Cases Of Infectious Diseases Research Articles

Predicting influenza in China from October 1, 2023, to February 5, 2024: A transmission dynamics model based on population migration

IntroductionSince November 2023, influenza has ranked first in reported cases of infectious diseases in China, with the outbreak in both northern and southern provinces exceeding the levels observed during the same period in 2022. This poses a serious health risk to the population. Therefore, short to medium-term influenza predictions are beneficial for epidemic assessment and can reduce the disease burden. MethodsA transmission dynamics model considering population migration, encompassing susceptible-exposed-infectious-asymptomatic-recovered (SEIAR) was used to predict the dynamics of influenza before the Spring Festival travel rush. ResultsThe overall epidemic shows a declining trend, with the peak expected to occur from week 47 in 2023 to week 1 in 2024. The number of cases of A (H3N2) is greater than that of influenza B, and the influenza situation is more severe in the southern provinces compared to the northern ones. ConclusionOur method is applicable for short-term and medium-term influenza predictions. As the spring festival travel rush approaches. Therefore, it is advisable to advocate for nonpharmaceutical interventions (NPIs), influenza vaccination, and other measures to reduce healthcare and public health burden.

The Role of High-Level Isolation Units in Response to High-Consequence and Emerging Infectious Diseases: Experience of the German STAKOB Network.

This case study describes the experience of the German Permanent Working Group of Competence and Treatment Centers for High Consequence Infectious Diseases, known as STAKOB (Ständiger Arbeitskreis der Kompetenz- und Behandlungszentren für Krankheiten durch hochpathogene Erreger). STAKOB brings together public health authorities (competence centers) and high-level isolation units (treatment centers) to collaborate on the clinical management of high-consequence infectious diseases (HCIDs) and emerging infectious diseases. The network is coordinated by the Robert Koch Institute, Germany's federal public health institute. The main tasks of STAKOB are to strengthen HCID clinical and public health management and increase expert knowledge on HCID and non-HCID emerging infectious diseases in Germany. STAKOB enables the exchange of knowledge and experiences; development of guidelines on infection prevention and control measures, clinical management, and therapy; and support for the World Health Organization and other outbreak responses internationally. The past years have shown how important the STAKOB network is for Germany-not only in providing critical care for HCID cases but also increasing capacity to support public health and clinical management of emerging infectious disease cases. However, maintaining several high-level isolation units in Germany requires a high commitment of financial, material, and human resources. Due to the rarity of HCID and emerging infectious disease events, maintaining the appropriate level of preparedness and ensuring sufficient investments is an ongoing struggle. Nevertheless, it is essential to have a network ready to react to HCID and non-HCID emerging infectious diseases in times of a changing biosecurity and infectious landscape.

Optimizing the long short-term memory algorithm to improve the accuracy of infectious diseases prediction

<p><span lang="EN-US">This study discusses the implementation of the proposed optimized</span><span lang="EN-US">long short-term memory (LSTM) to predict the number of infectious disease cases that spread in Central Java, Indonesia. The proposed model is developed by optimizing the output layer, which affects the output value of the cell state. This study used cases of four infectious diseases in Indonesia's Central Java Province, namely COVID-19, dengue, diarrhea, and hepatitis A. This model was compared to basic LSTM and MinMax schaler LSTM improvement to see the difference in the accuracy of each disease. The results showed a significant difference in the average prediction results with real cases between the three models. The main objectives of this study were: </span><span lang="EN-US">modifying the LSTM algorithm to predict the number of infectious disease cases to get a smaller residual value</span><span lang="EN-US">, <span>comparing the results of the optimization accuracy of the LSTM algorithm with the LSTM algorithm in previous studies, and evaluating the use of spatial variables in applying infectious disease prediction models using the LSTM algorithm. The results found that the performance difference between the proposed optimization algorithm and the model in the previous study was obtained. The proposed LSTM optimization algorithm had an accuracy improvement of about 2% over the previous model.</span></span></p>

