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1.
Vaccine ; 38(20): 3665-3670, 2020 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-32245644

RESUMO

BACKGROUND: Middle school students are recommended as the primary target population for human papillomavirus (HPV) vaccination. This study aimed to assess HPV and HPV vaccine knowledge, and to evaluate the effect of a school-based educational intervention, immediately and one year later, on HPV knowledge and vaccine acceptability among adolescents in mainland China. METHODS: A school-based interventional follow-up study was conducted in seven representative cities in mainland China from May 2015 to May 2017. "Train-the-trainer" strategy was employed to educate school teachers in this study. Students aged 13 to 14 years old were assigned to intervention classes and control classes. All students were required to complete the baseline questionnaire. Students in the intervention classes were given a 45-minute lecture regarding HPV and HPV vaccine knowledge and were then asked to complete a post-education questionnaire. One year later, all students were asked to complete the post-education questionnaire again. RESULTS: Baseline HPV knowledge was low among Chinese adolescents, with only 12.6% and 15.7% of students having heard of HPV and HPV vaccines, respectively. After the intervention, the level of HPV-related knowledge increased immediately, and students with higher knowledge levels of HPV and HPV vaccines were more willing to get vaccinated. One year after the intervention, the knowledge of HPV and HPV vaccines was dramatically diminished. However, knowledge was significantly higher in intervention classes compared to control classes. CONCLUSIONS: Knowledge and awareness of HPV and vaccination are generally deficient among Chinese adolescents. School-based health education was very effective in improving awareness and positive attitudes about HPV and HPV vaccines within a short time. Integrating health education on HPV into the existing school-based sexual health curriculum could be an effective way to increase HPV vaccination coverage and help to eliminate preventable HPV-associated cancers in China.

2.
BMJ ; 350: h770, 2015 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-25788018

RESUMO

OBJECTIVE: To determine whether an education programme targeted at schoolchildren could lower salt intake in children and their families. DESIGN: Cluster randomised controlled trial, with schools randomly assigned to either the intervention or control group. SETTING: 28 primary schools in urban Changzhi, northern China. PARTICIPANTS: 279 children in grade 5 of primary school, with mean age of 10.1; 553 adult family members (mean age 43.8). INTERVENTION: Children in the intervention group were educated on the harmful effects of salt and how to reduce salt intake within the schools' usual health education lessons. Children then delivered the salt reduction message to their families. The intervention lasted for one school term (about 3.5 months). MAIN OUTCOME MEASURES: The primary outcome was the difference between the groups in the change in salt intake (as measured by 24 hour urinary sodium excretion) from baseline to the end of the trial. The secondary outcome was the difference between the two groups in the change in blood pressure. RESULTS: At baseline, the mean salt intake in children was 7.3 (SE 0.3) g/day in the intervention group and 6.8 (SE 0.3) g/day in the control group. In adult family members the salt intakes were 12.6 (SE 0.4) and 11.3 (SE 0.4) g/day, respectively. During the study there was a reduction in salt intake in the intervention group, whereas in the control group salt intake increased. The mean effect on salt intake for intervention versus control group was -1.9 g/day (95% confidence interval -2.6 to -1.3 g/day; P<0.001) in children and -2.9 g/day (-3.7 to -2.2 g/day; P<0.001) in adults. The mean effect on systolic blood pressure was -0.8 mm Hg (-3.0 to 1.5 mm Hg; P=0.51) in children and -2.3 mm Hg (-4.5 to -0.04 mm Hg; P<0.05) in adults. CONCLUSIONS: An education programme delivered to primary school children as part of the usual curriculum is effective in lowering salt intake in children and their families. This offers a novel and important approach to reducing salt intake in a population in which most of the salt in the diet is added by consumers.Trial registration ClinicalTrials.gov NCT01821144. .


Assuntos
Educação em Saúde , Instituições Acadêmicas , Cloreto de Sódio na Dieta/administração & dosagem , Adulto , Pressão Sanguínea/fisiologia , Doenças Cardiovasculares/prevenção & controle , Criança , China , Dieta Hipossódica , Humanos , Avaliação de Programas e Projetos de Saúde , Fatores de Risco , Cloreto de Sódio na Dieta/efeitos adversos , Sódio na Dieta/urina
3.
Asian Pac J Cancer Prev ; 13(7): 3529-33, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22994789

