For immediate release - Thursday 18 April 2013

Autism prevalence in China

Research collaboration to explore whether autism is currently underdiagnosed; pilot study suggests one per cent of the Chinese population has autism

Researchers from the University of Cambridge, the China Disabled Persons’ Federation (CDPF) and the Chinese University of Hong Kong (CUHK) met today to launch a new collaborative study into the prevalence of autism in mainland China.

Autism Spectrum Conditions (ASC) affect one per cent of the general population in Western countries. However, it is unclear as to whether autism is as prevalent in China. A pilot study conducted by the University of Cambridge’s Autism Research Centre and Cambridge Institute of Public Health suggests that autism in China is currently under-diagnosed and may be in line with Western countries at one per cent. This collaboration will enable Cambridge, CDPF and CUHK to to determine whether a one per cent estimate also applies to China.

At the discussions were the University of Cambridge’s Vice-Chancellor Professor Sir Leszek Borysiewicz, the Chinese University of Hong Kong’s Vice-Chancellor Professor Joseph Sung and Director-General of Rehabilitation Department of CDPF Professor Hong You.

If it is confirmed that China has the same prevalence rate as Western countries, an astonishing 14 million people could have the condition. The researchers argue that a correct estimate of the number of people affected will enable better care and planning for these individuals.

This collaborative project is led by Dr Sophia Xiang Sun, who recently completed her PhD in Cambridge and has joined CUHK in the School of Public Health and Primary Care. With the funding support from CDPF and CUHK, the project will entail a large epidemiological study involving 250,000 people across 14 cities within 14 provincial regions in mainland China. The aim of the research is to implement the validated techniques from the pilot to whole populations to provide key estimates on the prevalence of ASC, and to build capacity in research and appropriate clinical and social support services in China.

Dr Sophia Xiang Sun said: “This is an important new study. Previous research into the autism spectrum in China has mainly focused on the most severe subtype, childhood autism. That may partly explain the low prevalence previously reported. By adopting standardised study methodology and instruments, we can compare the results with Western countries and obtain a better understanding of the current situation of this condition in China.”

 Congratulations to Dr Stephen Burgess, statistician in the Cardiovascular Epidemiology Unit, who has won a four year Wellcome Trust Postdoctoral Fellowship to develop his work on distinguishing between correlation and causation for potential risk factors in cardiovascular disease.

 Stephen’s goal is to develop new statistical tools which can be applied to improve understanding of the causes and development of diseases and clinical and pharmacological interventions.

 Stephen’s work will extend Mendelian randomization (a technique for assessing cause-effect relations from observational data using genetic variation) to cover situations where there are large numbers of genetic variants, multiple risk factors, and data from a variety of sources. He will focus on risk factors for cardiovascular disease, using data from the European-based EPIC study and the Pakistan-based PROMIS study. He will be collaborating with world experts from London, Bristol, Ghent and Harvard.

 The Sir Henry Wellcome Postdoctoral Fellowship scheme provides a unique opportunity for the most promising newly qualified postdoctoral researchers to make an early start in developing their independent research careers, working in the best laboratories in the UK and overseas. Stephen will hold the Fellowship for four years, starting from January 2013.

- Find out more about Stephen and his work here - http://www.phpc.cam.ac.uk/ceu/staff-profile-page-template/staff/stephen-burgess/

 Dr Daniela De Angelis, lead investigator at the MRC Biostatistics Unit, comments:

“Unlike previous publications, our modelling approach was used to disentangle the competing contributions of increased rates of diagnosis of existing HIV infections and of HIV incidence (new infections) to observed HIV diagnoses in MSM. By applying the model to the latest surveillance data we were able to provide a comprehensive picture of the HIV epidemic amongst MSM in England and Wales over the past 10 years”.

 Published in Lancet Infectious Diseases, the research found no evidence of a decline in levels of HIV over the last decade, with new infections plateauing at 2,300–2,500 annually from 2006 onwards. Undiagnosed HIV infections in MSM increased from 7,370 in 2001 to 7,690 in 2010. Despite a 20 per cent reduction in the average time between infection and diagnosis, from 4 years to 3.2 years, 38 per cent of infections in 2010 were still diagnosed after the time patients should have started antiretroviral (ARV) treatment.

