基层三甲医院2012—2015年医院感染现患率及危险因素

目的了解医院感染现患情况及其危险因素,为医院感染预防与控制提供依据。方法采用横断面调查的方法,床旁调查和查阅住院病历相结合,对2012—2015年某基层三甲医院住院患者进行医院感染现患率调查及危险因素分析。结果共调查住院患者4 725例,2012—2015年医院感染现患率分别为6.00%、4.77%、3.93%、3.05%,差异有统计学意义（P＜0.05）;抗菌药物使用率分别为30.56%,33.82%,32.84%,34.48%,差异无统计学意义（P＞0.05）;感染部位以下呼吸道为主（43.00%）,其次为手术部位（16.43%）;年龄≥65岁、慢性全身性疾病（包括糖尿病,肝硬化,慢性肾功能不全,慢性肺部疾病）,免疫缺陷（白细胞＜1.5×109/L）、昏迷、气管切开、使用呼吸机是医院感染的危险因素。结论医院感染现患率调查可促进医院感染管理持续改进,应加强手术部位感染监测和医院感染危险因素的评估。     

基层医院医院感染现患率调查分析

目的 了解基层医院医院感染现患率,常见感染部位,影响因素,发现医院感染管理中存在的问题,为有效开展医院感染目标性监测提供依据.方法 参照〈全国医院感染现患率调查〉方案,制定统一表格,采取床边调查和在架病案调查相结合的方式.结果 实际调查1110例,实查率为98.67%,医院感染现患率是3.96%,现患例次率是4.32%,抗感染药物使用率60%.结论 侵入性操作、免疫抑制剂、放化疗、年老体弱、慢性疾病是医院感染的主要危险因素,为有效开展目标性监测提供了依据.另外,高端抗生素的滥用也是今后医院感染管理研究的重要课题.     

不同场所暗娼艾滋病性病相关危险行为研究

[目的]了解深圳市不同场所暗娼艾滋病知识知晓率、艾滋病性病相关危险行为特征,为政府制订预防控制措施提供科学依据.[方法]面对面对暗娼进行行为学调查,同时抽血化验HIV、梅毒.[结果]共调查335名目标人群,平均年龄22.5岁,艾滋病相关知识知晓率为70.2%,第1次商业性行为平均年龄20.2岁;最近1次商业性行为安全套使用率88.9%,最近1次非商业性行为安全使用率为41.0%;中低档暗娼发生商业性行为的频率更高;梅毒阳性率2.4%.[结论]虽然深圳市暗娼艾滋病性病感染率较低,但存在感染相关危险因素,必须加强健康教育和行为干预工作力度,尤其要关注中低档暗娼.     

北京市延庆县不同职业人群慢病行为危险因素调查

目的了解不同职业人群慢性非传染性疾病(慢病)的行为危险因素,为制定有效的慢病防治措施提供依据。方法按照等比例多阶段整群抽样方法,采用集中调查和入户调查相结合的方式对不同职业人群进行调查。结果本次共调查336人,吸烟率为29.5%;酗酒率为15.2%;不运动率为46.4%;不吃早餐率为8.3%;高盐饮食率27.7%;高脂饮食率14.9%。慢病总患病率为32.4%。不同职业人群之间卫生保健服务存在显著差异。结论被调查人员存在不健康生活方式者较高,慢病发病率较高,应该对不同人群实施有针对性的健康教育,开展不同形式的干预活动,改变人群不健康行为,减少危险因素,控制疾病发生和发展。     

阜阳市男男性行为者艾滋病知识、行为以及HIV感染状况研究

目的了解安徽省阜阳市男男性行为者(MSM)艾滋病知识水平、行为特征以及HIV感染率,为制定防治策略提供依据。方法收集MSM人口学、行为学、艾滋病知识等相关信息,并采集血液标本进行HIV检测。结果共调查264名MSM,艾滋病相关知识知晓率为92.4%,HIV感染率为5.7%。在最近六个月8,7.1%的MSM与同性发生过肛交性行为,安全套使用率为有时使用率58.7%,每次都用率34.8%;21.6%的MSM与异性发生过性行为,安全套使用率为有时使用率29.8%,每次都用率26.3%。感染HIV的相关危险因素为:高年龄组、离异或丧偶、以及性交时从不使用安全套。结论阜阳市MSM人群中高危险性行为普遍存在,HIV感染率高,应尽快采取针对性的行为干预措施。     

