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Objective:To analyze epidemiological characteristics of leprosy in China from 2016 to 2020, and to provide a scientific basis for further elimination of leprosy.Methods:Data collation and statistical analysis were conducted on annual reports on leprosy epidemic surveillance in China (excluding Hong Kong, Macao, and Taiwan regions) from 2016 to 2020.Results:From 2016 to 2020, a total of 2 697 new cases of leprosy were reported in China, including 46 (1.71%) children, 894 (33.15%) females, 374 (13.87%) floating people, 2 443 (90.58%) multibacillary cases, and 546 (20.24%) cases of grade 2 disabilities. A total of 203 relapsed cases were reported in the meantime. By the end of 2020, there had been 1 893 registered leprosy cases in China, and the number of cases was 68.62% fewer than that in 2010 (6 032 cases) ; there were 36 (1.2%) counties or cities with a prevalence rate above 1 per 100 000, and 72 (17.73%) new cases suffered from grade 2 disabilities.Conclusion:From 2016 to 2020, the reported incidence and prevalence of leprosy in China steadily decreased year by year, and overall, leprosy was still lowly prevalent.
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Objective@#To investigate the migration characteristics and follow-up treatment among HIV/AIDS patients after HIV confirmation in Yiwu City, Zhejiang Province from 2016 to 2020, so as to provide insights into the optimization of the HIV/AIDS control strategy among floating populations.@*Methods@#The reported HIV/AIDS patients' demographics, follow-up and treatment data in Yiwu City from 2016 to 2020 were captured from the HIV/AIDS Prevention and Control Information System of Chinese Disease Control and Prevention Information System. The migration characteristics, antiretroviral therapy and outcomes of HIV/AIDS patients were analyzed after HIV confirmation, and the factors affecting the migration of HIV/AIDS patients after HIV confirmation were identified using a Cox proportional hazard regression model.@*Results@#A total of 1 189 HIV/AIDS patients were enrolled, including 988 men (83.10%) and 806 cases without Zhejiang provincial household registration (67.79%). There were 441 patients (37.09%) migrating out of Yiwu City after HIV confirmation, with a migration rate of 17.73/100 person-years, and there were 366 patients migrating out of Zhejiang Province, with a cross-province migration rate of 30.78%. Among participants without Zhejiang provincial household registration, 395 patients (49.01%) migrated out of Yiwu City, including 337 patients (85.32%) returning to their household registration provinces, which mainly included Yunnan, Sichuan, Guizhou and Hunan. Cox proportional hazard regression analysis showed a high risk of migration among minority ethnic populations (HR=1.375, 95%CI: 1.044-1.811), retires (HR=3.605, 95%CI: 1.771-7.335), students (HR=8.969, 95%CI: 4.095-19.645), patients without Zhejiang provincial household registration (HR=4.545, 95%CI: 3.164-6.529) and patients identified through physical examination of floating populations or employees (HR=1.318, 95%CI: 1.006-1.727), and a low risk among married patients with spouses (HR=0.721, 95%CI: 0.569-0.913) and with an educational level of junior high school and above (HR: 0.428~0.753, 95%CI: 0.280-0.952). Among all floating HIV/AIDS patients, there were 26 cases lost to follow-up (5.90%) and 49 deaths (11.11%). In addition, the proportion of absence of antiretroviral therapy, HIV infection progressing into AIDS patients and failure in HIV inhibition were all greater among floating HIV/AIDS patients than among non-floating patients (P<0.05).@*Conclusions@#A high risk of migration was found among HIV/AIDS patients without Zhejiang provincial household registration, unmarried patients, patients with a low education level, retirees, students, and patients identified through physical examination of floating populations or employees in Yiwu City from 2016 to 2020, and migration does not facilitate the sustainability of antiretroviral therapy and follow-up, which may affect the prognosis of HIV/AIDS.
