Trends in Incidence of HIV and Syphilis Among Men Who Have Sex with Men — Tianjin Municipality, China, 2013–2022
This study investigated the trends in the incidence of HIV and syphilis among men who have sex with men (MSM) in Tianjin, as well as the influencing factors, providing data support for targeted prevention and control strategies in this population. A prospective cohort study was conducted, recruiting MSM through community-based organizations from April 2013 to March 2022. Based on baseline surveys and HIV/syphilis testing, participants were followed up and tested every six months. The trends in HIV/syphilis incidence were calculated, and Cox proportional hazards regression models were used to analyze factors associated with HIV/syphilis incidence. A total of 2,110 MSM were included in the analysis. The overall HIV incidence was 2.3 per 100 PYs (95% CI: 2.0, 2.7). The rate showed a declining trend over time, decreasing from 5.2 (95% CI: 3.2, 7.2) in 2013–2014, 4.2 (95% CI: 3.0, 5.4) in 2015–2016, 2.4 (95% CI: 1.7, 3.1) in 2017–2018, 2.2 (95% CI: 1.5, 2.9) in 2019–2020, 1.9 (95% CI: 0.9, 2.9) per 100 PYs in 2021–2022, respectively. Multivariate analysis showed that sexual orientation, having unprotected anal sex in the last six months, age at first homosexual intercourse, use of psychoactive substances, syphilis infection, and frequency of follow-up were associated with HIV incidence. 1,927 MSM were included in the analysis of syphilis incidence, with the overall syphilis incidence of 4.8 per 100 PYs (95% CI: 4.2, 5.3). The syphilis incidence showed an increasing trend, rising from 3.6 (95% CI: 1.9, 5.3) in 2013–2014, 2.7 (95% CI: 1.9, 3.6) in 2015–2016, 4.8 (95% CI: 3.8, 5.8) in 2017–2018, 5.9 (95% CI: 4.8, 7.1) in 2019–2020, to 7.2 (95% CI: 4.5, 9.8) per 100 PYs in 2021–2022, respectively. Multivariate analysis showed that marital status, sexual orientation and use of psychoactive substances were associated with syphilis incidence. The trends in HIV and syphilis incidence among MSM in Tianjin differ significantly. Considering the widespread presence of risk factors such as the use of psychoactive substances, there is an urgent need for more targeted and integrated public health strategies to effectively curb the spread of HIV and syphilis in this high-risk population.
男男性行为人群HIV/梅毒新发感染趋势 — 中国天津市，2013年–2022年
本文调查了天津市男男性行为者（MSM）中 HIV与梅毒的新发感染趋势及其影响因素，为在该人群中开展有针对性的防治策略提供数据支持。本研究采用队列研究方法，于2013年4月至2022年3月通过社会组织招募MSM人群建立开放性队列，在基线调查和HIV/梅毒检测的基础上，对所有参与者进行每六个月的定期随访调查和检测，计算发病率的变化趋势，并使用 Cox比例风险回归模型深入分析 HIV和梅毒新发感染的相关影响因素。共有2,110名MSM纳入分析，HIV新发感染率总体为2.3/100人年（95% CI：2.0, 2.7/100人年），随年份呈现下降趋势，从2013–2014年的5.2/100人年（95% CI：3.2, 7.2/100人年）、2015–2016年的4.2/100人年（95% CI：3.0, 5.4/100人年）、2017–2018年的2.4/100人年（95% CI：1.7, 3.1/100人年）、2019–2020年的2.2/100人年（95% CI：1.5, 2.9/100人年）下降为2021–2022年的1.9/100人年（95% CI：0.9, 2.9/100人年）。多因素分析显示，性取向、最近六个月无保护性性行为、首次同性性行为年龄、精神活性物质的使用、梅毒感染情况以及随访次数均与HIV新发感染有关。1927例调查对象纳入梅毒新发感染分析，梅毒新发感染率为4.8/100人年(95% CI：4.2, 5.3/100人年)。与HIV新发感染趋势相反，梅毒的新发感染率在研究期间呈现上升趋势，从2013–2014年的3.6/100人年（95% CI: 1.9, 5.3/100人年）、2015–2016年的2.7/100人年（95% CI: 1.9, 3.6/100人年）、2017–2018年的4.8/100人年（95% CI: 3.8, 5.8/100人年）、2019–2020年的5.9/100人年（95% CI: 4.8, 7.1/100人年）上升为2021–2022年的7.2/100人年（95% CI: 4.5, 9.8/100人年）。多因素分析显示，婚姻状况、性取向、精神活性物质的使用与梅毒新发感染有关。天津市MSM人群中HIV、梅毒发病趋势不同，考虑精神活性物质使用等危险因素的普遍存在，需要采取更具针对性的干预措施，以有效控制HIV、梅毒在这一高危人群中的传播。
For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.121


Effectiveness of Frequent Viral Load Testing Plus Additional Interventions to Prevent HIV Transmission in Heterosexual, Serodiscordant Couples — Yunnan Province, China, 2019–2021
