Introduction: Antimicrobial resistance is a global health crisis and primarily caused by antibiotic misuse. Antibiotic misuse among children is particularly concerning, and its prevalence may vary from region to region in China with different development levels. Methodology: Zhejiang and Shaanxi were selected to represent developed and less developed provinces in China, respectively. Data of 2924 parents in Zhejiang and 3355 parents in Shaanxi whose children were 0-13 years old were collected through multi-stage stratified cluster random sampling and a self-administrated questionnaire. Chi-square tests and logistic regression models were used for statistical analysis. Results: Compared to parents in Zhejiang, those in Shaanxi were more likely to keep antibiotics for children at home, to engage in self-medication with antibiotics for children, and to make their children take antibiotics prophylactically. While there were no significant provincial differences between parents’ requests for antibiotics during pediatric consultations, parents in Shaanxi province were more likely to receive prescribed antibiotics. Conclusions: Children in less developed provinces face higher risks of antibiotic misuse at home as well as when attending medical practitioners. Comprehensive educational interventions are required to improve antibiotic use for children all over China but particularly in less developed provinces such as Shaanxi. Furthermore, non-prescription sales and over-prescribing of antibiotics should be reduced by targeted strategies.

Background: The Yinzhou Center for Disease Prevention and Control (CDC) in China implemented an integrated health big data platform (IHBDP) that pooled health data from healthcare providers to combat the spread of infectious diseases, such as dengue fever and pulmonary tuberculosis (TB), and to identify gaps in vaccination uptake among migrant children. Methods: IHBDP is composed of medical data from clinics, electronic health records, residents’ annual medical checkup and immunization records, as well as administrative data, such as student registries. We programmed IHBDP to automatically scan for and detect dengue and TB carriers, as well as identify migrant children with incomplete immunization according to a comprehensive set of screening criteria developed by public health and medical experts. We compared the effectiveness of the big data screening with existing traditional screening methods. Results: IHBDP successfully identified six cases of dengue out of a pool of 3972 suspected cases, whereas the traditional method only identified four cases (which were also detected by IHBDP). For TB, IHBDP identified 288 suspected cases from a total of 43,521 university students, in which three cases were eventually confirmed to be TB carriers through subsequent follow up CT or T-SPOT.TB tests. As for immunization screenings, IHBDP identified 240 migrant children with incomplete immunization, but the traditional door-to-door screening method only identified 20 ones. Conclusions: Our study has demonstrated the effectiveness of using IHBDP to detect both acute and chronic infectious disease patients and identify children with incomplete immunization as compared to traditional screening methods.

Objectives To describe the situation of COVID-19-related stigma towards patients with COVID-19 and people from the city of Wuhan in China and to assess the associations between COVID-19-related stigma, health literacy and sociodemographic characteristics during March 2020, the early stage of the pandemic. Design A cross-sectional online survey. Setting The study surveyed 31 provinces in China. Participants This study surveyed 5039 respondents in China. Outcome measures Public stigma towards both patients with COVID-19 and Wuhan residents was measured. Binary logistic regression was used to identify the factors associated with public COVID-19-related stigma. Results Among the participants, 122 (2.4%) reported themselves and 254 (5.0%) reported the communities they lived in as holding a stigmatising attitude towards patients with COVID-19, respectively. Additionally, 114 (2.5%) and 475 (10.3%) reported that themselves and the communities they lived in, respectively, held a stigma against people from Wuhan, which was the most severely affected area in China. People aged over 40, lived in areas with severe epidemics (adjusted OR (aOR)=2.03, 95% CI (1.05 to 3.92)) and who felt it difficult to find and understand information about COVID-19 (aOR=1.91, 95% CI (1.08 to 3.37); aOR=1.88, 95% CI (1.08 to 3.29)) were more likely to stigmatise patients with COVID-19. People who were male, aged 41–50 and had difficulty understanding information (aOR=2.08, 95% CI (1.17 to 3.69)) were more likely to stigmatise people from Wuhan. Conclusions Patients with COVID-19 and Wuhan residents suffered stigma at both the individual and the community levels. Those who had low health literacy, who lived in areas with a large number of COVID-19 cases and who were of ethnic minorities were more likely to stigmatise others. Tailored interventions are encouraged to improve health literacy and consequently to reduce public COVID-19-related stigma.

Background: Antibiotic misuse and unsafe disposal harm the environment and human health and contribute to the global threat of antimicrobial resistance. Household storage of antibiotics for unsupervised use and careless disposal of medications is a common practice in China and most low- and middle-income countries. Currently, few interventions are available to address this challenge. Objective: This study assesses the feasibility and acceptability of an evidence-based, theory-informed, community-based take-back programme for disposing household’s expired, unwanted, or unused antibiotics in rural China. Methods: We adopted the RE-AIM framework and the community-based participatory research principles in the development, implementation, and evaluation of the intervention. The RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) and Medical Research Council’s frameworks were employed in analysing and reporting evaluation results. A mixed-methods, controlled pre-and post-test design was used for (1) quantitative surveying of a representative community panel of 50 households, and (2) qualitative semi-structured stakeholders’ interviews to explore intervention and study design feasibility and acceptability at three phases: pre-intervention, intervention, and post-intervention. Quantitative and qualitative data from a similar village—serving as a control—were also collected. Results: All a priori feasibility objectives were met: Conversion to consent was 100.0% (100 screened, approached, recruited, and consented). All participants completed the pre-intervention assessment, and 44/50 households in the intervention village completed the post-intervention assessment. The programme, embedded in existing social and physical infrastructure for dissemination, directly reached over 68.2% (30/44) of its target audience. Stakeholders reported the intervention and study design as feasible and acceptable. Conclusions: This study illustrates the feasibility, acceptability, and potential efficacy of community-based antibiotic take-back programmes in China to encourage safe disposal and decrease the availability of expired, unwanted, or unused antibiotics in the household for unsupervised use.