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Objective@# To establish a comprehensive health evaluation index system for HIV-infected pregnant women in floating populations, so as to support the elimination of mother-to-child transmission of HIV. @*Methods@# The preliminary framework of the comprehensive health evaluation indicators was constructed based on literature review and focus group discussion. Experts from maternal and child healthcare, clinical medicine and public health were invited to participate in two-round Delphi consultations. The indicators were scored and weighed according to the importance, priority and measurability, and determined according to means and coefficients of variation of scores. The effectiveness of the consultation was evaluated by positive coefficient, authority coefficient and coordination coefficient.@*Results@# Twenty-six experts participated in this study, including 19 women. There were 5 experts aged 30-40 years, 14 experts aged 41-50 years, and 7 experts aged 51 years and over. There were 17 experts with a master degree and above. All experts had vice senior professional titles and above. The positive coefficients in the two rounds of consultations were 96.30% and 100.00%, the authority coefficients were 0.84 and 0.89, respectively. Finally, 4 primary indicators (individuals and families, disease factors, social environment, health service utilization) and 50 secondary indicators were identified, with the coefficients of variation ranging from 0.084 to 0.236 and the coordination coefficients ranging from 0.282 to 0.405 (all P<0.001). Among the secondary indicators, getting antiviral drugs at the place of residence was restricted to floating populations or not (0.780), HIV viral load during pregnancy (0.750), the registration of maternal and childbirth care manuals at the place of residence was restricted to floating populations or not (0.749), and first-trimester registration or not (0.738) had a high weight. @*Conclusion @#This index system can provide the reference for evaluating the health equity of HIV-infected pregnant and lying-in women in floating populations.
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OBJECTIVES@#The Fourth Plenary Session of the 19th Central Committee of the Communist Party of China put forward the idea of "promoting the equalization of basic public services". The utilization of basic public health services by the floating population is an important indicator to measure the equalization of basic public health services. This study aims to understand the intergenerational differences in the utilization of basic public health services between the older generation and the new generation of floating population, and to analyze the influential factors.@*METHODS@#We employed the personal questionnaire (A) of the national health and family planning dynamic monitoring survey on floating population in 2017. Pearson Chi-square test, bi-grouping logistic regression, and Poisson regression were applied to analyze the basic situation of the floating population and the intergenerational differences in the use of basic public health services between the new and old generations.@*RESULTS@#The proportions of the new generation and the old generation who had established the residents' health records in the inflow area were 36.42% and 34.96%, respectively, with the significant difference (@*CONCLUSIONS@#Although the coverage of basic public health services for the two generations of floating population is obviously different, the utilization of basic public health services of the floating population is still at a low level both in the new generation and in the old generation. There is an urgent need to improve the utilization of public health services for the whole floating population according to the characteristics of generations.
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Humans , China/epidemiology , Educational Status , Health Services , Rural Population , Urban PopulationABSTRACT
Objective @#To analyze the prevalence and influencing factors of leprosy reactions in Zhejiang Province from 2010 to 2019, so as to provide reference for the control of leprosy.@*Methods@#Through the national leprosy management system, the new leprosy cases in Zhejiang Province from 2010 to 2019 were recruited to analyze the incidence of leprosy reactions in different demographic characteristics and leprosy clinical features. The multivariate logistic regression analysis was conducted to explore the influencing factors for leprosy reactions.@*Results @#Totally 191 leprosy cases were investigated. The incidence rate of leprosy reactions was 29.32%; the the incidence rate of typeⅠand type Ⅱreaction was 16.75% and 9.42%, respectively. There were 33 leprosy reaction cases (58.93%) before multidrug therapy (MDT) , 13 cases (23.21%) during 0-6 months of MDT, 5 cases (8.93%) during 7-12 months of MDT, 3 cases (5.36%) during over 12 months of MDT, and 2 cases (3.57%) after MDT. The results of the multivariate logistic analysis showed that the cases who were 35 years old or below (OR=2.245, 95%CI: 1.006-5.008) , were not floating population (OR=3.442, 95%CI: 1.394-8.494) , were infected outside family (OR=3.878, 95%CI: 1.075-13.993) and were smear positive (>0+,OR=4.514, 95%CI: 1.365-14.926; >3+,OR=4.727, 95%CI: 1.443-15.485) were risk factors for leprosy reactions.@*Conclusions@#The prevalence of leprosy reactions is high in Zhejiang Province from 2010 to 2019, and is associated with age, floating population, source of infection and BI.