珠海市2010-2012年暗娼艾滋病哨点监测结果分析

目的了解珠海市暗娼人群艾滋病流行现状和相关危险因素,为本市艾滋病综合防控提供参考依据。方法采用分层整群随机抽样方法,抽取在市区从事商业性性交易的女性,每年不低于400名。使用国家统一的哨点监测问卷进行调查,并检测HIV抗体、梅毒抗体和丙肝抗体。结果三年共调查暗娼1 210名,调查对象平均年龄为(25.1±6.0)岁,未婚占50.17%,初中及以下文化占64.46%,外省户籍占91.24%;艾滋病基本知识知晓率、最近一次商业性行为安全套使用率、最近一月内每次都使用安全套比例、过去一年里接受艾滋病有关宣传干预率和接受艾滋病检测率均呈逐年升高的趋势;但艾滋病基本知识知晓率仍偏低(85.93%)、安全套使用率未达100.0%(93.09%)、吸毒和性病感染情况依然较为普遍。结论珠海市艾滋病防控工作效果逐年显现,但暗娼人群中仍存在导致全市艾滋病疫情快速蔓延的危险因素,须加大宣传教育和行为干预力度,同时扩大监测检测,做到病例早发现,早管理,减少二代传播。     

男男性行为者294例的艾滋病相关行为分析

目的了解男男性行为者(MSM)的艾滋病相关行为特征,为研究针对该人群的有效的行为干预措施提供依据。方法选取经常活跃在酒吧、公园等场所活动的MSM,对其进行感染艾滋病危险行为特点及交友方式调查。结果采用SPSS统计软件进行统计分析。结果共调查294人,最近6个月平均性伴数(4.71±18.75)人,安全套使用率较低,肛交每次使用安全套率45.49%,口交只有15.85%,HIV主动检测率32.31%;76.64%的人初次性行为对象为男性,66.53%的人主要通过因特网结交性伴。结论被调查的MSM存在性伴数较多、安全套使用率低等艾滋病高危行为,而HIV主动检测率较低,急需研究针对该人群的切实有效的干预措施。     

118名低档暗娼HIV感染及安全套使用情况分析

目的了解贵阳市区低档暗娼HIV感染率、安全套使用及相关影响因素。方法采用滚雪球和同伴介绍方法,对参与调查低档暗娼进行问卷调查及HIV检测,并分析其HIV感染率、安全套使用情况及影响因素。结果共调查118名低档暗娼,艾滋病知识知晓率为41.5%,HIV感染率为8.5%,最近1个月安全套坚持使用率为35.6%,多因素分析显示,在贵阳工作时间≥12个月与不知晓艾滋病知识是最近1个月安全套坚持使用的危险因素(P值均<0.05)。结论贵阳市低档暗娼HIV感染率较高,高危性行为普遍。应加强干预,积极推广同伴教育,提高艾滋病知晓率及安全套使用率。     

成都市男男性行为人群艾滋病感染状况及危险因素分析

目的分析成都市2011年男男性行为人群艾滋病哨点监测结果,探索HIV感染影响因素,为制定有效的干预措施、防治策略提供依据。方法采用横断面问卷调查方法,获得人口学及行为学资料,并进行HIV抗体和梅毒检测。对HIV感染危险因素进行单因素x。检验和多因素Logistic回归分析。结果2011年成都市共调查男男性行为者251人,HIV感染率为15．54％,梅毒感染率13．55％,艾滋病相关知识知晓率90．03％;最近6个月与同性发生肛交性行为占86．5％,最近1次安全套使用率为62．21％,安全套坚持使用率为36．87％;20．72％的男男性行为者与异性发生过性行为,且安全套坚持使用率为19．23％。结论成都市男男性行为人群HIV感染率较高,且高危性行为广泛存在,艾滋病知识知晓率较高、但安全套坚持使用率较低,应进行安全套发放和VCT服务,减少HIV感染的影响因素。     

