Enhancing the security of E-Health services in Bangladesh using blockchain technology

The telemedicine service concept was mainly established to benefit the underprivileged people from rural areas of a country. However, due to the low literacy and awareness rates among rural population of Bangladesh, the service is not much effective. This paper represents a study on the awareness of the rural population of telemedicine service in Bangladesh and few key findings indicate how the awareness could be increased. The research also suggests that utilizing blockchain technology can enhance the data security and privacy. The research reveals some of the findings which can raise the awareness and popularity of telemedicine service among rural population. We have proposed implementation of blockchain technology which can vastly improve the security issue.

Distribution of risk factors of hypertension patients in different age groups in Tianjin

Background

To analyze the risk factors for hypertension in different age groups of urban and rural residents in Tianjin.

Methods

A total of 33,997 people (35–75 years old) from 13 community health service centers and primary hospitals in Tianjin participated in this study. They were divided into the youth group (≤ 40 years old), middle-aged group (41–65 years old), and elderly group (> 65 years old). Then, a questionnaire survey was administered, followed by physical and blood biochemical examinations. The demographic characteristics and prevalence were recorded and counted. Subsequently, risk factors were analyzed using univariate and stepwise multivariate logistic regression analysis.

Results

In the youth, middle-aged, and elderly groups, the prevalence rate of hypertension was 18.65, 51.80, and 76.61%, respectively. Logistic regression analysis showed that obesity(OR: 3.263, 95% CI: 1.039–1.656), men (OR: 2.117, 95% CI: 1.691–2.651), diabetes (OR: 1.978, 95% CI: 1.398–2.799), high triglycerides(OR 1.968 95% CI: 1.590–2.434) and family history of stroke (OR: 1.936, 95% CI: 1.287–2.911) are the five factors in youth. In middle-aged group, the significantly associating factors were obesity (OR: 2.478, 95% CI: 2.330–2.636), diabetes (OR: 2.173, 95% CI: 1.398–2.799), family history of stroke (OR: 1.808, 95% CI: 1.619–2.020), maleness (OR: 1.507, 95% CI: 1.412–1.609),Hypertriglyceridemia (OR 1.490 95% CI: 1.409–1.577),family history of cardiovascular disease (OR: 1.484, 95% CI: 1.307–1.684),Hypercholesterolemia (OR 1.228 95% CI: 1.160–1.299). In the elderly group, obesity (OR: 2.104, 95% CI: 1.830–2.418), family history of strokes (OR: 1.688, 95% CI: 1.243–2.292), diabetes mellitus (OR: 1.544, 95% CI: 1.345–1.773), family history of cardiovascular disease (OR: 1.470, 95% CI: 1.061–2.036), hypertriglyceridemia (OR: 1.348, 95% CI: 1.192–1.524) increased the risk for hypertension. Waist circumference (WC) and waist-to-height ratio (WHtR) increased with age, and the value of these two measures for predicting hypertension was better than BMI in middle-aged group.

Conclusion

Obesity is the most important risk factor for hypertension in all age groups. Diabetes, family history of strokes and high triglyceride were also significant risk factors for all age groups. There was a gender difference between the young and middle-aged groups, with men more likely to hypertension. Waist circumference (WC) and waist-to-height ratio (WHtR) were better predictors of hypertension than BMI in middle-aged group.

[Changing trends regarding the rates of prevalence, awareness and treatment of hypertension and the differences by demographic and economic factors, among adult farmers in nine provinces in China, from 1991 to 2015]

