2003年湖南省血吸虫病疫情纵向观察点监测报告

目的掌握“十五”期间湖南省血吸虫病疫情流行现状及变化趋势,为制定防治对策提供科学依据。方法监测20个疫情纵向观察点的螺情、居民和耕牛病情。结果20个观察点粪检6 287人,感染率为6.92%;粪检877头家畜,感染率为9.01%。各试点垸内活螺密度为0.0004~2.0284只/0.11 m2,未查到感染性钉螺。垸外活螺平均密度为1.3366只/0.11 m2,感染螺平均密度为0.0034只/0.11 m2。结论湖南省血吸虫病流行区居民和耕牛感染率仍较高,特别是高度和中度流行区更为明显。提示全省今后防治策略的重点应针对中、高度流行区的居民和耕牛。     

湖北省2009年国家监测点血吸虫病疫情监测结果分析

目的分析湖北省2009年国家级血吸虫病疫情监测点疫情变化,了解湖北省血吸虫病流行现状,为制定血吸虫病防治对策提供科学依据。方法根据《全国血吸虫病监测方案》的要求,16个监测点开展人群及家畜病情、螺情和相关因素调查,采用SPSS12.0软件统计分析监测结果。结果湖北省16个监测点居民感染率为1.03%,耕牛感染率为1.98%,活螺平均密度为0.2934只/0.11m2,感染螺平均密度为0.00041只/0.11m2,钉螺感染率为0.139%。各项疫情指标较前4年有所下降。结论监测点人畜感染率呈现持续下降,但部分监测村钉螺感染率仍较高,因此,应加强钉螺控制措施,提高药物灭螺质量,防止疫情反弹。     

2005-2009年湖南省汉寿县丁家拐村血吸虫病疫情监测报告

目的了解目平湖湖沼型疫区血吸虫病流行动态,为制定防治对策和考核防治效果提供科学依据。方法进行病情与螺情监测。结果居民感染率逐年下降,由2005年6.61%降至2009年1.25%,男性高于女性,职业人群以渔民最高。耕牛粪阳率维持在10%左右,垸外钉螺密度大幅度下降,由2005年秋季的4.24只/0.11m2降至2009年的0.03只/0.11m2,2005年秋季垸外阳性螺密度0.004只/0.11m2,2006年以后未查到感染性钉螺。结论今后耕牛与渔民是防治工作重点。     

湖北省2008年国家监测点血吸虫病疫情监测结果分析

目的分析湖北省2008年国家级血吸虫病疫情监测点监测结果,了解湖北省血吸虫病流行现状,为制定血吸虫病防治对策提供科学依据。方法根据《全国血吸虫病监测方案》的要求,开展16个监测点的监测工作,并统计分析各项指标。结果湖北省16个监测点居民感染率为1.10％,耕牛感染率为2.42％,活螺平均密度为0.2757只／0.11m^2,感染螺平均密度为0.00062只／0.11m^2,钉螺感染率为0.226％。结论虽然16个监测点人畜感染率降低到5％以下,但部分监测村钉螺感染率仍较高,以传染源控制为主的血吸虫病综合防治措施要进一步认真落实。     

武汉市蔡甸区国家血吸虫病监测点9年疫情监测

目的掌握监测点血吸虫病疫情动态,为制定防治对策提供科学依据。方法按照《全国血吸虫病疫情监测方案》开展了人群及家畜病情、螺情监测工作,并将9年的各项监测指标进行统计分析。结果 2013年与2005年相比,人群血清学IHA检查阳性率下降幅度为78.96%;居民感染率下降幅度为89.08%,农民和渔民的血吸虫感染率分别下降了89.81%和100.00%;耕牛阳性率到2011年下降了79.75%,2012年后全面淘汰了耕牛,实现了以机代牛;钉螺面积下降了59.27%,活螺密度下降了22.59%,钉螺感染率由0.35%下降为零。结论血吸虫病监测点通过开展常规及综合防治措施,人群感染率和耕牛粪检阳性率明显下降,螺情变化明显,疫情得到了有效控制。     