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Objective@#To analyze the epidemiological characteristics of adult inpatients with gas burns in the Department of Burns of Hwa Mei Hospital of University of Chinese Academy of Sciences (hereinafter referred to as the author′s unit) , so as to provide evidence for the prevention of gas burn.@*Methods@#Medical records of all inpatients with flame burns admitted to the author′s unit from January 2011 to December 2017 were collected. The percentage of adult inpatients with gas burns in total inpatients with flame burns in the same period, and their gender, age, injury season, accident place, burn severity, common compound injury, complication, population caliber, education, industry, as well as the pre-injury disease and prognosis of elderly inpatients with gas burns were retrospectively analyzed. In addition, the age, accident place, education, and industry of the floating population in the adult inpatients with gas burns were analyzed separately and compared with the total population of adult inpatients with gas burns in 7 years. Data were processed with chi-square test or Fisher′s exact probability test (Monte Carlo algorithm).@*Results@#During the 7 years, 1 490 inpatients with flame burns were admitted to the author′s unit, among which 511 were adult inpatients with gas burns, accounting for 34.30%. The number of adult inpatients with gas burns increased gradually during the 7 years, but its percentage in the total inpatients with flame burns during the same period showed no significant difference (χ2=7.087, P>0.05). Among the 511 adult inpatients with gas burns (hereinafter referred to as the patients in this group), there were 315 males and 196 females, with a male/female ratio of 1.61 to 1.00, and the middle-aged patients were the most, up to 270 cases, accounting for 52.84%. The distribution of adult inpatients with gas burns during the 7 years was significantly different in gender and age (χ2=54.810, 27.832, P<0.01). Among the patients in this group, most were injured in summer, totally 251 cases, accounting for 49.12%, and the accident place was mainly at home, totally 388 cases, accounting for 75.93%. The distribution of adult inpatients with gas burns during the 7 years was significantly different in injury season (χ2=42.254, P<0.01), but not in accident place (χ2=6.782, P>0.05). The patients in this group were mainly with moderate burns (237 cases, accounting for 46.38%), and the distribution trend of burn severity of adult inpatients with gas burns was basically the same during the 7 years (χ2=19.680, P>0.05); 176 patients (34.44%) were accompanied by inhalation injury, and 30 patients (5.87%) were accompanied by blast injury of lung; post injury complications occurred in 20 patients (3.91%). In the elderly inpatients with gas burns, 44.44% (32/72) were accompanied by pre-injury basic diseases, and the proportion of death or unhealed reached 18.06% (13/72). Most of the patients in this group were permanent residents (358 cases, accounting for 70.06%) and received secondary education (304 cases, accounting for 59.49%), and the majority of them were engaged in manufacturing/construction (138 cases, accounting for 27.01%), self-employed business (90 cases, accounting for 17.61%), and catering (90 cases, accounting for 17.61%) industries. The distribution of adult inpatients with gas burns during the 7 years was significantly different in population caliber, education, and occupation (χ2=17.496, 29.898, 88.896, P<0.05 or P<0.01). Among the patients of this group, the floating population were mainly young (90 cases, accounting for 58.82%) and middle-aged (62 cases, accounting for 40.52%), with main accident place at home (97 cases, accounting for 63.40%), generally received secondary education (101 cases, accounting for 66.01%), and were mainly engaged in manufacturing/construction (71 cases, accounting for 46.41%), self-employed business (26 cases, accounting for 16.99%), and catering (20 cases, accounting for 13.07%) industries. Compared with the total adult inpatients with gas burns in 7 years, the floating population were younger, more injured in the workplace, and more concentrated in industry (χ2=42.924, 9.390, 27.819, P<0.01).@*Conclusions@#Gas burn was the leading injury cause of inpatients with flame burns in the author′s unit, which mainly occurred in summer and at home; the patients were mainly male, young and middle-aged, and permanent residents, most of which were with moderate burn, often accompanied by inhalation injury. Most of the patients were of secondary education, engaged in manufacturing/construction, self-employed business, and catering industries, among which the floating population were younger, more injured in the workplace, and more concentrated in industry. In order to prevent gas burn, we should pay more attention to the propaganda and education of gas safety among young and middle-aged men, floating population, retired old people and housewives, especially in summer, we should do a good job in gas safety inspection at home. In addition, we should urge enterprises to further strengthen the supervision of production safety.
