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Objective:To analyze the prevalence of malnutrition among human immunodeficiency virus-exposed uninfected (HEU) children and to identify the associated factors in Hunan Province.Methods:All children born to human immunodeficiency virus (HIV)-infected mothers retrieved from Information System of Prevention of Mother-to-Child Transmission of human immunodeficiency virus Management (IPMTCT) in Hunan Province between July 2013 and June 2019 were included. Information including maternal demographic characteristic, maternal comorbidities/complications, anti-retroviral therapy during pregnancy, anti-retroviral prophylaxis for children, birth weight, and disease during follow-up was collected. The length and weight of children at one, three, six, nine, 12 and 18 months of follow-up time points were detected, and the prevalences of stunting, underweight, wasting and malnutrition among HEU children were evaluated. The generalized estimating equation was used to fit the logistic regression model to analyze the associated factors for malnutrition.Results:A total of 656 HEU children were finally included. The prevalences of stunting, underweight, wasting, and malnutrition among HEU children were highest at one month of age, which were 11.9%(78/656), 9.1%(60/656), 7.0%(45/656) and 21.0%(138/656), respectively. Maternal comorbidities/complications (adjusted odds ratio (a OR)=2.30, 95% confidence interval ( CI) 1.48 to 3.58), mono/dual anti-retroviral therapy during pregnancy (a OR=2.38, 95% CI 1.54 to 3.68), birth weight <2 500 g (a OR=2.66, 95% CI 1.69 to 4.21) and disease during follow-up (a OR=1.73, 95% CI 1.10 to 2.70) were the risk factors for malnutrition among HEU children (all P<0.050). Both taking zidovudine (a OR=0.60, 95% CI 0.38 to 0.94) and nevirapine (a OR=0.31, 95% CI 0.18 to 0.52) for anti-retroviral prophylaxis were the protective factors for malnutrition among HEU children (both P<0.050). Conclusions:The prevalence of malnutrition among HEU children is high. The prevalence of malnutrition is affected by maternal comorbidities/complications, anti-retroviral therapy during pregnancy, and birth weight, diseases during follow-up and anti-retroviral prophylaxis for children.
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Objective To examine the association between maternal syphilis treatmentand the adverse pregnancy outcomes.Methods Syphilis-infected pregnant women retrieved from Information System of Prevention Mother-to-child Transmission of Human Immunodeficiency Virus (HIV),Syphilis,and Hepatitis B Management in Hu'nan Province between January 2012 and December 2017 were retrospectively studied.Information of demographic characteristics,pregnancy history,and syphilis infection/treatment history among these syphilis-infected pregnant women were collected and analyzed.According to the anti-syphilis treatment situation during pregnancy,syphilis-infected pregnant women were divided into three groups:non-treatment group,non-standardized treatment group and standardized treatment group.The incidences of adverse pregnancy outcomes among the three groups were calculated.Multivariate logistic regression was used to control confounding factors and analyze the association between maternal syphilis treatment and the adverse pregnancy outcomes.The adjusted odds ratios (aOR) and 95％ confidence interval (CI) were calculated.Results Among 9 059 syphilis-infected pregnant women,13.9％ (1 262),31.3％ (2 834),and 54.8％ (4 963)were untreated,non-standardized treated and standardized treated patients,respectively.The incidences of total adverse pregnancy outcomes in the non-treatment,non-standardized treatment and standardized treatment groups were 25.5％ (322),20.8％ (589),and 16.2％ (806),respectively.The incidences of stillbirth in the three groups were 2.3％ (29),1.3％ (38),and 