Association of physical activity with risk of chronic kidney disease in China:A population-based cohort study

Background:Information on the association between physical activity(PA)and the risk of chronic kidney disease(CKD)is limited.We aimed to explore the associations of total,domain-specific,and intensity-specific PA with CKD and its subtypes in China.Methods:The study included 475,376 adults from the China Kadoorie Biobank aged 30-79 years during 2004-2008 at baseline.An interviewer-administered questionnaire was used to collect the information about PA,which was quantified as metabolic equivalent of task hours per day(MET-h/day)and categorized into 4 groups based on quartiles.Cox regression was used to analyze the association between PA and CKD risk.Results:During a median follow-up of 12.1 years,5415 incident CKD cases were documented,including 1159 incident diabetic kidney disease(DKD)cases and 362 incident hypertensive nephropathy(HTN)cases.Total PA was inversely associated with CKD risk,with an adjusted hazard ratio(HR,95%confidence interval(95%CI))of 0.83(0.75-0.92)for incident CKD in the highest quartile of total PA as compared with participants in the lowest quartile.Similar results were observed for risk of DKD and HTN,and the corresponding HRs(95%CIs)were 0.75(0.58-0.97)for DKD risk and 0.56(0.37-0.85)for HTN risk.Increased nonoccupational PA,low-intensity PA,and moderate-to-vigorous-intensity PA were significantly associated with a decreased risk of CKD,with HRs(95%CIs)of 0.80(0.73-0.88),0.85(0.77-0.94),and 0.85(0.76-0.95)in the highest quartile,respectively.Conclusion:PA,including nonoccupational PA,low-intensity PA,and moderate-to-vigorous-intensity PA,was inversely associated with the risk of CKD,including DKD,HTN,and other CKD,and such associations were dose dependent.

Comparative Study on the Immunogenicity and Efficacy of Different Post-exposure Intramuscular Rabies Vaccination Regimens in China

Objective This study aimed to compare the current Essen rabies post-exposure immunization schedule(0-3-7-14-28)in China and the simple 4-dose schedule(0-3-7-14)newly recommended by the World Health Organization in terms of their safety,efficacy,and protection.Methods Mice were vaccinated according to different immunization schedules,and blood was collected for detection of rabies virus neutralizing antibodies(RVNAs)on days 14,21,28,35,and 120after the first immunization.Additionally,different groups of mice were injected with lethal doses of the CVS-11 virus on day 0,subjected to different rabies immunization schedules,and assessed for morbidity and death status.In a clinical trial,185 rabies-exposed individuals were selected for post-exposure vaccination according to the Essen schedule,and blood was collected for RVNAs detection on days 28and 42 after the first immunization.Results A statistically significant difference in RVNAs between mice in the Essen and 0-3-7-14 schedule groups was observed on the 35th day(P<0.05).The groups 0-3-7-14,0-3-7-21,and 0-3-7-28 showed no statistically significant difference(P>0.05)in RVNAs levels at any time point.The post-exposure immune protective test showed that the survival rate of mice in the control group was 20%,whereas that in the immunization groups was 40%.In the clinical trial,the RVNAs positive conversion rates on days 28(14 days after 4 doses)and 42(14 days after 5 doses)were both 100%,and no significant difference in RVNAs levels was observed(P>0.05).Conclusion The simple 4-dose schedule can produce sufficient RVNAs levels,with no significant effect of a delayed fourth vaccine dose(14–28 d)on the immunization potential.

The Survey of Cronobacter spp.(formerly Enterbacter sakazakii) in Infant and Follow-up Powdered Formula in China in 2012

Objective To determine Cronobacter spp. contamination in infant and follow-up powdered formula in China. Methods All of 2282 samples were collected from the retail markets in China from January 2012 to December 2012, and analyzed for Cronobacter spp. by the Chinese National Food Safety Standard. Characterization of the isolates was analyzed by pulsed-field gel electrophoresis（PFGE） with XbaI and Spe I restriction enzymes. Results Cronobacter spp. strains were isolated from 25 samples, and the positive rates in infant powdered formulas and follow-up powdered formulas were 0.90%（10/1011） and 1.18%（15/1271）, respectively. Analysis of variable data regarding different purchasing store formats, seasonality, and production locations as well as comparison of infant versus follow-up formulas did not reveal statistically significant factors. During the sampling period, one of six surveillance zones did exhibit a statistically significant trend towards higher positive rate. PFGE characterization of Cronobacter spp. to elucidate genetic diversity revealed only three pairs of Cronobacter spp. out of 25 having the same PFGE patterns. Conclusion The current investigation indicated a lower positive rate of Cronobacter spp. in the powdered formula in China. This evidence suggested contamination originating from multiple different sources during the manufacturing process.

