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<p><b>OBJECTIVE</b>To investigate the impact of impoundment and active public health interventions on rodent populations and rodent-borne diseases in the Three Gorges reservoir region from 1997 to 2012.</p><p><b>METHODS</b>Surveillance data from 1997 to 2012 were extracted from the Public Health Surveillance System of The Three Gorges established in 1997. Temporal changes in the incidences of hemorrhagic fever with renal syndrome (HFRS) and leptospirosis, rodent density, pathogen-carrying rates, and their correlations were analyzed.</p><p><b>RESULTS</b>The average indoor and outdoor rodent densities decreased overall from 1997 to 2012. The average densities decreased by 47.72% (from 4.38% to 2.29%) and 39.68% (from 4.41% to 2.66%), respectively, after impoundment (2003-2012) compared with before impoundment (1997-2002). The average annual incidence rates of HFRS and leptospirosis were 0.29/100,000 and 0.52/100,000, respectively, and decreased by 85.74% (from 0.68/100,000 to 0.10/100,000) and 95.73% (from 1.47/100,000 to 0.065/100,000), respectively, after impoundment compared with before impoundment. Incidences of HFRS and leptospirosis appear to be positively correlated with rodent density in the reservoir area.</p><p><b>CONCLUSION</b>This study demonstrated that rodent density and incidences of rodent-borne diseases decreased and were maintained at low levels during construction of the Three Gorges dam. Measures that reduce rodent population densities could be effective in controlling rodent-borne diseases during large-scale hydraulic engineering construction.</p>
Subject(s)
Animals , Animal Distribution , China , Epidemiology , Disease Reservoirs , Hantavirus Infections , Epidemiology , Leptospirosis , Epidemiology , Virology , Population Density , Rodent Diseases , Epidemiology , Microbiology , Virology , Rodentia , Seasons , Time Factors , Water Supply , ZoonosesABSTRACT
<p><b>OBJECTIVE</b>To evaluate the effect of comprehensive control and prevention for chronic diseases in demonstration plot of Chongqing.</p><p><b>METHODS</b>Residents were enrolled through multi-stage stratified random sampling method from 17 districts or counties which had successfully established demonstration plots and 21 districts or counties which had not established demonstration plots (non-demonstration plot for short) yet on May, 2012. Questionnaire was designed to survey awareness of health knowledge, health behaviors and utilization of health supportive tools. The results were analyzed by SPSS 15.0 software.</p><p><b>RESULTS</b>We investigated 15 108 residents, 6156 of which were in demonstration plot and others (8951) were not. The findings revealed the percentage of the people who were aware the national action of health lifestyle in demonstration plot and in non-demonstration plot were 44.4% (2734/6157) and 40.2% (3598/8951), respectively, and the awareness of the hypertension risk of too much sodium were 72.4% (4458/6156) and 67.5% (6042/8951), respectively, and the awareness of the cardinal vascular disease (CVD) risk of obesity and overweight were 77.2% (4753/6157) and 69.6% (6230/8951), respectively. About the residents' health behaviors in demonstration plot and in non-demonstration plot, the utilization rates of salt restriction scoop or pot were 23.5% (1447/6157) and 17.9% (1602/8951), and the utilization rates of oil restriction pot were 16.7% (1028/6157) and 11.8% (1064/8951), respectively. Totally, 33 of the 37 indexes were shown higher in demonstration plot than that in non-demonstration plot (P < 0.05).</p><p><b>CONCLUSION</b>The chronic diseases comprehensive control and prevention in demonstration plot was more effective, and the remarkable improvement of health knowledge and behaviors level had been achieved in demonstration plot.</p>
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , China , Chronic Disease , Health Knowledge, Attitudes, Practice , Outcome Assessment, Health Care , Surveys and Questionnaires , Universal PrecautionsABSTRACT
<p><b>OBJECTIVES</b>To learn the use of fund investment and actual expenditure cost among men who have sex with man (MSM) intervention in the city, in order to provide related evidences for carrying out the intervention effectively MSM.</p><p><b>METHODS</b>Financial records were used to collect the information about the fund source and allocation of the resource invested for the MSM intervention between 2006 and 2009. Key staff was interviewed to get related information. The activity-based costing method was adopted to analyze the actual expenditure of MSM intervention in different sites, and the allocation of the total cost to each activity, the intervention times in different sites and the unit cost in actual HIV testing person-times promoted by MSM intervention was then calculated.