[Evaluation of health education in primary school students from schistosomiasis-endemic areas around Poyang Lake by KAP hierarchical evaluation method].

OBJECTIVE: To quantitatively evaluate the intervention effect of schistosomiasis health education on the knowledge, attitude and behavior (KAP) among the primary school students. METHODS: A questionnaire was designed to collect baseline data. Questionnairing was conducted among students of grades 3 and 4 from the Central Primary School, Liyuzhou Primary School, and Meichi Primary School in Wuxing Farm of Nanchang City in June 2010. Eighty-four students from Central Primary School were selected as experiment group, and 62 students in the other two schools served as control group. Health education intervention (knowledge lectures, information dissemination, intensive education and so on) was conducted for the students in experiment group from September 2010 to October 2011. Final KAP questionnaire survey was carried out after intervention. A KAP hierarchical evaluation method was used to calculate the KAP scores in the two groups before and after intervention. RESULTS: After health education, the total KAP score in experiment group increased from 8.40 before education to 9.36 (t = 2.994 4, P < 0.01), higher than that of the control (8.53, t = 5.335 5, P < 0.01). The scores of knowledge, attitude and behavior of schistosomiasis control increased from 6.16, 9.10, and 8.67 before education to 8.12, 9.86, and 9.45 after education in experiment group (t = 5.716 8, P < 0.01; t = 3.2764, P < 0.01; t = 3.276 4, P < 0.01), respectively. Compared to the experiment group, after health education the scores of knowledge (6.34, t = 3.517 5, P < 0.01) and attitude of schistosomiasis control (9.43, t = 2.311 9, P < 0.05) were lower in control group; but no significant difference was found on the score of behavior between the two groups. After health education, the scores of 26 indices in experiment group were higher than that of the control and before education. CONCLUSION: The health education intervention is effective for schistosomiasis control in the experiment school.

[Evolution of spatial-temporal pattern of schistosome infection rates in Nanchang County, Jiangxi Province].

OBJECTIVE: To explore the evolution of spatial-temporal pattern of schistosome infection rates in Nanchang County, Jiangxi Province. METHODS: Based on the data of schistosome infection rates at unit of administrative villages during 2006 to 2009, the evolution of spatial-temporal pattern of schistosome infection rates was analyzed by means of global Moran's I, Getis-Ord General G, local Getis-Ord Gi and variogram. RESULTS: Since 2006, the global Moran's I index increased, and all the Getis-Ord General G index G (d) values were 0.02, all the Z(d) values were of statistic significance (all P values were < 0.01). The hotspots mainly distributed in the northeast and southeast of the county, while the cold spots and secondary cold spots mainly distributed in the southwest. The optimal fitted variograms of the 3 years were all Gaussian model, the Nugget coefficient decreased from 0.026 to 0.006. The spatial autocorrelation of schistosome infection rates got stronger, the ranges shrank by 9.04%. CONCLUSION: The schistosome infection rates in Nanchang County have a tendency of clustering towards the areas along the lake, and the impact of the structural factors is increasing, but the effect range of spatial correlation is decreasing.

[Comparison of knowledge, attitude and practice of students left at home or not on schistosomiasis prevention and control].

The questionnaire survey on knowledge, attitude and practice (KAP)of students left at home or not about schistosomiasis prevention and control showed that there were no statistically significant differences of the scores of KAP between the two groups of students (all P values were above 0.05).

[Spatial clustering detecting for schistosomiasis in Nanchang County].

OBJECTIVE: To explore the cluster of schistosomiasis in Nanchang County, Jiangxi Province. METHODS: Based on the data of schistosome infection cases and population, the spatial analysis technology, global autocorrelation and hotspot detection methods in ArcGIS 9.2 software were used to render the spatial autocorrelation coefficient graph. The autocorrelation index change trend of schistosome infection rates in different spatial scales was described. In addition, the hotspot area of schistosome infection rates in study area was detected by using the representative distance for pace parameters combined with actual situation. RESULTS: The spatial distribution of schistosome infection in study area was characteristic of clusters in 2009. The spatial autocorrelation coefficient graph indicated that the peak of wave happened in the distances of 1 900 m, 2 600 m, 3 800 m and 5 000 m, respectively. Comparing with the geographical conditions, the hotspots in 5 000 m spatial scale were more realistic than other distances. In this scale, 2 hotspots and 2 second hotspots were explored. CONCLUSION: The spatial clustering analysis combined with the spatial autocorrelation analysis can explore the schistosomiasis gathering area more precisely.