Objective: To analyze the changes on the rates of prevalence, awareness and treatment of hypertension as well as the differences of the disease by demographic and economic factors, among adult farmers in nine provinces of China. Methods: Adult farmers, (including fishermen and hunters) with completed data on demographics, socio-economic characteristics, disease histories and physical measurements were selected from the 1991-2015 China Health and Nutrition Survey. Hypertension was defined based on the Chinese guidelines. Multivariate logistic regression was used to analyze the influence of demographic and economic factors on the rates of prevalence, awareness and treatment of hypertension among those adult farmers in 2015. Results: A total of 18 236 participants were included. From 1991 to 2015, rates of prevalence, awareness and treatment of hypertension among the adult farmers in nine provinces all significantly increased (P<0.05). Results from the multivariate analysis showed that farmers aged ≥45 years were 98% more likely to suffer from hypertension than those aged 18-44 years. Farmers who were overweight or obese were 1.58 times and 5.21 times more likely to suffer from hypertension than those in the control group (BMI<24.0 kg/m(2)), respectively. The rates on awareness of hypertension among farmers with junior high school education (OR=0.23) or above (OR=0.12) or with junior high school education (OR=0.30) were both lower than those with primary school education or below. Rates on the awareness and treatment of hypertension in obese farmers were 5.77 times and 7.52 times of those in the control group. Conclusions: The rates of prevalence of hypertension showed increasing trends during 1991-2015, with a slower increase in the rates of awareness and treatment in the farmers. Age ≥45 year-olds, and being obese were the risk factors for farmers to have hypertension, which suggested the above population should be focused on hypertension prevention strategy and practice.

Awareness of HIV/AIDS and its routes of transmission as well as access to health knowledge among rural residents in Western China: a cross-sectional study

BACKGROUND

The purpose of this study was to evaluate the coverage of HIV health education among rural residents in western China by ascertaining their awareness of HIV/AIDS and its transmission routes, and to investigate how these residents receive health information.

METHODS

A survey was conducted through stratified clustered sampling at 99 county hospitals in 11 provinces in western China. Information was collected on awareness of HIV/AIDS and its transmission routes, as well as residents' access to health knowledge. Chi-square analysis was used to analyse the differences in HIV/AIDS awareness (knowing of the existence of HIV/AIDS, hereinafter referred to as "HIV awareness rate") between different subgroups categorized by demographic status, regional factors, and different methods of access to health knowledge. To further analyse the effects of access to health knowledge on HIV awareness, a logistic regression model was established. The relationship between access to health knowledge and transmission routes was also examined using chi-square analysis.

RESULTS

The HIV awareness rate of the total 9274 participants was 80.9%. There were statistically significant differences between subgroups classified by age (χ² = 482.118, p<0.001), education (χ² = 853.465, p<0.001), occupation (χ² = 340.553, p<0.001), income (χ² = 186.448, p<0.001), cumulative HIV cases according to province (χ² = 59.513, p<0.001), per capita annual net income of rural households according to province (χ² = 64.676, p<0.001), proportion of minority population according to province (χ² = 94.898, p<0.001), direct access to health knowledge (medical staff: χ² = 419.775, p<0.001; mass media: χ² = 740.238, p<0.001; family members: χ² = 12.189, p<0.001; socializing: χ² = 48.780, p<0.001; health education activities: χ² = 154.400, p<0.001), and indirect access to health knowledge (having a non-communicable disease with medical instructions χ² = 78.709, p<0.001; physical examinations: χ² = 135.679, p<0.001). The logistic regression model showed that education and mass media had the strongest impacts on HIV awareness among all methods of access. Participants had the least awareness of HIV's mother-to-child transmission route.

CONCLUSION

The HIV awareness rate indicated that previous HIV health education covered 80% of the rural population in western China. Mass media should take greater responsibility in HIV health education for the general population, and special attention should be paid to the elderly, the most impoverished population, minority community as well as the mother-to-child transmission route.

