Clustering of Non-communicable Diseases Risk Factors in Healthy Adults Aged 35 Years and Older in Shenzhen,China

We assessed the prevalence of non‐ communicable diseases（NCDs） risk factors with a focus on their clustering among healthy adults in Shenzhen, China. Data from the 2011 China Health and Nutrition Survey, comprising a regionally representative sample of 806 healthy adults aged 35 years or older, were obtained to determine the prevalence of five risk factors for NCDs. The prevalence of current smoking, central obesity, impaired fasting glucose, borderline hypertension, and borderline high total cholesterol was 19.97%, 28.29%, 4.47%, 10.55%, and 36.10%, respectively. A total 63.77% of participants had at least one risk factor. Upon examination of risk factor clustering, we observed that 7.57% of participants had at least three risk factors. Using this threshold as a cutoff, clustering of risk factors was associated with sex [odds ratio（OR） = 3.336, 95% confidence interval（CI）： 1.782 to 6.246], physical activity（OR = 1.913, 95% CI： 1.009 to 3.628）, and BMI（OR = 7.376, 95% CI： 3.812 to 14.270）. The prevalence of risk factors for NCDs is fairly high among healthy adults in Shenzhen, with a clustering tendency.

Climate Induced Virus Generated Communicable Diseases:Management Issues and Failures

In the present review article human diseases caused by various groups of pathogens have been explained with its etiology,epidemiology and treatment.In addition,effect of climatic changes on parasites and pathogens has been demarcated with rising incidences of diseases.In response to environmental changes,mainly external and internal microenvironment of body and drug regimens taken by patients;virus is regularly changing its form and new mutant variants are coming out.These are circulating in many Indian states and cross border countries and causing high infectivity and mortality in human patients.These variants with new mutations are challenging existing drugs and other prophylactic measures and massively disrupting functions of a tissue,organ,or entire organism.Diseases caused by viruses are showing new trends in virulence,with high infectivity,morbidity and mortality.Due to climatic effect and drug resistance and new mutations in pathogens disease burden has been exacerbated enormously at global level.In all cases of helminthes,protozoan’s,fungi,bacteria,virus pathogens and parasites available drug structure seem to be failed or their usefulness has been much reduced due to evolution of new mutant variants with multiple drug resistance.There are serious failures at the level of operation,management and control of disease.The utmost failure is due to lack of appropriate vaccine,drug regimens,clinical care and awareness among people.These are major reasons that is why diseases become uncontrolled and unmanageable.

ANY PROGRESS IN BATTLE AGAINST COMMON COLD?——Interview With William Jordan,M.D.,Expert on Communicable Diseases

Q:Dr.Jordan,do we know any more thesedays about the commnon cold and what eauses it? A:We used to think that the common eold was a simple,single disease.Now we know that it ean becaused by more than 100 different vjruses and rharsome nonviral agentsl resPonsible for allergies caneause similar symPtoms.Whatever the cause,the symPtofns are similar:The nose runs and getselogged;the throat is irritated:there is sneezing andsome coughing.

Emerging and re-emerging infectious diseases: Challenges and opportunities for militaries

The communal nature of living and training environments, alongside suboptimal hygiene and stressors in the field, place military personnel at higher risk of contracting emerging infectious diseases. Some of these diseases spread quickly within ranks resulting in large outbreaks, and personnel deployed are also often immunologically na?ve to otherwise uncommonly-encountered pathogens. Furthermore, the chance of weaponised biological agents being used in conventional warfare or otherwise remains a very real, albeit often veiled, threat. However, such challenges also provide opportunities for the advancement of preventive and therapeutic military medicine, some of which have been later adopted in civilian settings. Some of these include improved surveillance, new vaccines and drugs, better public health interventions and inter-agency co-operations. The legacy of successes in dealing with infectious diseases is a reminder of the importance in sustaining efforts aimed at ensuring a safer environment for both military and the community at large.

