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Objective: To establish a dynamic syndromic surveillance system in the border areas of Yunnan Province based on information technology, evaluate its effectiveness and timeliness in the response to common communicable disease epidemics and improve the communicable disease prevention and control in border areas. Methods: Three border counties were selected for full coverage as study areas, and dynamic surveillance for 14 symptoms and 6 syndromes were conducted in medical institutions, the daily collection of information about students' school absence in primary schools and febrile illness in inbound people at border ports were conducted in these counties from January 2016 to February 2018 to establish an early warning system based on mobile phone and computer platform for a field experimental study. Results: With syndromes of rash, influenza-like illness and the numbers of primary school absence, the most common communicable disease events, such as hand foot and mouth disease, influenza and chickenpox, can be identified 1-5 days in advance by using EARS-3C and Kulldorff time-space scanning models with high sensitivity and specificity. The system is easy to use with strong security and feasibility. All the information and the warning alerts are released in the form of interactive charts and visual maps, which can facilitate the timely response. Conclusions: This system is highly effective and easy to operate in the detection of possible outbreaks of common communicable diseases in border areas in real time, so the timely and effective intervention can be conducted to reduce the risk of local and cross-border communicable disease outbreaks. It has practical application value.
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Humanos , Influenza Humana , Vigilância de Evento Sentinela , Síndrome , China , Telefone CelularRESUMO
Objective To establish a suitable exponential smoothing prediction model for school absentees due to illness, to discuss its application value for predicting school absences due to illness, and to provide a basis for early warning of absence due to illness. Methods Numbers of schools absences by year and month due to illness in 30 primary schools from November 2015 to June 2017 were collected from symptom monitoring system of border county, southern Yunnan and Simple seasonal model, Winters addition model and Winters multiplication model were used to build simulation. The data of July 2017 to December 2017 were used for model validation. The three models were overall compared and evaluated through indicator analysis, statistical analysis and residual diagram analysis. The best model was selected to predict school absences due to illness from January 2018 to March 2018. Results Simple seasonal model, Winters addition model and Winters multiplication model were used to fit the variation trend of number of school absences due to illness in time series. The root mean square error (RMSE) of three models were 445.11, 420.99 and 258.75; R2adj were 0.72, 0.72 and 0.77; R2 were 0.92, 0.93 and 0.98; P values of Ljung-Box Q were 0.54, 0.43 and 0.21. As for prediction method linear trend, Alpha were 0.999, 1.000 and 0.298. The average relative error between predicted value and actual value was 9.62%, 21.90% and 7.52%. Conclusion Winters multiplication model has practical value to predict school absence due to illness and provide scientific basis for early identification of abnormal signals.
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Objective To analyze the relationship between socioeconomic position and prevalence of hypertension, diabetes, coronary heart disease, stroke, chronic obstructive pulmonary diseases (COPD) and multi-morbidity among older adults in rural Yunnan Province. Methods A total of 4 833 older adults aged 60 years and over were selected by multi-stage stratified random sampling method in rural Yunnan Province. Information was acquired from questionnaire and health examination. Principal component analysis was used to construct the socioeconomic comprehensive score. Results The prevalence of hypertension, diabetes, stroke, coronary heart disease, COPD and multi-morbidity in target persons was 50.6%, 10.2%, 6.4%, 5.5%, 5.4% and 16.1% respectively. The prevalence of hypertension and diabetes was much higher in female compared with male (both P<0.05), in contrast the prevalence of COPD was much higher in male than female( 2=5.499, P=0.019)The prevalence of hypertension, stroke, coronary heart disease, COPD and multi-morbidity was increased with age(all P<0.05);Minority ethnic were more likely to develop hypertension, coronary heart disease, COPD and multi-morbidity than Han ethnic(all P<0.05). The results of multivariate logistic regression analysis showed that older adults with lower socioeconomic position had higher probability of suffering from hypertension, coronary heart disease, stroke, COPD and multi-morbidity (all P<0.05). Conclusions There are significant socioeconomic differences between socioeconomic position and prevalence of five major chronic diseases and multi-morbidity among older adults in rural Yunnan province. Older adults with low socioeconomic position should be key population for future prevention and control of chronic diseases.