Implementasi Hygiene dan Sanitasi di Kantin Kopikir Ika Universitas Mulawarman

Food is a necessity for humans, yet cases of food poisoning and infectious diseases related to food continue to rise. Contributing factors include poor personal hygiene, inadequate food handling, and unclean equipment. Food vendors often lack educational backgrounds in hygiene and sanitation, which affects the quality of the dishes they serve. This community service initiative emphasizes the importance of implementing hygiene and sanitation practices in the Kopikir Ika canteen at Mulawarman University. The methods used include socialization, observation, and education for the canteen operators. The results show increased awareness and understanding of the operators regarding the importance of hygiene and sanitation, as well as the steps taken to improve cleanliness standards in the canteen and the quality of the food products served.

Resurgence of Kawasaki Disease Following Relaxation of Coronavirus Disease 2019 Pandemic Restrictions in Japan

ObjectivesTo compare the number and incidence of Kawasaki disease (KD) patients in years 2 through 4 of the coronavirus disease 2019 (COVID-19) pandemic, and determine the impact of 3 years of implementation infection control measures and their subsequent relaxation on the epidemiology of KD in Japan. Study designWe conducted a population-based, cohort study including consecutive KD patients in Kobe City between 2021 and 2023. We compared the incidence of KD cases, in relation to timing of infection control measures, as well as infectious disease cases based on a regional surveillance system. Data from a previous 2016 through 2020 study were used for comparison. ResultsA total of 566 children with KD were identified during the study period. During the infection control period in 2021 to 2022, the incidence of KD remained low compared with the pre-pandemic level (281.3 and 327.5/100,000 children aged 0-4 years in 2021to 2022 and 2016 through 2019, respectively), but a recovery trend began in the 0-1-year age group. During the relaxation period in 2023, the incidence of KD increased across a wide age range, reaching the highest recorded in Japan (426.7/100,000 children aged 0-4 years), and the median age of onset increased to age 30 months. The resurgence of KD coincided with the patterns for multiple infectious diseases in 2023. The seasonality of KD observed before the pandemic was altered. ConclusionsKD resurged in 2023 after relaxation of the prolonged COVID-19 pandemic restrictions in Japan. This phenomenon coincided with the rise of multiple infectious diseases, and supports the pathogenesis of KD being triggered by infectious agents.

Epidemiology of Viral Infectious Diseases Reported in Saudi Arabia.

Efficient epidemiological monitoring of virus diseases is crucial in evaluating general public health, the prevalence of specific diseases, the pattern of spread, and implementing preventative and control strategies into action. This study analyzed data obtained from the Field Epidemiology Program (FETP) which is part of the Ministry of Health (MOH) in Saudi Arabia, which contained reported cases of infectious diseases over four years, from January 2018 to December 2021, to investigate and highlight the significant trend and incidence rate for each viral infectious disease. Of the reported viral infectious diseases, hepatitis B and C, dengue fever (DF), influenza, chickenpox, and measles were the highest reported viral cases over four years. For the aforementioned diseases, males were often more susceptible to viral infections than females. Except for DF, this viral infection was more common in Saudi citizens. Viral illnesses like hand, foot, and mouth disease were less prevalent, while neurological viral disorders such as acute flaccid paralysis were rarely detected. There was an overall reduction in viral cases recorded during 2020-2021, which may be attributed to the implementation of preventive measures during the Coronavirus Disease 2019 (COVID-19) pandemic or an underreporting of cases during the lockdown of that time. The prevalence of these common viral infections in the Saudi population suggests that understanding the mechanisms influencing changes in these viruses, methods of transmission, and the burden of these diseases is a priority for health policy. This understanding is necessary to develop effective intervention and preventive strategies.

Factors influencing healthcare workers' and health system preparedness for the COVID-19 pandemic: A qualitative study in Ghana.

