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In prospective cohort study, multi follow up is often necessary for study subjects, and the observed values are correlated with each other, usually resulting in time-dependent confounding. In this case, the data generally do not meet the application conditions of traditional multivariate regression analysis. Sequential conditional mean model (SCMM) is a new approach that can deal with time-dependent confounding. This paper mainly summarizes the basic theory, steps and characteristics of SCMM.
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Mediation analysis is mainly used to explore the causal mechanism between independent variable X and dependent variable Y. It determines whether mediator M plays a role and evaluate the role’s degree in the causal path by decomposing the causal path between the independent variable X and the dependent variable Y. However, the classical mediation analysis is generally used for single mediator. This paper introduces a new mediation analysis method for multiple mediators.
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At present, traditional methods on statistics have limitations in controlling time- varying confounding. This paper introduces an analysis method, parametric g-formula, which would adjust time-varying confounding, and also exemplifies the steps of its implementation for purpose to provide a new reference for researchers to deal with long-term observational data.
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In the studies of modem epidemiology,exposure in a short term cannot fully elaborate the mechanism of the development of diseases or health-related events.Thus,lights have been shed on to life course epidemiology,which studies the exposures in early life time and their effects related to the development of chronic diseases.When exploring the mechanism leading from one exposure to an outcome and its effects through other factors,due to the existence of time-variant effects,conventional statistic methods could not meet the needs of etiological analysis in life course epidemiology.This paper summarizes the dynamic path analysis model,including the model structure and significance,and its application in life course epidemiology.Meanwhile,the procedure of data processing and etiology analyzing were introduced.In conclusion,dynamic path analysis is a useful tool which can be used to better elucidate the mechanisms that underlie the etiology of chronic diseases.
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In the studies of modem epidemiology,exposure in a short term cannot fully elaborate the mechanism of the development of diseases or health-related events.Thus,lights have been shed on to life course epidemiology,which studies the exposures in early life time and their effects related to the development of chronic diseases.When exploring the mechanism leading from one exposure to an outcome and its effects through other factors,due to the existence of time-variant effects,conventional statistic methods could not meet the needs of etiological analysis in life course epidemiology.This paper summarizes the dynamic path analysis model,including the model structure and significance,and its application in life course epidemiology.Meanwhile,the procedure of data processing and etiology analyzing were introduced.In conclusion,dynamic path analysis is a useful tool which can be used to better elucidate the mechanisms that underlie the etiology of chronic diseases.
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Basal metabolic rate (BMR) is of great significance to the setting of daily energy requirements and the scientific diet guidance for the population. There are 3 kinds of measurement methods for BMR, including the direct calorimetry, the indirect calorimetry, and the equation estimation. The direct calorimetry method is difficult to implement and is only used in some special populations. The indirect calorimetry and the equation estimation are two methods that are currently used commonly. The indirect calorimetry is highly accurate and suitable for individual for basal metabolic measurement or datum collection via equation estimation. The equation estimation is simple and convenient, which is suitable for large samples.
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Humanos , Metabolismo Basal , Fisiología , Investigación Biomédica , Calorimetría Indirecta , Metabolismo EnergéticoRESUMEN
Objective To understand the current distribution and characteristics of advanced schistosomiasis patients who accepted medical assistance in Hunan Province in 2015,so as to provide the evidence for perfecting the policy and measures of the medical assistance to advanced schistosomiasis patients. Methods The patients who had been diagnosed as advanced schis-tosomiasis were verified and confirmed according to the standard of the medical assistance to advanced schistosomiasis patients in Hunan Province in 2015. The epidemiological survey was conducted to investigate the demographic characteristics,history of diagnosis and treatment,and medical assistance to these persons. Results There were 3850 advanced schistosomiasis patients who accepted the medical assistance in Hunan Province in 2015,and among them,2664 patients were male(69.19%),and 1186 were female(30.81%). Most of them(92.82%)came from the main schistosomiasis endemic areas,such as Yueyang, Changde and Yiyang. There were 2369 cases of ascites(61.53%),1466 cases of splenomegaly(38.08%),15 cases of colon proliferation and dwarf(0.39%). The mean age of advanced schistosomiasis patients who accepted the medical assistance was (62.94 ± 11.67)years old,with 64.31% of them being more than 60 years old. The age of initial diagnosis of advanced schistoso-miasis was(53.85 ± 21.32)years old,and it was concentrated in 40-60 years old(68.57%). The mean duration of advanced schistosomiasis was(9.58 ± 10.06)years,and it was mainly distributed in 10 years(75.95%). The mean duration from initial diagnosis of schistosomiasis to advanced schistosomiasis was(22.33 ± 14.20)years. The priority of the medical assistance to ad-vanced schistosomiasis patients was given to the county hospitals(76.57%);and the effective rate of assistance was 94.46%. To-tally 86.57% of the patients with advanced schistosomiasis got the medical insurance(rural cooperative medical care,urban medical care,etc.). Conclusions The burden of the medical assistance to advanced schistosomiasis patients is still heavy be-cause of many patients and low cure rate in Hunan Province. The ascites patients and high age patients should be the important objects of the medical assistance.
