Early Warning and Monitoring of Coronavirus Disease 2019 Using Baidu Search Index and Baidu Information Index in Guangxi,China

Coronavirus disease 2019(COVID-19)is an emerging infectious disease,and it is important to detect early and monitor the disease trend for policymakers to make informed decisions.We explored the predictive utility of Baidu Search Index and Baidu Information Index for early warning of COVID-19 and identified search keywords for further monitoring of epidemic trends in Guangxi.A time-series analysis and Spearman correlation between the daily number of cases and both the Baidu Search Index and Baidu Information Index were performed for seven keywords related to COVID-19 from January 8 to March 9,2020.The time series showed that the temporal distributions of the search terms“coronavirus,”“pneumonia”and“mask”in the Baidu Search Index were consistent and had 2 to 3 days'lead time to the reported cases;the correlation coefficients were higher than 0.81.The Baidu Search Index volume in 14 prefectures of Guangxi was closely related with the number of reported cases;it was not associated with the local GDP.The Baidu Information Index search terms“coronavirus”and“pneumonia”were used as frequently as 192,405.0 and 110,488.6 per million population,respectively,and they were also significantly associated with the number of reported cases(rs>0.6),but they fluctuated more than for the Baidu Search Index and had 0 to 14 days'lag time to the reported cases.The Baidu Search Index with search terms“coronavirus,”“pneumonia”and“mask”can be used for early warning and monitoring of the epidemic trend of COVID-19 in Guangxi,with 2 to 3 days'lead time.

中国六省儿童HIV感染者的流行病学调查

目的了解中国六省儿童HIV感染者的流行病学状况。方法对6个艾滋病高发省份的儿童感染者进行横断面调查,采集患者人口学、感染途径、诊断时间、临床分期、实验室检测等数据。结果共650例患儿入选,男405例,女245例,平均年龄(7.9±3.2)岁,可能感染到确诊的平均时间间隔为(7.1±3.2)年。依次分布于河南570例(87.7%),广西23例(3.5%),云南21例(3.2%),湖北19例(2.9%),安徽10例(1.5%),山西7例(1.1%)。其中母婴传播488例(75.1%),输血及血制品传播102例(15.7%),静脉吸毒传播3例(0.5%)。以采供血为主要传播途径的省份(包括河南、山西、湖北、安徽)和以静脉吸毒为主要传播途径的省份(包括广西、云南)感染者的平均年龄分别为(8.1±3.2)和(5.4±2.2)岁,两组相比差异有显著性(P<0.001)。178例(39.3%,178/453)符合接受抗病毒治疗标准,其中133例(74.7%,133/178)未接受治疗,45例(25.3%,45/178)采用成人药物治疗。结论母婴传播是儿童感染HIV的主要途径,应当加强我国儿童HIV感染者的诊断和治疗工作。

Application of community-based and integrated strategy to reduce malaria disease burden in southern Tanzania:the study protocol of China-UK-Tanzania pilot project on malaria control

Background:During the past six decades,remarkable success on malaria control has been made in China.The major experience could be shared with other malaria endemic countries including Tanzania with high malaria burden.Especially,China’s 1-3-7 model for malaria elimination is one of the most important refined experiences from many years’efforts and key innovation measures for malaria elimination in China.Methods:The China-UK-Tanzania pilot project on malaria control was implemented from April,2015 to June,2018,which was an operational research with two communities receiving the proposed interventions and two comparable communities serving as control sites.The World Health Organization"Test,Treat,Track"(WHO-T3)Initiative,which calls for every suspected case to receive a diagnostic test,every confirmed case to be treated,and for the disease to be tracked,was integrated with Chinese experiences on malaria control and elimination for exploration of a proper model tailored to the local settings.Application of China’s 1-3-7 model integrating with WHO-T3 initiative and local resources aiming at reducing the burden of malaria in terms of morbidity and mortality by 30%in the intervention communities in comparison with that at the baseline survey.Discussion:The China-UK-Tanzania pilot project on malaria control was that at China’s first pilot project on malaria control in Africa,exploring the feasibility of Chinese experiences by China-Africa collaboration,which is expected that the strategies and approaches used in this project could be potential for scaling up in Tanzania and African countries,and contribute to the acceleration of malaria control and elimination in Africa.

