General office of the national health and family planning commission concerning the Chinese residents chronic diseases and nutrition monitoring program (trial) 
 
 
The national health and family planning commission of the People's Republic of China 
 
 
The 2014-10-11
 
 
Countries who do CDC letter [2014] no. 814 

Provinces, autonomous regions and municipalities directly under the central government health and family planning commission (health bureaus), the xinjiang production and construction corps health bureau:
        For chronic diseases and nutrition monitoring information management system, improve the chronic diseases and nutrition monitoring system, clear responsibilities, standardize work process, improve the public health service benefits the service efficiency of funds, do a good job in Chinese residents chronic disease and nutritional surveillance by commission to make the Chinese residents chronic diseases and nutrition monitoring program (try out) "(can be downloaded from http://www.nhfpc.gov.cn). Hereby printed and distributed to you, please according to the requirement to organize and implement carefully. 

General office of national health and family planning commission
On September 10, 2014 

Chinese residents chronic diseases and nutrition monitoring scheme
 
 
(trial) 

For the implementation of the "China's chronic disease prevention and control work plan (2012-2015)" and "China's food and nutrition development compendium (2014-2020), chronic diseases and nutrition monitoring information management system, to perfect our chronic diseases and nutrition monitoring system, this scheme.
A, goals,
(a) overall goal.
Based on the existing chronic disease and its risk factors monitoring, nutrition and health status monitoring to consolidate and expand, to establish suitable for China's national conditions of chronic diseases and risk factors and nutrition monitoring system. Long-term, continuous and systematic gathering information, a comprehensive grasp of our country residents nutritional status, mainly chronic illnesses and the related factors affecting the current conditions and trends. Chronic diseases and nutrition related data sharing platform and mechanism, realizes the data analysis and comprehensive utilization, timely release of authoritative information for the government to formulate and adjust the chronic disease prevention and control and nutrition improvement and related policy, results provide a scientific basis to evaluate the prevention and control work.
(2) specific goals.
1. Mastering in different regions, different age and different gender residents dietary structure, the main food and nutrition intake, current conditions and trends. Understand the current situation of different kinds of food nutrition and trends.
2. Mastering in different regions, different age and different gender residents' height, weight, head circumference, waist circumference, blood pressure, blood sugar, blood lipid status and changing trend growth and health indicators.
3. Mastering in different regions, different age and different gender residents tobacco use, alcohol consumption, lack of physical activity such as chronic behavioral risk factors for epidemic status and changing trend.
4. Mastering in different regions, different age and different gender people poor nutrition, lack of nutrients, obesity, high blood pressure, diabetes, dyslipidemia, chronic obstructive pulmonary disease (copd), stroke, and acute myocardial infarction (ami) of chronic diseases such as illness or disease status, residents awareness, treatment and control high blood pressure, diabetes and the change trend.
5. Chronic diseases and nutrition monitoring report released regularly, to evaluate effect of the relevant prevention and control measures, provide scientific basis for formulate and adjust the relevant national policy.
Second, the monitoring scope and frequency
Based on the country's 605 death monitoring, combined with local actual condition and continuity determine the scope of the monitoring work. Extract 302 points to carry out adult chronic diseases and nutrition monitoring in China, from 100 points to carry out the pilot cardiocerebrovascular events report for Chinese residents, from 150 points to carry out children and nurse nutrition health monitoring in China, from 125 points to carry out the pilot chronic obstructive pulmonary disease (copd) monitoring for Chinese residents. Extraction of 50 points to carry out the rural compulsory education students nutrition health monitoring. Chinese food ingredients monitoring in 20 points.
Since 2014, every three years to complete 1 round Chinese residents chronic diseases and nutrition monitoring work. Monitoring in the first round (2014-2016) monitoring and task distribution are shown in table 1.
 
 
 