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Objective:To explore the prognosis of posttraumatic stress disorder (PTSD) in flood survivors 13 years after they had been diagnosed with PTSD symptoms,and investigate the relationship between their personality traits and the prognosis of PTSD.Method:In this cross-sectional study,the survivors of Dongting Lake flood in 1998-1999 in Hunan in China,who were investigated and screened as PTSD symptoms positive in 2000 were selected as the target population,from which a sample of 200subjects was drawn using amulti-stage random sampling method.The Posttraumatic Stress Disorder Scale Civilian Version (PCL-C) was used to examine and re-screen the participants of PTSD symptoms in order to explore the prognosis of PTSD.Participants whose PCL-C scores were equal to 44 or higher were classified as the PTSD symptoms positive group,while those with PCL-C scores less than 44 were classified as the recovered group.Personality traits were then assessed,using the Revised Eysenck Personality Questionnaire Short Scale for Chinese (EPQ-RSC),in both the recovered group and the PTSD symptoms positive group.Finally,the multivariate logistic regression analysis was used to investigate the relationship between the prognosis of PTSD and personality traits.Results:Totally 200 subjects were eligible for this study and completed the questionnaires,but 16 of them had their questionnaires excluded from data analysis because they provided incomplete information.Thus,the response rate was 92.0％.According to the PCL-C's cut-off score,22 participants were still screened as PTSD symptoms positive and were classified as the PTSD symptoms positive group,whereas the other 162 participants were screened as PTSD symptoms negative and were classified as the recovered group.Compared with the recovered group,the EPQ-RSC extroversion scores for the PTSD symptoms positive group were significantly lower [(51.8 ± 10.7) vs.(45.1 ± 13.2),P ＜ 0.05] and their neuroticism scores were significantly higher [(46.5 ± 10.1) vs.(58.3 ± 12.2),P ＜ 0.05].The multivariate logistic regression analysis showed,after adjusting for the variables such as gender and age,that higher neuroticism (OR ＝ 3.63,95％ CI:1.05 -12.54) was a risk factor for the persistent PTSD symptoms in the flood survivors.Conclusions:It suggests that neuroticism is associated with prognosis of PTSD in flood survivors,those with higher neuroticism scores appear to have problems to recover from PTSD.
