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Objective To study the emergency staff's knowledge, skills and their training demand in centers for disease control and prevention (CDC) at county and municipal levels in Zhejiang Province. Methods Using multistage cluster sampling, 518 emergency staff from 34 CDCs in Zhejiang Province were involved in this study. A questionnaire survey was conducted among the emergency staff to evaluate their emergency knowledge and training demand. The differences between the staff from CDCs at county and municipal levels were evaluated. Results The average score of the emergency staff was 2.93 about all emergency knowledge. Some items' scores were lower, such as nuclear radiation control, first aid, risk management, ethics, laws and emergency system. The score of the survey items were similar at county and municipal level except education degree, positional title, and proportion of staff in emergency training, score of epidemiology, risk management and first aid. The highest degree of training demand was professional knowledge related to emergency response. The emergency staff inclined to the training mode (≥4) about short-term training, field guidance, drill and exercise and case study. Conclusion We should improve the health emergency training according to the demand and target of fostering inter-disciplinary talents for fieldwork. We should strengthen training of basic theories, basic knowledge and basic skills, to cover the shortage. The short-term training and practical training should be the main training model.
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Objective To evaluate capacity among emergency staffs from center of disease control and prevention in Zhejiang Province at municipal and county levels, and to analyze the influencing factors. Methods Using multi-stage cluster sampling, 501 emergency staffs from 33 CDCs of the two levels in Zhejiang Province was involved in this study. Characteristics of the study population and their emergency acknowledge and capacities were collected by questionnaire. Rank test, correlation analysis and multiple logistic regression analysis were used to assess the level of capacities and analyze the influencing factors. Results At municipal and county levels, there were 165 (32.93%) and 336(67.07%) emergency staffs respectively, and the median scores of emergency acknowledge were 60 and 58.33, and the lowest scores of the knowledge both were Nuclear/Radiation. The median scores of emergency capacities were 61.82 and 55.76, and the lowest score of the capacities were both Sampling/Detection. Ordinal multivariate logistic regression analysis indicated that the scores of emergency knowledge (OR=1.19, 95%CI: 1.16-1.22), senior title (ORprimary title=0.22, 95%CI: 0.13-0.39; ORmiddle title=0.37, 95%CI: 0.23-0.60), male (OR=2.00, 95%CI: 1.39-2.89), experience of emergency tour (OR=1.63, 95%CI: 1.01-2.61) and the level of CDC (OR=1.57, 95%CI: 1.06-2.34) were the positive influencing factors of emergency capacity. Conclusion In Zhejiang Province, there were significant weaknesses in the Nuclear/Radiation knowledge and Sampling/Detection ability among emergency staffs of municipal-level and county-level CDCs. Level, gender, title, scores of emergency knowledge and experience of emergency tour were the influencing factors.
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Objective To learn the status and equity of human resource allocation for health so as to provide evidence for health administrative department. Methods Descriptive analysis and annual percent changes (APC) were used to analyze the numbers and trends of human resource allocation for health from 2011 to 2015, and Gini coefficients were used for equity evaluation. Results In 2015, Hangzhou had the largest number (12.62) of medical personnel per 1000 persons while Jiaxing had the least amount (7.43) . Hangzhou had the largest number (10.32) of medical technical personnel per 1000 persons while Wenzhou had the least amount (6.23) . Hangzhou had the largest number (3.86) of licensed (assistant) doctors per 1000 persons while Jiaxing had the least amount (2.15) . Hangzhou had the largest number (4.23) of registered nurses per 1000 persons while Wenzhou had the least amount (2.42) . Jiaxing had 8.06 medical personnel, 7.03 medical technical personnel, 2.33 licensed (assistant) doctors and 2.86 registered nurses per square kilometer which were all the largest number while Lishui had 1.21 medical personnel, 1.00 medical technical personnel, 0.39 licensed (assistant) doctors and 0.38 registered nurses per square kilometer which were all the least. The doctor-to-nurse ratio was only 1:1.01 in 2015. Both numbers of human resources for health per 1000 persons and per square kilometer increased year by year from 2011 to 2015, and Gini coefficients of each index expressed by per 1000 persons were all under 0.2, while it ranged from 0.2 to 0.3 when they were expressed by per square kilometer. Conclusion Numbers of human resource allocation for health had an increasing trend and the allocation was fair, but the equity evaluated by service population was better than by service areas, and the research about accessibility of regional human resource allocation for health needs to be concerned.
