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Objective To evaluate the effectiveness of health education on knowledge, attitude and practice (KAP) relating to malaria control among overseas enterprise employees. Methods In September 2019, on-site malaria control health education was conducted among all Chinese employees of a China-funded mining enterprise in the Democratic Republic of Congo. The KAP questionnaire for malaria control was generated on the Questionstar website, and the participants were subjected to two questionnaire surveys prior to and 14 months after health education. After the questionnaires were recovered, all valid questionnaires were divided into 4 groups, including the baseline group (the questionnaires filled out by respondents who received health education and participated in two questionnaire surveys before health education), the loss-to-follow-up group (the questionnaires filled out by respondents who received health education but only participated in the questionnaire survey after health education), the retest group (the questionnaires filled out by respondents who received health education and participated in two questionnaire surveys after health education) and the new group (questionnaires filled out by respondents who did not receive health education and only participated in the questionnaire survey after health education) according to subjects’ receiving health education and participation in two questionnaire surveys. The correct rate of malaria control knowledge, the proportion to good attitudes towards malaria control and the proportion of good practices towards malaria control were compared between the baseline group and the loss-to-follow-up group, between the baseline group and the retest group, and between the retest group and the new group. Results A total of 110 and 142 valid questionnaires were recovered during the two surveys, and the recovery rates were 90.9% and 70.3%, respectively. There were 77, 77, 33, and 65 valid questionnaires recovered from the baseline group, the loss-to-follow-up group, the retest group, and the new group, respectively. There were no significant differences in respondents’ gender, age and educational levels between the baseline group and the loss-to-follow-up group (all P values > 0.05), and there were no significant differences between the two groups in terms of the mean score of malaria control knowledge (Z = 2.011, P > 0.05), the mean score of attitudes towards malaria control (t = −0.787, P > 0.05) and the mean score of practices towards malaria control (t = −0.787, P > 0.05). There were significant differences between the retest group and the baseline group in terms of the mean score of malaria control knowledge (10.83 vs. 9.79; Z = −4.017, P < 0.05), the mean score of attitudes towards malaria control (29.48 vs. 28.61; Z = −1.981, P < 0.05) and the mean score of practices towards malaria control (6.43 vs. 5.91; Z = −2.499, P < 0.05). There were no significant differences between the retest group and the new group in terms of gender, age or education levels (all P values > 0.05), and a higher mean score of malaria control knowledge was found in the retest group than in the new group (10.83 vs. 9.81; Z = −2.962, P < 0.05), while no significant differences were seen in the mean score of attitudes towards malaria control (29.48 vs. 30.17; Z = −1.158, P > 0.05) and the mean score of practices towards malaria control (6.43 vs. 6.37; Z = −0.048, P > 0.05) between the two groups. Conclusion Malaria control health education may significantly improve the understanding of malaria control knowledge, positive attitudes towards malaria control and the compliance of practices towards malaria control among overseas enterprise employees.
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OBJECTIVE@#To investigate the clinical features and outcome of neonatal acute respiratory distress syndrome (ARDS) in southwest Hubei, China.@*METHODS@#According to the Montreux definition of neonatal ARDS, a retrospective clinical epidemiological investigation was performed on the medical data of neonates with ARDS who were admitted to Department of Neonatology/Pediatrics in 17 level 2 or level 3 hospitals in southwest Hubei from January to December, 2017.@*RESULTS@#A total of 7 150 neonates were admitted to the 17 hospitals in southwest Hubei during 2017 and 66 (0.92%) were diagnosed with ARDS. Among the 66 neonates with ARDS, 23 (35%) had mild ARDS, 28 (42%) had moderate ARDS, and 15 (23%) had severe ARDS. The main primary diseases for neonatal ARDS were perinatal asphyxia in 23 neonates (35%), pneumonia in 18 neonates (27%), sepsis in 12 neonates (18%), and meconium aspiration syndrome in 10 neonates (15%). Among the 66 neonates with ARDS, 10 neonates (15%) were born to the mothers with an age of ≥35 years, 30 neonates (45%) suffered from intrauterine distress, 32 neonates (49%) had a 1-minute Apgar score of 0 to 7 points, 24 neonates (36%) had abnormal fetal heart monitoring results, and 21 neonates (32%) experienced meconium staining of amniotic fluid. Intraventricular hemorrhage was the most common comorbidity (12 neonates), followed by neonatal shock (9 neonates) and patent ductus arteriosus (8 neonates). All 66 neonates with ARDS were treated with mechanical ventilation in addition to the treatment for primary diseases. Among the 66 neonates with ARDS, 10 died, with a mortality rate of 15% (10/66), and 56 neonates were improved or cured, with a survival rate of 85% (56/66).@*CONCLUSIONS@#Neonatal ARDS in southwest Hubei is mostly mild or moderate. Perinatal asphyxia and infection may be the main causes of neonatal ARDS in this area. Intraventricular hemorrhage is the most common comorbidity. Neonates with ARDS tend to have a high survival rate after multimodality treatment.
