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BackgroundMalaria remains a public health concern in Hubei Province despite the significant decrease in malaria incidence over the past decades. Furthermore, history reveals that malaria transmission is unstable and prone to local outbreaks in Hubei Province. Thus, understanding spatial, temporal, and spatiotemporal distribution of malaria is needed for the effective control and elimination of this disease in Hubei Province.MethodsAnnual malaria incidence at the county level was calculated using the malaria cases reported from 2004 to 2011 in Hubei Province. Geographical information system (GIS) and spatial scan statistic method were used to identify spatial clusters of malaria cases at the county level. Pure retrospective temporal analysis scanning was performed to detect the temporal clusters of malaria cases with high rates using the discrete Poisson model. The space-time cluster was detected with high rates through the retrospective space-time analysis scanning using the discrete Poisson model.ResultsThe overall malaria incidence decreased to a low level from 2004 to 2011. The purely spatial cluster of malaria cases from 2004 to 2011 showed that the disease was not randomly distributed in the study area. A total of 11 high-risk counties were determined through Local Moran’s I analysis from 2004 to 2011. The method of spatial scan statistics identified different 11 significant spatial clusters between 2004 and 2011. The space-time clustering analysis determined that the most likely cluster included 13 counties, and the time frame was from April 2004 to November 2007.ConclusionsThe GIS application and scan statistical technique can provide means to detect spatial, temporal, and spatiotemporal distribution of malaria, as well as to identify malaria high-risk areas. This study could be helpful in prioritizing resource assignment in high-risk areas for future malaria control and elimination.

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ObjectiveTo provide information about the role of liver fluke infection as a risk factor for hepatobiliary pathological changes and promote awareness among the people living in endemic areas, a systematic review and meta-analysis based on published studies was conducted to examine the association between liver fluke infection and hepatobiliary pathological changes.MethodsRelevant original literature was searched in multiple literature databases, including PubMed, Cochrane, Clinical Evidence, Trip Database, Clinical Trials, Current Controlled Trials, Web of Science, the China National Knowledge Infrastructure (CNKI) database, and the Wanfang academic journal full-text database. Studies were selected based on strict screening with inclusion and exclusion criteria. Tests of heterogeneity, sensitivity and publication bias were performed with the Review Manager software, version 5.3, and meta-regression analyses were performed with the Stata software, version 11.0 (Stata Corporation, College Station, TX, USA). Pooled risk ratios (RRs) and odds ratios (ORs) with their 95% confidence intervals (95% CIs) were calculated and used to evaluate the risk of hepatobiliary pathological changes resulting from liver fluke infection. Linear trend analyses were conducted to determine the dose-response relationship using IBM SPSS Statistics 20.0.ResultA total of 36 studies were included in the meta-analysis. Significant associations were found between liver fluke infection and cholangitis or cholecystitis (RR: 7.80, P<0.001; OR: 15.98, P<0.001), cholelithiasis (RR: 2.42, P = 0.03; OR: 4.96, P = 0.03), hepatocellular carcinoma (OR: 4.69, P<0.001) and cholangiocarcinoma (RR: 10.43, P<0.001; OR: 4.37, P<0.001). In addition, heavier infection was significantly associated with higher incidence of hepatobiliary pathological changes (P<0.05). However, cirrhosis was not significantly associated with liver fluke infection (RR: 3.50, P = 0.06; OR: 5.79, P = 0.08). The statistical heterogeneity was significant, no significant difference was observed in the sensitivity analysis, and no publication bias was found.ConclusionThe meta-analysis found that liver fluke infection was significantly associated with cholangitis, cholecystitis, cholelithiasis, hepatocellular carcinoma and cholangiocarcinoma and that more severe infection was associated with higher incidence. However, the association between liver fluke infection and cirrhosis was not significant.

Indoor allergen exposures were positively associated with asthma diagnosis and persistent respiratory symptoms among Chinese adolescents. Neither early-life nor current exposure to animals was protective for asthma or asthma-related symptoms.

OBJECTIVE:To examine relationships between body mass index (BMI) and psychological correlates in Chinese school adolescents during the period of economic transition. DESIGN: Baseline data of 1655 Chinese adolescents aged 11-15 y were retrieved from a longitudinal smoking cessation and health promotion program in Wuhan, China. Assessments of body weight and height, depressive symptoms, perceived peer isolation (PPI) and perceived availability of social support (PASS) were collected. RESULTS: Based on the International Obesity Task Force (IOTF) age-and sex-specific BMI cutoffs, 12.5% of boys and 9.2% of girls were overweight. In girls, high BMI was significantly related to higher self-reported depressive symptoms, and was dominantly mediated by PPI. On the contrary, high BMI boys reported significantly lower levels of PPI although high PPI level aggravated depressive symptoms. For both girls and boys, the observed effect of PPI on the relationship between BMI and depressive symptoms was sustained only in low PASS boys and girls. CONCLUSIONS: The present study revealed different effects of PPI on the association of BMI and depressive symptoms between boys and girls, which were buffered by levels of PASS. The findings of this study may contribute to our understanding of the influences of psychological correlates in pediatric overweight in the Eastern cultural environment.

BackgroundHubei Province, China, has been operating a malaria elimination programme. This study aimed at investigating the epidemiologic characteristics of malaria in Hubei Province (2005–2016) to plan resource allocation for malaria elimination.MethodsData on all malaria cases from 2005 to 2016 in all counties of Hubei Province were extracted from a web-based reporting system. The numbers of indigenous and imported cases during the disease control (2005–2010) and elimination (2011–2016) stages, as well as their spatiotemporal distribution, were compared.ResultsA total of 8109 malaria cases were reported from 2005 to 2016 (7270 and 839 cases during the control and elimination stages, respectively). Between 2005 and 2010, indigenous malaria cases comprised the majority of total cases (7114/7270; 97.9%), and Plasmodium vivax malaria cases accounted for most malaria cases (5572/7270; 76.6%). No indigenous malaria cases have been reported in Hubei Province since 2013. Imported malaria cases showed a gradually increasing trend from 2011 to 2016, Plasmodium falciparum was the predominant species in these cases, and the number of counties with imported cases increased from 4 in 2005 to 47 in 2016. During the control and elimination stages, the most likely spatial clusters for indigenous cases included 13 and 11 counties, respectively. However, the cluster of indigenous malaria cases has not been identified since September 2011. For imported cases, the most likely cluster and three secondary clusters during both stages were identified.ConclusionsHubei Province has made significant achievements in controlling and eliminating malaria; however, the region now faces some challenges associated with the increasing number and distribution of imported malaria cases. Priorities for malaria elimination should include better management of imported malaria cases, prevention of secondary malaria transmission, and ensuring the sustainability of malaria surveillance.