 Analysing additional HPA surveillance data from the same period, the authors found these trends occurred despite the fact that MSM HIV testing had increased by 3.7 times to 59,300 STI clinic tests per year in 2010, and that the  proportion of MSM receiving HIV care had risen from 69 per cent to 80 per cent) with a greater proportion of MSM eligible for ARV treatment accessing it (from 75 per cent to 84 per cent).

 Dr Valerie Delpech, HPA head of HIV surveillance, said:

“We are seriously concerned about the level of ongoing HIV transmission and the significant impact this is having within the MSM community. The most plausible explanation for these results is continuing unsafe sexual behaviour coupled with insufficient HIV testing, showing us just how vital safe sex programmes engaging MSM remain.

 “MSM should get an HIV and STI screen at least annually, and every three months if having unprotected sex with new or casual partners – and we urge clinicians to take every opportunity to offer the test to this group. By coupling earlier and more frequent testing with programmes that reduce unsafe sexual behaviour in MSM, whilst maintaining high levels of treatment and retention in care, we could substantially reduce HIV transmission.”

 For access to the paper or to speak to the lead researcher, please contact press.office@headoffice.mrc.ac.uk or call 0207 395 2345

 Notes to editors

Nearly one in 12 MSM in London and one in 20 in the UK now have HIV (47 per 1,000). MSM can reduce their risk of getting or transmitting HIV, or a sexually transmitted infection, by:

• Always using a condom correctly and consistently when having sex with new or casual partners, until all partners have had a sexual health screen.
• Avoiding overlapping sexual relationships and reduce the number of sexual partners.
• Getting an HIV and STI screen at least annually, and every three months if having unprotected sex with new or casual partners

 The Medical Research Council has been at the forefront of scientific discovery to improve human health. Founded in 1913 to tackle tuberculosis, the MRC now invests taxpayers’ money in some of the best medical research in the world across every area of health. Twenty-nine MRC-funded researchers have won Nobel prizes in a wide range of disciplines, and MRC scientists have been behind such diverse discoveries as vitamins, the structure of DNA and the link between smoking and cancer, as well as achievements such as pioneering the use of randomised controlled trials, the invention of MRI scanning, and the development of a group of antibodies used in the making of some of the most successful drugs ever developed. Today, MRC-funded scientists tackle some of the greatest health problems facing humanity in the 21st century, from the rising tide of chronic diseases associated with ageing to the threats posed by rapidly mutating micro-organisms. www.mrc.ac.uk

The MRC Centenary Timeline chronicles 100 years of life-changing discoveries and shows how our research has had a lasting influence on healthcare and wellbeing in the UK and globally, right up to the present day. www.centenary.mrc.ac.uk

 The Health Protection Agency is an independent UK organisation set up by the government in 2003 to protect the public from threats to their health from infectious diseases and environmental hazards. In April 2013 the Health Protection Agency will become part of a new organisation called Public Health England, an executive agency of the Department of Health. To find out more, visit our website: www.hpa.org.uk or follow us on Twitter @HPAuk. The HPA press office can be contacted on 0208 327 7901 or email colindale-pressoffice@hpa.org.uk.

12th October 2012

A collaboration to transform public health has been forged between the University of Cambridge and the University of North Carolina at Chapel Hill (UNC) Gillings School of Global Public Health.  The collaboration will build on the two universities’ complementary strengths in biostatistics, epidemiology, obesity, non-communicable diseases, ageing, health behaviour and global health. In its first year, the partnership has committed research funding to four areas: dementia, obesity, tobacco and alcohol control policies, and health data gaps that limit our understanding of disease progression and treatment.

Co-chairs of the research collaborative, Professor Carol Brayne, Professor of public health medicine and Director of the Cambridge Institute of Public Health, and Barbara Rimer, Dean and Alumni Distinguished Professor at UNC’s School of Global Public Health, have high expectations for the partnership. They hope to obtain funding for at least two more projects in the coming year and to develop incubator funding for developmental planning work that will lead to public and private resourcing in both countries.  Their goal is to develop innovation labs on the model of the Gillings Innovation Lab format, which focus on promising research initiatives, and to offer prestigious graduate fellowships linked to major strategic areas of collaboration.

Dementia – a growing global crisis

With an ageing global population and predictions that the incidence of Alzheimer’s disease will quadruple by 2050, there is an urgent need to understand and reduce risk factors for dementia.  The University of Cambridge and UNC collaborative study will investigate the impact of risk factors such as ethnicity, urban versus rural location, social networks and culture on dementia and cognitive health.