[Prevalence, awareness, treatment and control of hypertension in adult residents in Jiangsu province]

Objective: To investigate the prevalence, awareness, treatment and control of hypertension in adult residents in Jiangsu province and provide evidence for the prevention and control of hypertension. Methods: A population-based cardiovascular disease screening project was conducted during 2015-2018 in Jiangsu, a total of 95 348 community-dwelling adults aged 35-75 years from 6 project areas were included in the study. The prevalence rate of hypertension and rates of awareness, treatment and control of hypertension in the adults with different characteristics were analyzed. Multilevel model was applied to identify the influencing factors. Results: Among 95 348 adults surveyed, 54 407 were hypertensive, the standardized prevalence rate was 48.1%. The prevalence rate was significantly higher in males than in females (62.1% vs. 54.0%, P<0.05). Among the hypertension patients, the rates of awareness, treatment and control of hypertension were 56.6%, 45.3% and 12.0% (standardized rates: 52.2%, 41.0% and 11.2%), respectively, and all the rates were positively associated with age (all P<0.05). Multilevel model analysis showed that those who were males, at older age, lived in rural area, suffered from diabetes, had frequent alcohol drinking and those who were overweight/obese had higher risk for hypertension (all P<0.05). Among people with hypertension, those who had younger age, lower education level, lower household income level and those who had frequent alcohol drinking had lower awareness, treatment and control rates of hypertension (all P<0.05). Conclusions: The prevalence rate of hypertension was high, but related awareness, treatment and control rates were low in adult residents in Jiangsu province. Comprehensive measures should be taken to improve awareness, treatment and control of hypertension in whole population, especially in young adults, and those with low education or income levels.

[Prevalence, awareness, treatment and control of hypertension in elderly residents in Hebei province]

Objective: To understand the prevalence, awareness, treatment and control of hypertension in elderly residents in Hebei province. Methods: Elderly residents aged ≥60 were selected though multistage clustering sampling during August to December, 2015. Design based methods were adopted to analyze the prevalence, awareness, treatment and control of hypertension in local residents of Hebei. Results: A total of 2 501 elderly adults were included in the study. The overall prevalence rate of hypertension was 63.7% (58.3% in males, 69.0% in females), the awareness rate of hypertension was 42.4% (35.7% in males, 48.0% in females), the treatment rate was 38.2% (32.0% in males, 43.3% in females), and the control rate was 9.0% (8.1% in males, 9.7% in females). The results of multivariate analysis indicated that age, sex, degree of education, BMI and central obesity were the factors influencing the prevalence, awareness, treatment and control of hypertension in elderly population in Hebei. Conclusions: The prevalence of hypertension was high, but the rates of awareness, treatment and control of hypertension were low in elderly residents in Hebei. The influences of overweight, obesity and central obesity on hypertension were significant in the elderly. It is necessary to standard the management of hypertension and reduce the risk factors for hypertension in elderly population to improve the control of hypertension.

[Investigation on malaria knowledge and demands on related training for CDC staff in Qinghai Province, China]

OBJECTIVE

To investigate the malaria knowledge of CDC staff and their demands on related training in malaria non-endemic areas, so as to provide the reference for planning the appropriate curriculum.

METHODS

All the participants who were the staff of county CDCs all over Qinghai Province and attended the provincial training workshop were surveyed. A self-administered questionnaire survey was carried out and the data was statistically analyzed.

RESULTS

A total of 115 participants were involved in this survey. They were mostly (85.21%) from county CDCs. The general knowledge of malaria among the respondents was well, and the average rate of correct answers was 70.35%. However, the answers to the general knowledge of malaria and anti-malaria treatment were not well enough. The rates of correct answers were 61.96% and 48.99% respectively. The differences among the groups of job title ranking, department of working and level of CDC were not significant (F = 0.13-2.02, all P > 0.05). The number of correct answers was significantly increased after the training course. The average score after the training was 79.20±15.16 while the pre-training score was 70.34±17.46 (t = 3.86, P < 0.05), especially in the answers to general malaria knowledge and malaria surveillance and response (t = 4.30, 4.97, both P < 0.05). The general knowledge of malaria was considered as the most need of training as 80% of the respondents voted "Yes", according to the demand analysis. There was no significant difference among the different groups (F = 0.61-3.11, both P > 0.05).

