Epidemiological Characteristics of Falls from the National Injury Surveillance System — China, 2019–2022

Siyi Chen¹; Yuliang Er¹; Yuan Wang¹; Leilei Duan^1,#; PengPeng Ye¹

1. National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China

^# Corresponding author: Leilei Duan, duanleilei@ncncd.chinacdc.cn.

Falls are a significant public health issue in China, causing substantial morbidity and mortality. This study aimed to analyze the epidemiological characteristics of fall-related injuries in China from 2019 to 2022 using data from the National Injury Surveillance System. The analysis included demographic characteristics, location, time, activity, injury nature, injured body part, and severity. A total of 2,324,577 fall cases were recorded, with 1,345,181 males and 982,396 females, and the urban-rural ratio was 1:0.38. Most falls occurred at home (39.41%) and during leisure activities (39.40%), leading to the most common injuries being bruises (45.22%) and lower limb injuries (31.57%), with 73.41% of cases being mild. Falls in children under 10 predominantly occurred at home (56.71%) with a high proportion of head injuries. Adolescents aged 10-19 experienced falls mainly in school and during sports activities (27.37%). The elderly (>60 years) had more fractures (36.84%) and an age-dependent increase in head injuries and severe harm. Falls exhibit distinct epidemiological patterns across different age groups in China. Targeted interventions are essential for high-risk groups, including children, adolescents, and the elderly. Public health strategies should focus on the safety of home, school and sports environments. Enhanced surveillance is crucial for preventing and controlling fall-related injuries in high-risk areas.

全国伤害监测系统跌倒病例流行特征 —中国，2019–2022年

陈思怡¹；耳玉亮¹；汪媛¹；段蕾蕾^1，#；叶鹏鹏¹

¹中国疾病预防控制中心慢性非传染性疾病预防控制中心，北京，中国。

^# 通信作者: 段蕾蕾，duanleilei@ncncd.chinacdc.cn。

跌倒是我国重要的公共卫生问题，导致了大量的伤残和死亡。本研究旨在分析2019至2022年全国伤害监测系统记录的跌倒伤害病例的流行病学特征。分析包括了人口学信息、发生地点、时间、发生时活动、伤害性质、受伤部位和严重程度。共记录2,324,577例跌倒案例，其中男性1,345,181例，女性982,396例,城市与农村发生跌倒的比例为1:0.38。大多数跌倒发生在家中（39.41%）和休闲活动中（39.40%），跌倒导致的最常见伤害是挫伤/擦伤（45.22%）和下肢伤害（31.57%），其中73.41%的案例为轻度伤害。10岁以下儿童跌倒主要发生在家中（56.71%），且发生头部伤害的比例较高。10至19岁青少年的跌倒病例较多发生在学校和体育活动中（27.37%）。60岁以上发生跌倒的老年人中骨折的比例较高（36.84%），并且随着年龄的增长，头部伤害和严重伤害的比例增加。跌倒在我国不同年龄组中表现出不同的流行病学模式。针对包括儿童、青少年和老年人在内的高风险群体，实施针对性干预措施至关重要。公共卫生策略应聚焦于家庭、学校和体育环境安全。加强监测对于预防和控制高风险区域的跌倒相关伤害至关重要。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.256

Epidemiological Analysis of Tuberculosis Infection and Trend Changes — 152 Belt and Road Partner Countries, 2013–2021

Rong Du^1,2,&; Xiao Xiao^3,4,&; Jing Chen^3,4; Xin Shen^3,4,#; Qi Zhao^1,2,#

1. Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China;

2. NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China;

3. Division of Tuberculosis and HIV/AIDS Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China;

4. Shanghai Institutes of Preventive Medicine, Shanghai, China.

^& Joint first authors.

^# Corresponding author: Xin Shen, shenxin@scdc.sh.cn; Qi Zhao, zhaoqi@shmu.edu.cn.