 
Third, sampling method
(a) the demographic characteristics, such as social economy, geographical distribution as sample representative sampling basis, using multi-stage stratified cluster sampling method, take to carry out the following monitoring.
1. Chinese adult chronic diseases and nutrition monitoring. Extract 302 with the national and provincial representative monitoring points, each monitoring point (the district/county) extract three villages and towns (street), each of the villages and towns (street) to extract two village (house) committee, each village (house) committee draw 45 families were investigated, including 20 in three consecutive 24-hour dietary survey. Respondents for 6 months to live in the region more than 18 and older residents, the sample size is not less than 180000 people, including pregnant women sample size not less than 9000 people.
2. Chinese children and nurse nutrition health monitoring. Extract 150 nationally representative monitoring points of each monitoring point (the district/county) of two villages and towns (street), each of the villages and towns (street) to extract two village (house) committee, each village (house) committee that children aged from 0 to 5, 100, 6 to 17 years old children of 60, the mother of 2 children under the age of 25. Among them, on 12 0 to 5 years old children, 18 6 to 17 years old children, the mother of five children under the age of 2 dietary investigation, sample deficiencies, as appropriate, increase a village (house) committee. The sample size is not less than 110000 people.
3. Chinese residents chronic obstructive pulmonary disease (copd) monitoring the pilot. Extract 125 nationally representative monitoring points of each monitoring point (the district/county) extract three villages and towns (street), each of the villages and towns (street) to extract two village (house) committee, each village (house) committee from 100 households in the investigation. Monitoring object to living in the region of 6 months above 40 years old and older residents, the sample size is not less than 70000 people.
4. Pilot cardiocerebrovascular events report for China residents. Adult chronic disease and nutritional surveillance in China 100 monitoring stations on routine at the same time to carry out the pilot cardiocerebrovascular events report for China residents. Monitoring in county and above the county level comprehensive hospital, medical and health institutions at the grassroots level of specialized subject hospital, hospital business, were the army hospital where patients have cardio-cerebrovascular disease diagnosis ability such as medical institutions are the responsibility of the unit to disease. Monitoring objects with local residents of the household registration for monitoring stations, covering a population of 55 million people. 
(2) in the concentrated extract 50 special difficulties in monitoring (the district/county) to carry out the rural compulsory education students nutrition health monitoring. Respectively from the school canteen, enterprises (units) and family (individual) three meals model school, the random selection of 20% of primary school and junior high school, each school grade class, 1-2 level 40 people a year. The sample size is not less than 50000 people.
(3) 19 provinces throughout the country and shenzhen China food monitoring. Each province (city) from three points, sampling, sample collected at each sampling 30 kinds of food, the sample amount not less than 600.
Four, monitoring content and method
(a) Chinese adult chronic disease and nutritional surveillance.
1. Ask the investigation. Collect the basic information of the individuals and families, risk exposure conditions, major chronic disease and health services, etc.
2. Physical measurement. Measure the height, weight, waist circumference (except pregnant women) and blood pressure.
3. The biochemical tests. Detection of hemoglobin in the blood, fasting glucose, glycosylated hemoglobin, cholesterol, triglycerides, high-density lipoprotein cholesterol, sampling inspection trace nutrients such as vitamin A, vitamin D, zinc, iron, protein, c-reactive protein, insulin, blood uric acid and testing for thyroid-stimulating hormone (TSH), three iodine thyroid glycine (T3), L - thyroxine (T4), urine, urine iodine and sodium can get better, etc.
4. Dietary survey. For the family members to take part in the investigation of dietary survey of family cooking oil and seasoning weighing 3 days and 3 days dietary review 24 hours a day. For the rest of the food frequency survey respondents.
(2) the Chinese children and nurse nutrition health monitoring.
1. Ask the investigation. Collect the basic information of the individual and family, nutrition and health risk factors related to exposure.
2. Physical measurement. Measuring height (length), weight, 6 years old and above waist circumference and blood pressure, the participants under the age of 3 subjects increased head circumference measurement.
3. The biochemical tests.
Children 0-5 years old: the detection of hemoglobin in the blood, vitamin A, vitamin D, ferritin, transferrin receptor, zinc, lead, etc.
6 to 17 children: detection of hemoglobin in the blood, fasting blood glucose, blood lipid, sampling of vitamin A, vitamin D, zinc, lead, etc.
Mother: children under 2 years measuring hemoglobin in the blood, fasting blood glucose, blood lipid, sampling of vitamin A, vitamin D, ferritin, transferrin receptor, zinc, etc.
4. Dietary survey. For the family members to take part in the investigation of dietary survey of family cooking oil and seasoning weighing 3 days and 3 days dietary review 24 hours a day. For the rest of the food frequency survey respondents. To children 0-5 years old feeding behavior.
(3) of Chinese residents in chronic obstructive pulmonary disease (copd) monitoring the pilot.
1. Ask the investigation. Collect the basic information of the individual and family, respiratory symptoms, medical history and risk factors.
2. Physical measurement. Measure the height, weight, waist circumference and blood pressure.
3. The lung function.
(4) pilot cardiocerebrovascular events report for China residents.
All medical institutions within the monitoring of acute myocardial infarction (I21 I22) and sudden cardiac death (I46.1), stroke (I60 I64 cardiocerebrovascular events reported cases of network, such as conditional area to extract information from the hospital information system (HIS).
(5) rural compulsory education students nutrition health monitoring.
1. Ask the investigation. Collect school and county (district) basic situation, students personal basic information and study result, absence from school, eating and health knowledge level, etc.
