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To determine the prevalence of hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis B core anti-body (anti-HBc) in a representative population in China 14 years after introduction of hepatitis B vaccination of infants.National serosurvey, with participants selected by multi-stage random sampling. Demographics and hepatitis B vaccination history collected by questionnaire and review of vaccination records, and serum tested for HBsAg, antibody to anti-HBc and anti-HBs by ELISA.The weighted prevalences of HBsAg, anti-HBs and anti-HBc for Chinese population aged 1-59 years were 7.2%, 50.1%, 34.1%, respectively. HBsAg prevalence was greatly diminished among those age15 years compared to that found in the 1992 national serosurvey, and among children age5 years was only 1.0% (90% reduction). Reduced HBsAg prevalence was strongly associated with vaccination among all age groups. HBsAg risk in adults was associated with male sex, Western region, and certain ethnic groups and occupations while risk in children included birth at home or smaller hospitals, older age, and certain ethnic groups (Zhuang and other).China has already reached the national goal of reducing HBsAg prevalence to less than 1% among children under 5 years and has prevented an estimated 16-20 million HBV carriers through hepatitis B vaccination of infants. Immunization program should be further strengthened to reach those remaining at highest risk.

To determine the prevalence of hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis B core anti-body (anti-HBc) in a representative population in China 14 years after introduction of hepatitis B vaccination of infants.National serosurvey, with participants selected by multi-stage random sampling. Demographics and hepatitis B vaccination history collected by questionnaire and review of vaccination records, and serum tested for HBsAg, antibody to anti-HBc and anti-HBs by ELISA.The weighted prevalences of HBsAg, anti-HBs and anti-HBc for Chinese population aged 1-59 years were 7.2%, 50.1%, 34.1%, respectively. HBsAg prevalence was greatly diminished among those age15 years compared to that found in the 1992 national serosurvey, and among children age5 years was only 1.0% (90% reduction). Reduced HBsAg prevalence was strongly associated with vaccination among all age groups. HBsAg risk in adults was associated with male sex, Western region, and certain ethnic groups and occupations while risk in children included birth at home or smaller hospitals, older age, and certain ethnic groups (Zhuang and other).China has already reached the national goal of reducing HBsAg prevalence to less than 1% among children under 5 years and has prevented an estimated 16-20 million HBV carriers through hepatitis B vaccination of infants. Immunization program should be further strengthened to reach those remaining at highest risk.

Summary Infectious diseases remain the major causes of morbidity and mortality in China despite substantial progress in their control. China is a major contributor to the worldwide infectious disease burden because of its population size. The association of China with the rest of the world through travel and trade means that events in the country can affect distant populations. The ecological interaction of people with animals in China favours the emergence of new microbial threats. The public-health system has to be prepared to deal with the challenges of newly emerging infectious diseases and at the same time try to control existing diseases. To address the microbial threats, such as severe acute respiratory syndrome, the government has committed substantial resources to the implementation of new strategies, including the development of a real-time monitoring system as part of the infectious-disease surveillance. This strategy can serve as a model for worldwide surveillance and response to threats from infectious diseases.

This report summarizes the discussions and recommendations from a consultation held in New York City, USA (31 January-2 February 2006) organized by the joint World Health Organization-United Nations Programme on HIV/AIDS HIV Vaccine Initiative and the International AIDS Vaccine Initiative. The consultation discussed issues related to the design and implementation of phase IIB 'test of concept' trials (phase IIB-TOC), also referred to as 'proof of concept' trials, in evaluating candidate HIV vaccines and their implications for future approval and licensure. The results of a single phase IIB-TOC trial would not be expected to provide sufficient evidence of safety or efficacy required for licensure. In many instances, phase IIB-TOC trials may be undertaken relatively early in development, before manufacturing processes and capacity are developed sufficiently to distribute the vaccine on a large scale. However, experts at this meeting considered the pressure that could arise, particularly in regions hardest hit by AIDS, if a phase IIB-TOC trial showed high levels of efficacy. The group largely agreed that full-scale phase III trials would still be necessary to demonstrate that the vaccine candidate was safe and effective, but emphasized that governments and organizations conducting trials should consider these issues in advance. The recommendations from this meeting should be helpful for all organizations involved in HIV vaccine trials, in particular for the national regulatory authorities in assessing the utility of phase IIB-TOC trials in the overall HIV vaccine research and development process. (c) 2007 Lippincott Williams & Wilkins.