</p><p><b>RESULTS</b>Interventions through internet and in bar and bathhouse were conducted in the certain city. Total funds for MSM intervention between 2006 and 2009 were 4.441 million, 56.7% (¥2.530 million) of which were from international cooperation programs, whose direct cost covered 50.5% (¥2.243 million) of the total cost. The actual expenditure in interventions through Internet was ¥750 656 (16.9%), including direct expenditure ¥317 088 and indirect expenditure ¥433 568. The actual expenditure in interventions in bar was ¥2 061 846 (46.4%), including direct expenditure ¥1 114 423 and indirect expenditure ¥947 423. The actual expenditure in interventions in bathhouse was ¥1 628 751 (36.7%), including direct expenditure ¥811 474 and indirect expenditure ¥817 277. The person-times of receiving MSM intervention and the unit cost for promoting HIV test through the above 3 access all decreased. The average cost for one person-time intervention through internet and in bar and bathhouse decreased from ¥68.7 (1011 person-times), ¥67.3 (3282 person-times), ¥67.9 (3140 person-times) in 2006 to ¥40.9 (25 523 person-times), ¥30.2 (28 121 person-times), ¥17.5 (28 381 person-times) in 2009 respectively, and the cost for promoting one person-time HIV test decreased from ¥1789.2 (58 person-times), ¥1175.6 (188 person-times), ¥574.2 (312 person-times)per person time to ¥676.9 (394 person-times), ¥556.5 (1637 person-times), ¥316.5 (2237 person-times) respectively.</p><p><b>CONCLUSION</b>The unit cost of MSM intervention through internet and in bar and bathhouse decreased, as well as the cost for HIV test promotion per person-time in the city. Meanwhile, the intervention covered more and more people annually.</p>
Subject(s)
Humans , Male , Acquired Immunodeficiency Syndrome , Economics , Epidemiology , China , Epidemiology , Costs and Cost Analysis , Health Expenditures , Homosexuality, MaleABSTRACT
Objective To evaluate the impact on the health status of population in the area where the ‘Three Gorges Reservoir Water Storage Project' had been operated and to provide references for the development of related disease control strategies.Methods In the Three Gorges Reservoir Area,17 towns/streets in nine counties were chosen as surveillance points.Data on surveillance program would include infectious diseases,birth,death,biological agents etc.Methods related to time and spatial analysis and the comparison on pre- and post- water storage were used to analyze and describe the long-term changing trend of meteorological index,distribution of biological agent and diseases,and human health status.Relationships between number of infectious diseases and media biological density and meteorological parameters were also analyzed.Results When the water storage program came into being in 2003,the indoor (2.22%) and outdoor (2.76%) densities of rats were significantly lower than pre-water storage period (indoor 4.38% vs.outdoor 4.43%) and the annual average density of mosquito (35.09 mosquitoes per room and per hour) was also lower than before (54.24 mosquitoes per room and per hour).The incidence rates of encephalitis B,malaria,leptospirosis,and hemorrhagic fever had reduces 22.88%,84.85%,95.03% and 81.82% than before.The incidence rates of malaria,leptospirosis,and hemorrhagic fever were all below 0.4/100 000 and the incidence of encephalitis B was below 2/100 000.The average infant mortality was 11.83‰.The annual infant mortalities,after adjusted by missing report numbers,were between 13.07‰ and 23.88‰ which were lower than the national annual average level.The thirteen year standard mortalities were 3.77‰-5.12‰,with the total rate lower than the national average level in the same years.Conclusion In 2003,the incidence rates of malaria,encephalitis B,leptospirosis,epidemic hemorrhagic fever kept going down in the surveillance sites in the Three Gorges Reservoir Area,and the overall population's health status was well enough to show that there was no negative impact on the health status of population living in the area after the water storage project was inplemented.
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Objective To study the outcomes of AIDS intervention programs and to provide scientific evidence for developing pertinent strategy on intervention among men who have sex with men (MSM).Methods MSM were recruited through snowballing and investigated by face to face interview in 2006 and 2007 respectively.SPSS 12.0 was used to compare the change of cognition about AIDS,sexual behavior,prevalence rates of HIV and Syphilis before and after the intervention program among the population under study.Results The cognition about AIDS among MSM was obviously improved after the intervention with the rate increased from 74.3% to 82.4% (P=0.01).The rate of last time condom use among MSM increased from 56.4% to 65.5% (P=0.00).The rate of consistent condom use during six months among MSM increased from 31.8% to 41.9% (P=0.00).The rates of both condom use during commercial sex with men and with women did not change much among MSM.The prevalence rates of HIV in 2006 and 2007 were 10.4% and 10.8% and of syphilis in 2006 and 2007 were 9.3% and 7.3% respectively which were not significantly different between before and after the intervention.Conclusion The cognition about AIDS among MSM was improved obviously.However,the rate of consistent condom use was still low,reflecting the segregation phenomenon between their behavior and cognition.All our findings implied that it was crucial to carry out AIDS prevention and control programs.
