Bai L.,Chinese National Institute for Communicable Disease Control and Prevention |
Cirendunzhu,Tibet Autonomous Region Center for Disease Control and Prevention |
Woodward A.,University of Auckland |
Dawa,Tibet Autonomous Region Center for Disease Control and Prevention |
And 4 more authors.
Science of the Total Environment | Year: 2014
Background: Tibet, with an average altitude of more than 4,000 meters, is warming faster than anywhere else in China. However, there have been no studies in Tibet of the relation between ambient temperature and mortality. Methods: We examined mean temperature and daily mortality in three Tibetan counties (Chengguan, Jiangzi and Naidong) using a distributed lag non-linear model (DLNM) based on 5,610 deaths that occurred in 2008-2012. We separately investigated hot and cold effects on non-accidental deaths, cardiovascular deaths, out-of-hospital deaths and vulnerability factors including age, sex and education. Results: In all three counties, the effect of heat tended to be immediate, while the impact of cold lasted longer. The effects were consistent but modest in size and not statistically significant except for cumulative cold effects in Jiangzi (lag=0-14, RR=2.251, 95% CI=1.054-4.849). Those who were more vulnerable to temperature extremes tended to be men, the elderly (over 65. years) and illiterate persons. We found stronger temperature effects on cardiovascular deaths than on all-cause mortality, and we also observed an increase in out-of-hospital mortality in one county. Conclusions: This is the first study to investigate the temperature-mortality relationship in Tibet, and the findings may guide public health programs and other interventions to protect the population against extreme temperatures in a developing Tibet. © 2014 The Authors.
Wang H.,U.S. Center for Disease Control and Prevention |
Cui H.,Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention |
Ding Z.,U.S. Center for Disease Control and Prevention |
Ba P.,U.S. Center for Disease Control and Prevention |
And 12 more authors.
Clinical and Vaccine Immunology | Year: 2013
Despite remarkable progression toward polio eradication worldwide, wild poliovirus (WPV) importation has been a great challenge for China, as it shares borders with countries where WPV is endemic. The objective of this study was to estimate poliovirus antibody seroprevalence among children <15 years of age in 3 border provinces (Yunnan Province, Tibet Autonomous Region, and Xinjiang Uygur Autonomous Region) in China. A cross-sectional, hospital-based study was undertaken in 3 border provinces in 2010. Individuals < 15 years old who visited hospitals at the prefecture level or above to have their blood drawn for any reason were invited to participate in our study. Neutralizing antibody titers to polio serotypes 1 (P1), P2, and P3 were assayed according to the World Health Organization manual for the virological investigation of polio. Antibody titers of ≥8 were considered positive. Among the 1,360 subjects enrolled, 1,220 (89.7%), 1,259 (92.6%), and 1,112 (81.8%) were seropositive to P1, P2, and P3, respectively, and 1,051 (77.3%) subjects were seropositive to all three serotypes. The highest seropositive rates were observed in Xinjiang Uygur Autonomous Region. By age, 3- to 5-year-old subjects had the highest rate of seropositivity, and seropositivity decreased significantly with increasing age. The risk of WPV importation will continue until WPV transmission has been interrupted worldwide. Consistent with the Global Polio Eradication Initiative's polio endgame strategy, China must maintain its polio-free status by ensuring adequate population immunity against polio. Because immunity wanes with increasing age, a booster dose with bivalent type 1 and 2 oral poliovirus vaccine could be considered for teenagers in China. Copyright © 2013, American Society for Microbiology. All Rights Reserved.