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He G.X.,National Center for Control and Prevention | He G.X.,University of Amsterdam | Hof S.V.D.,University of Amsterdam | Werf M.J.V.D.,University of Amsterdam | And 6 more authors.
BMC Infectious Diseases | Year: 2010

Background: Hospitals with inadequate infection control are risky environments for the emergence and transmission of tuberculosis (TB). We evaluated TB infection control practices, and the prevalence of latent TB infection (LTBI) and TB disease and risk factors in health care workers (HCW) in TB centers in Henan province in China.Methods: A cross-sectional survey was conducted in 2005. To assess TB infection control practices in TB centers, checklists were used. HCW were tuberculin skin tested (TST) to measure LTBI prevalence, and were asked for sputum smears and chest X-rays to detect TB disease, and questionnaires to assess risk factors. Differences between groups for categorical variables were analyzed by binary logistic regression. The clustered design of the study was taken into account by using a multilevel logistic model.Results: The assessment of infection control practices showed that only in a minority of the centers the patient consultation areas and X-ray areas were separated from the waiting areas and administrative areas. Mechanical ventilation was not available in any of the TB centers. N95 respirators were not available for HCW and surgical masks were not available for TB patients and suspects. The LTBI prevalence of HCW with and without BCG scar was 55.6% (432/777) and 49.0% (674/1376), respectively (P = 0.003). Older HCW, HCW with longer duration of employment, and HCW who worked in departments with increased contact with TB patients had a higher prevalence of LTBI. HCW who work in TB centers at the prefecture level, or with an inpatient ward also had a higher prevalence of LTBI. Twenty cases of pulmonary TB were detected among 3746 HCW. The TB prevalence was 6.7/1000 among medical staff and 2.5/1000 among administrative/logistic staff.Conclusion: TB infection control in TB centers in Henan, China, appears to be inadequate and the prevalence of LTBI and TB disease among HCW was high. TB infection control practices in TB centers should be strengthened in China, including administrative measures, renovation of buildings, and use of respirators and masks. Regular screening of HCW for TB disease and LTBI needs to be considered, offering preventive therapy to those with TST conversions. © 2010 He et al; licensee BioMed Central Ltd. Source


Fan H.-J.,Tianjin University | Gao H.-W.,Tianjin University | Ding H.,Tianjin University | Zhang B.-K.,National Center for Public Health Surveillance and Information Service | Hou S.-K.,Tianjin University
Disaster Medicine and Public Health Preparedness | Year: 2015

There is growing concern in West Africa about the spread of the Ebola hemorrhagic fever virus. With the increasing global public health risk, a coordinated international response is necessary. The Chinese government is prepared to work in collaboration with West African countries to assist in the containment and control of the epidemic through the contribution of medical expertise and mobile laboratory testing teams. Nationally, China is implementing prevention programs in major cities and provinces, the distribution of Ebola test kits, and the deployment of a new national Ebola research laboratory. Copyright © Society for Disaster Medicine and Public Health, Inc. 2015. Source


Fang L.-Q.,Beijing Institute of Microbiology and Epidemiology | Ma J.-Q.,National Center for Public Health Surveillance and Information Service | Cao W.-C.,Beijing Institute of Microbiology and Epidemiology
Clinical Infectious Diseases | Year: 2011

Background. Differences between male and female individuals in response to infectious diseases are an overlooked global health problem. Methods. The relationship between sex and disease outcome was examined in populations of patients with hemorrhagic fever with renal syndrome (HFRS) in mainland China, where most cases of hantavirus exposure occur. HFRS in China is diagnosed on the basis of symptoms and is confirmed with serological testing. The geographical distribution, incidence, and case fatality rates (CFRs) of HFRS in China were estimated and compared by patient sex and age. In a subset of patients with HFRS, clinical manifestations of HFRS were assessed using latent class analysis and compared by sex. Results. There were 80,671 HFRS cases reported during the period 2004-2008, with a majority of HFRS cases (39.2%) occurring among individuals 20-39 years of age. The incidence of HFRS was higher among male patients than among female patients for all individuals >10 years of age. There were 945 deaths (CFR, 1.17%) due to HFRS in China during the period 2004-2008. CFRs were higher among women than among men between the ages of 20-39 and ≥50 years of age. There were no sex differences in the geographical distribution of HFRS cases or deaths. Although the prevalence of each clinical marker did not differ by sex, 2 profiles of clinical markers were identified that were related to both severity of disease and sex. Conclusions. These data illustrate a paradox in which the incidence of disease is greater for males, but the severity of disease outcome is worse for females. Several behavioral, societal, and biological factors are hypothesized to be involved. © 2011 The Author. Source


