ABSTRACT
Objective To explore the effectiveness of comprehensive schistosomiasis control interventions based on urban-rural integration system construction to carry out the schistosomiasis control in hilly schistosomiasis endemic areas ,so as to offer a new mode to consolidate the achievements of schistosomiasis control in the new situation. Methods Shouan Town and Changqiu Township in Pujiang County in hilly schistosomiasis endemic regions were selected as demonstration areas. The com-prehensive schistosomiasis control interventions based on urban-rural integration system construction were implemented ,includ-ing the land consolidation,centralized residence and so on. The effectiveness the interventions was evaluated. Results In Shouan Town and Changqiu Township,the transformed environments with Oncomelania hupensis snail habitats were 1330.61 hm2 and 1456.84 hm2,the areas with snails decreased from 94.31 hm2 and 83.00 hm2 in 2000 to both 0 in 2015,the positive rates of serological tests for schistosomiasis decreased from 11.8%and 7.53%in 2000 to 1.01%and 1.86%in 2015,and the pos-itive rates of parasitological tests decreased from 0.18%and 0.15%in 2000 to both 0 in 2015 respectively. The numbers of cattle decreased from 358 and 368 in 2000 to 4 and 6 in 2015 respectively. In 2000,the schistosome infection rates of cattle were 3.63%and 6.51%in Shouan Town and Changqiu Township respectively,and from 2004,no infected cattle were found. Conclu-sion The comprehensive schistosomiasis control interventions based on urban-rural integration system construction can de-crease the schistosome infection rate and area with snails effectively,providing a new mode for schistosomiasis elimination.
ABSTRACT
Objective To study the natural history of HIV-1 infection among intravenous drug users (IDUs) detected in late 1989 in the study area and the factors related to survival of these IDUs infected with HIV. Methods 196 injecting drug users first detected during August and December, 1989 were observed in Ruili county, Yunnan province. Data gathered from the 20-year follow-up program was collected and analyzed retrospectively. Results After 20 years' follow-up period, 90.3% of the 196 IDUs with HIV infection died, 5.1% of them were still alive, and 4.6% were lost. The crude pre-AIDS mortality rate was 98.1/1000 person-years, and the AIDS mortality rate was 54.9/1000 person-years. Malaria, septicemia were the main causes of death among the natural diseases whereas overdose and accidental causes were the principal causes related to those non-disease deaths.The median survival time from sero-conversion to death was 8.6 years (95%CI: 7.6-9.7). The median survival time from sero-conversion to death due to AIDS was 11.3 years (95%CI: 10.3-12.8) with the incubation time as around 10.3 years. People older than 30 years at seroconversion and length of drug usage were associated with shorter survival time, with hazards ratios as 1.9 and 0.7, respectively.Conclusion A high pre-AIDS mortality was observed among IDUs. Both the median survival time from sero-conversion to death and the HIV incubation period were shorter than that observed in the developed countries. Age of HIV infection seemed to have a strong effect on survival.