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Kawuki J, Nambooze J, Chan PSF, Chen S, Liang X, Mo PKH, Wang Z. Differential practice and associated factors of COVID-19 personal preventive measures among the slum and estate communities of Uganda: A community-based cross-sectional survey. J Glob Health 2023; 13:06039. [PMID: 37712388 PMCID: PMC10502765 DOI: 10.7189/jogh.13.06039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023] Open
Abstract
Background Compliance with personal preventive measures (PPMs) remains essential in the prevention and control of the coronavirus disease 2019 (COVID-19) pandemic and future infectious disease outbreaks. This study aimed at examining and comparing the practice of COVID-19 PPMs and associated factors in selected slum and estate communities of Uganda. Methods This was a cross-sectional survey conducted among 1025 slum and estate residents in Uganda. The outcome variable was compliance with COVID-19 PPMs, including face mask use, hand washing/hygiene, and social distancing. Logistic regression models were fitted to assess the associated factors, using SPSS (version 26). Results Of the 1025 participants, 511 and 514 were slum and estate residents, respectively. Compliance with PPMs was as follows; face mask use (slum 45.0% vs. estate 49.6%; P = 0.27), hand washing/hygiene (slum 38.4% vs. estate 44.9%; P = 0.04), and social distancing (slum 19.4% vs. estate 36.0%; P < 0.001). Compared to estate residents, slum residents had more knowledge related to COVID-19, perceived COVID-19 would have a longer timeline and larger impact on their life, had more depression and anxiety symptoms, and faced more difficulties to access information. Illness perceptions, infection risk, and severity perceptions were associated with higher odds of PPMs compliance in both groups, except for perceiving a high chance of contracting COVID-19, which was associated with lower odds of social distancing in the slum community. Depression and anxiety symptoms were associated with higher odds of PPMs compliance in both groups. Frequent exposure to COVID-19 information through health care workers and family members and friends was associated with higher odds of all the PPMs in both communities. Moreover, getting COVID-19 information from local channels was significantly associated with higher odds of mask use and hand hygiene, but only in the estate community. Conclusions Our findings provided implications to improve PPMs compliance in future infectious disease outbreaks. To improve PPMs compliance rates, redesigning community education to focus on fostering positive perceptions and addressing the water and sanitation needs of slum communities are essential. Moreover, designing programs that provide free or subsidised face masks and soap to the most vulnerable and engaging religious leaders are also vital strategies.
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Affiliation(s)
- Joseph Kawuki
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Joweria Nambooze
- Department of Nutritional Sciences and Dietetics, Kyambogo University, Kyambogo, Uganda
| | - Paul Shing-fong Chan
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Siyu Chen
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Xue Liang
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Zixin Wang
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
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Wang Z, Chan PSF, Fang Y, Yu FY, Ye D, Zhang Q, Wong MCS, Mo PKH. Chatbot-Delivered Online Intervention to Promote Seasonal Influenza Vaccination During the COVID-19 Pandemic: A Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2332568. [PMID: 37695585 PMCID: PMC10495860 DOI: 10.1001/jamanetworkopen.2023.32568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 07/30/2023] [Indexed: 09/12/2023] Open
Abstract
Importance Receiving seasonal influenza vaccination (SIV) is important for adults during the COVID-19 pandemic. There are few robust evaluations of tailored interventions for improving SIV uptake among adults 65 years or older. Objective To evaluate the relative efficacy of a stages of change (SOC)-tailored online intervention compared with a standard, non-SOC-tailored online intervention in increasing SIV uptake among Hong Kong residents 65 years or older. Design, Setting, and Participants This nonblinded parallel-group randomized clinical trial was conducted between December 1, 2021, and July 31, 2022, in Hong Kong, China. Eligible participants were 65 years or older, had Cantonese- and/or Mandarin-speaking skills, were community-dwelling, had Hong Kong residency, were smartphone users, and had not received SIV for the 2021 to 2022 influenza season. Participants were recruited through random telephone calls, and those who completed the baseline telephone survey were randomized to either the intervention or control group. Both complete case and intention-to-treat (ITT) analyses were performed. Intervention In the intervention group, a simplified rule-based chatbot first assessed participants' SOC related to SIV uptake and then automatically selected and sent participants SOC-tailored online health promotion messages (videos) through a messaging application (WhatsApp; Meta) once every 2 weeks for 4 sessions. In the control group, the chatbot sent a link to access through the messaging application a standard online health promotion message (video) covering general SIV information every 2 weeks for 4 sessions. Main Outcomes and Measures The primary outcome was self-reported SIV uptake at month 6, which was validated by the research team. The secondary outcome was SOC measured at both baseline and month 6 by validated questions. Results A total of 396 participants (mean [SD] age of 70.2 [4.3] years; 249 females [62.9%]) were randomized to the intervention (n = 198) or control (n = 198) group. The ITT analysis showed that the validated SIV uptake rate was higher in the intervention group than the control group at month 6 (50.5% vs 35.3%; P = .002). The mean (SD) SOC score was higher in the intervention group than the control group (2.8 [1.4] vs 2.4 [1.4]; P = .02). More participants in the intervention group completed at least 1 episode of intervention than in the control group (77.3% vs 62.6%; P < .001). Conclusions Results of this trial indicate that the SOC-tailored online intervention was more effective than the non-SOC-tailored intervention and may be a sustainable new method in increasing SIV uptake among adults 65 years or older. Trial Registration ClinicalTrials.gov Identifier: NCT05155241.