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Objective To investigate the epidemic characteristics of pulmonary tuberculosis (TB) in Minhang District of Shanghai, and to provide a scientific basis for TB prevention and control. Methods Data from active TB patients registered in Minhang District of Shanghai from 2009 to 2019 was collected and analyzed using descriptive epidemiological method. Results From 2009 to 2019 the registration rates of TB patients in Minhang district of Shanghai showed a downward trend, with an average annual registration rate of 32.35/100 000, including 3 611 (41.08%) patients who were registered permanent residents of Shanghai and 5 179 (58.92%) patients who were non-permanent residents. The ratio of men to women was 2.04:1. Workers accounted for more cases (22.77%) than other occupations among patients without registered permanent residence, while retirees accounted for the majority of cases (38.60%) among patients with registered permanent residence. Among the TB patients without registered residence, the highest proportion (45.86%) was in the 20-29 years old group, while the highest proportion in permanent residents was in the 50-59 years old group (19.47%). The peak incidence occurred in May in patients without registered permanent residence, while the peak incidence was in June in patients with registered permanent residence. Conclusion It is necessary to strengthen the prevention and control of TB in people without registered permanent residence of Shanghai, and at the same time, to strengthen the prevention and control of TB in old people and students with registered permanent residence of Shanghai.
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To investigate the mental health status of the floating population in Chengdu and explore its influencing factors. A questionnaire-based survey was conducted on non-Chengdu household workers over 16 years old in four directions(east,south,west,and north)of Chengdu from June 2017 to June 2018 to collect their social demographic characteristics and mental health status information through respondent driven sampling method.The 12-item general health questionnaire(GHQ-12) was used to assess the mental health status of the respondents,and a multivariate logistic regression model was used to analyze the influencing factors of mental health. The average score of GHQ-12 was(1.09±1.61)and the detection rate of mental problems was 7.11%.The main mental problems were anxiety and nervousness.Multivariate unconditional logistic regression analysis showed that over 55 years old(=0.425,95%=0.213-0.847),junior middle school education(=0.541,95%=0.356-0.824),length of residence ≥5 years(5-9 years:=0.603,95%=0.394-0.923;≥10 years:=0.534,95%=0.346-0.823),annual income ≥18 000 yuan(18 000-35 999 yuan:=0.524,95%=0.328-0.836;36 000-59 999 yuan:=0.327,95%=0.190-0.565;≥60 000 yuan: =0.356,95%=0.192-0.662),and a good relationship with employers(=0.519,95%=0.363-0.742)were the protective factors for the mental health.Divorce/widowhood(=2.351,95%=1.341-4.124),plan to return hometown after 5 years(=1.805,95%=1.084-3.006)and not yet consideration of leaving Chengdu(=1.844,95%=1.269-2.681)were the risk factors. The mental health of the floating population in Chengdu is generally good.However,floating individuals with poor marital status and/or poor sense of belonging to Chengdu are at higher risk of mental problems.The local government should formulate and improve the policies and measures related to social welfare and public services for the floating population and try to enhance their urban integration and sense of belonging,thus improving their mental health.
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Adolescent , Humans , Middle Aged , Cross-Sectional Studies , Health Status , Mental Health , Risk Factors , Surveys and QuestionnairesABSTRACT
Objective@#To understand medical treatment seeking behaviors and its influencing factors in employed floating population in China and provide evidence for the development of health service policies for floating population.@*Methods@#Data were from the national chronic disease and risk factor surveillance (floating population part) in 2012. Floating population were selected through multistage clustering sampling stratified by industries in 170 counties and districts from 31 provinces (autonomous regions, municipality directly under the central government) and Xinjiang Production and Construction Corps in the mainland of China. Information on demographic basic information, health status and health seeking behaviors six months before the investigation were collected through face-to-face questionnaire interview. The people aged 18-59 who had physical discomfort in the past six months was analyzed. After complex weighted analysis, multinomial logistic regression model was used to analyze the health seeking behavior and its influencing factors in the employed floating population.