Age-period-cohort analysis of pulmonary tuberculosis reported incidence, China, 2006-2020

Background:Tuberculosis(TB)poses a severe public health challenge in China and worldwide.This study evaluated the effects of age,period,and birth cohort on reported incidence trends of TB based on population and refined the characteristics of high-risk groups.Methods:Aggregate data that reported pulmonary tuberculosis(PTB)cases from China Tuberculosis Management Information System(TBIMS)from 2006 to 2020 were used to analyze effect coefficients through the age-period-cohort(APC)model based on intrinsic estimator(IE)method,and converted them into relative risk(RR)to estimate trends.Results:A total of 14.82 million cases of PTB were reported in China from 2006 to 2020,showing a continuous downward trend.The reporting rate increased with age by age group,with 70-74 years old being 2-3 times higher than that in 20-24 years old.APC analysis model showed that age effects were bimodal in 20-24 years old[RR=2.29,95%confidence interval(CI):1.73-3.03]and 70-74 years old(RR=1.95,95%CI:1.67-2.27),and lower than the overall average in the groups under 15 years old.Stratified results showed that the risk was higher for women under age 40 than men and higher for men over 40.The risk was higher in urban than in rural areas under 30 years old and slightly higher in rural than in urban between 30 and 64 years old.The risk for 15-34 years old was significantly higher in the east than in other regions.The period effects showed a decreasing trend,and the risk was higher in rural in recent years.Except for cohorts born in 1961-1965 and 2001-2005,where theRR increased,the later the cohort was born,the lower the risk.The cohort 1926-1930 in eastern had the highest risk(RR=3.49,95%CI:2.44-4.98).Conclusions:The reported incidence of PTB continued to decline in China from 2006 to 2020.The young(20-24 years old)and the elderly(70-74 years old)were equally at high risk.There were differences in the age,period and cohort effects on PTB incidence among gender,urban-rural and regions.Our findings better reflected the characteristics of high-risk populations,thus contributing to the development of timely and effective intervention strategies,and providing clues for etiological research.

Implication of Reported Viral Hepatitis Incidence Rate Change in Hubei Province, China, between 2004-2010

This study examined the change of reported incidence rate for viral hepatitis in Hubei province, China, between 2004 to 2010 to provide scientific evidence for viral hepatitis control. Reported viral hepatitis infection cases were queried from Centre for Disease Control of Hubei Province, China. The incidence of viral hepatitis A decreased steadily across the study period. Viral hepatitis B composed 85% of the viral hepatitis cases. When reported incidence rates for chronic hepatitis B increased, the rates of acute and unclassified cases dropped from 2005 to 2010. The reported viral hepatitis B incidence rate for males was around 1.5-2 times higher than for females. The average annual percentage change of reported viral hepatitis B incidence rates was 4%. The same index for viral hepatitis C was 28%. The reported viral hepatitis B incidence rate of people under 20 years old declined over the period. This decrease was mainly attributed to the recent implementation of vaccination plan. Reported incidence rate of viral hepatitis E also rose in those years. Having a better understanding on reported incidence rates of the present surveillance system is important for developing strategies for further prevention of viral hepatitis. In addition, the data showed that a surveillance system that differentiates new and former infected cases will be more effective in providing evidence for disease control.

German critical incident reporting system database of prehospital emergency medicine: Analysis of reported communication and medication errors between 2005–2015

BACKGROUND: Communication failure in prehospital emergency medicine can affect patient safety as it does in other areas of medicine as well. We analyzed the database of the critical incident reporting system for prehospital emergency medicine in Germany retrospectively regarding communication errors.METHODS: Experts of prehospital emergency medicine and risk management screened the database for verbal communication failure, non-verbal communication failure and missing communication at all.RESULTS: Between 2005 and 2015, 845 reports were analyzed, of which 247 reports were considered to be related to communication failure. An arbitrary classifi cation resulted in six different kinds: 1) no acknowledgement of a suggestion; 2) medication error; 3) miscommunication with dispatcher; 4) utterance heard/understood improperly; 5) missing information transfer between two persons; and 6) other communication failure.CONCLUSION: Communication defi cits can lead to critical incidents in prehospital emergency medicine and are a very important aspect in patient safety.

Reconstruction of incidence reporting rate for SARS-CoV-2 Delta variant of COVID-19 pandemic in the US

In recent years,advanced regularization techniques have emerged as a powerful tool aimed at stable estimation of infectious disease parameters that are crucial for future projections,prevention,and control.Unlike other system parameters,i.e.,incubation and recovery rates,the case reporting rate,Ψ,and the time-dependent effective reproduction number,R_(e)t,are directly influenced by a large number of factors making it impossible to pre-estimate these parameters in any meaningful way.In this study,we propose a novel iteratively-regularized trust-region optimization algorithm,combined with SuSvIuIvRD compartmental model,for stable reconstruction ofΨand R_(e)t from reported epidemic data on vaccination percentages,incidence cases,and daily deaths.The innovative regularization procedure exploits(and takes full advantage of)a unique structure of the Jacobian and Hessian approximation for the nonlinear observation operator.The proposed inversion method is thoroughly tested with synthetic and real SARS-CoV-2 Delta variant data for different regions in the United States of America from July 9,2021,to November 25,2021.Our study shows that case reporting rate during the Delta wave of COVID-19 pandemic in the US is between 12%and 37%,with most states being in the range from 15%to 25%.This confirms earlier accounts on considerable under-reporting of COVID-19 cases due to the impact of”silent spreaders”and the limitations of testing.

Nursing-related Patient Safety Events in Hospitals

To explore the method of identifying nursing-related patient safety events, types, contributing factors and evaluate consequences of these events in hospitals of China, incident report program was established and implemented in 15 patient units in two teaching hospitals of China to get the relevant information. Among 2935 hospitalized patients, 141 nursing-related patient safety events were reported by nurses. Theses events were categorized into 15 types. Various factors contributed to the events and the consequence varied from no harm to patient death. Most of the events were pre- ventable. It is concluded that incident reporting can provide more information about patient safety, and establishment of a program of voluntary incident reporting in hospitals of China is not only urgent but also feasible.