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Affiliation(s)
- Zixin Wang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Paul Shing-fong Chan
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Fuk-yuen Yu
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Danhua Ye
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Qingpeng Zhang
- Musketeers Foundation Institute of Data Science, The University of Hong Kong, Hong Kong SAR, China
- Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Martin C. S. Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Phoenix K. H. Mo
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
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Chan PSF, Fang Y, Kawuki J, Chen S, Liang X, Mo PKH, Wang Z. Parental Acceptance, Parental Hesitancy, and Uptake of Seasonal Influenza Vaccination among Children Aged 6-59 Months: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2023; 11:1360. [PMID: 37631928 PMCID: PMC10459009 DOI: 10.3390/vaccines11081360] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 08/02/2023] [Accepted: 08/09/2023] [Indexed: 08/29/2023] Open
Abstract
This systematic review and meta-analysis summarises the literature on parental acceptance, parental hesitancy, uptake, and the associated factors of seasonal influenza vaccination (SIV) among children aged 6-59 months. Studies were sourced from the following platforms: PubMed, Web of Science, MEDLINE, and EMBASE databases. A random-effects model was used to evaluate the prevalence and 95% confidence intervals (CI) of parental acceptance, parental hesitancy, and SIV uptake in the last flu season and lifetime among children. A total of 36 studies were included for analysis. The overall prevalence was 64% for parental acceptance (95% CI: 51-75%), 34% for parental hesitancy (95% CI: 22-48%), 41% for SIV uptake in the last flu season (95% CI: 33-50%), and 46% for SIV uptake in a lifetime (95% CI: 20-74%). Associated factors of parental acceptance/hesitancy and uptake included the age of the children or parents, parental education level, household income level, ethnicity, and other modifiable factors, including perceived benefits, perceived barriers, perceived severity, perceived susceptibility, and cues to action related to SIV. Meta-regression analyses revealed regional differences in parental acceptance (Americas: 79% vs. Asia: 60%). The results provided implications informing us of the development of intervention programs targeting parents to improve SIV coverage among young children.
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Affiliation(s)
- Paul Shing-fong Chan
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (P.S.-f.C.); (J.K.); (S.C.); (X.L.); (P.K.-h.M.)
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, China;
| | - Joseph Kawuki
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (P.S.-f.C.); (J.K.); (S.C.); (X.L.); (P.K.-h.M.)
| | - Siyu Chen
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (P.S.-f.C.); (J.K.); (S.C.); (X.L.); (P.K.-h.M.)
| | - Xue Liang
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (P.S.-f.C.); (J.K.); (S.C.); (X.L.); (P.K.-h.M.)
| | - Phoenix Kit-han Mo
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (P.S.-f.C.); (J.K.); (S.C.); (X.L.); (P.K.-h.M.)
| | - Zixin Wang
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (P.S.-f.C.); (J.K.); (S.C.); (X.L.); (P.K.-h.M.)
