Background: The thirteen-valent pneumococcal conjugate vaccine (PCV13) is not included in the national immunization program and is administered voluntarily with informed consent in China. In preparation for assessing the impact of pilot introduction in Hainan Province, we conducted a carriage study among children under 5 years of age from four locations in Hainan Province, China. Methods: From March to June 2022, nasopharyngeal (NP) swabs, collected from healthy children aged younger than 59 months who lived in the 4 different locations (Haikou, Wanning, Baisha and Qiongzhong) in Hainan Province, were tested for pneumococcus using conventional culture. Pneumococcal isolates were serotyped using the Quellung reaction. Risk factors associated with pneumococcal colonization were assessed using univariate analysis and multivariable logistic regression adjusting for age, daycare attendance and other factors. Results: Pneumococcus was isolated in 710 (30.4%) of the 2333 children enrolled. Of 737 pneumococci, 29 serotypes were identified; 60.9% were PCV13 serotypes; the most common vaccine serotypes were 6B (20.4%), 19F (13.0%), 6A (11.9%) and 23F (6.1%); and the most common nonvaccine serotypes were 23A (12.9%), 34 (6.1%) and nontypeable (NT) pneumococci (5.6%). Children vaccinated with PCV13 had lower carriage (17.7% vs 32.5%; P = 0.0001) and fewer PCV13 serotypes (41.9% vs 62.7%; P = 0.0017) compared to unimmunized children. After adjustment, NP carriage was higher among children attending daycare (aOR = 2.3, 95% CI: 1.7–3.2), living in rural areas (aOR = 1.4, 95% CI: 1.1–1.8), living with siblings (aOR = 1.3, 95% CI: 1.0–1.6) and whose mothers had completed senior high/technical secondary school (aOR = 1.5, 95% CI: 1.1–2.0). In contrast, completion of 3–4 doses of PCV13 were associated with a lower carriage rate (aOR = 0.6, 95% CI: 0.4–0.9). Conclusions: We established the baseline of pneumococcal carriage, serotype distribution and PCV13 immunization rates among healthy children under 5 years of age in Hainan Province, prior to the introduction of PCV13 into the national immunization program. The high proportion of PCV13 serotypes suggests that PCV13 introduction will likely have a substantial impact on pneumococcal carriage in Hainan Province. Graphical

Although there is an association between income status and concentration of perfluoroalkyl and polyfluoroalkyl substance (PFAS), the association remains uncertain in patients with hypertension, hyperlipidemia, and comorbidities. Data from the 2013–2016 National Health and Nutrition Examination Survey were analyzed. A total of 2665 adults were included, and the data included participants' serum PFAS (perfluorooctanoic acid [PFOA], perfluorononaic acid, perfluorodecanoic acid, perfluoroundecanoic acid, perfluorohexane sulfonic acid, and perfluorooctane sulfonic acid) levels and selected covariates. Multivariate linear regression models were used to examine the association between the ratio of family income to poverty (PIR) and individual serum PFAS concentrations in the hypertensive and/or hyperlipidemia groups after adjusting for covariates. The potential effects of sex and age on the results were explored using stratified analysis. A mediating effect model was used to explore the mediating effects of body mass index (BMI) and waist circumference on the association results. After adjusting for potential confounders, for hyperlipidemia and comorbidities (hypertension and hyperlipidemia), serum levels of multiple common PFAS increased by 0.09% (95%Confidence interval [CI] 0.02–0.15%) to 0.13% (95%CI 0.08–0.19%) and 0.10% (95%CI 0.02–0.17%) to 0.12% (95%CI 0.06–0.18%), respectively, with each 1% increase in PIR. The covariate model and stratified analyses results suggested the potential effects of different covariates such as age and sex, leading to changes in the statistical significance of the association results. BMI significantly mediated the effect of PIR on PFOA in hyperlipidemia (13%, P < 0.001). Household income in adults with hyperlipidemia and comorbidities positively correlated with serum PFAS concentration in the United States. Obesity played an indispensable mediating role in the association between economic income and PFAS concentration.

Background: Alcohol consumption is a significant risk factor for premature mortality and increased disease burden worldwide, especially among young and middle-aged individuals. This study aims to evaluate drinking patterns and alcohol consumption among adults in Hainan Province, while also identifying associated factors.Methods: Analyses based on the 2022 “2 + 3” epidemiological survey in Hainan were conducted, and the drinking types, quantities, and frequencies among local residents were described. Chi-square tests and multiple linear regression were employed for the statistical analysis.Results: A total of 32,857 adults participated, yielding an overall drinking rate of 42.8%. The drinking rate was significantly higher among men (64.4%) than women (18.9%). The highest drinking rates were found in the 30–59 age group, especially among individuals aged 30–39. Ethnic minorities had a higher drinking rate (70.1%) than Han individuals. Lower educational attainment was associated with lower drinking rates, although the prevalence of active drinkers was higher. Men preferred strong liquor and beer, whereas women favored beer and rice wine. The average weekly alcohol consumption was 59.8 mL for men and 10.9 mL for women, with 43.6% of men exceeding 100 mL weekly, compared to 12.7% of women.Conclusion: This study emphasizes the complexity and diversity of drinking behaviors among adults in Hainan Province. Sociodemographic factors, including gender, age, ethnicity, education, marital status, occupation, and region, are closely linked to drinking behaviors. The findings provide a scientific basis for developing targeted public health strategies, highlighting the need for effective interventions to mitigate alcohol-related health issues among high-risk populations.

Background: To investigate the epidemiology and related factors of iodine deficiency disorders (IDD) in Hainan Province, to know the iodine nutrition status and thyroid disease status of residents, and to explore whether salt iodization should be adopted to prevent and control IDD in island areas. To provide a basis for the effective implementation of scientific iodine supplement prevention and control strategy.Methods: All 21 cities, counties (districts) in the province were investigated. Superficial soil, residential drinking water, common food, urine samples of children, adults and pregnant women, household salt samples, thyroid B-ultrasound of adults and pregnant women, adult blood samples were collected. Soil iodine, water iodine, food iodine, urine iodine, daily salt intake, salt iodine, thyroid volume, nodules and thyroid function were measured.Results: The median iodine content in soil was 4.37mg/kg, the median iodine content in drinking water was 6.0μg/L, the iodized salt coverage rate was 98.6%, and the consumption rate of qualified iodized salt was 97.9%. The median urinary iodine concentration (MUIC) in children and adults was 180.3μg/L and 151.6μg/L, respectively, which was the adequate level of iodine. The median urinary iodine in pregnant women was 144.6μg/L, which was slightly lower than the adequate level. The main source of iodine intake was salt iodine, which contributed 59.8% to total dietary iodine. Kelp, milk and seaweed, whose contribution rates were 8.2%, 7.3% and 6.6%, respectively. The total iodine contribution rate of other foods was 18.1%, among which the contribution rate of fish, shrimp and crabs was only 2.4%. The overall prevalence of thyroid diseases was 27.01%. The detection rates of subclinical hypothyroidism and subclinical hyperthyroidism in males were significantly higher than those in females, and the detection rates of thyroid nodules and goiter were significantly lower than those in females. The detection rates of thyroid nodules in central mountainous areas were significantly higher than those in eastern and western coastal areas.Conclusions: At present, the iodine nutrition level in Hainan Province is generally in a suitable state, and the iodine intake of residents mainly comes from iodized salt. The strategy of salt iodization prevention and control of IDD should be adhered to in island area.