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Objective To provide diagnostic clue for the investigation and laboratory examination in outbreak of common respiratory infectious diseases using a computer -aided classification model.Methods The variables were extracted from medical literature,case data of infectious diseases,reports of outbreaks such as symptoms and signs,abnormal lab test results,epidemiologic features,the incidence rates of the infectious diseases.Then a classification model was constructed using Naive Bayesian classifier and SAS 9.1 .3 Data from eight historical outbreaks of respiratory infectious diseases were used to test the model.Results Among eight outbreaks,the discriminate probability of diagnosing a disease correctly by ranking it first on the output lists of the model was 53.85%.The sensitivity was 53.85%,and specificity was 1 00.00%, and +LR was from 5.73 to ∞.The discriminant probability of diagnosing a disease correctly by ranking it within the three most probable diseases on these lists was 98.34%.The sensitivity was 98.34% and the specificity was 82.1 4%,and +LR was from 1 .26 to ∞.Conclusion A Bayesian classification model could be applied to classification and discriminant of common respiratory infectious diseases,and could improve the ability for early diagnosis of the outbreak caused by respiratory infectious diseases.
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Objective To learn the status of human resources of vaccination clinics in Zhejiang province and to give suggestions for optimizing the allocation.Methods Investigation and the focus group interview were conducted in Zhejiang Province to learn the configuration standards in vaccination clinics.Results The mean number who attended the immunization work every vaccination day in those clinics was five.The number of staff in each clinic differed from county to county but all reached 0.9 persons serving for 10,000 residents.There should not be less than four persons in each vaccination clinic theoretically.It should be necessary to increase one vaccination staff in every 50 injection doses of vaccine workload.Conclusion The staff of vaccination clinics is inadequate and unbalanced in Zhejiang Province.We should increase staff numbers according to workload and served population.
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<p><b>OBJECTIVE</b>To investigate the coverage rate of primary immunization of measles containing vaccine (MCV1) among migrant children in Yiwu,Zhejiang province.</p><p><b>METHODS</b>Household cluster sampling survey and probability proportion to size sampling method were adopted. A total of 967 migrant children born from 1st July 2007 to 1st July 2010 and their caregivers were selected as target population. Standard face-to-face interviews were conducted to investigate the subjects' knowledge, attitude, practice (KAP) of immunization, MCV1 vaccination and determinants. Multi-variable weighted average score method was adopted to evaluate the result of our survey on KAP. Kaplan-Meier analysis was adopted to assess the coverage of MCV1 and Cox regression analysis was adopted to explore the influencing factors associated with the coverage of MCV1.</p><p><b>RESULTS</b>Out of the 967 children, 104 were born in 2007, accounting for 10.8%; 301 were born in 2008, accounting for 31.1%; 343 were born in 2009, accounting for 35.5% and 219 were born in 2010, accounting for 22.6%. Among the surveyed caregivers, 71.9% (695/967) were mothers and 90.2% (872/976) were migrant from other provinces. According to the result of survey on KAP among caregivers, 56.2% (543/967) scored ≥ 4 points on knowledge, 75.8% (734/967) scored ≥ 4 points on attitude and 48.7% (471/967) scored ≥ 4 points on behavior. 86.6% (838/967) of surveyed caregivers' education levels were under junior middle school.85.9% (831/967) of the migrant children were born in hospitals.36.3% (351/967) of the surveyed families' household income were under 2000 yuan per month.32.7% (316/967) of surveyed caregivers waited less than 15 min for immunization for each time. Coverage rate of MCV1 was 85.9% (831/967; 95%CI: 83.7%-88.1%). The timely coverage rates at 8 months, 12 months, and 24 months were 58.8% (569/967; 95%CI: 55.5%-62.1%), 88.2% (853/967; 95%CI: 86.0%-90.4%) and 98.6% (953/967; 95%CI: 97.8%-99.4%), respectively. The average age of MCV1 immunization for each birth cohort between 2007 and 2010 were 10.4, 10.1, 10.1 and 9.3 month, respectively; without statistical significance (χ(2) = 0.722, P = 0.398). According to the analysis by Cox regression, the caregivers aged ≤ 25 years (24.3% (235/967), RR = 1.520 (95%CI: 1.280-1.800)), the caregivers' education level above college (2.8% (27/967), RR = 3.841 (95%CI: 2.287-6.451)), delivered in county-level hospital (49.4% (478/967), RR = 6.048 (95%CI: 4.311-8.485)), household income > 4000 yuan per month (21.7% (210/967), RR = 1.366 (95%CI:1.163-1.604)), the average score of attitude towards immunization ≥ 4 points (75.9%(734/967), RR = 2.613 (95%CI: 1.026-6.655)), the average waiting time for each vaccination ≤ 15 min (32.7% (316/967), RR = 2.116 (95%CI: 1.341-3.339)) were the important factors to improve the timely immunization coverage rate of MCV1 among migrant children.</p><p><b>CONCLUSION</b>The coverage of MCV1 were obviously delayed among migrant children in Yiwu, Zhejiang province. We suggest that the investigation of migrant children should be strengthened and remind or recall mechanism for immunization should be established. Increasing the open days for immunization clinics and reducing the waiting time for vaccination could also improve the coverage and timeliness of the MCV vaccination.</p>