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Kawuki J, Fang Y, Yu FY, Ye D, Chan PSF, Chen S, Wang Z. Facilitators and barriers to use rapid antigen test for SARS-CoV-2 among community-dwelling older adults in Hong Kong: A population-based cross-sectional random telephone survey. PLOS Glob Public Health 2023; 3:e0002196. [PMID: 37552663 PMCID: PMC10409272 DOI: 10.1371/journal.pgph.0002196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/06/2023] [Indexed: 08/10/2023]
Abstract
Faster diagnosis of Coronavirus disease 2019 (COVID-19) is crucial for surveillance, prompt implementation of infection control measures and adequate patient care among older adults. This study investigated the behavioral intention to use Rapid Antigen Tests (RAT) and associated factors among older adults in Hong Kong for health monitoring and when having COVID-19-like symptoms. This was a population-based cross-sectional random telephone survey of 370 Chinese-speaking adults aged ≥65 years. The behavioral intention to use RAT was the main outcome, and logistic regression models were used to assess the associated factors, using SPSS (version 26.0.). Results indicate that among the participants, 90.3% had used RAT, of which 21.6% obtained positive results. The common challenges faced when using RAT included: difficulty choosing the right RAT kit, uncertainty about how to use RAT, and not knowing what to do after getting a positive result. Additionally, 27.3% intended to use RAT regularly for health status monitoring without any symptoms, while 87.0% if they had COVID-19-like symptoms. After adjustment for significant background characteristics, positive attitudes, perceiving Hong Kong government and their children and/or other family members would support them using RAT, belief that RAT health promotion materials were helpful to understand how to use RAT and thoughtful consideration of the veracity of COVID-19 specific information were associated with higher behavioral intention to use RAT both when having no symptoms and in presence of COVID-19-like symptoms. Having negative attitudes toward RAT was associated with a lower intention of RAT use only when having no symptoms. Addressing difficulties faced when using RAT, strengthening positive attitudes, involving significant others and empowering with adequate information-veracity evaluating skills are potentially vital strategies to increase RAT use among older adults.
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Affiliation(s)
- Joseph Kawuki
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Yuan Fang
- Department of Health and Physical Education, the Education University of Hong Kong, Hong Kong, China
| | - Fuk-yuen Yu
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Danhua Ye
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Paul Shing-fong Chan
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Siyu Chen
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Zixin Wang
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
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Zhang K, Chan PSF, Li X, Fang Y, Cai Y, Zou H, Cao B, Cao H, Hu T, Chen Y, Wang Z. Low Behavioral Intention to Use Any Type of HIV Testing and HIV Self-Testing among Migrant Male Factory Workers Who Are at High Risk of HIV Infection in China: A Secondary Data Analysis. Int J Environ Res Public Health 2023; 20:5029. [PMID: 36981938 PMCID: PMC10048950 DOI: 10.3390/ijerph20065029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 03/02/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
This study investigated the prevalence of and factors associated with behavioral intention to take up any type of HIV testing and HIV self-testing (HIVST) in the next six months among male migrant workers, who were at high risk of HIV infection, in Shenzhen, China. This was a secondary data analysis. A total of 363 subjects who had sexual intercourse with non-regular female sex partners and/or female sex workers in the past six months were selected. Logistic regression models were fitted for data analysis. About 16.5% of participants reported having used HIV testing in their lifetime and 12.7% for HIVST. Among the participants, 25.6% and 23.7% intended to take up any type of HIV testing and HIVST in the next six months, respectively. Significant factors associated with the behavioral intention to take up HIV testing and HIVST included individual-level factors based of the Health Belief Model (e.g., perceived benefit, perceived cue to action, perceived self-efficacy) and interpersonal-level factors (e.g., frequency of exposure to health-related content or HIV and STI-related content on short video apps). This study provided practical implications for designing interventions to increase the uptake of HIV testing and HIVST among migrant workers.
