[Development and challenges of tobacco epidemic surveillance in China].
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Tobacco use is the leading preventable risk factor causing the global burden of disease and one of China's most significant public health issues. Continuous and dynamic tobacco monitoring can provide critical index data for developing tobacco control strategies and measures and evaluating the impact of tobacco control. The WHO has incorporated monitoring programs into the crucial content of tobacco control and put forward relevant compliance requirements in the Framework Convention on Tobacco Control (FCTC). The Chinese government has actively promoted tobacco control significantly since the entry into force of the FCTC in China and continuously strengthened tobacco monitoring. In 2021, China's tobacco monitoring was honored to have reached the highest level required by the WHO. This study introduces the sampling design of tobacco surveys, monitoring content, the definition of key indicators and data weighting based on a complex sampling design, analyzing the challenges facing in the current setting, and provides a reference for the understanding and utilization of the data, the comparison of the results, and the future development of tobacco monitoring. The surveys involved in this study will focus on the specialized epidemiological surveys of tobacco for adults and adolescents carried out nationwide.烟草使用是导致全球疾病负担主要的可预防危险因素,是我国面临的重大公共卫生问题。连续动态的烟草监测可以为制定控烟策略和措施、评价控烟效果提供关键指标数据。WHO将烟草监测纳入控烟的重要内容并在《烟草控制框架公约》中提出相关履约要求。中国政府积极推进控烟工作,特别是《烟草控制框架公约》生效以来,烟草监测得到不断加强,2021年起,我国的烟草监测工作被WHO评为达到最高等级。本文主要对全国范围内开展的成人和青少年烟草流行病学专项调查抽样设计、监测内容、关键指标定义和基于复杂抽样的数据加权进行阐述,并提出我国当前烟草监测面临的挑战,以期为我国烟草流行专项调查数据的理解和利用、调查结果的比较以及今后我国烟草监测工作的开展提供参考。.Topics:
There are many AIDS cases and people infected with HIV in India. While the government responded to the AIDS pandemic faster than it has to any other disease or health issue including family planning the response was slower than ideal. There are many related problems in India which are changing only gradually. Despite the widespread nature of HIV infection in India much can still be done to reduce the impact of the epidemic upon the population. India must sensitize its politicians to the serious nature of the problem and develop nongovernmental organizations which can become involved. Politicians can then effectively mobilize the health sector. While governments are expected to enable its people to understand how to avoid the risk of HIV transmission thereby reducing the chance of infection it is clear that the government of India cannot by itself control HIV through legislation or programs. The authors also note that the central and state governments have been hampered in their efforts by existing public health problems and the lack of reliable information to apply to intervention programs for change. Accurate and reliable epidemiological data are needed. The authors describe the existing health status and infrastructure of the nation outline the initial response to the AIDS pandemic and discuss some specific intervention projects legislative aspects of HIV infection and the financial details of AIDS control activity in India.
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Vaccination is an essential component of modern public health programs and is among our most cost-effective medical interventions. Yet despite vaccines' clear effectiveness in reducing risks of diseases that previously attacked large proportions of the population, caused many deaths, and left many people with permanent disabilities, current vaccination policies are not without controversy. Vaccines, like all other pharmaceutical products, are not entirely risk-free; while most known side effects are minor and self-limited, some vaccines have been associated with very rare but serious adverse effects. Because such rare effects are often not evident until vaccines come into widespread use, the Federal government maintains ongoing surveillance programs to monitor vaccine safety. The interpretation of data from such programs is complex and is associated with substantial uncertainty. A continual effort to monitor these data effectively and to develop more precise ways of assessing risks of vaccines is necessary to ensure public confidence in immunization programs.
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The U.S. Department of Health and Human Services (HHS), CDC, other U.S. government agencies, the World Health Organization (WHO), and international partners are taking multiple steps to respond to the current Ebola virus disease (Ebola) outbreak in West Africa to reduce its toll there and to reduce the chances of international spread. At the same time, CDC and HHS are working to ensure that persons who have a risk factor for exposure to Ebola and who develop symptoms while in the United States are rapidly identified and isolated, and safely receive treatment. HHS and CDC have actively worked with state and local public health authorities and other partners to accelerate health care preparedness to care for persons under investigation (PUI) for Ebola or with confirmed Ebola. This report describes some of these efforts and their impact.
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The attitudes of Ontario youth toward the sale and price of cigarettes, making smoking against the law, and tobacco company truthfulness were assessed in 2001 and compared to adult attitudes in 2000 and youth attitudes in 2003. Youth were more supportive of restricting cigarette sales and raising prices than adults, and more likely to agree that the government should make smoking against the law, but they were less distrustful of tobacco companies. In 2003, youth were more supportive of sales restrictions and making smoking illegal, and more distrustful of tobacco companies, than in 2001. More comprehensive assessments and continued monitoring of youth attitudes are needed.