0.6％ (28),respectively;those of preterm birth were 12.6％(159),10.5％ (297),and 6.0％ (299),respectively;those of low birth weight were 6.4％ (81),6.2％(175),and 3.3 ％ (162),respectively;those of small for gestational age were 10.9％ (138),8.4％ (237),and 8.0％ (399),respectively;those of neonatal death were 1.3％ (17),1.0％ (28) and 0.3％ (15),respectively;those of neonatal asphyxia were 1.9％ (24),0.9％ (25),and 0.9％ (46),respectively;those of neonatal pneumonia were 0.6％ (8),0.9％ (26),and 0.6％ (32),respectively;those of birth defects were 2.8％(35),1.3％ (37),and 1.1％ (57),respectively;those of neonatal congenital syphilis were 2.5％ (31),2.4％ (69),and 0.8％ (42),respectively.Compared with standardized treatment group,maternal syphilis without treatment was associated with increased risks of total adverse pregnancy outcomes (aOR =1.73),stillbirth (aOR =4.82),preterm birth (aOR =2.52),low birth weight (aOR =1.88),neonatal death (aOR =3.29),neonatal asphyxia (aOR =2.42) and birth defects (aOR =3.26) all P ＜ 0.01;maternal syphilis with non-standardized treatment was associated with increased risks of total adverse pregnancy outcomes (aOR =1.34),stillbirth (aOR =2.54),preterm birth (aOR =1.98),low birth weight (aOR =1.84),neonatal death (aOR =2.49) and neonatal congenital syphilis (aOR =1.70,P ＜ 0.05 or 0.01).Conclusions Maternal syphilis without treatment or with non-standardized treatment would increase the risks of adverse pregnancy outcomes.It is necessary to further strengthen the early screening and early treatment for syphilis-infected pregnant women,and improve the rate of standardized treatment to reduce the occurrence of adverse pregnancy outcomes.
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Objective To describe the prevalence of preterm birth (PB),low birth weight (LBW),and small for gestational age (SGA) among HIV-infected pregnant women and to identify associated risk factors in Hunan province.Methods This study appeared a retrospective one on HIV-infected pregnant women retrieved from Information System of Prevention of Mother-to-child Transmission of HIV management in Hunan province,between January 2011 and December 2017.Information regarding demographic characteristics,pregnancy,antiretroviral therapy (ART),husbands/partners' relevant situation and pregnancy outcomes,among these HIV-infected pregnant women were collected and analyzed.The incidence rates on PB,LBW and SGA were calculated.Multivariate logistic regression was used to analyze the associated risk factors.Results A total of 780 HIV-infected pregnant women were enrolled.The prevalence rates on PB,LBW and SGA in HIV-infected pregnant women appeared as 7.9％ (62/780),9.9％ (77/780) and 21.3％ (166/780),respectively.Results from the multivariate logistic regression analysis showed that factors as pregnancy related diseases as moderate/severe anemia,hypertensive,initial time of ART ＜14 gestational weeks (compared to those women without ART during pregnancy) and husbands/partners' age ＞35 years old (compared to husbands/partners' age 26-30 years old) etc.,were associated with an increased risk of PB with adjusted OR as 4.59 (95％CI:1.51-13.95),4.90 (95％CI:1.56-15.46),2.40 (95％CI:1.26-4.56) and 2.29 (95％CI:1.21-4.36).For LBW,pregnancy moderate/severe anemia,pregnancy HBV infection and initial time of ART ＜ 14 gestational weeks were associated with an increased risk of LBW,with adjusted OR as 3.28 (95％CI:1.13-9.54),4.37 (95％CI:1.42-13.44) and 2.68 (95％CI:1.51-4.76),respectively.For SGA,pregnancy HBV infection and initial time of ART ＜ 14 gestational weeks were risk factors for SGA,with adjusted OR as 4.41 (95％CI:1.43-13.63) and 2.67 (95％CI:1.51-4.73),respectively.Conclusion Preterm birth,LBW and SGA were common adverse pregnancy outcomes for HIV-infected pregnant women and were associated with factors as pregnancy complications,ART and husbands/partners' age.
