Burden of Communicable, Maternal and Perinatal Diseases in Gansu, China Wangxi Hai Northwest University for Nationalities West of China Institute of Environment and Health

2/32 Self-introduction Educational Experience  Henan Institute of Science and Technology Bachelor Study Topic: Changes of Physiological Function and Behaviors of Rats Induced by High Fluoride and Low Iodine  2007-Present West of China Institute of Environment and Health, Northwest University for Nationalities Master Study Topic: Prevention and Control Study of Zoonosis, Environment and climate impact on infectious and chronic diseases

3/32 Self-introduction Research Experience  Study on Hepatitis E Epidemic Situation of Animals and Population in Gansu Province  Spatial analysis study on tumor’s distribution in Wuwei area of Gansu province  Death pattern and disease burden study of residents in Gansu Province

4/32 Self-introduction Research Experience  Lead poisoning investigation of Longnan, Gansu  Hypertension and diabetes risk factor study of Gansu Province  Environmental and geographical evaluation system of diseases in minorities areas of Gansu province

5/32 Introduction of Gansu Province Area of land ： 454,400 km 2 (including 14 cities of 86 counties or districts) Population: 26million Capital City: Lanzhou ●

6/32 Introduction of the Project  Death Pattern and Disease Burden Study of Residents in Gansu Province  Investigation Time:  Sponsor: Gansu CDC

7/32 Introduction of the Project  Surveillance Points: 5 counties (districts) in Gansu  Data source: Investigation according to Medical Certificate System of the Cause of Death  Methods: Retrospective Study of Cause of Death

8/32 Introduction of the Project  Data classification: ICD-10  The Indicator of diseases burden: Potential Years of Life Lost (PYLL)  Related Population, Birth, Socioeconomic Situation Data also collected

9/32 Introduction of the Project  5 Surveillance Points investigated 34,201 cases  Mortality of the investigation in Gansu was per 100,000 higher than that of the whole country (608.8 per 100,000)  Mortality of diseases:  Communicable, maternal & perinatal diseases 38.6 per 100,000  Noncommunicable diseases per 100,000  Injuries 63.9 per 100,000.

10/32 Introduction of the Project  Every year PYLL caused by all kinds of diseases and injuries is approximately 1,620,000.  Male’s PYLL higher than Female’s  Rural population’s PYLL higher than urban area’s.

11/32 Introduction of the Project  Top 5 causes of death according to mortality are Circulatory System Diseases, Cancer, Respiratory System Diseases, Injury & poisoning and Infectious & parasitic diseases  Top 5 causes of death according to PYLL are Injury & poisoning, Circulatory System Diseases, Cancer, Perinatal Diseases and Respiratory System Diseases

12/32 Burden of Communicable Diseases  Mortality of Communicable Diseases is 27.5 Per 100,000, higher than that of whole China(13.5 Per 100,000) Gender Male Female Mortality Age group 0 1 5

13/32 Burden of Communicable Diseases  5 main causes of deaths in communicable diseases are hepatitis, TB, pneumonia, acute upper respiratory tract infection and intestinal bacterial diseases. Hepatitis TB Pneumonia Acute upper respiratory tract infection Intestinal bacterial diseases Diarrhea

14/32 Burden of Communicable Diseases  In Gansu communicable diseases leads to 102,000 PYLL every year.  PYLL caused by communicable diseases is 34.9% of Communicable, maternal & perinatal diseases. Lower than the percentage of its death number account for the group (71.4%).  It shows that the age of death people caused by communicable diseases are older, this kind of diseases cause lower years of life lost of population.

15/32 Burden of Communicable Diseases  Hepatitis account for 31.0% of Communicable Diseases, mortality is 8.5 per 100,000. Twice than that of whole China (4.1 per 100,000). Gender Male Female Mortality Age group

16/32 Burden of Communicable Diseases  Hepatitis caused 29,000 PYLL every year in Gansu.  PYLL caused by hepaitits is 48.8% of Communicable, maternal & perinatal diseases. Higher than the percentage of its death number account for the group (31.0%).  Hepatitis cause higher years of life lost of population in communicable diseases.