[Systematic surveillance of water body in schistosomiasis susceptible areas in Nanchang County by sentinel mice].

OBJECTIVE: To determine the status of cercariae of Schistosoma japonicum in water bodies of the Nanchang County section of Poyang Lake region. METHODS: By using sentinel mice, the schistosome infectivity of water bodies was detected in 8 surveillance areas (59 experimental points in total) along the Fu River, Wuxing Farm, south branch of the Ganjiang River, and middle branch of the Ganjiang River from June to July 2011. RESULTS: A total of 600 sentinel mice were placed in the experimental areas and 584 were retrieved, among which 577 mice were dissected and 1 mouse was infected with S. japonicum (4 worms collected), with the infection rate of 0.17%. CONCLUSION: By using the sentinel mouse method to survey the water body schistosome infectivity, the status of Oncomelania snails should be mainly considered, and the infection rate of sentinel mice is affected by water situation, water level, flow velocity, etc.

[Survey on knowledge and attitude of schistosomiasis control among villagers in susceptible zones in Poyang Lake area].

OBJECTIVE: To understand the status of health education on schistosomiasis for residents in susceptible zone and provide a reasonable basis for related study. METHODS: A questionnaire survey on knowledge, attitude about schistosomiasis of the residents was conducted. RESULTS: Status of education on schistosomiasis of susceptible areas for the residents in general is not optimistic, the frequency of contacting with infected water was high, the demographic characteristics were also significant: (1) The passing rate for the villagers' schistosomiasis knowledge was too low, only 39.6%, the difference between awareness rates of schistosomiasis knowledge among villagers with different educational levels was significant (P < 0.05); (2) The overall level of correct attitude for schistosomiasis control was poor, only 37.7% of the villagers with a good attitude, the differences among villagers with different ages and occupations were significant (both P values < 0.05); (3) 73.5% of the villagers had ever contacted with infected water, and different groups contacted with infected water in different ways, 67.5% of men contacting for bathing, fishing, 63.7% of women contacting for washing clothes. CONCLUSIONS: Health education for schistosomiasis control in susceptible zones should be strengthened, the reasons for differences in cognitive level about schistosomiasis control among the villagers with different demographic characteristics and the better models for educational interventions for different villagers need to be explored.

[Preliminary study on the comprehensive evaluation method of schistosomiasis health education--a field study in a heavy endemic area in lake region].

OBJECTIVE: To explore a comprehensive evaluation method of knowledge, attitude and behavior (KAP) about schistosomiasis control among students of susceptibility zone in lake region. METHODS: A comprehensive KAP evaluation indicator system was developed by using analytic hierarchy process (AHP). The system consists of three layers. First-layer indices include knowledge, altitude and behavior of schistosomiasis control. 17 specific parts compose second-layer indices. Third-layer indices have 30 specific aspects. The experts were invited to provide comments for these indicators, and indicator weights were formulated by using AHP. A questionnaire survey was conducted among students of grade 3 and 4 from Central Primary School, Liyuzhou Primary School and Meichi Primary School in Wuxing Farm. Status of health education for schistosomiasis was evaluated by this method. RESULTS: n the indicator system, the weights of behavior, altitude and knowledge were 0.54, 0.30, and 0.16, respectively. The average score of KAP indicator was 8.45. The score for behavior, altitude and knowledge indicators was 8.86, 8.90, and 6.25, respectively. The scores of some indicators such as fishing outside and inside level, washing outside level and grazing in marshland were 8.17-9.29. CONCLUSION: This comprehensive evaluation method can be used to evaluate basic situation and effect of health education in schistosomiasis intervention. The health education should be strengthened in the survey site.

[Study on quality of schistosomiasis knowledge questionnaire of primary pupils in Wuxing Farm School of Nanchang City].

