Cluster of Acute Appendicitis Among High School Tibetan Students in Nanchang, China: Investigation, Control, and Prevention

ObjectiveInfectious etiology of acute appendicitis is a current hot topic. The most of study on appendicitis came from sporadic patients and focused on clinical treatment rather than control and prevention of appendicitis in the population. The present study aims to investigate the epidemiological f...

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Main Authors: Yitian Guo, Deqiang Ye, Guifang Yang, Guozhen Liu, Xiaochen Cui, Shiyun Tan, Yi Guo
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-04-01
Series:Frontiers in Public Health
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2022.889793/full
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author Yitian Guo
Deqiang Ye
Guifang Yang
Guozhen Liu
Xiaochen Cui
Shiyun Tan
Yi Guo
author_facet Yitian Guo
Deqiang Ye
Guifang Yang
Guozhen Liu
Xiaochen Cui
Shiyun Tan
Yi Guo
author_sort Yitian Guo
collection DOAJ
description ObjectiveInfectious etiology of acute appendicitis is a current hot topic. The most of study on appendicitis came from sporadic patients and focused on clinical treatment rather than control and prevention of appendicitis in the population. The present study aims to investigate the epidemiological features of cluster of acute appendicitis, risk factors, and evaluate effectiveness of control and prevention in population.MethodsWe conducted longitudinal study on a cluster of acute appendicitis among Tibetan students at a high school in eastern China, which was divided into three stages: 1. We retrospectively collected epidemiological data and clinical data to explore risk factor and possible transmission route in August of 2005; 2. We conducted targeted measures from August of 2005 and analyzed incidence trend from 2000 to 2010; 3. Since no new patients occurred in 2011, we conducted surveillance from the beginning of 2012 until July 2018.ResultsAmong 973 Tibetan students, there were 120 patients with more female patients (102 of 499, 20.4%) than male patients (18 of 474, 3.8%) from January of 2000 to December of 2010. The 4-year cumulative incidence rates in female students enrolled in 2001, 2002, 2003, 2004, 2005, 2006 were 26.8% (11 of 41), 27.1% (13 of 48), 44.7% (21 of 47), 42.4% (14 of 33), 23.1% (9 of 39), and 19.3% (11 of 57), respectively before their graduation. There was a clustering feature. Mutual contact with patients before the onset of symptoms was an important risk factor (Adjusted OR 4.89, 95% CI: 1.67–14.35). Transmission route may be fecal-oral infection. Before conducting targeted measures, the incidence rate increased from 2000 and peaked in 2005. After conducting targeted measures, the incidence rate decreased year by year until 2010. Under surveillance from January of 2012 to July of 2018, only four sporadic patients occurred at this school.ConclusionThis cluster of acute appendicitis had features of an infectious disease in epidemiology, which can be controlled and prevented by targeted measures. Our study may also be used for prevention of sporadic patients and be generalized in general population as cluster of appendicitis occurred in many provinces of China.
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spelling doaj.art-7f30382fb73d461ca38fbfe784d742e12022-12-22T01:38:19ZengFrontiers Media S.A.Frontiers in Public Health2296-25652022-04-011010.3389/fpubh.2022.889793889793Cluster of Acute Appendicitis Among High School Tibetan Students in Nanchang, China: Investigation, Control, and PreventionYitian Guo0Deqiang Ye1Guifang Yang2Guozhen Liu3Xiaochen Cui4Shiyun Tan5Yi Guo6Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, ChinaDepartment of Surgery, Infectious Disease Hospital Affiliated to Nanchang University (Nanchang Ninth Hospital), Nanchang, ChinaDepartment of Pathology, Zhongnan Hospital of Wuhan University, Wuhan, ChinaSwedish Bellevue Primary Care Clinic, Bellevue, WA, United StatesDepartment of Epidemiology and Biostatistics, Wuhan University School of Public Health, Wuhan, ChinaDepartment of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, ChinaDepartment of Epidemiology and Biostatistics, Wuhan University School of Public Health, Wuhan, ChinaObjectiveInfectious etiology of acute appendicitis is a current hot topic. The most of study on appendicitis came from sporadic patients and focused on clinical treatment rather than control and prevention of appendicitis in the population. The present study aims to investigate the epidemiological features of cluster of acute appendicitis, risk factors, and evaluate effectiveness of control and prevention in population.MethodsWe conducted longitudinal study on a cluster of acute appendicitis among Tibetan students at a high school in eastern China, which was divided into three stages: 1. We retrospectively collected epidemiological data and clinical data to explore risk factor and possible transmission route in August of 2005; 2. We conducted targeted measures from August of 2005 and analyzed incidence trend from 2000 to 2010; 3. Since no new patients occurred in 2011, we conducted surveillance from the beginning of 2012 until July 2018.ResultsAmong 973 Tibetan students, there were 120 patients with more female patients (102 of 499, 20.4%) than male patients (18 of 474, 3.8%) from January of 2000 to December of 2010. The 4-year cumulative incidence rates in female students enrolled in 2001, 2002, 2003, 2004, 2005, 2006 were 26.8% (11 of 41), 27.1% (13 of 48), 44.7% (21 of 47), 42.4% (14 of 33), 23.1% (9 of 39), and 19.3% (11 of 57), respectively before their graduation. There was a clustering feature. Mutual contact with patients before the onset of symptoms was an important risk factor (Adjusted OR 4.89, 95% CI: 1.67–14.35). Transmission route may be fecal-oral infection. Before conducting targeted measures, the incidence rate increased from 2000 and peaked in 2005. After conducting targeted measures, the incidence rate decreased year by year until 2010. Under surveillance from January of 2012 to July of 2018, only four sporadic patients occurred at this school.ConclusionThis cluster of acute appendicitis had features of an infectious disease in epidemiology, which can be controlled and prevented by targeted measures. Our study may also be used for prevention of sporadic patients and be generalized in general population as cluster of appendicitis occurred in many provinces of China.https://www.frontiersin.org/articles/10.3389/fpubh.2022.889793/fullappendicitisclustercontrolpreventionsurveillance
spellingShingle Yitian Guo
Deqiang Ye
Guifang Yang
Guozhen Liu
Xiaochen Cui
Shiyun Tan
Yi Guo
Cluster of Acute Appendicitis Among High School Tibetan Students in Nanchang, China: Investigation, Control, and Prevention
Frontiers in Public Health
appendicitis
cluster
control
prevention
surveillance
title Cluster of Acute Appendicitis Among High School Tibetan Students in Nanchang, China: Investigation, Control, and Prevention
title_full Cluster of Acute Appendicitis Among High School Tibetan Students in Nanchang, China: Investigation, Control, and Prevention
title_fullStr Cluster of Acute Appendicitis Among High School Tibetan Students in Nanchang, China: Investigation, Control, and Prevention
title_full_unstemmed Cluster of Acute Appendicitis Among High School Tibetan Students in Nanchang, China: Investigation, Control, and Prevention
title_short Cluster of Acute Appendicitis Among High School Tibetan Students in Nanchang, China: Investigation, Control, and Prevention
title_sort cluster of acute appendicitis among high school tibetan students in nanchang china investigation control and prevention
topic appendicitis
cluster
control
prevention
surveillance
url https://www.frontiersin.org/articles/10.3389/fpubh.2022.889793/full
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