Characteristics of Long-term Nonprogressors and Viremia Controllers Infected with HIV-1 via Contaminated Blood Donations or Transfusions Conducted 20 Years Earlier

To characterize long-term nonprogressors （LTNPs） and viremia controllers （VCs）, infected with HIV-1 through contaminated blood donation or transfusion between 1992 and 1996 in Henan, China. LTNPs and VCs were defined by CD4＋T lymphocyte （CD4） count and viral load （VL）. Of 29,294 patients infected with HIV-1 via contaminated blood donation or transfusion that had conducted for more than 20 years, 92 were LTNPs/VCs. There were 70 LTNPs （0.24%）, 43 VCs （0.15%）, and 48 LTNPs＋VCs- （0.16%）.

Distribution of Avian Influenza A Viruses in Poultry-Related Environment and Its Association with Human Infection in Henan, 2016 to 2017

Objective To survey avian influenza A viruses(AIVs) in the environment and explore the reasons for the surge in human H7 N9 cases.Methods A total of 1,045 samples were collected from routine surveillance on poultry-related environments and 307 samples from human H7 N9 cases-exposed environments in Henan from 2016 to2017. The nucleic acids of influenza A(Flu A), H5, H7, and H9 subtypes were detected by real-time polymerase chain reaction.Results A total of 27 H7 N9 cases were confirmed in Henan from 2016 to 2017, 24 had a history of live poultry exposure, and 15 had H7 N9 virus detected in the related live poultry markets(LPMs). About 96%(264/275) Flu A positive-environmental samples were from LPMs. H9 was the main AIV subtype(10.05%) from routine surveillance sites with only 1 H7-positive sample, whereas 21.17% samples were H7-positive in H7 N9 cases-exposed environments. Samples from H7 N9 cases-exposed LPMs(47.56%)had much higher AIVs positive rates than those from routine surveillance sites(12.34%). The H7+H9 combination of mixed infection was 78.18%(43/55) of H7-positive samples and 41.34%(43/104) of H9-positive samples.Conclusion The contamination status of AIVs in poultry-related environments is closely associated with the incidence of human infection caused by AIVs. Therefore, systematic surveillance of AIVs in LPMs in China is essential for the detection of novel reassortant viruses and their potential for interspecies transmission.

Genomic Epidemiology of ST34 Monophasic Salmonella enterica Serovar Typhimurium from Clinical Patients from 2008 to 2017 in Henan,China

Salmonella enterica serovar 4,[5],12:i:-(S.4,[5],12:i:-)is a monophasic variant of Salmonella enterica serovar Typhimurium that has emerged as a global serovar causing public health concern.To date,the epidemiology and genomic characterization of this pathogen in China have not been well described.We investigated the prevalence,antimicrobial resistance(AMR)phenotypes,and population genomics of sequence type 34(ST34)S.4,[5],12:i:-among cases of human salmonellosis in Henan Province,China.A total of 100 ST34 S.4,[5],12:i:-isolates were studied from 2008 to 2017 and found mostly resistant to ampicillin(AMP),streptomycin(STR),sulfonamides(SUL),and tetracycline(TET)(ASSu T).Bayesian phylogenetic analysis demonstrated that isolates identified in China were mostly related to the European lineage and evolved into two major clades with different resistance genes and plasmid profiles.Notably,clade 1 showed a significantly higher rate of mutations in gyr A and plasmid-mediated quinolone resistance genes.The carrying of the resistance-containing region(encoding R-type ASSu T),including bla(conferring resistance to AMP),str AB(STR),sul2(SUL),and tet(B)(TET)inserted into the flj BA operon,was responsible for most of the monophasic variants in clade 2.Inc HI2 plasmids were the dominant multi-drug resistance mobile genetic elements accounting for the transmission of acquired resistance genes in this serovar,and these were more prevalent in clade 1.Our findings highlighted the increasing prevalence of multi-drug resistant S.4,[5],12:i:-in China,along with the differential characteristics of resistance gene acquisition among various lineages.Based on our data,control measures are required to address the spread of this zoonotic pathogen.Further owing to its potential origin in food-producing animals,a"One Health"approach,should be implemented to support surveillance whilst informing interventional strategies.

