拉萨市世居藏族农村居民慢性肝胆疾病患病现状及危险因素

目的 了解西藏拉萨市世居藏族农村居民慢性肝胆疾病患病现状及其危险因素,为采取相应的干预措施提供参考依据。方法 采用分层随机抽样方法在拉萨市墨竹工卡县和林周县抽取的1 737名年龄≥18岁世居藏族农村居民进行问卷调查、体格检查、肝胆疾病B超检查和肝功能检测。结果 拉萨地区世居藏族农村居民慢性肝胆疾病总患病率为22.3%,各类型肝胆疾病患病率由高到低依次为:胆囊炎(11.3%)、胆囊结石(6.2%)、脂肪肝(4.5%)、肝包虫病(1.9%)、肝血管瘤(1.6%)、肝硬化(0.8%);多因素非条件logistic回归分析结果显示,女性、年龄≥45岁、月平均收入>2 000元、超重、肥胖、中心性肥胖和谷丙转氨酶(ALT)升高是拉萨地区世居藏族农村居民慢性肝胆疾病患病的危险因素。结论 拉萨地区世居藏族农村居民慢性肝胆疾病以胆囊炎为主,女性、年龄较大、月平均收入较高、体质指数(BMI)和ALT较高以及中心性肥胖居民是该地区慢性肝胆疾病防治的重点人群。     

Risk factors for cardiovascular disease and diet of urban and rural dwellers in northern Nigeria

Over the last 30 years, cardiovascular diseases (CVDs), including stroke and myocardial infarction, have increased in developing countries. Serum lipids and diet of the Fulani, a rural Nigerian population, were previously studied. Despite their consumption of a diet rich in saturated fat, the overall blood lipid profiles of Fulani men and women are generally favourable. However, Fulani males in the same study had mean serum levels of homocysteine, an emerging risk factor for CVD, that exceeded the upper limit of the homocysteine reference range. The authors were interested in knowing if these findings in the Fulani nomads were representative of the biochemical parameters of CVD risk in other ethnic groups in the same region of Nigeria. To address this question, the nutrient content of diets of 55 men, aged 20-75 years, and 77 women, aged 20-70 years, who were inhabitants of a large urban centre in northern Nigeria, was assessed, and their serum levels of total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, and homocysteine were determined. These data were compared with those of the same rural Fulani population studied previously. Urban subjects consumed more calories than rural subjects (men: 2061 vs 1691 kcal; women: 1833 vs 1505 kcal) and had a significantly higher mean body mass index (BMI) and percentage of body fat than rural subjects. Both urban males and females had carbohydrate intakes that were greater than those of Fulani pastoralists (men: 56% vs 33% total calories; women: 51% vs 38% total calories), but had a significantly lower dietary intake of total fat and saturated fat (men: 36% vs 51% of total calories; women: 40% vs 51% of total calories). With the exception of HDL-cholesterol levels, which were significantly lower in the rural population, the blood lipid profiles of rural subjects were more favourable compared to those of urban subjects. Both urban and rural males had homocysteine levels above the upper limit of the reference range for healthy adults (urban males--12.7 micromol/L; rural males-15.2 micromol/L). The dietary intakes of folate and vitamin B12 were lower for rural Fulani subjects, and this was reflected in their significantly lower serum concentrations of these two vitamins. Results of this study suggest that, although the lipid profiles of urban and rural men and women in northern Nigeria indicate a relatively low risk for CVD, their elevated serum homocysteine levels are a cause for concern. The high homocysteine levels among rural men and women could be explained in part at least by their marginal status with respect to folate and vitamin B12.     

Gender and ethnic differences in urban and rural first-contact schizophrenia outpatients in Trinidad

This study investigated gender and ethnic differences in the rate of first contact outpatients with schizophrenia in the setting of a more-urban region (MUR) and a less-urban region (LUR) in Trinidad. In a prospective study, 134 first-contact patients with a diagnosis of schizophrenia were selected from two ecologically different regions. RESULTS: Of this population, 56.7% were of African origin and 32.1% were of Indian descent. Gender differences were significant, with males accounting for 66.4% (n=89) of patients with schizophrenia (chi2 = 14.45, d.f. = 1, p = 0.0001). Further analysis by age categories revealed a significant male predominance at ages 20-24 (p = 0.0001) and 25-29 (p = 0.002). Young African males (15-19 y, p = 0.049) predominated in MUR compared with LUR. The results showed a marked presence of Afro-Trinidadian males in both outpatient clinics (p < 0.05). We conclude that gender and ethnicity are important variables in the presentation of schizophrenia in Trinidad, whereas neither rural nor urban environments appeared to influence the expression of schizophrenia.     