Effects of Multiple Cleaning and Disinfection Interventions on Infectious Diseases in Children: A Group Randomized Trial in China

Objective To assess the effectiveness of multiple cleaning and disinfection interventions in the homes and kindergartens, in reducing gastrointestinal and respiratory illnesses of children. Methods From October 2010 to September 2011, we performed a prospective, controlled study in China. 408 children under 5 years old were recruited and group randomized into intervention and control groups. Families and kindergartens in the intervention group were provided with antibacterial products for hand hygiene and surface cleaning or disinfection for one year. Each child＇s illness symptoms and sick leave were recorded every day. Results A total of 393 children completed the study, with similar baseline demographics in each of the 2 groups. Except for abdominal pain, the odds of symptoms （fever, cough and expectoration, runny nose and nasal congestion, diarrhea）, illness （acute respiratory illness and gastrointestinal illness）, and sick leave per person each month were significantly reduced by interventions. The rates of fever, diarrhea, acute respiratory illness, gastrointestinal illness and sick leave per person per year were significantly decreased as well. Conclusion Not only the acute respiratory children were significantly reduced by multiple and gastrointestinal illness but the sick leave rate in interventions.

Beyond Stitches: Analysis of Disease Burden in a Bangladeshi RMG Factory

Introduction: Bangladesh has experienced remarkable growth in RMG over the past 25 years. With the knitwear industry providing more than 4 million direct jobs, providing better occupational health and safety of workers remains a challenge. Aim of the study: The aim of the study was to analyze the disease burden of a RMG factory, and to highlight occupational health risks. Methods: A cross-sectional study design was employed for this analysis. A 17-month data entry (January 2020 - May 2021) was gathered from the factory in-house clinic. The socio-demographic and clinical diagnosis entries of 8421 entries were analyzed. Result: The population of the factory workers is 5370, where 40% (2148) are female workers and 60% (3222) are male workers. The mean age of respondents is 30 years, with a SD of ±7 years. Among the chief complaints, the most common was vomiting (14%;2262) fever (14%;2247), runny nose (11%;1842), cough (9%;1465), and loose motion (8%;1364). In the diagnosis categories, gastrointestinal diseases were more predominantly diagnosed (35%;2978), followed by viral fever (21%;1772), neurological diseases (16.5%;1389) and musculoskeletal disorders (9%;768). The average cost of medicine for each respondent is BDT 36. The factory covered costs of all medication for 99% (8380) of respondents. Only 0.5% (37) was referred to a tertiary hospital for further evaluation. Conclusion: Garments workers suffer mostly from long-term occupational health hazards. Factory owners and policy makers can contribute in various ways to improving primary healthcare options for workers.

Clinical diagnosis of severe COVID-19:A derivation and validation of a prediction rule

