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Abstract Background Intestinal infectious diseases (IIDs) are a significant public health issue in China, and the incidence and distribution of IIDs vary greatly by region and are affected by various factors. This study aims to describe the spatio-temporal trends of IIDs in the Chinese mainland and investigate the association between socioeconomic and meteorological factors with IIDs. Methods In this study, IIDs in mainland China from 2006 to 2017 was analyzed using data obtained from the China Center for Disease Control and Prevention. Spatio-temporal mapping techniques was employed to visualize the spatial and temporal distribution of IIDs. Additionally, mean center and standard deviational ellipse analyses were utilized to examine the spatial trends of IIDs. To investigate the potential associations between IIDs and meteorological and socioeconomic variables, spatiotemporal zero-inflated Poisson and negative binomial models was employed within a Bayesian framework. Results During the study period, the occurrence of most IIDs has dramatically reduced, with uneven reductions in different diseases. Significant regional differences were found among IIDs and influential factors. Overall, the access rate to harmless sanitary toilets (ARHST) was positively associated with the risk of cholera (RR: 1.73, 95%CI: 1.08-2.83), bacillary dysentery (RR: 1.32, 95%CI: 1.06-1.63), and other intestinal infectious diseases (RR: 1.88, 95%CI: 1.52-2.36), and negatively associated with typhoid fever (RR: 0.66, 95%CI: 0.51-0.92), paratyphoid fever (RR: 0.71, 95%CI: 0.55-0.92). Urbanization is only associated with hepatitis E (RR: 2.48, 95%CI: 1.12-5.72). And GDP was negatively correlated with paratyphoid fever (RR: 0.82, 95%CI: 0.70-0.97), and bacillary dysentery (RR: 0.77, 95%CI: 0.68-0.88), and hepatitis A (RR: 0.84, 95%CI: 0.73-0.97). Humidity showed positive correlation with some IIDs except for amoebic dysentery (RR: 1.64, 95%CI: 1.23-2.17), while wind speed showed a negative correlation with most IIDs. High precipitation was associated with an increased risk of typhoid fever (RR: 1.52, 95%CI: 1.09-2.13), and high temperature was associated with an increased risk of typhoid fever (RR: 2.82, 95%CI: 2.06-3.89), paratyphoid fever (RR: 2.79, 95%CI: 2.02-3.90), and HMFD (RR: 1.34, 95%CI: 1.01-1.77). Conclusions This research systematically and quantitatively studied the effect of socioeconomic and meteorological factors on IIDs, which provided causal clues for future studies and guided government planning.

The floating population has been growing rapidly in China, and their fertility behaviors do affect urban management and development. Based on the data set of the China Migrants Dynamic Survey in 2016, the logistic regression model and multiple linear regression model were used to explore the related factors of fertility behaviors among the floating populace. The artificial neural network model, the naive Bayes model, and the logistic regression model were used for prediction. The findings showed that age, gender, ethnic, household registration, education level, occupation, duration of residence, scope of migration, housing, economic conditions, and health services all affected the reproductive behavior of the floating population. Among them, the improvement duration of post-migration residence and family economic conditions positively impacted their fertility behavior. Non-agricultural new industry workers with college degrees or above living in first-tier cities were less likely to have children and more likely to delay childbearing. Among the prediction models, both the artificial neural network model and logistic regression model had better prediction effects. Improving the employment and income of new industry workers, and introducing preferential housing policies might improve their probability of bearing children. The artificial neural network and logistic regression model could predict individual fertility behavior and provide a scientific basis for the urban population management.