2. Physical measurement. Measure the height and weight.
3. Biochemical examination. Detection of hemoglobin in the blood, vitamin A, vitamin D, etc.
4. Dietary survey. The adoption school canteen food attributes.
(6) to monitor Chinese food ingredients.
1. The food sample information. Collect food varieties, producing area, the main production process, sampling time, location, location, quantity, the processing methods such as basic information and pictures.
2. Testing. Will measure indicators including energy, protein, fat, carbohydrate, moisture, ash content, cholesterol, 9 kinds of minerals, phosphorus, potassium, sodium, calcium, iron, zinc, magnesium, copper, manganese), 6 kinds of vitamins (A, E, B1, B2, C and carotene), amino acids, fatty acids; Choose test indicators, including dietary fiber, folic acid, niacin, biotin, pantothenic acid, selenium, iodine, trans fatty acids.
Five, the responsibilities and division of labor
(a) the national family planning bureau of disease prevention and control of health is responsible for the Chinese residents of chronic disease and nutritional surveillance organization management work, together with the relevant departments to carry out the central fiscal support the monitoring of funds, carry out supervision and effect evaluation, chronic diseases and nutrition monitoring report in Chinese residents. The Chinese center for disease control and prevention was established by chronic diseases, nutrition, statistics, epidemiology, clinical and other experts in the field of national technical experts, to guide the investigation design, implementation, quality control, and field data analysis, etc. Led by the Chinese center for disease control and prevention by the national center for cardiovascular disease, the national women's and children's monitoring of brain FangBan, office, Beijing university and other units to participate in the national working group, office is located in the Chinese center for disease control and prevention slow disease community. National working group responsible for formulating technical scheme and manual work, organize technical training, on-site to supervise, national laboratory testing, quality control, data collection and results analysis, completed the work report, put forward policy Suggestions.
(2) the provincial family planning administrative department of health is responsible for monitoring the areas under their respective jurisdiction of organization and management, coordinate to carry out the matching funds, make work plan, organization of provincial relevant professional organizations to carry out the supervision, inspection and performance evaluation report to urge to finish the work in time and report to the national health family planning bureau of disease prevention and control. Provincial center for disease control and prevention led is responsible for organizing technical training, on-site supervision, quality control, data collection and analysis result, for some samples for testing, complete technical report in time and report to the Chinese center for disease control and prevention.
(3) the municipal family planning administrative department of health is responsible for monitoring work to organize and implement the areas under their respective jurisdiction, organizing centers for disease control and prevention, and other related professional organizations to carry out supervision inspection and technical support.
(4) county district family planning administrative department of health is responsible for the organization and implementation of the monitoring of the monitoring work within their respective jurisdictions established by the centers for disease control and prevention as the main body field teams, to carry out a field investigation, field detection, part of the sample data entry, auditing and reporting work.
Six, data management
(a) data collection and input. In accordance with requirements of the national technical scheme, make full use of modern information technology, is in the charge of the monitoring data collection, preliminary examination and school work, step by step to report or straight to the Chinese center for disease control and prevention. Provincial center for disease control and prevention is mainly responsible for regular audit data quality of the monitoring, timely solve the problems found. The Chinese center for disease control and prevention is responsible for providing technical support, and the final data of the report and summary.
(2) data security management. Data collection, entry, audit department shall be in accordance with the relevant provisions of the state in order to strengthen the management of data security, in a timely manner to backup of data, to prevent accidental loss and leak.
(3) the data sharing and release. Establish data sharing mechanism, improve the efficiency of data use, national health and family planning commission and the provincial family planning administrative department of public health monitoring results released in due course. Specific data management way to see the Chinese residents chronic diseases and nutrition monitoring data management measure (trial) ".
Seven, supervision and quality control
National health and family planning commission of disease prevention and control bureau jointly with the related departments and the Chinese center for disease control and prevention unit, for all levels of monitoring unit to conduct supervision and inspection, supervision and assess the progress of work, effects, and the usage of funds. Local family planning administrative department of public health organizations at all levels in the area under its jurisdiction supervision assessment of the monitoring work, find problems in a timely manner to coordinate, tasks are completed on schedule.
Each monitoring laboratory performance verification qualified rear can carry out a field investigation. National working group will be to each province (city, area) the first start monitoring point on-site investigation for technical guidance and quality control, the province other monitoring stations should be sent to the scene to inspect it. National working group for the rest of the monitoring of the situation of random inspection and supervision work. Working group to deal with all the province monitoring stations at the provincial level the field work of supervision and quality control. Monitoring of technical force is weak, the national or provincial team will give the key technical guidance to promote the high quality to complete the monitoring task. After the annual monitoring tasks, for examination and assessment of national working group will work.