An eight-year study on maternal and child health service utility in Sichuan province / 中华流行病学杂志

Objective To evaluate the effect of intervention on factors influencing the health service utility regarding Maternal and Child Health (MCH)under the 'Qinba Health Project' in Sichuan province. Methods 15 towns in 5 programmed counties were selected, using the method of 'random layer sampling' to be the trial group. With similar MCH status and comparable to the trial group, another 9 towns in 3 non-programmed counties were chosen as the control group, using the same sampling method. Indicators on MCH service utility were compared with that in the control group, and the influencing factors of MCH service utility analyzed by logistic model. Results The main characteristics of the two groups were quite similar at the baseline study, with the average annual family incomes and MCH service per 1000 people. Annual input on MCH services from the government had an distinct increase. The average annual rates of increase regarding the indictors as clean delivery, hospitalized delivery, systematic care on maternal and children, maternal and infant mortality rates were: 1.95%, 9.34%, 4.82%, 3.04%, -2.67%, -13.84% (P<0.02) through χ2 trend tests. In the trial group, the changes seen in the 6 indicators were better in the control group than in the control group(P<0.05). Data from the logistic regression model showed that the major influencing factors on the use of hospitalized delivery service were: age of the pregnant woman, average annual income of the family, health insurance status, number of pre-delivery visits, whether on poverty alleviate program, and on knowledge of MCH. Conclusion The intervention project in this programmed area seemed effective and better than the non-programmed area, through an eight-year observation.

Quality of life and hostile mentality trend among 299 patients living with HIV/AIDS / 中华预防医学杂志

<p><b>OBJECTIVE</b>To assess the quality of life (QOL) and hostile mentality trend (HMT) of 299 patients living with HIV/AIDS (Human immunodeficiency virus/Acquired immune deficiency syndrome) in three provinces in China, and to understand the major concerns of the these patients.</p><p><b>METHODS</b>The SF-36 (short form -36) was used for assessing the QOL among 299 HIV-infected patients in Sichuan, Hubei and Guizhou provinces. Reliability and validity of SF-36 were evaluated. Consulting with experts and professionals, seven additional items were developed to evaluate the HMT. Mean scores of the 8 scales were compared between the patients and general rural residents in Sichuan province.</p><p><b>RESULTS</b>For SF-36, internal consistent coefficients (Cronbach's alpha) of the 8 scales were between 0.75 to 0.90, test-retest reliability coefficient ranged from 0.54 to 0.80. The item-subscale correlation coefficients ranged from 0.46 to 0.97. Mean scores of the 8 scales of the patients ranged from 28.50 to 77.87, and 70.27 to 91.87 for the general rural residents. The variations of the scales were tested by means of Mann-Whitney test with u value ranged from -17.43 to -23.87. The QOL of the patients living with HIV/AIDS were significantly inferior to those of general population (all P < 0.01). The mean scores of the seven items to evaluate HMT ranged from 46.21 to 82.89. The major concerns of the patients living with HIV/AIDS included financial insecurity and family responsibilities, followed by death threat and no cure of HIV/AIDS.</p><p><b>CONCLUSION</b>The SF-36 is a reliable instrument for assessing QOL of patients living with HIV/AIDS. The QOL of the patients living with HIV/AIDS in China is poor.</p>

The development and assessment on an instrument regarding quality of life for patients living with HIV/AIDS in China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To develop a specific quality of life (QOL) instrument for Chinese patients living with HIV/AIDS and to assess its reliability and validity.</p><p><b>METHODS</b>A primary questionnaire was developed with reference to existing instrument and information through discussion with experts, front-line professionals and patients living with HIV/AIDS. This questionnaire was applied in 443 patients living with HIV/AIDS. Some items were removed through the results of responsive rate, factor analysis, correlation matrix,internal consistency and so on. Reliability and validity were assessed after items reduction.</p><p><b>RESULTS</b>The developed instrument contained 44 items, including 10 scales and other 3 items used for the evaluation of curative effect and side effect of anti-virus drug. No substantial ceiling/floor effects existed. All scales' internal consistency coefficients were > or = 0.70 and the whole instrument was 0.90. The two week retest reliability coefficient of the whole instrument was 0.80, and there were 6 scales below 0.70 of this coefficient. Multitrait/multiitem assessment indicated scaling success rates were all 100% for all items. Spearman correlation coefficient of total score of this instrument with SF-36 was 0.69.</p><p><b>CONCLUSION</b>It was the first time that the developed QOL-CPLWHA instrument introducing the scale of hostility regarding mentality trend as well as expressed its acceptable reliability and validity so could be used for the evaluation of Chinese patients living with HIV/AIDS.</p>

