Objective To know about the baseline and quality of clinical prophylaxis and treatment study on communicable diseases in China, by identifying and assessing the clinical studies published in Chinese Journal of Infectious Diseases for 18 years. Method Handsearching page by page to identify and register the clinical studies from the journal, the definition of randomized controlled trial (RCT) and controlled clinical trial (CCT) strictly according to the Cochrane Collaboration Handbook (1997). Results There were totally 214 clinical studies during the 18 years, including 67 RCTs, 67 CCTs and 80 Non-CCTs. The average sample size of the RCTs was 103.0±70.2 (range from 17 to 296). Counted by every 5 years period (3 years period from 1998 to 2000), the proportion of RCTs in clinical studies was increasing steadily. The proportion were 22.9% from 1983 to 1987 (11/48), 29.2% from 1988 to 1992 (14/48), 41.9% from 1993 to 1997 (26/62), 28.6% from 1998 to 2000 (16/56) respectively. The main diseases studied in 214 clinical studies include: virus hepatitis (65 studies), hemorrhagic fever with renal syndrome (19 studies), typhoid fever (11 studies), bacterial infection (13 studies), bacillary dysentery (5 studies), epidemic encephalitis B (3 studies) and parasitosis (9 studies). Conclusion RCT study design should be applied as much as possible. The quality of clinical studies on communicable diseases in China remains to be improved. Multi-center and large-scale collaborative study is worthy to advocate.
The World Health Organization estimates that 25% of the 57 million annual deaths that occur globall are caused by microbes. A study reported 1 415 species of infectious organisms are known to be pathogenic to humans. Zoonoses constitute 61% of all known infectious diseases, with humans serving as the primary reservoir for only 3% of them. Of the 175 infectious species considered to be emerging, 75% are zoonotic. Zoonotic diseases and their impact on human and animal health are not monitored, prevented, and treated in an integrated way, despite the fact that etiologies and treatments are similar across species. The efficacy and resistance of a drug in one species has a bearing on others, in the context of zoonoses. Further, an RCT involving many species is effective in a natural setting, is robust, and may require fewer human volunteers. One Health is based on a systems approach and a collaborative effort of multiple disciplines – working locally, nationally, and globally – to attain optimal health for people, animals, and the environment. Systematic reviews and meta-analyses have so far been independent and discipline oriented. Pooling of results for diagnostic test accuracies and treatment effects of drugs for zoonoses across species has to be done, since the results of preclinical trials emanate from laboratory animals. The Cochrane Collaboration is the platform of choice to initiate a new group on zoonoses to carry out systematic meta-analyses of diagnostic tests and drug efficacies without bias, thus underpinning the systems approach and One Health.
Objective To describe the design and application of an emergency response mobile phone-based information system for infectious disease reporting. Methods Software engineering and business modeling were used to design and develope the emergency response mobile phone-based information system for infectious disease reporting. Results Seven days after the initiation of the reporting system, the reporting rate in the earthquake zone reached the level of the same period in 2007, using the mobile phone-based information system. Surveillance of the weekly report on morbidity in the earthquake zone after the initiation of the mobile phone reporting system showed the same trend as the previous three years. Conclusion The emergency response mobile phone-based information system for infectious disease reporting was an effective solution to transmit urgently needed reports and manage communicable disease surveillance information. This assured the consistency of disease surveillance and facilitated sensitive, accurate, and timely disease surveillance. It is an important backup for the internet-based direct reporting system for communicable disease.
Background and Objective Nearly half of million have been reported dead after earthquakes in recent 20 years, and many people always concern seriously about whether those corpses pose a risk to epidemics after earthquakes. An evidence-based approach was conducted to assess the relationship between dead bodies and epidemic disease outbreak systematically. Methods We searched PubMed, The Cochrane Library (Issue 1, 2008), CNKI and WHO website and screened the references of eligible studies. Results A total of 10 papers published beween 1988 to 2007 were included for final analysis, including 2 editorials, 4 reviews and 4 technical reports (technical note or manual). The risk factors for epidemic outbreak after earthquakes were associated primarily with safe water, food and sanitation facilities, as well as the density of population, and no evidence was found that those corpses would pose a risk to the outbreak. But standard infection control precautions should be observed when human corpses were handled. Conclusion Management of dead bodies should be brought into the emergency preparedness system, disaster manuals and guidelines. A community-centered approach to informing communities about the management of the dead following earthquake is also needed. Meanwhile, the myth of about dead bodies and disease outbreak should be dispelled.