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Objective To describe the prevalence of preterm birth (PB),low birth weight (LBW),and small for gestational age (SGA) among HIV-infected pregnant women and to identify associated risk factors in Hunan province.Methods This study appeared a retrospective one on HIV-infected pregnant women retrieved from Information System of Prevention of Mother-to-child Transmission of HIV management in Hunan province,between January 2011 and December 2017.Information regarding demographic characteristics,pregnancy,antiretroviral therapy (ART),husbands/partners' relevant situation and pregnancy outcomes,among these HIV-infected pregnant women were collected and analyzed.The incidence rates on PB,LBW and SGA were calculated.Multivariate logistic regression was used to analyze the associated risk factors.Results A total of 780 HIV-infected pregnant women were enrolled.The prevalence rates on PB,LBW and SGA in HIV-infected pregnant women appeared as 7.9％ (62/780),9.9％ (77/780) and 21.3％ (166/780),respectively.Results from the multivariate logistic regression analysis showed that factors as pregnancy related diseases as moderate/severe anemia,hypertensive,initial time of ART ＜14 gestational weeks (compared to those women without ART during pregnancy) and husbands/partners' age ＞35 years old (compared to husbands/partners' age 26-30 years old) etc.,were associated with an increased risk of PB with adjusted OR as 4.59 (95％CI:1.51-13.95),4.90 (95％CI:1.56-15.46),2.40 (95％CI:1.26-4.56) and 2.29 (95％CI:1.21-4.36).For LBW,pregnancy moderate/severe anemia,pregnancy HBV infection and initial time of ART ＜ 14 gestational weeks were associated with an increased risk of LBW,with adjusted OR as 3.28 (95％CI:1.13-9.54),4.37 (95％CI:1.42-13.44) and 2.68 (95％CI:1.51-4.76),respectively.For SGA,pregnancy HBV infection and initial time of ART ＜ 14 gestational weeks were risk factors for SGA,with adjusted OR as 4.41 (95％CI:1.43-13.63) and 2.67 (95％CI:1.51-4.73),respectively.Conclusion Preterm birth,LBW and SGA were common adverse pregnancy outcomes for HIV-infected pregnant women and were associated with factors as pregnancy complications,ART and husbands/partners' age.
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Objective@#To describe the status of, and to identify the factors associated with, complementary feeding among infants and young children aged 6- 23 months in poor rural areas of Hunan Province, China.@*Methods@#A total of 8 735 infants and young children aged 6- 23 months from 30 poor rural counties in the Wuling and Luoxiao Mountains in Hunan Province were selected by township-level probability-proportional-to-size sampling in August 2015. Questionnaires were used to collect information on the feeding status of the infants in the previous 24 hours, along with personal/family information. The qualified rate of minimum dietary diversity (MDD), the minimum meal frequency (MMF) and the minimum acceptable diet (MAD) were calculated according to the WHO indicators for assessing infant and young child feeding practices. Multi non-conditional logistic regression models were used to analyze factors associated with complementary feeding among infants and young children aged 6- 23 months.@*Results@#The findings indicated that 73.9% (6 452/8 735) of infants and young children aged 6-23 months received the minimum dietary diversity, 81.6% (7 124/8 735) of infants and young children aged 6- 23 months received the minimum meal frequency and 49.0% (4 276/8 735) of infants and young children aged 6- 23 months received an acceptable diet. Compared with the boys, the OR for the MMF and MAD for the girls were 1.15 and 1.11, respectively. Compared with the 6-11 month group, the OR for the MDD for the 12-17 month and 18-23 month groups were 0.41 and 0.38, respectively; the OR for the