@*Results@#A total of 11 134 suitable people aged 18-59 years were included in the study. The number and proportion of the people seeking medical treatment, having self-treatment and having no treatment were 4 950 (44.5%), 3 880 (34.8%) and 2 304 (20.7%), respectively. Multinomial logistic regression analysis showed that women were 1.275 times (95%CI: 1.100-1.477) more likely to seek medical treatment compared with men. The medical treatment seeking rates of floating population in the eastern, central and western areas were 2.153 times (95%CI: 1.669-2.777), 2.310 times (95%CI:1.777-3.002), 2.177 times (95%CI: 1.695-2.796) higher than that of floating population in northeastern area. In terms of seeking treatment, the proportion of the floating population with annual income of more than 25 000 yuan was 1.255 times (95%CI: 1.088-1.448) higher than that of the floating population with annual income of 25 000 yuan or less than 25 000 yuan. The proportion of the floating population with severe physical discomfort within the past six months was 8.076 times (95%CI: 6.091-10.707) higher than that of the floating population without severe physical discomfort and the proportion of the floating population who participated in medical insurance in both original living places and current living places was 1.566 times (95%CI: 1.250-1.961) higher than that of the floating population who did not participate in medical insurance in two places. The incidence ratio of medical care seeking and self-treatment in new generation of floating population was 1.369 (95%CI: 1.157-1.619) and 1.240 (95%CI: 1.042-1.475) compared with old generation of floating population. Compared with the widowed/divorced/separated, the incidence ratio of medical treatment seeking and self-treatment for the married/cohabited was 1.590 (95%CI: 1.057-2.391) and 1.815 (95%CI: 1.209-2.725). The more severe physical discomfort, the higher level medical institutions they chose (P<0.05).@*Conclusions@#The treatment rate in medical institutions of employed floating population was low in China. Gender, generation of floating population, marital status, area, annual income, severity of physical discomfort in past six months and the way to participate in medical insurance were the main factors affecting the medical treatment seeking behaviors of employed floating population.
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Objective To understand the situation of Schistosoma japonicum infections in foating population and its epidemi-ological characteristics in China,so as to provide insights into the development of the surveillance strategy and interventions for schistosomiasis. Methods According to the protocol of national surveillance project,indirect hemagglutination test(IHA) was employed for serological screening of S.japonicum infections among the floating population in the national schistosomiasis surveillance sites of China from 2005 to 2014,and the sero-positives were subjected to parasitological examinations.In addition, epidemiological analyses were performed to describe the characteristics of schistosomiasis in the floating population. Re-sults A total of 11 834 floating population were monitored at the national schistosomiasis surveillance sites of China during the study period,and 11 558 persons received serological tests,with 419 sero-positives screened.Then,370 sero-positive floating populations were detected using parasitological examinations,and 25 stool positives were detected.The prevalence of S.japoni-cum infections significantly varied in time(Χ 2=15.103 7),occupations(Χ 2=115.182 7)and regions(Χ 2= 13.177 5)in the study subjects during the study period(all P<0.05).A high adjusted prevalence of S.japonicum infections was seen in the boat-men and fishermen in several provinces. Conclusions Boatmen and fishermen are at a high risk of S. japonicum infections among the floating population,and should be paid more attention to in future schistosomiasis surveillance and control activities due to their strong mobility and difficulty of monitoring.
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Objective To investigate the prevalence and co-prevalence of tobacco use,excessive alcohol use,insufficient intake of vegetable and fruit,physical inactivity,and overweight or obesity in floating population and influencing factors in China,2012.Methods Data from the 2012 China Chronic Disease Risk Factor Survey in Floating Population in China were used.In this survey,48 704 people aged 18-59 years in floating population were selected through stratified multistage clustering sampling in 170 counties and districts from 31 province (autonomous regions and municipalities) and Xinjiang Production and Construction Corps.The gender specific prevalence and co-prevalence of five risk factors were estimated,and the rank sum test was used for result comparison.Results Among the people surveyed,27.4％ had one risk factor,37.1％ had two risk factors,28.5％ had ≥3 risk factors.The prevalence or co-prevalence of risk factors were positively correlated with age (P＜0.05),income level (P＜0.05) and migration time (P＜0.05),and negatively correlated with educational level (P＜0.05).People who were males,in Han ethnic group,engaged in construction and from other provinces were more likely to have more risk factors (P＜0.05).Conclusion The prevalence and co-prevalence of tobacco use,excessive alcohol use,insufficient intake of vegetable and fruit,physical inactivity and overweight or obesity were high in floating population in China,suggesting that it is necessary to strengthen the comprehensive behavior intervention in floating population.