Characterization of Salmonella Enterica Serotype Typhimurium from Outpatients of 28 Hospitals in Henan Province in 2006

Objective To characterize the diarrheal patients with Salmonella typhimurium （S. typhimurium） infections and to set up the first baseline for S. typhimuri_um pulsed-field gel electrophoresis （PFGE） patterns in Henan province, thus laying a foundation for comprehensive surveillance of Salmonella in human as well as foods. Methods S. typhimurium isolates recovered from outpatients with diarrhea in Henan province from May to October of 2006 were characterized. Antimicrobial susceptibility tests of 8 antimicrobial agents and PFGE were carried out to analyze the S. typhimurium isolates. Results Twenty-four （0.9%） S. typhimurium isolates were identified from 2661 stool specimens of diarrheal cases. Eighty-eight percent of isolates showed resistance to at least one antimicrobial agent. The resistance to chloramphenicol （79%） was most common. Fifty-eight percent of isolates were resistant to ciprofloxacin. All the 14 ciprofloxacin-resistant isolates were resistant to more than five antimicrobial agents. Thirty-three percent of S. typhimurium isolates were resistant to ampicillin, chloramphenicol, streptomycin, sulfamethoxazole, and tetracycline （R-type ACSSuT）. Eight antimicrobia-resistant phenotypes were found among the 24 isolates in 16 PFGE patterns. Conclusion The rate of multidrug-resistant S. typhimurium is relatively high in S. typhimurium PFGE patterns of Henan province. Multidrug-resistant S. typhimurium should be considered a public health threat.

Investigating the Aggregation of Imported Cutaneous Leishmaniasis in Henan, Central China

Leishmania is a parasitic disease caused due to infection with Leishmaniasis,which is prevalent in 88 countries across the globe[1].Clinically,Leishmaniasisis is divided into 3 types:visceral leishmaniasis(VL),mucosal cutaneous leishmaniasis(MCL),and cutaneous leishmaniasis(CL)[2].

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。

Comparison of Xpert MTB/RIF, Real Amp, and CPA Tests in Detecting Mycobacterium tuberculosis

Today, tuberculosis (TB) remains a global public health threat associated with significantly high rates of morbidity and mortality. The World Health Organization's (WHO) Global Tuberculosis Report 2018[1] has reported that in 2017, 10.0 million people across the world had developed TB diseases that resulted in an estimated 1.6 million deaths, and 889, 000 people developed TB in China that led to 39, 000 TB-related deaths. Therefore, rapid and accurate detection of Mycobacterium tuberculosis (MTB) is important for initiating early treatment and reducing mortality. Traditional diagnostic methods for pulmonary TB incorporate chest radiography and sputum smear microscopy;however, several cases of tuberculosis go undiagnosed because of the low sensitivity of smear microscopy[2].

Factors associated with primary transmission of multidrug-resistant tuberculosis compared with healthy controls in Henan Province, China