17/32 Burden of Communicable Diseases  Hepatitis B is the major infectious diseases in Gansu province, Hepatitis E also have growth trend.  According to our serosurvey, both population and domestic animals in Gansu Province have higher Hepatitis E Virus IgG positive rate

18/32 Burden of Communicable Diseases  Pneumonia mortality is 5.9 per 100,000. Lower than that of whole China (10.0 per 100,000). Gender Male Female Mortality Age group

19/32 Burden of Communicable Diseases  Pneumonia bring about 28,000 PYLL every year in Gansu  PYLL caused by pneumonia is 9.6% of infectious diseases. Lower than the percentage of its death number account for the group (21.4%).  Pneumonia cause lower years of life lost of population in infectious diseases.

20/32 Burden of Maternal Diseases  Maternal Diseases contains pregnancy, childbirth and the puerperium diseases.  These diseases once were main cause of death of child-bearing period woman  Present they have came down at a low level

21/32 Burden of Maternal Diseases  Mortality of Maternal Diseases is 3.8 Per 100,000 in child-bearing period woman, higher than that of whole China (0.5 Per 100,000) Gender City Countryside Mortality Age group

22/32 Burden of Maternal Diseases  5 main causes of deaths in maternal diseases are direct obstetric causes, PPH, Pregnancy-induced hypertension syndrome, obstetric infection, abortion Direct obstetrical causes Postpartum hemorrhage Pregnancy-induced hypertension syndrome Obstetric infection Abortion

23/32 Burden of Maternal Diseases  Maternal diseases caused13,000 PYLL every year in Gansu.  PYLL caused by maternal diseases is 4.4% of Communicable, maternal & perinatal diseases. Higher than the percentage of its death number account for the group (2.7%).  Maternal diseases cause higher years of life lost of population.

24/32 Burden of Perinatal Diseases  Perinatal diseases refers to the fetus or the newborn’s diseases caused by pregnancy, childbirth or after birth environmental effects in the perinatal period (from 28 weeks pregnancy to a week after birth)

25/32 Burden of Perinatal Diseases  Mortality of Perinatal Diseases is Per 100,000 in fetus and newborn, higher than that of whole country (549.2 Per 100,000). 84.1% death cases happened in the first week after birth. Gender City Countryside Mortality Age (Day)

26/32 Burden of Perinatal Diseases  4 main causes of deaths in perinatal diseases are Birth injury and asphyxia of newborn, Premature infant, Haemolytic disease of newborn and Cold injury syndrome Birth injury and asphyxia of newborn Premature infant Haemolytic disease of newborn Cold injury syndrome

27/32 Burden of Perinatal Diseases  In this investigation perinatal diseases caused178,000 PYLL every year in Gansu.  PYLL caused by perinatal diseases is 60.7% of Communicable, maternal & perinatal diseases. Far higher than the percentage of its death number account for the group (25.9%).  Perinatal diseases cause very high years of life lost of population

28/32 Brief Introduction of West of China Institute of Environment and Health  West of China Institute of Environment and Health has been established in March,  Founder and first director: Guowei YU Ph.D  It belongs to Northwest University for Nationalities.

29/32 Brief Introduction of West of China Institute of Environment and Health  Research of this institution is focus on promoting environment health development of western China  Especially for northwestern minority people  And provide science supports for environment protection and health promotion

30/32 Brief Introduction of West of China Institute of Environment and Health Missions ：  Establish environment health research in western China;  Train environment health talents for local minorities’ community;  Combine environment surveillance with health surveillance;  Establish co-operation environmental health research relationship between China and other countries.

31/32 Brief Introduction of West of China Institute of Environment and Health

32/32 Thank You ！ Lanzhou