This study aimed to investigate the current status and trends of tuberculosis (TB) infection among countries along the Belt and Road Initiative, to provide a scientific basis for TB prevention and control efforts. The study included 152 countries that have signed cooperation agreements under the Belt and Road Initiative with China. Data were obtained from the Global Burden of Disease 2021 (GBD 2021). The prevalence of TB infection was assessed using age-standardized TB infection prevalence, and trends from 2013 to 2021 were analyzed through the estimated annual percentage change (EAPC). The results indicated that in 2021, all 152 Belt and Road partner countries reported TB infections, with the majority of countries exhibiting TB infection prevalence between 10% and 30%. Among these, 9 countries (5.92%) had an infection prevalence below 10%, while 8 countries (5.26%) had an infection prevalence of 40% or higher. In terms of prevalence by continent, TB infection was relatively high in Oceania, Africa, and Asia, while lower prevalence was observed in South America and Europe. Between 2013 and 2021, 148 countries (97.37%) demonstrated a decreasing trend in TB infection prevalence, while Sri Lanka (EAPC=1.19, 95% CI=1.06, 1.32) and the Philippines (EAPC=0.04, 95% CI=0.03, 0.06) were the only countries to show an increasing trend. Timor-Leste (EAPC=-0.02, 95% CI=-0.05, 0.02) exhibited no significant change. To achieve the End-TB Strategy, countries must enhance collaboration and communication in TB prevention and control strategies.

结核感染流行现状及变化趋势研究 — 152个 “一带一路”共建国家，2013–2021年

杜荣^1,2，&，肖筱^3，&，陈静³，沈鑫^3，#，赵琦^1,2，#

1 复旦大学公共卫生学院流行病学教研室，上海，中国；

2 国家卫生健康委员会卫生技术评估重点实验室，复旦大学，上海，中国；

3上海市疾病预防控制中心结核病与艾滋病防治所，上海，中国；

4 复旦大学公共卫生学院社会医学教研室，上海，中国。

^& 共同第一作者

^# 通信作者: 沈鑫, shenxin@scdc.sh.cn; 赵琦, zhaoqi@shmu.edu.cn。

本研究旨在了解“一带一路”共建国家结核感染的流行现状及变化趋势，为结核病防控提供科学依据。研究对象为与中国签署“一带一路”合作文件的152个国家，数据来源于2021年全球疾病负担研究数据库。通过年龄标准化结核感染率描述各国的感染流行情况，采用年估计百分比变化（EAPC）描述2013至2021年间结核病感染的流行趋势。结果显示，2021年，“一带一路”的152个共建国家均报告有结核感染，大多数国家的结核感染率在10%至30%之间。其中，有9个国家（5.92%）的感染率低于10%，而8个国家（5.26%）的感染率达到或超过40%。从各大洲的流行情况来看，大洋洲、非洲和亚洲的结核感染率相对较高，而南美洲和欧洲的感染率较低。在2013至2021年期间，148个国家（97.37%）的结核感染率呈下降趋势，只有斯里兰卡（EAPC=1.19, 95% CI=1.06，1.32）和菲律宾（EAPC=0.04, 95% CI=0.03，0.06）感染率呈上升趋势，东帝汶（EAPC=-0.02, 95% CI=-0.05，0.02）则无显著变化。为共同实现终结结核病的战略目标，各国应加强在结核病预防和控制方面的交流与合作。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.257

Novel Genetic Loci Associated with PhenoAge Acceleration — Changzhou City, Jiangsu Province, China, 2012–2019

Yifan Wang^1,&; Yue Jiang^2,3,&; Hui Wang^4,&; Shuang Liang¹; Muhammed Lamin Sambou¹; Mei Wang¹; Meiqi Yang¹; Yakubu Salimata¹; Feifei Xu¹; Chenjie Li¹; Xiao Wang¹; Junpeng Yang⁵; Meng Zhu^1,4; Cheng Wang^1,2,3,6; Guangfu Jin^1,2,3,4; Hongxia Ma^1,2,3,4; Honggang Yi⁷; Hongbing Shen^1,3,4,8,#; Juncheng Dai^1,2,4,9,#