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Objective To investigate the prevalence and co-prevalence of tobacco use,excessive alcohol use,insufficient intake of vegetable and fruit,physical inactivity,and overweight or obesity in floating population and influencing factors in China,2012.Methods Data from the 2012 China Chronic Disease Risk Factor Survey in Floating Population in China were used.In this survey,48 704 people aged 18-59 years in floating population were selected through stratified multistage clustering sampling in 170 counties and districts from 31 province (autonomous regions and municipalities) and Xinjiang Production and Construction Corps.The gender specific prevalence and co-prevalence of five risk factors were estimated,and the rank sum test was used for result comparison.Results Among the people surveyed,27.4％ had one risk factor,37.1％ had two risk factors,28.5％ had ≥3 risk factors.The prevalence or co-prevalence of risk factors were positively correlated with age (P＜0.05),income level (P＜0.05) and migration time (P＜0.05),and negatively correlated with educational level (P＜0.05).People who were males,in Han ethnic group,engaged in construction and from other provinces were more likely to have more risk factors (P＜0.05).Conclusion The prevalence and co-prevalence of tobacco use,excessive alcohol use,insufficient intake of vegetable and fruit,physical inactivity and overweight or obesity were high in floating population in China,suggesting that it is necessary to strengthen the comprehensive behavior intervention in floating population.
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Objective To analyze the investigation data of the national schistosomiasis surveillance sites in 2015,so as to provide scientific evidences for schistosomiasis control,elimination and surveillance. Methods According to National Schisto-somiasis Surveillance Programme(version 2014),457 surveillance sites were selected,and the investigation data in residents, floating population,domestic animals and Oncomelania hupensis snails were collected and analyzed from four types of endemic counties. Results A total of 4468 seropositive cases were detected from 133350 residents,among which 4457 residents with seropositive results received the etiological tests,and 71 of them were identified with positive results. Most of them were fisher-men and farmers in the middle and old-aged group. The schistosomiasis infection rate was 0.05% in local population. Totally 977 seropositive cases were examined from 85047 migrant individuals,and 16 positive cases were found out from 966 individuals who took etiological tests,which showed the schistosomiasis infection rate was 0.02% in floating population. Imported cases were found among floating people in four provinces,namely Zhejiang,Hunan,Hubei and Anhui provinces. No acute schistoso-miasis cases were reported. A total of 13406 head of cattle received examinations and only 5 were determined as stool positives. The cattle infection rate was 0.04%. The snail survey covered an area of 22295.13 hm2 and snails were found in an area of 7426.63 hm2,including 3.47 hm2 newly detected area with snails. No schistosome-infected snails were found. Conclusions Based on the collected data from 457 national schistosomiasis surveillance sites of China,the Schistosoma japonicum infection rate is 0.05% in local population which maintains a stably descending trend. In floating population,there are imported schistosome-in-fected persons. Cattle are still a vulnerable species infected with schistosome. Although no infected snails are found,snails are widely distributed in endemic areas. Some provinces detect areas with snails for the first time or the reproduction of snails. The staff in endemic provinces should carry out the surveillance work according to National Schistosomiasis Surveillance Programme (version2014)to improve the surveillance system,and enhance the sensibility and effectiveness of surveillance work.
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Objective: To study the status and identify the determinants of outpatient service utilization of rural floating population in Beijing who have different accumulated residence time.Methods: The survey data of rural floating population health and health care services in Beijing in 2014 were used, and the migrant population aged 18 years and above were taken as the research object.Whether to use outpatient service within two weeks was taken as dependent variable, gender, age, education level, self-assessment score of socioeconomic status, accumulated residence time in Beijing, health insurance, average household income, suffering from high blood pressure or diabetes as independent variables.Logistic regression model was used to analyze the influencing factors.Results: The average age of the research object was 36.7 years, with mostly secondary education.The average accumulated residence time in Beijing was 8.4 years.The two-week prevalence rate was 10.3%, the two-week visiting rate calculated by person-time was 6.0%.The Logistic regression model suggested that, socioeconomic status, accumulated residence time and suffering from high blood pressure or diabetes were statistically significant determinants of outpatient service utilization.Conclusion: The research object is a younger and less educated population, their health status is better and outpatient service utilization is lower.It is found that people who have longer accumulated residence time in Beijing have lower outpatient service utilization.This is because people with longer residence time have lower age-adjusted two-week prevalence rate.This is also because people with longer residence time have larger proportion of taking continuous measures under doctor's advice.It does not mean people with longer residence time have lower utilization of medical service.The residence time variable plays the role of proxy variable.It can solve the problem of variables' endoge-neity.At the same time, it can reflect the influence to outpatient services utilization of some determinants,which are not included in the model but varies with residence time.