RESUMO

OBJECTIVES: To investigate the current prevalence and knowledge of cervical cancer, breast cancer and reproductive tract infections (RTIs) in rural Chinese women, and to explore the acceptance and feasibility of implementing a combined screening program in rural China. METHODS: A population-based, cross-sectional study was conducted among women aged 30 to 59 years old in Xiangyuan County, Shanxi Province from 2009 to 2010. Socio-demographic characteristics, knowledge of cervical cancer, breast cancer and RTIs, and the attitude toward single or combined screening were collected by an interview questionnaire. Each participant received a clinical examination of the cervix, breast and reproductive tract. Examinations included visual inspection, mammography, laboratory tests and pathological diagnosis. RESULTS: A total of 1,530 women were enrolled in this study. The prevalence of cervical precancerous lesions, suspicious breast cancer, suspicious benign breast disease and RTIs was 1.4%, 0.2%, 14.0% and 54.3%, respectively. Cervicitis, trichomonas vaginitis, and bacterial vaginitis were the three most common RTIs among our participants. Television, radio broadcast, and public education during screening were the major source of healthcare knowledge in rural China. Moreover 99.7% of women expressed great interest in participating in a combined screening project. The affordable limit for combined screening project was only 50 RMB for more than half of the rural women. CONCLUSION: A combined screening program would be more effective and popular than single disease screening projects, while appropriate accompanied education and a co-pay model for its successful implementation need to be explored, especially in low-resource settings.


Assuntos
Neoplasias da Mama/epidemiologia , Infecções do Sistema Genital/epidemiologia , Neoplasias do Colo do Útero/epidemiologia , Adulto , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/microbiologia , China/epidemiologia , Estudos Transversais , Feminino , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Mamografia/métodos , Programas de Rastreamento/métodos , Prevalência , Infecções do Sistema Genital/diagnóstico , População Rural , Inquéritos e Questionários , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/microbiologia
4.
Asian Pac J Cancer Prev ; 13(5): 2369-78, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22901224

RESUMO

OBJECTIVES: To assess knowledge of HPV and attitudes towards HPV vaccination among the general female population, government officials, and healthcare providers in China to assist the development of an effective national HPV vaccination program. METHODS: A cross-sectional epidemiologic survey was conducted across 21 urban and rural sites in China using a short questionnaire. 763 government officials, 760 healthcare providers, and 11,681 women aged 15-59 years were included in the final analysis. Data were analyzed using standard descriptive statistics and logistic regression. RESULTS: Knowledge of HPV among the general female population was low; only 24% had heard of HPV. Less than 20% of healthcare providers recognized sexually naive women as the most appropriate population for HPV vaccination. There was high acceptance of the HPV vaccine for all categories of respondents. Only 6% of women were willing to pay more than US $300 for the vaccine. CONCLUSIONS: Aggressive education is necessary to increase knowledge of HPV and its vaccine. Further proof of vaccine safety and efficacy and government subsidies combined with increased awareness could facilitate development and implementation of HPV vaccination in China.


Assuntos
Pessoal Administrativo/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/estatística & dados numéricos , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/uso terapêutico , Neoplasias do Colo do Útero/prevenção & controle , Adolescente , Adulto , Atitude Frente a Saúde , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Papillomaviridae/patogenicidade , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/virologia , Prognóstico , Inquéritos e Questionários , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/virologia , Vacinação , Saúde da Mulher , Adulto Jovem
5.
BMC Health Serv Res ; 12: 123, 2012 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-22624619

RESUMO

BACKGROUND: Cost estimation is a central feature of health economic analyses. The aim of this study was to use a micro-costing approach and a societal perspective to estimate aggregated costs associated with cervical cancer screening, diagnosis and treatment in rural China. METHODS: We assumed that future screening programs will be organized at a county level (population ~250,000), and related treatments will be performed at county or prefecture hospitals; therefore, this study was conducted in a county and a prefecture hospital in Shanxi during 2008-9. Direct medical costs were estimated by gathering information on quantities and prices of drugs, supplies, equipment and labour. Direct non-medical costs were estimated via structured patient interviews and expert opinion. RESULTS: Under the base case assumption of a high-volume screening initiative (11,475 women screened annually per county), the aggregated direct medical costs of visual inspection, self-sampled careHPV (Qiagen USA) screening, clinician-sampled careHPV, colposcopy and biopsy were estimated as US$2.64,$7.49,$7.95,$3.90 and $5.76, respectively. Screening costs were robust to screening volume (<5% variation if 2,000 women screened annually), but costs of colposcopy/biopsy tripled at the lower volume. Direct medical costs of Loop Excision, Cold-Knife Conization and Simple and Radical Hysterectomy varied from $61-544, depending on the procedure and whether conducted at county or prefecture level. Direct non-medical expenditure varied from $0.68-$3.09 for screening/diagnosis and $83-$494 for pre-cancer/cancer treatment. CONCLUSIONS: Diagnostic costs were comparable to screening costs for high-volume screening but were greatly increased in lower-volume situations, which is a key consideration for the scale-up phase of new programs. The study's findings will facilitate cost-effectiveness evaluation and budget planning for cervical cancer prevention initiatives in China.