兰州市城关区暗娼人群艾滋病和梅毒流行病学分析

目的了解兰州市城关区暗娼人群(FSW)艾滋病和梅毒流行特征及相关影响因素,为有针对性地开展健康教育和行为干预提供科学依据。方法在知情同意的原则下,采用两阶段整群抽样的方法,对城关区娱乐场所从事商业性交易的女性,进行面对面问卷调查。调查内容包括人口学状况、艾滋病相关知识、安全套的使用和求医行为等。血液采集进行艾滋病、梅毒抗体检测。结果共调查FSW1200人,未检出HIV感染者,检出梅毒108例,检出率为9.00%;最近1个月商业性性行为安全套每次使用率为78.33%,最近一次商业性性行为安全套使用率为92.50%。49.66%的调查对象有固定性伴,其最近1个月安全套每次使用率为43.50%,最近一次安全套使用率为51.25%。结论暗娼人群安全套使用率低,存在艾滋病/梅毒感染的潜在危险,应继续加大健康教育和行为干预力度,促进其建立良好的行为和生活方式。     

Reproducibility of a telephone questionnaire on risk factors associated with behavior and preventive practices

OBJECTIVE: To assess the reproducibility of a questionnaire used in a surveillance system for risk factors of non-communicable diseases (SIVFRENT), based on continuous surveys through telephone interviews. METHODS: The same questionnaire was administered telephonically to a cross-section of 586 individuals aged between 18 and 64 years representative of the Autonomous Community of Madrid (Spain) on 2 occasions with an interval of 13 to 32 days. Twenty-seven variables related to perceived health status, anthropometry, physical activity, smoking, alcohol consumption, preventive practices, injuries and road safety were analyzed. To assess response stability, absolute agreement, unweighted and weighted kappa values, and the intraclass correlation coefficient (ICC) were used in nominal, ordinal and quantitative categorical variables, respectively. RESULTS: The response rate to the second interview involving 461 people was 78.7%. The comparison of prevalences and averages from both interviews revealed that in 19 out of the 27 indicators analyzed, the relative deviation was under 5% and exceeded 20% in only 2 indicators. Absolute agreement was greater than 85% in 13 of the 20 categorical variables. In 10 variables, the kappa and ICC coefficients were greater than 0.8, in 13 they ranged from 0.6 to 0.8, in 3 from 0.4 to 0.6 and only 1 was below 0.4. A uniform pattern of sociodemographic variables associated with disagreement was not observed. CONCLUSIONS: The results suggest that the telephone questionnaire used in the surveillance system on risk factors associated with behavior and preventive practices (SIVFRENT) is reproducible in a wide sample representative of the adult population of the Autonomous Community of Madrid.     

Telephone coverage and measurement of health risk indicators: data from the National Health Interview Survey.

OBJECTIVES: This study compared health behavior variables for all US households and households with telephones to measure the potential impact of telephone coverage on estimates from telephone surveys. METHODS: Data were derived from the 1991 through 1994 version of the National Health Interview Survey. RESULTS: Ninety-five percent of respondents lived in households with telephones. Differences in health indicators were small (< 1%) in comparisons between all households and those with telephones. Results were similar when only respondents below the poverty level were included. CONCLUSIONS: Telephone noncoverage effects appear to be small, supporting the use of telephone surveys for health risk behavior surveillance with most population groups.     

From risk-based health surveillance to health promotion: an evidence-based experience in a health care setting

In the European countries the health surveillance may be provided as a part of the national health system intervention. In Italy, the legislative Decree (626/94) makes the health surveillance compulsory for all those workers who are exposed to occupational risks. The aim of this study was to describe the introduction of preventive and protective measures, according to the new regulations, in the teaching hospital of the University of Modena. The population examined in 2000 included 1523 workers. Specific health surveillance protocols were prepared on the grounds of the risk characteristics based on the scientific evidence and on the risk perception. The intervention was oriented towards health promotion. The subjects were classified into 10 groups according to the risk characteristics. The percentage of workers ranged from 4% to 42%, depending on the exposure-related health changes. Moreover, the study explored some of the health surveillance benefits: an improvement in worker's satisfaction, an improvement in relationship between stakeholders, an early detection of health changes and a sickness absence reduction after the influenza vaccination program.     

