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7.1 Basic Situation
In 2006, the distribution of monitoring sites on public health in the reservoir area was the same as in the last year, including the monitoring stations in urban area of Chongqing, Fengdu County and Wanzhou District of Chongqing and Yichang City of Hubei province. The total population under the monitoring program this year was 614,302, 105,406 people more than in 2005. Among them, 311,190 were male and 303,112 female with gender ratio of 1.03:1.
In 2006, there were 288 health institutions at all levels in the areas under the monitoring program, 25 less than in the last year. The total number of hospital beds of these institutions was 3,719, 352 less than in 2005. The total amount of public health workers at all levels was 4,686, 983 more compared with that of 2005, mainly due to the adjustment of health institutions in the reservoir area.
7.2 Life Statistics
7.2.1 Birth and Death
There were altogether 3,929 babies born within the monitoring area in 2006, 2,062 of which were male and 1,867 female with birth rate of 6.40¡ë, down by 16.67% compared with in 2005. A total of 3,071 people died in the area, 1,805 of which were male and 1,266 female. The death rate was 5.00¡ë, down by 15.68% than in 2005. The death rate was 5.80¡ë for male and 4.18¡ë for female, drop by 13.95% and 17.88% respectively compared with that of 2005. The birth rate was 5.65¡ë, 13.39¡ë, 3.96¡ë, and 5.47¡ë respectively in Chongqing, Fengdu, Wanzhou, and Yichang where the death rate was 4.42¡ë, 6.71¡ë, 4.23¡ë, and 5.84¡ë respectively. Among them, the birth rate was higher than death rate in Chongqing and Fengdu. While in Wanzhou and Yichang, the death rate was higher than the birth rate. Compared with in 2005, there was some rise of death rate in Chongqing but certain drop in Yichang, Wanzhou and Fengdu.
In 2006, there were 42 reported baby deaths in the monitoring area, 26 of which were male and 16 female with infant mortality of 10.69¡ë, 16.48% reduction than in 2005.
7.2.2 Analysis of Death Cause
According to ICD-10 disease classification, the death reason and mortality comparison of different gender population of the reservoir area in 2006 showed the highest mortality in circulatory system diseases for both male and female population. The order of the top 5 causes of death was the following: circulatory system disease (32.53%), malignant tumor (23.48%), respiratory system diseases (19.64%), injury and poisoning (9.61%) and digestive system diseases (3.09%). They caused 88.35% of the total deaths, indicating that they were top 5 killers among the population in the reservoir area. Compared with in 2005, the percentages of circulatory system disease, malignant tumor, and injury and poisoning had some reduction. And respiratory system disease and digestive system disease had higher proportion.
In gender analysis, the order of death cause of female was similar to that of general population. To female, respiratory system disease rose to as No.2 killer and tumor down to No.3. Among different regions, the order of death cause of the people in Chongqing and Fengdu was same as that of general population. In Wanzhou, No.1 killer was tumor with circulatory system disease down to No.2. In Yichang, No.1 killer was tumor with respiratory disease up to No.2 and circulatory system disease down to No.3.
7.3 Disease Monitoring
7.3.1 Infectious Diseases Monitoring
A total of 3,914 cases of infectious diseases were reported by all monitoring sites in 2006 with the morbidity of 637.15/100,000 and 4 deaths. The total mortality was 0.65/100,000. There was no report of the case of class A infectious diseases such as plague and cholera and no outbreak of any epidemic disease.
A total of 2,770 cases (14 types) of Class B infectious diseases occurred with the morbidity of 450.92/100,000, down by 24.44% compared with that of the last year. The morbidity order from high to low was 846.98/100,000 in Fengdu, 399.98/100,000 in Chongqing, 375.84/100,000 in Wanzhou and 252.02/100,000 in Yichang. Compared with in 2005, the morbidity went up by 5.53% in Yichang and dropped by 18.26%, 32.19% and 24.63% respectively in Fengdu, Chongqing and Wanzhou. The order of the top 5 Class B infectious diseases was same as in the last year, i.e. viral hepatitis (195.67/100,000), TB (181.18/100,000), dysentery (33.53/100,000), gonorrhea (19.53/100,000) and syphilis (12.70/100,000).
1,144 cases (5 types) Class C infectious diseases were reported with morbidity of 186.23/100,000, up by 22.45% compared with that of 2005. The morbidity order from high to low was 498.68/100,000 in Fengdu, 171.23/100,000 in Chongqing, 97.59/100,000 in Wanzhou and 64.54/100,000 in Yichang. It had 89.03% rise in Fengdu, 35.93% rise in Chongqing, 34.52% drop in Wanzhou and 4.00% reduction in Yichang as compared with that of 2005.
The percentage of the incidences of respiratory disease, blood & sexual infectious disease, digestive disease, and natural epidemic focus-based disease was 34.03%, 33.19%, 32.19% and 0.38% of the total respectively. Compared with in 2005, the incidences of respiratory disease changed its order with that of blood & sexual infectious disease. The cases of infectious disease added whooping cough, rabies and leptospirosis with the elimination of kidney hemorrhagic fevers syndrome. There was some reduction of the incidence of such diseases as viral hepatitis, dysentery, typhoid, lymphadenopathy, epidemic encephalitis and TB with some rise of other type of diseases. However, the cases were not many and imposed little impacts on the general epidemic.
