bioRxiv Science⌕ Search
Home/Archive/bioRxiv

bioRxiv · 10.1101/472340

Exploratory study of factors associated with human brucellosis in mainland China based on time-series-cross-section data from 2005 to 2016

Lin, Y.·Zhang, T.·Zhang, X.
View original source ↗Export metadata ↓

Abstract

ObjectiveMany studies focused on reasons behind the increasing incidence and the spread of human brucellosis in mainland China, yet most of them lacked comprehensive consideration with quantitative evidence. Hence, this study aimed to further investigate the epidemic mechanism and associated factors of human brucellosis in China so as to provide suggestions on more effective countermeasures.\n\nMethodsData of human brucellosis incidence and some associated factors in economy, animal husbandry, transportation and health were collected at provincial level from 2005-2016. Time series plot and cluster analysis were first used to visualize incidence levels and categorize provinces based on their incidence level and epidemic trend of human brucellosis. Furthermore, according to the characteristics of data, the dynamic panel data model in combination with supervised principal component analysis was proposed to explore the effects of associated factors on human brucellosis.\n\nResults[circled1] The incidence rate of human brucellosis has increased threefold (from 1.41 in 2005 to 4.22 in 2016) in mainland China. Incidence rates in the north have always been higher than those in the south, but the latter also experienced an upward trend especially in the recent five years. [circled2] The 31 provinces of mainland China were categorized into three clusters, and each cluster had its own characteristics of incidence level and epidemic trend. [circled3] Public health expenditure and rural medical expenditure proportion were potential protective factors of human brucellosis, with attribute risks of -0.74 and -1.04 respectively. Other factors (such as amount of sheep, total length of highways, etc.) exhibited relatively trivial effects.\n\nConclusionsThe epidemic status of human brucellosis has changed in both spatial and temporal dimensions in recent years. Apart from those traditional control measures, more attention should be paid to the improvement of medical healthcare especially in rural areas in order to strengthen the control effect.

Source connections

Explore related subjects

epidemiologyPreprint

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Lin, Y., Zhang, T., Zhang, X.. 2018-11-16. Exploratory study of factors associated with human brucellosis in mainland China based on time-series-cross-section data from 2005 to 2016. https://doi.org/10.1101/472340

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related preprints

bioRxiv2018

Economic performance and cost-effectiveness of using a DEC-salt social enterprise for eliminating the major neglected tropical disease, lymphatic filariasis

BackgroundSalt fortified with the drug, diethylcarbamazine (DEC), and introduced into a competitive market has the potential to overcome the obstacles associated with tablet-based Lymphatic Filariasis (LF) elimination programs. Questions remain, however, regarding the economic viability, production capacity, and effectiveness of this strategy as a sustainable means to bring about LF elimination in resource poor settings.\n\nMethodology and Principal FindingsWe evaluated the performance and effectiveness of a novel social enterprise-based approach developed and tested in Leogane, Haiti, as a strategy to sustainably and cost-efficiently distribute DEC-medicated salt into a competitive market at quantities sufficient to bring about the elimination of LF. We undertook a cost-revenue analysis to evaluate the production capability and financial feasibility of the developed DEC salt social enterprise, and a modeling study centered on applying a dynamic mathematical model localized to reflect local LF transmission dynamics to evaluate the cost-effectiveness of using this intervention versus standard annual Mass Drug Administration (MDA) for eliminating LF in Leogane. We show that the salt enterprise because of its mixed product business strategy may have already reached the production capacity for delivering sufficient quantities of edible DEC-medicated salt to bring about LF transmission in the Leogane study setting. Due to increasing revenues obtained from the sale of DEC salt over time, expansion of its delivery in the population, and greater cumulative impact on the survival of worms, this strategy could also represent a significantly more cost-effective option than annual DEC tablet-based MDA for accomplishing LF elimination.\n\nSignificanceA social enterprise approach can offer an innovative market-based strategy by which edible salt fortified with DEC could be distributed to communities both on a financially sustainable basis and at sufficient quantity to eliminate LF. Deployment of similarly fashioned intervention strategies would improve current efforts to successfully accomplish the goal of LF elimination, particularly in difficult-to-control settings.\n\nAuthor summaryWith less than three years remaining for meeting the 2020 target set by WHO for accomplishing the global elimination of Lymphatic Filariasis (LF), concerns are emerging regarding the feasibility of meeting this goal using the current tablet-based Mass Drug Administration strategy. Salt fortified with the antifilarial drug, diethylcarbamazine (DEC), could offer an intervention that avoids many of the barriers connected with tablet-based elimination programs. We analyzed the economic performance and cost-effectiveness of a novel DEC-salt social enterprise developed and tested in Leogane arrondissement, Haiti, as a particularly significant strategy for accomplishing sustainable LF elimination in such complex settings. We show that because of increasing revenue from the sale of the DEC salt over time, expansion of its delivery in the population, and the adverse effect of continuous consumption of the drug on worms, the delivery of DEC through a salt enterprise can represent a significantly more cost-effective option than annual DEC tablet-based MDA for accomplishing LF elimination in settings, like Leogane. We indicate that development of policy and research into how to deploy similarly-fashioned interventions, or work with the salt industry to increase population use of medicated salt, would improve present efforts to successfully accomplish the elimination of LF.

epidemiology↗
bioRxiv2018

Molecular epidemiology and high mortality of Crimean-Congo hemorrhagic fever in Oman: a re-emerging infection

