Utility of the Tétanos Quick Stick® in the vaccine catch-up of adult migrants without proof of prior vaccination

BackgroundUnknowing immunity status make migrants vaccine catch-up difficult. The interest of using a rapid tetanus immunotest as the Tétanos Quick Stick® (TQS®) to assess immunity status against tetanus has been evaluated in emergency rooms and it is now commonly used. The study aim was to evaluate TQS® as a tool for migrants’ vaccine catch-up.MethodsFrom December 2018 to February 2019, a prospective study was performed and included consecutively migrants who attented to the primary medicine outconsultation of a health care centre in Paris. Migrants above 18, without any records of tetanus immunization were included and a TQS® was performed during a medical consultation. Adapted vaccine catch-up was then proposed. Immunity against tetanus among migrants, factors associated with positive TQS® and costs savings were evaluated.ResultsTQS® test was positive for 32% of the 310 included patients. In the univariable analysis, factors associated to the presence of a positive TQS® test were a female gender (OR = 1.69 CI95% [1.02–2.80]) and an urban living in the country of origin (OR = 1.79 CI95% [1.07–3.02]). In the multivariable analysis, these factors were not significantly associated to a positive TQS®. Anamnesis was not correlated to the immunity status: only 26% of the migrants who reported vaccinations in childhood, adolescence and adulthood had a positive TQS® test. The use of TQS® test allowed savings of 6,522 US$ as compared to the immediate catch-up strategy for the 310 patients.ConclusionThe TQS® test is an acceptable, simple, rapid and cost saving test that could find a place in the migrants’ vaccine catch-up.     

深圳市龙岗区坪地外来工亚健康状态的研究

目的 :探讨深圳市龙岗区坪地外来工亚健康状况及其影响因素 ,为预防亚健康提供科学依据。方法 :采用统一表格对 12 68深圳市龙岗区坪地外来工进行调查。结果 :外来工的平均年龄为 ( 2 4.96± 6.10 )a ,其亚健康状态总体发生率为 65 .3 0 %,男性亚健康状态发生率为 63 .2 1%,女性为 67.91%,男性和女性之间差异无统计学意义。亚健康状态主要影响因素为 :结婚与否、睡眠时间、工作时间、加班时间以及工作是否有压力和居住环境差等因素 ,而与吸烟、饮酒、文化程度等因素无相关。结论 :深圳龙岗区坪地外来工中普遍存在亚健康状态 ,其发生较高且与工作环境、工作时间、加班时间有密切关系 ,故应引起政府部门及社会各界高度重视 ,加强对外来工的健康保护     

The resurgence of tuberculosis in the Republic of Ireland: Perceptions and reality

Tuberculosis remained a very significant cause of death in Ireland until the mid-20th century and still occupies a prominent position in the folk memory. As I show with reference to recent Irish media coverage, the global resurgence of tuberculosis is therefore viewed with concern in Ireland. Using data collated by the Health Protection Surveillance Centre between 1998 and 2005 however, I show that the recent increase in tuberculosis incidence in Ireland is less than is popularly perceived. This increase is largely associated with economic immigrants attracted to Ireland by the ‘Celtic Tiger’ economic boom, but there is little evidence to suggest that this has had a negative impact on the Irish-born population. Drug resistance is still a small but growing problem. Whilst vigilance is required, it is argued that the recent increase does not at present indicate a likely return to the situation in the mid-20th century.     

流动人口的计划生育管理分析

对1998年在上海闵行区开展的“以现居住地为主”的计划生育综合干预项目中外来育龄妇女的计划生育管理状况进行分析,综合运用定量与定性研究方法以了解她们的计划生育管理状况及对计生管理的态度和要求,评价计生管理干预对改善本市外来育龄妇女的计生管理状况及提高她们对计划生育管理的认知的效果。结果显示：通过管理干预,外来育龄妇女携带原籍计划生育证明的比例和持有计划生育信息卡的比例以及暂住证上加盖计划生育合格章的比例均明显增加,妇女对计划生育服务的满意度也明显增加。认为“以现居住地为主”的流动人口计划生育管理有助于计划生育管理,应进一步加强流入地与流出地的联络、协调与积极配合,加强流动人口的计生双向管理。     