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Traffic-related pollutants have been reported to increase the morbidity of respiratory diseases. In order to apply management policies related to motor vehicles, studies of the floating population living in cities are important. The rate of metro rail transit system use by passengers residing in Seoul is about 54% of total public transportation use. Through the rate of metro use, the people-flow ratios in each administrative area were calculated. By applying a people-flow ratio based on the official census count, the floating population in 25 regions was calculated. The reduced level of deaths among the floating population in 14 regions having the roadside monitoring station was calculated as assuming a 20% reduction of mobile emission based on the policy. The hourly floating population size was calculated by applying the hourly population ratio to the regional population size as specified in the official census count. The number of people moving from 5 a.m. to next day 1 a.m. could not be precisely calculated when the population size was applied, but no issue was observed that would trigger a sizable shift in the rate of population change. The three patterns of increase, decrease, and no change of population in work hours were analyzed. When the concentration of particulate matter less than 10 μm in aerodynamic diameter was reduced by 20%, the number of excess deaths varied according to the difference of the floating population. The effective establishment of directions to manage the pollutants in cities should be carried out by considering the floating population. Although the number of people using the metro system is only an estimate, this disadvantage was supplemented by calculating inflow and outflow ratio of metro users per time in the total floating population in each region. Especially, 54% of metro usage in public transport causes high reliability in application.
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Censuses , Korea , Motor Vehicles , Particulate Matter , Population Density , Seoul , TransportationABSTRACT
Objective To understand the situation and epidemic characteristics of imported falciparum malaria in Huai'an City from 2010 to 2016,so as to provide the evidence for formulating the prevention and control strategies of imported falci-parum malaria in the city. Methods The epidemic data of imported falciparum malaria in Huai'an City from 2010 to 2016 were analyzed by using the descriptive epidemiological method. Results A total of 308 malaria cases were reported in Huai'an City from 2010 to 2016 with the average annual incidence of 0.88/105. A total of 240 imported falciparum malaria cases were report-ed,of which 18 cases(7.50%)developed into severe illness,and 2 severe patients died. The cases were reported in every coun-ty(district),and the incidence rates of Qingpu District and Huai'an District were higher than the city average level. The cases occurred every month,so there was no significant seasonal variation in the reporting time of the cases. Most of the patients were young men and aged 30-49 years. The occupational distribution revealed that the patients were mainly farmers,workers and mi-grant workers. The main source of infection was from African countries. The median interval from symptom appearing to definite diagnosis was 1 day,and the longest interval was 236 days. Twenty-nine cases were diagnosed within 24 hours,accounting for 12.08%. Conclusions The epidemic situation of imported falciparum malaria in Huai'an City is grim. In order to consolidate the achievements of malaria eradication,it is necessary to further improve the multi-sectoral cooperation mechanism,strengthen the management of floating population and take effective measures to reduce the risk of imported falciparum malaria.
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Objective To analyze the epidemiological characteristics of malaria in Hechi City,Guangxi Zhuang Autono?mous Region from 2005 to 2015,so as to provide the evidence for formulating and adjusting measures of malaria elimination. Methods The data of malaria cases in 11 counties of Hechi City from 2005 to 2015 were collected and analyzed by using Micro?soft Office Excel 2003 and SPSS 17.0. Results A total of 160 malaria cases were reported in Hechi City from 2005 to 2015, and the annual average malaria incidence was 3.6 per million. There were 10 local recurrence cases(accounting for 6.25%,10/160)and 150 imported cases(accounting for 93.75%,150/160). For the etiology,Plasmodium vivax accounted for 51.87%(83/160)in these cases,P. falciparum accounted for 34.38%(55/160),P. ovale accounted for 1.25%(2/160),P. malariae account?ed for 5.00%(8/160),and the indeterminate accounted for 7.50%(12/160). During the period of 11 years,the malaria inci?dence first dropped and then rose. There were no local cases after 2009. However,an imported falciparum malaria death case was reported in 2010,a severe imported falciparum malaria case was reported in 2013 and another in 2015. A severe case of ma?ternal?neonatal vivax malaria was reported in 2014. These cases were mainly distributed in 10 counties of Hechi City,with more young male adults who engaged in digging mining. More cases concentrated from April to August. Most of the reported malaria cases were imported,60.00%(96/160)of them returned from Africa and Southeast Asia,and 33.75%(54/160)from other do?mestic provinces. The median of the interval from symptom appearance to diagnosis was 5 d,and there was a significant differ?ence among the above years(c2=33.40,P<0.05). Conclusions Malaria is still an important public health problem in Hechi City,and the appropriate control measures and effective tools should be strengthened for malaria elimination. The key to consoli?date the achievements of malaria control is strengthening the malaria monitoring management of the floating population.