CONCLUSIONS

The malaria knowledge is well mastered by the staff of CDCs in Qinghai Province, and the further training courses are requested and addressed in the target areas such as general malaria knowledge, anti-malaria treatment, malaria surveillance and response.

[Rate of prevalence, awareness, treatment and control of hypertension among women at reproductive age in China in 2013]

Objective: To analyze the rate of prevalence, awareness, treatment and control of hypertension among women at reproductive age (18-49 years old) in China in 2013. Methods: The analysis used data obtained from the China Chronic and non-communicable disease surveillance in 2013.The surveillance included 176 534 adults aging ≥18 years old, who were selected from 302 surveillance points by multi-stage cluster random sampling method. A total of 46 674 women at reproductive age (18-49 years old) were investigated. Blood pressures were measured by electronic blood pressure monitor. After being weighted according to complex sampling scheme and post-stratification, the rate of prevalence, awareness, treatment and control of hypertension were compared by different characteristics such as age, education, urban and rural areas, and geographic locations. Results: The prevalence of hypertension among women at reproductive age (18-49 years old) in China in 2013 was 13.5%. The rate in the rural areas was higher than that in urban areas (χ(2)=46.23, P<0.05), which were 14.5% and 12.3%, respectively. The prevalence in eastern, central and western geographic locations were separately 13.9%, 13.2% and 13.1%, there was no statistical difference (χ(2)=0.56, P>0.05). The hypertension prevalence in all age groups (18-24, 25-29, 30-34, 35-39, 40-44, 45-49 years old) were 6.6%, 9.2%, 9.6%, 12.0%, 17.9% and 28.3%, respectively. The prevalence of hypertension showed a rising trend with age increasing (t=12.32, P<0.05). The awareness, treatment and control rates of hypertension were separately 25.8%, 22.7% and 7.4% in women at reproductive age (18-49 years old), which were 31.6%, 28.2% and 9.4%, respectively in urban areas; and 21.3%, 18.5% and 5.9%, respectively in rural areas. The rates in urban areas were all higher than those in rural areas (chi square were separately 18.98, 21.31, and 6.80, P values <0.05). The treatment rate of hypertension was 86.8% among who had been aware of hypertension, and the treatment rate of hypertension was 31.8% among who received control of hypertension. The treatment rate among who had been aware of hypertension in eastern, central and western locations were 89.3%, 88.3% and 79.5%, respectively. The control rates in eastern, central and western locations were 8.5%, 8.1% and 4.7%, respectively. The treatment rate among who had been aware of hypertension and control rate in the eastern and central geographic locations was higher than that in western locations (chi square were separately 10.05 and 7.25, P values <0.05). Conclusion: The prevalence of hypertension in women at reproductive age (18-49 years old) was comparatively high, and the rates of awareness, treatment and control were low. The differences showed statistical significance between urban and rural areas.

[Survey of degree of passive smoking exposure and related risk awareness in adults in China, 2013]

Objective: To understand the passive smoking exposure level and related risk awareness in adults in China in 2013. Methods: A face-to-face questionnaire survey was conducted in 179 570 adults selected through multistage cluster sampling from Chinese chronic disease and risk factors surveillance sample population (2013) in 302 surveillance sites. The effective sample size was 176 179 adults. After comprehensive weighting of the samples, the passive smoking exposure level and the awareness rate of related risks were analyzed. Results: The passive smoking exposure rate was 52.8% (95%CI: 51.2%-54.4%) and the rate decreased with age (χ(2)=515.8, P<0.000 1). The exposure rate was highest in persons engaged in commercial services (61.6%, 95%CI: 58.6%-64.5%). The awareness rate of related risks was 67.9% (95%CI: 65.8%-69.9%). The awareness rate was higher in urban area (77.0%, 95%CI: 75.0%-79.1%) than in rural area (60.0%, 95%CI: 57.7%-62.4%), in males (69.8%, 95%CI: 67.8%-71.7%) than in females (65.9%, 95%CI: 63.7%-68.1%). The awareness rate of three related diseases in urban residents (49.8%, 95%CI: 47.3%-52.4%) were higher than that in rural residents (37.9%, 95%CI: 35.4%-40.5%); the awareness rate of passive smoking related lung cancer was highest (88.5%, 95%CI: 87.5%-89.5%), followed by lung disease in children (70.0%, 95%CI: 68.1%-71.9%), the awareness rate of passive smoking related heart disease was lowest (46.8%, 95%CI: 44.6%-49.1%). Conclusion: The passive smoking exposure level is relatively high in adults in China, and the awareness rate of passive smoking exposure risks, especially heart disease, is low.

