An approach to assessment of Keshan disease elimination at the township level

et al. 2022

Front. Nutr.

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BackgroundNo spatial analysis of hair selenium and Keshan disease (KD) on a nationwide county-level has been performed. Selenium deficiency is a recognized environmental risk factor for KD. Hair selenium is one of the recognized biomarkers of selenium nutrition. This study aimed to perform a geographically precise and visualized assessment of the achievement of KD prevention and control at the level of selenium nutrition in terms of etiology.MethodsA spatial ecological study was conducted. The hair selenium content of the residents was assayed using an atomic fluorescence spectrometer. The spatial analysis was performed using ArcGIS.ResultsThe median of the hair selenium levels of the 3,028 participants in the 1,174 counties was 0.38 mg/kg, and the content of inhabitants in KD endemic counties was significantly lower than that in KD non-endemic counties (0.34 vs. 0.39 mg/kg, z = −10.03, P < 0.0001). The proportion of Se-deficient and Se-marginal counties in KD endemic counties was significantly higher than that in KD non-endemic counties (59.4 vs. 29.0%, z = −7.45, P < 0.0001). The global autocorrelation analysis was not statistically significant (Moran's I = 0.0005, P = 0.68). Local autocorrelation analysis identified 174 low-low clusters of hair selenium levels, 83 (47.7%) of which are KD endemic counties located in KD endemic provinces of Henan, Gansu, Shaanxi, Inner Mongolia, Jilin, and Heilongjiang. The hair selenium featured a positive correlation with per capita GDP (rs = 0.20, P < 0.0001).ConclusionThe median of the hair selenium levels of inhabitants living in KD endemic counties was significantly lower than that in KD non-endemic counties. All the 83 KD endemic counties with low-low clusters of hair selenium levels should be prioritized in KD precision prevention and control. These findings are geographically precise and visualized evidence of the assessment of the effectiveness of KD prevention and control at the level of selenium nutrition in terms of etiology.

Section: Introductionmentioning

confidence: 87%

A county-level spatial epidemiological study of hair selenium and Keshan disease

Jia

et al. 2022

Front. Nutr.

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“…The goals of national KD prevention and control programs are elimination of Keshan disease (5,6). In assessing the effectiveness of KD prevention, control, and elimination, the incidence or prevalence is the most important indicator.…”

Section: Introductionmentioning

confidence: 99%

A County-Level Spatial Study of Serum Selenoprotein P and Keshan Disease

Jia

et al. 2022

Front. Nutr.

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BackgroundKeshan disease (KD) is strongly associated with selenium deficiency. Selenoprotein P (SELENOP) is a recognized molecular biomarker of selenoproteins and an important indicator of selenium nutrition. This study was aimed at providing geographically precisely visualized evidence of selenium nutrition at molecular level for assessing KD prevention, control, and elimination on the etiological perspective.MethodsWe used spatial ecological design for this study. The serum SELENOP levels of the residents were measured by ELISA. ArcGIS version 9.0 was used for spatial description, spatial autocorrelation analysis of SELENOP levels and spatial regression with per capita disposable income.ResultsThe mean serum SELENOP levels of the 6,382 residents in 1,688 counties were 4.62 ± 1.82 μg/mL. The mean serum SELENOP levels of the residents living in the townships and rural areas of KD endemic counties were not statistically significantly lower than those of the KD non-endemic counties. The mean serum SELENOP levels were globally clustered (Moran's I = 0.03, z = 6.37, and P < 0.0001), and 99.3% (553/557) of the cold spots, identified by local autocorrelation analysis (Getis-Ord-Gi* analysis), were located in the KD endemic provinces of Shaanxi, Shanxi, Henan, Hebei, Shandong, Inner Mongolia, Gansu, Hubei, Chongqing, Yunnan, and Sichuan. The serum SELENOP level was positively correlated with per capita disposable income (t = 3.52, P = 0.0004).ConclusionsThe results of this study were the geographically precisely visualized evidence of selenium nutrition at molecular level for assessing KD elimination on the etiological perspective. The cold spot counties found by Getis-Ord-Gi* analysis in the KD endemic provinces should be the high priority of KD precision prevention and control.

“…IJOMEH 2021;34(5) 2 pling method of a key village survey based on county-wide case-searching according to the Implementation Project for Prevention and Control of Endemic Disease [16]. The method was similar to that described by Li [17]. First, case-searching was conducted by reviewing medical records in all county-, township-, and village-level medical institutions within the 66 counties.…”

mentioning

confidence: 99%

A spatial study on Keshan disease prevalence and selenoprotein P in the Heilongjiang Province, China

Zhang

Int J Occup Med Environ Health

et al. 2021

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Objectives: Few spatial studies on Keshan disease (KD) prevalence and serum selenoprotein P (SELENOP) levels have been reported in the Heilongjiang Province, China. This study aimed to investigate the spatial relationships between KD prevalence, SELENOP levels, and the socio-economic status for the precise prevention and control of KD. Material and Methods: The study was carried out in all the 66 KD endemic counties in the Heilongjiang Province using a non-probability sampling method of a key village survey based on county-wide case-searching. The participants completed a questionnaire and had their serum SELENOP levels measured using enzyme-linked immunosorbent assay. Thematic maps were created, and spatial regression analysis was performed by ordinary least squares using ArcGIS 9.0. Results: Overall, 53 676 residents were surveyed based on case-searching, and blood samples were collected from 409 residents. In total, 50 chronic KD cases were identified with a total prevalence of 9.3/10 000 population. The prevalence in the Tangyuan County was the highest (250/10 000 population). The mean serum SELENOP level was 13.96 mg/l. The spatial regression analysis showed that KD prevalence positively correlated with SELENOP levels and negatively with per capita disposable income among rural residents. Conclusions: The Tangyuan County should be considered for the precise prevention and control of KD. Further research is necessary to verify the reliability of SELENOP for estimating body selenium levels, and to better understand the relationship between selenium intake and KD in the investigated area.