Maintaining mammography adherence through telephone counseling in a church-based trial

OBJECTIVES: This study assessed the effectiveness of telephone counseling in a church-based mammography promotion intervention trial. METHODS: Thirty churches were randomized to telephone counseling and control conditions; telephone interview data were used in assessing intervention effects on mammography adherence. Separate analyses were conducted for baseline-adherent participants (maintaining adherence) and baseline-nonadherent participants (conversion to adherence). RESULTS: Year 1 follow-up data indicated that the telephone counseling intervention maintained mammography adherence among baseline-adherent participants and reduced the nonadherence rate from 23% to 16%. CONCLUSIONS: Partnerships between the public health and faith communities are potentially effective conduits to promote maintenance of widely endorsed health behaviors such as regular cancer screening.     

Domestic and travel-related foodborne gastrointestinal illness in a population health survey

Routine surveillance data underestimate incidence of foodborne gastrointestinal (FGI) illness and provide little information on illness related to travel. We analysed data from the Welsh Health Survey to estimate population incidence, and to examine risk factors for FGI and factors associated with consulting a doctor. Reported frequency of any FGI in the 3 months before interview was 20.0% [95% confidence interval (CI) 19.5-20.4; equivalent to 0.8 episodes per person-year], and for travel-related FGI was 1.6% (95% CI 1.5-1.8). In the final model, sex, age group, marital status, self-reported health, long-term illness, smoking and alcohol consumption were all independent predictors of FGI. People who consulted a doctor were likely to be older, in poorer health, taking regular medication, or to report mental illness. FGI is common but risk factors for illness and consultation differ and impressions of the epidemiology of the disease based on surveillance data are therefore distorted.     

Effects of enhanced calling efforts on response rates,estimates of health behavior,and costs in a telephone health survey using random-digit dialing.

Public health researchers frequently rely on random-digit dialing (RDD) telephone surveys in monitoring trends in health behavior and evaluating health promotion interventions. RDD response rates have declined during the past decade, and cost-effective methods to increase response rates are needed. The authors evaluated two levels of enhanced calling efforts in an RDD survey of cancer-related health behavior in the State of Washington. The first level of enhanced calling effort was 1 month after 11 original calling attempts to a household, when the authors attempted up to 11 recalls. The second level was 6 months after the first answered call, when the authors recalled those persons who could not be interviewed. Enhanced calling efforts increased the overall survey response rate by 11 percent. Nine percentage points of the increase were attributable to call backs. There were demographic differences among the participants reached at different levels of calling effort, but no consistent associations of level of calling effort with health behavior related to alcohol use, smoking, diet, or health screening. Marginal costs for interviews completed with enhanced calling efforts were about 50 percent higher than costs for interviews reached in the first 11 calls. The authors concluded that enhanced calling efforts may be justified, because they increase confidence in the generalizability of survey results. However, the authors found very little change in survey results by including interviews from persons who were difficult to reach and to interview.     

Validity of food and beverage intake data obtained by telephone survey

OBJECTIVE: To evaluate the reproducibility and validity of data on food and beverage intake obtained by means of a telephone-based surveillance system. METHODS: Reproducibility and validity analyses were carried out in two random subsamples (n=112 and n=119, respectively) of the total sample (N=2,024) of adults (> or =18 years) studied by the system in 2005 in the municipality of S?o Paulo, Southeastern Brazil. Indicators evaluated included protective factors (daily or almost daily intake of fruit and vegetables) and risk factors (daily or almost daily intake of soft drinks, frequent intake of foods containing saturated animal fat, and abusive intake of alcoholic beverages) for the development of chronic diseases. Reproducibility was studied by comparing the results of the original telephonic interview with those of another interview carried out 7-15 days later. Validity was analyzed by comparing the results of the telephone interview with those of three 24-hour recalls (our gold-standard) carried out up to 5 days following the original interview. RESULTS: The frequency of the studied indicators remained relatively constant between the first and second telephone interviews, with kappa coefficients ranging from 0.57 to 0.80, indicating good reproducibility for all indicators. In relation to the gold standard, there was a trend towards overestimating the frequency of intake of protective foods, but of foods associated with increased risk of chronic diseases. Sensitivity and specificity were high for indicators of consumption of risk-associated foods (close to 80%), and variable in the case of protective foods (42% to 80%). CONCLUSIONS: The evaluation showed evidence of good reproducibility and adequate validity for most indicators employed in the system, which indicates that maintaining this system operational in coming years will provide a useful instrument for evaluating public policies for the promotion of a healthy diet and for control of non-communicable chronic diseases with a dietary component in Brazil.     