目的 探讨成都市传染病医院护理应急体系的构建方法、效果。 方法 成立护理应急管理小组；组建护理应急梯队；储备应急物资和设备；加强护理应急人员知识技能培训和实战演练；严格防护措施与消毒隔离流程。 结果 出色地完成了多次突发传染病的救治工作，培养了一支具有丰富应急救治经验的专业护理人员队伍。 结论 建立完善的护理应急体系可有效提高突发事件的应急保障能力。
目的 总结成都市某男男性行为人群（MSM）中人类免疫缺陷病毒（HIV）感染者合并其他传染病的情况，为科学防治艾滋病提供依据。 方法 2010年1月－12月，采用网络、现场、活动场所收发调查问卷，用Excel统计结果数据。 结果 共调查104例艾滋病患者，合并肝炎感染者11例（10.58%），其中乙肝病毒感染者8例（7.69%），丙肝病毒感染者3例（2.88%）；合并性传播疾病感染61例（58.65%），其中梅毒感染26例（25%），尖锐湿疣感染者17例（16.35%），生殖器疱疹感染者10例（9.62%），淋病感染者2例（1.92%），沙眼衣原体感染者4例（3.85%），生殖道支原体感染者2例（1.92%）；合并真菌感染者87例（62.14%），其中耶氏肺孢子菌感染者6例（5.77%），马尔尼菲青霉菌感染者2例（占1.92%），隐球菌感染者5例（4.81%），组织胞浆菌1例（0.96%）；合并结核感染者23例（22.12%）及非结核分枝杆菌3例（2.88%）；病毒感染14例（13.46%），全部为水痘-带状疱疹病毒感染；寄生虫感染（弓形虫）1例（0.96%）。 结论 在MSM人群中HIV患者性传播疾病感染比例高；真菌感染率高；结核感染率高；HCV感染和弓形虫感染率低。
ObjectiveTo provide scientific evidence for the prevention and control of infectious diseases in hospitals through analyzing the data of notified infectious diseases collected in one general comprehensive hospital from 2009 to 2014. MethodsDescriptive method was used to analyze the data of infectious diseases reported through the reporting system in 6 years in the hospital, and then the incidence, diseases classification and transmission route were summarized. ResultsA total of 15 847 cases, covering 32 notified infectious diseases, were reported between 2009 and 2014, including 15 144 category-B (95.56%) and 703 category-C (4.44%) infectious disease cases, among which the top four were syphilis, hepatitis B, tuberculosis and acquired immune deficiency syndrome (AIDS), with AIDS showing upward trend year by year. There were also 38 H1N1 cases of emerging infectious disease cases. In the view of the trend, there was an upward trend from 2009 to 2012, while there was a downward trend from 2012 to 2014. There were cases for all age groups, and most cases occurred among patients at an age of 40 to 44, accounting for 11.25% of the total cases. Eighteen occupations were involved, and the top five in terms of the number of infections accounted for 63.96% of all the cases. ConclusionCategory-B infections have been the major diseases reported in our hospital from 2009 to 2014. Therefore, the priority of our job in the future should be focused on prevention and control of syphilis, hepatitis B, tuberculosis and AIDS.
Objective To optimize the report procedure of infectious diseases, solve the problems during routine surveillance such as incomplete report and incorrect report, in order to improve the report quality of infectious diseases. Methods Common problems in the report cards which were systematically collected in the infectious disease report management system were analyzed. Then, through negotiation with engineers of the information center, procedures which might easily lead to errors were deleted, report procedures were optimized. Furthermore, clinicians were also trained on infectious disease report from time to time. The entire study was divided into three periods, including baseline period (from October 1, 2012 to December 31, 2013), intervention period (from January 1, 2014 to December 31, 2014) and enhanced intervention period (from January 1, 2015 to December 31, 2015). The incorrect report rate and incomplete report rate were automatically calculated and compared among the three periods to evaluate the report quality. Results Compared with the baseline period, the total incomplete rate in the enhanced intervention period decreased from 8.21% to 3.19% (χ2=103.143,P<0.001), the incorrect report rate of hepatitis B virus decreased from 32.84% to 21.63% (χ2=19.002,P<0.001), and the incorrect report rate of syphilis decreased from 24.93% to 6.86% (χ2=90.416,P<0.001). respectively. Conclusion The infectious disease report system plays a very important role in timely identification of errors and improvement of incomplete and incorrect report, and is of great significance in the management of infectious diseases.
Medical institutions of China still face two challenges in hospital infections currently: one challenge is from infection, including infectious diseases, multidrug-resistant bacteria healthcare-associated infection (HAI), and classic HAI; the another challenge comes from the management of HAI in medical institutions, such as lack of full-time staff and insufficient capacity, inadequate infection control organizations, insufficient awareness of infection control among medical staff, and unbalanced development. To cope with these severe challenges, we must do the following three aspects: establishing the discipline of HAI, and improving people’s infection control ability through human-orienting; improving the management organization and system of HAI; improving the awareness of infection control among all medical staff, carrying out scientific and orderly infection prevention and control work in accordance with the law, and adhering to evidence-based infection control.