BACKGROUND The widespread coronavirus disease 2019(COVID-19)has led to high morbidity and mortality.Therefore,early risk identification of critically ill patients remains crucial.AIM To develop predictive rules at the time of admission to identify COVID-19 patients who might require intensive care unit(ICU)care.METHODS This retrospective study included a total of 361 patients with confirmed COVID-19 by reverse transcription-polymerase chain reaction between January 19,2020,and March 14,2020 in Shenzhen Third People’s Hospital.Multivariate logistic regression was applied to develop the predictive model.The performance of the predictive model was externally validated and evaluated based on a dataset involving 126 patients from the Wuhan Asia General Hospital between December 2019 and March 2020,by area under the receiver operating curve(AUROC),goodness-of-fit and the performance matrix including the sensitivity,specificity,and precision.A nomogram was also used to visualize the model.RESULTS Among the patients in the derivation and validation datasets,38 and 9 participants(10.5%and 2.54%,respectively)developed severe COVID-19,respectively.In univariate analysis,21 parameters such as age,sex(male),smoker,body mass index(BMI),time from onset to admission(>5 d),asthenia,dry cough,expectoration,shortness of breath,asthenia,and Rox index<18(pulse oxygen saturation,SpO2)/(FiO2×respiratory rate,RR)showed positive correlations with severe COVID-19.In multivariate logistic regression analysis,only six parameters including BMI[odds ratio(OR)3.939;95%confidence interval(CI):1.409-11.015;P=0.009],time from onset to admission(≥5 d)(OR 7.107;95%CI:1.449-34.849;P=0.016),fever(OR 6.794;95%CI:1.401-32.951;P=0.017),Charlson index(OR 2.917;95%CI:1.279-6.654;P=0.011),PaO2/FiO2 ratio(OR 17.570;95%CI:1.117-276.383;P=0.041),and neutrophil/lymphocyte ratio(OR 3.574;95%CI:1.048-12.191;P=0.042)were found to be independent predictors of COVID-19.These factors were found to be significant risk factors for severe patients confirmed with COVID-19.The AUROC was 0.941(95%CI:0.901-0.981)and 0.936(95%CI:0.886-0.987)in both datasets.The calibration properties were good.CONCLUSION The proposed predictive model had great potential in severity prediction of COVID-19 in the ICU.It assisted the ICU clinicians in making timely decisions for the target population.

China's great wall, Israel's Bar Lev Line, and passive infectious disease surveillance

Emerging infectious diseases are some of modern society's greatest threats. Like some great construction efforts designed to protect mankind, current public health measures against these emerging pathogens have not always been successful. This paper highlights the importance of embracing new interdisciplinary approaches towards emerging pathogen threats. One such approach, termed One Health, is quickly being embraced by professional organizations and public health institutions across the world as a way forward. This paper briefly discusses the above problems and preliminary steps taken by Chinese academic institutions to embrace the One Health approach.

Prevention of Gastrointestinal Pathologies: Comparative Study of the Microbial Flora of the Sanitary Surfaces of the Toilets of Students and Staff of the Félix Houphouët-Boigny University

Pathologies transmissible by hand such as gastrointestinal pathologies constitute a real public health problem, especially in sub-Saharan Africa where hygienic conditions are precarious. This study took place at Félix Houphouët-Boigny University from April to August 2018. The samples were taken from toilet surfaces such as doorknobs, tap heads, flush push buttons and seats WC. A total of three hundred and sixty-eight (368) samples were obtained, including 170 from the staff toilets and 198 from the student toilets. The results revealed the presence of total coliforms, Escherichia spp and Salmonella spp. The surfaces of student toilets were the most contaminated surfaces. The presence of entero-bacteria on the contact surfaces of the toilets of the Félix Houphouët-Boigny university represents a health risk for the university population.

Brazilian Spotted Fever Mortality Profile: 2018 to 2022

Background: Spotted Fever (SF) is an acute febrile zoonosis of variable severity that typically occurs in an endemic manner with worldwide distribution. Considering that SF is a disease of significant public health importance, this study aims to identify the mortality profile due to SF in Brazil from 2018 to 2022. Methods: Quantitative and descriptive cross-sectional approach. Data were collected from Brazilian Spotted Fever (BSF) cases registered in the Notifiable Diseases Information System (SINAN-DATASUS) across all regions of Brazil. The data collected includes information on the following variables: year of symptom, evolution, sex, race, environment of infection, region of notification, and age group. Subsequently, the data was entered into Microsoft Excel to create tables and graphs. The chi-square test was then applied to statistically analyze the associations between qualitative variables. A modified Poisson regression model with robust variance was constructed to analyze the age group data and determine which categories had different probabilities of death. The results show the estimates obtained for prevalence ratios, as well as their respective confidence intervals and p-values. The statistical software SAS version 9.4 was used to perform the analysis and a significance level of 5% was considered. Results: From 2018 to 2022, a total of 1126 cases of BSF were reported. Out of these cases, 59.3% (668) were cured, 32.4% (364) resulted in death, 1.1% (13) died from other causes and 7.2% (81) had no recorded outcome. Regarding the region with the highest death rate, the Southeast region led with 99.45% (362) of cases, followed by the Northeast region with 0.45% (2). As for the age group, the majority (63.7%) fell between the ages of 20 and 59 years old. In terms of race/color, 52.7% of the population identified as white. Regarding the contamination environment, 39.3% were in leisure areas. The outcome of death by BSF showed statistically significant associations with sex (p-value = 0.03) and age group (p-value = 0.003). Conclusion: The profile of deaths from Brazilian Spotted Fever primarily affects individuals from the Southeast region of the country, particularly men, and whites aged 20 years or older being contaminated mainly in leisure environments. This study provides a detailed understanding of the pattern of BSP-related deaths, providing crucial information for public health authorities. These insights provide valuable support for formulating informed policies and effective BSP control and prevention strategies.

