BackgroundUnderstanding social disparities in obesity are presently an essential element in establishing public health priorities. However, the association between socioeconomic status (SES) and obesity has not been assessed in rural Northwest China. This study aims to explore the effect of SES on overweight/obesity and abdominal obesity by gender and age in rural Northwest China.MethodsA total of 3030 participants between the ages of 18 to 80 years from rural Hanzhong, Shaanxi province, Northwest China were enrolled in our study using a two-level stratified random cluster sampling technique. Adjusted odds ratio (AOR) were used to assess the relationship between socioeconomic status and obesity after controlling for confounding factors using logistic regression.ResultsOur results indicated that the prevalence of abdominal obesity (38.8%) was the highest in rural Northwest China when compared with overweight (27.8%) and obesity (5.7%). When adjusting for possible risk factors, there were significant gender disparities in SES-obesity association. In men, the likelihoods of overweight/obesity and abdominal obesity were higher in the high SES groups when compared to the low SES groups. However, women with a high level of education were less likely to have overweight/obesity (AOR:0.78, 95% CI: 0.62, 0.98) than their counterparts with a low level of education. After the inclusion of multiple lifestyle factors, we still observed a strong positive association between age and obesity in the population.ConclusionsBoth gender and age differences in SES-obesity association were clearly observed in our study. Therefore, interventional measures should be employed in rural Northwest China to reduce the obesity epidemic that specifically takes into account gender and age differences.

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Background: A recent measles importation-related outbreak in the China-Myanmar border region required outbreak response immunization to stop the outbreak, raising the question of measles immunity in the area. We conducted two measles serological surveys to develop a seroepidemiological profile of native Chinese citizens and registered Myanmar immigrants to identify strategies to promote measles elimination in the border region. Methods: We conducted a clinic-based measles serosurvey of Myanmar registered immigrants (n = 300) and a population-based serosurvey of Chinese Lincang residents (n = 355). Serum samples were tested with enzyme-linked immunosorbent assays to assess immunity to measles. Results: We found that Myanmar immigrants had a seropositivity rate of 85.3% (95% CI: 81.3-89.4) with a GMT of 924.9 mIU/ml, and Lincang Chinese nationals had a seropositivity rate of 94.6% (95% CI:92.3-97.0) with a GMT of 1363.3 mIU/ml. Myanmar children 2-6 years of age and 7-14 years of age were more likely to be susceptible to measles than same-aged Chinese children: odds ratios 23.00 (95% CI: 5.10-103.69, P < .001) and 7.95 (95% CI: 1.66-38.01,P = .009), respectively. Conclusions: We recommend conducting a catch-up vaccination program for Myanmar children ≤15 years old.

Background: Measles outbreaks often require labor-and resource-intense response. A border-area measles outbreak occurred in Yunnan province that required outbreak response immunization for its containment. We report results of our investigation into the outbreak and the health sector costs of the response activities, with the goal of providing evidence for policy makers when considering the full value of vaccines and of measles elimination. Methods: We conducted case investigations to determine sources of infection and routes of transmission. Costs of outbreak response activities incurred by health sector were determined through retrospective interviews and record reviews of staff. Results: In total, 67 measles cases were confirmed, including 4 cases imported from Myanmar. Among the 33 cases aged between 8 months and 14 y old, 22 (66•7%) had received 2 doses of MCV; 2 (6•0%) had received 1 dose of MCV; 9 (27•3%) had not received MCV. The first 4 cases had been infected in Myanmar, and we identified 8 transmission clusters with a total of 62 cases. Transmission among Yunnan province residents occurred in schools, family settings, and at gatherings. The overall cost to control the outbreak was $214,774, for a per-case cost of $3,206. The outbreak response vaccination campaign accounted for 64% of the total outbreak costs. Conclusions: Despite high population immunity among Yunnan province children and adolescents, an import-related measles outbreak occurred among individuals who were not vaccinated or had vaccine failure in the across-border area. The economic cost of the outbreak was substantial. Investment in a sensitive measles surveillance system to detect outbreaks in a timely manner, maintaining high population immunity to measles, and reinforcing cross-border collaboration with neighboring countries support achieving and sustaining measles elimination in the border areas of China.