西藏城乡居民心血管病高危人群筛查及危险因素

目的  了解西藏地区城乡居民心血管病高危人群现况及其影响因素,为制定西藏心血管疾病的预防控制措施提供依据。 方法  2016年5月-2019年10月采用随机整群抽样方法在西藏7个项目市(区)抽取41 476名35~75岁城乡居民进行问卷调查、体格测量和实验室检测。 结果  在符合条件的41 476名城乡居民中筛出高危者9 185人,高危率为22.15%,其中有1个危险因素者7 882人(85.81%),2个危险因素者1 457人(15.86%),≥3个危险因素146人(1.59%)。心血管病史型检出率为0.89%,血压高型检出率为18.62%,血脂异常型检出率为3.74%,WHO评估10年患病风险≥20%的检出率为2.17%。≥40岁、职业为农民和居住在农村的居民更易成为心血管病高危人群(均有P＜0.05),女性和婚姻状况为在婚的西藏城乡居民更不易成为心血管病高危人群。 结论  西藏35~75岁心血管病高危人群中男性高危率高于女性,高危率随着年龄的增长而逐渐升高,西藏城乡居民心血管病高危因素以血压高为主,男性、非在婚、年龄较大者、农民等是该地区心血管病综合防治的关键人群。     

A serosurvey for HTLV-I among high-risk populations and normal adults in Egypt

The prevalence of antibodies to human T-cell lymphotropic virus type I (HTLV-I) was determined in high-risk groups and normal adults in Egypt. Among 647 individuals tested, 6 (0.9%) were confirmed positive by western blot analysis. These included 2 (0.7%) of 279 drug addicts, 1 (3.3%) of 30 patients with sexually transmitted diseases, and 3 (2.2%) of 133 healthy individuals. Antibody was not detected in 47 blood recipients or 158 prostitutes. There was no correlation between sex or geographical location and HTLV-I infection. Fifty-three of the 647 sera (8%) were initially reactive by ELISA, but only 12 sera were repeatedly reactive. Since only 4 of these repeatedly reactive sera were confirmed by the western blot, the frequency of false positives using the DuPont screening ELISA was 1.2% (8/643). Two additional sera, confirmed positive by western blot, had been reactive, but not repeatedly, by ELISA. In comparison to the prevalence of HTLV-I antibody among risk groups in many parts of the world, the prevalence in Egypt was low.     

河北省城乡居民卫生服务需求与利用趋势分析与对策

目的:了解河北省城乡居民的卫生服务需求与利用情况,为制定政策提供依据。方法:采取多级分层整群随机抽样,确定5 998户的20 529名常住居民作为调查对象,用统一的调查表进行询问调查。结果:调查人群的两周患病率为18.75%,城市高于农村,与1993年相比有上升趋势;慢性病患病率为16.9%,城市高于农村,与1998年相比有上升趋势;两周就诊率为14.32%,比1993年明显下降,两周未就诊率为57.60%。居民住院率为2.56%,与1993年相比有下降趋势。结论:城乡居民的卫生服务需要量呈上升趋势,卫生服务的需求量及利用率呈下降趋势。应采取有效措施,提高卫生服务利用率。     

Higher bone mineral density in rural compared with urban dwellers: the NOREPOS study

