To establish a risk assessment system for infectious disease prevention and control in schools in Shangcheng District, Hangzhou and determine risk levels for each school, and propose corresponding risk management measures, so as to provide a scientific reference for infectious disease prevention and control in primary and secondary schools.

Based on the Failure Mode and Effects Analysis (FMEA) method, potential failure analysis and current situation investigation of infectious disease prevention and control risks were conducted in 110 primary and secondary schools from 2022 to 2024 in Shangcheng District, Hangzhou. Risk levels were classified using K-Means cluster analysis.

Through expert panel discussions using FMEA, 6 first-level indicators and 28 second-level indicators were identified. The top three risk priority numbers were implementation of required prevention and control measures for clustered infectious disease outbreaks in schools in the past three years (189.00), student morning/afternoon health checks (168.00), and reporting status of clustered infectious disease outbreaks in schools in the past three years (144.00). The comprehensive prevention scores of schools ranged from 61.00 to 98.00 (mean: 87.40). There were no statistically significant differences in the average scores(primary school: 88.17±7.39, nine-year consistent education: 86.26±7.68, junior high school: 85.55±8.20, and high school: 88.72±4.91) and risk level distribution of schools with different educational stages(F/H=0.95, 1.47, P>0.05).K-Means cluster analysis divided the schools into 5 risk levels with cluster centers at 93.25, 85.78, 79.69, 70.29, 61.00 (F=309.21, P < 0.05), with 80% of schools classified as low-risk or below.

The infectious disease prevention and control risk assessment system for primary and secondary schools can be established, and hierarchical management can be conducted according to school risk levels, thereby improving the efficiency and effectiveness of school infectious disease prevention and control, and enhancing the precision and sustainability of prevention efforts.

To investigate the current status of refractive errors and insufficient hyperopia reserve in preschool children aged 3-6 years in Hefei and to analyze influencing factors, so as to provide a scientific basis for formulating targeted myopia prevention policies and comprehensive interventions.

In May 2022, a stratified cluster random sampling method was used to select 897 preschool children from 8 kindergartens across four districts (Baohe, Yaohai, Shushan, and Economic and Technological Development Zone) in Hefei, and Children's Visual Health-related Behavior Assessment Scale was used to collect personal information and environmental factors. Pre- and post-cycloplegic refraction tests were conducted to assess insufficient hyperopic reserve and refractive development levels. Group comparisons were conducted using χ² test, t-test or analysis of variance. Multivariate regression analysis was performed to identify key factors influencing hyperopic reserve, axial length and spherical equivalent in preschool children.

The detection rates of refractive errors among preschool children were 6.8% for hyperopia, 1.6% for myopia, and 11.1% for astigmatism. Notably, the prevalence of myopia was significantly higher in boys (2.3%) than in girls (0.7%) (χ²=3.88, P < 0.05). Additionally, 8.8% of the children exhibited insufficient hyperopic reserve. The results of multiple regression analysis showed that preschool children with high myopia in the father, high myopia in the mother, longer daily duration of near work, and longer daily electronic product use time had increased risks of axial growth (β=0.12, 0.09, 0.15, 0.11), SE reduction (β=-0.10, -0.07, -0.18, -0.13), and insufficient hyperopic reserve (OR=1.87, 2.22, 1.40, 1.28) (P < 0.05). While, preschool children with longer sleep time and daily outdoor activity duration had lower risks of axial growth (β=-0.11, -0.10), SE reduction (β=0.39, 0.51), and insufficient hyperopia reserve (OR=0.54, 0.51) in preschool children (P < 0.05).

The rates of refractive errors and insufficient hyperopia reserve in preschool children in Hefei are relatively low, which are influenced by many factors. Parents, kindergartens and relevant departments should implement early vision monitoring and intervention for preschool children, and cultivate their scientific eye-use habits.

To investigate the characteristics and risk factors of an outbreak of acute hemorrhagic conjunctivitis (AHC) in a boarding middle school in Guangdong Province, in order to provide a scientific evidence for effective prevention and control of campus AHC outbreaks.

From September 1st to 28th 2023, case identification was conducted among 559 students and 60 faculty members using standardized definition. Descriptive analysis was conducted on the three distrubution patterns of the outbreak. Questionnaires were designed, and a case-control study was adopted to analyze the possible risk factors of the disease transmission. The propensity score matching (PSM) method was used to control the difference of baseline data.