[A comparison of knowledge awareness rates and influencing factors of clonorchiasis among residents in 4 counties (cities) of Hunan Province]

OBJECTIVE

To understand the status of knowledge awareness rates and influencing factors of clonorchiasis among the residents in 4 counties (cities) of Hunan Province, so as to provide the references for formulating the prevention and control strategy of clonorchiasis in the province.

METHODS

A total of 1 224 subjects were selected by the multi-stage cluster sampling method and investigated with questionnaires and face-to-face interviews.

RESULTS

The clonorchiasis knowledge awareness rates of the residents were 15.67% in Yongzhou City, 9.94% in Yueyang City, 13.25% in Wangcheng County, and 21.96% in Tongdao County, respectively. In the whole province, the clonorchiasis knowledge awareness rates of the residents were 44.67%, 56.43%, 60.95%, and 42.46% in the etiology, clinical manifestations, epidemiological characteristics and daily prevention, respectively. The logistic regression showed that the influencing factors of clonorchiasis knowledge awareness rates were the daily dining place, whether or not having the medical personnel in the family, the degree of attention to the relevant news reports, and the history of parasitic diseases.

CONCLUSIONS

The level of clonorchiasis than that in other areas, but the overall level of clonorchiasis knowledge awareness of the residents in Hunan Province is not high. Therefore, the relevant authority should strengthen the health education in clonorchiasis prevention knowledge including personal daily food hygienic knowledge. knowledge awareness rate of the residents in the west-southern areas of Hunan Province is higher.

The prevalence, awareness, treatment, and control of dyslipidemia in northeast China: a population-based cross-sectional survey

Background

Dyslipidemia is an important independent modifiable risk factor for cardiovascular disease. The aim of this study was to explore the current prevalence, awareness, treatment and control of dyslipidemia and its associated influence factors in northeast China.

Methods

In this population-based cross-sectional study, we adopted a multi-stage, stratified sampling method to obtain a representative sample of 4052 permanent residents aged 40 years and over from different urban and rural regions in Dehui City of Jilin Province. All subjects completed a questionnaire and were examined for risk factors. Continuous data were presented as means ± standard deviations (SD) and compared using the Student’s t-test. Categorical variables were presented as proportions and compared using the Rao-Scott-χ² test in different subgroups. The associated influence factors for the prevalence, awareness, treatment and control of dyslipidemia were evaluated through multivariate logistic regression.

Results

The prevalence of dyslipidemia was 62.1% overall, with 33.5, 43.9, 0.6, and 8.8% for high total cholesterol, triglyceride, low-density lipoprotein cholesterol, and low high-density lipoprotein cholesterol, respectively. Among those with dyslipidemia, the proportion of subjects who were aware, treated, and controlled was 14.4, 33.9, and 19.9%, respectively. Overweight or obesity (OR = 2.156; 95% CI: 1.863, 2.533), hypertension (OR = 1.643; 95% CI: 1.425, 1.893), or diabetes mellitus (OR = 2.173; 95% CI: 1.661, 2.844) increased the prevalence of dyslipidemia, also these participants were more likely to be aware of their condition, however, this did not increase the likelihood of treatment and control. Living in urban areas and higher education level also increased the awareness of dyslipidemia. Personal history of coronary heart disease was the strongest influence factors associated with better awareness, treatment and control of dyslipidemia. Overweight or obesity (OR = 0.404; 95% CI: 0.235, 0.695) and lack of exercise (OR = 0.423; 95% CI: 0.215, 0.830) were associated with poor control of dyslipidemia.