Role of Diabetes Mellitus on Treatment Effects in Drug-susceptible Initial Pulmonary Tuberculosis Patients in China

We assessed the role of diabetes mellitus（DM） on treatment effects in drug‐susceptible initial pulmonary tuberculosis（PTB） patients. A prospective study was conducted in eight provinces of China from October 2008 to December 2010. We enrolled 1,313 confirmed drug‐susceptible initial PTB patients, and all subjects received the treatment regimen（2 H3 R3 E3 Z3/4 H3 R3） as recommended by the national guidelines. Of the 1,313 PTB patients, 157（11.9%） had DM; these patients had more sputum smear‐positive rates at the end of the second month [adjusted odds ratios（aO R） 2.829, 95% confidence intervals（CI） 1.783‐4.490], and higher treatment failure（aO R 2.120, 95% CI 1.565‐3.477） and death rates（aO R 1.536, 95% CI 1.011‐2.628）. DM was a contributing factor for culture‐positive rates at the end of the second month and treatment failure and death of PTB patients, thus playing an unfavorable role in treatment effects of PTB.

A Qualitative Exploration of the Role of Antiretroviral Therapy on Chinese Rural Life

Objective To explore factors influencing the quality of life of people living with HIV/AIDS （PLHA） and receiving antiretroviral therapy （ART） in rural China. Methods In-depth interviews with 20 PLHA recruited from the USAID-funded Longitudinal cohort of eligible PLHA receiving treatment were conducted in March 1999. Participants were Enhanced Evaluation of ART Project, which tracks a at five collaborating treatment centers in Guangxi Autonomous Region, China. An interview guide （semi-structured with open-ended questions） was developed to provide a qualitative examination of the quality of life of PLHA. Results Participants identified that ART affects physical health, including the experience of pain, side effects, and opportunistic infections. ART imposes lifestyle constraints such as reduced mobility due to drug procurement, and social restrictions due to the daily drug regimen. Participants discussed the psychological burden of taking drugs, and the fear of accidental transmission to others, or having their disease status known by others, as well as optimistic feelings about their future due to ART. ART poses a significant drain on individual＇s economic resources due to related medical costs, and inability to seek seasonal migrant labor due to reduced mobility. Conclusion While China＇s national free ART program improved the physical health of those surveyed, their social and economic needs were left unaddressed. To improve life outcomes for PLHA, and by extension, the wider Chinese population, quality of life measures should be included when evaluating the success of the ART program.

Risk of Treatment Failure in Patients with Drug-susceptible Pulmonary Tuberculosis in China

The objective of this prospective study of the risks of treatment failure in patients with drug-susceptible pulmonary tuberculosis （PTB） was to provide reference data to help develop a disease control strategy. Participants were recruited in eight provinces of China from October 2008 to December 2010. A total of 1447 patients with drug-susceptible PTB and older than 15 years of age were enrolled.

Effects of Cotrimoxazole Prophylaxis Initiation and Discontinuation on Mortality and Attrition Rates among HIV Patients Who Initiate ART in Southwest China:An Observational Cohort Study

Combination antiretroviral therapy(ART)reduced AIDS-related mortality and increased survival among patients living with HIV by interrupting HIV replication,enhancing immune recovery,and preventing the onset of opportunistic infections[1].In China,ART has rapidly been scaled up since the beginning of the National Free Antiretroviral Treatment Program(NFATP)in 2003[2].By the end of 2016,489,411 individuals diagnosed with HIV were receiving free antiretroviral treatment in China.China is firmly committed to reducing overall AIDS-related mortality and HIV incidence within the country.However,similar to other low-and middle-income countries,the NFATP is challenged by high mortality and attrition shortly after patients initiate ART[3].