Study on socio-behavioral risk factors of acquired drug resistance of tuberculosis in Sichuan province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the socio-behavioral risk factors on acquired drug resistance of tuberculosis (ADR-TB).</p><p><b>METHODS</b>Using pair matched case control study, 316 ADR-TB samples from 949 cases and 316 controls (pair matched for age and sex) were selected by systematical sampling method and studied through questionnaires. All the study subjects were selected from outpatients of the institute of TB control and prevention,between June 2002 and June 2005 in Sichuan province. Socio-behavioral risk factors were analyzed with conditional logistic regression and estimated with adjusted odds ratios (OR) and confidence interval (CI).</p><p><b>RESULTS</b>Data showed that the major socio-behavioral risk factors were associated with low economic status, incomplete DOTS, poor compliance and interruption during treatment with adjusted OR and CI as 5.623 (3.462-9.386), 8.875 (6.136-15.442), 6.467(3.942-10.622) and 4.906 (2.477-10.654) respectively.</p><p><b>CONCLUSION</b>ADR-TB could be controlled by taking effective measures against the socio-behavior risk factors.</p>

Study on the quality of life and its influencing factors in Miao and Gelao Minority groups in Guizhou province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate and evaluate the quality of life and its influencing factors in Miao and Gelao Minority groups in Guizhou province with the aim of providing evidence for valid health promotion measures.</p><p><b>METHODS</b>Based on a self-designed questionnaire to evaluate the quality of life on 582 subjects. Kruskal-wallis test and stepwise regression analysis were used to test the quality of life and its influencing factors.</p><p><b>RESULTS</b>There were significant differences among the groups of quality of life and its influencing factors. The quality of life of Miao Minority was the highest and Gelao the lowest. Sex, age, acute disease prevalence of the past two-weeks, prevalence of chronic diseases, drinking unboiled water, tobacco-smoking habit, educational level and the family expenditure on life were correlated with all or most of the domains of quality of life.</p><p><b>CONCLUSION</b>The key steps on quality of life promotion should include: strengthening the basis medical health service, pushing cooperative medical service, enhancing prevention and care of chronic diseases, speeding the development of economics etc.</p>

Study on AIDS related risk behaviors and the correlated factors among three groups of population in Sichuan province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To provide the basis for AIDS intervention, the study on the relationship between AIDS related risk behaviors and the related factors was carried out among prostitutes, injection drug users and long-distance truck drivers.</p><p><b>METHODS</b>Questionnaire investigation and statistical analysis as chi(2) test, F test, logistic regression were adopted to analysis the relationship between AIDS related risk behaviors and the correlated factors.</p><p><b>RESULTS</b>Knowledge about AIDS seemed to be related to their level of understanding the problem (in commercial sex workers r = 0.307, P = 0.000, in injection drug users F = 93.07, P = 0.000, in truck man F = 30.06, P = 0.000). Condom use when entertaining their clients last time was related to the knowledge of HIV transmission in commercial sex workers and truck drivers (OR = 1.171, 1.145) and knowledge of HIV prevention (OR = 1.081, 1.397), in drug users regarding gender difference (OR = 2.121).</p><p><b>CONCLUSION</b>This study addressed that the effective means to reduce the rate of AIDS risk behaviors and to lessen the harm of AIDS are to improve the knowledge of AIDS and the effective methods to prevent AIDS in the high risk population.</p>

Quantitative assessment of risks for coronary heart diseases in urban residents in Sichuan / 中华预防医学杂志