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Objective To analyze the sleep quality status and its relationship with cardiovascular disease in rural elderly in Yunnan Province. Methods Multistage stratified random sampling method was used to select 1629 residents aged 60 years and over from Ning Er County in Yunnan province. Each participant received questionnaire survey and physical examination. Multivariate logistic regression analysis was used to analyze the relationship between sleep quality status and cardiovascular disease. Results Among the study population, the overall Pittsburgh Sleep Quality Index (PSQI) score was 7.48±3.89,and was 6.67±3.69 for males and 8.07±3.92 for females. The prevalence of sleep disorder, hypertension, coronary heart disease and stroke were 56.78%, 52.85%, 8.16% and 8.66%, respectively. Females had higher prevalence of sleep disorder than males (62.81% and 48.55%，P<0.001). The elderly with lower annual average family per capital income and bad access to medical services had higher prevalence of sleep disorder than their counterparts (P<0.001).The elderly with sleep disorder was more likely to suffer from hypertension, coronary heart disease and stroke (P<0.05). Conclusion The prevalence of sleep disorder is high in rural elderly in Yunnan Province. Improving sleep quality among the elderly can prevent and control cardiovascular diseases to a certain degree.
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Objective To analyze the prevalence, awareness, treatment, control and self-management of diabetes among the elderly in Midu County of Yunnan province. Methods A stratified random sampling method was used to carry out on-site questionnaire survey and blood glucose measurement among 1,603 older people aged≥60 in Midu County of Yunnan province. Results The overall prevalence, awareness, treatment and control rate of diabetes among the elderly were 10.11％, 56.17％, 75.82％and 37.36％respectively. The rates of self-monitoring of blood glucose, taking medicine prescribed by doctors and hypoglycemic measures in the last two weeks were 43.96％, 80.22％ and 98.90％ respectively. People with higher average annual income had higher prevalence of diabetes ( <0.05) . The awareness rate of diabetes in women (67.42％) was significantly higher than that in males (42.47％, <0.01). Self monitoring of blood glucose in patients with house toilet (46.99％) in house was higher than those without toilet (12.50％, <0.05). The higher the level of education, the higher the rate of taking medicine prescribed by doctors ( <0.05) . Patients who do not live alone and have toilet in house have a higher rate of weight control (67.07％and 66.27％) than those living alone and without toilet (22.22％and 25％,<0.05).Conclusions The findings indicate a relatively high prevalence of diabetes and low level of self-management of diabetes among older people in Midu County. It should adopt targeted diabetes health education and intervention according to different characteristics of the population so as to improve their level of diabetes self-management.
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Objective The aim of this study was to analyze the status and influencing factors of public health service utilization in rural patients with severe mental illness in Yunnan province. Methods The main caregivers of patients with severe mental illness in Yunnan province were selected by stratified cluster sampling method. Multivariate logistic regression was used to analyze the influencing factors of public health service utilization. Results A total of 284 cases of rural patients with severe mental illness were investigated, including 144 males (50.7％) and 140 females (49.3％) . The rate of medical file filing, follow-up rate of village doctor, participation rate of free physical examination and health education acceptance rate among patients with severe mental illness were 89.8％, 84.9％, 73.2％and 56.7％respectively (<0.05) . Female patients had higher participation rate of free physical examination than male patients, and patients having work and patients with controlled disease condition and their caregivers had higher rates of health education acceptance rate than their counterparts ( <0.05) . Conclusion Measures should be taken to strengthen the work of medical examination for male patients, and to expand health education activities for patients having no work and patients with uncontrolled disease condition, so as to improve the public health service utilization in rural areas of Yunnan province.