Norway has a very high incidence of osteoporotic fractures, with substantial regional differences in fracture incidence. The present study evaluated whether there are differences in bone mineral density (BMD) between regions in Norway with differences in fracture incidence. The authors used data collected in four large, population-based, multipurpose studies performed in four regions of Norway during 1994-2001. Distal forearm BMD was measured by single energy x-ray absorptiometry in 10,667 participants aged 40-75 years. Cross-calibration was performed by using the European Forearm Phantom. Mean distal forearm BMD was lower in the urban populations of Tromso, Oslo, and Bergen compared with the rural county of Nord-Trondelag, whereas there was no difference between the rural part of Tromso and Nord-Trondelag. For women, body mass index explained some of these differences. The prevalence of low BMD (z score < or = -1) in Oslo, Bergen, and urban Tromso, compared with Nord-Trondelag, was 1.6-1.7 times higher in men and 1.5-2.0 times higher in women, whereas no significant difference was found between rural Tromso and Nord-Trondelag. In this study, higher BMD was found in rural compared with urban areas of Norway, which might help explain the differences in fracture incidence. There was no apparent north-south gradient in BMD.     

A survey of leptospirosis in febrile patients mainly from hospitals and clinics in Trinidad

Acute and convalescent sera were obtained from 202 febrile patients, most of whom were admitted to or attended hospitals or clinics in northern Trinidad during the 12 months from mid-February 1977 to mid-February 1978. Laboratory tests confirmed that 10 of the patients were suffering from current leptospirosis while another 54 had serological evidence of previous leptospiral infections.Antibodies to strains of the Icterohaemorrhagiae serogroup were most commonly found, followed by those to the Hebdomadis and Autumnalis serogroups.Isolates were obtained from the blood of two and the urine of three of the 10 current cases. Four of these strains were identified as belonging to copenhageni serovar of the Icterohaemorrhagiae serogroup and one to serovar brasiliensis of the Bataviae serogroup.Seven of the patients suffering from leptospirosis were males, all rural dwellers, and all except one under 20 years of age. Two of the three female patients were over 60 years old and were urban dwellers. It was not possible to identify the sources of infection with certainty, although dogs may have been responsible for three of the Icterohaemorrhagiae and one of the Canicola infections.Of the 192 patients who were not currently infected, serological evidence of previous infection was obtained in 31 (40%) males and 23 (21%) females and was most common among farmers and rural workers.     

Stress and emotional arousal in urban environments: A biosocial study with persons having experienced a first-episode of psychosis and persons at risk

This article examines the entanglement between feelings of stress and discomfort, physiological arousal and urban experiences of persons living with early psychosis. It adopts a biosocial approach, using mixed methods combining ambulatory skin conductance monitoring, mobile interviews and contextual data, collected through GPS and video recordings. The study draws on and strives to cross-fertilize two recent strands of research. The first relates to the use of digital phenotyping in mental health research. The second explores stress and emotional arousal in cities using ambulatory physiological measures. Empirically, the paper is based on fieldwork in Basel, Switzerland, with nine participants recruited within the Basel Early Treatment Service (BEATS), and four controls. We focus on three salient elements in our results: visual perception of moving bodies, spatial transitions and openness and enclosure of the built environment. The analysis shows how these elements elicit physiological responses of arousal and expressed feelings of discomfort. In the concluding section we discuss the methodological implications of these results and suggest the notion of regime of attention as a focus for future biosocial research on urban mental health.     

Dissemination of health information among rural dwellers in Africa: a Ghanaian experience

This paper looked at how effectively the Ghanaian Ministry of Health disseminated health information within the country. Standardized questionnaires were administered to samples from two villages to find out how they obtained information about four selected health topics--cholera, immunization, ORT and AIDS--and what they knew about these health topics. We found that respondents relied almost equally on conversation with family and friends on the one hand and radio on the other, for information on the selected health topics. Health workers and a traditional communication channel, the 'town-crier', also played significant roles. Our data appeared to indicate that messages on the four selected health topics were not being properly and accurately conveyed and suggestions aimed at redressing this situation were put forward.     

Direct mail as a prompt for follow-up care among persons at risk for hypertension

We undertook a direct mail campaign to urge persons identified as being at risk for hypertension to seek medical advice. Those who received a single mailing displayed a 28% increase in the proportion who subsequently discussed their blood pressure with a physician and a 12% increase in the proportion who had their blood pressure rechecked, while those persons who received six mailings reported an equivalent increase in physician discussions but a smaller increase in rechecking their blood pressure. These results support the use of inexpensive social marketing strategies as follow-up methods for blood pressure screening programs.     