Comparison of different strategies for controlling HIV/AIDS spreading in MSM

As proposed in the UNAIDSs 2014 report,to end global AIDS epidemic by 2030,90%of people living with HIV need to be diagnosed,90%of the diagnosed need to receive antiretroviral therapy(ART),and 90%of those on treatment need to achieve viral suppression(90-90-90 strategy).The strategies focus on the reservoir.It controls HIV spreading by reducing infectiousness of HIV infected individuals via diagnosis and treatment.In this manuscript,we compared the effects of HIV/AIDS interventions that focus on different individuals in MSM population through a dynamics model.Our results showed that,the success or not of the”90-90-90”strategies depends on a very important factor:the infectious strength among individuals taking ART.Without highly effective HIV treatment,the”90-90-90”strategies are likely to fail.Therefore,we call for the combination of both primary prevention among the susceptible with the 90-90-90 strategy among the infected to curb the HIV epidemic in Chinese MSM.

Risk Factors of Condom Use among Clients of Commercial Sex Workers in Saunas and Beauty Parlors in China

Objectives: To describe and analyze risk factors associatedwith disuse of condoms during commercial sexual intercourseamong clients attending sauna and massage centers. Methods: Selected female sex workers from saunas andbeauty parlors were trained as interviewers. They surveyedclients during provision of sexual services. Informationcollected included customers' demographics, knowledge ofSTDs, rationale for and history of condom use. Risk factorsfor condom usage were assessed though logistical modeling.Results: A total of 50 clients were interviewed. The rates ofcondom usage for last sexual intercourse with commercial andnon-commercial partners were 57% and 53% for clients ofsauna centers and 30% and 40% for clients of beauty parlors,respectively. The choice to use a condom was influenced byclients 60.8% of the time, sex workers 30.4%, and otherfactors 8.8%. The choice against using a condom was decidedupon by clients 69.7% of the time, sex workers 9.1%, andother factors 21.2%. Multivariate analysis showed thateducational level and perception of risk of infection werefactors for condom use. Clients with a high school educationhad a higher condom use rate than those with a middle schooleducation or less. Furthermore, clients who perceived risk ofdisease used condoms more frequently than those who did not.Conclusions: Clients played a significant role in decidingwhether or not to use a condom during commercial sex. Lackof perception of risk is a major factor for not using condoms.A program for promotion of prophylactics targeting bothcommercial sex workers and their clients is recommended.

Genetic Characterization of Four Strains Borrelia Burgdorferi Isolated in China

To study the genetic characterization of four strains of Borrelia burgdorferi isolated in China. PCR technique was used to amplify the 5S-23S rRNA intergenic spacer DNA from the whole cellular DNA of isolated GXLD-4, 9, 18 and Chang 14, and then the amplified products were cloned into plasmid pGEM-T Easy and sequenced. It was found that the 5S-23S rRNA intergenic spacer DNA of the four isolates was 242?bp, revealing the nucleotide sequence identity of more than 99%. The four isolates had higher sequence identify with Borrelia valaisiana than with other genetic groups. These four isolates most likely belong to Borrelia valaisiana genomic group.

COVID-19 Case Likely Caused by Contaminated Object During Hotel Disinfection-Guangxi Zhuang Autonomous Region,China,January 2021

On January 13,2021 in Nanning City of Guangxi Zhuang Autonomous Region,an individual(Patient A)tested positive for coronavirus disease 2019(COVID-19).Patient A provided a disinfection service for a business hotel in Nanning that was designated by the government to accept international travelers entering China and quarantine the travelers for 14 days.Patient A had no history of travel and had previously tested negative for COVID-19 twice on January 4 and January 11,2021.