Adequate preparedness of health systems, particularly healthcare workers (HCWs), to respond to COVID-19 is critical for the effective control of the virus, especially in low- and middle-income countries where health systems are overburdened. We examined Ghanaian HCWs' perceived preparedness to respond to the pandemic and the factors that shaped their preparedness and that of the health system. Semi-structured in-depth interviews were conducted with n = 26 HCWs responsible for the clinical management of COVID-19 patients and three administrators responsible for developing and implementing COVID-19 policies at the facility level. Interviews were conducted over the phone in English, transcribed, and analyzed using a thematic analysis approach. Generally, HCWs felt inadequately prepared to contain the spread of COVID-19 due to resource shortages and inadequate training. HCWs, similarly, perceived the health system to be unprepared due to insufficient clinical infrastructure and logistical challenges. The few who felt prepared identified readiness in managing high consequence infectious disease cases and pre-existing protocols as enablers of HCW preparedness. The health system and HCWs were unprepared to manage the COVID-19 pandemic due to inadequate training, logistical challenges, and weak clinical infrastructure. Interventions are urgently needed to improve the health system's preparedness for future pandemics.

Incidence and mortality rates of 14 site-specific infectious diseases in 10 diverse areas of China: findings from China Kadoorie Biobank, 2006-2018

BackgroundInfectious diseases remain a major global health concern, including in China, with an estimated >10 million cases of infectious disease in 2019. We describe the burden of site-specific infectious diseases among Chinese adults. MethodsFrom 2004 to 2008, the prospective China Kadoorie Biobank enrolled 512,726 adults aged 30-79 years from 10 diverse areas (5 rural, 5 urban) of China. During the 12 years of follow-up, 101,673 participants were hospitalized for any infectious disease. Descriptive analyses examined standardized incidence, mortality and case fatality of infections. FindingsThe incidence of any infectious disease was 1856 per 100,000 person-years; respiratory tract infections (1069) were most common. The infectious disease mortality rate was 31.8 per 100,000 person-years (20.3 and 9.4 for respiratory and non-respiratory infections, respectively) and case fatality was 2.2% (2.6% and 1.6% for respiratory and non-respiratory infections, respectively). Infectious disease incidence and mortality rates were higher at older ages and in rural areas. There were no clear sex differences in infectious disease incidence rates, but mortality and case fatality rates were twice as high in men as in women. InterpretationInfectious diseases were common in Chinese adults. The observed burden of, and disparities in, site-specific infections can inform targeted prevention efforts. FundingKadoorie Foundation, Wellcome Trust, MRC, BHF, CR-UK, MoST, NNSF.

Determination of Serum Vitamin D Levels in Patients with COVID-19

Background: In 2019, the first cases of an acute respiratory infectious disease were announced in the city of Wuhan, China. In places where the speed of transmission and the resulting high prevalence and death from this virus is high, it is important to find things that help prevent and reduce the symptoms and complications of the disease, one of these things. Things are serum levels of vitamin D. As a result of this study, serum levels of vitamin D were measured in patients with Covid-19. Methods: From December to March of 1400, 100 samples of people hospitalized in Khurshid laboratory were examined to identify the RNA of the Covid-19 virus by Real Time PCR method and at the same time to check the serum levels of vitamin D. The data was statistically analyzed using SPSS software. Results: The average age of the patients was between 12.45 and 40.8 years. Comparison the two Covid-19 positive and negative groups in terms of symptoms, it was found that the patients with RH positive had more positive PCR percentage and a significant difference was reported between RH positive and Covid-19 (p=0.006). In comparing the relationship between disease symptoms and the rate of PCR positive reports of gastrointestinal symptoms, history of significant disease, cough, fever, a significant difference was reported (p<0.001). Also, 50% of the samples were PCR positive. Based on the t-test, a significant difference was reported between the serum levels of vitamin D and Covid-19 (p<0.001). Conclusion: The results showed that the vitamin D is an acceptable protective factor against Covid19 infection and its deficiency increases the probability of infection.