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Objective Less surveys on the economic burden of hepatitis B (HB)-related diseases have been conducted in China,so the socioeconomic harm caused by the diseases is not clear and the key parameters for economic evaluation of hepatitis B prevention and treatment are lacking.This study aimed to analyze the direct,indirect and intangible expenditures of hospitalized patients with HB-related diseases during hospitalization and during a year in different areas of China.Methods The hospitals for infectious diseases and the large general hospitals in 12 areas in China were selected in the study.All the inpatients with HB-related diseases were surveyed by cluster sampling of consecutive cases.The direct expenditure included direct medical cost and direct non-medical cost.The indirect expenditure,including work loss of patients and caregivers,were calculated by using human capital method for urban and rural populations in 12 areas.The intangible expenditure were reflected by willing to pay and stochastic tournament.The influencing factors of direct and indirect costs were identified by stepwise linear multi-variation regression analysis.Results A total of 27 hospitals in 12 areas were included in the survey.A total of 4 718 cases were surveyed,the overall response rate was 77.7％.The average hospital stay was 29.2 days (27-34) and the hospitalization expenditure was averagely 16 832.80 yuan (RMB) per case,in which the highest proportion (61.2％)was medicine fees [10 365.10 yuan (RMB)].The average direct expenditure and indirect expenditure were consistent with the severity of illness,which were 18 336.10 yuan (RMB) and 4 759.60 yuan (RMB) respectively,with the ratio of 3.85:1.The direct medical expenditure [17 434.70 yuan (RMB)] were substantially higher than the direct non-medical expenditure [901.40 yuan (RMB)].It was found that the hospitalization expenses was highest in direct medical expenditure and the transportation expenses was highest in direct non-medical expenditures.Among the average indirect expenditure,the loss of income for the patients [3 832.50 yuan (RMB)] was higher than that for the caregivers [927.20 yuan (RMB)],The total direct and indirect expenditure was highest for liver transplantation,followed by severe hepatitis,hepatocellular carcinoma and decompensated cirrhosis,acute hepatitis B,compensated cirrhosis and chronic hepatitis B.The influencing factors for both direct and indirect expenditure were high hospital level,severity of hepatitis B,living in urban area,antiviral therapy,long hospitalization and monthly income of family.For average 3.74 outpatient visits and 1.51 hospitalization,the average annual direct,indirect and intangible expenditure for HB-related diseases were 30 135.30,6 253.80 and 44 729.90 yuan (RMB) [totally 81 119.00 yuan (RMB)],accounting for 37.3％,7.7％ and 55.0％,respectively.Of the annual direct medical expenditure [28 402.80 yuan (RMB)],which were much higher than non-medical expenditure [1 732.50 yuan (RMB)],hospitalization expenditure [26 074.20 yuan (RMB)] was higher than outpatient visit expenditure [4 061.10 yuan (RMB)].The annual indirect expenditures for outpatient visit and hospitalization were 763.60 and 5 490.10 yuan (RMB),respectively.Of the annual intangible expenditure,the highest was that for/primary hepatocellular carcinoma,followed by cirrhosis,chronic hepatitis B,severe hepatitis B,liver transplantation and acute hepatitis B.Conclusions A heavy economic burden has been caused by HB-related diseases in China,and patients are more likely to rely on medical service rather than non-medical service.It is necessary to take effective treatment measures to prevent the adverse outcome of HB related diseases and achieve significant economic benefits.The influence of HB related diseases on mental health of the people can be reflected by an economics term,intangible expenditure.
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Objective To analyze the prevalence of schistosomiasis in Hunan province,and provide scientific evidence for the control and elimination of schistosomiasis.Methods The changes of infection rates ofSchistosoma (S.)japonicum among residents and cattle in Hunan from 1984 to 2015 were analyzed by using dynamic trend diagram;and the time regression model was used to fit the infection rates of S.japonicum,and predict the recent infection rate.Results The overall infection rates of S.japonicum in Hunan from 1984 to 2015 showed downward trend (95.29％ in residents and 95.16％ in cattle).By using the linear regression model,the actual values of infection rates in residents and cattle were all in the 95％ confidence intervals of the value predicted;and the prediction showed that the infection rates in the residents and cattle would continue to decrease from 2016 to 2020.Conclusion The prevalence of schistosomiasis was in decline in Hunan.The regression model has a good effect in the short-term prediction of schistosomiasis prevalence.
