Cystic and alveolar echinococcosis: an epidemiological survey in a Tibetan population in southeast Qinghai, China.

An epidemiological investigation on echinococcosis was made in Jiuzhi County of Qinghai Province, western China. Ultrasonography and an indirect hemagglutination test revealed a morbidity of 8.0% (124/1,549) and a seroprevalence of 25.8% (287/1,113), respectively, in the Tibetan population. The morbidity in herdsmen (16.6%) and Buddhist priests (15%) was significantly higher than that in other occupation groups (3.2%), and it was higher in females (9.8%) than in males (6.2%). The ultrasound images showed a coexistence of cystic echinococcosis (CE) and alveolar echinococcosis (AE), occupying 69 and 31% of the cases, respectively. An Echinococcus Western blot assay was performed as a serological backup test for differentiating CE and AE. The assay revealed that serum samples from most cases with a positive AE image showed a specific antibody against antigen bands at 16/18 kDa. Autopsy proved that 9 out of 12 stray dogs were infected with Echinococcus granulosus (n = 8) and E. multilocularis (n = 1). Inspection at the abattoirs demonstrated a hydatid rate of 78.5% in yaks and 82.6% in sheep. The data indicate that Jiuzhi County is an important endemic area for both CE and AE, in both human and animal populations.

Changes in attitudes, knowledge and behavior associated with implementing a comprehensive school health program in a province of China.

After successful pilot projects, Zhejiang Province, China, decided to systematically scale-up health promoting schools (HPS) over the entire province of 47 million. This study describes the interventions and self-reported changes in attitudes, knowledge and behavior during the first phase of scaling-up. Group interviews were conducted with a sample of 191 participants (school administrators, teachers, students and parents) from nine schools with a total of approximately 15 200 students. Grounded theory guided data analysis. Schools implemented all HPS components (school health policy, physical school environment, psychosocial school environment, health education, health services, nutrition services, counseling/mental health, physical exercise, health promotion for staff and outreach to families and communities), adapted to local circumstances. Participants reported a range of changes in attitudes (paying more attention to health, attaining better 'psychological quality' and confidence, forming friendships between teachers and students and feeling more relaxed), knowledge and concepts (increasing knowledge about various health issues, developing a broader concept of health and gaining better understanding about the HPS concept) and behavior (actively participating, increasing physical activity, improving sanitary habits, reducing or quitting smoking, eating more nutritiously, increasing safety behavior, sustaining less injuries and improving parent-child communication). This qualitative study shows the feasibility and efficacy of implementing HPS in Zhejiang Province, China.

Global progress of echinococcosis control and an insight to the national control program.

Global distribution and prevalence of the two echinococcosis, research progress, and control programs in a number of countries were summarized. Strategies, measures and possible research topics were discussed in relation to the national control program which has been launched in western China since 2005.

Strategies for implementing health-promotion schools in a province in China

After successful pilot projects in 10 schools (four schools with tobacco control and six schools with nutrition interventions, plus 10 control schools), Health and Education officials in Zhejiang Province, China, decided to scale up Health Promoting Schools (HPS) systematically over the entire province, starting with an initial cohort of 51 additional schools, reaching from primary to vocational schools. Interviews with school personnel during the first phase of scaling up illuminated the key pre implementation, implementation, and monitoring and evaluation activities. Pre implementation activities included choosing an entry point, setting up a special HPS committee, and establishing a work plan. Implementation activities included conducting mobilization meetings, prioritizing health, popularizing the HPS concept, ensuring community cooperation and participation, acting as role models, offering training, and using new teaching and learning methods. Monitoring and evaluation activities included process, baseline, and final evaluations and changing standards of evaluation to a more holistic evaluation that schools go through to become Health Promoting Schools. Schools also reported that they faced, and overcame, a number of challenges including understanding and integrating the HPS concept and lack of professional development and support. Results revealed that schools transitioned from a passive model of education to interactive pedagogy put priority on health and viewed it as a co-responsibility, reshaped assessment to a more holistic approach and called for more training and technical support. Participants mentioned that they gained knowledge and skills and developed a deeper understanding about health. Health impact was also demonstrated, for instance in reduced injuries and reduced smoking, and educational impact was demonstrated, for instance in improved relationships of children to parents and teachers, improved social qualities, and improved teacher satisfaction. (AU)

Epidemiological investigation on Clonorchis sinensis in human population in an area of South China.

To detect the prevalence of Clonorchis sinensis, one of the important helminthes in the human population of the Guangxi Region where Schistosoma japonicum was endemic but eliminated in the late 1980s, the Kato-Katz thick smear technique was used for examining fecal samples from selected townships in Hengxian County. Among 1,552 people examined, 491 (31.6%) were found infected with C. sinensis. By counting eggs per gram feces (EPG), it was found that the light, moderate, and heavy intensities of infection occupied 55.4, 33.0, and 11.6%, respectively, with an average EPG of 4,845 in the infected subjects. The survey revealed that the prevalence in the age groups of 0 - 9 and 10 -19 years old was less than 10% but was 45 - 50% in the groups between 30 - 39 and 60 - 69 years old. A much higher prevalence was demonstrated in the male population (41.9%) than in the females (20.5%), and heavier intensity of infection was also found in the males than in the females. These results indicated that the prevalence of this liver fluke is increasing in the past decade in that region, and there is an urgent need to further assess the epidemiological factors in reference to the area's changing socioeconomic conditions and human behavior, contamination of the environment and fish ponds, inadequate farming/fishery practices, and the infection of domestic animals.