Association between ambient temperature and risk of notifiable infectious diseases in China from 2011 to 2019

ABSTRACT Previous studies on temperature and infectious diseases primarily focused on individual disease types, yielding inconsistent conclusions. This study collected monthly data on notifiable infectious disease cases and meteorological variables across 7 provinces in China from 2011 to 2019. A distributed lag nonlinear model was used to evaluate the association between ambient temperature and infectious diseases within each province, and random meta-analysis was applied to evaluate the pooled effect. Extreme hot temperature (the 97.5th percentile) was positively associated with the risk of respiratory infectious diseases with the relative risk (RR) of 1.45 (95%CI: 1.01–2.08). Conversely, extreme cold temperature (the 2.5th percentile) was negatively associated with intestinal infectious diseases and zoonotic diseases and vector-borne diseases, reporting RRs of 0.43 (95%CI: 0.30–0.60) and 0.46 (95%CI: 0.38–0.57), respectively. This study described the nonlinear association between ambient temperature and infectious diseases with different transmission routes, informing comprehensive prevention and control strategies for temperature-related infectious diseases.

The burden of infectious diseases throughout and after the COVID-19 pandemic (2020-2023) and Russo-Ukrainian war migration.

Understanding how the infectious disease burden was affected throughout the COVID-19 pandemic is pivotal to identifying potential hot spots and guiding future mitigation measures. Therefore, our study aimed to analyze the changes in the rate of new cases of Poland's most frequent infectious diseases during the entire COVID-19 pandemic and after the influx of war refugees from Ukraine. We performed a registry-based population-wide study in Poland to analyze the changes in the rate of 24 infectious disease cases from 2020 to 2023 and compared them to the prepandemic period (2016-2019). Data were collected from publicly archived datasets of the Epimeld database published by national epidemiological authority institutions. The rate of most of the studied diseases (66.6%) revealed significantly negative correlations with the rate of SARS-CoV-2 infections. For the majority of infectious diseases, it substantially decreased in 2020 (in case of 83%) and 2021 (63%), following which it mostly rebounded to the prepandemic levels and, in some cases, exceeded them in 2023 when the exceptionally high annual rates of new cases of scarlet fever, Streptococcus pneumoniae infections, HIV infections, syphilis, gonococcal infections, and tick-borne encephalitis were noted. The rate of Clostridioides difficile enterocolitis was two-fold higher than before the pandemic from 2021 onward. The rate of Legionnaires' disease in 2023 also exceeded the prepandemic threshold, although this was due to a local outbreak unrelated to lifted COVID-19 pandemic restrictions or migration of war refugees. The influx of war migrants from Ukraine could impact the epidemiology of sexually transmitted diseases. The present analysis indicates that continued efforts are needed to prevent COVID-19 from overwhelming healthcare systems again and decreasing the control over the burden of other infectious diseases. It also identifies the potential tipping points that require additional mitigation measures, which are also discussed in the paper, to avoid escalation in the future.

Choroby zakaźne skóry jako wciąż aktualny problem diagnostyczny i terapeutyczny – przegląd nietypowych przypadków klinicznych

Infectious skin diseases constitute a significant public health problem. Despite the systematic development of many modern diagnostic and therapeutic tools, they still pose a serious challenge for clinicians. Due to their prevalence and mild course in most cases, they are often marginalized, which can delay their diagnosis and treatment initiation. Such an approach in more clinically advanced cases can have serious consequences, sometimes leading to tragic outcomes. This work presents a series of four cases of common infectious skin diseases with an unusually atypical clinical picture: the history of a 49-year-old female patient with recurrent erysipelas of the right lower leg co-occurring with a SARS-CoV-2 infection, a 75-year-old male patient with a generalized form of herpes zoster, a 38-year-old female patient with a complicated severe course of head lice, and a 34-year-old male patient with a severe form of post-steroid mycosis. In each of these cases, difficulties in making the correct diagnosis were highlighted, even though they represent some of the most common bacterial, viral, parasitic, and fungal dermatoses. The paper discusses the risk factors for these diseases, the pathophysiology of their atypical course, the effects and challenges in the therapeutic approach conducted. Infectious skin dermatoses require aggressive treatment and should never be underestimated.