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Objective Less surveys on the economic burden of hepatitis B (HB)-related diseases have been conducted in China,so the socioeconomic harm caused by the diseases is not clear and the key parameters for economic evaluation of hepatitis B prevention and treatment are lacking.This study aimed to analyze the direct,indirect and intangible expenditures of hospitalized patients with HB-related diseases during hospitalization and during a year in different areas of China.Methods The hospitals for infectious diseases and the large general hospitals in 12 areas in China were selected in the study.All the inpatients with HB-related diseases were surveyed by cluster sampling of consecutive cases.The direct expenditure included direct medical cost and direct non-medical cost.The indirect expenditure,including work loss of patients and caregivers,were calculated by using human capital method for urban and rural populations in 12 areas.The intangible expenditure were reflected by willing to pay and stochastic tournament.The influencing factors of direct and indirect costs were identified by stepwise linear multi-variation regression analysis.Results A total of 27 hospitals in 12 areas were included in the survey.A total of 4 718 cases were surveyed,the overall response rate was 77.7％.The average hospital stay was 29.2 days (27-34) and the hospitalization expenditure was averagely 16 832.80 yuan (RMB) per case,in which the highest proportion (61.2％)was medicine fees [10 365.10 yuan (RMB)].The average direct expenditure and indirect expenditure were consistent with the severity of illness,which were 18 336.10 yuan (RMB) and 4 759.60 yuan (RMB) respectively,with the ratio of 3.85:1.The direct medical expenditure [17 434.70 yuan (RMB)] were substantially higher than the direct non-medical expenditure [901.40 yuan (RMB)].It was found that the hospitalization expenses was highest in direct medical expenditure and the transportation expenses was highest in direct non-medical expenditures.Among the average indirect expenditure,the loss of income for the patients [3 832.50 yuan (RMB)] was higher than that for the caregivers [927.20 yuan (RMB)],The total direct and indirect expenditure was highest for liver transplantation,followed by severe hepatitis,hepatocellular carcinoma and decompensated cirrhosis,acute hepatitis B,compensated cirrhosis and chronic hepatitis B.The influencing factors for both direct and indirect expenditure were high hospital level,severity of hepatitis B,living in urban area,antiviral therapy,long hospitalization and monthly income of family.For average 3.74 outpatient visits and 1.51 hospitalization,the average annual direct,indirect and intangible expenditure for HB-related diseases were 30 135.30,6 253.80 and 44 729.90 yuan (RMB) [totally 81 119.00 yuan (RMB)],accounting for 37.3％,7.7％ and 55.0％,respectively.Of the annual direct medical expenditure [28 402.80 yuan (RMB)],which were much higher than non-medical expenditure [1 732.50 yuan (RMB)],hospitalization expenditure [26 074.20 yuan (RMB)] was higher than outpatient visit expenditure [4 061.10 yuan (RMB)].The annual indirect expenditures for outpatient visit and hospitalization were 763.60 and 5 490.10 yuan (RMB),respectively.Of the annual intangible expenditure,the highest was that for/primary hepatocellular carcinoma,followed by cirrhosis,chronic hepatitis B,severe hepatitis B,liver transplantation and acute hepatitis B.Conclusions A heavy economic burden has been caused by HB-related diseases in China,and patients are more likely to rely on medical service rather than non-medical service.It is necessary to take effective treatment measures to prevent the adverse outcome of HB related diseases and achieve significant economic benefits.The influence of HB related diseases on mental health of the people can be reflected by an economics term,intangible expenditure.
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Objective To analyze the prevalence of schistosomiasis in Hunan province,and provide scientific evidence for the control and elimination of schistosomiasis.Methods The changes of infection rates ofSchistosoma (S.)japonicum among residents and cattle in Hunan from 1984 to 2015 were analyzed by using dynamic trend diagram;and the time regression model was used to fit the infection rates of S.japonicum,and predict the recent infection rate.Results The overall infection rates of S.japonicum in Hunan from 1984 to 2015 showed downward trend (95.29％ in residents and 95.16％ in cattle).By using the linear regression model,the actual values of infection rates in residents and cattle were all in the 95％ confidence intervals of the value predicted;and the prediction showed that the infection rates in the residents and cattle would continue to decrease from 2016 to 2020.Conclusion The prevalence of schistosomiasis was in decline in Hunan.The regression model has a good effect in the short-term prediction of schistosomiasis prevalence.
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Objective To explore the long-term prognosis and influence of social support and coping style of patients with post-traumatic stress disorder (PTSD) after suffering from floods.Methods Patients suffered PTSD due to Dongting lake flood in 1998 were selected through cluster random sampling.PTSD scale civilian version (PCL-C) was used to examine and diagnose the participants in this study.PTSD was then evaluated by the social support rating scale (SSRS) and the simple coping style questionnaire (SCSQ).Results Among all the 120 subjects,14(11.67％) of them were diagnosed as having PTSD.Compared with the rehabilitation group,scores on subjective support,objective support,total social support and positive coping,total of coping style from the nonrehabilitation group all appeared significant low (P＜0.05).Data from the multivariate logistic regression showed that social support (OR=0.281,95％CI:0.117-0.678) and coping style (OR=0.293,95％ CI:0.128-0.672) were protective factors of the chronic PTSD after the floods while disaster experience (OR=1.626,95％CI:1.118-2.365) appeared as a risk factor.Conclusion Chronic PTSD developed after the floods called for attention.Better social support,positive coping style could significantly improve the long-term prognosis of patients with PTSD after the floods.