Assessing the prevalence of young children living in households prepared for COVID-19 in 56 low-and middle-income countries

Background:The COVID-19 pandemic and governments’attempts to contain it are negatively affecting young children’s health and development in ways we are only beginning to understand and measure.Responses to the pandemic are driven largely by confining children and families to their homes.This study aims to assess the levels of and associated socioeconomic disparities in household preparedness for protecting young children under the age of five from being exposed to communicable diseases,such as COVID-19,in low-and middle-income countries(LMICs).Methods:Using data from nationally representative household surveys in 56 LMICs since 2016,we estimated the percentages of young children under the age of five living in households prepared for communicable diseases(e.g.,COVID-19)and associated residential and wealth disparities at the country-and aggregate-level.Preparedness was defined on the basis of space for quarantine,adequacy of toilet facilities and hand hygiene,mass media exposure at least once a week,and phone ownership.Disparities within countries were measured as the absolute gap in two domains—household wealth and residential area-and compared across regions and country income groups.Results:The final data set included 766,313 children under age five.On average,19.4%of young children in the 56 countries lived in households prepared for COVID-19,ranging from 0.6%in Ethiopia in 2016 to 70.9%in Tunisia in 2018.In close to 90%of countries(50),fewer than 50%of young children lived in prepared households.Young children in rural areas or in the poorest households were less likely to live in prepared households than their counterparts.Conclusions:A large portion of young children under the age of five in LMICs were living in households that did not meet all preparedness guidelines for preventing COVID-19 and caring for patients at home.This study highlights the need to ensure all families in LMICs have the means to prevent the spread of the pandemic or other communicable illnesses to young children during pandemics.

Capacity Development of National Reference Centers (NRC) to Face the Challenges of Emerging Infections in Côte d’Ivoire

Background: Some national and international strategies for the detection and prevention of emerging infectious diseases have been established across sectors. The capacity to carry out these tasks varies from country to country, and that remains largely undervalued. The Pasteur Institute of C?te d’Ivoire has created and implemented the capacity of national reference centers to fight against emerging and other infectious diseases. Objective: Show on the one hand the strategies used to develop the National Reference Centers and the IPCI and on the other hand the results obtained by performing these strategies. Method: Datas collection by documentary analysis (published scientific articles and grey literature) was done on Google Scholar, PUBMED and institutional reference documents. The documentary research was carried out to have a better understanding of strategies used to create and develop the NRCs in microbiology of communicable diseases. Results: Seven integrated strategies were launched: 1-training and workforce development;2-investigation of epidemics or public health events;3-strengthening laboratory epidemiological research;4-strengthening surveillance systems;5-improving communication with partners and stakeholders;6-building national and international collaborations;and 7-strengthening technical and technological platforms. In two decades, the number of researchers has risen from 10 in 2004 to ninety (90) in 2021, with 12 senior researchers and 32 junior researchers. A number of health service staff had attended a qualifying training course, 27 investigations into outbreaks and other public health events had been carried out, 18 short-term research projects had been launched, major surveillance programs and epidemiological research efforts on vector-borne, food-borne and nosocomial infections had begun, and several scientific manuscripts had been published or were edited in the writting press. Conclusion: The Ivorian experience shows that, with concerted effort, considerable progress can be made in the development and implementation of an infectious disease control program.

