[Impact of HIV and Mycobacterium tuberculosis co-infection on related mortality].

Objective: To understand the impact of HIV and Mycobacterium tuberculosis (MTB) co-infectious (HIV/MTB) on related mortality in Guangxi Zhuang Autonomous Region, provide evidence for the development of a better HIV/MTB co-infection control and prevention program. Methods: A multiple cross-systems check (MCSC) approach was used to confirm the HIV/MTB co-infection individuals on data related to treatment, follow-up, epidemiological comprehensive and Tuberculosis (TB) special report system. Social demography characteristics, incidence of TB among HIV positive individuals, HIV incidence among MTB infection persons etc., were described. We compared the mortalities and related risks between HIV/MTB co-infection and mono HIV positive individuals as well as between the HIV/MTB co-infection and mono MTB infection persons, using both the Chi Square test and the Cox's proportional hazard regression model (Cox). Results: Reported data showed that the incidence of MTB co-infection in the HIV cohort was 17.72% (2 533/14 293), while HIV incidence in the TB patients was 5.57% (2 351/42 205), respectively. The mortality of HIV/MTB co-infection in the HIV/AIDS cohort was 15.16% (384/2 533) within one-year of observation and was significantly higher than the mortality (13.63%,1 603/11 760) of mono HIV positive individuals (P<0.000 1). The percentage of the HIV/AIDS death cases was 19.33% (384/1 987) who registered and died in the 2011 calendar year were caused by MTB co-infection. Among all the HIV/MTB co-infection patients who had been identified from the HIV cohort, 60.05% (1 521/2 533) had initiated ART, 15.48% (392/2 533) had been cured for TB and 27.48% (696/2 533) had been under complete TB regimen. Among the confirmed HIV/MTB cases from the TB cohort, the cure rate of TB was 19.70% (463/2 351) and the percentage of completed TB regimen was 37.26% (876/2 351). The percentage of the individuals whose CD(4)(+) T lymphocyte cells count appeared less than 200 cell/µl was 64.13% (785/1 224), upon the HIV diagnoses were made. Compared with individuals who were under mono HIV infection, the mortality risk on HIV/MTB co-infection was 1.17 times higher during the five-year observation period, then the patients with only mono MTB infection and the mortality risk in patients with HIV/MTB co-infection was 25.68 times higher under the 12-month observation period. Conclusions: Both the incidence and mortality of HIV/MTB appeared high in Guangxi, with mortality and the risk of mortality in the HIV/MTB co-infection group significantly higher than that in both the HIV mono infection and the MTB mono infections groups. Both the rate of antiretroviral treatment coverage and the cure rate of TB treatment should be increased in no time as well as the capability of early TB case-finding among people living with HIV.

Different quantitative measures of the impact of injury deaths on the community in the Guangxi Province, China.

BACKGROUND: Injury has been identified as a major health problem in China. Different quantitative measures based on the concept of years of potential life lost have been derived for assessing the burden of injury and other diseases. However, few studies have been conducted to compare the usefulness of these measures in terms of providing practical information. This study aims to examine the utility of different measures in assessing the impact of injury to Chinese society. METHODS: This is a population-based epidemiological study utilising surveillance and fielded-gathered data. Data are obtained from the disease surveillance information system and record on each death certificate. The mortality rates, years of potential life lost (YPLL), potentially years of productive life lost (PYPLL), and the valued years of potential life lost (VYPLL) are calculated and compared for deaths due to injury and other major diseases. Data on different causes of injury were analysed in the same manner. RESULTS: In comparison to other causes of death, injury deaths had the highest annual rates of YPLL (1265.1 years/100,000 persons), PYPLL (517.8 years/100,000 persons), and VYPLL (378.6 years/100,000 persons). Premature deaths due to injury provided the only positively valued VYPLL among all major causes of death. Among the injury deaths, motor vehicle traffic-related death caused the largest YPLL (13,274 years), PYPLL (5461 years), and VYPLL (3064 years). CONCLUSION: In considering the burden of deaths to society, mortality rate only is an insufficient measure. The age, the years of overall life and expected productivity and related economic consequences have to be taken into consideration. As an indicator of the economic impact and burden of premature deaths to society, the VYPLL seems to be an advantageous utility. Injury posts the greatest public health problem to the developing economy of China.

Epidemiological profile of mortality due to injuries in three cities in the Guangxi Province, China.

This study aimed to provide epidemiological information on injury mortality in three major cities in Guangxi Province of South Western China. This was a population-based descriptive study utilising surveillance and field-gathered data. Data were obtained from the disease surveillance information system and record on each death certificate. Mortality rates were compared between sex and among different age groups for different causes of injury. Regression modelling was applied to examine for any increasing trend of injury mortality within the study period. Drowning was a severe problem for boys and girls younger than 5 years. Among all estimated mortality rates (per 100,000 person-years) for all sex, age groups, and categories of death, they were the highest with a rate of 29.8 (95%CI = 16.7-42.9) for boys and 29.6 (95%CI = 15.9-43.3) for girls. The overall mortality rates of motor vehicle and other transport-related injury was also similar to those developed countries. There was a marginally significant trend of increasing injury mortality within the study period.