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Objective To explore the long-term prognosis and influence of social support and coping style of patients with post-traumatic stress disorder (PTSD) after suffering from floods.Methods Patients suffered PTSD due to Dongting lake flood in 1998 were selected through cluster random sampling.PTSD scale civilian version (PCL-C) was used to examine and diagnose the participants in this study.PTSD was then evaluated by the social support rating scale (SSRS) and the simple coping style questionnaire (SCSQ).Results Among all the 120 subjects,14(11.67％) of them were diagnosed as having PTSD.Compared with the rehabilitation group,scores on subjective support,objective support,total social support and positive coping,total of coping style from the nonrehabilitation group all appeared significant low (P＜0.05).Data from the multivariate logistic regression showed that social support (OR=0.281,95％CI:0.117-0.678) and coping style (OR=0.293,95％ CI:0.128-0.672) were protective factors of the chronic PTSD after the floods while disaster experience (OR=1.626,95％CI:1.118-2.365) appeared as a risk factor.Conclusion Chronic PTSD developed after the floods called for attention.Better social support,positive coping style could significantly improve the long-term prognosis of patients with PTSD after the floods.
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OBJECTIVE@#To understand the associated factors on human immunodeficiency virus (HIV) transmission via heterosexual contact and to provide evidence for decision-maker for prevention of HIV. @*METHODS@#Questionnaire survey was conducted in 250 HIV-positive persons to understand their socio-demographic characteristics and sexual behavior. Meanwhile, 431 persons who had heterosexual contact with the HIV carriers were traced to their HIV infection status. The factors associated with continued HIV transmission were reviewed by case-control analysis. @*RESULTS@#Among the 432 persons, 59 were HIV-positive because of heterosexual contact. The secondary attack rate and the growth rate was 13.7% (59/431) and 0.236 (59/250), respectively. The factors associated with the spread of HIV included: the degree of knowledge on HIV/AIDS, psychological reflection after infection, the condition for condom usage among spouses, and regular sexual partners or non regular sexual partners. @*CONCLUSION@#The secondary attack rate and the growth rate of HIV transmission by heterosexual contact are high. Improvement of the knowledge about HIV/AIDS prevention and control, enhancement of psychological education and promotion of condom usage can reduce the risk for continued HIV transmission.
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Humanos , Infecciones por VIH , Heterosexualidad , Incidencia , Factores de Riesgo , Sexo Seguro , Conducta Sexual , Parejas Sexuales , Encuestas y CuestionariosRESUMEN
OBJECTIVE@#To analyze the sexual behavior characteristics of the sexually transmitted HIV-positive people and to estimate the secondary transmission rate. @*METHODS@#Field investigation and literature review were conducted among sexually transmitted HIV-positive people to collect general information during the last 6 months before notification of HIV infection. A mathematical model was used to estimate the secondary transmission rate. @*RESULTS@#A total of 769 HIV-positive people were recruited for the study, 186 of them were women, 286 were men who have sex with women (MSW), 242 were men who have sex with men (MSM) and 55 were men who have sex with men and women (MSMW). During 6 months, the average sex partner among these 4 groups were 2.29, 1.61, 3.32 and 4.10, respectively; the sexual behavior frequency were 26.03, 20.97, 14.77 and 25.51, respectively; the rates of non-use of condom were 74.14%, 73.53%, 59.60% and 72.06%, respectively; the secondary transmission rate were 0.0095, 0.0151, 0.1759 and 0.1985, respectively. Under constant conditions of other factors, the secondary transmission rates decreased by 30.13%-82.00%, 23.00%-49.51%, and 16.10%-19.09%, respectively, if there was a reduction in 1 sex partner, 1 time/month for the sexual frequency and 20% of rate for non-use of condom. @*CONCLUSION@#The HIV secondary transmission from MSMW HIV-positive people to general population was the highest. Change in sexual behavior of the HIV-positive people can decrease the HIV secondary transmission rate significantly.
