BackgroundSexually Transmitted Infections (STIs) are a global challenge. China, once said to have eradicated STIs, is now facing a rapid rise in the prevalence of HIV/STIs. This review of reviews aims to map HIV/STI risk factors among the Chinese population, with the objective of identifying risk factors to inform the formulation of effective prevention strategies.MethodsA systematic search using key terms related to HIV/STIs, risk factors and the Chinese population in both English and Chinese databases (PubMed, PsycINFO, the Cochrane Library; Wanfang data, CNKI, VIP and SINOMED) was conducted, and peer-reviewed systematic reviews on the topic from 1991 to 2014 were selected. Identified risk factors were grouped into different level determinants based on the HIV Social Epidemiology Model, and then evaluated and reported based on the PRISMA checklist.FindingsOf the twenty-eight reviews included, the majority were focused on well-established, individual level risk factors within key populations, with some highlighting the complexity of interacting factors (e.g., alcohol use and higher income in male migrants). While twenty-two reviews covered individual factors, only ten mentioned social factors and five had contents on structural factors. There are gaps in the evidence on social and structural level impacts of HIV/STIs, such as on stigma, discrimination, health policy, access to care, and illicit drug control policies. Migration and social expectation appear to pose a significant threat in aggravating the HIV/STI situation in China; for example, incarceration patterns indicated a significant risk of HIV/STIs for female sex workers.ConclusionsSince international guidelines recommend an integrated and multi-level approach to HIV/STI prevention, a comprehensive approach targeting interventions at all levels along the continuum of care is needed to effectively curtail HIV/STI transmission in China. More research is needed to better understand the impact of socio-political interventions within a Chinese context.

Influenza-like illness can be caused by a wide range of respiratory viruses. In order to investigate the epidemiology of viral pathogens related to influenza-like illness in children of Wuhan, the largest city in central China, throat swab samples were collected from 1,472 young patients, from July 2008 to June 2010, before and after the occurrence of the 2009 pandemic influenza A (H1N1) virus (pH1N1). It was found that 923 patients (62.7%) were positive for at least 1 virus and 90 patients (9.8%) were detected for multiple (≥2) respiratory viruses by real-time PCR detection of 16 viruses. Seasonal influenza A virus was the predominant pathogen among all the 16 viruses with a positive rate of 13.3% (196/1,472), which was followed by pH1N1 (159/1,472). It was also noted that the viral distribution pattern in Wuhan changed upon the introduction of the pH1N1 virus.

We investigated the seasonality of tuberculosis (TB) in Wuhan, China, to evaluate the increased risk of disease transmission during each season and to develop an effective TB control strategy. We applied spectral analysis to the weekly prevalence data of sputum smear positive (SSP) and sputum smear negative (SSN) pulmonary TB reported from 2006 to 2010. Cases of both SSP and SSN feature 1·0- and 0·5-year periodic modes. The least squares method was used to fit curves to the two periodic modes for SSP and SSN data. The curves demonstrated dominant peaks in spring similar to cases reported previously for other locations. Notably for SSP, dominant peaks were also observed in summer. The spring peaks of SSP and SSN were explained in terms of poorly ventilated and humid rooms and vitamin D deficiency. For the summer peaks of SSP, summer influenza epidemics in Wuhan may contribute to the increase in TB prevalence.

Measles is regarded as a disease that can be eliminated by vaccination; however, disease epidemics still occur in Wuhan, China. This study explored the effect of measles control programmes on the periodic structure of disease epidemics in Wuhan. The monthly reported measles incidence from 1953 to 2008 was divided into pre-vaccine range (1953-1965) and post-vaccine range (1966-2008). For the incidence in each range, spectral analysis was conducted and power spectral density (PSD) was obtained. In PSD for the pre-vaccine range, the most dominant spectral line was observed at a 2·0-year period, as in the case of Japan. It was confirmed that spectral lines of periodic modes longer than a 1-year cycle of the incidence rates behave in response to the introduction of measles control programmes. The investigation of periodic structures of measles epidemics will contribute to effective measles control programmes in Wuhan.