2002-2013年鼎城区林家村血吸虫病疫情监测

目的了解洞庭湖澧水流域林家村血吸虫病流行动态,为洞庭湖洲垸亚型流行区制定血吸虫病防治对策提供科学依据。方法收集2002-2013年林家村血吸虫病情、螺情、人口和社会经济数据,以及实施的各种防治措施等资料,分析林家村血吸虫病疫情指标的动态演变规律。结果林家村居民血吸虫病人群感染率逐年下降,由2002年8.13%降至2013年0.70%,其中男性感染率高于女性,职业以渔民感染率最高。12年间耕牛粪检阳性率维持在8%左右。垸外钉螺密度大幅度下降,由2003年秋季最高10.60只/0.1m2降至2014年秋季1.77只/0.1m2。2003年垸外秋季感染螺平均密度高达0.023只/0.1m2,2007年以后未检测到感染性钉螺。结论林家村血吸虫病疫情大幅度下降,耕牛和渔民是今后防治的工作重点。     

2006年湖北省血吸虫病监测点疫情比较分析

[目的]了解疫区血吸虫病流行动态和影响因素,预测流行趋势.[方法]按照<湖北省血吸虫病监测方案>要求的项目与方法,收集锣场镇两个监测点的疫情监测资料.[结果]2类村人群感染率为5.97%,耕牛感染率为9.4%,活螺密度为1.79只/0.11 m2;3类村人群感染率为1.62%,耕牛感染率为10%,活螺密度为0.28只/0.11 m2,两村人群感染率差异有统计学意义(χ2=17.06,P<0.01).[结论]2类村属于重点防治村,加大耕牛禁牧力度,加强健康教育是目前控制疫区人群感染率的主要措施.     

2007年四川省血吸虫病疫情监测

目的 掌握四川省血吸虫病疫情,为防治工作提供科学依据.方法 按照全国血吸虫病监测方案,在四川省的9个国家级监测点开展2007年监测工作.结果 9个血吸虫病监测点的钉螺面积为206 870m2,钉螺密度0.011～52只/0.11m2,平均钉螺密度0.23只/0.11m2,未发现感染性钉螺.仁寿和中江点未查出血吸虫病患者,其他各点感染率在0.27%～0.98%之间,全省平均人群血吸虫病感染率0.41%.9个监测点中未发现患血吸虫病家畜.结论 四川省血吸虫病进一步下降,应加强巩固防止血吸虫病疫情回升.     

2002—2013年鼎城区林家村血吸虫病疫情监测

目的 了解洞庭湖澧水流域林家村血吸虫病流行动态,为洞庭湖洲垸亚型流行区制定血吸虫病防治对策提供科学依据。 方法 收集2002— 2013年林家村血吸虫病情、螺情、人口和社会经济数据,以及实施的各种防治措施等资料,分析林家村血吸虫病疫情指标的动态演变规律。 结果 林家村居民血吸虫病人群感染率逐年下降,由2002年8.13%降至2013年0.70%,其中男性感染率高于女性,职业以渔民感染率最高。12年间耕牛粪检阳性率维持在8% 左右。垸外钉螺密度大幅度下降,由2003年秋季最高10.60只/0.1m²降至2014年秋季1.77只/0.1 m²。2003年垸外秋季感染螺平均密度高达0.023只/0.1 m²,2007年以后未检测到感染性钉螺。 结论 林家村血吸虫病疫情大幅度下降,耕牛和渔民是今后防治的工作重点。     

2010年四川省血吸虫病监测结果分析

目的分析2010年四川省国家级血吸虫病疫情监测点的疫情数据，了解监测点血吸虫病现状及疫情变化趋势，为防治工作提供科学依据。方法按照《全国血吸虫病监测方案》在四川9个国家级监测点开展2010年钉螺和血吸虫病监测工作。结果9个监测点居民血检阳性率在2．73％～17．02％之间，平均血检阳性率和感染率（Kato—Kmz法）分别为7．62％和0．10％，人群感染度（EPG）几何均数为0．003，耕牛感染率为1．02％。共查出钉螺面积128285m。，活螺密度在0．02～1．29只／0．1m2之间，平均活螺密度为0．21只／0．1m2，未发现感染性钉螺。结论四川省血吸虫病已控制在较低水平，但仍需进一步加强健康教育、家畜管理以及钉螺控制，防止疫情回升。     