1 Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing City, Jiangsu Province, China;

2 State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing City, Jiangsu Province, China;

3 China International Cooperation Center for Environment and Human Health, Nanjing Medical University, Nanjing City, Jiangsu Province, China;

4 State Key Lab of Cancer Biomarkers, Prevention and Treatment; Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing City, Jiangsu Province, China;

5 The First School of Clinical Medicine, Nanjing Medical University, Nanjing, China;

6 Department of Bioinformatics, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing City, Jiangsu Province, China;

7 Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing City, Jiangsu Province, China;

8 The Chinese Center for Disease Control and Prevention, Beijing, China;

9 Jiangsu Life and Health Industry Academician Collaborative Innovation Center, Nanjing City, Jiangsu Province, China;

& Joint first authors.

^# Corresponding author: Juncheng Dai, djc@njmu.edu.cn; Hongbing Shen, hbshen@njmu.edu.cn.

China is rapidly encountering population aging, yet studies on aging are limited by traditional aging measure: chronological age (CA), particularly in the field of genomics. To overcome this limitation, several novel aging measures have been proposed but lack of comparison evaluation. Therefore, this study was aimed to develop and select the more accurate measure for aging, and identify novel aging-associated genetic variants. In this study, we developed three aging measures: KDM-BioAge, PhenoAge, Homeostatic Dysregulation (HD), with potential promotion based on biomarkers screened by lasso regression in 7,584 participants from the Changzhou cohort. We assessed their performances and chose PhenoAge as the best aging measure by area under the receiver operating Characteristic (ROC) curve (AUC=0.79). To identify aging-associated loci, we conducted a genome-wide association study (GWAS) using PhenoAge acceleration (PhenoAgeAccel) as the aging phenotype among 1,215 genotyped participants through a linear regression model. Twenty-four aging-associated variants were identified, with three being previously recognized as aging loci and, twenty-one suggesting novel contributions. These loci primarily are related with programmed cell death, cell cycle and immune system pathways. Then, we further explored the functions of these loci on a multi-omics scale. Results of phenome-wide association analysis (PheWAS) showed that these variants were mainly related to metabolic diseases. These findings might provide new insights into the aging and facilitate the development of a practical screening program based on PhenoAge, which aims at promoting healthy aging in China.

基于一项前瞻性队列研究发现的与表型年龄加速相关的新遗传位点 — 常州市，江苏省，中国，2012-2019年

王一帆^1,&；江玥^2,3,&；王慧^4,&；梁爽¹；穆罕默德·拉明·山博¹；王梅¹；杨美琪¹；雅库布·萨利马塔¹；许飞飞¹；李辰杰¹；王潇¹；杨俊鹏⁵；朱猛^1,4；王铖^1,2,3,6；靳光付^1,2,3,4；马红霞^1,2,3,4；易洪刚⁷；沈洪兵^1,3,4,8,#;戴俊程^1,2,4,9,#；

