Экскурс современным эпидемиологическим проблемам и эволюционным учениям в эпидемиологии

Facilitating the WHO expanded program of immunization: the clinical profile of a combined diphtheria, tetanus, pertussis, hepatitis B and Haemophilus influenzae type b vaccine

Objective To investigate the death status and cause of death of newborns in critical care centers at different levels in Henan province. Methods Retrospective analysis was performed on the death cases at 85 critical neonatal treatment centers in 18 cities of Henan province from January to December 2018, and the similarities and differences in neonatal mortality, age of death and causes of death among cities and county-level critical neonatal care centers were compared. Results (1) A total of 99 832 neonates were admitted to 85 hospitals, and 318 neonates died, with a mortality rate of 3.19‰.A total of 42 066 neonates were admitted to 21 municipal hospitals, and 194 neonates died, with a mortality rate of 4.6‰.Among them, 109 cases (56.2%) were premature infants (14 cases were of 28 weeks, 70 cases were of 28-34 weeks, 25 cases were of >34-37 weeks), and 85 cases (43.8%) were full-term infants.A total of 57 766 neonates were admitted to 64 county-level hospitals, with 124 deaths and a mortality rate of 2.1‰.Among them, 67 cases (54.0%) were full-term infants, 57 cases (46.0%) were premature infants (9 cases were of 28 weeks, 34 cases were of 28-34 weeks and 14 cases were of >34-37 weeks). The mortality rates at muni-cipal hospital were higher than those at the county-level hospitals, and the difference was statistically significant (χ2=46.589, P<0.05). (2) Neonatal death mainly occurred within 1 week after birth, especially within 1 day after birth.There were 81 deaths (41.8%) in 21 municipal hospitals within 1 day, including 50 premature infants (61.7%) and 31 full-term infants (38.3%). There were 75 deaths (60.5%) in 64 county-level hospitals within 1 day, including 34 premature infants (45.3%) and 41 full-term infants (54.7%). The mortality rate in county-level hospitals was higher than that in the municipal hospital within 1 day, and the difference was statistically significant(χ2=10.621, P< 0.05). (3)The top 5 causes of neonatal death in the municipal and the county-level hospitals were pulmonary diseases (130 cases, 40.8%), birth asphyxia (74 cases, 23.3%), infection (50 cases, 15.7%), congenital malformation (24 cases, 7.5%), and very-early premature/very-low birth weight infants (12 cases, 4.1%). (4)For early (within 1 week after birth) death of full-term infants, the main causes of death in municipal hospitals were lung diseases (mainly neonatal respiratory distress syndrome/acute respiratory distress syndrome), birth asphyxia, infection, congenital malformation.The leading causes of death at county-level hospitals were birth asphyxia, pulmonary diseases and infection.For premature infants who died within 1 week, the main causes of death at the municipal and the county-level hospitals were pulmonary diseases and birth asphyxia.For late-stage (2-4 weeks after birth) death of neonates, whether full-term infants or premature infants, the main cause of death in municipal and county-level hospitals was infection. Conclusions There are differences in neonatal mortality, mortality within 1 day after birth and the first cause of death at critical neonatal treatment centers at municipal and county-level hospitals.For the early-stage(within 1 week) neonates, the main causes of death in municipal and county-level hospitals are lung diseases (mainly neonatal respiratory distress syndrome/acute respiratory distress syndrome), birth asphyxia and infection.For the late-stage neonates, infection is the main cause of death in the municipal and the county-level hospitals.It is necessary to improve the neonatal care ability of critical neonatal treatment centers at different levels separately in order to reduce neonatal mortality. Key words: Infant, newborn; Mortality; Cause of death

