Evaluation by villagers of the malaria control project on Lombok and Sumbawa Islands, west Nusa Tenggara Province, Indonesia.

The cooperative malaria control project between Indonesian and Japanese institutions was conducted from 2001 to 2004 at small malaria endemic foci on Lombok and Sumbawa Islands. The aim of this research was to evaluate the effects of the project according to the opinions of the villagers. We conducted a KAP survey of a simple random sample of 300 householders on each island. The conclusion of the study was that the project reduced malaria incidence significantly on Lombok. However, the effects were not as clear on Sumbawa. Poor socio-economic status and lack of school education were important related factors. Therefore, health education, or behavioral change communication, was an essential component of malaria control.

A deficient public health system as a contributing cause of Severe Acute Respiratory Syndrome (SARS) epidemic in mainland China.

SARS (Severe Acute Respiratory Syndrome) is a newly emerging infectious disease which spread over 32 countries and areas, infected more than 8,000 people and causing more than 900 deaths from November 2002 to August 2003. More than 90% of the SARS cases and death were reported from China. Nevertheless, we still know little about this disease, particularly in etiology. SARS, as an emergency of Public Health System (PHS), alarmed health workers throughout the world proving there is still the potential for an epidemic of an emerging infection both in developed and developing areas. Many reports indicated that the insufficiency of the PHS of China was one of the critical factors contributing to the outbreak of SARS. In this study, we attempt to demonstrate some of the categories of PHS that contributed to the SARS epidemic. Two of the categories studied were the living environment and health resources. In the living environment area, the population and population density were examined. Health resources include the medical facilities, health workers, and per capita public health expenditures. An understanding of these areas is important to prevent future epidemic.

Effects of a school-based education program for schistosomiasis control.

The role and effect of school-based education for schistosomiasis control needs to be explored further to raise the standard of health in the widely infected areas over the world. This study investigated the effect, particularly the retention or duration of effect, of a school education program for schistosomiasis control. The study was conducted from September 2000 to February 2001 in a district of Mount Darwin, Zimbabwe. Two hundred ninety-nine fifth graders from 8 primary schools were examined for their knowledge, attitude, beliefs and practice regarding schistosomiasis, based on a KABP form, three times in succession. The examinations were a baseline examination, a pre-examination checking for the effect of the program, and a post-examination assessing retention after three-months. Analyses of the examination results indicated a considerable effect of the program in all aspects except for practice. Further detailed analyses on 161 matched pair subjects comparing the difference between the pre- and post-examination results demonstrated how the subjects maintained or rather increased what they had learned, illustrating an amplifying resonance or percussion effect, that is, a group dynamic effect in the school setting. No clear correlation, however, was shown between the education effect and the infection rate of the subject groups. Ways to prevent the deterioration of the practice aspect, and the cause of the negative correlation between the infection rate and education effect need to be closely investigated, while trying out more participatory-type education is an absolute necessity.

Combating HIV/AIDS in Mainland China: an epidemiological review of prevention and control measures.

Two decades have already passed since the first HIV/AIDS case was described in 1981. Cumulatively, over 20 million people have unfortunately lost their lives, and more than 40 million people are now living with HIV, and most of them are from developing countries. China, as the biggest developing country, has an impact on the epidemic of HIV/AIDS. From the first case of AIDS diagnosed in Mainland China in 1985, the epidemic has spread at an alarming rate. The feature of HIV/AIDS spread in Mainland China concerns its geographical characteristics that can be described as occurring in three phases. According to data from World Health Organization (WHO), it was estimated that about 840,000 people are living with HIV/AIDS in China, and 80,000 of them have already developed AIDS. WHO warned that, if there were no effective preventive measures adopted, that the number of HIV/AIDS infected cases would reach 10 million in China by 2010. In this study, we described the current situation of the epidemic of HIV/AIDS, as well as an historic review. The development of policy-making and the control measures are also highlighted. The experience from China described in this study would hopefully be for more public awareness of this crisis that is threatening all the citizenry of China.

Comparison of four health systems: Cuba, China, Japan and the USA, an approach to reality.

The ultimate responsibility for the overall performance of a country's health system lies with government, which in turn should involve all sectors of society in its stewardship. A comparison in structure, financing and function of the health systems of Japan, the USA, Cuba and China, as well as their main health and social-demographic results, is shown here. Two clear examples of inequalities, between regions in China and between ethnic and social groups in the USA, let us see different health indicators of both countries. To achieve and maintain a healthy population with good health results does not necessarily depend on a big budget or richness in a country. Good governmental policies regarding public health and social security are crucial to achieve good quality of life equally distributed to the whole population. Some suggestions are given.