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Objective To investigate the current status of the willingness of organ donation among floating population in Guangdong Province and explore its influence factors.Methods The questionnaire survey was conducted to investigate general information of the floating population and their willingness of organ donation,knowledge of organ donation,attitude towards organ donation and death as well as the willingness of family discussion (organ donation),etc.The correlation analysis of variables and the willingness of organ donation in floating population was conducted by Spearman rank correlation,and the multivariate analysis was conducted by multiple linear regression model.Results Among the floating population,the people who were female,from city,owned an average monthly household income per capita of RMB 4 001 -5 000 yuan,got acquaintance with the organ donors or their families,got acquaintance with accepted the organ donors or their families had higher willingness of organ donation (all in P <0.05 ).Scores of the willingness of organ donation,knowledge of organ donation,attitude towards organ donation and the willingness of family discussion were 1.95 ± 0.91 ,5.02 ±2.40,92.00 ±1 6.78 and 3.98 ±1 .28 respectively.The willingness of family discussion,knowledge of organ donation and recognition of the value of organ donation showed positive correlation with the willingness of organ donation (P <0.05-0.01 ).The cause hindering organ donation and fear of death showed negative correlation with the willingness of organ donation (all in P <0.01 ).Five variables were integrated into the multiple linear regression analysis model,including willingness of family discussion,knowledge of organ donation,recognition of the value of organ donation, cause hindering organ donation and fear of death.Conclusions The willingness of organ donation among the floating population in Guangdong Province is on or below the medium level,and its influence factors include willingness of family discussion,knowledge of organ donation,recognition of the value of organ donation,cause hindering organ donation and fear of death.
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Objectives:To analyze the influencing factors and status of hospital seeking behavior among floating population by focusing on the function of health insurance , and provide evidence to comprehensively promote tiered health care system in China .Methods:Using data from 2014 National Floating Population Dynamic Monitoring Survey , multivariate logistic regressions were applied to analyze the influencing factors of hospital seeking behavior for inpatient care .Chi-square tests were used to analyze the different proportion of having basic medical insurance reimbursement and reasons for not having it for different hierarchical inpatient care , and T test were used to analyze the ratio of basic medical insurance reimbursement for hospital costs .Results:The proportion of hospitalization at the county level and below was 56.4%among floating population , the proportion of inflow patients being 51.5%and the rest of the hospital population being counted at a proportion of 37.9%, lower than the corresponding proportion of 72.6%among local res-idents derived from the Fifth National Health Services Survey , but this ratio was 78.9%among registered population . The multivariate logistic regression results indicated that demographic , socio-economic and flow characteristics , hospital location and reasons for hospitalization have significantly affected the migrant inpatients facilities , but health insurance did not significantly influence the hospital seeking behaviors among floating population .Conclusions:The proportion of hospitalization at the county level and below was low among migrants and this proportion presented great regional differ -ences;and medical insurance didn't play a guiding role in the diversion of the internal floating population .
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Objective:To study the effects of basic medical insurance ecdemic settlement policy on health services utilization.Methods:Based on data from China Health and Retirement Longitudinal Survey conducted in 2011 and 2013, a multivariate logistic regression analysis was used to compare the effect of basic health insurance registering site on health services utilization before and after the implementation of basic medical insurance ecdemic settlement policy .Results:Af-ter the basic medical insurance ecdemic settlement policy was carried out , health services utilization was improved .Con-clusions:The basic medical insurance ecdemic settlement policy can effectively improve the portability of health insur-ances, reducing the crowd remote medical disorders of off-site medical services to improve health care accessibility .