Genetic Characterization of Two Human Cases Infected with the Avian Influenza A(H5N6)Viruses—Guangxi Zhuang Autonomous Region,China,2021

Summary What is known about this topic?H5N6 has replaced H5N1 as a dominant avian influenza virus(AIV)subtype in southern China.The increasing genetic diversity and geographical distribution of H5N6 pose a serious threat to the poultry industry and human health.What is added by this report?A total of 2 cases of H5N6 that occurred from February 2021 to July 2021 in Guangxi.

Detection of Variants of B.1.617 Lineage from Five Returning Chinese Nationals at a Guangxi-Vietnam Border Port——Guangxi Zhuang Autonomous Region,China,April 2021

A 47-year-old male(Patient A)passenger from Vietnam whose nucleic acid results for coronavirus disease 2019(COVID-19),also known as severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),were positive at Pingxiang Customs on April 29,2021,and subsequently confirmed by Guangxi CDC laboratories on April 30.

Changes in the epidemiology of hepatitis A in three socio-economic regions of China,1990-2017

Background:Hepatitis A(HepA)vaccination and economic transitions can change the epidemiology of HepA.China's Gross Domestic Product(GDP)per capita was known to be inversely associated with the incidence of HepA,but a deeper understanding of the epidemiology of HepA in different socio-economic regions is lacking.We compare the changing epidemiology of HepA in three socioeconomic-geographic regions of China.Methods:We obtained data on all HepA cases reported through the National Notifiable Disease Reporting System and assessed trends and changes in age-specific incidence rates by age quartile and season.We categorized the country into three regions,the sequential years into five era,compared the incidence,quartile age;seasonal intensity and coverage of HepA of the three regions.Linear regression was peiformed to analyse trends in incidence of HepA and to analyse the association between coverage and incidence.Results:The annual mean incidences of HepA in the eastern,central,and western regions decreased from 63.52/100000,50.57/100000 and 46.39/100000 in 1990-1992 to 1.18/100000,1.05/100000 and 3.14/100000 in 2012-2017,respectively.Decreases in incidence were seen in all age groups in the three regions;the incidence was highest(9.3/100000)in the youngest age group(0-4 years)of the western region,while in the central region,the age group with the highest incidence changed from 0 to 9 years to adults>60 years old.In 2017,the median age of HepA cases was 43 years(Q-Q3:33-55),47 years(Q1-Q3:32-60)and 33 years(Q1-Q3:9-52)in the eastern,central,and western provinces,respectively.Seasonal peaks became smaller or were nearly elimination nationwide,but seasonality persisted in some provinces.After the Expanded Program on Immunization(EPI)included HepA vaccine into the routine schedule in 2007,HepA coverage increased to>80%in the three regions and was negatively association with the HepA incidence.Conclusion:The incidence of HepA decreased markedly between 1990 and 2017.A socioeconomic inequity in coverage of HepA vaccine was almost eliminated after HepA vaccine was introduced into China's EPI system,but inequity in incidence still existed in lower socio-economic developed region.

Pretreatment HIV drug resistance in adults initiating antiretroviral therapy in China,2017

Background:After the scale-up of antiretroviral therapy(ART)for HIV infected people,increasing numbers of patients have pretreatment drug resistance(PDR).In this study,the prevalence of PDR was evaluated in adults initiating antiretroviral therapy in China.Methods:Blood samples were obtained from 1943 patients who initiated antiretroviral therapy(ART)in 2017 from 13 provinces or cities in China.Pol sequences were used to analyze drug resistance and construct transmission networks.Logistic regression model was used to estimate the potential factors associated with PDR.Results:In total,1711 eligible patients(76.0%male;87.8%aged≥25 years)were included,of which 117(6.8%)had PDR.The highest rates of PDR were 12.2%in Liangshan Prefecture of Sichuan and 9.3 and 8.9%in Dehong and Lincang Prefecture of Yunnan.A multivariate logistic regression analysis revealed that PDR was significantly higher among intravenous drug users(adjusted Odds Ratio(aOR)=2.64,95%CI:1.57–4.44)and individuals from Liangshan,Dehong,and Lincang(aOR=2.04,95%CI:1.26–3.30).In total,754 sequences were used to generate 164 transmission networks.Five transmission networks had two or three sequences containing the same mutations,two networks contained subjects from Liangshan,and one network contained subjects from Dehong.Conclusions:Overall,the PDR prevalence was moderate,with a particularly high prevalence in areas with severe HIV epidemics.These results indicate the importance of continuous PDR monitoring in patients initiating antiretroviral therapy.