Needs and concerns of patients in isolation care units - learnings from COVID-19: A reflection

With strict measures in place to contain the spread of coronavirus disease 2019,many have been isolated as suspected or confirmed cases.Being isolated causes much inconvenience for the patients and family.Patients'and next-of-kins’needs and concerns during isolation will be shared together with suggestions for key process improvements.Our hospital’s Senior Patient Experience Managers contact all patients admitted to the isolation wards on a daily basis to provide some form of support.Common issues raised were gathered and strategies to help with their needs and concerns were discussed.Being in isolation is a challenging period for both patients and family.Nonetheless,we can implement measures to mitigate against the adverse effects of isolation.Patient education,effective and efficient means of communication,close monitoring for signs of distress and anxiety,and early intervention could help patients cope better with the whole isolation experience.Nursing management may want to consider implementing the measures shared in the article to manage patient’s stress while not compromising on staff safety.

The priority areas and possible pathways for health cooperation in BRICS countries

As one of the largest alliances of middle-income countries,the BRICS,known as an acronym for five countries including“Brazil,Russia,India,China,and South Africa”,represents half of the global population.The health cooperation among BRICS countries will benefit their populations and other middle-and low-income countries.This study aims to summarize the current status of health cooperation in BRICS countries and identify opportunities to strengthen BRICS participation in global health governance.A literature review was conducted to analyze the status,progress,and challenges of BRICS’health cooperation.Content analysis was used to review the 2011-2021 annual joint declarations of the BRICS Health Ministers Meetings.The priority health areas were identified through segmental frequency analysis.Our research suggested that communicable diseases,access to medicine,and universal health coverage appeared most frequently in the content of declarations,indicating the possible top health priorities among BRICS’health collaboration.These priority areas align with the primary health challenges of each country,including the threats of double burden of diseases,as well as the need for improving health systems and access to medicines.Respective external cooperation,inter-BRICS health cooperation,and unified external cooperation are the main forms of health cooperation among BRICS countries.However,challenges such as the lack of a unified image and precise position,lack of practical impact,and weak discourse power have impeded the impact of BRICS on health governance.This study suggests that the BRICS countries should recognize their positioning,improve their unified image,and establish cooperative entities;at the same time,they should increase their practical strength,promote non-governmental cooperation,and expand the cooperation space through the“BRICS Plus”mechanism with countries with similar interests to join.

Monkeypox awareness,knowledge,and attitude among undergraduate preclinical and clinical students at a Malaysian dental school:An emerging outbreak during the COVID-19 era

Objective:To evaluate the awareness,knowledge,and attitude on monkeypox viral infection among preclinical and clinical dental students in Malaysia.Methods:A cross-sectional study was conducted among 229 preclinical and clinical dental students via an online self-reported questionnaire.The questionnaire included 3 items on awareness,15 items on knowledge,9 items on attitude and 2 open-ended questions.Data were presented as frequencies and percentages.Chi-square test was used to compare knowledge and awareness scores between preclinical and clinical dental students and content analysis was performed for open-ended responses.Results:Preclinical and clinical dental students were aware of the existence of monkeypox(89.5%and 94.4%,respectively),that the disease emerged in non-endemic countries(81.0%and 87.1%,respectively)and that it was declared a public health emergency of international concern by the World Health Organization(73.3%and 79.0%,respectively).Clinical dental students’overall knowledge level was significantly higher than preclinical dental students(P=0.014).Both preclinical(95.2%)and clinical(96.8%)dental students demonstrated positive attitudes toward monkeypox with no significant difference(P=0.736)noted between them.Three themes emerged from the open-ended questions:(1)reimplementation of nationwide lockdown,(2)impact on the economy and health,and(3)disruption to the educational system.Students also anticipated their face-to-face learning to be reduced should there be a new outbreak.Conclusions:Both preclinical and clinical dental students showed comparable awareness and attitudes,while the latter demonstrated greater satisfactory knowledge toward the re-emergence of monkeypox during the COVID-19 pandemic.Nonetheless,efforts to improve dental students’understanding of this alarming outbreak are required,to safeguard their health and minimise transmission.