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<p><b>OBJECTIVE</b>To analyze the association between hypertension and tobacco exposure Luoping county of Yunnan province and estimate the direct cost attributable to hypertension .</p><p><b>METHODS</b>Using Probability proportional to size (PPS) sampling method, 5000 rural residents aged over 18 years were selected from 12 townships in Luoping county, Yunnan province in April 2011, from which 4611 subjects completed the survey. Self-designed questionnaires were used to collect general information, smoking status, costs for outpatient consultation, inpatient, treatment, medication, travel, accommodation and extra-nutrition caused by hypertension as well as the information of health-related behavior. Their height, weight, waist circumference, hip circumference and blood pressure were measured. The direct economic burden of hypertension was calculated. Chi-square (χ(2)) test was used to compare gender differences of hypertension prevalence, smoking and passive smoking. And t test was used to compare the differences of direct economic burden of hypertension among different gender, smoking and passive smoking status. Multivariable logistic regression model was used to analyze the influence factors of hypertension.</p><p><b>RESULTS</b>Among the 4611 subjects, the age was (46.90 ± 16.74) years old. Male accounted for 49.8% (2294/4611) and female 50.2% (2317/4611) . The smoking rate was higher in males (75.7% (1736/2294)) than in females(1.6% (38/2317)) (χ(2) = 2669.21, P < 0.01). The passive smoking rate was lower in males (10.0% (230/2294)) than in females (46.2% (1070/2317)) (χ(2) = 744.27, P < 0.05). Non-tobacco exposure rate in males (14.3% (328/1537)) was lower than in females (52.2% (1209/1537)) (χ(2) = 744.37, P < 0.05) . The risk of hypertension in smokers and passive smokers were higher than those without tobacco exposure, OR (95%CI) was 1.41 (1.15-1.71) (P < 0.05) and 1.31 (1.07-1.63) (P < 0.05) respectively. The per capita direct cost of hypertension was (3444.09 ± 3067.83) Yuan. Of this, tobacco exposure (4552.46 ± 3189.05) Yuan was higher than non-tobacco exposure (1907.71 ± 1383.94) Yuan (t = -3.81, P < 0.05) . Moreover, smokers were (6951.71 ± 3422.87) Yuan higher than passive smokers (3128.09 ± 2083.17) Yuan (t = 3.19, P < 0.05) and males (5827.39 ± 3240.50) Yuan were higher than females (2633.03 ± 2569.01) Yuan (t = 3.22, P < 0.05) . The total direct costs of hypertension attributable to smoking and SHS was 41 million and 38 million, respectively.</p><p><b>CONCLUSION</b>Both smoking and SHS had significant impact on prevalence and economic burden of hypertension in Luoping county. Implementing effective strategies to control tobacco exposure is useful to reduce the economic burden of hypertension in the study region.</p>
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Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , China , Epidemiologia , Efeitos Psicossociais da Doença , Hipertensão , Economia , Epidemiologia , População Rural , Poluição por Fumaça de Tabaco , EconomiaRESUMO
<p><b>OBJECTIVE</b>To explore the quality of life among people living with HIV/AIDS (PLWHA) and analyze the influencing factors in Kunming.</p><p><b>METHODS</b>A cross-sectional survey was conducted from March to April in year 2011, and 247 PLWHA were selected by convenience sampling from Yunnan CDC, Yunnan and Kunming infectious disease hospitals. General questionnaires, the simplified Chinese edition of medical outcomes study-HIV health survey (MOS-HIV, including 11 dimensions) and Social Support Scale were used. t test and multivariable linear regression model were used to analyze the results.</p><p><b>RESULTS</b>For the subjects investigated, the age was (39.8 +/- 11.9) years old, the median (quartile) value of symptoms related to HIV infection was 1(2). As to the scores of quality of life measured by MOS-HIV, physical summary score was 47.4 +/- 11.2, mental summary score was 43.6 +/- 9.7; for the scores of 11 dimensions of the MOS-HIV,that were general health (42.9 +/- 19.9), physical function (79.4 +/- 24.9), role function (59.8 +/- 48.2), social function (67.0 +/- 33.6), cognitive function (71.0 +/- 25.4), pain (81.3 +/- 26.2), mental health (62.0 +/- 22.3), vitality (49.3 +/- 23.8), health distress (74.4 +/- 21.0), quality of life (51.8 +/- 21.1), health transition (49.0 +/- 29.8). The total score of social support was 28.6 +/- 7.6, of which the score of subjective social support was 17.2 +/- 6.3, the score of the objective social support was 5.9 +/- 2.2; the score of the utilization of social support was 5.5 +/- 1.9. Multivariable linear regression analysis showed that the more the symptoms related to HIV infection, the lower the physical summary scores (standardized coefficients b' = -0.22), the general health (b' = - 0.31), the physical function (b' = -0.16), the role function (b' = -0.23), the pain (b' = -0.21), the mental health (b' = -0.22), the vitality (b' = -0.22) and the health distress scores (b' = - 0.24) (all P values < 0.05); the older the age, the lower the physical summary scores (b' = - 0.16), the mental summary scores (b' = - 0.16), the physical function (b' = -0.26), the vitality (b' = -0.26) and the quality of life scores (b' = -0.17) (all P values < 0.05); the higher the score of the subjective social support,the higher the physical summary scores (b' = 0.26), the mental summary scores (b' = 0.22), the general health (b' = 0.27), the social function (b' = 0.26), the mental health (b' = 0.15) and the quality of life scores (b' = 0.22) (all P values < 0.05); the higher the score of the utilization of social support, the higher the physical function (b' = 0.16) and the health transition scores (b' = 0.31) (all P values < 0.05).</p><p><b>CONCLUSION</b>PLWHA in Kunming have relatively lower scores of quality of life. A large number of symptoms during infection, older age and lower score of subjective social support were the hazard factors of quality of life in PLWHA.</p>