成都市城乡居民糖尿病患病率及影响因素研究

目的 探讨成都市城乡居民糖尿病患病率及其影响因素。方法 采用整群抽样方法 抽取1847名成都市城乡居民,利用问卷调查居民一般情况及过去一年食物摄人情况,测量身高、体重,并行口服葡萄糖耐量试验,在总人群和城乡居民中分别以因子分析提取膳食模式,并以多因素非条件logistic回归分析糖尿病影响因素。结果 调查对象中糖尿病患病率达23.2%,人口标化患病率为20.2%;城乡居民糖尿病患病率分别为28.7%和11.1%。经logistic回归分析,总人群中,与青年人比较,中年人(OR=2.337,95%Cl:1.305～4.185)和老年人(OR=5.990,95%Cl:3.389～10.586)有更高的糖尿病患病风险;职业为管理人(OR=1.434,95%Cl:1.000～2.057)和普通职员(OR=2.870,95%CI:1.653～4.980)较务农人员有更高的患病风险。城市居民中,中年人(OR=2.973,95%CI:1.101～8.031)和老年人(OR=5.972,95%Cl:2.267～15.730)与青年人比较有更高的患病风险;职业为普通职员(OR=2.196,95%C1:1.213～3.975)较务农人员有更高的患病风险;在农村居民中,高能量高蛋白膳食模式者(OR=1.404,95%Cl:1.113-1.772)有更高的糖尿病风险。结论 成都市城乡居民糖尿病患病率较高,年龄、职业和膳食结构均对糖尿病有影响,且影响因素存在差异,营养改善工作应按照城乡人群特点区分。     

Deprivation and stillbirth risk in rural and urban areas

The objective of the study was to investigate whether stillbirth risk was higher, and the effect of deprivation on inequality in stillbirth risk more marked, in rural than in urban areas. We carried out a cohort study of all 280 757 singleton births to mothers domiciled in Cumbria, north-west England, 1950-92. After allowing for individual social class and community deprivation, the risk of stillbirth was lower outside urban centres both during 1950-65 (OR = 0.91, 95% CI 0.84, 1.00) and during 1966-92 (OR = 0.82, 95% CI 0.73, 0.92). In earlier years, unsupported mothers in rural areas and mothers living in remote areas were particularly at risk. Urban/rural differences in risk were not explained by individual social class, community deprivation or overcrowding and have persisted over a 40-year time period.     

Serological studies on leptospirosis in livestock and chickens from Grenada and Trinidad

Sera from 1,206 livestock animals and chickens on Grenada and Trinidad were tested for leptospiral antibodies by the microscopic agglutination test. 376 of the sera were positive (25% of those tested on Grenada and 44% on Trinidad). The positive sera were obtained from 25% of 324 cattle, 35% of 130 pigs, 35% of 146 sheep, 25% of 44 goats and 11% of 175 chickens on Grenada; and 92% of 26 cattle, 53% of 122 pigs, 76% of 87 horses and donkeys and 11% of 144 chickens on Trinidad. Eight sera from ducks and geese on Trinidad were tested and found to be negative. The serogroups most commonly found to react with the sera of the Grenadian animals were Autumnalis, Icterohaemorrhagiae, Hebdomadis and the related serogroups Sejroe and Mini, and Pyrogenes; in the Trinidadian animals they were Icterohaemorrhagiae, Autumnalis, Hebdomadis and its related serogroups, and Panama. Strains of serogroup Pomona do not appear to have become established as livestock pathogens on the islands.     

A comparative study of knowledge and attitude of urban and rural dwellers towards vagrant sufferers of schizophrenia in Delta State of Nigeria

This study aimed at assessing comparatively knowledge of schizophrenia and attitudes towards vagrant sufferers in urban and rural areas of the state. The sample of 583 and 120 respondents from urban and rural areas were drawn using the multi-stage sampling technique. The administered structured questionnaire consisted of respondents' socio-demographies, knowledge of schizophrenia, and attitude towards vagrant sufferers of Schizophrenia. Data generated were statistically analyzed using the SPSS version 11 of Fishers test (ANOVA). The significant finding among others shows that knowledge is most potent factor to determine attitude towards vagrant sufferers of schizophrenia. Conclusively, it was recommended that government legislate against mass media organizations negative depictions of sufferers of mental illness. Also, mass media organizations engage ill compulsory informative, educative and enlightenment campaigns to positively change attitudes of people towards people living with schizophrenia.     