1. 南京医科大学公共卫生学院全球健康中心，流行病学系，南京市，江苏省，中国；

2． 南京医科大学生殖医学与子代健康全国重点实验室，南京市，江苏省，中国；

3． 南京医科大学科技部环境与人类健康国际联合研究中心，南京市，江苏省，中国；

4． 南京医科大学部省共建肿瘤个体化医学协同创新中心，江苏省恶性肿瘤生物标志物与防治重点实验室，南京市，江苏省，中国；

5． 南京医科大学第一临床学院，南京市，江苏省，中国；

6． 南京医科大学生物医学工程与信息学院，生物信息学学系，南京市，江苏省，中国；

7． 南京医科大学公共卫生学院，生物统计学系，南京市，江苏省，中国；

8． 中国疾病预防控制中心，北京市，中国；

9． 江苏生命健康产业院士协同创新中心，南京市，江苏省，中国；

^& 共同第一作者

^# 通信作者：戴俊程，djc@njmu.edu.cn；沈洪兵，hbshen@njmu.edu.cn。

中国的人口老龄化不断加剧，但是衰老研究尤其是衰老的基因组学研究仍然受限于实际年龄（CA）这一传统的衰老量化方法。一些新的衰老量化方法可用来解决这一局限性，但是这些方法之间缺少比较研究。因此本研究旨在构建并选择最适合的衰老量化方法，并以此为基础鉴定更多衰老相关的遗传位点。本研究基于常州队列招募的7,584名参与者，利用Lasso回归筛选出的生物标志物构建了三种具有推广潜力的衰老量化方法：KDM生理年龄、表型年龄和体内平衡失调指数。根据ROC曲线下面积（AUC）来评估比较这些方法的表现，最终选择表型年龄作为最适合本队列的衰老量化方法（AUC=0.79）。进一步，本研究在以表型年龄加速（PhenoAgeAccel）为表型的全基因组关联分析中鉴定了24个衰老相关遗传位点，其中3个与既往报道的衰老位点有关，21个为新发现的位点。这些位点主要参与细胞程序性死亡，细胞周期和免疫相关通路。全表型关联研究结果显示这些位点主要与年龄相关的代谢和心血管疾病有关。本研究的发现为衰老提供了新的见解，同时研究结果提示以表型年龄为基础的衰老筛查可以促进中国人群的健康衰老。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.258

Burden of Vaginitis Among Chinese Women Aged 18–74 Years — Five Provinces, China, 2023

Zixuan Fan^1,2; Chenyang Pei¹; Jing Ma³; Chengdong Xu^4,5; Zhenbo Wang^2,4,#; Yuanli Liu^1,#; Yuehua Hu^6,#

1. School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; 

2. Key Laboratory of Regional Sustainable Development Modeling, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China.

3. Institute for Hospital Management of Tsinghua University, Shenzhen City, Guangdong Province, China;

4. University of Chinese Academy of Sciences, Beijing, China;

5. State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China;

6. Office of Epidemiology, Chinese Center for Disease Control and Prevention, Beijing, China.

^# Corresponding authors: Zhenbo Wang, wangzb@igsnrr.ac.cn; Yuanli Liu, liuyuanli_pumc@163.com; Yuehua Hu, huyh@chinacdc.cn.

This study aims to assess the epidemiological characteristics and disease burden of vaginitis among Chinese women aged 18–74 years across five provinces and to explore the role of cervical cancer screening policies in the prevention and management of vaginitis. Based on a 2023 cross-sectional survey, this study included 37,353 participants from five provinces using a stratified cluster sampling method. Data on sociodemographic characteristics, behavioral habits, self-reported health status, and awareness of screening policies were collected through a structured questionnaire. Descriptive statistics, chi-square tests, and multivariable logistic regression models were employed for analysis, with sensitivity analyses conducted to ensure the robustness of the results. In this study, the prevalence of vaginitis was 32.2% (12,029 cases), with 88.8% of patients receiving treatment at professional medical institutions. Women aged 35–54 years were identified as a high-risk group (OR=1.183, 95% CI: 1.109, 1.262). An elevated risk of infection was observed among married women, those with multiple pregnancies, and individuals with poor self-rated health. Smoking (OR=1.186, 95% CI: 1.036, 1.357) and alcohol consumption (OR=1.606, 95% CI: 1.52, 1.697) were significant risk factors. Awareness of cervical cancer screening policies was associated with a reduced risk of vaginitis (OR=0.922, 95% CI: 0.856, 0.993). Regional analysis revealed significantly higher infection rates in Hubei and Yunnan compared to Shandong. This study highlights the significant disease burden of vaginitis among women in China, underscoring the necessity of optimizing health policies and interventions. Cervical cancer screening has demonstrated a positive role in promoting the early diagnosis and treatment of vaginitis. It is recommended to continue focusing on high-risk populations as key intervention targets while enhancing health education for young women and those with multiple pregnancies to enhance reproductive health awareness and access to healthcare services. Furthermore, addressing regional disparities should be prioritized in policymaking to promote equity in women's health and reproductive care.