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Affiliation(s)
- Kechun Zhang
- Longhua District Center for Disease Control and Prevention, Shenzhen 518110, China
| | - Paul Shing-fong Chan
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Xinyue Li
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, China
| | - Yong Cai
- School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
- Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia
| | - Bolin Cao
- School of Media and Communication, Shenzhen University, Shenzhen 518060, China
| | - He Cao
- Longhua District Center for Disease Control and Prevention, Shenzhen 518110, China
| | - Tian Hu
- Longhua District Center for Disease Control and Prevention, Shenzhen 518110, China
| | - Yaqi Chen
- Longhua District Center for Disease Control and Prevention, Shenzhen 518110, China
| | - Zixin Wang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
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Chan PSF, Lee MLT, Fang Y, Yu FY, Ye D, Chen S, Kawuki J, Liang X, Wang Z. Hesitancy to Receive the Second COVID-19 Vaccine Booster Dose among Older Adults in Hong Kong: A Random Telephone Survey. Vaccines (Basel) 2023; 11:vaccines11020392. [PMID: 36851269 PMCID: PMC9963661 DOI: 10.3390/vaccines11020392] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 01/24/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023] Open
Abstract
A second COVID-19 vaccine booster dose is effective and safe for older adults. This study investigated hesitancy to take up a second COVID-19 vaccine booster dose and its determinants among older adults in Hong Kong. Participants were Chinese-speaking community-dwelling adults aged 65 years or above. Telephone numbers were randomly selected from up-to-date telephone directories. A total of 370 participants completed the telephone survey. Logistic regression models were fitted for data analysis. Among the participants, half (52.4%) were hesitant to receive the second COVID-19 vaccine booster dose. After adjustment for significant background characteristics, perceived benefits (AOR: 0.50, 95%CI: 0.42, 0.60), cues to action (AOR: 0.39, 95%CI: 0.30, 0.52), and perceived self-efficacy (AOR: 0.37, 95%CI: 0.21, 0.66) of receiving the second booster dose were associated with lower vaccine hesitancy. Perceived barriers (AOR: 1.23, 95%CI: 1.12, 1.34) and vaccine fatigue (tired of receiving repeated COVID-19 vaccination) (AOR: 1.90, 95%CI: 1.52, 2.38) were associated with higher vaccine hesitancy. Level of hesitancy to receive the second booster dose was high among older adults in Hong Kong. Health authorities should address vaccine fatigue and modify perceptions related to the second booster dose.
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Affiliation(s)
- Paul Shing-fong Chan
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Marco Lok-tin Lee
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, China
| | - Fuk-yuen Yu
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Danhua Ye
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Siyu Chen
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Joseph Kawuki
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Xue Liang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Zixin Wang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
- Correspondence:
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Zhang K, Chen S, Chan PSF, Fang Y, Cao H, Chen H, Hu T, Chen Y, Zhou X, Wang Z. Changes in HIV Testing Utilization Among Chinese Men Who Have Sex With Men During the COVID-19 Pandemic in Shenzhen, China: An Observational Prospective Cohort Study. Front Med (Lausanne) 2022; 9:842121. [PMID: 35755039 PMCID: PMC9218425 DOI: 10.3389/fmed.2022.842121] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 05/16/2022] [Indexed: 12/03/2022] Open
Abstract
Background The Coronavirus Diseases 2019 (COVID-19) directly affects HIV prevention and sexual health services utilization among men who have sex with men (MSM). This study investigated changes in human immunodeficiency virus (HIV) testing utilization among MSM before and after the COVID-19 pandemic received initial control in Shenzhen, China. Methods This study was a sub-analysis of a prospective observational cohort study conducted among MSM in Shenzhen, China between August 2020 and May 2021. Participants were recruited through outreaching in gay venues, online recruitment, and peer referral. Participants completed a baseline online survey between August and September 2020 and a follow-up online survey between April and May 2021. This study was based on 412 MSM who reported to be HIV-negative/unknown sero-status at baseline, 297 (72.1%) of them completed the follow-up online survey. Multilevel logistic regression models (level 1: sources of recruitment; level 2: individual participants) were fitted. Results When comparing follow-up data with baseline data, a significant increase was observed in the uptake of any type of HIV testing (77.9% at Month 6 vs. 59.2% at baseline, p < 0.001). After adjusting for age group, education level, current employment status and monthly personal income, two predisposing factors were associated with higher uptake of HIV testing during the follow-up period. They were: (1) condomless anal intercourse with male non-regular male sex partners at follow-up only (AOR: 5.29, 95%CI: 1.27, 22.01) and (2) sanitizing before and after sex at baseline (AOR: 1.26, 95%CI: 1.02, 1.47). Regarding enabling factors, utilization of HIV testing (AOR: 3.90, 95%CI: 2.27, 6.69) and STI testing (AOR: 2.43, 95%CI: 1.20, 4.93) 6 months prior to the baseline survey was associated with higher uptake of HIV testing during the follow-up period. Having the experience that HIV testing service providers reduced service hours during the follow-up period was also positively associated with the dependent variable (AOR: 3.45, 95%CI: 1.26, 9.41). Conclusions HIV testing utilization among MSM might rebound to the level before the COVID-19 outbreak after the pandemic received initial control in China. This study offered a comprehensive overview to identify potential reasons that can influence the uptake of HIV testing among Chinese MSM.