BackgroundAccurate incidence prediction of sexually transmitted diseases (STDs) is critical for early prevention and better government strategic planning. In this paper, four different forecasting models were presented to predict the incidence of AIDS, gonorrhea, and syphilis.MethodsThe annual percentage changes in the incidence of AIDS, gonorrhea, and syphilis were estimated by using joinpoint regression. The performance of four methods, namely, the autoregressive integrated moving average (ARIMA) model, Elman neural network (ERNN) model, ARIMA-ERNN hybrid model and long short-term memory (LSTM) model, were assessed and compared. For 1-year prediction, the collected data from 2011 to 2020 were used for modeling to predict the incidence in 2021. For 5-year prediction, the collected data from 2011 to 2016 were used for modeling to predict the incidence from 2017 to 2021. The performance was evaluated based on four indices: mean square error (MSE), mean absolute error (MAE), and mean absolute percentage error (MAPE).ResultsThe morbidities of AIDS and syphilis are on the rise, and the morbidity of gonorrhea has declined in recent years. The optimal ARIMA models were determined: ARIMA(2,1,2)(0,1,1)12, ARIMA(1,1,2)(0,1,2)12, and ARIMA(3,1,2)(1,1,2)12 for AIDS, gonorrhea, and syphilis 1-year prediction, respectively; ARIMA (2,1,2)(0,1,1)12, ARIMA(1,1,2)(0,1,2)12, and ARIMA(2,1,1)(0,1,0)12 for AIDS, gonorrhea and syphilis 5-year prediction, respectively. For 1-year prediction, the MAPEs of ARIMA, ERNN, ARIMA-ERNN, and LSTM for AIDS are 23.26, 20.24, 18.34, and 18.63, respectively; For gonorrhea, the MAPEs are 19.44, 18.03, 17.77, and 5.09, respectively; For syphilis, the MAPEs are 9.80, 9.55, 8.67, and 5.79, respectively. For 5-year prediction, the MAPEs of ARIMA, ERNN, ARIMA-ERNN, and LSTM for AIDS are 12.86, 23.54, 14.74, and 25.43, respectively; For gonorrhea, the MAPEs are 17.07, 17.95, 16.46, and 15.13, respectively; For syphilis, the MAPEs are 21.88, 24.00, 20.18 and 11.20, respectively. In general, the performance ranking of the four models from high to low is LSTM, ARIMA-ERNN, ERNN, and ARIMA.ConclusionThe time series predictive models show their powerful performance in forecasting STDs incidence and can be applied by relevant authorities in the prevention and control of STDs.

BackgroundSyphilis has spread throughout China, especially in Zhejiang Province which endangers the health and lives of people. However, the spatial and temporal epidemiological studies of syphilis in Zhejiang are not thorough enough. The temporal and spatial variation and the relevant factors of syphilis incidence should be analyzed for more effective prevention and control in Zhejiang, China.MethodsData on confirmed cases of syphilis in Zhejiang Province from 2005 to 2018 was used and the spatio–temporal distributions were described. The spatial autocorrelation analysis and SaTScan analysis were performed to identify spatio–temporal clusters. A Bayesian spatial Conditional Autoregression (CAR) model was constructed to explore the relationships between syphilis incidence and common social and natural indicators.Results474,980 confirmed cases of syphilis were reported between 2005 and 2018 with a large peak in 2010. Farmers and unemployed people accounted for the largest proportion of confirmed cases. And the significant spatial clusters of syphilis were concentrated in the north of Zhejiang Province, especially in more economically developed regions. Seven spatio–temporal clusters were identified and the main three high–risk areas were located in Hangzhou (RR = 1.62, P < 0.05), Zhoushan and Ningbo (RR = 1.99, P < 0.05), and Lishui (RR = 1.68, P < 0.05). The findings showed that the morbidity of syphilis was positively correlated with the Gross Domestic Product (GDP) per capita, the number of health technicians per 10,000 people, the proportion of the elderly and air temperature were negatively correlated with the proportion of the urban population, the proportion of men and precipitation.ConclusionsThe spatio–temporal analysis revealed that the prevalence of syphilis was still serious in Zhejiang Province. Syphilis high–risk areas were mainly located in the more developed coastal regions where more targeted intervention measures were required to be implemented. The study highlighted the need to strengthen Sexually Transmitted Diseases (STD) screening and health education for high–risk groups and improve the coverage of syphilis testing to reduce hidden syphilis cases.

Background: Vitamin D supplementation improves the immune function of human body and can be a convenient way to prevent influenza. However, evidence on the protective effect of vitamin D supplementation on influenza from Randomized Controlled Trials (RCTs) is inconclusive.Methods: RCTs regarding the association between vitamin D supplementation and influenza were identified by searching PubMed, Cochrane library, Embase and Chinese Biomedical Database (CBM) from inception until present (last updated on 10 November 2021). Studies that reported dosages and durations of vitamin D supplementation and number of influenza infections could be included. Heterogeneity was assessed using Cochran's Q test and I2 statistics, the meta-analysis was conducted by using a random-effects model, the pooled effects were expressed with risk ratio (RR) with 95% confidence interval (95% CI).Results: 10 trials including 4859 individuals were ultimately eligible after scanning. There was no evidence of a significant heterogeneity among studies (I2 = 27%, P = 0.150). Meta-regression analysis finding indicated that country, latitude, average age, economic level, follow-up period and average daily vitamin D intake did not cause the statistical heterogeneity. The study finding indicates that substitution with vitamin D significantly reduces the risk of influenza infections (RR = 0.78, 95% CI:0.64–0.95). No evidence of publication bias was observed. Omission of any single trial had little impact on the pooled risk estimates.Conclusions: The meta-analysis produced a corroboration that vitamin D supplement has a preventive effect on influenza. Strategies for preventing influenza can be optimized by vitamin D supplementation.