Emergency preparedness among people living near US army chemical weapons sites after September 11, 2001

We examined trust in the army and perceptions of emergency preparedness among residents living near the Anniston, Ala, and Richmond, Ky, US Army chemical weapons stockpile sites shortly after September 11, 2001. Residents (n = 655) living near the 2 sites who participated in a cross-sectional population were relatively unprepared in the event of a chemical emergency. The events of September 11 gave rise to concerns regarding the security of stored chemical weapons and the sites' vulnerability to terrorist attacks. Although residents expressed trust in the army to manage chemical weapons safely, only a few expressed a desire to actively participate in site decisions. Compliance with procedures during emergencies could be seriously limited, putting residents in these sites at higher levels of risk of exposure to chemical hazards than nonresidents.     

《中国心血管病报告2018》概要

  目的  评价中国西南5省高血压患病、知晓、治疗和控制的地区差异情况,为改善当地高血压防治管理现状提供依据。  方法  基于心血管病高危人群早期筛查与综合干预项目,自2016年1月 — 2018年11月,通过方便抽样于西南5省选择30个项目点,并调查项目点所在地区35～75岁常住居民的心血管病患病状况。分析各地区高血压患病、知晓、治疗和控制现状,并对风险标化后患病、知晓、治疗和控制率进行地区间比较。  结果  研究纳入394 957名对象,高血压患者159 014名,平均年龄（58.8 ± 9.5）岁,男性占40.2 %,总体高血压患病、知晓、治疗和控制率分别为40.3 %,43.7 %,29.8 % 和9.6 %。30个调查地区居民高血压患病、知晓、治疗和控制率的中位数分别为40.4 %,42.6 %,29.9 % 和7.3 %;校正个体特征后的风险标化高血压患病、知晓、治疗和控制率中位数分别为39.2 %,42.2 %,30.0 % 和9.6 %,风险标化后各率的地区差异仍明显存在。8个地区居民的患病率高于西南5省平均水平,主要在云南省和西藏自治区;10个地区居民知晓、治疗和控制率3者均低于西南5省平均水平。  结论  中国西南5省在高血压患病、知晓、治疗和控制上存在着显著地区差异,亟需地区针对性的改进措施和对薄弱地区的重点干预。     

Hazards for nearby residents and cleanup workers of waste sites.

This study weighs the risks to workers of cleaning up Superfund sites against the risks to residents if the sites were not cleaned up. Risks are measured by the number of deaths and disabilities due to injuries and diseases, as well as by the costs of these deaths and disabilities. We posit three methods to clean up the sites: one that is labor-intensive and two that are not. We posit 24 hypothetical sites, with varying numbers of residents and levels of cancer death and cancer disability rates. Depending on the cleanup method, the number of residents, and the rates, we find that the risks to workers frequently outweigh the risks to residents. We conclude that risks to workers should be accounted for in Environmental Protection Agency judgments regarding which and how Superfund sites should be cleaned up.     

Dioxins and Related Compounds in Human Breast Milk Collected Around Open Dumping Sites in Asian Developing Countries: Bovine Milk as a Potential Source

In this study, concentrations of dioxins and related compounds (DRCs)—such as polychlorinated dibenzo-p-dioxins, polychlorinated dibenzofurans, and coplanar polychlorinated biphenyls—were found in human breast milk from women living near dumping sites of municipal waste and reference sites in India, Cambodia, Vietnam, and the Philippines during 1999 to 2000. DRCs were detected in all human breast milk samples analyzed, demonstrating that residents in these Asian developing countries have been exposed to these contaminants. In India, the concentrations of DRCs in human breast milk from women living near the investigated dumping site were notably higher than those from women living near reference sites and from women in other Asian developing countries. Toxic equivalent quantity (TEQ) levels of DRCs were comparable with or higher than those reported in the general populations of developed countries since 1990. In contrast, levels of these contaminants in human breast milk in women from Cambodia and Vietnam were not significantly different between milk from women living near the dumping and reference sites. These results indicate that significant pollution sources for DRCs are present in Indian dumping sites and that residents there have been exposed to relatively higher levels of these contaminants. TEQ levels in human breast milk from the dumping site in India tended to decrease with an increase in the number of previous deliveries by mothers, whereas no significant relationship was observed in Cambodia, Vietnam, or the Philippines. This suggests that mothers who have been exposed to relatively high levels of DRCs transfer greater amounts of these contaminants to the first infant than later ones through breast-feeding, which in turn implies that the first children of these mothers might be at higher risk from DRCs. When the residue levels of DRCs in bovine milk collected from the Indian dumping site and reference sites were examined, TEQ levels in bovine milk from the dumping site were higher than those from reference sites. This result suggests that bovine milk is a potential source of DRCs for residents living near the dumping site in India. To our knowledge, this is the first comprehensive study on exposure to DRCs of residents living in proximity to open dumping sites of municipal waste in Asian developing countries.     