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Affiliation(s)
- Kechun Zhang
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Siyu Chen
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Paul Shing-fong Chan
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - He Cao
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Hongbiao Chen
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Tian Hu
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Yaqi Chen
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Xiaofeng Zhou
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Zixin Wang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- *Correspondence: Zixin Wang
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Chan PSF, Fang Y, Chidgey A, Fong F, Ip M, Wang Z. Would Chinese Men Who Have Sex With Men Take Up Human Papillomavirus (HPV) Screening as an Alternative Prevention Strategy to HPV Vaccination? Front Med (Lausanne) 2022; 9:904873. [PMID: 35721088 PMCID: PMC9205561 DOI: 10.3389/fmed.2022.904873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
Background Men who have sex with men (MSM) are at high risk for human papillomavirus (HPV) infection. A community-based organization (CBO)-private clinic service model promoting HPV vaccination among MSM was implemented in Hong Kong. The aim of this study was to evaluate the effectiveness of this service model in increasing HPV screening among MSM. Methods This was a secondary analysis of the CBO-private clinic service model in increasing HPV screening among MSM. Participants were Hong Kong Chinese-speaking MSM aged 18–45 years who had never received HPV vaccination. All participants completed a telephone survey at baseline before receiving online intervention promoting HPV vaccination and completed another telephone survey 12 months afterward. Results A total of 350 participants completed a baseline telephone survey and received interventions promoting HPV vaccination. Among 274 participants being followed up at Month 12, 33 (12.0%) received any type of HPV screening during the study period. Such uptake rate was similar to the prevalence of HPV screening in the past year measured at baseline (12.0 vs. 9.9%, p = 0.43). More MSM preferred HPV vaccination or HPV vaccination plus HPV screening, and very few preferred HPV screening alone. After adjusting for significant baseline characteristics, higher perceived susceptibility to HPV (adjusted odds ratio (AOR): 1.16, 95% confidence interval (CI): 1.00–1.34) and receiving HPV vaccination during the study period (AOR: 7.03, 95% CI: 3.07–16.13) were significantly associated with higher HPV screening uptake. Conclusions The CBO-private clinic service model promoting HPV vaccination had limited impact in increasing HPV screening among MSM in Hong Kong. MSM in Hong Kong may not use HPV screening as an alternative prevention strategy to HPV vaccination. Future programs preventing HPV-related diseases among MSM in Hong Kong should focus on HPV vaccination promotion.
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Affiliation(s)
- Paul Shing-fong Chan
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | | | | | - Mary Ip
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Zixin Wang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- *Correspondence: Zixin Wang
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Zhang K, Fang Y, Chan PSF, Cao H, Chen H, Hu T, Chen Y, Zhou X, Wang Z. Behavioral Intention to Get a Booster Dose of COVID-19 Vaccine among Chinese Factory Workers. Int J Environ Res Public Health 2022; 19:ijerph19095245. [PMID: 35564639 PMCID: PMC9099970 DOI: 10.3390/ijerph19095245] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 12/15/2022]
Abstract
China started to offer a booster dose of COVID-19 vaccine to members of the adult population in October 2021. This study investigated the behavioral intention to receive a booster dose of COVID-19 vaccine among factory workers who had completed their primary vaccination series. Participants were full-time factory employees at least 18 years of age in Shenzhen, China. In Shenzhen, factory workers need to receive a physical examination every year. The study sites covered all six organizations providing physical examinations for factory workers. All eligible workers attending these sites between 26 and 31 October 2021 were invited to complete an online survey. This study was based on 2329 participants who had completed the primary COVID-19 vaccination series. Two-level logistic regression models were fitted. Among the participants, 84% intended to receive a free booster dose of COVID-19 vaccine within the next six months. After controlling for significant background characteristics, we found that perceptions related to a booster dose as well as interpersonal level factors such as information exposure on social media, thoughtful consideration of the veracity of the information, and satisfaction with vaccine-related promotional materials were determinants of behavioral intention. Factory workers in China reported a high level of behavioral intention to receive a booster dose of the COVID-19 vaccine.
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Affiliation(s)
- Kechun Zhang
- Longhua District Center for Disease Control and Prevention, Shenzhen 518110, China; (K.Z.); (H.C.); (H.C.); (T.H.); (Y.C.); (X.Z.)