Background:It is estimated that there are about 74,000 primary multidrug-resistant tuberculosis(MDR-TB)patients per year according to the prevalence of MDR-TB of 5.7%among new TB patients in China.Thus,the risks of primary transmission of MDR-TB require further attention.This study aimed to identify the factors associated with primary transmission of MDR-TB in Henan province,where the number of new TB patients is ranked second highest in China.Methods:A 1:1 matched case–control study was conducted in Henan,China.Cases were primary MDR-TB patients who were individually matched with a healthy control without TB from the same neighborhood.The study was conducted from July 2013 to June 2014.Both case and control were matched by age(±5 years)and sex.Conditional logistic regression was used to compute adjusted odds ratios(AORs)with corresponding 95%confidence intervals(CIs)for risk factors associated with primary MDR-TB.Results:For the study,146 pairs of participants were recruited.The final multivariable logistic regression model disclosed that after adjusting for age and sex,primary MDR-TB cases were more likely to be single(AOR,5.4;95%CI,1.4–20.7),earn an annual income of≤12,000 yuan(RMB)(AOR,9.9;95%CI,2.0–48.1),experience more life pressure/stress(AOR,10.8;95%CI,2.8–41.5),not be medically insured(AOR,50.1;95%CI,8.2–306.8),and suffer from diabetes,cardiovascular disease or other respiratory diseases,or cancer(AOR,57.1;95%CI,8.6–424.2).Conclusions:In order to control primary transmission of MDR-TB in China,we recommend that improving the social support,living standards and medical security of the lower social class become a priority.

Outbreak of Dengue Fever in Central China,2013

In 2013,the first dengue fever（DF） outbreak in central China was reported in the central of Henan province,northern temperate regions,although they have been sequentially recorded in Southern China.106 suspected DF cases were reported and 73 patients were confirmed dengue virus type 3（DEN-3） infections.62/392（15.8%） local health persons showed DEN antibodies positive.To this day Henan is the northernmost province in China which has been reported about outbreak of DF and what is important is that it warns us the endemic range of DF has been expanded geographically in China.

Low Doses of Rifampicin Used in New Tuberculosis Patients Correlated to Increased Frequency of Rifampicin-Resistance and Poorer Treatment Outcomes

The prognosis of patients with previously treated tuberculosis (TB) was suggested to be dependent on whether the initial treatment was in compliance with the established guidelines. The aim of this retrospective multicenter study was to determine the proportion of new TB patients who received standard doses of rifampicin in multiple provinces of China, and the relationship between low doses of rifampicin and frequency of rifampicin-resistance as well as treatment outcomes. A total of 713 new TB patients were treated with either once-daily dose of bulk anti-TB drugs (group I) or every other day combination blister packs of anti-TB drugs containing rifampicin (group II) at more than 30 TB treatment centers/hospitals in China. Treatment history, therapeutic doses of rifampicin, and information about patients were extracted from their medical records and analyzed, and rifampicin-resistance of isolates collected from patients following the treatment as well as treatment outcomes were compared between two treatment groups. Among 522 patients in treatment group I, 154 (29.5%) received standard and 363 (69.5%) received low doses of rifampicin;238 (45.6%) isolates were rifampicin-resistant, and 243 (46.6%) were successfully treated. Among 191 patients in treatment group II, 175 (91.6%) received standard and 15 (7.9%) received low doses of rifampicin;72 (37.7%) isolates were rifampicin-resistant, and 105 (55%) were successfully treated. When patients who received low doses of rifampicin were compared to others within the same treatment group, increased rates for rifampicin-resistance and treatment failure were observed. Results from this study showed that most new TB patients in treatment group I (69.5%) received low doses of rifampicin, and their treatment outcomes were worse than those in treatment group II, indicating that low doses of rifampicin used for the initial treatment of new TB patients were correlated to increased frequency of rifampicin-resistance and poorer treatment outcomes.

Study of HIV-1 Drug Resistance in Patients Receiving Free Antiretroviral Therapy in China