7.3.2 Endemic Diseases Monitoring
In 2006, all monitoring sites carried investigations on iodine deficiency on 1,122 children aged 8-12. Among them, 110 had I¡ã thyroid enlargement with the enlargement rate of 9.80%, down by 2.36 percentage points than in 2005, falling into the slight prevalence. The thyroid enlargement rate in Wanzhou, Fengdu, Chongqing and Yichang was 13.75%, 12.50%, 10.06% and 1.71% respectively. It had 0.3 percentage point drop in Wanzhou, no change in Fengdu, and 2.29 percentage points rise in Chongqing compared with that of the last year. A sample of 1,512 households were investigated on their salt consumption, 1,458 of which consumed iodized salt with the coverage of 96.43%, up by 1.09 percentage points than that of 2005. Among the 1,458 households, 1,356 consumed qualified iodine-added salt with qualification rate of 93.00%, and the consumption rate of such salt being 89.68%, down by 2.48 and 1.36 percentage points respectively compared with in 2005.
The investigation on endemic fluorine disease was carried out in Xingshan County of Yichang City with sampling of 234 people, 13 of them had endemic fluorine disease, taking up 5.56% of the total.
The IHA testing result on serum antibody for schistosomiasis at Wanzhou monitoring site showed 1 positive case among the 90 returned local people from endemic areas taking up 1.11%. The test was also conducted on 108 migrants from the endemic areas showing 2 positive cases with the infection rate of 1.85%.
Some monitoring sites also carried out the serum antibody tests for such diseases as kidney syndrome hemorrhagic fevers, leptospirosis and encephalitis B. Among 314 serum samples, 2 samples showed positive result for kidney syndrome hemorrhagic fevers, accounting for 0.60%. In 261 serum samples, 61 samples were positive for leptospirosis, taking up 23.37%. In 770 serum samples, 191 of which were positive for encephalitis B, accounting for 24.81%.
7.4 Biological Media Monitoring
7.4.1 Mouse Monitoring
In 2006, the indoor and outdoor mouse density was 2.17% and 1.91% respectively, down by 1.91 and 1.99 percentage points compared with that of 2005. In the spring, the indoor mouse density was 2.67% and outdoor mouse density 1.64%. In autumn, the indoor mouse density was 1.76% and outdoor mouse density 2.17%. The outdoor mouse density was higher probably due to many outdoor foods in autumn.
Sewer rat dominated the indoor mouse species, accounting for 61.44%. Small house mouse ranked the second and took up 31.33%. In outdoor environment, small insect-eating animals (mainly muskrat) still were in dominance, accounting for 67.35% followed by sewer rat that took up 15.31%. As the host animal for kidney syndrome hemorrhagic fevers and leptospira, black strip rat rose its percentage from 2.38% in 2005 to 8.16% in 2006. Among all monitoring sites, Fengdu had the highest indoor mouse density at 4.26% and Chongqing the lowest at 0.72%. Fengdu had the highest outdoor mouse density at 9.08% and Wanzhou the lowest at 0.50%.
In 2006, each monitoring site carried out pathogen test on the lung samples (308) and kidney samples (308) of rat shaped animals. 3 samples in Wanzhou and 1 sample in Yichang were positive to hemorrhagic fevers, accounting for 4.29% and 2.27% respectively. 2 samples in Yichang were positive to leptospira, taking up 4.55%.
7.4.2 Mosquitoes Monitoring
In 2006, the overall adult mosquito density in livestock pens of all monitoring sites was far higher than that of the indoor. The general mosquito density of livestock pens was 101.9/pen*artificial hour, lower than 113.74/ pen*artificial hour in 2005 and 5-year average level before 135 m impoundment (198.57/pen*artificial hour). The adult mosquito density in livestock pens of each monitoring site had some reduction except Fengdu compared with that of 2005. The overall indoor adult mosquito density was 30.88/room*artificialhour, similar to that of 2005 and dramatically lower than the 5-year average level before 135 m impoundment (63.97/room*artificial hour). Compared with 2005, the indoor adult mosquito density of each monitoring site had a drop at different degrees. This might be due to the reduction of mosquito reproduction sites because of severe drought in 2006.
The adult mosquito density in pens and rooms had basically same 10-day change trend during May-September. However, the indoor adult mosquito density went up in late September. Fengdu and Yichang experienced the earliest peak of indoor adult mosquito density in early June. The latest peak was in Wanzhou in late September. Chongqing experienced the peak in the last 10 days of July. The peak of pen mosquito density had the earliest appearance in Fengdu in the first 10-day of June and latest appearance in Yichnag in the last 10-day of August. Chongqing and Wanzhou experienced the peak of pen mosquito density during the last 10-day of July.
For all monitoring sites, Chongqing had the highest indoor mosquito density (44.00/room*artificial hour) followed by Wanzhou (37.84/ room*artificial hour) with the lowest in Yichang (8.31/room*artificial hour). As for pen mosquito density, the highest occurred in Wanzhou (129.92/pen*artificial hour) followed by Fengdu (111.56/pen*artificial hour) with the lowest in Chongqing (83.02/pen*artificial hour).
In the species composition of adult mosquitoes, 58.80% indoor mosquitoes and 64.53% mosquitoes in pens was Armigeres subalbatus. Culex pipiens fatigans ranked No.2 as indoor mosquito, taking up 20.18%. Anopheles sinensis ranked No.2 mosquito in livestock pens, taking up 12.65%.
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