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Femenino , Humanos , Masculino , Infecciones por VIH , Modelos Teóricos , Conducta Sexual , Parejas SexualesRESUMEN
OBJECTIVE@#To investigate the epidemiological situation and temporal-spatial clustering changes of hand-foot-mouth disease (HFMD) in Hunan. @*METHODS@#Spatial autocorrelation and temporal-spatial clustering analysis were used to analyze the HFMD in Hunan. @*RESULTS@#The incidence rates of HFMD ranged from 54.31/10 million to 318.06/10 million between 2009 and 2015 in Hunan. Cases mainly displayed in 5-year-old or even younger children and there were two epidemic periods each year. HFMD cases did not show a random distribution but with significant spatial aggregation. When local autocorrelation analysis was applied at the county/district level, 4 hot spots in Changsha, Yiyang, Loudi and Zhuzhou were discovered. The tendency for temporal and spatial clustering existed among HFMD cases in Hunan. The temporal dimension of HFMD was from April to July annually. Clustering areas gathered in the northern regions in 2009 and in the middle regions from 2010 to 2012. They moved to middle-southern regions in 2013 or 2014 and middle-western regions in 2015. @*CONCLUSION@#The HFMD incidence from 2009 to 2015 in Hunan showed temporal and spatial clustering tendency, with the shifting trend of clustered areas toward south and west.
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Humanos , Análisis por Conglomerados , Enfermedad de Boca, Mano y Pie , IncidenciaRESUMEN
<p><b>OBJECTIVE</b>To investigate the intrauterine growth retardation (IUGR) and its determinants so as to provide evidence for maternal and child health care programs to be carried out.</p><p><b>METHODS</b>Fourteen townships were selected by cluster random sampling from 37 townships in Liuyang. A total of 6 105 pregnant women who had established their health care programs during April 2008 and March 2011, were recruited in this study. Records on pregnancy care manual and delivery were collected. 6 105 single live births were divided into two groups (IUGR group and control group). Those whose birth weight was below the 10th percentile for mean weight corrected for gestation age were grouped as IUGR group. Chi-square test and Multivariate logistic Regression method were used to estimate the determinants of IUGR.</p><p><b>RESULTS</b>A total of 6 105 women, pregnant with a singleton gestation were enrolled in the study: 528 of these pregnancies were complicated with IUGR (8.65%). Data from the multivariate logistic regression analysis showed that maternal age less than 25 (OR = 1.268), prim parity (OR = 1.706), BMI less than 18.5 kg/m² at first obstetrical examination (OR = 1.709), deficiency in weight gain during pregnancy (OR = 1.576) and pregnancy-induced hypertension syndrome (OR = 1.698) were related risk factors to intrauterine growth retardation.</p><p><b>CONCLUSION</b>Maternal age, prim parity, BMI, weight gain during pregnancy and pregnancy-induced hypertension syndrome were factors associated to the intrauterine growth retardation. Effective measures in reducing the intrauterine growth retardation should include factors as monitoring maternal weight and the change of weight during pregnancy in order to maintain the weight at normal ranges. Prevention and therapy for pregnancy-induced hypertension syndrome, should also be strengthened.</p>
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Femenino , Humanos , Embarazo , Peso al Nacer , Peso Corporal , Retardo del Crecimiento Fetal , Hipertensión Inducida en el Embarazo , Edad Materna , Paridad , Mujeres Embarazadas , Factores de Riesgo , Aumento de PesoRESUMEN
<p><b>OBJECTIVE</b>To understand the risks and associated factors of HIV transmission by sharing syringes among HIV-positive drug users.</p><p><b>METHOD</b>The survey was conducted among HIV-positive injecting drug users (IDUs-HIV+) who received HIV counseling, testing and treatment in Changsha city Infectious Disease Hospital and Hengyang city No.3 People's Hospital from July 2012 to May 2013 to understand their socio-demographic characteristics, HIV prevalence and syringe sharing. A total of 503 IDUs-HIV+ were involved in and provided the contact list of 2 460 drug users who had the syringe sharing experience over one month with IDUs-HIV+. 