Comparison of text-messaging to voice telephone interviews for active surveillance of adverse events following immunisation

ObjectivesIn 2013, the Follow-up and Active Surveillance of Trivalent Influenza Vaccine in Mums (FASTMum) program began using short message service (SMS) to collect adverse event information in pregnant women who recently received trivalent influenza vaccine (TIV). This study was designed to compare data collected via SMS and telephone for the purposes of monitoring vaccine safety.MethodsA number of 344 women who received TIV were randomly assigned to a telephone interview group. They were telephoned seven days post-vaccination and administered a standard survey soliciting any adverse events following immunisation (AEFI) they experienced. They were matched by brand of vaccine, age group, and residence to 344 women who were sent a SMS seven days post-vaccination. The SMS solicited similar information. AEFI reported by SMS and telephone interview were compared by calculating risk ratios.ResultsResponse rate was higher to SMS compared to telephone interview (90.1% vs. 63.9%). Women who were surveyed by SMS were significantly less likely to report an AEFI compared to women who were surveyed by telephone (RR: 0.41; 95% CI: 0.29–0.59). The greatest discrepancies between SMS and telephone interview were for self-reported injection site reactions (3.1% vs. 16.8%) and unsolicited (or “other”) events (11.4% vs. 4.1%). Data collected by SMS was significantly timelier.ConclusionsData collection by SMS results in significantly improved response rates and timeliness of vaccine safety data. Systems which incorporate SMS could be used to more rapidly detect safety signals and promote more rapid public health response to vaccine quality issues.     

射阳县农村居民高血压相关知识、行为、需求及影响因素的研究

目的了解江苏省射阳县农村居民对高血压相关知识、行为、需求情况及其影响因素，为采取有针对性的高血压健康教育与健康促进措施提供依据。方法以多级分层整群随机抽样法，对射阳县18岁以上常住居民进行问卷调查，同时测量身高、体重和血压。结果调查对象的高血压患病率为27．6％，男性为23．2％，女性为32．1％，男女患病率均随年龄增长而上升。高血压相关知识知晓率在12．9％～88．1％之间，行为形成率在10.8％～80．2％之间，健康知识需求率在31．5％～76．3％之间。超重、年龄、职业、吸烟、饮酒、睡眠不足、心理压力较大、饮食习惯不良等影响因素与高血压发生有关（P〈0．05）。结论射阳县农村居民高血压患病率较高，而高血压相关知识知晓率与行为形成率不高，应根据不同人群的需求采取有针对性地健康教育健康促进干预措施。     

Chronic joint symptoms and prior arthritis diagnosis in community surveys: implications for arthritis prevalence estimates

OBJECTIVES: Alternative definitions of arthritis in community surveys provide very different estimates of arthritis prevalence among older Americans. This telephone interview study examines prevalence estimates based on the current Behavioral Risk Factor Surveillance System (BRFSS) arthritis case definition. METHODS: Interviews were conducted with 851 Chicago residents age 45 and older. Logistic regression was used to compare the age and sex controlled prevalence of poor health, restricted activity, and arthritis risk factors among those with a previous arthritis diagnosis from a health professional, those with undiagnosed chronic joint symptoms, and those who were joint symptom free and without a previous arthritis diagnosis. RESULTS: BRFSS-defined arthritis prevalence was 47% of older residents, including 33% reporting a previous arthritis diagnosis and 14% chronic undiagnosed joint symptoms. Only 25% of these respondents reported current arthritis treatment by a doctor. After controlling for age and sex, respondents with a previous arthritis diagnosis and those with undiagnosed chronic symptoms had significantly worse health and functioning, and more prevalent arthritis risk factors, than respondents without joint symptoms. CONCLUSIONS: BRFSS-defined arthritis included almost half the area population over age 45. Both diagnosed and undiagnosed chronic joint symptoms are associated with major functional limitations and arthritis risk after controlling for age and sex. The inclusion of previously undiagnosed chronic joint symptoms in the BRFSS arthritis definition is appropriate and indicates that previous arthritis prevalence estimates may be too low.