Conclusion

The prevalence of dyslipidemia among adults aged 40 years and over in northeast China was high, however, the awareness, treatment, and control of dyslipidemia was measured at far from desirable levels. Renewed efforts taking influence factors into account are needed to improve the current unsatisfactory condition.

[Evaluation of health education of medium- and long-term planning of schistosomiasis prevention and control in Kunshan City]

OBJECTIVE

To evaluate the effect of health education on schistosomiasis in Kunshan City, so as to provide the evidence for making the consolidating strategy in the late stage of interruption of schistosomiasis transmission.

METHODS

The residents, middle school students and elementary school students were randomly sampled from one community, one middle school and one elementary school of each of two towns and they were investigated with interviews and questionnaires for the implementation of health education on schistosomiasis prevention and control.

RESULTS

A total of 452 middle school students (232 cases) and primary school students (220 cases) were surveyed. The awareness rate of total schistosomiasis knowledge was 98.21% among the students (the awareness rate of basic schistosomiasis knowledge was 98.42% and the awareness rate of preventive schistosomiasis knowledge was 98.01%). Among the 220 elementary school students, the awareness rate of total schistosomiasis knowledge was 97.21% (the awareness rate of basic schistosomiasis knowledge was 97.60% and the awareness rate of preventive schistosomiasis knowledge was 96.82%). Among the 232 middle school students, the awareness rate of total schistosomiasis knowledge was 99.17% (χ² = 34.661, compared with the rate of the elementary school students) [the awareness rate of basic schistosomiasis knowledge was 99.20% (χ² = 13.045, compared with the rate of the elementary school students) and the awareness rate of preventive schistosomiasis knowledge was 99.14% (χ² = 21.796, compared with the rate of the elementary school students)]. There were significant differences between the elementary school students and middle school students in above-mentioned awareness rates (all P < 0.001). There were schistosomiasis health education materials or teaching plans in all the four schools. Among the 402 residents surveyed, the awareness rate of total schistosomiasis knowledge was 98.87%.

CONCLUSIONS

The effect of health education on schistosomiasis prevention and control is very well, and the total awareness rate of schistosomiasis prevention and control knowledge among the population has reached the goal (more than 95%) of the medium- and long-term planning of schistosomiasis prevention and control in Kunshan City.

[Prevention and control knowledge of echinococcosis in students in Qinghai Province]

OBJECTIVE

To understand the situation of prevention and control knowledge of echinococcosis in students in Qinghai Province, so as to provide an evidence for effective prevention and control of echinococcosis.

METHODS

The students of Grade Four or above were randomly selected with the multi-stage stratified cluster sampling method and investigated with the questionnaire about echinococcosis in Qinghai Province.

RESULTS

Totally 23 600 students were selected and surveyed, with the pass rate of 66.0% (15 566 cases). The pass rates of the male and female students were 65.1% (7 947 cases) and 66.9% (7 619 cases) respectively, and the difference was significant (χ² = 8.454, P < 0.01). The difference of pass rates among different districts of Qinghai Province was statistically significant (χ² = 3 848.619, P < 0.01).

CONCLUSIONS

The general aware rate of echinococcosis knowledge in students is not high in Qinghai Province, and therefore, it is necessary to enhance the health education, especially for students in pasturing areas.

[Infection situation of intestinal nematodes and knowledge about prevention and control of intestinal nematodiasis in Jingjiang City]

OBJECTIVE

To investigate the infection situation of intestinal nematodes and knowledge about the prevention and control of intestinal nematodiasis, so as to explore the effective control measures in Jingjiang City.

METHODS

The towns where more floating people lived were randomly selected and the infection situation of intestinal nematodes was investigated with KatoKatz method, and the residents'awareness of the prevention and control of nematodiasis was surveyed with questionnaires.