Peer Reviewed: Using Resident Health Advocates to Improve Public Health Screening and Follow-Up Among Public Housing Residents,Boston, 2007-2008

Introduction

Promoting screening for hypertension, high cholesterol, diabetes, and dental disease, particularly among residents of public housing, is a key strategy for achieving the objectives of Healthy People 2010. This community-based participatory research study tested a resident health advocate (RHA) intervention in public housing to increase use of mobile screening and to assess postscreening follow-up care for people with positive screening results.

Methods

During the summers of 2007 and 2008, a mobile health unit screened residents at 4 housing developments for hypertension, high cholesterol, diabetes risk, and dental disease. In the first summer, at 2 intervention sites, RHAs used personal contacts and repeated flyers to recruit residents; 2 control sites received standard recruitment, which was to leave flyers with the development manager. In the second summer, the 2 control sites from the previous year became intervention sites. For both summers combined, we calculated the number of people at intervention and control sites who used the van and we examined rates of appointments made and kept for residents who had positive screening test results.

Results

Screening rates were higher in the intervention condition compared with the control condition (relative risk [RR], 1.55; 95% confidence interval [CI], 1.12-2.15). Approximately 65% of participants screened positive for at least 1 condition. The proportion of participants with screen-positive findings who had follow-up appointments increased from 15% in 2007 to 55% in 2008.

Conclusion

The use of RHAs increased participation in health screening among public housing residents and rates of follow-up medical visits for people with positive screening results.     

福建省第5次结核病流行病学调查结果的启示

目的分析福建省第5次结核病流行病学抽样调查结果,为改进结防工作质量提供依据。方法按照全国统一调查方法与标准,对5个流调点≥15岁居民进行症状调查、摄胸片和肺结核知晓率调查;对可疑患者行痰涂片、痰培养和社会经济情况问卷调查。结果共调查7 020人,受检率95.9%。活动性肺结核患病率427.35/10万;涂阳患病率142.45/10万;菌阳患病率156.70/10万。患者家庭人均年纯收入低于当地农村居民。防治知识知晓率为63.1%,农村(58.5%)低于城镇(82.4%)。结论福建农村肺结核患病情况仍较严重,乡村卫生院(所)仍是发现病人的重点。各级政府必须持续增加经费投入,切实减轻患者负担,开展健康促进活动,提高防治知识知晓率。     

Explaining direct care resource use of nursing home residents: findings from time studies in four states

OBJECTIVE: To explain variation in direct care resource use (RU) of nursing home residents based on the Resource Utilization Groups III (RUG-III) classification system and other resident- and unit-level explanatory variables. DATA SOURCES/STUDY SETTING: Primary data were collected on 5,314 nursing home residents in 156 nursing units in 105 facilities from four states (CO, IN, MN, MS) from 1998 to 2004. Study Design. Nurses and other direct care staff recorded resident-specific and other time caring for all residents on sampled nursing units. Care time was linked to resident data from the Minimum Data Set assessment instrument. Major variables were: RUG-III group (34-group), other health and functional conditions, licensed and other professional minutes per day, unlicensed minutes per day, and direct care RU (wage-weighted minutes). Resident- and unit-level relationships were examined through hierarchical linear modeling. DATA COLLECTION/EXTRACTION METHODS: Time study data were recorded with hand-held computers, verified for accuracy by project staff at the data collection sites and then merged into resident and unit-level data sets. PRINCIPAL FINDINGS: Resident care time and RU varied between and within nursing units. RUG-III group was related to RU; variables such as length of stay and unit percentage of high acuity residents also were significantly related. Case-mix indices (CMIs) constructed from study data displayed much less variation across RUG-III groups than CMIs from earlier time studies. CONCLUSIONS: Results from earlier time studies may not be representative of care patterns of Medicaid and private pay residents. New RUG-III CMIs should be developed to better reflect the relative costs of caring for these residents.     