MMF for the 12-17 month and 18-23 month groups were 1.53 and 2.46, respectively; and the OR for the MAD for the 12-17 month and 18-23 month groups were 0.60 and 0.60, respectively. Compared with the Han ethnic group, the OR for the MDD, MMF and MAD for the Miao ethnic group were 1.43, 1.72 and 1.56, respectively; for the Tujia ethnic group were 2.21, 2.02 and 2.11, respectively; and for the Dong ethnic group were 0.62, 0.61 and 0.64, respectively. When analyzing data related to the children's mothers, compared with women who gestated at the age of 25- 29, the OR for the MMF for women who gestated at less than 20 years of age was 1.59 and at greater than or equal to 35 years of age was 1.33. Compared with women with primary school education or below, the OR for the MDD, MMF and MAD for women with junior high school education were 0.77, 0.74 and 0.80, respectively; for women with senior high school education were 0.67, 0.65 and 0.68, respectively; and for women educated to university level or above were 0.66, 0.47 and 0.60, respectively. Compared with the normal birth weight group, the OR for the MMF for the low birth weight group was 0.71, and for the high birth weight group was 1.30. Compared with the caregivers who provided qualified feeding knowledge, the OR for the MDD, MMF and MAD for the caregivers who provided unqualified feeding knowledge were 1.45, 1.30 and 1.40, respectively. Compared with the breastfed group, the OR for the MDD and the MMF for the non-breastfed group were 0.53 and 0.36, respectively. All P values were <0.05.@*Conclusion@#Most infants and young children aged 6-23 months in poor rural areas of China met the MDD and MMF requirements, but fewer met the MAD requirements. The risk factors in infants and young children for complementary feeding included being of female gender, lower in age (months), of Miao or Tujia ethnicity, being born to a mother who gestated at less than 20 or ≥35 years of age, being born to a mother of low education, having a high birth weight, having a caregiver who provided unqualified feeding knowledge and being breastfed.
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Objective:To investigate the status and influential factors associated with 2-week prevalence of fever and diarrhea among infants and young children at the age of 6-23 months in poor rural areas.Methods:A total of 8 735 rural infants and young children aged 6-23 months in 30 poor counties of Wuling Mountains and Luoxiao Mountains in Hunan Province were selected in August 2015,and the questionnaires were used to collect information on the prevalence of fever and diarrhea,person and families,and feeding status.The data for prevalence of fever and diarrhea in infants and young children were calculated,and multi-non-conditional logistic regression model were used to analyze the influential factors.Results:The 2-week prevalence of fever and diarrhea in infants and young children was 20.8％ and 12.2％ respectively.The ages (OR=0.66,95％CI 0.58 to 0.75),Dong ethnicity(OR=1.42,95％CI 1.17 to 1.74) and low body weight (OR=1.31,95％CI 1.11 to 1.54) were influential factors for fever among infants and young children in poor rural areas;female (OR=0.86,95％CI 0.76 to 0.98),12-17 months (OR=0.80,95％CI 0.69 to 0.93),18-23 months (OR=0.51,95％CI 0.43 to 0.60),other ethnic minorities (OR=1.70,95％CI 1.13 to 2.56),non-complementary feeding (OR=1.65,95％CI 1.05 to 2.59) and low body weight (OR=1.39,95％CI 1.14 to 1.70) were the influential factors of diarrhea among infants and young children.Conclusion:The 2-week prevalence of fever and diarrhea among infants and young children aged 6-23 months in poor rural areas were quite serious.Low age,Dong ethnicity,and low birth weight are high risk factors for fever.Male,no addition of complementary feeding,and low birth weight are high risk factors for diarrhea.