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong 999077, China;
| | - Paul Shing-fong Chan
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China;
| | - He Cao
- Longhua District Center for Disease Control and Prevention, Shenzhen 518110, China; (K.Z.); (H.C.); (H.C.); (T.H.); (Y.C.); (X.Z.)
| | - Hongbiao Chen
- Longhua District Center for Disease Control and Prevention, Shenzhen 518110, China; (K.Z.); (H.C.); (H.C.); (T.H.); (Y.C.); (X.Z.)
| | - Tian Hu
- Longhua District Center for Disease Control and Prevention, Shenzhen 518110, China; (K.Z.); (H.C.); (H.C.); (T.H.); (Y.C.); (X.Z.)
| | - Yaqi Chen
- Longhua District Center for Disease Control and Prevention, Shenzhen 518110, China; (K.Z.); (H.C.); (H.C.); (T.H.); (Y.C.); (X.Z.)
| | - Xiaofeng Zhou
- Longhua District Center for Disease Control and Prevention, Shenzhen 518110, China; (K.Z.); (H.C.); (H.C.); (T.H.); (Y.C.); (X.Z.)
| | - Zixin Wang
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China;
- Correspondence:
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Zhang K, Chan PSF, Chen S, Fang Y, Cao H, Chen H, Hu T, Chen Y, Zhou X, Wang Z. Factors Predicting COVID-19 Vaccination Uptake Among Men Who Have Sex With Men in China: An Observational Prospective Cohort Study. Front Med (Lausanne) 2022; 9:838973. [PMID: 35360721 PMCID: PMC8963419 DOI: 10.3389/fmed.2022.838973] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 02/17/2022] [Indexed: 01/15/2023] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected sexual minorities including men who have sex with men (MSM). This study investigated factors associated with the uptake of COVID-19 vaccination among MSM in China. Methods Inclusion criteria were: (1) born biologically male, (2) had oral or anal sex with men in the past year, (3) aged at least 18 years, and (4) lived in Shenzhen, China. Prospective participants were recruited through outreach in gay bars and saunas, online recruitment, and peer referrals. Participants completed a baseline online survey between August and September 2020 and a follow-up online survey between April and May 2021. Logistic regression models were fitted for data analysis. Results Among 420 participants who completed the baseline survey, 303 completed the follow-up survey. Among participants being followed up, 113 (37%) received at least one dose of COVID-19 vaccination during the study period. After adjusting for significant sociodemographic characteristics, five baseline predisposing factors predicted COVID-19 vaccination uptake during the follow-up period, including asking whether their partners had COVID-19 symptoms [adjusted odds ratio (AOR): 1.17, 95% confidence interval (CI): 1.00-1.38], washing hands before and after sex (AOR: 1.23, 95% CI: 1.03-1.46), sanitizing before and after sex (AOR: 1.17, 95% CI: 1.00-1.37), perceived higher risk of COVID-19 transmission through sexual behaviors (AOR: 1.28, 95% CI: 1.04-1.58), and panic about COVID-19 (AOR: 1.48, 95% CI: 1.16-1.89). Regarding enabling factors, receiving testing for sexually transmitted infections (STI) (AOR: 2.19, 95% CI: 1.25-3.85) and other prevention measures for human immunodeficiency virus (HIV)/STI (AOR: 2.61, 95% CI: 1.56-4.37) 6 months prior to the baseline survey were associated with higher uptake of COVID-19 vaccination. Conclusion MSM's uptake rate of COVID-19 vaccination was comparable to that of the general population in Shenzhen, China. This study offered an overview for us to identify tapping points that can encourage COVID-19 vaccination uptake among Chinese MSM.