18-74岁女性阴道炎疾病负担研究 — 五省份，中国，2023年

樊子暄^1,2；裴晨阳¹；马晶³；徐成东^4,5；王振波^2,4,#；刘远立^1,#；胡跃华^6,#

1. 中国医学科学院北京协和医学院卫生健康管理政策学院，北京，中国；

2. 中国科学院地理科学与资源研究所区域可持续发展分析与模拟院重点实验室，北京，中国；

3. 清华大学医院管理研究院，深圳市，广东省，中国；

4. 中国科学院大学，北京，中国； 

5. 中国科学院地理科学与资源研究所资源与环境信息系统国家重点实验室，北京，中国； 

6. 中国疾病预防控制中心流行病学办公室，北京，中国

^# 通信作者：王振波, wangzb@igsnrr.ac.cn；刘远立, liuyuanli_pumc@163.com；胡跃华, huyh@chinacdc.cn。

本研究旨在评估中国五省18-74岁女性阴道炎的流行病学特征及其疾病负担，探讨宫颈癌筛查政策在阴道炎防治中的作用。基于2023年横断面调查，研究覆盖五省37,353名参与者，采用分层整群抽样方法。通过结构化问卷收集社会人口统计特征、行为习惯、健康自评及筛查政策知晓情况等数据。分析采用描述性统计、卡方检验及多变量逻辑回归模型，并通过敏感性分析验证结果的稳健性。本研究中阴道炎患病率为32.2%（12,029例），其中88.8%的患者曾接受专业医疗机构治疗。35-54岁女性为高危群体（OR=1.183, 95% CI: 1.109，1.262）。已婚、多次妊娠及健康状况自评较差者感染风险显著升高。吸烟（OR=1.186, 95% CI: 1.036，1.357）和饮酒（OR=1.606, 95% CI: 1.52，1.697）为重要风险因素。宫颈癌筛查政策知晓情况与阴道炎感染风险降低相关（OR=0.922, 95% CI: 0.856，0.993）。区域分析显示，湖北与云南的感染率显著高于山东。本研究揭示了我国女性阴道炎的显著疾病负担，凸显了优化健康政策和干预措施的必要性。宫颈癌筛查在推动阴道炎早诊早治方面具有积极作用，建议继续将高危人群作为重点干预对象，同时加强针对年轻女性和多次妊娠女性的健康教育，以提升生殖健康素养和医疗利用水平。此外，建议将缩小地区差异作为政策优先事项，以促进妇女健康和生殖保健的公平性。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.259

Construction of a Competency Evaluation Indicator System for Emergency Response Staff in Disease Control and Prevention Institutions — China, 2023

Zhaohe Li^1,2,&; Xijiang Wang^3,&; Wenqing Bai^1,2; Haoliang Liu^1,2,4; Yue Gu^1,2; Jiayi Zhang^1,2; Huimin Li^1,2,4; Hongtao Wu^1,2; Ruiqi Ren^1,2; Chao Li^1,2; Qi Wang^1,2; Zainawudong Yushan^5,#; Lei Zhou^1,2,#

1. Public Health Emergency Center, Chinese Center for Disease Control and Prevention, Beijing, China;

2. National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China;

3. Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi City, Xinjiang Uygur Autonomous Region, China;

4. School of Public Health, Nanjing Medical University, Nanjing City, Jiangsu Province, China;

5. Chinese Center for Disease Control and Prevention, Beijing, China;

& Joint first authors.

