| Section one: Study on the application of some epidemiological indexes in the prevention and control of thalassemiaObjective Some measurement indexes of thalassemia were cons tructed,for providing theoretical basis for the epidemiological study,and measurement indexes for prevention and control of thalassemia,scientific research and performance appraisal.Methods Frequency analysis method,theoretical analysis method and expert consultation method were used to scientifically define,measurement and calculation,analysis and evaluation,and practical application of measurement indexes related to the prevention and control of thalassemia,which was based on the actual experience of prevention and control of thalassemia in Guangxi,the relevant policies,prevention requirements and the literatures of thalassemia.Results In this study,the specificity of thalassemia were analy zed,14 indexes of frequency measurement and 6 indexes of perfor mance evaluation for the prevention and control of thalassemia were scientifically defined and the corresponding formulas were established.The corresponding epidemiological analysis and practical evaluat ion were given.The 14 indexes were incidence of thalassemia,prev alence of thalassemia,gene carrier rate of thalassemia,positive rate of alpha thalassemia,positive rate of beta thalassemia,etc.The 6indexes of performance evaluation were the rate of premarital medic al check,screening rate of thalassemia and prenatal diagnosis rate,etc.Conclusion Measurement indexes of thalassemia were specificit y,and the 20 indexes of the index system of prevention and contro l of thalassemia have important epidemiological significance are of great practical significance.It is a basic epidemiological study with strong scientific and practical significance.Section two: Study on some epidemiology of thalassemiaObjective Analysis of the positive rate of screening and some epidemiological characteristics of thalassemia in health recorded population.To explore the nationality,time and regional distribution differences and geographical trend of thalassemia in Guangxi and to reduce the incidence of birth defects,also to provide scientific basis for optimizing the allocation of resources.Methods The date of routine blood test in 2013~2015 and cas es of prenatal diagnosis of thalassemia in 2015 was obtained from t he pregnant women in health records in different counties(cities/dis tricts)in Guangxi.Took the positive rate of screening of pregnant who were in health recorded.Using the classical statistical analysis method combined with geo spatial analysis technology to take descr iptive epidemiological analysis for studying on some epidemiological characteristics of thalassemia.Results(1)Three years difference analysis of screening positiv e rate.The positive rate of screening of thalassemia of people of r eproductive age who were in health recorded in Guangxi in 2013~2015 were 18.41%(95%CI:17.54~19.67)?20.75%(95%CI:19.75~21.82)?21.04%(95%CI:19.82~21.86),respectively,which showing a statistica lly significant difference(?2= 2062.97,P<0.001)and an increasing tre nd(P<0.001).(2)Spatial and temporal difference analysis of screeni ng positive rate.There are regional differences in the trend of the positive rate of screening of thalassemia in 14 cities in Guangxi,an d the trend of the direction was not the same.There are 9 cities t hat have gradually increased over time,and only 5 showing rise at irst then decline.The result of which has regional high value agg regation characteristics.Because of both global Moran's I coefficient s and the global Getis coefficients were positive and statistically sig nificant(P<0.001).Both the results of local Moran's I and local ho tspot analysis of the positive rate of screening of thalassemia were similar to the spatio-temporal evolution trend of regional distribution(3)The results of the study have geographical trend characteristics.From the south to the north of Guangxi,it showed obvious inverte d "U" shape.The map of the three dimensional contour also pointe d out that the regions of longitude of 106°~107° and longitude of109°~110° with latitude of 23°~24° showed peak distribution charac teristics.(4)Differential analysis of alpha and beta thalassemia.Res ults of prenatal diagnosis in 2015 showed that Alpha thalassemia de tection rate is higher than that of beta thalassemia(?2=11.92,P=0.003)and with no difference in detection rate of different nationalitie s(?2=3.31,P=0.191),while Beta thalassemia was the opposite(?2=6.60,P=0.037),what's more,the proportion of Zhuang nationality(53.70%)was higher than Han nationality(49.60%),with ?2=6.52 and P=0.011.Conclusion(1)Differences of time distribution,regional distribution and national distribution are existed in thalassemia in Guangxi.(2)The positive rate of screening was found un-randomly distributed,but with geographically clustered,geographic trends and peak distribution characteristics.(3)The significant epidemiological features of thalassemia can provide scientific basis for the key prevention and control areas of thalassemia in Guangxi. |
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