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Affiliation(s)
- Kechun Zhang
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Paul Shing-fong Chan
- Jockey Club (JC) School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Siyu Chen
- Jockey Club (JC) School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - He Cao
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Hongbiao Chen
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Tian Hu
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Yaqi Chen
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Xiaofeng Zhou
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Zixin Wang
- Jockey Club (JC) School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Yuan J, Cao B, Zhang C, Chan PSF, Xin M, Fang Y, Chen Y, Huang D, Li L, Xuan X, Zhang G, Pan Y, He Y, Wang Z. Changes in Compliance With Personal Preventive Measures and Mental Health Status Among Chinese Factory Workers During the COVID-19 Pandemic: An Observational Prospective Cohort Study. Front Public Health 2022; 10:831456. [PMID: 35359764 PMCID: PMC8960195 DOI: 10.3389/fpubh.2022.831456] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 02/07/2022] [Indexed: 01/06/2023] Open
Abstract
Coronavirus Disease 2019 (COVID-19) vaccination together with good compliance with personal preventive measures may help eradicate the ongoing pandemic. This observational prospective cohort study investigated the changes in compliance with personal preventive measures, depressive symptoms, and sleep quality among factory workers within a 3-month follow-up period. A total of 663 workers were recruited by a stratified multi-stage cluster sampling in March 2020, and all of them completed a follow-up survey three months later. Multilevel logistic and linear regression models (level 1: factories; level 2: individual participants) were fitted. A significant decline was observed in consistent facemask wearing in workplace (from 98.0 to 90.3%, P < 0.001) and in other public spaces (from 97.1 to 94.4%, P = 0.02), sanitizing hands (from 70.9 to 48.0%, P < 0.001), household disinfection (from 47.7 to 37.9%, P < 0.001) and probable depression (from 14.9 to 1.5%, P < 0.001) over the follow-up period. A significant improvement in avoiding crowded places (from 69.8 to 77.4%, P = 0.002) and sleep quality (proportion of participants reporting poor sleep quality dropped from 3.9 to 1.2%, P = 0.002) was also observed. Efforts are needed to maintain compliance with personal preventive measures during the pandemic. Mental health problems were uncommon and likely to be one-off among Chinese factory workers.
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Affiliation(s)
- Jinqiu Yuan
- Big Data Center, Precision Medicine Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
- Clinical Research Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Bolin Cao
- School of Media and Communication, Shenzhen University, Shenzhen, China
| | - Changhua Zhang
- Center for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Paul Shing-fong Chan
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Meiqi Xin
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Yaoxi Chen
- School of Media and Communication, Shenzhen University, Shenzhen, China
| | - Dongfeng Huang
- Department of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Lifang Li
- Department of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Xujun Xuan
- Department of Andrology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Gengpeng Zhang
- Department of Chinese Medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Yihang Pan
- Big Data Center, Precision Medicine Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
- *Correspondence: Yihang Pan
| | - Yulong He
- Center for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
- Yulong He
| | - Zixin Wang
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Zixin Wang
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Wang Z, Fang Y, Chan PSF, Chidgey A, Fong F, Ip M, Lau JTF. Effectiveness of a Community-Based Organization-Private Clinic Service Model in Promoting Human Papillomavirus Vaccination among Chinese Men Who Have Sex with Men. Vaccines (Basel) 2021; 9:vaccines9111218. [PMID: 34835149 PMCID: PMC8620588 DOI: 10.3390/vaccines9111218] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/15/2021] [Accepted: 10/15/2021] [Indexed: 01/21/2023] Open
Abstract
This study evaluated the effectiveness of the community-based organization (CBO)-private clinic service model in increasing human papillomavirus (HPV) vaccination uptake among unvaccinated men who have sex with men (MSM) in Hong Kong during a 12-month follow-up period. A CBO-private clinic model was implemented to promote HPV vaccination among Chinese MSM. A CBO with good access to MSM approached MSM aged 18–45 years who had never received an HPV vaccination, invited them to receive an online health promotion, and referred them to receive HPV vaccination at gay-friendly private clinics. A baseline survey and a follow-up evaluation at Month 12 were conducted. A total of 350 participants completed the baseline survey. Among 274 participants who were followed up at Month 12, 46 (16.8%) had taken up at least one dose of HPV vaccination. After adjusting for significant baseline characteristics, the perceived susceptibility (AOR:1.25, p = 0.002) and perceived severity (AOR:1.21, p = 0.003) of HPV and HPV-related diseases, perceived benefits (AOR:1.16, p = 0.03), self-efficacy to receive HPV vaccination (AOR:1.37, p = 0.001), and behavioral intention to take up HPV vaccination at baseline (AOR:6.99, p < 0.001) significantly predicted HPV vaccination uptake. The process evaluation of the program was positive. The CBO-private clinic service model was helpful in increasing HPV vaccination uptake among MSM.
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Affiliation(s)
- Zixin Wang
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (P.S.-f.C.); (M.I.)