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Objective@#To describe the situation and identify factors associated with malnutrition among infants and young children aged 6-23 months in poor rural areas in Hunan Province in 2015.@*Methods@#8 735 rural infants and young children aged 6-23 months in 30 poor counties of Wuling Mountains and Luoxiao Mountains in Hu'nan province were selected by township-level probability proportional to size sampling (PPS) in August 2015, infants' body length and weight were measured, and questionnaires were used to collect infants' information on personal and family, and feeding status in the past 24 h. The prevalence of stunting, underweight and wasting were calculated according to the Growth Standards of Child Aged Under 7 in China which was established in 2009 by Community Health Department of National Health and Family Planning Commission, China (formerly Chinese MOH), and the prevalence of malnutrition was calculated according to the classification of children with anthropometric failure. Multi non-conditional logistic regression model were used to analyze factors associated with malnutrition among infants and young children aged 6-23 months.@*Results@#The prevalence of malnutrition among infants and young children aged 6-23 months was 13.7% (1 198/8 735), the prevalence of stunting, underweight and wasting among infants and young children aged 6-23 months were 4.8% (419/8 735), 9.7% (849/8 735) and 6.1% (531/8 735) respectively. Compared with male group, the OR value of malnutrition for the female group was 1.16; Compared with Han ethnic group, the OR value of malnutrition for the Miao and Tujia ethnic group were 0.83 and 0.66, respectively; Compared with mother with an education level of primary school or below, the OR value of malnutrition for the mother with junior high school, senior high school and university or above education were 0.65, 0.61 and 0.56, respectively; Compared with father with an education level of primary school or below, the OR value of malnutrition for the father with senior high school and university or above education were 0.71 and 0.61 respectively; Compared with normal birth weight group, the OR value of malnutrition for the low birth weight group and high birth weight group were 2.85 and 0.27 respectively; Compared with normal delivery group, the OR value of malnutrition for the premature delivery group was 1.37; all P values<0.05.@*Conclusion@#The prevalence of malnutrition among infants and young children aged 6-23 months in poor rural areas in Hunan province in 2015 was high; Infants and young children who were female, Han ethnic, parents with low education, low birth weight and premature delivery had higher risk of malnutrition.
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Objective To observe the effects of therapy of supplementing spleen to strengthen lung on patients with adenomatous colonic polyps (ACP) after endoscopic removal . Methods One hundred ACP patients with spleen deficiency and dampness blended with blood stasis were randomly divided into 2 groups after endoscopic removal, 50 cases in the treatment group and 50 cases in the control group. Both groups were treated with diet and behavioral therapy, and the treatment group was simultaneously given oral use of modified Shen Ling Baizhu Powder plus self-moxibustion of bilateral acupoint Zusanli point. After treatment for 6 months and 1.5 years, all of the patients were asked to do the examination of colonoscopy, body mass, body mass index (BMI), and triglyceride (TG). Results (1) After treatment, the mean overall symptom scores of the two groups were improved (P 0.05). The effect of the treatment group on improving body mass, BMI and TG was better than that of the control group (P < 0.05). Conclusion The therapy of supplementing spleen to strengthen lung is effective on relieving symptoms of ACP patients, and also has an effect on decreasing BMI and TG as well as the recurrence of ACP after endoscopic removal.
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Objective:To research the risk factors of developing Oppositional Defiant Disorder (ODD).Methods:Among 427 students in an elementary school in Changsha, we screened out thirty-four children with ODD by the criteria of DSM-IV. They and other thirty-four normal children from the same school were included in the case-control study. Education levels, jobs and Cartel 16 Personality Factors (16PF) were filled out by their parents. Combined Raven's Test (CRT) was used to evaluate children's intelligence.Results:The prevalence rate of ODD in children increased with the decrease of their father's and mother's education level (for father's education level form advanced education, secondary education to primary, the rate increased from 6.6%,7.2% to 12.0%) and (for mother, 5.3%,7.5%,10.6%). The rate of ODD was highest in children with father and mother doing small business (16.7% and 16.5%, ?~2=12.67～12.68,P
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Objective :To explore the behavior characters of children diagnosed as ODD with ADHD symptoms. Methods: The diagnosis of ODD was made according to the ICD-10 criteria . 40 Children having ODD with ADHD symptoms (combined group ) and 22 Children having ODD but without ADHD symptoms (ODD group) were collected from outclinics. The parents of all subjects completed Achenbach Child Behavior Checklist (CBCL) and a family information list. Results: The onset and help-seeking age of the combined group were younger than that of ODD group. They had more disobey, attacking, and extroversive behaviors. Their fathers were more agitative. Parents of the combined group used more beating and scolding in parenting. Conclusion: ODD children with ADHD symptoms had more behavior problems and incur worse parenting style. Their family need more help in early age.