Assuntos
Detecção Precoce de Câncer/economia , Custos de Cuidados de Saúde/tendências , Serviços de Saúde Rural/economia , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/cirurgia , Neoplasias do Colo do Útero/terapia , Adulto , China , Custos e Análise de Custo , Feminino , Humanos , Pessoa de Meia-Idade , Pesquisa Qualitativa
6.
Cancer Epidemiol ; 36(4): 384-90, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22377277

RESUMO

OBJECTIVE: Cervical cancer is the second most common cancer among women worldwide, and over 85% of cervical cancers occur in developing countries such as China. Lack of resources for nationwide cervical cancer screening in China makes vaccination against oncogenic strains of HPV particularly important. Knowledge of age at sexual debut and sexual behavior is essential prior to implementation of a national vaccination program. METHODS AND MATERIALS: A cross-sectional epidemiologic survey was conducted across 21 urban and rural sites in China to assess age at sexual debut and sexual behavior. 98.6% of the 11,852 recruited women aged 15-59 years were included in the analysis. Data were collected using a short, nurse-administered questionnaire and analyzed using standard descriptive statistics and survival analysis. RESULTS: In urban areas, more than ten percent of the 15-19 year old age group were already sexually active at the time of interview; this number increased to nearly 44% in the 20-24 year old age group. Chinese young women with an occupation were more likely to be sexually active compared to female students of the same age, irrespective of area of residence. The crude median sexual debut age for the youngest age group was 17 years, earlier than the sexual debut age reported by older cohorts. Younger age cohorts had an earlier menarche age than older cohorts and were more likely to have more sexual partners than older women, and more likely to have partners with more than one female partner. CONCLUSION: There is a trend towards earlier sexual debut and riskier sexual behaviors in younger age groups of Chinese women. These findings suggest that HPV vaccination of women between the ages of 13 and 15 years, before the completion of national compulsory education, is likely to contribute to the prevention of HPV infection and cervical cancer in China.


Assuntos
Vacinas contra Papillomavirus/administração & dosagem , Comportamento Sexual/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , China , Feminino , Humanos , Pessoa de Meia-Idade , Infecções por Papillomavirus/prevenção & controle , Inquéritos e Questionários , Adulto Jovem
7.
BMC Public Health ; 12: 153, 2012 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-22381149

RESUMO

BACKGROUND: Information on the health-related quality of life (HRQoL) of patients with genital warts (GW) in populations in mainland China is still limited. The aim of the study was to use a generic instrument to measure the impact of genital warts on HRQoL in men and women in this setting. METHODS: A multi-centre hospital-based cross-sectional study across 18 centers in China was conducted to interview patients using the European quality of life-5 dimension (EQ-5D) instrument; respondents' demographic and clinical data were also collected. RESULTS: A total of 1,358 GW patients (612 men, 746 women) were included in the analysis, with a mean age of 32.0 ± 10.6 years. 56.4% of the patients reported some problems in the dimension of Anxiety/Depression (highest), followed by Pain/Discomfort (24.7%) and Mobility (3.5%). The overall visual analogue scale (VAS) score of the study population was found to be 65.2 ± 22.0, and the EQ-5D index score was found to be 0.843 ± 0.129 using Japanese preference weights (the Chinese preference was unavailable yet). Patients with lower VAS means and EQ-5D index scores were more often female, living in urban area, and suffering multiple GW (all p values < 0.05), but the values did not differ notably by age (p values > 0.05). CONCLUSIONS: The HRQoL of patients with GW was substantially lower, compared to a national representative general population in China (VAS = ~80); the findings of different subgroups are informative for future GW prevention and control efforts.


Assuntos
Condiloma Acuminado/psicologia , Qualidade de Vida , Adulto , Distribuição por Idade , Ansiedade/epidemiologia , Ansiedade/psicologia , China/epidemiologia , Condiloma Acuminado/epidemiologia , Condiloma Acuminado/prevenção & controle , Estudos Transversais , Depressão/epidemiologia , Depressão/psicologia , Feminino , Indicadores Básicos de Saúde , Humanos , Entrevistas como Assunto , Masculino , Limitação da Mobilidade , Dor/complicações , Dor/epidemiologia , Medição da Dor , Características de Residência/estatística & dados numéricos , Distribuição por Sexo , Inquéritos e Questionários
8.
BMC Cancer ; 11: 239, 2011 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-21668946