- Correspondence: (Z.W.); (J.T.F.L.)
| | - Yuan Fang
- Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong, China;
| | - Paul Shing-fong Chan
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (P.S.-f.C.); (M.I.)
| | | | | | - Mary Ip
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (P.S.-f.C.); (M.I.)
| | - Joseph T. F. Lau
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (P.S.-f.C.); (M.I.)
- Correspondence: (Z.W.); (J.T.F.L.)
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Chan PSF, Chidgey A, Lau J, Ip M, Lau JT, Wang Z. Effectiveness of a Novel HIV Self-Testing Service with Online Real-Time Counseling Support (HIVST-Online) in Increasing HIV Testing Rate and Repeated HIV Testing among Men Who Have Sex with Men in Hong Kong: Results of a Pilot Implementation Project. Int J Environ Res Public Health 2021; 18:ijerph18020729. [PMID: 33467770 PMCID: PMC7830557 DOI: 10.3390/ijerph18020729] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/18/2020] [Accepted: 01/14/2021] [Indexed: 11/16/2022]
Abstract
HIV self-testing (HIVST) with online real-time counseling (HIVST-online) is an evidence-based intervention to increase HIV testing coverage and to ensure linkage to care for men who have sex with men (MSM). A community-based organization (CBO) recruited 122 MSM who had ever used HIVST-online (ever-users) and another 228 new-users from multiple sources and promoted HIVST-online. A free oral fluid-based HIVST kit was sent to all the participants by mail. Experienced HIVST administrators implemented HIVST-online by providing real-time instruction, standard-of-care pre-test and post-test counseling via live-chat application. The number of HIVST-online sessions performed was documented by the administrators. The post-test evaluation was conducted 6 months after the pre-test survey. At month 6, 63.1% of ever-users and 40.4% of new-users received HIVST-online. Taking other types of HIV testing into account, 79.4% of ever-users and 58.6% of new-users being followed up at month 6 received any HIV testing during the project period. Ever-users were more likely to receive HIVST-online and any HIV testing as compared to new-users. Four HIVST-online users were screened to be HIV positive and linked to the treatment. The process evaluation of HIVST-online was positive. Implementation of HIVST-online was helpful to improve HIV testing coverage and repeated HIV testing among Chinese MSM. A larger scale implementation should be considered.
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Affiliation(s)
- Paul Shing-fong Chan
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (P.S.-f.C.); (M.I.)
| | | | - Jason Lau
- AIDS Concern, Hong Kong, China; (A.C.); (J.L.)
| | - Mary Ip
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (P.S.-f.C.); (M.I.)
| | - Joseph T.F. Lau
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (P.S.-f.C.); (M.I.)
- Correspondence: (J.T.F.L.); (Z.W.)
| | - Zixin Wang
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (P.S.-f.C.); (M.I.)
- Correspondence: (J.T.F.L.); (Z.W.)
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Lloyd SN, Kavanagh J, Chan PSF, Ferreira AM, Gu FL, Pavone-Macaluso M, Xia S, Blacklock SN. A multicentre prospective study of prostatic volume in asymptomatic men in various continents. Prostate Cancer Prostatic Dis 1997; 1:97-100. [PMID: 12496923 DOI: 10.1038/sj.pcan.4500213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/1997] [Accepted: 09/12/1997] [Indexed: 11/09/2022]
Abstract
Objective: To compare prostatic volumes in asymptomatic Asian men with similar controls in Europe. Patients and methods: Six centres (Beijing, Hong Kong, Jinan, Lisbon, Palermo and Stirling) independently selected asymptomatic men aged 55 y or more for assessment of prostatic volume using transrectal ultrasound (total=320 men) between 1992 and 1993. Results: Prostatic volumes in asymptomatic men were greater in Beijing than Hong Kong, Stirling and Palermo (P<0.05) and were smaller in Stirling than Beijing and Jinan (P<0.05). Conclusions: These results suggest that men from Stirling are less likely to have large prostates, but there is no evidence that men from any of the six cities are more likely to have small prostates. This small series may suggest that benign prostatic hyperplasia (BPH) is as common in China as in European cities. The differences may be due to some cities (Beijing, Jinan and Lisbon) having a greater proportion of high values, perhaps suggesting looser selection criteria. This may indicate an abandonment of traditional Asian foods with their presumptive beneficial effect in favour of a Western dietary style.
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Affiliation(s)
- S N Lloyd
- Pyrah Department of Urology, St. James's University Hospital, Leeds
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