Bioacoustics in population control of insects of medical importance: A review.

Vector transmitted diseases are accountable for more than 17% of all infectious disease cases worldwide according to World Health Organization. Insect vectors play a key role in transmitting diseases and loss of lives. Modified and advanced vector control strategies with chemical insecticides are needed as vectors are resistant to a particular insecticide. Moreover, chemical control is cost-inductive and may give rise to health issues. In this review, bioacoustics have been narrated as a novel technology for eco-friendly and cost-effective control of insect vectors. Many insects that rely on sounds for communication and copulation can be trapped, killed, and repelled through the mimicked sounds of conspecific males or females, generating disturbing noises. Sound can also be harnessed to prevent the mating success of insects. There is need for future studies on rejection calls and harmonic convergences in insect vectors. In-depth investigations on the higher harmonics of insect calls, along with artificial intelligence, will be beneficial for the development of successful sound- evoked control of insects of medical importance.

Epidemiologic Trends and Distributions of Imported Infectious Diseases Among Travelers to Japan Before and During the COVID-19 Pandemic, 2016 to 2021: A Descriptive Study.

Little is known about the trends of imported infectious diseases among travelers to non-endemic countries during the novel coronavirus disease 2019 (COVID-19) pandemic. This article aimed to describe those among travelers to Japan. This is a descriptive study based on national surveillance data. Imported infectious disease cases were defined as those with a reported overseas source of infection among 15 diseases pre-selected based on the probability and impact of importation. The number of notified cases from April 2016 to March 2021 were described by disease and time of diagnosis. The relative ratio and absolute difference in case counts-both by number and per arrival-were calculated by disease comparing those from the pandemic period (April 2020-March 2021) to the pre-pandemic period (April 2016-March 2020). A total of 3,524 imported infectious disease cases were diagnosed during the study period, including 3,439 cases before and 85 cases during the pandemic. The proportionate distribution of diseases changed but notification counts of all 15 diseases decreased during the pandemic. Accounting for arrivals, however, seven diseases showed a two-fold or greater increase, with a notable absolute increase per million arrivals for amebiasis (60.1; 95% confidence interval [CI], 41.5-78.7), malaria (21.7; 95% CI, 10.5-33.0), and typhoid fever (9.3; 95% CI, 1.9-16.8). The epidemiology of imported infectious diseases changed during the pandemic. While the number of imported infectious disease cases decreased, the number of cases per arrivals increased considerably both in relative and absolute terms for several diseases of public health and clinical importance.

Rapid Increase of Female but not Male Obesity: Analysis of the 2023 Vanuatu Health Transition Project Survey on Aneityum

Globally, obesity rates are continuing to increase and countries in the midst of modernization are most vulnerable. Developing nations are undergoing a health transition alongside rapid economic modernization. The nation of Vanuatu, like other Pacific island countries, is experiencing such a transition marked by decreased cases of infectious disease and increased incidence of chronic and non-communicable diseases. Aneityum is a small and sparsely populated island in Vanuatu and is behind more developed islands in its transition. This present study is the latest in a multi-year project examining health in Vanuatu as it undergoes a health transition with an increased prevalence of chronic disease, namely cardiovascular diseases and type 2 diabetes. In this study, we sought to continue tracking the population health on Aneityum, to analyze health differences between men and women, and to compare findings to previous data in Vanuatu. In July and August of 2023, adult males [n=41] and females [n=62] were surveyed and had their anthropometric measurements taken on Aneityum in Vanuatu. Mean anthropometric measurements (body mass index, body fat percentage, waist circumference) continued to be significantly greater among women than men (P-value < 0.05). Women exhibited higher rates of obesity in all metrics than in previous studies while men remained relatively unchanged. While men still have lower obesity rates compared to those from Efate in 2011, the women of Aneityum have reached similar levels as their counterparts from a decade ago. There is debate whether Ni-Vanuatu populations are more accurately measured by WHO or Asian-Pacific BMI cutoffs. When Asian-Pacific BMI guidelines are applied, male obesity rate rises 4.87% and the female obesity rate rises 17.74%, indicating drastically worse population health than previously thought. Potential explanations for the disparity in obesity rates between males and females include sex-associated fat distribution patterns, social inequality, and cultural habits. This paper provides valuable insights into the state of Vanuatu's health in its transitional period and a greater understanding of the interplay between sex and health.

