis of all children aged 8-12 was collected in 13 countries (districts) in 1986 and 2000. The date of 1986 was compared with that of 2000; the survey results were compared with those of 2000, and assessed by the standards for "Control Criteria for Endemic Fluorosis Areas" and "Elimination of Coal-burning Type of Endemic Fluorosis". Results The total detectable rate of dental fluorosis of children aged 8-12 was 5.42% (12 446/229 428), and the total dental fluorosis index was 0.094 that covered 229 428 children from 1 673 villages of 166 towns of 13 counties (districts) in the province. The detection rate and dental fluorosis index in every county (district) ranged from 2.83% to 9.39% and from 0.037 to 0.174, respectively. The ratio of dental fluorosis detection rate ≤ 15% and > 15-30% was accounted for 98.09% (1 641/1 673) and 1.91% (32/1 673), respectively in the 1 673 villages. Compared with that of 2000 in each county (district), the difference was statistically significant (all P < 0.01). Compared between 2000 and 1986, the differences were not statistically significant in Zunyi County, Meitan County and Baiyun District (Χ2 = 0.045, 0.067, 3.420, all P > 0.05), but the prevalence was significantly lower in Huishui County, Wudang District and Huaxi District (Χ2 = 537.70, 352.03, 374.84, all P < 0.01). The prevalence was increased to varying degrees in counties (districts) including Honghuagang, Zhenning, Changshun, Pingba, Longli, Xifeng and Kaiyang (Χ2 = 9.48, 219.97, 116.93, 288.24, 626.39, 272.38, 14.35, all P < 0.01). Conclusions The detection rate of dental fluorosis of children aged 8-12 is significantly dropped and lower than 10%. All surveyed countries are up to the standards of elimination except Pingba, where 32 villages are in a level of control. It's recommended that comprehensive assessment should be carried out with relevant health standard in endemic fluorosis areas.


Zhang N.-H.,Institute of Endemic Disease | An D.,Institute of Endemic Disease | He P.,Institute of Endemic Disease | Li D.-S.,Institute of Endemic Disease | And 2 more authors.
Chinese Journal of Endemiology | Year: 2010

Objective: To explore the effect of different processing and drying methods of corn and hot pepper on fluorine content in coal-burning type of the endemic fluorosis areas, and to screen food processing and drying methods which meet the quality requirements of grain drying and able to effectively reduce the total fluoride intake of local population. Methods: Farmers of endemic fluorosis area in Bijie, Guizhou province were divided into 3 groups: sun-baked drying group, stove drying group with air-tight cover and stove drying group with no cover, 10 households in each group. Corn and fresh hot pepper and samples dried for 2 weeks, or 1, 3, 6-month were collected, and water and fluoride content were detected, and the total daily fluoride intake were calculated in accordance with the "Determination of Water in Food"(GB/T 5009.3-2003) and "Determination of Fluorine in Foods" (GB/T 5009.18-2003). Results: Fluoride content in fresh corn and dried for 2 weeks, or 1, 3, 6-month [of sunbaked drying group: (1.40 ± 0.16), (1.56 ± 0.14), (2.15 ± 0.47), (2.70 ± 0.64), (4.06 ± 1.75)mg/kg, stove drying group with air-tight coven(1.41 ± 0.16),(2.39 ± 0.56), (4.60 ± 0.97), (8.46 ± 5.55), (11.36 ± 3.60)mg/kg, stove drying group with no cover; (1.40 ± 0.13), (4.69 ± 3.97), (4.47 ± 2.77), (9.65 ± 6.47), (26.12 ± 14.52) mgAg] and pepper [sun-baked drying group: (5.41 ± 1.61), (16.60 ± 7.62), (32.60 ± 7.88), (50.26 ± 17.60), (24020 ± 27249)mgAg, stove drying group with air-tight cover: (754 ± 2.95), (3238 ± 1150), (119.18 ± 156.45), (224.00 ± 196.58), (495.70 ± 417.29)mgAg, stove drying group with no cover: (4.82 ± 1.25), (44.30 ± 13.48), (122.89 ± 66.43), (334.23 ± 166.05), (531.01 ± 397.40)mgAg] increased with elongation of drying time, and the group difference was significant(F= 44.77, 128,71, 126.87, 41.61, 53.63, 170.63, all P< 0.05), with the largest rate of increase in stove drying group with no cover, and the lowest in sun-baked drying group; fluoride was significantly lower (t = 7.93,63.07,5.36,11.98,55.76,7.45, all P < 0.05) after sample washing; total fluoride intake per person per day was 2.57 mg in local adult when ate washed and sun-baked corn, peppers, the total fluoride intake were 5.92, 8.14 mg when ate the food processed by other two drying methods and washed corn, peppers, respectively. Conclusions: In the coal-burning type of fluorosis endemic area, should take appropriate health education measures, and instruct local residents to use sun bake their edible corn and pepper for human consumption, and cultivate a habit of washing com and pepper before cooking, which can reduce the population total fluoride intake, and control endemic fluorosis.

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