[Progress of research regarding the influenza early warning system, based on "Big Data"].

Shortcomings have been inherited in the traditional influenza early warning system, often expressed through the scope, accuracy on prediction and real-time performance of the monitor related programs. With the new round of scientific and technological revolution and the increasingly maturity of modern information system, related technology on influenza early warning has become the focus of research in this field, based on big data analysis technology. Using the traditional influenza surveillance and early warning system as reference, this paper summarizes the progress of influenza early warning research, based on the Internet, influencing factors, time and space trends, and risk assessment etc., to summarize the trends on the advantages, shortcomings and future development of big data, used in the early warning system on influenza.

Rural sex work in Cambodia: work characteristics, risk behaviours, HIV, and syphilis.

OBJECTIVE: To identify prevalence and risks factors for syphilis and HIV among rural female sex workers (FSWs) in Cambodia and to describe differences between rural and urban FSWs. METHODS: Interviews and sera were collected from 114 FSWs and tested for HIV using the Serodia-HIV test and positives confirmed with the enzyme linked immunosorbent assay. Syphilis was tested for with the rapid plasma reagin with passive particle agglutination test for detection of antibody of Treponema pallidum. Study data were merged with data from a study of urban FSWs from Phnom Penh that applied similar questionnaires and sampling design to compare STI prevalence and behaviours. RESULTS: 42% of rural FSWs were HIV positive; 22% had past or current syphilis. In multivariate models HIV was significantly associated with age > or = 25 (OR = 6.1 95% CI: 1.0 to 36.6), a non-commercial partner in the past year (OR= 0.33, 95% CI: 0.11 to 0.93), and prevalence of past or current syphilis (OR = 2.9, 95% CI: 1.0 to 8.8). There was significantly higher active syphilis (14% v 4%), older mean age (25 v 21), fewer daily clients (2 v 5), lower monthly income (61 US dollars v 174 US dollars), and longer duration of sex work (2.3 years v 1.4 years) among rural than among urban FSWs. CONCLUSIONS: These findings reveal a high burden of HIV and syphilis among FSWs in rural Cambodia. As FSWs age and become infected with STI/HIV they may move out of cities into less competitive but less savvy markets; their high mobility may contribute to the expansion of the HIV epidemic into rural Cambodia and lower risk populations.

Sexual bridging by Cambodian men: potential importance for general population spread of STD and HIV epidemics.

BACKGROUND: Linkages between sexual networks influence STD and HIV epidemics. GOAL: This study quantifies male sexual "bridging" and associated factors in Cambodia's 1997 behavioral surveillance survey. STUDY DESIGN: Among persons randomly selected from clusters of military, police, and motorcycle taxidrivers in five cities, associations between individual characteristics, behaviors, social context, and "active bridging" were tested using logistic regression analyses. RESULTS: The authors defined 20.5%, 15.7%, and 14.7% of military, police, and motorcycle taxidrivers as active bridgers (men who have unprotected sex with high and low risk partners). Among the military and police, logistic regression revealed that age (odds ratio [OR], 1.05), age of first sexual intercourse (OR, 0.89), having friends who frequent sex workers (OR, 3.31), and residence in the port city (OR, 3.34) were associated with active bridging. Among motorcycle taxidrivers, residence in the border city (OR, 2.23) or the port city (OR, 2.84) was associated with active bridging. Sexually transmitted disease symptoms during the past year were significantly associated with active bridging. CONCLUSIONS: Social characteristics influence sexual bridging more than individual ones. The pervasiveness of bridging and the association with sexually transmitted disease symptoms underscore the potential of men who are active bridgers to spread sexually transmitted disease and HIV in Cambodia beyond high-risk groups.

Alterations within the quinolone resistance-determining regions of GyrA and ParC of Neisseria gonorrhoeae isolated in the Far East and the United States.

The genetic mutations within the quinolone resistance-determining regions (QRDRs) of gyrA and parC of 234 Neisseria gonorrhoeae strains isolated in the Far East and the United States, which exhibited either clinically significant ciprofloxacin resistance (CipR) or intermediate ciprofloxacin resistance (CipI) were characterized. A number of GyrA/ParC amino acid alteration patterns were identified, the most prevalent alteration pattern among CipR isolates being GyrA-91,95/ParC-Asp-86- > Asn (91,95/Asp-86- > Asn). Isolates containing 91,95/Asp-86- > Asn belonged to a number of A/S classes, penicillin/tetracycline resistance phenotypes, and plasmid profiles. These results strongly suggest that the continuing emergence of ciprofloxacin-resistant gonococci is not due to the spread of a single or a few strains but to numerous factors such as 'spread of existing strains, importation of new strains and, possibly, de novo development of ciprofloxacin resistance in previously susceptible strains.