RESULTS

From 2013 to 2015, totally 4 555 local residents and 2 278 floating people were investigated in Jingjiang City. The infection rate of intestinal nematodes was 0.29% (13 cases) in the local people, while the rate was 0.75% (17 cases) in the floating people, and the difference was significant (χ² = 7.380, P < 0.01). The differences of the intestinal nematode infection rates between sexes in both local residents and floating people were not significant (χ² = 0.010, 0.048, both P > 0.05). The awareness rate of intestinal nematodiasis prevention and control of the local residents was significantly higher than that of the floating people (χ² = 9.649-164.533, all P < 0.01).

CONCLUSIONS

The floating people is the focus of intestinal nematodiasis control, and the health education of ancylostomiasis control should be strengthened in Jingjiang City.

[Effect of two-level community-based health education pattern on schistosomiasis control]

OBJECTIVE

To implement a two-level community-based health education pattern of schistosomiasis in residents of endemic areas in marshland and lake regions, so as to explore the suitable pattern of health education under hypo-endemic situation.

METHODS

Two schistosomiasis endemic villages in Jiangling County, Hubei Province were collected as study areas, and among which, one village was treated as an intervention group, where the two-level community-based health education pattern as well as regular control measures was implemented; the other village was a control group, where only regular control measures were implemented. The awareness rates on schistosomiasis control, the rates of correct behavior and the compliance rates of examination, treatment and chemotherapy of the two groups before and after the intervention were compared.

RESULTS

According to the results of the baseline survey in 2014, the awareness rates of schistosomiasis control of the intervention and control groups were 84.00% and 77.45%, respectively, the correct rates of behavior of the two groups were 72.00% and 63.73%, respectively, and the compliance rates of the treatment were 80.36% and 82.28%, respectively, there were no statistically significant differences between all the above rates of the two groups (all P > 0.05). After the intervention of the two-level community-based health education, the correct rates of behavior, and the compliance rates of examination and chemotherapy of the two groups were 92.31% and 80.37%, 95.11% and 82.55%, 84.13% and 63.64%, respectively, and the differences between all the rates above of the two groups were statistically significant (all P < 0.05). When compared to those before intervention, the growing rates of the compliance rates of examination, treatment and chemotherapy of the intervention group were 20.97%, 15.33% and 23.29%, respectively, while those of control group were 14.27%, 4.17%, -3.77%, respectively, the growing rates of the intervention groups were higher than those of the control groups.

CONCLUSIONS

Through the two-level community-based pattern of health education, the compliance rates of examination and treatment of the residents have improved, and therefore, the pattern is suitable for popularization and application in marshland and lake regions.

[Investigation on awareness rates of malaria prevention knowledge among residents and students in Huai'an District, Huai'an City]

OBJECTIVE

To understand the awareness status on malaria control knowledge of residents, primary and middle school students in Huai'an District, Huai'an City, so as to provide the evidences for promoting the malaria elimination process in this district.

METHODS

Three towns in Huai'an District were selected randomly, and one village, one primary school and one junior middle school in each town were chosen as the investigation sites. The residents over 18 years old, the primary school students in Grade 4 to 6, and the junior middle students in the investigation sites were investigated by questionnaires to understand their awareness status on knowledge of malaria control.

RESULTS

Totally 305 residents and 618 students were investigated. The awareness rate of students was 89.97%, and the rates of the junior middle school students and primary school students were 85.94% and 94.10%, respectively, the difference between them was statistically significant (P＜0.01). The awareness rate of the residents was 80.98%, which was lower than that of the students (P＜0.05). For the students, the awareness rate on "precaution of malaria" (96.74%) was the highest, while that on "drug of malaria" (68.93%) was the lowest. For the residents, the rate on "transmission route of malaria" (95.08%) was the highest, that on "4·26 is Malaria Day" (64.26%) was the lowest. Expect the items of "transmission route of malaria" and "precaution of malaria" (both P＞0.05), the differences of the awareness rates on all the other items between the students and residents were statistically significant (all P＜0.01).