ECHO-AGE: An Innovative Model of Geriatric Care for Long-Term Care Residents With Dementia and Behavioral Issues

ObjectivesTo design, implement, and assess the pilot phase of an innovative, remote case-based video-consultation program called ECHO-AGE that links experts in the management of behavior disorders in patients with dementia to nursing home care providers.DesignPilot study involving surveying of participating long-term care sites regarding utility of recommendations and resident outcomes.SettingEleven long-term care sites in Massachusetts and Maine.ParticipantsAn interprofessional specialty team at a tertiary care center and staff from 11 long-term care sites.InterventionLong-term care sites presented challenging cases regarding residents with dementia and/or delirium related behavioral issues to specialists via video-conferencing.MethodsBaseline resident characteristics and follow-up data regarding compliance with ECHO-AGE recommendations, resident improvement, hospitalization, and mortality were collected from the long-term care sites.ResultsForty-seven residents, with a mean age of 82 years, were presented during the ECHO-AGE pilot period. Eighty-three percent of residents had a history of dementia and 44% were taking antipsychotic medications. The most common reasons for presentation were agitation, intrusiveness, and paranoia. Behavioral plans were recommended in 72.3% of patients. Suggestions for medication adjustments were also frequent. ECHO-AGE recommendations were completely or partially followed in 88.6% of residents. When recommendations were followed, sites were much more likely to report clinical improvement (74% vs 20%, P < .03). Hospitalization was also less common among residents for whom recommendations were followed.ConclusionsThe results suggest that a case-based video-consultation program can be successful in improving the care of elders with dementia and/or delirium related behavioral issues by linking specialists with long-term care providers.     

广西死因监测点居民2008-2012年循环系统疾病死亡状况及疾病负担分析

目的 了解广西壮族自治区死因监测点居民2008-2012年循环系统疾病死亡状况及其疾病负担,为制定防治策略和措施提供参考依据。方法 收集广西壮族自治区死因监测点死因登记报告信息系统中2008年1月1日-2012年12月31日上报的居民循环系统疾病监测数据,分析该地区居民循环系统疾病死亡特征及疾病负担。结果 2008-2012年广西壮族自治区死因监测点共报告循环系统疾病死亡居民33 308例,年均死亡率为218.41/10万,年均标化死亡率为217.42/10万;其中,2008、2009、2010、2011、2012年年均死亡率分别为175.46/10万、219.68/10万、222.02/10万、241.92/10万、225.53/10万,居民循环系统疾病死亡率呈上升趋势（χ²趋势=182.93,P<0.001）;居于前4位的主要循环系统疾病依次为脑血管病、缺血性心脏病、高血压病、风湿热和风湿性心脏病,年均死亡率依次为120.67/10万、57.60/10万、14.27/10万、6.42/10万;2008-2012年广西壮族自治区死因监测点居民因循环系统疾病死亡导致的潜在寿命损失年（YPLL）为162 061人年,潜在寿命损失年率（YPLLR）为10.63‰,标化潜在寿命损失年率（SYPLLR）为10.34‰。结论 广西壮族自治区死因监测点居民2008-2012年循环系统疾病死亡率呈上升趋势,居民循环系统疾病的疾病负担较重。     

广西乡(镇)市售猪肉猪人肉孢子虫感染的初步报告

目的了解广西乡(镇)市售猪肉猪人肉孢子虫感染情况。方法选择居民有吃生猪肉的乡(镇)为调查点,采用直接压片法,对乡(镇)市售猪肉采样镜检猪人肉孢子虫包囊。结果调查的10个乡(镇)均查到自然感染猪人肉孢子虫的猪,猪的阳性村为51.85%,猪感染率为33.64%,标本阳性率为8.32%。结论调查的乡(镇),市售猪肉平均猪人肉孢子虫感染率为33.64%。