# Corresponding author: Lei Zhou, zhoulei@chinacdc.cn; Zainawudong Yushan，znwdys@chinacdc.cn.

Currently, there is no established scientific standard to guide disease control and prevention organizations in the selection of emergency response personnel to respond to major infectious disease outbreaks. Drawing from competency theory, this study developed an indicator system for evaluating the emergency response capabilities of staff at disease control and prevention institutions focused on major infectious disease, and an empirical study was carried out.  Qualitative methods, including literature reviews and interviews, informed the development of an initial competency indicator system. Then, two rounds of expert consultation were conducted by Delphi method to determine the indicator system, and 383 respondents were selected for questionnaire survey. Experts were eligible if they possessed at least an associate senior title or higher, a master’s degree or higher, and a minimum of 5 years of experience in fields such as epidemic prevention, emergency response, health policy, health management, and infectious disease epidemiology theory and practice. Indicators were screened according to expert scores, and verified by expert authority coefficient, concentration degree of expert opinions and coefficient of variation. The respondents of the empirical study were from the staff of the national, provincial, municipal and county CDCs. The survey results were analyzed by Cronbach's α coefficient, confirmatory factor analysis, convergent validity test and discriminative validity test. Utilizing the Delphi method, the indicator system comprises 4 first-level indicators: Knowledge base, Professional skills, Personal qualities, Personality and Motivation. Further, it includes 10 second-level and 46 third-level indicators. The results of the empirical study show that the indicator system has good reliability, acceptable discriminant and convergent validity, and that competency can be evaluated scientifically. The system provides an efficient tool for selecting and organizing emergency personnel for response tasks, thereby enhancing the Center for disease control and prevention staff's capacity for emergency management. It can provide a reference for emergency personnel during both routine operations and crises.

.

疾控机构应急处置工作人员胜任力评价指标体系的构建 — 中国，2023

李朝荷^1,2,&；王希江^3,&；白文清^1,2；刘豪梁^1,2,4；谷玥^1,2；张佳艺^1,2；李慧敏^1,2,4；吴洪涛^1,2；任瑞琦^1,2；李超^1,2；王琦^1,2；再那吾东·玉山^5,#；周蕾 ^1,2,#

1. 中国疾病预防控制中心卫生应急中心，北京，中国；

2. 传染病溯源预警与智能决策全国重点实验室，中国疾病预防控制中心，北京，中国；

3. 新疆维吾尔自治区疾病预防控制中心，乌鲁木齐市，新疆维吾尔自治区，中国；

4. 南京医科大学公共卫生学院，南京市，江苏省，中国；

5. 中国疾病预防控制中心，北京，中国；

^& 共同第一作者。

^# 通信作者：周蕾，zhoulei@chinacdc.cn；再那吾东·玉山，znwdys@chinacdc.cn。

目前没有一个可以协助疾控机构遴选应对重大传染病疫情应急处置工作人员的科学标准。本研究在胜任力理论的基础上，运用德尔非法建立了基于重大传染病疫情的疾控机构应急处置工作人员胜任力评价指标体系，并进行了实证研究。本研究主要采取文献研究、访谈法等定性研究方法确定初步胜任力指标体系，采用德尔菲法进行了2轮专家咨询确定指标体系，并选取了383名调查对象进行了实证调查。研究主要选取的专家为副高及以上、研究生及以上、从事疫情防控、应急处置、卫生政策与卫生管理、传染病流行病学理论研究与实践工作5年及以上，根据专家评分进行指标筛选，并通过专家权威系数、专家意见集中程度和变异系数进行验证。实证研究的调查对象来自国家、省、市、县各级疾控中心的工作人员，调查结果采用Cronbach's α系数信度检验、验证性因子分析、聚敛效度和区分效度检验进行分析。通过德尔菲法，本研究构建了包括知识基础、专业技能、个人素养、个性动机4个一级指标，以及10个二级指标和46个三级指标在内的基于重大传染病疫情的疾控机构应急处置工作人员胜任力评价指标体系。实证研究结果显示该指标体系具有良好的内部一致性，区分效度和聚敛效度也均可接受，能够科学地对胜任力进行评价。本研究构建的胜任力评价指标体系能够为应急处置任务快速遴选和组织合适的应急工作人员，并可以帮助疾控机构工作人员针对性地提高应急处置能力，能够从平战结合的角度为疾控机构应急人才队伍提供参考。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.260