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To investigate the factors associated with delay in 1) care-seeking (patient delay), and 2) diagnosis by health providers (health system delay), among smear-positive tuberculosis patients, before large-scale DOTS implementation in South India.New smear-positive patients were interviewed using a structured questionnaire.Among 531 participants, the median patient, health system and total delays were 20, 23 and 60 days, respectively. Twenty-nine per cent of patients delayed seeking care for > 1 month, of whom 40% attributed the delay to their lack of awareness about TB. Men postponed seeking care for longer periods than women (P = 0.07). In multivariate analysis, the patient delay was greater if the patient had initially consulted a government provider (adjusted odds ratio [AOR] 2.2, P < or = 0.001), resided at a distance >2 km from a health facility (AOR 1.6, P = 0.04), and was an alcoholic (AOR 1.6, P = 0.04). Health system delay was >7 days among 69% of patients. Factors associated with health system delay were: first consultation with a private provider (AOR 4.0, P < 0.001), a shorter duration of cough (AOR 2.6, P = 0.001), alcoholism (P = 0.04) and patient's residence >2 km from a health facility (AOR 1.8, P = 0.02). The total delay resulted largely from a long patient delay when government providers were consulted first, and a long health system delay when private providers were consulted first.Public awareness about chest symptoms and the availability of free diagnostic services should be increased. Government and private physicians should be educated to be aware about the possibility of tuberculosis when examining out-patients. Effective referrals for smear microscopy should be developed between private and public providers.
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Legislative measures against smoking in Singapore began in the early 1970s, and can be said to have been the start of a comprehensive smoking control programme. With the launch of the National Smoking Control Programme (NSCP) in 1986, a National Smoking Control Coordinating Committee was set up to look into legislation and fiscal measures. To further increase the dimension and impact of the programme, a Civic Committee on Smoking Control was formed in 1996. This committee also looks into and recommends legislative measures. The NSCP is an ongoing programme that aims to reduce smoking rates through a combination of strategies, including education, establishment of no-smoking areas and increasing taxation and legislative measures. Existing legislation is regularly and systematically reviewed and revised, and new laws are recommended to strengthen our smoking control efforts. Concurrently, penalties and ways to improve enforcement of the legislation are also updated. The legislative measures that have been implemented in Singapore over the years include prohibition of tobacco advertising and promotion, restrictions on the sale of tobacco products, licensing of sales outlets, use of health warnings on cigarette packets, controlling and labelling of tar and nicotine contents, restriction of smoking in public places and prohibition of smoking in public by the under-eighteens. Several factors have helped make legislative measures work in Singapore. These include political will and support, starting legislation early, comprehensive legislative measures, enforcement measures and continuous review. To sustain these efforts, Singapore needs to continue to stay abreast of world-wide measures on smoking control.
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Both government and private sector organizations are seeking ways to maintain and improve the health of the public in the world to control the costs at the same time. For this aim internet and use of georeferenced public health information for Geographic Information System application is an important and exciting development for the nation’s Department of Health and Human Services and other health agencies. Technological progress towards public health geospatial data integration, analysis, and visualization of space-time events using the Web portends eventual robust use of Geographic Information System by public health and other sectors of the economy. Increasing Web resources from distributed spatial data portals and global geospatial libraries, and a growing suite of Web integration tools, will provide new opportunities to advance disease surveillance, control and prevention, and insure public access and community empowerment in public health decision making.
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This study was conducted to examine the contributions of professional health associations, non-governmental organisations, government ministries, and community-based organisations in implementing community-based interventions for the reduction of maternal mortality in Delta State Nigeria. It also seeks to demonstrate the challenge of coordinating activities of several stakeholders and quantifying the impact on reduction of maternal mortality.Various publications, reports, public presentations and policy documents on activities of professional health associations, non- governmental organisations, government ministries, and community-based organisations in Delta State of Nigeria were collected and analysed by the authors.Professional health associations, non-governmental organisations and community-based organisations in Delta State have contributed to the reduction of maternal mortality through advocacy, awareness creation, and sensitisation programmes on reproductive health using behaviour change communication materials. Participation in programmes organised by the Delta State Ministry of Health has also contributed to some positive outcomes. These include the successful implementation of Delta State Free Maternal Health Care Programme since November 2007 and increase in contraceptive utilisation.Professional health associations, non-governmental organisations, government ministries and community-based organisations have impacted positively in the quest for reduction of maternal mortality. The challenge is in coordination of interventions and tracking indicators to measure desired impact.
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By December 1993, 1243 people from 21 of China's 30 provinces, municipalities, and autonomous regions had been reported to China's Ministry of Public Health as being HIV-seropositive. 36 of these individuals had AIDS, of whom 19 had histories of IV drug use and 7 contracted the infection through sexual contact. 34 of the people with AIDS were male. Of the reported cases of HIV infection, 827 were drug users, 333 were foreign nationals who had returned to China, and 12 were men and women who had had extramarital sex. There were only 3 homosexual men and 5 STD patients. 79.7% of reported HIV infections were from Yunnan Province, 6.0% from Guangdong Province, 4.7% from Beijing, and 3.1% from Shanghai municipalities. While IV drug use is currently the dominant mode of HIV transmission, especially to the south, heterosexual transmission is expected to dominate elsewhere in the country. A Ministry of Public Health study predicts, in a medium scenario of HIV transmission, there will be 80,000-100,000 people with HIV and 10,000-25,000 people with AIDS in China by 2000. There will be significant medical costs and loss of productivity as a result of these high levels of infection, disease, and eventual mortality. The authors briefly discuss prevention and control and the government response.
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