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Objective To evaluate capacity among emergency staffs from center of disease control and prevention in Zhejiang Province at municipal and county levels, and to analyze the influencing factors. Methods Using multi-stage cluster sampling, 501 emergency staffs from 33 CDCs of the two levels in Zhejiang Province was involved in this study. Characteristics of the study population and their emergency acknowledge and capacities were collected by questionnaire. Rank test, correlation analysis and multiple logistic regression analysis were used to assess the level of capacities and analyze the influencing factors. Results At municipal and county levels, there were 165 (32.93%) and 336(67.07%) emergency staffs respectively, and the median scores of emergency acknowledge were 60 and 58.33, and the lowest scores of the knowledge both were Nuclear/Radiation. The median scores of emergency capacities were 61.82 and 55.76, and the lowest score of the capacities were both Sampling/Detection. Ordinal multivariate logistic regression analysis indicated that the scores of emergency knowledge (OR=1.19, 95%CI: 1.16-1.22), senior title (ORprimary title=0.22, 95%CI: 0.13-0.39; ORmiddle title=0.37, 95%CI: 0.23-0.60), male (OR=2.00, 95%CI: 1.39-2.89), experience of emergency tour (OR=1.63, 95%CI: 1.01-2.61) and the level of CDC (OR=1.57, 95%CI: 1.06-2.34) were the positive influencing factors of emergency capacity. Conclusion In Zhejiang Province, there were significant weaknesses in the Nuclear/Radiation knowledge and Sampling/Detection ability among emergency staffs of municipal-level and county-level CDCs. Level, gender, title, scores of emergency knowledge and experience of emergency tour were the influencing factors.
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Objective To establish a evaluation indicator system for the emergency response capability of CDC by taking Zhejiang Province as an example.Method The manuscript of evaluation indicator system for Zhejiang province was established based on literature review and expert meeting.A 3 -rounds Delphi process was conducted and the specialist participating level,authority coefficient and Kendall's W were calculated to assess the indicator system.The weight of index was calculated by method of proportionate allocation.Results Three rounds of Delphi consultations was conducted by 1 7 consulters that from the administrative department of public health,scientific research institution or CDCs,and the response rate were 94.1 2%,87.50%,88.24% respectively.The specialist authority coefficient was 0.81 ±0.05.The final indicator system was consisted of 7 first -class indicators (Emergency response system,Emergency response team, Emergency response supply,Emergency coping capability,Surveillance and early warming,Scientific research and exchange,Communication and cooperation),22 second -class indicators and 77 third -class indicators.The W for each class of indicator were 0.701 ,0.531 ,0.547 and 0.697,0.629,0.548 respectively (P <0.01 ).The CV for each indicator ranges from 0.00 to 0.24.Conclusion The indicator system established in the study has good reliability and feasibility,and the specialists'opinions were consistent.The indicator system could be used in common assessment of CDC's emergency response capability in Zhejiang Province.
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Objective To investigate the spatial and temporal distribution of highly pathogenic avian influenza H5N1 based on Geography Information System (GIS),and to learn the mechanism of the occurrence and spread of H5N1.Methods A total of 2 069 officially confirmed cases of H5N1 outbreak reported to WHO and World Organization for Animal Health (OIE)from 2003 to 2012 were analyzed using a GIS based approach.Hot spot analysis (Getis-Ord Gi*)was used in the spatial and temporal analysis.Results From 2003 to 2012,2 069 cases of H5N1 outbreak was reported in Vietnam (1 055),Bangladesh (528)and Indonesia (209).The most of the outbreaks were reported in Ganges Delta,Mekong Delta,areas around Dacca and West Java.The occurrence,spread and distribution pattern of the disease varied within different spatial scale,and the epidemic showed a bipolar distribution in Vietnam,aradial distribution in Bangladesh and a shrinking pattern in Indonesia.Conclusion Highly pathogenic avian influenza H5N1 was first emerged in city and then spread through poultry trading or transportation,and finally caused epidemic in regions with high density poultry and intensive agriculture.Hot spot analysis had a great application value in disease surveillance and early warning.
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Objective To explore the risk factors of patients with re -treatment multidrug resistant pulmonary tuberculosis (MDR -TB)and to provide suggestions for intervention.Methods A case -case control study was carried out between patients with or without re -treatment MDR -TB,with a questionnaire interview and multivariate logistic regression analysis to explore the risk factors of re -treatment MDR -TB.Results A total of 172 patients were enrolled in this study including 99 re -treatment MDR -TB patients and 73 re -treatment non -MDR -TB patients(P >0.05).There was no significant difference between case group and control group in gender,age,residence and marital status.The sick time,the anti -tuberculosis treatment time,the number of anti -tuberculosis treatments,the rate of adverse reactions,history of taking isoniazid or rifampicin and the number of treatment interruption were higher in cases than those in control group(P <0.05),while the months of first -treatment were lower than those in control group(P <0.05).The number of anti -tuberculosis treatments(≥3),adverse reactions during treatment,the months of first -treatment were significant risk factors by the multivariable regression model,with the adjusted ORs and 95%CIs of 5.07 (1.89,13.64),4.27 (2.04, 8.94)and 2.35(1.06,5.22),respectively.Conclusion The number of anti -tuberculosis treatments,adverse reactions during treatment,the months of first -treatment were risk factors of patients with re -treatment MDR -TB.
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<p><b>OBJECTIVE</b>To examine vibrio cholera (V.C) in aquatic products of littoral area, Zhejiang Province and to provide scientific evidence for administration of aquatic products and cholera epidemic control.</p><p><b>METHODS</b>All 990 samples of aquatic products collected from local markets, eateries and aquafarms in three chosen areas. Samples were proliferated in alkaline liquid medium, and purified in NO: 4 medium, the isolations were identified biochemically, and phenotype of strains were defined by phagocyte and coagulation with V.C. diagnostic serum. Three virulence genes (ctx, ace, zct) of the isolated strains were detected by polymerase chain reaction (PCR).</p><p><b>RESULTS</b>There were 1.41% samples caught by V.C., having a carrying rate highest in turtles of 8.9%. 14 strains were defined as three serogroups, and the numbers of Inaba, Ogawa, and Hikojima types were 2, 2, 10 respectively. Virulence genes had detected in 9 of 12 stains. All genes were detected in 5 strains, only ZOT genes in 3 strains, and both CTX and ACE genes in 1 strain.</p><p><b>CONCLUSIONS</b>Aquatic products from inshore in Zhejiang Province caught with V.C. strains might be divided into three serogroups. Most of them should be virulence genes. Cholera epidemic outbreak might be caused by those contaminated products.</p>