ABSTRACT
Objective To understand the late detection of new HIV/AIDS cases in Changshu City from 2015 to 2019， and to provide scientific basis for AIDS prevention and control. Methods The newly reported HIV/AIDS cases in Changshu City from 2015 to 2019 were collected through the “information system for integrated prevention and treatment of AIDS”. According to the criteria for late detection of HIV/AIDS， the influencing factors of late detection of HIV/AIDS were verified and the relevant epidemiological analysis was carried out. Results A total of 423 cases of HIV/AIDS were reported in Changshu City from 2015 to 2019， and the average incidence rate was 4.33/105. The overall incidence rate did not show a downward trend （χ2trend=3.543， P=0.060）. The incidence rate of males （7.35/105） was higher than that of females （0.93/105）. The trend of incidence rate in males was significantly decreased （χ2trend=6.264， P=0.012）， but it did not have a significant change in females （χ2trend=1.717， P=0.190）. The average annual HIV/AIDS late detection rate was 23.88% （101/423）， with the highest in 2015 （33.68%） and the lowest in 2017 （12.94%）.It showed a valley distribution pattern with first decline and then rise. The difference in HIV/AIDS late detection rate in recent five years was statistically significant （χ2=17.087， P=0.002）. At the end of the report， the proportion of male patients （89.11%） was higher than that of females （10.89%）， and nearly half （46.53%） of the patients were in elderly group aged 50 years old （46.53%）. Patients with local registered residence （58.42%） had higher late detection rate than those with foreign household registration （41.58）. Most the patients were junior high school educated （36.63%）， followed by primary school （26.73%） and senior high school （21.78%）. 68.32% of the patients were married and had a spouse. The top three occupations in patients were farmers （24.75%）， workers （24.75%） and business services （22.77%）， and the other occupations accounted for less than 10%. Most of the HIV positive samples were from other diseases （36.63%）， followed by testing consultation （29.70%） and preoperative testing （16.83%）. 77.23% of the late detection patients had no history of sexual diseases. Late detection in homosexuals （57.43%） were higher than that in heterosexuals （42.57%）. Conclusion The late detection rate of HIV/AIDS in Changshu City in recent five years showed a downward trend and then an upward trend. In the future， we should focus on the elderly， MSM， young students and other high-risk groups of HIV infection， strengthen health education and publicity， expand the scope of HIV testing， improve the ability of early detection， and effectively reduce the risk of HIV transmission.
ABSTRACT
ObjectiveTo investigate the late detection of HIV/AIDS cases in the elderly in Jilin Province and analyze its influencing factors， to provide theoretical basis for improving their life quality. MethodsThe first CD4 values of HIV/AIDS patients aged 50 years and above living in Jilin Province were used to estimate late detection， and the influencing factors of late detection in elderly cases were analyzed. ResultsThe average CD4 cell count of newly reported HIV/AIDS cases aged 50 and above in Jilin Province from 1996 to 2021 was （230.55±191.97）， the low value group accounted for the largest proportion （50.8%）， and the late detection rate was 59.3% （1397/2325）. The late detection cases were mainly from sexual transmission （46.8% for same-sex and 48.2% for heterosexual contact）. From the perspective of sample sources， most of the late detection patients were diagnosed while testing for other illnesses， followed by testing and consulting. In terms of contact history， the late detection of cases of men who have sex with men was higher. The binary logistic regression analysis showed that gender， marriage， sample source and report year were the factors affecting the late detection of AIDS. The late detection rate of males was higher， and cases of married couples were more likely to be late detection. With the increase of report year， the late detection rate decreased， and testing and counseling could effectively reduce the late detection rate of AIDS. ConclusionThe CD4 cell count in the first detection of HIV/AIDS in the elderly in Jilin Province is low， and the late detection rate of male cases is high. In recent years， the expansion of voluntary counseling and testing in Jilin Province has effectively reduced the late detection rate of HIV/AIDS. At the same time， sex education should be strengthened for the elderly， healthy marital relationships should be advocated and more attention should be paid to the mental health of the elderly.
ABSTRACT
Background & objectives: Asymptomatic bacteriuria during pregnancy if left untreated, may lead to acute pyelonephritis, preterm labour, low birth weight foetus, etc. Adequate and early treatment reduces the incidence of these obstetric complications. The present study was done to determine presence of asymptomatic bacteriuria (ASB) and obstetric outcome following treatment in early versus late pregnancy. Methods: A prospective cohort study was conducted at a tertiary care teaching hospital of north India. Pregnant women till 20 wk (n=371) and between 32 to 34 wk gestation (n=274) having no urinary complaints were included. Their mid stream urine sample was sent for culture and sensitivity. Women having > 105 colony forming units/ml of single organism were diagnosed positive for ASB and treated. They were followed till delivery for obstetric outcome. Relative risk with 95% confidence interval was used to describe association between ASB and outcome of interest. Results: ASB was found in 17 per cent pregnant women till 20 wk and in 16 per cent between 32 to 34 wk gestation. Increased incidence of preeclamptic toxaemia (PET) [RR 3.79, 95% CI 1.80-7.97], preterm premature rupture of membrane (PPROM)[RR 3.63, 45% CI 1.63-8.07], preterm labour (PTL) [RR 3.27, 95% CI 1.38-7.72], intrauterine growth restriction (IUGR)[RR 3.79, 95% CI 1.80-79], low birth weight (LBW) [RR1.37, 95% CI 0.71-2.61] was seen in late detected women (32-34 wk) as compared to ASB negative women, whereas no significant difference was seen in early detected women (till 20 wk) as compared to ASB negative women. Interpretation & conclusions: Early detection and treatment of ASB during pregnancy prevents complications like PET, IUGR, PTL, PPROM and LBW. Therefore, screening and treatment of ASB may be incorporated as routine antenatal care for safe motherhood and healthy newborn.