Prevalence and risk factors of active pulmonary tuberculosis among elderly people in China:a population based cross-sectional study

Background:The problem of population aging is a critical public health concern in modern China,and more tuberculosis(TB)control efforts are needed to reach elderly people at high priority.In this study,we aim to determine the prevalence and identify the risk factors of TB among elderly people in China.Methods:A multistage cluster-sampled cross-sectional survey was conducted in 2013,and 27 clusters were selected from 10 counties of 10 provinces in China.All consenting participants greater than or equal to 65 years of age were screened for pulmonary TB with a chest X-ray(CXR)and a symptom questionnaire.Three sputum specimens for bacteriological examination by microscopy and culture were collected from those whose screening was positive.Prevalence was calculated,a multiple logistic regression model was performed to confirm the risk factors,and population attributable fraction(PAF)of each risk factor was calculated to indicate the public health significance.Results:Of 38888 eligible people from 27 clusters,34269 participants finished both questionnaire and physical examination.There were 193 active pulmonary TB cases,62 of which were bacteriologically confirmed.The estimated prevalence of active pulmonary TB and bacteriologically confirmed TB in those 65 years of age and older was 563.19 per 100000(95%CI:483.73-642.65)and 180.92 per 100000(95%CI:135.89-225.96),respectively.Male sex,older age,living in rural areas,underweight,diabetes,close contact of pulmonary TB(PTB)and previous TB history are all risk factors for TB.The risk of TB increased with increasing age and decreasing body mass index(BMI)after adjusting for other factors,and there is a positive dose-response relationship.Conclusions:In China,active case finding(ACF)could be implemented among elderly people aged 65 and above with underweight,diabetes,close contact history and previous TB history as a priority,which will get significant yields and be cost-effective.

Treatment outcomes of HIV patients with hepatitis B and C virus co-infections in Southwest China:an observational cohort study

Background:Antiretroviral therapy(ART)has reduced mortality among people living with HIV(PLWH)in China,but co-infections of hepatitis B virus(HBV)and hepatitis C virus(HCV)may individually or jointly reduce the effect of ART.This study aimed to evaluate the impacts of HBV/HCV coinfections on treatment drop-out and mortality among PLWH on ART.Methods:A retrospective cohort study analysis of 58,239 people living with HIV(PLWH)who initiated antiretroviral therapy(ART)during 2010-2018 was conducted in Guangxi Province,China.Data were from the observational database of the National Free Antiretroviral Treatment Program.Cox proportional hazard models were fitted to evaluate the effects of baseline infection of HBV or HCV or both on death and treatment attrition among PLWH.Results:Our study showed high prevalence of HBV(11.5%),HCV(6.6%)and HBV-HCV(1.5%)co-infections.The overall mortality rate and treatment attrition rate was 2.95[95%confidence interval(CI):2.88-3.02]and 5.92(95%CI:5.82-6.01)per 100 person-years,respectively.Compared with HIV-only patients,HBV-co-infected patients had 42%higher mortality[adjusted hazard ratio(a HR)=1.42;95%CI 1.32-1.54],HCV-co-infected patients had 65%higher mortality(a HR=1.65;95%CI:1.47-1.86),and patients with both HCV and HBV co-infections had 123%higher mortality(a HR=2.23;95%CI:1.87-2.66).Conclusions:HBV and HCV coinfection may have an additive effect on increasing the risk of all-cause death among PLWH who are on ART.It is suggested that there is need for primary prevention and access to effective hepatitis treatment for PLWH.