RESUMO

BACKGROUND: A new lower-cost rapid-throughput human papillomavirus (HPV) test (careHPV, Qiagen, Gaithersburg, USA) has been shown to have high sensitivity for the detection of high grade cervical intraepithelial neoplasia. METHODS: We assessed the outcomes and cost-effectiveness of careHPV screening in rural China, compared to visual inspection with acetic acid, when used alone (VIA) or in combination with Lugol's iodine (VIA/VILI). Using data on sexual behaviour, test accuracy, diagnostic practices and costs from studies performed in rural China, we estimated the cost-effectiveness ratio (CER) and associated lifetime outcomes for once-lifetime and twice-lifetime screening strategies, and for routine screening at 5-yearly, 10-yearly and IARC-recommended intervals. The optimal age range for once-lifetime screening was also assessed. RESULTS: For all strategies, the relative ordering of test technologies in reducing cervical cancer incidence and mortality was VIA (least effective); VIA/VILI; careHPV@1.0 pg/ml and careHPV@0.5 pg/ml (most effective). For once-lifetime strategies, maximum effectiveness was achieved if screening occurred between 35-50 years. Assuming a participation rate of ~70%, once-lifetime screening at age 35 years would reduce cancer mortality by 8% (for VIA) to 12% (for careHPV@0.5) over the long term, with a CER of US$557 (for VIA) to $959 (for careHPV@1.0) per life year saved (LYS) compared to no intervention; referenced to a 2008 GDP per capita in Shanxi Province of $2,975. Correspondingly, regular screening with an age-standardised participation rate of 62% (which has been shown to be achievable in this setting) would reduce cervical cancer mortality by 19-28% (for 10-yearly screening) to 43-54% (using IARC-recommended intervals), with corresponding CERs ranging from $665 (for 10-yearly VIA) to $2,269 (for IARC-recommended intervals using careHPV@1.0) per LYS. CONCLUSIONS: This modelled analysis suggests that primary careHPV screening compares favourably to visual inspection screening methodologies in rural China, particularly if used as part of a regular screening program.


Assuntos
Ácido Acético , Neoplasia Intraepitelial Cervical/diagnóstico , Corantes , Sondas de DNA de HPV , DNA Viral/análise , Detecção Precoce de Câncer/métodos , Custos de Cuidados de Saúde , Ensaios de Triagem em Larga Escala , Programas de Rastreamento/métodos , Infecções por Papillomavirus/diagnóstico , Exame Físico/métodos , Neoplasias do Colo do Útero/diagnóstico , Adulto , Neoplasia Intraepitelial Cervical/economia , Neoplasia Intraepitelial Cervical/epidemiologia , Neoplasia Intraepitelial Cervical/virologia , China/epidemiologia , Simulação por Computador , Análise Custo-Benefício , Detecção Precoce de Câncer/economia , Feminino , Ensaios de Triagem em Larga Escala/economia , Humanos , Iodetos , Programas de Rastreamento/economia , Pessoa de Meia-Idade , Modelos Teóricos , Infecções por Papillomavirus/economia , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/transmissão , Infecções por Papillomavirus/virologia , Exame Físico/economia , População Rural , Comportamento Sexual , Fatores de Tempo , Neoplasias do Colo do Útero/economia , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias do Colo do Útero/virologia
10.
Zhonghua Liu Xing Bing Xue Za Zhi ; 29(9): 930-3, 2008 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-19173862

RESUMO

OBJECTIVE: To explore the relationships between the polymorphisms of xeroderma pigmentosum A (XPA) and the susceptibility of esophageal cancer (EC), as well as its interaction with environmental factors-gene in Changzhi area, Shanxi province. METHODS: A case-control study was conducted, including 196 cases of EC and 201 controls. XPA 23G polymorphisms were determined with polymerase chain-restriction on fragment length polymorphism (PCR-RFLP). RESULTS: The risk of EC was significantly degraded in the individuals who had been carrying the XPA heterozygote (A/G) and mutation genotype (G/G), compared to those with wild genotype (chi2 = 16.21, P < 0.01) and the ORs were 0.58 (0.37-0.91) and 0.32 (0.18-0.56), respectively. There was negative interaction between XPA 23G mutation genotype and the consumption of pickled food (S = 0.04, API= -0.77). CONCLUSION: Genetic polymorphism in the XPA 23G might be associated with esophageal cancer in Changzhi area, and there was a negative action between XPA predisposing genotype and the consumption of pickled food.


Assuntos
Neoplasias Esofágicas/genética , Polimorfismo Genético , Proteína de Xeroderma Pigmentoso Grupo A/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Predisposição Genética para Doença , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade
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