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Female , Humans , Infant, Newborn , Pregnancy , China , Meconium Aspiration Syndrome , Respiratory Distress Syndrome, Newborn , Retrospective StudiesABSTRACT
To analyze the situation of malaria elimination, identify the current main challenges and difficulties of maintaining the achievements of malaria elimination, and find out feasible solutions in Jiangsu Province.Through randomized grouping, the subject discussion and questionnaires were conducted by malaria control staffs from centers for diseases control and prevention of 13 cities of Jiangsu Province and Jiangsu Institute of Parasitic Diseases. The basic characteristics of participants and the effect of the discussion were analyzed through questionnaires.Twenty-seven professional participants were randomly divided into 3 groups. Totally 27 questionnaires were released and 24 valid questionnaires were retrieved. Among the 24 participants, 79.1% (19/24) of them were with mid-level and senior professional titles, and 66.7% (16/24) of them had worked for more than 10 years. Before the group discussion, only 16.7% (4/24) of the participants were aware of the current main challenges and difficulties in Jiangsu Province. After the discussion, 87.5% (21/24) of them thought the discussion increased their understanding of the challenges and difficulties. Through the subject discussion, the expert group summarized the current challenges and difficulties as well as the solutions in malaria prevention in Jiangsu Province in 4 aspects, namely the management guarantee of prevention work, diagnosis and treatment of the cases, field epidemiological investigation and others. Finally, a framework about these discussion results was established.During the post-stage of malaria elimination, Jiangsu Province still faced many challenges and difficulties, such as management guarantee, case diagnosis and treatment, epidemiology survey and focus disposals, and malaria surveillance sustainability. The feasible solutions of these challenges may provide examples for other provinces and regions which are undergoing malaria elimination or in post-stage of malaria elimination.
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To evaluate the implementation effect of the optimization strategy for the use and management of malaria rapid diagnostic testing (RDT) technology in Jiangsu Province, so as to provide the empirical evidence and suggestions for promoting the standardized use of RDT technology.Questionnaire surveys of primary-level health professionals’ RDT-related knowledge, attitude, and practice (KAP) and work satisfaction were conducted in 4 pilot cities in Jiangsu Province before and after the intervention.After the implementation of the intervention, 13.9% of surveyed laboratory technicians, 21.9% of surveyed clinicians and 4.1% of surveyed staff of the centers for disease control and prevention (CDCs) had significant improvements in RDT-related knowledge. About 10.9% of the surveyed laboratory technicians and 25.6% of the surveyed CDC staff improved their attitudes toward RDT technology. About 38.4% of the surveyed laboratory technicians and 10.0% of the surveyed clinicians improved the standardized use of RDT technology. All types of primary-level health professionals had high evaluation in the satisfaction and effectiveness of the optimization strategy. However, the evaluation of the surveyed clinicians was slightly lower than that of the laboratory technicians and CDC staff.The optimization strategy in this project can effectively improve the knowledge, attitude and behavior of all types of primary-level health professionals and help to promote the standardized use of RDT technology.
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To investigate the malaria rapid diagnostic testing (RDT) - related knowledge, attitude, practice (KAP) of primary healthcare professionals in Jiangsu Province and analyze the corresponding influencing factors.Four cities in Jiangsu Province were selected as the study sites by the typical sampling method to conduct a survey for the RDT related KAP and work satisfaction of primary healthcare professionals, and the multiple logistic regression model was used to explore the relevant influencing factors.Totally 1 150 questionnaires were issued and 949 valid questionnaires were collected with the recovery rate of 82.52%. The valid questionnaires included 453 questionnaires from laboratory technicians, 466 from clinicians, and 30 from malaria prevention and control workers. Totally 83.98% of the surveyed professionals had a low mastering level of essential RDT-related knowledge. A total of 52.17% of the surveyed laboratory technicians recognized that the application of RDT technology could effectively improve the current primary-level microscopy work, and the degree of recognition of RDT technological advantage in the laboratory technicians was higher than that in the clinicians. Totally 79.25% of the surveyed laboratory technicians regarded themselves to be capable of conducting the standardized RDT operation, and 84.55% of the surveyed clinicians regarded themselves to be capable of conducting the qualified malaria clinical diagnostic practice. The key influencing factors of RDT-related KAP of primary healthcare professionals included the laboratory technicians’ gender, educational level, employer’s institutional level, professional title, and working years, and the employer’s institutional level of clinicians.The primary healthcare professionals in Jiangsu Province exhibita good acceptability towards RDT technology. However, their essential knowledge on RDT remains to be improved. Therefore, it is necessary to establish a specific training and educational system for primary healthcare professionals to better guarantee the advantageous impact of RDT technology on the consolidation of the malaria elimination work achievements.