420 IDUs-HIV+ among 503 were defined as infection sources due to sharing syringe with at least one drug user. Among them, 234 HIV-negative persons were in control group, and 186 HIV-positive were in cased group. A total of 1 220 drug users were followed up among 2 460 and defined as vulnerable population. The HIV transmission rate was calculated based on the HIV prevalence among vulnerable population. Based on the result of HIV transmission to vulnerable population from 420 infection sources, case-control study and the multivariate logistic regression analysis were adopted to explore the associated factors of HIV transmission among IDUs-HIV+.</p><p><b>RESULTS</b>As the sources of HIV transmission, 420 IDUs-HIV+ had an average duration of (4.5 ± 1.2) years for drug use. As a susceptible population, 1 220 drug users sharing syringes with the 420 IDUs-HIV+ had an average duration of (1.1 ± 0.5) years for drug use. There were 238 HIV-positive persons among 1 220 vulnerable drug users, with a transmission rate of 0.57. In the case-control study, the proportion of male subjects was 87.1% (162/186) in the case group, which was higher than that in the control group (77.8%, 182/234). The proportion of subjects who received support after knowing their HIV infection status was 51.1% (95/186) in the case group, which was lower than that in the control group (79.5%, 186/234). The proportion of subjects sharing syringes every time of using drugs was 47.8% (89/186) in the case group, which was higher than that in the control group (36.8%, 86/234). The proportion of subjects having AIDS awareness was 21.0% (39/186) in the case group, which was lower than that in the control group (64.5%, 151/234); the proportion of subjects having close contact with HIV-positive persons for more than 106 days was 60.2% (112/186) in the case group, which was higher than that in the control group (31.6%, 74/234). The proportion of subjects maintaining the original drug use method after being infected with HIV was 50.5% (94/186) in the case group, which was higher than that in the control group (16.7%, 39/234) (all P values < 0.05). The multivariate logistic regression analysis was carried out to analyse high correlate factors of HIV transmission by sources of transmission, and the AIDS awareness, duration of contact between sources of transmission and vulnerable population, access to support following confirmed HIV infection were protective factors, OR (95% CI) values were 0.155 (0.104-0.262), 0.170 (0.106-0.253), and 0.306 (0.189-0.450), respectively; while the frequency of syringe sharing and continuous drug use after being infected with HIV were risk factors, and the OR (95% CI) values were 3.06 (1.77-5.29), and 3.54 (2.16-5.80), respectively.</p><p><b>CONCLUSION</b>HIV transmission by IDUs-HIV+ might be contained by raising AIDS awareness, providing comprehensive psychological support, conducting needle exchange and methadone maintenance treatment and reducing syringe sharing.</p>
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Anciano , Humanos , Masculino , Estudios de Casos y Controles , Consumidores de Drogas , Infecciones por VIH , Metadona , Compartición de Agujas , Prevalencia , Factores de Riesgo , Abuso de Sustancias por Vía IntravenosaRESUMEN
OBJECTIVE@#To study the effect of underground work on cardiovascular system health in coal miners. @*METHODS@#Male coal miners, who received electrocardiographic examinations between June, 2013 and August, 2014 in Hunan Prevention and Treatment Institute for Occupational Diseases to exclude pneumoconiosis, were enrolled for this study (n=3 134). Miners with 2 years or more underground work experience were selected as the exposed group (n=2 370), while miners without underground work experience were selected as the control group (n=764). The prevalence of electrocardiographic abnormalities and the influential factors were compared between the 2 groups. @*RESULTS@#The prevalences of electrocardiographic abnormalities, hypertension, heart rate abnormalities and cardiovascular system abnormalities in the exposed group vs the control group were 37.6% vs 25.4%, 20.5% vs 13.4%, 5.7% vs 6.0%, 49.8% vs 35.2%, respectively. The cardiovascular system abnormalities were correlated with the underground work (OR=3.128, 95% CI: 1.969-4.970), the underground work experience (OR=1.205, 95% CI: 1.070-1.358) and the type of works (mining worker OR=1.820, 95% CI: 1.527-2.169; auxiliary worker OR=1.937, 95% CI: 1.511-2.482; other worker OR=3.291, 95%CI: 2.120-5.109). @*CONCLUSION@#Underground work may increase the prevalence of cardiovascular system abnormalities for coal miners. The longer the coal miners work in underground, the higher the risk of the cardiovascular system abnormalities they are.