Surveillance for Keshan disease in Zhangjiakou, Hebei, 2019−2021

  Objective  To understand the prevalence of Keshan disease and related risk factors in Zhangjiakou, Hebei province, and provide evidence for the accurate prevention and control of Keshan disease.

  Methods  According to the endemic disease prevention and treatment plan (2019) and the Keshan disease surveillance plan in Hebei (2019 edition) , Keshan disease surveillance was conducted in villages or townships in 8 counties or districts where Keshan disease was endemic in Zhangjiakou during 2019–2021, in which clinical health examination, including electrocardiogram (ECG), cardiac ultrasound and X-ray chest examinations, was conducted for local residents. According to the national requirement of control and elimination of major endemic diseases (2019 edition), the prevalence of Keshan disease in the 8 counties or districts was evaluated. At the same time, in 2019, hair selenium and grain selenium content surveys were conducted in 7 Keshan disease endemic counties or districts and 2 non-Keshan disease endemic counties or districts in Zhangjiakou, and the hair samples of children and adults and main food samples were collected for selenium content testing.

  Results  From 2019 to 2021, a total of 51 Keshan disease cases were found in 31 townships in Keshan disease endemic areas in Zhangjiakou, including 8 chronic cases (15.69%) and 43 potential cases (84.31%). No new Keshan disease cases was found. ECG examination was given for 1 487 suspected Keshan disease cases, and the abnormal rate was 39.35% (585/1487). Cardiac ultrasound examination was given for 724 suspected Keshan disease cases, and the abnormal rate was 20.72% (150/724). Chest X-ray examination was given for 91 suspected Keshan disease cases, and the cardiac enlargement rate was 53.85% (49/91). A total of 270 hair samples were collected, and the mean selenium content was (0.351±0.101) mg/kg, indicating a moderate level of selenium nutrition. The mean selenium content (0.367±0.081) mg/kg in population in the non-disease endemic area was higher than that in population in the disease endemic area (0.346±0.106) mg/kg, and the difference was not significant (P>0.05). In 270 grain samples, the mean selenium content in non-disease endemic area (0.050±0.070) mg/kg was higher than that in the disease endemic area (0.039±0.037) mg/kg, there was no significant difference (P>0.05).

  Conclusion  The selenium nutrition in the population in Zhangjiakou has been improved, and the elimination of Keshan disease has met the requirement. In the future, comprehensive prevention and control measures should be continued to strengthen the treatment and management of chronic Keshan disease patients. It is suggested to include the treatment and follow-up of chronic Keshan disease patients into chronic disease management and medical insurance to improve the life quality and survival of patients with chronic Keshan disease.