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Objective: The study aimed to explore the initial effect of the Luohu healthcare group reform in Shenzhen based on the patient’s perspective. Methods: The questionnaire survey was conducted to investigate the views of patients in 3 hospitals and 23 community health centers in Luohu district. Results: A total of 936 valid ques-tionnaires were collected and analyzed. The valid response rate was 94. 55% . More than 90 percent of the total sur-veyed patients provided a good or very good evaluation on the healthcare services, service attitude, medical referral services and interpretation, communication skills, and better family doctor skills. More than 80 percent of the sur-veyed patients perceived well or very well on medical treatment, the convenience of medical referral, the referral process of the community health centers, and the specialists serving in community health centers mechanism. Conclu-sions: The results showed that patients had a slightly high satisfaction with family doctors and community health cen-ter, and after the group was founded, the proportion of patients who preferred going to community health centers after illness has been increasing significantly more than before. In future, a further development of the advantages of healthcare group should be brought into action and improve the relevant supporting policies. The long-term effect de-serves a further observation.
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Objective: The study aimed to explore the initial effect of the Luohu Healthcare Group Reform in Shenzhen based on the employee’s perspective. Methods: The questionnaire survey was conducted to investigate the views of employees in 3 hospitals and 23 community health centers in Luohu district. Results: A total of 480 ques-tionnaires were distributed and only 412 valid questionnaires were collected and analyzed. The valid response rate was 85. 83% . 37. 21% of doctors responded that they had motive power to work in community health centers; 75. 38 per-cent of employees stated that their healthcare organization changed a lot; Employees’average work satisfaction scores, interpersonal relationship and healthcare organization development were all above 4. 20, and the consistency of em-ployee evaluation was high. Conclusions: Most of the surveyed employees evaluated the initial stage of the Luohu health reform positively. Since the hospital group started to operate two years ago, the development of the affiliated health facilities has been on an upward trend. The formation of vertical alliance within the hospital group has e-merged; and physicians of secondary and higher-grade hospitals have had increasing willingness of working at the community health centers, especially in the departments of internal medicine and traditional Chinese medicine. The hospital group has been guiding all affiliated facilities to develop its unique signature specialty so that facilities can col-laborate with each other and evolve as a whole. Group employees have expectations that the hospital group will coordi-nate and incorporate interests of all stakeholders, fulfill the commitments, and develop a better future for the group.
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Health system reform at district-level is an important but often neglected component in health system reform of China. According with the national policy-strategy guidance and the local health needs and problems within its jurisdiction,Luohu District has taken a series of effective reform measures for promoting a comprehensive reform since 2015,in which the crucial part was the establishment of"LuoHu Hospital Group". The reform in Luohu was initiated by the district-level government under the favorable policy and external conditions. The district government departments explored and innovated,and developed a featured district-level health system reform road. This experi-ence shows that district-level government should be an active actor in the local health system reform in China. The re-form in Luohu is still on the way,and more effect is yet to emerge, but the experience is of important reference for the health system reform in other regions/cities of China.
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Objective: To discover and summarize the problems and useful practices in the current primary-level application of Rapid Diagnostic Test (RDT) of malariain the eradicationphase,and explore the feasibility of overall introduction of RDT in primary-level medical institutions. There in after, empirical evidence and policy suggestions are provided for the improvement of primary-level malaria diagnosis systerato better meet the working requirements in the malaria eradication phase. Methods : We selected four districts as theresearch sites from which 36 respondents were invited from city, county and township level. All of the respondents invited to receive face-to-face semi-structural key informants' interviews included hospital physicians, hospital lab professionals, CDC malaria prevention and control professionals, and previous malaria patients. The interviewing system was focused on group interviews. Results :In the current stage,the primary-level malaria control professionals cautiously welcomed the RDT technology application. The lack of complete and specific training system and unclear RDT technological orientation were the two main reasons for the confusions and challenges faced by the above-mentioned professionals in the practical work at the primary-level. The primary-level hospital physicians' attitude towards malaria diagnosis and treatment,and their awareness of related technologies highly depended on their actual experience of receiving malaria cases and the number of residents coming back from their foreign working places (especially Sub-Sahaxan Africa) within their hospitals' service areas as well,which also differs across different regions. Conclusions : From the actual need of healthcare professionals and malaria patients,it is necessary and feasible to introduce RDT in primary-level medical institutions,but on the condition that further strengthening of the training on malaria prevention and control,and essential education on the existing knowledge are provided.
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Objective:To study the satisfaction of patients and medical personnel after the new health care re-form.Methods:Using questionnaire survey method, we interviewed patients and medical personnel in 4 comprehen-sive hospitals and 8 community hospitals.The number of questionnaire is 1001,the number of patient questionnaire is 499,the number of medical personnel questionnaire is 502.Results:The overall satisfaction of patients and medical personnel are good.The patient's overall satisfaction score was 3.95, the average satisfaction score of administrative supervision,hospital environment,service attitude and service ability is more than 4 points,the average satisfaction score of the knowledge publicity,drug supply,medical expenses,medical care system and medical processes is less than 4 points.The satisfaction degree of return of work of medical personnel is lowest,The satisfaction degree of work-ing environment is highest.Community hospital medical staff and patient satisfaction is generally better than general hospital.Conclusion:The overall satisfaction of medical personnel and patients is good in the Shanghai area.In the fu-ture,more should be done on knowledge publicity,strengthening diagnosis and treatment process optimizing,medical expense controlling,and the improvement of the social practice environment and working conditions.