Sexual behaviour of commercial sex workers and their clients in Cambodia. Japan-Cambodia Collaborating Research Group.

OBJECTIVE: This study surveyed the sexual behaviour of commercial sex workers and their clients in an attempt to identify factors of transmission of STDs (including HIV/AIDS) and to control their epidemics in Cambodia and South-East Asia. DESIGN: Cross-sectional study. SETTING: Trained questioners asked items of the questionnaires to each objective subject in December 1996. Data were analysed to show the descriptive status by risk group of each person. PARTICIPANTS: 200 direct commercial sex workers, 220 indirect commercial sex workers, and 211 clients in Phnom Penh. RESULTS: Prostitution was widely accepted by both young males and females, and this was an easy way for young girls to obtain money. Although commercial sex workers and clients were knowledgeable about prevention methods against STDs, they seldom used condoms. Some commercial sex workers had been infected with STDs many times, and many of them incompletely treated the diseases by themselves. Social support from governmental and non-governmental organisation was poor. CONCLUSIONS: It is very important to support both commercial sex workers in practicing preventive methods against STDs and also visiting physicians when they notice symptoms of STDs. It is strongly recommended that not only governmental but also non-governmental organisations should be more active in this area.

[Epidemiological study on HIV/AIDS in Cambodia seroprevalence of HIV/STD among commercial sex workers].

OBJECTIVE: To describe epidemiological features of HIV prevalence among female commercial sex workers (CSWs) in Cambodia, a cross-sectional study using a questionnaire study and serological tests was carried out from December 1997 to January 1998. We report the main results of the analyses of serological tests in this article. METHODS: Two hundred ninety six CSWs working in Sisophon and Poi Pet, located in northwest Cambodia, Bantey Mean Chey province, were recruited for interview based on a questionnaire on sexual behavior, and serological tests. The blood samples were examined for HIV antibody, Chlamydia trachomatis IgG antibody, TPHA, Hepatitis B surface antigen, and Hepatitis B surface antibody. The relationship between HIV and the other STD's was analyzed by using logistic regression analysis. RESULTS: The HIV seroprevalence rate was 43.9% (130 out of 296). The seropositive rate of Chlamydia trachomatis IgG antibody (C.T.-IgG-Ab) was 73.3% (217 out of 296). Logistic regression analysis showed a significant association between C.T.-IgG-Ab positive and HIV prevalence. (Odds Ratio: 5.33; 95% Confidence Interval, 2.82-10.07). CONCLUSIONS: This study suggests that the existence of Chlamydia trachomatis is closely related with HIV prevalence among CSWs in Cambodia. Other STDs may also increase susceptibility to male-to-female sexual transmission of HIV. This suggests that appropriate prevention against STDs will be needed for the control of HIV prevalence in Cambodia.

Explosive spread of HIV-1 and sexually transmitted diseases in Cambodia.

PIP: A cross-sectional study conducted in 5 locations in Cambodia (Phnom Penh, Svay Pak, Sihanoukville, Battambang, and Sisophon) in 1996, compared prevalences of HIV and other sexually transmitted diseases (STDs) in 314 women seeking reproductive health services, 322 male police and military personnel, and 437 brothel-based sex workers (SWs). Among SWs, 38.7% had chlamydial and/or gonococcal infection and 13.8% were syphilis seroreactive. Among police and military personnel, 2.1% had chlamydial infection, 5.0% had gonorrhea, and 6.6% were syphilis seroreactive. 5.3% of reproductive health care clients had chlamydial and/or gonococcal infection and 4.0% were syphilis seroreactive. HIV prevalence was 40.6% among SWs (range by site, 19-51%), 12.5% among police and military personnel (range, 6-16%), and 4.5% in the reproductive health client group (range, 3-7%). Assays of serum specimens from 9 HIV-1-seropositive individuals revealed subtype E, suggesting that Cambodia's HIV epidemic is a result of regional spread from Thailand rather than importation by UN peacekeeping troops. 56% of police and military personnel acknowledged having sex with a prostitute in the month preceding the survey and 88.5% reported such an encounter in the past year; only 38% reported consistent condom use with commercial SWs. The high rates of HIV and other STDs identified in this study indicate an urgent need for preventive interventions, particularly ones focused on the commercial sex industry.^ieng