Prevalence of fatty liver disease and its risk factors in the population of South China

AIM: To investigate the population-based prevalence of fatty liver disease (FLD) and its risk factors in Guangdong Province,China. METHODS: A cross-sectional survey with multiple-stage stratified cluster and random sampling of inhabitants over 7-year-old was performed in 6 urban and rural areas of Guangdong Province,China. Questionnaires,designed by co-working of epidemiologists and hepatologists,included demographic characteristics,current medication use,medical history and health-relevant behaviors,i.e. alcohol consumption,smoking habits,dietary habits and physical activities. Anthropometric measurements,biochemical tests and abdominal ultrasonography were carried out. RESULTS: Among the 3543 subjects,609 (17.2%) were diagnosed having FLD (18.0% males,16.7% females,P > 0.05). Among them,the prevalence of confirmed alcoholic liver disease (ALD),suspected ALD and nonalcoholic fatty liver disease (NAFLD) were 0.4%,1.8%,and 15.0%,respectively. The prevalence rate (23.0%) was significantly higher in urban areas than (12.9%) in rural areas. After adjustment for age,gender and residency,the standardized prevalence of FLD in adults was 14.5%. Among them,confirmed ALD,suspected ALD and NAFLD were 0.5%,2.3%,and 11.7%,respectively,in adults and 1.3% (all NAFLD) in children at the age of 7-18 years. The overall prevalence of FLD increased with age in both genders to the peak of 27.4% in the group of subjects at the age of 60-70 years. The prevalence rate was significantly higher in men than in women under the age of 50 years (22.4% vs 7.1%,P < 0.001). However,the opposite phenomenon was found over the age of 50 years (20.6% vs 27.6%,P < 0.05). Multivariate and logistic regression analysis indicated that male gender,urban residency,low education,high blood pressure,body mass index,waist circumference,waist to hip ratio,serum triglyceride and glucose levels were the risk factors for FLD. CONCLUSION: FLD,especially NAFLD,is prevalent in South China. There are many risk factors for FLD.

Economic cost analysis of malaria case management at the household level during the malaria elimination phase in The People’s Republic of China

Background:In China,malaria has been posing a significant economic burden on households.To evaluate malaria economic burden in terms of both direct and indirect costs has its meaning in improving the effectiveness of malaria elimination program in China.Methods:A number of study sites(eight counties in five provinces)were selected from the malaria endemic area in China,representing the different levels of malaria incidence,risk classification,economic development.A number of households with malaria cases(n=923)were surveyed during the May to December in 2012 to collect information on malaria economic burden.Descriptive statistics were used to characterize the basic profiles of selected malaria cases in terms of their gender,age group,occupation and malaria type.The malaria economic costs were evaluated by direct and indirect costs.Comparisons were carried out by using the chi-square test(or Z-test)and the Mann-Whitney U test among malaria cases with reference to local/imported malaria patients,hospitalized/out patients,and treatment hospitals.Results:The average cost of malaria per case was 1691.23 CNY(direct cost was 735.41 CNY and indirect cost was 955.82 CNY),which accounted for 11.1%of a household’s total income.The average costs per case for local and imported malaria were 1087.58 CNY and 4271.93 CNY,respectively.The average cost of a malaria patient being diagnosed and treated in a hospital at the county level or above(3975.43 CNY)was 4.23 times higher than that of malaria patient being diagnosed and treated at a village or township hospital(938.80 CNY).Conclusion:This study found that malaria has been posing a significant economic burden on households in terms of direct and indirect costs.There is a need to improve the effectiveness of interventions in order to reduce the impact costs of malaria,especially of imported infections,in order to eliminate the disease in China.