Survival and disease burden analyses of occupational pneumoconiosis during 1958-2021 in Huangshi city, China: a retrospective cohort study.

BACKGROUND: Pneumoconiosis, a chronic disease stemming from prolonged inhalation of dust particles, stands as a significant global burden of occupational diseases. This study aims to investigate the survival outcomes of pneumoconiosis patients in Huangshi city, China, while also evaluating the disease burden on afflicted patients. METHODS: Data for this study were sourced from the Huangshi Center for Disease Control and Prevention. Survival analyses of pneumoconiosis patients were conducted employing life tables and the Kaplan-Meier method. The Cox proportional hazards models were deployed to identify factors influencing pneumoconiosis patients' survival duration. Competing risks models were employed to confirm the validity of the model outcomes. Additionally, in the disease burden assessment, disability-adjusted life years (DALYs) were computed for various demographic groups and time frames. RESULTS: A total of 5,641 pneumoconiosis cases, diagnosed in Huangshi City, Hubei Province between 1958 and 2021, were incorporated into the cohort analysis. The probability of mortality and the risk ratio increased with advancing age. Notably, the median survival time of stage III pneumoconiosis patients was significantly shorter compared with those in stages I and II. The Cox proportional hazards model and competing risks analyses underscored several significant factors influencing survival time, including dust exposure duration (HR = 1.197, 95% CI: 1.104-1.298), age at first diagnosis (HR = 3.149, 95% CI: 2.961-3.349), presence of silicosis (HR = 1.378, 95% CI: 1.254-1.515), and stage II-III pneumoconiosis (HR = 1.456, 95% CI: 1.148-1.848). Cumulatively, DALYs amounted to 7,974.35 person-years, with an average of 1.41 person-years. The period between 2000 and 2019 witnessed the highest disease burden. CONCLUSION: Our findings highlight the urgent need for improved prevention, earlier detection, and more effective management strategies for the occupational pneumoconiosis population. This study not only underscores the persistent issue of pneumoconiosis in industrial environments but also serves as a crucial call to action for policymakers and healthcare providers.

Prevalence and prevention and control effects of malaria in Huangshi, Hubei, 1951-2021 / 中国热带医学

@#Abstract: Objective To analyze the epidemiological characteristics, prevention and control strategies, measures and the effects achieved of malaria in Huangshi City from 1951 to 2021, and to offer a reference for further strengthening malaria eradication and control successes. Methods　Descriptive epidemiological methods were used to assess the prevalence, measurements, and impacts of malaria in different time periods based on data for malaria control in Huangshi City from 1951 to 2021, and we created "semi-log" line graphs and charts to display the prevalence of disease and the effort done in prior years in terms of prevention and control. Results　Between 1951 and 2021, 527 780 cases of malaria were recorded in Huangshi, with an average annual incidence rate of 40.07/10 000. The prevention and control of malaria has gone through four stages, namely, the high prevalence of malaria stage (1951-1979), the basic elimination stage (1980-1999), the consolidation stage (2000-2010), and the eradication stage (2011-2021). Different strategies and measures have been adopted in different epidemic periods. During the high epidemic period, great efforts have been made to carry out general surveys and treatments, and strengthen the management of symptomatic patients; during the eradication stage, prominent and classified prevention and control strategies were adopted. When the incidence rate dropped to below 1/10 000, the main measures adopted were malaria monitoring, including timely discovery and standardization of infectious sources, disposal of epidemic points, management of migrant population malaria and vector monitoring. Through active prevention and control, remarkable results were achieved, and the incidence rate of malaria fell to below 1/10 000 in 1989, reaching the level of "basic elimination of malaria" issued by the Ministry in 1999, and passed the provincial malaria elimination acceptance in 2015. In recent years, with the increasing labor exports and foreign exchanges, imported malaria has been on the rise. African countries are the main sources of imported malaria, and the main species is P.falciparum. Conclusions　Malaria was once one of the main infectious diseases endangering the health of people in Huangshi City. The preventive and control methods and procedures adopted in different epidemic periods are effective. Currently, we have entered the consolidation phase of malaria elimination, with the focus of work being to monitor, report, and timely and effectively respond to imported malaria cases, thus reducing the risk of local transmission.

Quality of life and hostile mentality trend of patients with HIV/AIDS in China.

OBJECTIVE: To assess the quality of life (QOL) and hostile mentality trend (HMT) of patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in China, and to identify their major concerns. STUDY DESIGN AND METHODS: Short Form-36 (SF-36) was used to assess QOL, and seven items were developed to assess the HMT. In-depth interviews were conducted with patients and health workers. RESULTS: SF-36 had moderate reliability, with Cronbach's alpha coefficients ranging from 0.75 to 0.90 and test-retest correlation coefficients ranging from 0.54 to 0.80 for the eight domains. The item-subscale correlation coefficients ranged from 0.46 to 0.97. The QOL of patients with HIV/AIDS was significantly lower than the average QOL of the general population (P<0.01). Hostile mentality of patients was significant (mean scores of the seven items ranged from 2.87 to 4.32, and the mean sum of scores was 3.45 from a range of 1-5). Cronbach's alpha coefficient of HMT items was 0.75 and the test-retest correlation coefficient was 0.80. The major concerns of patients with HIV/AIDS were financial insecurity and family responsibilities, followed by the fear of death and no cure for HIV/AIDS. CONCLUSION: SF-36 is a reliable instrument for the assessment of QOL of patients with HIV/AIDS. The QOL of patients with HIV/AIDS in China is poor. The HMT is a valuable indicator to monitor the outcomes of care for patients with HIV/AIDS.

[Quality of life and hostile mentality trend among 299 patients living with HIV/AIDS].

OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.

[The development and assessment on an instrument regarding quality of life for patients living with HIV/AIDS in China].

OBJECTIVE: To develop a specific quality of life (QOL) instrument for Chinese patients living with HIV/AIDS and to assess its reliability and validity. METHODS: 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. RESULTS: 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. CONCLUSION: 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.