Objective To analyze of causes of death in elderly patients undergoing maintenance hemodialysis (MHD) and their major risk factors. Methods A total of 105 patients aged ≥60 years under MHD treatment for more than 3 months from Jun 2010 were included with complete basic registration information in this retrospective cohort study. The deadline of the follow-up was 30 Jun 2013. Results Among 105 patients, the median age was 69 years and the median dialysis duration was 27 months. 33 patients died during the follow-up period. The main causes for death were cardiovascular disease (11 cases, 33.3%), infection (7 cases, 21.2%) and cerebrovascular disease (5 cases, 15.2%). Age and the proportion of patients with cardiovascular diseases and peripheral vascular calcification score were higher, and the proportion of hypertension patients was lower in death group than in survival group. After adjusting for age, body mass Index, kt/v, and calcification score, COX regression analysis indicated that complications with cardiovascular disease (HR=2.143, 95% CI: 1.010~4.613, P=0.049), without hypertension (HR=0.293, 95% CI: 0.097~0.889, P=0.03), and with lower serum level of albumin (HR=0.838, 95% CI: 0.748~0.904, P=0.002) were the main risk factors for mortality in elderly patients on MHD. Conclusions The main causes for death in elderly MHD patients are cardiovascular disease, infection and cerebrovascular disease. Malnutrition and the comorbidity of cardiovascular disease might be the main risk factors for mortality in elderly MHD patients. Key words: Hemodiafiltration; Cause of death

The molecular biologist against infectious disease: Infectious diseases, in both the developing and the developed world, still pose considerable challenges to biomedical research. But science alone is clearly not sufficient to overcome the burden of disease in the world

Objective To assess the leading causes of death and disability adjusted life year (DALY) due to non-communicable disease (NCD) in China. Methods World Health Report 2004 published by the World Health Organization (WHO) was reviewed, including total deaths, deaths per 100 000, age-standardized death rate per 100 000, total DALYs, DALYs per 100 000 and age-standardized DALYs per 100 000 by cause and by member state. Diseases or injuries were assigned to three levels: communicable diseases, NCD and injuries (the first level); categories of disease or injure (the second level); specific diseases (the third level). R2.15 was used for data analysis. Results NCD causes 737.6 million deaths, 141million total DALY years, 627 age standardized mortality per 100 000, and 10 829 age-standardized DALYs per 100 000. NCD account for 79.4% and 70.3% total death or all-cause DALYs. Conclusions Cardiovascular disease, malignant neoplasm and respiratory disease were the leading causes of death, while neuropsychiatric disorder, cardiovascular disease and sense organ disease were the most important causes of DALYs. Among China, the United Kingdom, the United States, Canada, Japan, Korea and India, China ranked second in age-standardized mortality rate of chronic disease. DALYs of esophagus cancer and chronic obstructive pulmonary disease were 6 or 2 times of world average level. Besides, the increasing trend in the prevalence of diabetes mellitus remains impressive. Key words: Global burden of disease; Non-communicable disease; Disability adjusted life year; Age-standard death rate

Abstract. Khariri, Andriani L. 2020. The predominance of non-communicable diseases and unhealthy eating patterns. Pros Sem Nas Masy Biodiv Indon 6: 624-627. Indonesia in the last decade has a double burden, namely infectious and non-communicable diseases. This is related to the slow decline in the incidence of infectious diseases and even tends to persist, but on the other hand the incidence of non-communicable diseases is moving fast enough and more dominating its impact. The World Health Organization (WHO) reports that nearly two-thirds of deaths worldwide are caused by non-communicable diseases. The mortality rate due to non-communicable diseases is expected to continue to increase worldwide with the largest increases occurring in low and middle-income countries. The main risk factors for non-communicable diseases include unhealthy community dietary behavior. This paper examines several types of non-communicable diseases that are affected due to unbalanced and unhealthy consumption behavior as a risk factor. In the results of the Basic Health Research (Riskesdas), several non-communicable diseases found a high prevalence such as stroke, hypertension, diabetes mellitus, heart disease, cancer and chronic kidney failure. In the list of diseases that are the highest causes of death in Indonesia, non-communicable diseases dominate the treats, whereas infectious diseases are only tuberculosis, which still plays the second highest cause of death after stroke. The burden faced by the Indonesian people in tackling health problems is increasing with the existence of an epidemiological transition marked by a shift in causes of death for all ages from infectious diseases to non-communicable diseases.