To investigate the prevalence of drug-resistance mutations,resistance to antiretroviral drugs,and the subsequent virological response to therapy in treatment-naive and antiretroviral-treated patients infected with HIV/AIDS in Henan,China,a total of 431 plasma samples were collected in Queshan county between 2003 and 2004,from patients undergoing the antiretroviral regimen Zidovudine + Didanosine + Nevirapine(Azt+Ddi+Nvp).Personal information was collected by face to face interview.Viral load and genotypic drug resistance were tested.Drug resistance mutation data were obtained by analyzing patient-derived sequences through the HIVdb Program(http://hivdb.stanford.edu).Overall,38.5% of treatment-naive patients had undetectable plasma viral load(VL),the rate significantly increased to 61.9% in 0 to 6 months treatment patients(mean 3 months)(P<0.005)but again significantly decrease to 38.6% in 6 to 12 months treatment patients(mean 9 months)(P<0.001)and 40.0% in patients receiving more than 12 months treatment(mean 16 months)(P<0.005).The prevalence of drug resistance in patients who had a detectable VL and available sequences were 7.0%,48.6%,70.8%,72.3% in treatment-na?ve,0 to 6 months treatment,6 to 12 months treatment,and treatment for greater than 12 months patients,respectively.No mutation associated with resistance to Protease inhibitor(PI)was detected in this study.Nucleoside RT inhibitor(NRTI)mutations always emerged after non-nucleoside RT inhibitor(NNRTI)mutations,and were only found in patients treated for more than 6 months,with a frequency less than 5%,with the exception of mutation T215Y(12.8%,6/47)which occurred in patients treated for more than 12 months.NNRTI mutations emerged quickly after therapy begun,and increased significantly in patients treated for more than 6 months(P<0.005),and the most frequent mutations were K103N,V106A,Y181C,G190A.There had been optimal viral suppression in patients undergoing treatment for less than 6 months in Queshan,Henan.The drug resistance strains were highly prevalent in antiretroviral-treated patients,and increased with the continuation of therapy,with many patients encountering virological failure after 6 months therapy.

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.

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.

Correlation Analysis on Total Lymphocyte Count and CD4 Count in HIV-infected Patients: A Retrospective Evaluation

CD4 count is the standard method for determining eligibility for highly active antiretroviral therapy （HAART） and monitoring HIV/AIDS disease progression, but it is not widely available in resource-limited settings. This study examined the correlation between total lymphocyte count （TLC） and CD4 count of HIV-infected patients before and after HAART, and assessed the thresholds of TLC for making decisions about the initiation and for monitoring HAART. A retrospective study was performed, and 665 HIV-infected patients with TLC and CD4 count from four counties （Shangcai, Queshan, Shenqiu and Weishi） were included in the study. Pearson correlation and receiver operating characteristic （ROC） were used. TLC and CD4 count after HAART was significantly increased as compared with pre-HAART （P〈0.01）. An overall positive correlation was noted between TLC and CD4 count （pre-HAART, r=0.73, P=0.0001; follow-up HAART, r=0.56, P=0.0001）. The ROC curve between TLC and CD4 count showed that TLC ≤ 1200 cells/mm3 could predict CD4 〈 200 cells/mm3 with a sensitivity of 71.12%, specificity of 66.35% at pre-HAART. After 12-month HAART, the optimum prediction for CD4 count 〈 200 cells/mm3 was a TLC ≤ 1300 cells/mm3, with a sensitivity of 63.27%, and a specificity of 74.84%. Further finding indicated that TLC change was positively correlated to CD4 change （r=0.77, P=0.0001） at the time point of 12-month treatment, and the best prediction point of TLC change for CD4 increasing was 135 cells/mm3. TLC and its change can be used as a surrogate marker for CD4 count and its change of HIV-infected individuals for making decisions about the initiation and for monitoring HAART in resource-limited settings.

Complete Human Immunodeficiency Virus-1 Specific T Lymphocyte Response to Chinese Human Immunodeficiency Virus-1 B/C Chronic Infectors

Objective To characterize the human immunodeficiency virus （HIV） -specific T lymphocyte responses and identify the immunodominant regions in Chinese HIV-1 recombinant subtype B/C chronic infectors at complete genome level. Methods Twenty-five HIV-I B/C recombinant chronic infectors were screened for their specific T lymphocyte responses to a panel of peptides corresponding to the complete HIV-1 subtype B genome by gamma interferon ELISPOT assay. Kruskal-Wallis nonparametric analysis of variance was used to test significant differences across gene regions, and Tukey pairwise analysis was used to identify differences between gene regions. Spearman rank correlation was used to assess the relation between responses. Results The order of recognized frequencies of specific T lymphocyte responses to HIV proteins was Nef〉Vpr〉Gag〉Pol〉Vpu〉Env〉Rev〉Vif〉Tat. When adjusted for protein length, Nef, Vpr, Gag, and Pol were the most intensely targeted proteins and the central region of Nef, Gag p24, Pol RT, and Vpr was most frequently recognized. No significant correlation was observed between the magnitude of IFN-γ production of HIV-l-specific T lymphocyte responses and plasma viremia, breadth of response and CD4 counts. Conclusion The central region of Nef, Gag p24, Pol RT, and Vpr is most frequently targeted in HIV-1 B/C recombinants chronic infectors. HIV-1-specific T lymphocyte responses and plasma viremia or CD4 counts play no protective role at complete genome level in these infectors.