<p><b>OBJECTIVE</b>To set a quantitative criteria for determining risk for coronary heart disease (CHD) so that potential risk of an individual dying from CHD can be identified and to lay a foundation for predicting individual risk of CHD.</p><p><b>METHODS</b>Data of case-control and cohort studies published during 1978 to 2002, as well as data of surveillance of behavior exposure in Sichuan province, were collected by retrieval of literatures. Pooled odds ratios (OR) and relative risks (RR) of all risk factors for CHD were estimated using various statistical models with software for meta-analysis, and attributable risk fractions of varied levels of risk factors could be converted.</p><p><b>RESULTS</b>A risk score conversion table (quantitative criteria for assessment) of main risk factors for CHD were developed for men and women aged 15 - 69 at an interval of five years, including smoking, passive smoking, hypertension, high blood cholesterol level, body mass index, lack of physical activity, alcohol drinking, past history of diabetes, and family history of CHD and hypertension. Individuals with all these risk factors had a risk score beyond 1.00, and risk score for those without them was equal to or below 1.00, which would increase with rise in one's risk level.</p><p><b>CONCLUSIONS</b>Estimation of risk of dying from CHD was based on risk score conversion table of risk factors for CHD, which could be used to predict individual potential risk of dying from CHD in the following 10 years. It lays a foundation for health education to persuade people to change their unhealthy lifestyles and behaviors, and could be used in community health services.</p>

Cost analysis of Shenqi Fuzheng injection on reducing adverse effects during chemotherapy / 中华流行病学杂志

<p><b>OBJECTIVE</b>The goals of this work was to analyse the cost of Shenqi Fuzheng injection-an extraction of a Chinese traditional herbs on reducing adverse effects in lung cancer patients during chemotherapy.</p><p><b>METHODS</b>In a randomized cross-over trial, each patient completed two identical cisplatin-based chemotherapy cycles, one with Shenqi Fuzheng injection, another without Shenqi Fuzheng injection. Adverse effects and change scores of quality of life (QOL) during chemotherapy were compared in tow cycles. The direct cost dealing with adverse effect and cost-effectiveness analysis were taken.</p><p><b>RESULTS</b>One hundred and thirty were enrolled with 123 of whom were evaluable. The patient characteristics were well balanced between the two groups. The chemotherapy cycles with Shenqi Fuzheng injection spent 220.5 more Chinese yuan, but the adverse effect of leukopenia, thrombocytopenia and vomiting were slight different and the change of score of several QOL domains showed significant better as compared to those in another cycle.</p><p><b>CONCLUSION</b>Shenqi Fuzheng injection could reduce the severity of toxicity related to chemotherapy and improve the QOL of patients and had some benefits in terms of cost-effectiveness.</p>

Quantitative assessment of risks on cerebral vascular diseases in urban residents in Sichuan / 中华流行病学杂志

<p><b>OBJECTIVE</b>To set a quantitative criteria for determining the risks on cerebral vascular disease (CVD) so to identify that potential risk of an individual dying from CVD and to predict the individual risk of CVD.</p><p><b>METHODS</b>Data on case-control and cohort studies published during 1978 to 2003 was collected through retrieval of literatures, and data on surveillance of behavior exposure was provided by Chengdu Municipal Center for Disease Control and Prevention. Pooled odds ratio (OR) and relative risk (RR) of all risk factors for CVD were estimated using software for meta-analysis to enable the varied levels of risk factors be converted into risk fractions by statistical models.</p><p><b>RESULTS</b>A risk score conversion table (quantitative criteria for assessment) of main risk factors for CVD was developed for men and women aged 35 - 69 at an interval of five years, including smoking, passive smoking, hypertension, high blood cholesterol levels, body mass index, lack of physical activity, alcohol drinking, dietary fat consumption, milk intake, oral contraceptive use, past history of diabetes and CVD, family history of CVD etc. Individuals with all these risk factors had a risk score beyond 1.00, but was equal to or below 1.00 when without. The risk score would increase along with the rise of one's risk level.</p><p><b>CONCLUSION</b>Estimation of risk of dying from CVD was based on risk score conversion table of risk factors for CVD, which could be used to predict individual potential risk of dying from CVD in the following 10 years. Our data provides evidence that education to be strengthened to persuade people to change their unhealthy lifestyles and behaviors.</p>