Cancer incidence among first generation Scottish, Irish, West Indian and South Asian migrants living in England and Wales

Objectives. To examine the incidence of cancers among persons born in Scotland, Northern Ireland, the Irish Republic, Caribbean Commonwealth and Indian subcontinent and living in England and Wales. Methods. Longitudinal Study of 1% of population of England and Wales followed from 1971 to 1989. Standardised incidence ratios (SIRs) were derived for commonly occurring cancers and all cancers using the age-sex-specific rates for all females and all males in the Longitudinal Study. Results. The incidence of all malignant neoplasms among West Indians (females SIR = 67, male SIR = 70) and Indians (female SIR = 32, male SIR = 52) was low. Among South Asians, this pattern was consistent for Hindus, Sikhs and Moslems. Scottish females showed raised incidence of lung cancer (SIR = 149) and those from the Irish Republic of oral cavity and pharynx (SIR = 321), oesophageal (SIR = 219) and liver (SIR = 373) cancers. Among Northern Irish females, incidence of lung cancer (SIR = 193) was raised. West Indian and South Asian females showed low incidence of breast cancer (SIR = 55 and 45, respectively). High incidence of laryngeal (SIR = 229) and renal (SIR = 203) cancers was observed for Scottish males and of oral cancer (SIR = 259) for males from the Irish Republic. At ages 15-64, raised incidence of prostate cancer (SIR = 129) and of leukaemia (SIR = 252) was also observed for men from the Irish Republic. Northern Irish males showed raised incidence of stomach cancer (SIR = 200). Conclusion. This study describes patterns of cancer incidence among migrant groups, most of which reflect environmental influences. This has challenging implications for sensitive targeting of primary interventions. It is important not to be complacent about lower risks of main cancers among West Indians and South Asians. In all Longitudinal Study members, breast cancer was the most common malignancy among females and lung cancer among males. This was also true for all migrant groups with the exception of Northern Irish women for whom lung cancer was the most common.     

上海市闵行区暂住人口结核病人诊断延迟因素定性研究

[目的]分析上海市暂住人口结核病人诊断延迟情况及因素,为防制决策服务。[方法]对闵行区结核病防治工作人员、暂住人口结核病人进行访谈,对5家医院内科门诊和6家药店进行模拟患者观察。[结果]暂住人口结核病人诊断延迟情况严重,经济条件差是暂住人口就诊延迟的重要原因,卫生服务提供方(包括医院和药店)对病人诊断延迟造成一定影响。[结论]要改善暂住人口结核病人诊断延迟严重的状况,最主要的是要对暂住人口的结核病诊疗在政策给予优惠经济上给予适当减免。鉴于暂住人口生病后在药店买药情况普遍,药店从业人员的基本医药知识的保证也是值得关注的。     

Vaccine coverage in children born to migrant mothers in Australia: A population-based cohort study

BackgroundOverall, infant immunisation coverage is currently >90% in Australia, but there are pockets of under-immunised children including children from migrant backgrounds. This study aimed to examine whether on-time vaccination coverage of diphtheria-tetanus-pertussis dose 3 (DTP3) for children born in Australia differed by mother’s region of birth and if so, what factors were associated with these differences.MethodsWe conducted a population-based cohort study using linked data on perinatal, immunisation and birth records for 2 million children born in Western Australia and New South Wales between 1996 and 2012. We assessed on-time coverage of DTP3 (vaccination from 2 weeks prior to, and up until 30 days after, the due date) in children with mothers born overseas. Logistic regression models were developed to determine factors associated with on-time coverage for each maternal region of birth and all regions combined, adjusting for a range of demographic factors. Adjusted estimates of coverage were calculated for the different regions of birth.ResultsOn-time DTP3 coverage was 76.2% in children of Australian born mothers, lower in children of mothers from Oceania (66.7%) and North America (68%), and higher in children born to mothers from South-East Asia (79.9%) and Southern Asia (79.3%). While most variables were consistently associated with lower coverage in all regions of birth, higher socioeconomic status and jurisdiction of birth showed varied results. Adjusted estimates of DTP3 coverage increased in children born to mothers from Australia (78.3%), Oceania (70.5%), Northern Africa (81.5%) and the Middle East (79.6%). DTP3 coverage decreased in children born to mothers from Europe and former USSR (74.6%), North-east Asia (75.2%), Southern Asia (76.7%), North America (65.5) and South/Central America and the Caribbean (73.2%).ConclusionsOn-time vaccination rates differed by mother’s region of birth. More research is needed to determine the main reasons for these remaining differences to improve vaccine uptake and also help guide policy and practice.     