To examine the relationship between hypertension and health-related quality of life in patients attending hospital clinics in China.A cross-sectional survey. Patients over the age of 35 years attending outpatient clinics in 18 hospitals of eight major cities of northern and southern China were interviewed between June and July, 1999. Trained fieldworkers completed questionnaires regarding demographics, hypertension knowledge and awareness, treatment history and quality of life issues. Qualified physicians performed blood pressure assessments.A total of 9703 volunteers were enrolled; 4510 (46.5%) had hypertension. The results showed that hypertensive subjects scored lower in the multiple linear regression analyses in most questions on the quality of life questionnaire than those without hypertension after controlling for age, sex, sociodemographic factors, and co-morbidity. There was a strikingly high prevalence of physical complaints or symptoms. Among the variables considered, age, sex, hypertension, body mass index, educational level, smoking, history of cholesterol, family history of cardiovascular diseases and history of diabetes were statistically significantly correlated with health-related quality of life. Subjects aware of having high blood pressure had a lower health-related quality of life score than subjects with high blood pressure but unaware of the diagnosis. Among treated subjects, those with controlled hypertension had higher health-related quality of life scores than those with poorly controlled hypertension.Hypertensive individuals represent a vulnerable population that merits special attention from healthcare providers and systems. This is especially important given that low health-related quality of life can be a risk factor for subsequent cardiovascular events or complications.

A longitudinal survey of health and nutrition in China was undertaken in eight provinces (Liaoning, Jiangsu, Shandong, Henan, Hubei, Hunan, Guangxi, Guizhou). Data were collected in 1989, 1991, 1993 and 1997. The 1991 and 1993 data were used to investigate factors affecting intrahousehold food distribution. The discrepancy score and the ratio of food share to energy share were used to describe food distribution within households. Findings indicated that, in most cases, males had a higher proportion of nutrient intake than females, particularly in the young adult group where men presented with a higher discrepancy score than women for energy and all nutrients observed. The food and nutrient distribution tends to be more favourable to the middle-aged group, although the youngest group, while accepting relatively smaller amounts of cereals, ate much bigger amounts of meat, dairy products and fruits. Household members with higher incomes are more favoured in terms of food consumption and nutrient intake. Household leaders accepted a higher share of energy and nutrients in comparison with other members of the household across all age and sex groups. Administrators and people working in service or trade industries in rural areas are favoured in terms of food distribution relative to farmers and manual workers. Well-educated people accepted a better food allocation than others and those in employment received more nutrients than the unemployed. The 'contribution rule' (individuals who make a greater contribution to the family receive a larger share of the family's food) is discussed and deemed to be applicable in explaining the discrepancy in food distribution and nutrient intake among household members.

Background In 2004, the Ministry of Health issued the policy of decentralising microscopy services (MCs) to one third of all township hospitals in China. The study was conducted in Gansu Province, a poor western one in China. Ganzhou was one county in Gansu Province. Ganzhou County was identified as a unique case of further decentralisation of tuberculosis (TB) treatment services in township hospitals. The study evaluated the impact of the MC policy on providers and patients in Gansu Province. The second objective was to assess the unique case of Ganzhou County compared with other counties in the province. Methods Both quantitative and qualitative methods were used. All 523 MCs in the province completed an institutional survey regarding their performance. Four counties were selected for in-depth investigation, where 169 TB suspects were randomly selected from the MC and county TB dispensary registers for questionnaire surveys. Informant interviews were conducted with 38 health staff at the township and county levels in the four counties. Results Gansu established MCs in 39% of its township hospitals. From January 2006 to June 2007, 8% of MCs identified more than 10 TB sputum smear positive patients while 54% did not find any. MCs identified 1546 TB sputum smear positive patients, accounting for 9% of the total in the province. The throughputs of MCs in Ganzhou County were eight times of those in other counties. Interviews identified several barriers to implement the MC policy, such as inadequate health financing, low laboratory capacity, lack of human resources, poor treatment and management capacities, and lack of supervisions from county TB dispensaries. Conclusion Microscopy centre throughputs were generally low in Gansu Province, and the contribution of MCs to TB case detection was insignificant taking account the number of MCs established. As a unique case of full decentralisation of TB service, Ganzhou County presented better results. However, standards and quality of TB care needed to be improved. The MC policy needs to be reviewed in light of evidence from this study.

Background. Endemic hepatitis B virus (HBV) infection is a serious health problem in China. Hepatitis B vaccination of infants was introduced in 1992 and was progressively expanded during the subsequent 15 years. Methods. We conducted a national serosurvey, with participants selected by multiple-stage random sampling. Demographic characteristics and hepatitis B vaccination history were collected by a questionnaire and a review of vaccination records, and serum specimens were tested for hepatitis B surface antigen, antibody to hepatitis B core antigen, and hepatitis B surface antibody by enzyme-linked immunosorbent assay. Results. Hepatitis B vaccine coverage (3 doses) increased from 30.0% for children born in 1992 to 93.4% for children born in 2005. Receipt of a timely birth dose increased from 22.2% to 82.6% for children born during this interval. Multivariate analysis showed that older age, western and rural residence, birth at home, and certain ethnicities were risk factors for undervaccination with both full vaccine series and timely birth dose. The prevalence of hepatitis B surface antigen was reduced to 2.1% among all children and 1.0% among children born after 1999. The efficacy of hepatitis B vaccination with a timely birth dose was 88.3%. Conclusions. Hepatitis B vaccine has been successfully integrated into routine infant immunization in China, now reaching most infants within 24 h after birth, and the prevalence of hepatitis B surface antigen has been greatly reduced among children born after 1992.

