Were infections in migrants associated with the resurgence of measles epidemic during 2013-2014 in southern China? A retrospective data analysis.

OBJECTIVE: The 2009 province-wide and 2010 nationwide supplementary immunization activities (SIAs) greatly reduced measles prevalence in Guangdong, a province in southern China with the largest migrant population. However, during 2013-2014, Guangdong experienced a resurgence of the measles epidemic. This study was performed to examine the association between infections in migrants and the resurgence of the measles epidemic. METHODS: The records of 22 362 clinically and laboratory-confirmed measles cases from the years 2009 to 2014 were extracted from the National Infectious Disease Monitoring Information System. The epidemiological characteristics of infections in migrants during 2009-2012 were compared to those during 2013-2014. RESULTS: Infections in migrants were not significantly associated with the resurgence of the measles epidemic in 2013-2014 (p=0.98). Nevertheless, for infections among locals and migrants during 2009-2012 and 2013-2014, substantial increases in the proportion of infection were detected among children aged <8 months and the unvaccinated population (p<0.01). CONCLUSIONS: The study findings suggest that infections in migrants might not have been the major cause of the epidemic resurgence of measles. Instead, the resurgence was likely due to infections among children aged <8 months and the unvaccinated. Thus, officials are advised to give higher priority to appropriate populations when formulating control measures, and to strengthen routine surveillance of vaccination coverage among them.

What factors hinder ethnic minority women in rural China from getting antenatal care? A retrospective data analysis.

BACKGROUND: Mother-to-child transmission (MTCT) is one of the main transmission routes of HIV, and the probability of MTCT can be dramatically reduced with comprehensive interventions. In southwest and western regions in China, the level of development in rural areas is relatively backwards and retains some original features, which also increases the difficulty of controlling infectious diseases. The Liangshan Prefecture started the prevention of MTCT programme in 2009. However, the implementation of the programme is not ideal, and the coverage of HIV testing is still low. Many Yi (local major ethnicity) women did not take antenatal care (ANC) and just gave birth to their babies at home for a variety of reasons. METHODS: Women with pregnancy history in the last 5 years were recruited from two townships based on cluster sampling. Face-to-face interviews were conducted to collect data. Descriptive analysis was performed to describe demographic characteristics, history of pregnancy and ANC uptake, knowledge of and attitudes towards ANC. Multivariable analysis was used to identify factors associated with uptake of ANC. RESULTS: Among 538 women who completed the questionnaires, 77.9% knew that ANC was necessary during and after pregnancy. However, only 24.2% actually accessed ANC. Almost all women (94.6%) expressed their willingness to receive ANC for pregnancy but barriers towards actual uptake of ANC existed including shyness, lack of independence and unavoidable cost. Multivariate analysis showed that no experience of living outside of Zhaojue for more than 6 months, higher number of births, not knowing the necessity of ANC during pregnancy and not knowing the government's promotion policies for ANC were associated with lack of ANC uptake. CONCLUSION: Although ethnic minority women in rural Liangshan expressed strong intention to use ANC, actual uptake of ANC was low. Knowledge of ANC and HIV prevention for MTCT should be improved among this population, and efforts should be made to help them overcome barriers to accessing ANC.