OBJECTIVE: To evaluate the quality of a questionnaire about schistosomiasis knowledge of the pupils in Wuxing Farm School in Nanchang City. METHODS: The quality of the questionnaire about schistosomiasis knowledge was evaluated through reliability, validity, discrimination and some other indexes. RESULTS: The entire reliability of the survey was high with its split-half reliability of 0.68 and Cronbach alpha coefficient of 0.627. The content validity was good: the exploratory factor analysis revealed 5 common factors from 13 questionnaire items which could account for 58.3% of the total variance; the confirmatory factor analysis revealed that the construct validity of 13 questionnaire items was better than that of the whole questionnaire (17 items in total) (chi2 = 90.5, df = 65, GFI = 0.92, AGFI = 0.88, NFI = 0.58, CFI = 0.817, RMSEA = 0.049); the difficulty and the discrimination coefficients of the questionnaire were suitable, being 0.595 and 0.42 respectively. CONCLUSION: The questionnaire is qualified in general, but parts of the items need to be revised to perfect.

[Study of copper metabolism and liver damage in TX Mice-an animal model for liver disease].

OBJECTIVE: To provide right time points in selection of right aged animals and the normal physiological data of TX mice. METHODS: 7-12 months old TX and DL mice were studied, each group contained 3 female and 3 male mice of TX or DL mice. The concentration of copper in the serum, dry tissues (liver, brain and kidney), together with copper biochemistry indexes were measured. The liver histopathology was observed under light microscopy and electron microscope. RESULTS: Transaminase increased significantly only in 10 and 11-month- old (AST(TX10) = 218.3 U/L, AST(TX11) = 197.5 U/L, AST(DL10) = 171.5 U/L, AST(DL11) = 165.0 U/L, P(10) less than 0.001, P(11) = 0.022), but the copper concentration of liver, brain and kidney was significantly increased during 7-12 month old (the average concentration of copper, Liver(TX) = (750.0 +/- 85.5) mg/kg, Brain(TX) = (39.7 +/- 2.2)mg/kg, Kidney(TX) = (29.8 +/- 5.0) mg/kg, Liver(DL) = (11.6 +/- 1.5) mg/kg, Brain(DL) = (16.8 +/- 0.9) mg/kg, Kidney(DL) = (14.2 +/- 1.0) mg/kg, t = 21.16, 23.60, 7.47, for all these organs P less than 0.05). CONCLUSION: TX mice is a suitable model of liver disease with natural recovery, so selecting animal model of suitable time point is very important.

Diminution of toxic copper accumulation in toxic milk mice modeling Wilson disease by embryonic hepatocyte intrasplenic transplantation.

AIM: To observe the therapeutic effect of intrasplenic transplantation with embryonic hepatocytes on amelioration of hereditary copper accumulation in toxic milk (TX) mouse modeling Wilson disease. METHODS: Donor hepatocytes were harvested from 14-d fetal liver of a pregnant homogeneous DL mouse. These cells were successively cultured, labeled with fluorescein dye Hoechst 33342 for 24 h, and sequentially infused into the spleen parenchyma of the recipient TX mice. No host immunosuppression measures were taken. Two and four weeks after transplantation, the recipients were killed for routine histologic investigation and immunohistochemistry study up to 4 wk after transplantation. The serum copper and ceruloplasmin concentrations of the recipient mice were determined by graphite furnace atomic absorption spectroscopy. RESULTS: In the following 2nd and 4th wk after transplantation, the donor hepatocytes could be visualized in the livers of 47.3% recipients. The serum ceruloplasmin and copper concentrations increased by 1.6-fold after 2 wk and 2.0-fold times after 4 wk respectively, which ultimately rose from about 30% of the normal level to nearly 60% (P<0.01). The hepatic copper concentration decreased 7.2%, 4 wk after transplantation. Pathologic examination showed that there were many actively proliferative hepatocyte precursor cells with specific embryonic hepatocyte marker AFP migrated into hepatic sinusoids of the recipients. A large number of cells carrying hepatocytes marker and albumin were observed in the recipient spleen tissues. CONCLUSION: Embryonic hepatocytes are capable of differentiating into mature hepatocytes in vivo. After transplantation, the hereditary abnormalities of copper metabolism in TX mice could be corrected partially by intrasplenic transplantation of homogeneous embryonic hepatocytes.