BACKGROUND AND AIMSSaudi Arabia has no precise data on causes of death. We sought to ascertain the commonest causes of death as stated in death certificates of adults and evaluate the completeness of death certificates at a teaching hospital in Riyadh.DESIGN AND SETTINGA cross-sectional study carried out at King Khalid University Hospital in Riyadh, Saudi Arabia, during the year 2008.METHODSAll death certificates that were issued in 2008 were reviewed and data were checked by two reviewers. Causes of death were coded according to specially-designed codes.RESULTSThe mean (SD) age of death was 63.9 (20.7) years. More than 80% arrived alive at the hospital. Among the 410 certificates, 62.2% had the first reported cause of death being classified as “inappropriate” and this tended to be slightly, but significantly more frequent among women. The first most common appropriately reported cause of death was malignancy of any type (7.3%) followed by ischemic heart diseases (4.9%). Accidents and fractures were more common in the younger age groups and among men.CONCLUSIONSThis is the first study that documents the possible gaps among healthcare professionals in Saudi Arabia in their understanding of death and its certification based on the clinical assessment of the deceased. The findings needs to be validated by similar studies from other health care sectors. It is clear, however, that proven educational, system-related and legal interventions to improve the accuracy of death certification are strongly needed if the health care priorities are to be properly identified.

Mortality profile of patients with rheumatoid arthritis in France and its change in 10 years.

DIARRHEA IN EARLY LIFE: PROGRESS IN DIAGNOSIS AND CONTROL OF DISEASE

Objective To analyze the effect of microalbuminuria on predicting cardiovascular disease mortality and total mortality risk in 2181 subjects. Methods These subjects came from Beijing epidemiological data in the moderate-elderly population in June 2004. After 4 years follow up, the death of various reasons were observed of death of four-year period for various reasons in May 2008. In according to the albumin creatinine ratio(ACR) value, all subjects were divided into normal albuminuria group (NAU group), microalbuminuria group (MIAU group) and macroalbuminuria group (MAAU in according to the ACR). The various causes of death were analyzed, and the baseline clinical characteristics and metabolic markers were compared between the death group and survival group. In the follow-up, Cox regression model was used. After adjusted for age, DM history, history of hypertension, dyslipidemia and other potential risk factors, the relationship between ACR levels and cardiovascular- or all-cause mortality was analyzed. Results Totally 77 subjects died during the 4 years follow up. The all-cause mortality was 8.7/1000 person-year in total population. The CVD and malignant tumor were the main causes of death. Compared with the survival population, the proportion of MIAU, MAAU, and DM were significantly higher in the death population(18.2% vs 8.7%, 9.1% vs 1.6%, 50.6% vs 25.8%, P<0.01). The all-cause mortality was 6.8‰, 20.6‰ and 58.8 ‰ in NAU, MIAU, MAAU population respectively. In the NAU population, malignant tumor was the leading cause of death, followed by cardiovascular disease. While in MIAU and MAAU population, cardiovascular disease was the primary cause of death. After age, blood glucose, hypertension, dyslipidemia and other factors were adjusted, compared with the NAU, the risk of death of cardiovascular disease was increased by 1.72 times and the all-cause death increased by 1.01 times in MIAU group, risk of death of cardiovascular disease increased by 3.87 times and of all-cause death increased by 2.76 times in MAAU group. NAU, as the control group, when adjusted for age, blood glucose, blood pressure, lipid disorders by Cox regression, 18.32% of CVD deaths and 11.96% of all deaths could be attributed to the ACR≥30 mg/g. Conclusions Cardiovascular disease and malignant tumor are the main mortality causes for the total population. In the NAU population, malignant tumor is the leading cause of death, followed by cardiovascular disease. In MIAU and MAAU population, cardiovascular disease is the primary cause of death. Compared with NAU group, CVD deaths and all-cause deaths are significantly increased. Key words: Albuminuria; Cardiovascular diseases; Mortality

