Evaluating the quality of evidence for diagnosing ischemic heart disease from verbal autopsy in Indonesia

BACKGROUND Mortality and cause of death data are fundamental to health policy development.Civil Registration and Vital Statistics systems are the ideal data source,but the system is still under development in Indonesia.A national Sample Registration System(SRS)has provided nationally representative mortality data from 128 subdistricts since 2014.Verbal autopsy(VA)is used in the SRS to obtain causes of death.The quality of VA data must be evaluated as part of the SRS data quality assessment.AIM To assess the strength of evidence used in the assignment of Ischaemic Heart Disease(IHD)as causes of death from VA.METHODS The sample frame for this study is the 4,070 deaths that had IHD assigned as the underlying cause in the SRS 2016 database.From these,400 cases were randomly selected.A data extraction form and data entry template were designed to collect relevant data about IHD from VA questionnaires.A standardised categorisation was designed to assess the strength of evidence used to infer IHD as a cause of death.A pilot test of 50 cases was carried out.IBM SPSS software was used in this study.RESULTS Strong evidence of IHD as a cause of death was assigned based on surgery for coronary heart disease,chest pain and two out of:sudden death,history of heart disease,medical diagnosis of heart disease,or terminal shortness of breath.More than half(53%)of the questionnaires contained strong evidence.For deaths outside health facilities,VA questionnaires for male deaths contained acceptable evidence in significantly higher proportions as compared to those for female deaths.(P<0.001).Nearly half of all IHD deaths were concentrated in the 50-69 year age group(48.40%),and a further 36.10%were aged 70 years or more.Nearly two-thirds of the deceased were male(58.40%).Smoking behaviour was found in 44.11%of IHD deaths,but this figure was 73.82%among males.CONCLUSION More than half of the VA questionnaires from the study sample were found to contain strong evidence to infer IHD as the cause of death.Results from medical records such as electrocardiograms,coronary angiographies,and load tests could have improved the strength of evidence and contributed to IHD cause of death diagnosis.

A Review of the Latest Control Strategies for Mosquito-Borne Diseases

Mosquito-borne diseases are persistent and potentially severe posing a threat to global pandemic preparedness.The risk of mosquito-borne virus transmission is rapidly increasing due to the unprecedented spread of viruses such as dengue and chikungunya,the disruption of global mosquito-borne disease control efforts following the emergence of coronavirus diseases 2019(COVID-19)in 2019,global warming,and human activities.To address this global challenge,various innovative mosquito control technologies are being developed worldwide.This paper summarizes the latest advances in mosquito vector control,focusing on China’s latest mosquito control strategies,to provide insights into implementing novel mosquito-borne disease control measures.

A Review of Pathogens Transmitted by the Container-Inhabiting Mosquitoes, Aedes Albopictus, A Global Public Health Threat

ABSTRACT Dengue virus(DENV),Chikungunya virus(CHIKV),and Zika virus(ZIKV)are highly pathogenic human arboviruses transmitted by the Aedes(Stegomyia)albopictus(Skuse)(Diptera:Culicidae)or Ae.Albopictus mosquito.These arboviruses are responsible for causing fever,hemorrhagic conditions,and neurological diseases in humans post-bite from an infected Aedes mosquito.Over the past 80 years,the Ae.albopictus has infested every habitable continent.

Salt-Related Knowledge,Behaviors,and Associated Factors Among Chinese Adults--China,2015

What is already known about this topic?Excessive salt intake is an important risk factor for hypertension and cardiovascular diseases(CVDs).The amount of salt intake of Chinese is one of the highest all over the world.At a national level,the awareness of maximum daily salt intake recommended by the“Dietary Guidelines of Chinese residents”had not been reported.What is added by this report?This is the first nationally representative study about awareness of maximum daily salt intake in China.In 2015,the awareness rate of maximum daily salt intake and behavior rate of salt reduction among Chinese adults aged 18 years old and above was 6.1%and 37.3%,respectively.The awareness rate of maximum daily salt intake and behavior rate of salt reduction was low among adult residents in China.What are the implications for public health practice?To increase the behavior rate of salt reduction in China,awareness of the maximum daily salt intake needs to be strengthened to Chinese residents,especially in rural areas or for people with low education levels and low incomes.

Association between physical activity energy expenditure and cardiometabolic risk factor clustering among Chinese adults in 2015

To understand the association between cardiometabolic risk factor(CMRF)clustering and physical activity(PA)levels,we included 86520 Chinese adults aged 18–64 years having at least one CMRF(hypertension,diabetes,dyslipidemia,or obesity)from the China Chronic Disease and Nutrition Surveillance survey in 2015,a nationally and provincially representative investigation with a multistage clustering sampling design.Self-reported PA information was collected with the Global Physical Activity Questionnaire through face-to-face interviews.In view of the obesity epidemic in CMRF patients,PA energy expenditure(PAEE)per kilogram body weight was used,and was defined into four categories:(i)inactivity:0 kJ/kg/day;(ii)low activity:0–5 kJ/kg/day;(iii)moderate activity:6–11 kJ/kg/day;and(iv)vigorous activity:≥12 kJ/kg/day.The estimated weighted prevalence(95%confidence interval[CI])of having 1,2,3,and 4 CMRFs was 60.57%(59.48%–61.67%),28.10%(27.40%–28.79%),9.82%(9.22%–15.42%)and 1.50%(1.37%–1.63%),respectively.The rate(95%CI)of inactivity,low activity,moderate activity,and vigorous activity was 34.52%(32.69%–36.35%),22.22%(21.37%–23.37%),15.98%(15.38%–16.58%)and 27.28%(26.02%–28.53%),respectively.For those having 2,3 and 4 CMRFs(compared to those having 1 CMRF),the adjusted odds ratio(95%CI)for moderate activity and vigorous activity were 0.91(0.85–0.98)and 0.92(0.85–0.99),0.87(0.80–0.95)and 0.84(0.77–0.92),and 0.77(0.67–0.89)and 0.85(0.72–1.00),respectively.In conclusion,CMRF clustering was a pandemic among Chinese adults in 2015 and was inversely associated with PA level.PAEE(in kJ/kg/day)may be introduced into PA management practice,especially for populations with high body weight.