CONCLUSIONS

Although the awareness rates of malaria control knowledge in the population of Huai'an District, Huai'an City have achieved the goal of the relevant requirement, the health education on malaria control still should be strengthened, especially for the primary students, female residents and exported labor service personnel.

[Malaria awareness among residents and students during malaria elimination phase in Jinshan District, Shanghai City]

OBJECTIVE

To understand the awareness status of knowledge on malaria control among residents and students, so as to evaluate the effectiveness of health education during the elimination phase of malaria in Jinshan District, Shanghai City.

METHODS

In 2010 and 2014, the stratified sampling and cluster sampling methods were taken to selected the investigation sites, including 3 villages, 1 middle schools, 1 primary school, then the residents above 15 years old and the students in the above selected sites were investigated by questionnaires to understand their awareness status on malaria control.

RESULTS

In 2010, the general awareness rates of malaria control knowledge of the study objects were 74.22%, and those of the residents, middle school student, and primary school students were 75.68%, 61.86% and 72.20%, respectively. There was no significant difference between the awareness rates of objects with different gender (χ² = 1.755, P > 0.05). The rate of the residents was higher than that of the students (χ² = 59.838, P < 0.01). From 2010 to 2014, a serious of health education on malaria control was carried out. In 2014, the general awareness rate of knowledge on malaria control was 96.03%, and those of the residents, middle school student, and primary school students were 92.28%, 98.59% and 99.49%, respectively. The awareness rate of the students was higher than that of the residents (χ² = 275.794, P < 0.01).

CONCLUSIONS

Through the health education and community advocacy, the awareness rates of knowledge on malaria control among residents and students have improved and met the qualification of malaria elimination in Jinshan District.

Epidemiology of dyslipidemia in Chinese adults: meta-analysis of prevalence, awareness, treatment, and control

BACKGROUND

Numerous epidemiology studies on dyslipidemia have been conducted in China. However, a nationally representative estimate for dyslipidemia prevalence is lacking. The aim of this study is to appraise the nationwide prevalence, awareness, treatment, and control rates of dyslipidemia in adults in China.

METHODS

We performed a systematic review of the related observational studies published since 2003 by searching English and Chinese literature databases. Meta-analyses were conducted in eligible studies using a random effect model to summarize the dyslipidemia prevalence, awareness, treatment, and control rates. Heterogeneity and publication bias were analyzed. Sensitivity analyses were performed to explain heterogeneity and examine the impact of study quality on the results of meta-analyses.

RESULTS

Thirty-eight papers were included for meta-analyses, with a total sample size of 387,825. The prevalence, awareness, treatment, and control rates of dyslipidemia were 41.9% (95% CI: 37.7% - 46.2%), 24.4% (95% CI: 14.4% - 38.4%), 8.8% (95% CI: 7.7% - 10.0%), and 4.3% (95% CI: 4.1% - 4.5%), respectively. The prevalence of hypercholesterolemia, hypertriglyceridemia, mixed hyperlipidemia, low levels of high-density lipoprotein cholesterol, and high levels of low-density lipoprotein cholesterol were 10.1% (95% CI: 5.8% - 16.9%), 17.7% (95% CI: 14.0% - 22.1%), 5.1% (95% CI: 3.1% - 8.2%), 11.0% (95% CI: 8.0% - 15.0%), and 8.8% (95% CI: 4.1% - 17.8%), respectively. Sensitivity analyses revealed that males had a higher prevalence of dyslipidemia (43.2%) than females (35.6%). Study samples of age 30 and above in the eastern region tended to have higher prevalence of dyslipidemia. The quality of the studies has a slight impact on the pooled estimates.

CONCLUSIONS

The overall pooled prevalence of dyslipidemia in Chinese adults was estimated to be 41.9%, with males having a higher rate than females.