Objective To analyze the causes of complications and death of the femoral intertrochanteric fracture during perioperative period, and to assess the orthopedics surgery risk of aged. Methods 499 of 547 cases were retrospectively reviewed (132 male, 367 female), who underwent operation from May 2007 to Jun 2014 in our hospital. Their age varied from 59 to 103 years old, with an average of 78.3±7.3 years old. According to Evans classification, there were 84 cases of type I, 67 type II, 187 type III, and 161 type IV. The causes of death were analyzed and discussed. The factors including health assessment before operation, age, operating time and blood loss were studied statistically to find out their correlation with mortality of operation. Results There were altogether 354 complications, including pulmonary infection, urinary system infection, DVT, and cardiac events. There were 30 cases of death and the mortality was 6.0%. The major causes of death included infectious shock, pulmonary infection, cardiac events, kidney failure and hemorrhagic shock caused by hepatic rupture. Statistical results from the score of APACHE Ⅱ showed the factor which definitely influenced the mortality was the amount of blood loss during operation. APACHE Ⅱ scoring area under the ROC curve was 0.938, and the best cutoff value was 17.5 (about an index of 0.767), with the sensitivity of 86.7% and specificity of 90%. The area of risk of death under the ROC curve by APACHE Ⅱ score was 0.817, the best cutoff value of 16.765% (about an index of 0.483), and the sensitivity and specificity of 93.3% and 55.0%. Conclusion There were a lot of complications and accompanied diseases when femoral intertrochanteric fractures happened in aged patients. The main cause of death was septic shock. There were relationships between hemoglobin and the operating time and the degree of trauma. What's more, it was confirmed that the APACHE Ⅱ scoring system was very useful to value the condition of the patients with femoral intertrochanteric fractures, which can be recommended. Key words: Femoral fractures; Perioperative period; Intraoperative complications; Postoperative complications; Death; APACHE

Maternal fetal and infant mortality and morbidity are among the most significant public health problems in developing and resource-poor nations. In most developing countries important contributing factors to perinatal and maternal mortality are the lack of adequate diagnostic and pathology facilities inadequate or absent postmortem examination poor diagnostic pathology and microbiology capabilities and deficiency in surveillance systems statistical reporting and diagnostic accuracy of adverse maternal and perinatal health events. Most resource-poor nations have no pathologist trained in perinatal pathology who is available to address the clinical diagnostic public health and research aspects of these mortality and morbidity issues which are so prevalent in the developing world. The following article highlights some of the most important global perinatal health problems - including malaria low birth weight HIV/AIDS maternal malnutrition maternal death unsafe abortion and political turmoil - which would benefit by increased contributions from collaborations with physicians trained in perinatal pathology.

With the rapid development of medicine,acute and chronic infectious diseases have once been effectively controlled.A great change takes place in the main cause of death of hunmn beings,the previous main cause of death is infectious diseases and now changes into the heart and brain diseases,cancer and accidents.But in the recent 30years,many emerging infectious diseases are prevailing and re-emerging diseases revival in the world,so infectious diseases become a great public health problem again.In this paper,research progress ofinfectious disease is summarized. Key words: Infectious diseases; Epidemiology; Therapy

Prevalence and clinical relevance of helminth and tuberculosis co-infecion in children under five years of age in Tanzania

To determine the causes of death on autopsy in adult male patients in order to provide a baseline data for health care policy makers. An observational study. Pathology Departments of Army Medical College, Rawalpindi and Combined Military Hospital, Kharian, a tertiary care hospital, between 1982-2001. Data was taken from the autopsy record of the pathology departments and analysed for the causes of death. A total of 626 autopsies performed between 1982-2001 were analysed. Infectious diseases, malignancies and miscellaneous conditions comprised 209, 67 and 350 cases respectively. Infections included tuberculosis (n=62), typhoid fever (n=15), bacterial infections not otherwise specified (NOS) (n=52), parasitic diseases including malaria (n=6), fungal infections (n=12), viral infections (n=13) and infections NOS (n=49). Malignancies included lymphoreticular malignancies, leukemias, astrocytoma, carcinoma lung, liver, pancreas, stomach, gallbladder, renal and metastatic carcinomas. The miscellaneous diseases included accidental/traumatic conditions including one case of intrauterine foetal anoxia (n=59), and systemic and metabolic diseases involving different organs/systems (n=569) with more than one disease in some cases. Infections, particularly tuberculosis were a frequent cause of death in this series. The result of the study could indicate that cause of death is useful outcome indicator for disease control programmes.