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Objective To examine HIV prevalence and related risk factors among men who have sex with men(MSM) in Chongqing, and to explore the feasibility of using respondent-driven sampling (RDS) in the survey. Methods Based on results from formative research, a RDS survey was designed and conducted to collect demographic, behavioral and serologic data. RDSAT was used to calculate point estimation and confidence intervals. SPSS was used for bi-variate analysis using RDSAT exported weighed data. NETDRAW was used to draw network diagram. Results Among 617 subjects recruited, the adjusted HIV and syphilis prevalence rates were 16.8% and 10.9%, respectively. 73.0% of the subjects were 20 to 29 years old and 72.9% were officially registered residents of Chongqing. 83.4% were single, with the proportion of students the highest, accounting for 24.6%. During the last six months, 83.4% of them reported ever having anal sex, and 54.0% reported having unprotected anal sex. Conclusion This survey confirmed that Chongqing had a higher reported HIV prevalence among MSM than from other Chinese cities. Comprehensive intervention services were required to address this alarmingly high prevalence, with focus on intervention through internet and those having syphilis infection. RDS seemed one of the effective ways of recruiting hidden MSM populations in Chongqing which had a large population of active MSM who did not frequently visit MSM venues as compared with snowball method.
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Objective To evaluate the situation of HIV prevalence,incidence and drug resistance(DR)among recent HIV infected men who have sex with men(MSM)during the year of 2006.Methods A transect investigation was conducted through snowballing to recruite volunteers.HIV infected status was confirmed by ELISA and Western Blot(WB),the recent infected within 155 days were confirmed by BED-Capture ELISA Assay(BED-CEIA),which based on the principle that characteristics of the initial HIV antibody response in recent infections differs from those of established or long-term infections either by antibody titer,proportion,specificity,isotype or avidity.Bayer Trugene was applied to PCR the target sequence of HIV pol gene,and the sequences were analyzed to detect the prevalence of HIV gene mutation.Furthemore.HIV antiretroviral drug resistance among MSM was evaluated.The results were analyzed through three methods:Trugene DR 3.7 IVD(2006/07/27)Guidelines 1 1.0(2005/12/15)provided byBayer company,Stanford HIVdb and Gen02pheno.Results The prevalence and incidence of HIV among MSM were 10.4%and 7.98% PY,by three methods.There was only 1 sample found to have occurred resistant Drimary mutation which could be inferred that the average DR ratio was 4.55%(1/22).Conclusion The incidence and prevalence of MSM in Chongqing were notable,and the mutation rate stands at a low level when comparing to researches conducted in developed countries.Secondary mutations appeared frequently,suggesting that more research need to be conducted to understand how HIV was transmitting among the carriers.
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<p><b>OBJECTIVE</b>To examine HIV prevalence and its associated factors among men who have sex with men (MSM) and provide the evidence for the intervention program among MSM.</p><p><b>METHODS</b>A face-to-face questionnaire interview was conducted among MSM recruited by snowball sampling method in Yuzhong, Jiulongpo and Shapingba district of Chongqing from July to September, 2007. Totally, 1044 MSM were recruited. Associated factors with HIV prevalence were analyzed using forward stepwise logistic regression that HIV status was the dependent variable and demographics, AIDS awareness, sexual behaviors and the status of the intervention were independent variables.</p><p><b>RESULTS</b>A total of 1044 MSM were surveyed. The rate of AIDS awareness was 89.5% among MSM. The rate of unprotected anal sex during the past 6 months was 63.8%. The prevalence of HIV and syphilis was 8.5% (89/1044) and 12.5% (131/1044) respectively. The multivariate analysis identified that the older MSM (OR = 1.69, 95% CI: 1.13 - 2.52), junior school education (OR = 1.89, 95% CI: 1.17 - 3.05), younger than 18 years old of the first sex (OR = 3.11, 95% CI: 1.20 - 8.02), more than 10 sexual partners (OR = 2.24, 95% CI: 1.24 - 4.02), the history of having sex with women (OR = 2.40, 95% CI: 1.64 - 3.51) and syphilis infection (OR = 4.52, 95% CI: 2.77 - 7.38) were independent risk factors associated with HIV infection.</p><p><b>CONCLUSION</b>The rate of unprotected anal sex was high, so were the prevalence of HIV and syphilis among MSM. It should be urgent to conduct the intervention to stop AIDS rapid transmission among MSM.</p>