上海市闵行区外来人口结核病发现与治疗

[目的 ]　对上海市闵行区外来人口结核病防治工作进行基线调查 ,了解外来人口结核病防治工作中存在的问题及其原因 ,提出相应对策。　 [方法 ]　对闵行区疾病预防控制中心的日常结核病报表资料进行分析 ,同时采访结核病防治工作人员和外来人口结核病患者 ,收集定性资料进行分析。　 [结果 ]　外来人口结核病新登记率高于本地人口 ,而其实际的流行情况更加严重。但是外来人口对结核病的卫生服务需要不能得到满足。　 [结论 ]　缺乏有效管理方式、经济困难以及缺乏卫生知识是外来人口结核病防治工作中面临的主要困难。应加强管理 ,提供免费诊治 ,加强宣传教育。     

Consequences of criminalisation: the Dutch khat market before and after the ban

Abstract

Aims: To evaluate the consequences of criminalising khat, with a focus on the changes in law enforcement and the use, availability, price and quality of khat in the Netherlands. Methods: Mixed methods, including law enforcement data, expert interviews, focus group interviews with members of the Somali community, and a survey among 168 current (last month) khat users. Findings: Soon after the law changed (early in 2013), and khat had become an illicit drug, much of the khat imported from Africa was confiscated at Schiphol International Airport and users found it more difficult to obtain fresh khat leaves. About two years after the ban had been implemented, the price of fresh khat at user level had increased tenfold on average, and much of it was of poorer quality (e.g. sold in dried or powdered form). Conclusion: Criminalisation of khat in the Netherlands had substantial consequences for the khat market, predominantly because the ban was actively enforced at a crucial stage in the distribution chain (transcontinental import by air) and there was a lack of alternative transportation routes that could supply users with fresh khat. It is highly likely that the total number of Somali khat users in the Netherlands dropped, but that the proportion of dependent and poor, “problem users” increased.     

合肥市庐阳区娱乐场所年轻女性流动人群高危性行为及影响因素分析

目的了解合肥市庐阳区娱乐场所年轻女性流动人群艾滋病性病知识水平及性行为特征,探讨该人群高危性行为的影响因素。方法采用横断面调查的方法,采取随机抽样,抽取合肥市庐阳区22家娱乐场所为调查现场,招募符合要求的调查对象。调查内容包括社会人口学特征、艾滋病性病相关知识、安全套使用知识和自我效能、近1年患性病及生殖道感染状况、流产、近6个月性行为、性伴种类及安全套使用情况。运用EpiData3．0软件建立数据库并录入资料,运用SPSS13．0软件进行统计学分析。结果共调查娱乐场所流动女性180人,艾滋病基本知识知晓率为70．6％;30．0％的调查对象报告近1年患有性病或生殖道感染,58．3％既往有过流产;最近6个月有61．7％的调查对象发生过高危性行为,多因素Logistic分析结果显示,婚姻状态为已婚、累计打工时间〉3年、首次性行为年龄≤18岁、首次性行为未使用安全套者发生高危性行为危险性增加;随着安全套正确使用知识和安全套使用效能的增加,发生高危性行为危险降低。结论合肥市庐阳区娱乐场所女性流动人群性病艾滋病知识不足,高危性行为和生殖健康问题普遍存在,因此,需要制定针对性的干预策略和措施以提高该人群的生殖健康水平。