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.     

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。     

Increased genetic diversity of the Mycobacterium tuberculosis W-Beijing genotype that predominates in eastern China

ObjectivesTo determine the genetic diversity of Mycobacterium tuberculosis (M. tuberculosis) strains in a Chinese population predominately infected with strains of the W-Beijing family.MethodsA cross-sectional study was conducted in three counties of eastern China. M. tuberculosis strains were collected at TB clinics, and patients were interviewed by trained physicians at the time of TB diagnosis. RD105 and RD181 were used to identify W-Beijing and modern W-Beijing strains, respectively, while seven-locus variable numbers of tandem repeat–mycobacterial interspersed repetitive unit (VNTR–MIRU) analysis was employed to differentiate the genotypes of these strains.ResultsOf 441 strains studied, 394 (89.3%) were identified as W-Beijing family strains; of them, 299 were modern W-Beijing strains. VNTR–MIRU identified 409 genotypes from 426 strains, including 395 unique patterns and 14 clusters. Ancestral W-Beijing strains were more likely to be clustered (OR = 1.32, 95%CI: 0.58–2.97) compared to modern W-Beijing strains. The proportions of clustered strains were 14.6%, 4.2% and 0% at sites Funing (FN), Deqing (DQ) and Yinzhou (YZ), respectively. Of the seven MIRU loci, VNTR3820 was found to have the highest discriminatory power and allelic diversity.ConclusionsVNTR–MIRU typing appears to be a reliable method for analyzing M. tuberculosis transmission in relatively closed populations. The low clustering proportions indicate that endogenous relapse may be a main source of TB cases in eastern China. Furthermore, our results indicate that migration has played may play an important role in the recent transmission of the W-Beijing family of M. tuberculosis.     

合肥市庐阳区娱乐场所女性流动人群HIV检测服务利用及影响因素分析

目的了解合肥市庐阳区娱乐场所青年女性流动人群HIV咨询检测服务利用现状,探讨该人群寻求HIV检测服务的影响因素。方法通过横断面调查,采取随机抽样的方法,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、艾滋病性病知识、艾滋病咨询检测服务的知晓和利用情况、近一年患性病及生殖道感染状况、流产、近6个月性行为及性伴状况。结果共调查娱乐场所流动女性180人,33.9%的调查对象知道可在正规医院或疾控中心咨询艾滋病,47.2%的调查对象知道在疾控中心免费检测艾滋病;16.1%调查对象报告既往做过HIV咨询,31.7%报告既往做过HIV抗体检测;多因素Logistic分析结果显示,年龄在26~29岁,婚姻状态为已婚或同居,知道可在正规医院或疾控中心咨询艾滋病,近6个月与男朋友有性行为,有较高的艾滋病性病知识会促进其进行HIV抗体检测。结论合肥市庐阳区娱乐场所青年女性流动人群对艾滋病咨询检测服务的知晓和利用情况均有待加强,需要继续加强针对该人群的艾滋病防治知识的宣传教育,扩大艾滋病咨询检测服务的覆盖面。     

上海市浦东新区女性流动人口生殖健康认知现状调查

目的:了解上海市浦东新区流动人口女性生殖健康相关认知水平和行为现状,为开展健康干预奠定基础。方法:2012年1~6月,用整群抽样的研究方法在浦东新区随机抽取6个街镇,对其流动人口聚集的场所中595名女性流动人口进行问卷调查和生殖健康检查。结果:该人群首次性行为年龄为21.2±3.2岁,其中55%未采用任何避孕措施。文化程度越高,艾滋病和生殖避孕知识水平也越高(P0.05);该人群血清检查梅毒螺旋体阳性率为2.5%、人免疫缺陷病毒阳性率为0.416%、丙型肝炎阳性率为0.83%。结论:浦东新区女性流动人口生殖健康认知水平仍有待提高,应该加强生殖健康认知的宣教,提倡安全性行为,减少感染性传播疾病的发生风险。