Impact of COVID-19 on mortality trends and patterns in a tertiary care hospital of Central India:A retrospective study

Objective:To investigate the impact of COVID-19 on the mortality trends and patterns in a tertiary teaching hospital in Raipur,Chhattisgarh,India.Methods:A hospital-based retrospective study was conducted to analyze the case reports of all deaths from January 2016 to December 2021 in a tertiary teaching hospital in Raipur,Chhattisgarh,India.The socio-demographic profile and the pattern of causes of death were recorded.The deaths were classified according to the 10th revision of the International Classification of Diseases.Results:A total of 6128 deaths were registered from 2016 to 2021 and the maximum death number was observed in 2021(38.2%)followed by 2020(32.5%)when the country was hit by the COVID-19 pandemic.The highest number of deaths was observed in the age group of 51 to 65 years i.e.,31.1%of the total deaths.In all five years,male deaths were more than female deaths,and more than 50%occurred within three days of hospitalization during the study period.Conclusions:Even though there is a rise in the death rate due to the sudden hit of COVID-19,the burden of both communicable and non-communicable diseases remains gradually increasing over the five years.There is a need for health awareness in the community about changing lifestyles and their harmful effects on health.

A scoping review on the field validation and implementation of rapid diagnostic tests for vector-borne and other infectious diseases of poverty in urban areas

Background:Health personnel face challenges in diagnosing vector-borne and other diseases of poverty in urban settings.There is a need to know what rapid diagnostic technologies are available,have been properly assessed,and are being implemented to improve control of these diseases in the urban context.This paper characterizes evidence on the field validation and implementation in urban areas of rapid diagnostics for vector-borne diseases and other diseases of poverty.Main body:A scoping review was conducted.Peer-reviewed and grey literature were searched using terms describing the targeted infectious diseases,diagnostics evaluations,rapid tests,and urban setting.The review was limited to studies published between 2000 and 2016 in English,Spanish,French,and Portuguese.Inclusion and exclusion criteria were refined post hoc to identify relevant literature regardless of study design and geography.A total of 179 documents of the 7806 initially screened were included in the analysis.Malaria(n=100)and tuberculosis(n=47)accounted for the majority of studies that reported diagnostics performance,impact,and implementation outcomes.Fewer studies,assessing mainly performance,were identified for visceral leishmaniasis(n=9),filariasis and leptospirosis(each n=5),enteric fever and schistosomiasis(each n=3),dengue and leprosy(each n=2),and Chagas disease,human African trypanosomiasis,and cholera(each n=1).Reported sensitivity of rapid tests was variable depending on several factors.Overall,specificities were high(>80%),except for schistosomiasis and cholera.Impact and implementation outcomes,mainly acceptability and cost,followed by adoption,feasibility,and sustainability of rapid tests are being evaluated in the field.Challenges to implementing rapid tests range from cultural to technical and administrative issues.Conclusions:Rapid diagnostic tests for vector-borne and other diseases of poverty are being used in the urban context with demonstrated impact on case detection.However,most evidence comes from malaria rapid diagnostics,with variable results.While rapid tests for tuberculosis and visceral leishmaniasis require further implementation studies,more evidence on performance of current tests or development of new alternatives is needed for dengue,Chagas disease,filariasis,leptospirosis,enteric fever,human African trypanosomiasis,schistosomiasis and cholera.