Pediculosis capitis among rural and urban schoolchildren in Nigeria

The prevalence of head lice (Pediculus humanus capitis) was investigated among urban and rural schoolchildren in Ibadan City and three surrounding villages all in Southern Nigeria. 106 (5.7%) of 1860 urban schoolchildren examined were infested compared with only seven (1.5%) of 473 children from rural schools (P less than 0.05). Pediculosis appears to be an urban problem which may be associated with overcrowding. However, the intensity of head louse infestation was low among the urban schoolchildren with 74.6% of all lousy children harbouring one to five lice per head and only 6.0% with more than 30 lice per head.     

Trends in the incidence of cardiovascular diseases and risk factors among urban and rural Japanese males]

OBJECTIVES: To examine long-term trends in the incidence of coronary heart disease, stroke, and their risk factors among Japanese populations, we explored 32 years of surveillance data for male residents in urban and rural areas in Japan. METHODS: The surveyed populations were 40-79 year-old male residents in M community (population over 40 years old in 1995 was 11,121) of Y City in Osaka (urban area; Osaka) and I town (n = 3,571) in Akita prefecture (rural area; Akita). Incidence rates of coronary heart disease (myocardial infarction, angina pectoris), sudden cardiac death, percutaneous transluminal coronary angioplasty (PTCA) and stroke per 1,000 person-years were calculated for 1964-71, 1972-79, 1980-87 and 1988-95. Risk factors were evaluated by cross-sectional surveys conducted in the median years for each period. Dietary intake was examined by the 24-hour recall method in the latter three periods. RESULTS: Age-adjusted incidence of coronary heart disease per 1,000 men increased progressively from 0.27 in 1964-71 to 0.90 in 1988-95 (P = 0.222 for trend) among 40-59 year old residents in Osaka. Among their 60-79 year old counterparts, though the incidence was 2.62-3.11 and did not change over the periods studied, the combined rates for coronary heart disease and men who had a PTCA reached 3.79 in 1988-95. In contrast, the incidence of coronary heart disease among Akita residents did not change over time and stroke declined 70 percent between 1964-71 and 1988-95 (P < 0.001) in both 40-59 and 60-79 year age group: The decrease in cerebral infarction was less marked between 1980-87 and 1988-95 among 60-79 year old individuals. Significant increases in diastolic blood pressure, total serum cholesterol, body mass index, salt intake and total fat percent of total energy in Osaka, were associated with the elevation in the incidence of coronary heart disease. In Akita, blood pressure leveled off over the study period, but decreased less during the last decade whereas the prevalence of obesity increased. CONCLUSION: Trends in cardiovascular diseases and their risk factors differ among different geographical areas. The present long-term study, in particular, demonstrated an increase in the incidence of coronary heart disease among urban Japanese male residents in Osaka between the 1960s and the 1990s.     

海淀区居民血脂异常现状及危险因素分析

目的了解目前北京市海淀区居民血脂异常现状及其相关危险因素。方法采取等比例多阶段整群随机抽样的方法抽取了海淀区9个街道18个功能单位9个生活社区18岁以上常住居民总共2 615人进行询问和问卷式调查。根据诊断标准筛查出血脂异常人群。结果海淀区居民血脂异常发生率为49.67%,男性异常发生率高于女性;除低高密度脂蛋白胆固醇（HDLC）和男性的高甘油三脂（TG）以外,高低密度脂蛋白胆固醇（LDLC）、高胆固醇（TC）和女性的高TG的发生率在不同年龄、不同性别间均有显著性差异。在18～44岁,男性血脂异常发生率要高于女性。血脂异常人群锻炼率为75.92%。男性锻炼率为72.76%,女性锻炼率为78.08%,存在显著性差异。血脂异常也常与其他心脑血管危险因素合并存在,以高血压并存尤为突出。结论行为危险因素的改变对血脂异常的控制具有重要意义。