Co-principal investigators for the project are Peggye Dilworth-Anderson, Professor of health policy and management at UNC’s Gillings School of Global Public Health and interim co-director of UNC’s Institute on Aging, and University of Cambridge’s Carol Brayne.

At the heart of the study are data on the health of diverse cultural groups that have already been collected from studies conducted in the US. and UK.  Additional funding recently received from the UK-US Collaborative Development Award (CDA) Program will enable the dementia research to advance more rapidly.

Obesity policy – influencing policy and practice

June Stevens, Distinguished Professor and chair of nutrition at UNC, and John Danesh, Head of Cambridge’s Department of Public Health and Primary Care and Professor of epidemiology and medicine, co-lead an effort that will use an extensive database compiled by Cambridge researchers to influence US and UK obesity policy. The project also will answer key questions posed by a National Institutes of Health (NIH) panel charged with updating clinical guidelines related to risk of cardiovascular disease, stroke, hypertension and diabetes. Stevens is a member of the NIH panel.

Tobacco and alcohol policies – new tools to monitor local compliance

Kurt Ribisl, Professor of health behaviour at UNC and Theresa Marteau, Professor of behaviour and health at Cambridge and Director of Cambridge’s Behaviour and Health Research Unit, co-lead a project to expand use of an electronic store audit tool, developed at UNC, to describe neighbourhood and retail environments in four US and UK communities and monitor compliance with local tobacco and alcohol control policies.

Health care data – challenges and opportunities

Michael Kosorok, Professor and chair of biostatistics at UNC, and Vern Farewell, Programme leader at Cambridge’s Medical Research Council Biostatistics Unit, co-lead a project that addresses one of the great challenges and opportunities in health care – extracting information and meaning from large, complex data sets so that results reflect reality and can be used to improve population health and disease treatment.

The CDA program is sponsored by the Global Partnership Fund through the British government’s Department for Business, Innovation and Skills and its Foreign and Commonwealth Office.  It is administered through the UK’s Science and Innovation Network, http://www.fco.gov.uk/en/about-us/what-we-do/working-in-partnership/working-with-stakeholder-groups/science-innovation/science-innovation-network/ based in the USA. The program enables scientists, engineers, academic leaders and innovation experts in the US and UK to travel abroad for short visits to lay the groundwork for collaborative efforts.

For more information about the UNC-Cambridge partnership, contact Dr Jana Voigt at Cambridge’s Research Strategy Office jana.voigt@admin.cam.ac.uk, or Barbara Wallace, Director of corporate, foundation and global partnerships at UNC, at bobbi_wallace@unc.edu.

This month, the University of Cambridge will be profiling research that addresses public health. To begin, Professor Carol Brayne, Director of the Cambridge Institute of Public Health, explains how the goals of a new University Strategic Network, PublicHealth@Cambridge, will generate fresh insight into the health and well-being of populations.

"Our vision for PublicHealth@Cambridge is to develop synergy across Cambridge in areas of public health importance such as international health, social and behavioural science and methodological advances." - Professor Carol Brayne  Read more

Read more...

Download the Press Release.

In 2007 the PHG Foundation began funding research into conceptual and methodological issues arising in connection with epidemiology and population health. In contrast to the focus of traditional bioethics, the aim of this research has been to explore methodological (rather than purely ethical) issues, concerning population (and not merely individual) health. These issues include the nature of causation, methods for causal inference, the nature and communication of risk, the proper use of statistical significance testing, and the social determinants of health.

The project described in the  report was led by Dr Alex Broadbent and took place at the University of Cambridge. It produced a number of academic articles and included a series of workshops held at Cambridge during 2010. Papers presented there form the basis of a recent special section of the journal Preventive Medicine: ‘Epidemiology, Risk, and Causation’, Preventive Medicine 53(4-5), 213-59 (2011). A book on the philosophy of epidemiology by Dr Broadbent is now under contract with Palgrave Macmillan.

The report explains the goals and academic outputs of the project in more detail. In addition, a substantial portion is devoted to analysis of the key issues identified in the course of the research.

Download a copy.

Dr Philippa Brice
Communications Director
Direct Dial: +44 (0) 1223 740235
philippa.brice@phgfoundation.org

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