Gao H.-W.,Beijing Institute of Microbiology and Epidemiology | Wang L.-P.,National Center for Public Health Surveillance and Information Service | Liang S.,University of Florida | Liu Y.-X.,U.S. Center for Disease Control and Prevention | And 8 more authors.
PLoS ONE | Year: 2012

Malaria is re-emerging in Anhui Province, China after a decade long' low level of endemicity. The number of human cases has increased rapidly since 2000 and reached its peak in 2006. That year, the malaria cases accounted for 54.5% of total cases in mainland China. However, the spatial and temporal patterns of human cases and factors underlying the re-emergence remain unclear. We established a database containing 20 years' (1990-2009) records of monthly reported malaria cases and meteorological parameters. Spearman correlations were used to assess the crude association between malaria incidence and meteorological variables, and a polynomial distributed lag (PDL) time-series regression was performed to examine contribution of meteorological factors to malaria transmission in three geographic regions (northern, mid and southern Anhui Province), respectively. Then, a two-year (2008-2009) prediction was performed to validate the PDL model that was created by using the data collected from 1990 to 2007. We found that malaria incidence decreased in Anhui Province in 1990s. However, the incidence has dramatically increased in the north since 2000, while the transmission has remained at a relatively low level in the mid and south. Spearman correlation analyses showed that the monthly incidences of malaria were significantly associated with temperature, rainfall, relative humidity, and the multivariate El Niño/Southern Oscillation index with lags of 0-2 months in all three regions. The PDL model revealed that only rainfall with a 1-2 month lag was significantly associated with malaria incidence in all three regions. The model validation showed a high accuracy for the prediction of monthly incidence over a 2-year predictive period. Malaria epidemics showed a high spatial heterogeneity in Anhui Province during the 1990-2009 study periods. The change in rainfall drives the reemergence of malaria in the northern Anhui Province. © 2012 Gao et al. Source


Fang L.-Q.,Beijing Institute of Microbiology and Epidemiology | Goeijenbier M.,Rotterdam University | Zuo S.-Q.,Beijing Institute of Microbiology and Epidemiology | Wang L.-P.,U.S. Center for Disease Control and Prevention | And 10 more authors.
Viruses | Year: 2015

Hemorrhagic fever with renal syndrome (HFRS) caused by hantaviruses and transmitted by rodents is a significant public health problem in China, and occurs more frequently in selenium-deficient regions. To study the role of selenium concentration in HFRS incidence we used a multidisciplinary approach combining ecological analysis with preliminary experimental data. The incidence of HFRS in humans was about six times higher in severe selenium-deficient and double in moderate deficient areas compared to non-deficient areas. This association became statistically stronger after correction for other significant environment-related factors (low elevation, few grasslands, or an abundance of forests) and was independent of geographical scale by separate analyses for different climate regions. A case-control study of HFRS patients admitted to the hospital revealed increased activity and plasma levels of selenium binding proteins while selenium supplementation in vitro decreased viral replication in an endothelial cell model after infection with a low multiplicity of infection (MOI). Viral replication with a higher MOI was not affected by selenium supplementation. Our findings indicate that selenium deficiency may contribute to an increased prevalence of hantavirus infections in both humans and rodents. Future studies are needed to further examine the exact mechanism behind this observation before selenium supplementation in deficient areas could be implemented for HFRS prevention. © 2015 by the authors; licensee MDPI, Basel, Switzerland. Source

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