残余胆固醇与心血管、癌症死亡率的相关性:一项全国性队列研究

The health significance of triglyceride-rich lipoproteins,also known as remnant cholesterol,has been increasingly recognized.However,evidence of their associations with cause-specific mortality in the general population was previously insufficient.To explore these associations and their heterogeneities across subgroups,a prospective cohort study was conducted including 3,403,414 community-based participants from China HEART,an ongoing government-funded public health program throughout China,from November 2014 through December 2022.The study assessed mortality risk of all-cause mortality,cardiovascular disease(CVD)mortality(including mortality from ischemic heart diseases(IHD),ischemic stroke(IS),and hemorrhagic stroke(HS),separately),and cancer mortality(including lung cancer,stomach cancer,and liver cancer,separately).During the 4-year follow-up,23,646 individuals died from CVD(including 8807 from IHD,3067 from IS,and 5190 from HS),and 20,318 from cancer(including 6208 from lung cancer,3013 from liver cancer,and 2174 from stomach cancer).Compared with individuals with remnant cholesterol<17.9 mg/d L,multivariable-adjusted mortality hazard ratios(HRs)for individuals with remnant cholesterol≥27.7 mg/d L were 1.03(1.00–1.05)for all-cause mortality,1.17(1.12–1.21)for CVD(1.19(1.12–1.27)for IHD mortality,and 1.22(1.09–1.36)for IS mortality),and 0.90(0.87–0.94)for allcancer mortality(0.94(0.87–1.02)for lung cancer,0.59(0.53–0.66)for liver cancer,and 0.73(0.64–0.83)for stomach cancer).In summary,this study revealed a correlation between increased remnant cholesterol levels and an elevated risk of cardiovascular disease mortality,as well as a reduced risk of mortality for certain types of cancer.

Epidemiological Characteristics of Human Parainfluenza Viruses Infections-China,2019-2023

Introduction:A retrospective study based on sentinel surveillance was conducted in 10 provinciallevel administrative divisions(PLADs)in China to enhance the understanding of the epidemiological characteristics of human parainfluenza viruses(HPIVs).Methods:From January 2019 to June 2023,respiratory specimens were collected from individuals with acute respiratory infections(ARIs)and screened for four HPIVs serotypes and other common respiratory viruses using multiplex real-time polymerase chain reaction(PCR).This study analyzed the association of HPIVs infections with seasonal patterns,geographical distribution,demographic profiles,clinical features,and co-infection status.Results:During the study period,a total of 12,866 ARIs were included.The overall detection rate of HPIVs was 6.15%,varying from 5.04%in 2022 to 9.70%in 2020.The median age of HPIVs-infected patients was 3 years.HPIV2 was more prevalent among individuals aged 5–17 years(42.57%),while HPIV4 was more common in those over 65 years(12.24%).HPIV3(54.16%)and HPIV1(27.18%)were the predominant serotypes,and their prevalence exhibited significant seasonal fluctuations postcoronavirus disease 2019(COVID-19)pandemic.The peak of HPIV3 shifted three months later in 2020 compared to 2019 and returned to a summer peak thereafter.Two peaks of HPIV1 were observed in 2021 following the peak of HPIV3.Additionally,coinfections were frequent in HPIVs cases(overall rate:22.12%),with human rhinovirus being the most common co-infecting virus.Conclusions:The prevalence of HPIVs in China was predominantly due to HPIV3 and HPIV1,and their seasonal patterns were altered by pandemic restrictions.Hence,continuous surveillance of HPIVs is essential.