Perceived Environmental Health Effects of Clinical Waste Disposal in Ahoada Local Government Area of Rivers State Nigeria

The study examined the perceived health effects of clinical waste disposal in Adoada East Local Government Area of Rivers State, Nigeria on people. Purposive and random sampling techniques were employed for the collection of the data set comprising a sample size of 184 respondents selected from health/medical personnel, cleaners in health facilities, waste handlers, nurses, midwives, and doctors through structured questionnaires including basic statistical techniques using a criterion of 2.50 on the 4-point Likert scale. The result of the various analyses conducted revealed that the major types of waste generated from hospitals and medical facilities are needles, syringes scalpels, blades, and lancets, including placentas and other human tissues as well as papers, plastics, and glasses. The analysis from the returned questionnaires further indicates that the main methods of clinical waste disposal and treatment of used medical instruments/tools (autoclaving) include open burning of clinical wastes such as paper, plastic, cans, etc. The implications of the observed poor and inappropriate disposal of clinical waste in the study area include a high risk of infection among health/medical personnel and the spread of communicable diseases in the neighborhood. Given the depth of the analysis and the results generated, the study recommends the deployment of more qualified medical and para-medical personnel to the local government health facilities and the provision of modern equipment to tackle the rising cases of infectious diseases and community health associated with improper clinical waste disposal in the study area.

Hybrid capture shotgun sequencing detected unexpected viruses in the cerebrospinal fluid of children with acute meningitis and encephalitis

PurposeInvestigation of undiagnosed cases of infectious neurological diseases, especially in the paediatric population, remains a challenge. This study aimed to enhance understanding of viruses in CSF from children with clinically diagnosed meningitis and/or encephalitis (M/ME) of unknown aetiology using shotgun sequencing enhanced by hybrid capture (HCSS).MethodsA single-centre prospective study was conducted at Sant Joan de Déu University Hospital, Barcelona, involving 40 M/ME episodes of unknown aetiology, recruited from May 2021 to July 2022. All participants had previously tested negative with the FilmArray Meningitis/Encephalitis Panel.HCSS was used to detect viral nucleic acid in the patients’ CSF. Sequencing was performed on Illumina NovaSeq platform. Raw sequence data were analysed using CZ ID metagenomics and PikaVirus bioinformatics pipelines.ResultsForty episodes of M/ME of unknown aetiology in 39 children were analysed by HCSS. A significant viral detection in 30 CSF samples was obtained, including six parechovirus A, three enterovirus ACD, four polyomavirus 5, three HHV-7, two BKV, one HSV-1, one VZV, two CMV, one EBV, one influenza A virus, one rhinovirus, and 13 HERV-K113 detections. Of these, one sample with BKV, three with HHV-7, one with EBV, and all HERV-K113 were confirmed by specific PCR. The requirement for Intensive Care Unit admission was associated with HCSS detections.ConclusionThis study highlights HCSS as a powerful tool for the investigation of undiagnosed cases of M/ME. Data generated must be carefully analysed and reasonable precautions must be taken before establishing association of clinical features with unexpected or novel virus findings.