A total of 269 cases of AHC were identified, with an attack rate of 43.46%. The pathogen was confirmed as Coxsackie virus A24 variant (CA24v). Among these, 264 cases were students (attack rate of 47.23%) and 5 were staff (attack rate of 8.33%). A total of 153 pairs of PSM were successfully matched. After PSM matching, there were no statistically significant differences in gender, grade and class between the case group and the control group (χ²=0.12, 5.41, 11.24, P>0.05). The results of multivariate Logistic regression analysis showed that middle school students whose towels contacted with others (OR=1.81), and direct contact with other AHC cases recently (OR=4.89) were more likely to have AHC; while wearing glasses (OR=0.43) and frequent use of hand sanitizer (OR=0.37) were less likely to have AHC (P < 0.05).

The outbreak of AHC is caused by CA24v, demonstrating rapid spread and extensive impact within the school setting.

To evaluate the incremental vaccine effectiveness (VE) of two-dose of the mumps-containing vaccine (MuCV) in chidren, so as to provide a basis for optimizing mumps immunization strategies.

A 1∶2 frequency-matched case-control study was conducted by using reported mumps cases in childcare centers or schools from Lu'an, Hefei, Ma'anshan and Huainan cities of Anhui Province from September 1, 2023 to June 30, 2024, as a case group(383 cases). And healthy children in the same classroom were selected as a control group(766 cases). The MuCV immunization histories of participants were collected to estimate the incremental VE of the second dose of MuCV against mumps. Group comparisons were performed using the Chi-square test or t-test. For matched case-control pairs, the Cox regression model was employed to calculate the odds ratio (OR) with 95% confidence interval (CI) for two-dose MuCV vaccination and to estimate the incremental vaccine effectiveness (VE).

There were no statistically significant differences between the case and control groups regarding gender, age, dosage of MuCV vaccination and the time interval since the last dose vaccination(χ²/t=0.05, 0.20, 0.94, -0.02, P>0.05). The proportions of the case and control groups vaccinated with two doses of MuCV were 26.63% and 29.37%, respectively, and the overall incremental VE of the second dose of MuCV was 40.73% (95%CI=3.03%-63.77%, P < 0.05). Subgroup analyses revealed that the incremental VE for children with a period of ≥1 year between the two doses of MuCV was 54.13% (95%CI=1.90%-78.56%, P < 0.05), while for children with a period of < 1 year, it was 30.63% (95%CI=-28.59%-62.58%, P>0.05). The incremental VE of the second dose of MuCV was 30.36% (95%CI=-25.95%-61.50%, P>0.05) in kindergarten children and 66.73% (95%CI=14.92%-86.99%, P < 0.05) in elementary and secondary school students. The incremental VE was 28.78% (95%CI=-27.46%-60.21%, P>0.05) within five years of the last dose of MuCV vaccination and 66.07% (95%CI=-41.56%-91.87%, P>0.05) for vaccinations administered beyond five years.

The second dose of MuCV may offer additional protection for children; however, extending the interval between two-dose of MuCV (< 1 year) has shown limited incremental protective effects. Therefore, it is crucial to consider optimizing current immunization strategies for mumps.

To explore the association between CDKAL1 rs35261542, FAIM2 rs3205718, and VGLL4 rs2574704 polymorphisms with childhood obesity and related metabolic phenotypes to provide evidence for personalized prevention and management strategies.

Based on the 2023 Long-term Nutritional Health Effects of Early Childhood Nutrition Package Intervention project, the study enrolled 1 078 children aged 5-7 years from four counties in Henan (Songxian and Ruyang countries) and Guizhou (Guiding and Fuquan countries) provinces. Using BMI Z-scores, 87 overweight and obese(OVOB) children were selected and matched by sex, age, and BMI Z-score with 117 normal-weight controls. Participants were further stratified into four metabolic phenotype groups: metabolically healthy normal weight (MHNW, n=51), metabolically unhealthy normal weight (MUNW, n=66), metabolically healthy obesity (MHO, n=31) and metabolically unhealthy obesity (MUO, n=56) based on four conventional cardiometabolic risk factor (CR) criteria. Data were collected through questionnaires, anthropometric measurements, serum biochemical tests, and KASP genotyping. The distribution of three genetic polymorphisms (CDKAL1 rs35261542, FAIM2 rs3205718, VGLL4 rs2574704) across metabolic subgroups was analyzed. Multivariate Logistic regression models assessed associations between these polymorphisms and obesity/metabolic phenotypes.