Two-thirds of newly reported HIV-infections are from heterosexual contacts and one-tenth are from a spouse or regular partner. This study investigated the effect of frequent viral load test (VLT) plus additional preventative strategies on seroconversion in new diagnosed serodiscordant couples taking anti-retroviral therapy (ART) in China. Newly diagnosed HIV-1 serodiscordant couples who were identified through pre-operative testing and pre-pregnancy examination from local hospitals and voluntary HIV testing clinics were recruited across 15 health centers within Yunnan Province, China. Couples were randomly assigned to an intervention or standard-of-care group. The intervention group received ART and VLT at 1, 2, 3, 9, 12 and 18 months following HIV positive diagnosis. In addition, couples were informed about their viral load and subsequently counseled about safe sex practices and fertility planning. Couples in the standard-of-care group received VLT after 3 months. Seroconversion was the primary outcome and was compared between groups. The secondary outcome was viral load in 3 or 4 months after HIV positive spouse diagnosis. Chi-square test, student’s t-test, Cox regression, and Kaplan-Meier Estimates were used to compare the characteristics and outcome between two groups. As a result, 743 couples were randomized with 372 (486.7 PY) to the intervention group and 371 (470.8 PY) to the standard-of-care group. The number of participants who initiated ART within 7 and 14 days from diagnosis were significantly higher in the intervention group (P=0.011 and <0.001, respectively). In addition, rate of viral load <1000copies/L, <200copies/L, and <50copies/L within 3 or 4 months of diagnosis were significantly higher for the intervention group than the control group (P<0.05). No spouse (0/100PY) seroconverted in intervention group while 3 (0.6/100PY) seroconverted in control group. HIV transmission is more likely to occur in the first 6 months of ART initiation. However, seroconversion was not significantly different between groups. These results suggested frequent VL testing and counseling maximizing its treatment effect and reducing HIV transmission within serodiscordant couples. 
以病毒载量检测为基础的强化干预措施在预防HIV单阳家庭内传播有效性的随机对照研究— 中国云南省, 2019–2021年
新报告的艾滋病病毒感染者中有三分之二来自异性传播，十分之一来自配偶或固定性伴。本项研究旨在探讨以病毒载量检测(简称病载检测)为基础的强化预防干预措施对预防接受抗逆转录病毒治疗(简称抗病毒治疗)的新诊断HIV单阳家庭内HIV传播的效果。本研究招募了来自中国云南省15个县级医疗机构及自愿咨询检测门诊通过术前检测和孕前检查等途径发现的新诊断HIV单阳家庭。每个家庭被随机分配到干预组或常规对照组。干预组在单阳家庭阳性方HIV阳性诊断后及时推荐抗病毒治疗，并在1、2、3、9、12和18个月分别接受病毒载量检测。每次的病毒载量检测结果都会告知单阳家庭夫妻双方，同时开展行为干预及生育指导。常规对照组单阳家庭的阳性方在诊断3个月后接受病毒载量检测。单阳家庭阴性方HIV阳转是主要结局变量。次要结局变量是HIV阳性方诊断后3或4个月的病毒载量。采用卡方检验、t检验、Cox回归和Kaplan-Meier估计等方法比较两组间的特征和结局。在743个单阳家庭中，372个(486.7人年)被随机分配到干预组，371个(470.8人年)被随机分配到常规对照组。干预组在诊断后7天和14天内接收抗病毒治疗的人数显著高于对照组(P =0.011, P <0.001)。干预组在诊断后3、4个月内病毒载量<1000copies/L、<200copies/L、<50copies/L的比例均显著高于常规对照组(P<0.05)。干预组未发生家庭内HIV传播 (0.0/100PY)，对照组3个家庭发生家庭内传播(0.6/100PY)。尽管两组之间的HIV阳转率没有显著差异，但单阳家庭内的HIV传播更有可能发生在阳性方接受抗病毒治疗前的6个月。研究结果显示，强化的病毒载量检测和咨询可以最大限度地提高单阳家庭阳性方的抗病毒治疗效果，并减少单阳家庭中的HIV传播。
For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.122


The Epidemiological Characteristics and Spatiotemporal Clustering of Measles — China, 2005–2022
A new study reveals substantial progress in China’s efforts to eliminate measles. Analyzing data from 2005 to 2022, researchers found a significant decline in measles incidence, with the most notable reductions occurring during 2008–2011 and 2015–2022. The study highlights the effectiveness of high vaccination coverage and targeted immunization activities in reducing measles cases. However, challenges remain, particularly in western provincial-level administrative divisions (PLADs) where logistical issues hinder routine immunization. The findings emphasize the importance of maintaining high vaccine coverage, enhancing prevention measures in high-risk regions, improving the diagnosis of vaccine-associated rash illnesses, and continuously advancing elimination efforts to sustain progress towards measles eradication in China.