Application of metagenomic next-generation sequencing in the clinical diagnosis of infectious diseases after allo-HSCT: a single-center analysis

BackgroundWe investigated the value of metagenomic next-generation sequencing (mNGS) in diagnosing infectious diseases in patients receiving allogeneic hematopoietic stem cell transplantation (allo-HSCT).MethodsFifty-four patients who had fever following allo-HSCT from October 2019 to February 2022 were enrolled. Conventional microbiological tests (CMTs) and mNGS, along with imaging and clinical manifestations, were used to diagnose infection following allo-HSCT. The clinical diagnostic value of mNGS was evaluated.ResultsA total of 61 mNGS tests were performed, resulting in the diagnosis of 46 cases of infectious diseases. Among these cases, there were 22 cases of viral infection, 13 cases of fungal infection, and 11 cases of bacterial infection. Moreover, 27 cases (58.7%) were classified as bloodstream infections, 15 (32.6%) as respiratory infections, 2 (4.3%) as digestive system infections, and 2 (4.3%) as central nervous system infections. Additionally, there were 8 cases with non-infectious diseases (8/54, 14.81%), including 2 cases of interstitial pneumonia, 2 cases of bronchiolitis obliterans, 2 cases of engraftment syndrome, and 2 cases of acute graft-versus-host disease. The positive detection rates of mNGS and CMT were 88.9% and 33.3%, respectively, with significant differences (P < 0.001). The sensitivity of mNGS was 97.82%, the specificity was 25%, the positive predictive value was 93.75%, and the negative predictive value was 50%. Following treatment, 51 patients showed improvement, and 3 cases succumbed to multidrug-resistant bacterial infections.ConclusionsmNGS plays an important role in the early clinical diagnosis of infectious diseases after allo-HSCT, which is not affected by immunosuppression status, empiric antibiotic therapy, and multi-microbial mixed infection.

The COVID-19 vaccination campaign in Switzerland and its impact on disease spread

We analyse infectious disease case surveillance data to estimate COVID-19 spread and gain an understanding of the impact of introducing vaccines to counter the disease in Switzerland. The data used in this work is extensive and detailed and includes information on weekly number of cases and vaccination rates by age and region. Our approach takes into account waning immunity. The statistical analysis allows us to determine the effects of choosing alternative vaccination strategies. Our results indicate greater uptake of vaccine would have led to fewer cases with a particularly large effect on undervaccinated regions. An alternative distribution scheme not targeting specific age groups also leads to fewer cases overall but could lead to more cases among the elderly (a potentially vulnerable population) during the early stage of prophylaxis rollout.

A retrospective study of variations in the kinds of diseases discharged from the Department of Infectious Diseases of a large general hospital in Central China during 2013-2019.

To analyze the changing trend of the absolute number and constituent ratio of various in-patient diseases in the Department of Infectious Diseases of a large general hospital in Central China during 2013-2019. A retrospective study was conducted to analyze the diagnostic data of discharged patients for seven consecutive years, from 2013 to 2019. The first discharge diagnosis is used as the basis for the disease classification. The absolute number, constituent ratio, and changing trend of major diseases in hepatobiliary diseases and infectious diseases were analyzed. The changing trend of the diseases during 2013-2019 showed that the absolute number of cases of hepatobiliary disease did not change significantly (p = 0.615), while the constituent ratio decreased significantly, from 68.01% in 2013 to 55.29% in 2019 (p<0.001). The absolute number (constituent ratio) of cases of infectious diseases increased significantly from 585 (21.91%) in 2013 to 1,244 (36.86%) in 2019 (p = 0.015, p<0.001). The major part of the increase was non-communicable infectious diseases (NCIDs). During 2013-2019, the proportion of cases of hepatobiliary disease gradually decreased. The absolute number and proportion of cases of infectious diseases, especially NCIDs, have increased rapidly.