Multivariate Logistic regression analysis showed that Homozygous mutant AA genotype of CDKAL1 rs35261542 was positively associated with OVOB(OR=3.63), MHO (OR=11.04), MUO (OR=4.88) (P < 0.05). Homozygous TT genotype of FAIM2 rs3205718 increased OVOB risk (OR=4.44, P < 0.05) but showed no association with metabolic phenotypes (P>0.05). Homozygous mutant TT of VGLL4 rs2574704 reduced the risks of MHO and MUO (OR=0.30, 0.24, P < 0.05). Cumulative genetic effects analysis demonstrated carriers of 1 or 2 risk genotypes of rs35261542 and rs3205718 had progressively higher OVOB risk (OR=2.53, 20.79), and the combination of rs35261542 and rs2574704 increased risks for both MHO (OR=8.50) and MUO (OR=5.00) (P < 0.05).

The AA genotype of rs35261542 (CDKAL1) positively correlates with childhood obesity and metabolic abnormalities. The TT genotype of rs3205718 (FAIM2) increases obesity risk but not metabolic phenotypes. The TT genotype of rs2574704 (VGLL4) shows protective effects against metabolic dysfunction. Risk genotypes exhibit dose-dependent cumulative effects on obesity and metabolic outcomes.

To construct a quality control evaluation indicator system for the surveillance of common diseases among students, so as to provide a reference for the quality control of surveillance projects.

Based on literature review and expert interviews, a preliminary framework and candidate indicators were developed from June to August in 2024. Twenty domain experts participated in two rounds of Delphi consultations conducted via email, providing importance ratings, judgment basis, familiarity levels, and feasibility assessments for each indicator. And a quality control evaluation indicator system for the surveillance of common diseases among students was ultimately constructed.

The consulted experts aged 33-53, with an average age of (45.25±5.03) years, were from government health administration departments(n=1), centers for disease control and prevention at different levels(n=16), academic and research institutions(n=3). Their work experience in school health-related fields ranged from 6 to 33 years, with an average of (16.70±8.25) years. The activeness of experts in both rounds of consultation was 100%, the mean expert authority coefficient was 0.90, and the mean feasibility evaluation was 0.75. Kendall's W test showed that the expert coordination coefficient for the first round was 0.26, and for the second round, it was 0.33 (P < 0.01). After two rounds of expert consultation, a set of quality control evaluation indicators for the surveillance of common diseases among students was ultimately constructed, including 6 first-level indicators, 19 second-level indicators, and 37 third-level indicators.

The scientifically developed evaluation indicator system facilitates high-quality implementation of student common disease surveillance programs.

To explore the association of screening myopia and sitting posture habits as well as screen viewing distance among primary school students, providing a scientific basis for myopia prevention and intervention among primary school students.

From April to June 2024, a convenient sampling method was used to enroll 1 394 fourth-grade students from four primary schools in a district of Beijing for vision examinations and questionnaire surveys. Logistic regression models were employed to analyze the relationship of screening myopia detection and sitting posture habits as well as viewing distance.

The screening myopia prevalence among primary school students was 63.8%. About 13.1% of students self-reported poor sitting posture, and 47.1% self-reported a viewing distance of ≤20 cm. After adjusting for covariates including age, gender, school, sleep quality, parental myopia status, physical fitness level, daily high-intensity physical activity, weekend outdoor activity time and types of after-school services, Logistic regression analysis showed that students with poor sitting posture were more likely to have screening myopia than those with normal sitting posture (OR=1.73, 95%CI=1.03-2.92); students with a viewing distance of ≤20 cm were more likely to have screening myopia than those with a viewing distance of >20 cm(OR=1.32, 95%CI=1.02-1.71)(P < 0.05). The association between sitting posture and screening myopia was more significant among boys(OR=2.00, 95%CI=1.03-3.88, P < 0.05). A multiplicative interaction was observed between sitting posture and viewing distance. Compared to primary school students with normal posture and a viewing distance of >20 cm, those with poor posture and a viewing distance of >20 cm were more likely to have screening myopia (OR=1.82, 95%CI=1.12-2.96, P < 0.05).

Both sitting posture habits and screen viewing distance are related to screening myopia in primary school students. Poor sitting posture poses a higher risk than screen distance, and the two factors exhibit an interactive effect on myopia risk.