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Objective To examine syphilis testing capacity, screening coverage rates and types of syphilis tests used in medical facilities in southern China. Methods Eleven of the 14 municipalities in Guangdong province participated. Data on syphilis testing capacity, screening coverage and types of syphilis tests used were collected from all types of public medical facilities offering prenatal care (n = 109). A total of 494 680 women who delivered during 2004-2008 were studied. Findings In 2008, 54196 pregnant women (43.1%) were not screened for syphilis. Among such women, 32 863 (60.6%) attended clinics without any syphilis testing capacity and 21 333 (39.4%) attended clinics that performed testing but were not screened. The likelihood of not having syphilis test capacity was much higher for hygiene stations (odds ratio, OR: 10; 95% confidence interval, CI: 4-25), services at the township level (OR: 33; 95% CI: 10-100) and services with [less than or equal to] 1000 deliveries per year (OR: 1.002; 95% CI: 1.001- 1.003). These same service characteristics correlated with lower screening coverage rates (P < 0.01). Only one antenatal clinic had the capacity to conduct both treponemal and non-treponemal tests for diagnosing syphilis. Conclusion Syphilis screening is available in very few of the basic medical facilities offering prenatal care where most neonates in southern China are delivered. In light of this and of the increasing incidence of syphilis in the area, expanding point-of-care rapid syphilis testing is a priority. Objectif Etudier la capacite a effectuer le depistage de la syphilis, les taux de couverture du depistage et les types de tests syphilitiques utilises dans les etablissements medicaux en Chine meridionale. Methodes Onze des 14 municipalites de la province de Guangdong ont participe a cette etude. Les donnees relatives a la capacite a effectuer le depistage de la syphilis, a la couverture du depistage et aux types de tests syphilitiques utilises ont ete recueillies aupres de toutes les sortes d'etablissements medicaux proposant des soins prenataux (n=109). Un total de 494 680 femmes ayant accouche entre 2004 et 2008 ont fait l'objet de l'etude. Resultats En 2008, 54196 femmes enceintes (43,1%) n'ont pas subi le depistage de la syphilis. Parmi ces retomes, 32 863 d'entre elles (60,6%) se sont rendues dans des cliniques ne disposant d'aucune capacite pour effectuer le depistage de la syphilis et 21 333 d'entre elles (39,4%) n'ont pas subi de depistage, bien qu'elles soient allees dans des cliniques aptes a le realiser. La probabilite du manque de capacite de depistage de la syphilis etait beaucoup plus elevee pour les centres de sante (rapport des cotes, RC: 10; intervalle de confiance de 95%, IC: 4-25), les services au niveau communal (RC: 33; IC de 95%: ]0-100) et les services realisant moins de 1000 accouchements par ah (RC: 1,002; IC de 95%: 1,001-1,003). Ces memes caracteristiq ues de service etaient en correlation avec des taux de couverture de depistage inferieurs (P Conclusion Le depistage de la syphilis n'est disponible que dans tres peu d'etablissements medicaux de base qui proposent des soins prenataux, dans lesquels la plupart des nouveau-nes de Chine meridionale voient lejour. A la lumiere de ces informations et de l'incidence croissante de la syphilis dans cette region, I'extension du depistage rapide de la syphilis aux points sanitaires est une priorite. [TEXT NOT REPRODUCIBLE IN ASCII] Objetivo Examinar la capacidad para realizar pruebas de sifilis, evaluar las tasas de cobertura y los tipos de pruebas de sifilis utilizados en centros medicos del sur de China. Metodos Participaron once de los catorce municipios de la provincia de Guangdong. Se recopilaron datos sobre la capacidacl de realizar pruebas de sifilis, la cobertura de evaluacion y los tipos de pruebas de sifilis de todos los tipos de centros medicos publicos que ofrecen cuidados prenatales (n=109). Se estudio a un total de 494 680 mujeres que dieron a luz durante el periodo 2004-2008. Resultados En el ano 2008, 54]96 mujeres embarazadas (el 43,1%) no fueron evaluadas para la sifilis. De estas mujeres, 32863 (el 60,6%) acudieron a clinicas sin capacidad para realizar pruebas de sifilis y 21 333 (e139,4%) acudieron a clinicas que realizaban la prueba, aunque esta no se les realizo. La probabilidad de no disponer de capacidad para realizar la prueba de sifilis era muy superior en puestos de salud (cociente de probabilidades, CP: 10; interva lo de confianza dei 95% IC: 4-25), servicios municipales (CP: 33; IC dei 95%: 10-100) y servicios con [less than or equal to] 1000 partos ai aho (CP: 1.002; IC dei 95%: 1.001-1.003). Estas mismas caracteristicas de servicio correlacionadas con tasas de cobertura de evaluacion inferiores (P Conclusion La evaluacion de la sifilis esta disponible en muy pocas de las instalaciones medicas basicas que ofrecen cuidados prenatales y donde se da a luz a la mayor parte de los neonatos del sur de China. A causa de esto y del aumento de la incidencia de la sifilis en la zona, la ampliacion de los puntos de asistencia para la realizacion de pruebas rapidas de sifilis es una prioridad., Introduction The last decade has seen a pronounced resurgence of syphilis in China, (1-3) especially in south-eastern coastal provinces, which carry the greatest disease burden. (4,5) One such province is [...]

