Background: A prolonged measles epidemic occurred in Wenzhou City, China after a nationwide measles mass immunization campaign (MMIC) in 2010. We conducted an investigation to identify factors contributing to this epidemic and to provide evidence-based recommendations for measles elimination strategies in China. Methods: Measles was diagnosed using the national standard case-definitions. We estimated the population vaccination coverage based on the proportion of measles patients that had been vaccinated. In a case–control investigation, all measles patients who received treatment in The Second Affiliated Hospital of Wenzhou Medical College (Hospital S) during November 1 to December 31, 2010 served as cases; controls were randomly selected among all other patients who received treatment in Hospital S during the same time period, frequency matched by month of hospital visit. We reviewed medical records of case- and control-patients to compare their exposure history at Hospital S and to its intravenous rehydration room (IV room) during the incubation period (7–21 days before their illness onset). Results: The attack rate of measles in Wenzhou City was 3.3/100,000 during September 1, 2010 to January 11, 2011. Children aged 8-11 m had the highest attack rate (171/100,000) of all age groups. In children not age-eligible for the MMIC but should have been routinely vaccinated after the MMIC, the vaccination rate was only 52%. In the case–control investigation, 60% (25/42) of case-patients compared with 21% (35/168) of control-patients had visited Hospital S (adjusted OR_M-H = 5.5, 95% CI = 2.7–11). Among unvaccinated children who had received treatment in Hospital S, 84% (21/25) of case-patients compared 38% (11/29) of control-patients had visited the IV room (adjusted OR_M-H = 9.2, 95% CI = 1.5–59). Conclusion: Relaxed routine measles vaccination among children after the MMIC was the main factor responsible for this epidemic. Exposure in the IV room at Hospital S facilitated the epidemic. To reach the goal of measles elimination, the Chinese public health authorities should make greater efforts to improve timely routine measles vaccination, and to reduce nosocomial transmission.

Background: The association between adverse childhood experiences (ACEs) and obesity in developing countries has been underexplored and inconsistent. Methods: This cross-sectional study used data of 10,054 adults aged ≥ 45 years from the China Health and Retirement Longitudinal Study. Information on 12 ACE indicators was collected via questionnaires. General obesity was defined as a body mass index (BMI) of ≥28 kg/m². Central obesity was defined as a waist circumference of ≥90 cm for males and ≥85 cm for females. Logistic and linear regression analyses were conducted to evaluate the association of ACEs with general obesity, central obesity, BMI, and waist circumference where appropriate. Results: Compared to the non-exposed group, the experience of ≥3 ACEs was significantly associated with decreased risks of general obesity (OR = 0.83, 95% CI: 0.69, 0.999), central obesity (OR = 0.88, 95% 0.77, 0.997), and smaller BMI (β = −0.27, 95% CI: −0.50, −0.04) and waist circumference (β = −0.89, 95% CI: −1.52, −0.26). Compared to the high socioeconomic status (SES) group, such associations were more evident in those with a low SES, except for central obesity. Conclusion: ACEs were shown to be inversely associated with later-life obesity in China, especially in socioeconomically disadvantaged populations. The context-specific impacts reflect divergent roles of socioeconomic position in the obesity epidemic between developed and developing countries. Further investigations are needed to confirm whether physical activity could shift the direction of this association.

Exposure to fine particulate matter (PM_2.5) has been linked to visual impairment. Nevertheless, evidence associating PM_2.5 constituents with visual impairment in schoolchildren is sparse. To explore the effects of long-term exposure to PM_2.5 and its constituents on visual impairment. We conducted a large cross-sectional population-based study to recruit 59,054 schoolchildren from four cities in Guangdong province, China, and used the ChinaHighAirPollutants (CHAP) dataset to estimate 3-year average concentrations of PM_2.5 and its constituents (black carbon (BC), organic matter (OM), nitrate (NO₃^-), sulfate (SO₄^2-) and ammonium (NH₄⁺)) based on individuals' home addresses. Visual acuity was measured with a standardized logarithmic chart, and visual impairment was defined as visual acuity below 4.9 (Snellen 5/6 equivalent) in at least one eye. We utilized generalized linear mixed models and weighted quantile sum regression to assess the association between PM_2.5 constituents and visual impairment. The observed associations typically displayed a nonlinear pattern. Compared to the lowest quartile of PM_2.5 and its constituents, the fourth quartile was associated with higher odds of visual impairment in schoolchildren (e.g., the adjusted odds ratio (OR) was 1.23 (95% CI: 1.13, 1.33) for PM_2.5, 1.53 (95% CI: 1.40, 1.67) for OM, and 1.35 (95% CI: 1.27, 1.44) for BC), respectively. Similarly, joint exposure to PM_2.5 constituents was associated with visual impairment (OR = 1.17, 95% CI: 1.13, 1.22), while BC and OM contributed more to the observed associations. Long-term exposure to PM_2.5 and its constituents was significantly associated with higher rates of visual impairment in schoolchildren, with combustion-related BC and OM potentially driving the observed associations.