麻疹的流行病学特征和时空聚集性 — 中国，2005–2022年
中国在消除麻疹方面取得了实质性进展。通过分析2005年至2022年报告麻疹发病数据，发现中国麻疹的发病率显著降低，其中2008-2011年和2015-2022年的降幅最为明显。长期的监测数据变化显示，高疫苗接种率和有针对性的免疫活动对于降低麻疹发病率方面十分有效，中国正接近达到消除麻疹的目标。然而，挑战依然存在，特别是在西部地区，仍存在发病热点地区。需要进一步保持疫苗高覆盖率、加强西部地区的免疫服务能力、及时改进相关监测方案，加强疫苗相关出疹性疾病的诊断，进一步推进中国消除麻疹工作。
For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.123


A New Integrated Interpolation Method for High Missing Unstable Disease Surveillance Data — 12 Urban Agglomerations, China, 2009–2020
The prevalence of unstable and incomplete monitoring data in the context of syndrome analysis is a widespread issue. Numerous data interpolation techniques exhibit suboptimal performance in addressing this challenge. To enhance the precision of interpolation, the integration of the SHapley Additive explanation model (SHAP) into the structural equation model (SHAP-SEM) is proposed. Subsequently, a case study is conducted to evaluate the superiority of the novel model over the conventional one. The SHAP-SEM model was employed to construct an interpolation model using the Chinese respiratory syndrome surveillance database. We conducted three separate experiments to set up the model datasets, totaling 100 replicates. To assess the model's performance, we computed the root-mean-square error, correlation coefficient, and F-score. Our findings indicate that the SHAP-SEM model exhibits superior accuracy in data interpolation. This superiority is consistently observed across each season and in overall performance. We conclude that the SHAP-SEM model exhibits a remarkable ability to accurately interpolate volatile and deficient data. This capability contributes to the establishment of a comprehensive database essential for conducting risk assessments pertaining to syndromes.
一种高缺失不稳定疾病监测数据集成插值新方法— 中国12个城市群，2009–2020年
综合征分析中不稳定和不完整监测数据的流行是一个普遍存在的问题。许多数据插值技术在解决这一挑战方面表现出良好的性能。为了提高插值的精度，提出了将SHapley加性解释模型（SHAP）集成到结构方程模型（SHAP-SEM）中。随后，通过一个案例研究，评价了新模型相对于传统模型的优越性。采用SHAP-SEM模型与中国呼吸综合征监测数据库建立插值模型。我们进行了三个独立的实验来建立模型数据集，每次实验进行100次重复。使用均方根误差、相关系数和f分数来评估模型的性能。我们的结果表明，SHAP-SEM模型在数据插值方面具有较高的准确性，在所有季节和整体性能上始终优于其他模型。SHAP-SEM模型显示了准确填充缺失或不稳定数据的强大能力。这对于建立一个进行与综合征相关的风险评估所需的可靠数据库至关重要。
For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.124


A Case of Brucellosis Concomitant with Severe Fever with Thrombocytopenia Syndrome — Weifang City, Shandong Province, China, 2023
Brucellosis and severe fever with thrombocytopenia syndrome (SFTS) are neglected zoonoses, attributable respectively to Brucella and the SFTS virus (SFTSV). To investigate a patient exhibiting an unexplained fever admitted to Yidu Central Hospital of Weifang, and to understand the spatial-temporal distribution characteristics of the pathogen. Epidemiological investigation and laboratory tests were used to confirm the diagnosis of the patient. Information on corresponding disease patients admitted to the hospital in 2023 was collected and analyzed. The patient was confirmed to have SFTS and brucellosis. Through the spatiotemporal analysis of cases of brucellosis and SFTS admitted to Yidu Central Hospital of Weifang City in 2023, it was found that the distribution of cases showed spatiotemporal overlap, with overlapping distribution times from May to October and overlapping locations in Linqu County and Qingzhou county-level City, Weifang City. We present a rare case of co-infection involving brucellosis and SFTS, which contributes to the sparse body of knowledge on the simultaneous presence of multiple zoonotic diseases. Co-infections arising from the spatiotemporal overlap of Brucella and SFTSV are plausible, necessitating heightened awareness and enhanced diagnostic measures.
一例布鲁氏菌病合并发热伴血小板减少综合征感染患者报道 —中国山东省潍坊市，2023年
布鲁氏菌病和发热伴血小板减少综合征都是不可忽视的人兽共患病，分别由布鲁氏杆菌和大别班达病毒感染引起。对潍坊益都中心医院收治的一例不明原因发热患者进行调查，并了解其感染病原体的时空分布特征。通过流行病学调查和实验室检测明确诊断患者感染疾病，收集医院2023年收治的相应疾病患者信息并进行分析。患者被诊断为患有布鲁氏菌病和发热伴血小板减少综合征。通过对潍坊市益都中心医院2023年收治的鲁氏菌病和发热伴血小板减少综合征病例分析发现，两种疾病时空分布存在交叉，分布时间重合在5-10月，地点重合在潍坊市的临朐县和青州市。我们报告了一例布鲁氏菌病和发热伴血小板减少综合征合并感染的罕见病例，这有助于我们了解同时存在多种人畜共患疾病的可能性。布鲁氏菌病和发热伴血小板减少综合征的时空重叠可能导致合并感染，需要提高认识和加强诊断措施。
For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.125