To investigate the association between infancy weight gain and neurodevelopment among term-born infants. Singleton term-born infants (n = 5837) were included from the Born in Guangzhou Cohort Study. Absolute weight gain was obtained by calculating the weight difference from birth to exactly 12 months. The primary outcome was neurodevelopment at age one year, which included five developmental domains. Global developmental delay was defined as delays in ≥3 domains. Multivariable logistic regression was used to examine the associations between infancy weight gain and neurodevelopment. Compared with infants gaining 6001–7000 g (reference group), infants gaining ≤5000 g had higher odds of delay in adaptive, gross motor, fine motor, social, and global developmental delay, infants gaining 5001–6000 g had higher odds of gross motor delay and social delay. A sex-stratified analysis showed that compared with the reference group, gaining ≤5000 g was associated with higher odds of fine motor delay in male infants, while gaining >7000 g was associated with higher odds of fine motor delay in females. Inadequate infancy weight gain is associated with higher odds of poor neurodevelopment at age one year among term-born infants. [ABSTRACT FROM AUTHOR]

Abstract Background Many injection drug users (IDUs) in China have high risk sexual behaviors that contribute to the spread of HIV infection. Although many IDUs in China move through drug rehabilitation centers, this opportunity for sexual health education has largely been overlooked. Methods A convenience sample of 667 drug users from two rehabilitation centers in South China was recruited in the study. Two hundred and forty seven drug users from a single Guangdong Province rehabilitation center received the peer-based education intervention, while 420 drug users from another rehabilitation center received routine HIV/STI education and was used as the control. One hundred and eighty nine (22.1%) individuals refused to participate in the study. HIV/STI behavioral and knowledge domains were assessed at 3 months in rehabilitation centers after the intervention (first follow-up) and at 2-23 months in the community after release (second follow-up). Results Drug users who completed the intervention reported more frequent condom use with casual sex partners (60.0% vs. 12.5% condom use every time, p = 0.011) and less frequent injection (56.7% vs. 26.4% no injection per day, p = 0.008) at the second follow-up compared to those in the routine education group. Loss to follow up was substantial in both control and intervention groups, and was associated with living far from the detention center and having poor HIV knowledge at baseline. Conclusions This study shows that rehabilitation centers may be a useful location for providing behavioral HIV/STI prevention services and referral of individuals to community-based programs upon release. More research is needed on behalf of detained drug users in China who have complex social, medical, and legal needs.

Abstract Background Syphilis cases have risen in many parts of China, with developed regions reporting the greatest share of cases. Since syphilis increases in these areas are likely driven by both increased screening and changes in sexual behaviours, distinguishing between these two factors is important. Examining municipal-level primary syphilis cases with spatial analysis allows a more direct understanding of changing sexual behaviours at a more policy-relevant level. Methods In this study we examined all reported primary syphilis cases from Guangdong Province, a southern province in China, since the disease was first incorporated into the mandatory reporting system in 1995. Spatial autocorrelation statistics were used to correlate municipal-level clustering of reported primary syphilis cases and gross domestic product (GDP). Results A total of 52,036 primary syphilis cases were reported over the period 1995-2008, and the primary syphilis cases increased from 0.88 per 100,000 population in 1995 to 7.61 per 100,000 in 2008. The Pearl River Delta region has a disproportionate share (44.7%) of syphilis cases compared to other regions. Syphilis cases were spatially clustered (p = 0.01) and Moran's I analysis found that syphilis cases were clustered in municipalities with higher GDP (p = 0.004). Conclusions Primary syphilis cases continue to increase in Guangdong Province, especially in the Pearl River Delta region. Considering the economic impact of syphilis and its tendency to spatially cluster, expanded syphilis testing in specific municipalities and further investigating the costs and benefits of syphilis screening are critical next steps.

Objective: To examine the association between progesterone concentration in early pregnancy and duration of pregnancy and risk of preterm delivery.Methods: Women enrolled in the Born in Guangzhou Cohort Study from 2013-2014, with a singleton pregnancy, who had serum progesterone measured at least one time between 4 and 10 weeks of gestation were included. The association between progesterone concentration both continuous and as categorical variable (quartile) and the risk of preterm delivery was assessed with Cox proportional hazards regression. Differences of length of gestation in four progesterone concentration quartiles were assessed using the Log-rank test.Results: We studied 1860 mother-newborn pairs. The mean overall progesterone concentration was 65.7 ± 21.3 nmol/L, with mean progesterone concentrations in the four quartiles of 42.4 ± 6.2 nmol/L (n = 463), 56.2 ± 3.3 nmol/L (n = 462), 68.9 ± 4.5 nmol/L (n = 470), and 95.1 ± 15.3 nmol/L (n = 465). There was no significantly difference in duration of gestation in four progesterone concentration groups (p=.511). There was no relation between progesterone level and preterm delivery (adjusted hazard ratio (HR) per 10 nmol/l progesterone level 1.00 (95% confidence interval (CI) 0.90, 1.11)). After adjusting for potential confounders, the HR of any preterm delivery for quartiles 1, 2 and 3 versus the highest quartile of progesterone level (> 77.3 nmol/L) was 1.04 (95% CI 0.52, 2.07), 1.17 (95% CI 0.60, 2.28), and 1.46 (95% CI 0.76, 2.78), respectively. When analysis was done for spontaneous preterm delivery only, also no association with first trimester progesterone was found.Conclusion: Lower first trimester serum progesterone concentration is not associated with reduction of length of gestation or increased risk of preterm delivery. [ABSTRACT FROM AUTHOR]