Few studies have concentrated on the prevalence and related factors of depression and falls among the elderly living in rural communities of Guangzhou. A total of 335 participants aged ≥60 years were recruited by simple random sampling method. A structural equation model was applied to determine interrelationships between depression, falls and other variables. As high as 27.5% and 23.3% participants had reported depressive symptoms and falls, respectively. The path analysis showed the total effect (β = −0.58) of depression on quality of life (QOL) consisted of a direct effect (β = −0.51) and an indirect effect (β = −0.07), which was mediated by family function and number of falls, and the R² was 0.36. The model fit indices were χ²/df = 1.096, P > 0.05, Root Mean Square Error of Approximation (RMSEA) = 0.017, Tucker–Lewis Index (TLI) = 0.998 and Comparative Fit Index (CFI) = 0.999. Depression and falls were prevalent among the elderly living in rural communities of Guangzhou city. Pay attention to strengthen family function and prevent falls may prevent depression and improve the QOL among the elderly.

Objective: This study aimed to estimate the prevalence of dementia and its associated risk factors among older adults aged 65 years and above in Guangzhou, China.Methods: We conducted a community-based cross-sectional study involving 2,463 residents aged 65 years or older in Guangzhou, using a multi-stage whole-population random sampling method. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), with cutoff points adjusted by education level. Trained investigators collected information on demographic characteristics, health behavioral factors, and medical history through face-to-face interviews. Univariate analyses and multivariate logistic regression were performed to identify factors associated with dementia.Results: The prevalence of dementia was 14.94% among participants aged 65 and above, increasing from 13.30 to 34.58% across different age groups. Multivariate analysis showed that frequent falls (≥3 falls within the past year vs. no falls: OR = 2.72, 95% CI: 1.27–5.81, p < 0.05), older age (≥85 years vs. 65–74 years: OR = 2.62, 95% CI: 1.66–4.13, p < 0.001), depression (OR = 2.61, 95% CI: 1.36–5.00, p < 0.05) had the most significant associations with dementia risk. Lower educational attainment, prolonged sleep duration (≥8 h), lack of cognitive activity and physical activity, depression, as well as a history of stroke, also showed statistical differences.Conclusion: Dementia is highly prevalent among older adults in Guangzhou, posing a substantial public health challenge. Our findings emphasize the need for early identification and targeted interventions, including the promotion of physical and cognitive activities, fall prevention strategies, and better management of chronic conditions such as stroke, depression, and hearing loss, to reduce dementia risk and burden in aging communities.

Background Road traffic-related injuries are a public health problem worldwide and could be extremely harmful to the lives of children. However, limited studies explore the risk factors of road traffic-related injuries in Haddon matrix to improve children road safety in China. Methods Based on literature review, we specified a framework of risk factors of road traffic-related injuries in Haddon matrix for schoolchildren pedestrians. Then, we formulated Haddon matrix under pre-intervention data including a baseline questionnaire survey and on-the-spot investigation toward schoolchildren and their parents of a primary school. According to the risk factors in Haddon matrix, some interventions were implemented in the school zones. After applying the interventions, we again conducted the questionnaire survey to compare the differences before and after the interventions, thereby to see the effect of implementation. Results We determined the risk factors of road traffic-related injuries for schoolchildren pedestrians of the school in Haddon matrix. Three main interventions were proposed according to the Haddon matrix and the possibility of implementation, including implementing road safety education, improving road safety environment near the school zones, and implementing Family-Police-School traffic assistant mode. The interventions effectively improve the road environment as 7.87% increase in schoolchildren who always felt safe when walked near the school, 15.46% increase in schoolchildren who thought it was easy to cross the road, and 11.25% increase in parents who agreed it was always safe for their children to walk to school alone (P < 0.05). Most participants were satisfied with the interventions and thought the interventions were worth promoting (P < 0.01). Conclusions Schoolchildren are vulnerable road users, and they are in high risks of road traffic-related injuries. Therefore, more future studies analyzing risk factors associated with road traffic-related injuries in Haddon matrix are required to better protect children from road traffic-related injuries and deaths.