BackgroundCrimean-Congo hemorrhagic fever (CCHF) is a serious disease with a high fatality rate reported in many countries. The first case of CCHF in Oman was detected in 1995 and serosurveys have suggested widespread infection of humans and livestock throughout the country.\n\nMethodologyCases of CCHF reported to the Ministry of Health (MoH) of Oman between 1995 and 2017 were retrospectively reviewed. Diagnosis was confirmed by serology and/or molecular tests in Oman. Stored RNA from recent cases was studied by sequencing the complete open reading frame (ORF) of the viral S segment at Public Health England, enabling phylogenetic comparisons to be made with other S segments of strains obtained from the region.\n\nFindingsOf 88 cases of CCHF, 4 were sporadic in 1995 and 1996, then none occurred until 2011. From 2011-2017, incidence has steadily increased and 19 (23.8%) of 80 cases clustered around Eid Al Adha. The median (range) age was 33 (15-68) years and 79 (90%) were male. The major risk for infection was contact with animals and/or butchering in 73/88 (83%) and only one case was related to tick bites alone. Severe cases were over-represented: 64 (72.7%) had a platelet count < 50 x 109/L and 32 (36.4%) died. There was no intrafamilial spread or healthcare-associated infection. The viral S segments from 11 patients presenting in 2013 and 2014 were all grouped in Asia 1 (IV) lineage.\n\nConclusionsCCHF is well-established throughout Oman, with a single strain of virus present for at least 20 years. Most patients are men involved in animal husbandry and butchery. The high mortality suggests that there is substantial under-diagnosis of milder cases. Preventive measures have been introduced to reduce risks of transmission to animal handlers and butchers and to maintain safety in healthcare settings.\n\nAuthor summaryCrimean-Congo hemorrhagic fever, an often fatal tick-borne viral disease, has made an impact in the Sultanate of Oman--affecting nationals and expatriates alike--for the past 20 years. In this retrospective review of the epidemiology and outcomes of cases in Oman from 1995 to 2017, we identified 4 sporadic cases in 1995 and 1996, then none until 2011, followed by a steady increase until 2017. The mortality rate of 32 of 88 cases (36.4%) is high in comparison to studies from other countries and this could be explained by under-diagnoses of milder cases in the Sultanate.\n\nTransmission is commonly associated with animal husbandry and butchering and 88% cases were infected by contact with animals, whereas transmission by tick bite is more commonly recorded in some countries. A proportion of cases (23.8%) were clustered around the Eid-Al-Ahda festival which has, from 2011-2017, occurred in the summer months, which have a higher risk of transmission. This additional risk has been noted and preventive measures have been introduced to reduce the risk of transmission to animal handlers and butchers.

epidemiology↗
bioRxiv2018

Mother to child blocking of hepatitis B virus and post vaccination serological test in Qinghai province

BackgroundIn 2016, Qinghai Province and the Asian Liver Center of Stanford University in the United States cooperated to carry out a one-year project of hepatitis B mother-to-child blockade and post-immunization serological test in our province. Through this study, we evaluated the current situation of hepatitis B maternal and infant blockade and the effect of maternal and infant blockade in multi-ethnic areas of Qinghai Province.\n\nMethodsFrom May 1, 2016 to April 30, 2017, all pregnant women who gave birth in Qinghai Province were screened for HBsAg. For pregnant women who were screened for HBsAg positive, the medical staff had a detailed understanding of the history and treatment of hepatitis B, and provided scientific nutritional support and guidance. Free hepatitis B immunoglobulin (100 units) injections were given to newborns born to HBsAg-positive mothers within 12 hours after birth, and three doses of hepatitis B vaccination were given. All newborns born to HBsAg-positive mothers were followed up from 1 to 3 months after complete immunization of HBIG and HepB. The County (district) CDC was responsible for rapid fingertip blood screening, screening for HBsAg-positive children, collecting 3ml of venous blood for quantitative detection of HBsAg.\n\nResultsDuring the study period, 61381 pregnant women were hospitalized, 6027 (97.79%) pregnant women were screened for HBsAg. 1912 pregnant women were detected positive for HBsAg, with a positive rate of 3.19%. The HepB vaccine rate was 97.11% in live infants within 24 hours. The vaccination rate of hepatitis B vaccine was 94.78% and the injection rate of HBIG was 97.15% in 12-hour live delivery children of HBsAg positive mothers. A total of 864 newborns born to HBsAg positive mothers were followed up. Fast fingertip blood test was performed 1-3 months after HBIG injection and whole course hepatitis B vaccination. The positive rate of HBsAg was 5.21%. 34 positive serum samples were detected by chemiluminescent immunoassay in the laboratory of provincial CDC. The coincidence rate of HBsAg positive was 82.35%, and that of HBV DNA positive was 79.41%. Fifty-seven children with HBV surface antibody negative were detected and vaccinated with HBV vaccine free of charge in the whole course according to the national immunization program.\n\nConclusionThe infection rate of hepatitis B among women of childbearing age in Qinghai province is 3.19%, and the blocking rate of mother and infant is 94.79%. It is still necessary to strengthen the injection of hepatitis B vaccine and HBIG for positive mothers and children. Keyword: Hepatitis B, Mother to child blocking, Evaluation of the effect\n\nAuthor SummaryThis study revealed for the first time the infection rate of hepatitis B virus among women of childbearing age of different nationalities in Qinghai-Tibet Plateau through screening of pregnant women in hospital, blocking of mother and infant, and following-up of serum test after immunization. To evaluate the combined blocking effect of hepatitis B vaccine and HBIG by carrying out mother-to-child blocking and follow-up. The results of this study can provide beneficial reference for the development of hepatitis B virus mother-to-child blocking in minority population in Plateau area.

epidemiology↗