To introduce the autoregressive moving average (ARMA)(n, n-1) modeling strategy as to a convenient way for the determination of ARMA orders.ARMA(n, n-1) strategy was generally explained. A simulated ARMA(3,2) time series was generated and analized following this strategy.Combined with AIC information criteria and residue plot, the order of ARMA model was determined and complied well with the simulated data.ARMA(n, n-1) strategy may be convenient for the medical workers.

The burden of patients with smear-positive pulmonary tuberculosis(TB) and that of the communicability of the disease was investigated by using disability-adjusted life year(DALY) as an indicator. An assumed cohort of 2000 cases based on the age-specific incidence of 794 newly registered smear-positive cases in Beijing in 1994 was set up. The prognostic tree and diagram model of communicability under natural history and direct observed treatment short-course startegy(DOTS) were established according to the epidemiological evidence. The results showed that 29.6% of DALYs would be neglected if the burden caused by the communicability have not been considered. The results also showed that DOTS might reduce 97.3% of potential cases infected, reduce 92.9% of DALY to patient themselves, and reduce 99.9% of DALYs caused by the communicability as well.

This study aimed to analysis the relationship among body mass index (BMI) and waist circumference (WC) with chronic diseases risk factors--serum total cholesterol (TC), triglyceridaemia(TG), high density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), systolic blood pressure (SBP), diastolic blood pressure (DBP) and the prevalence of chronic diseases. The data was collected from 1995 to 1998 in the study of community base integrated intervention of non-communicable chronic diseases.The prevalence of overweight and obesity in male was 41.7% and 14.6%, in female was 32.0% and 20.4% in this population, respectively. BMI and WC had significant positive relationship with TC, TG, SBP and DBP but negative with HDL-C and HDL-C/TC. WC had significant positive relation with FBG. The prevalence of dyslipidaemia hypertension and diabetes were significantly increased in overweight and obese groups. For early prevention, we have to pay more attention to the population with BMI24.0 kg/m2, they had increased risk factors of non-communicable chronic diseases.

Objectives To determine awareness, treatment and control of hypertension in patients attending hospital clinics in China. Design A cross-sectional survey. Patients and setting Patients over the age of 35 years, who were attending outpatient clinics in 18 hospitals of eight major cities of Northern and Southern China, were interviewed face-to-face between June and July 1999. Methods Trained fieldworkers completed questionnaires regarding demographics, hypertension knowledge and awareness, treatment history and quality of life issues. Qualified physicians performed blood pressure assessment. Results A total of 9703 volunteers enrolled, of which 4510 (46.5%) were hypertensives. Among hypertensives, 23% were unaware of their high blood pressure. Although 89% of those aware reported receiving therapy, only 56% of them were taking medication regularly, and 33% were thus controlled. Although 69% of all hypertensives measuring at examination reported taking antihypertensive therapy, only 44% of them were actually taking medication regularly. Furthermore, 73% of hypertensives believed hypertension was not a serious problem, and required no regular medication. Conclusions The results showed that a substantial number of outpatients have a hypertensive range of blood pressure. Although most of these patients are already being treated with drug regimen, the patient's misconceptions and lack of knowledge about the disease appear to be the major cause of treatment failure. The low rate of high blood pressure control for both sexes calls for further improvements.

Discrepancy Score and Food Share to Energy Share were used to describe food distribution within a family. The results showed that dietary and nutritional status of people with discrepancy score below zero was worse than that of people with discrepancy score above zero. It proved that food allocation was closely related to dietary and nutritional status.

To estimate the current knowledge on hypertension and the effect of management on hypertension in patients attending hospital clinics.A cross-sectional survey was used in the outpatients over the age of 35 years in 18 general hospitals (provincial, district and community) which represented the different levels of medical care in 8 major cities covering Northern and Southern China including an interview with two blood pressure measurements and one questionnaire in one clinical visit.A total of 9 703 subjects participated in this project, who were similarly distributed by gender and age in the hospitals at different levels. Of all the 9 703 subjects, 4 510 (46.5%) were found to be hypertensive. 6.4%, 12.1%, 25.5%, 41.1% and 14.6% of all the participants were categorized into knowledge on hypertension grade 0, 1, 2, 3, 4 respectively. The classification was based on the number of correct answers to four questions about knowledge of hypertension. The higher the grade of hypertension knowledge the more response to higher rate of awareness, treatment, and control in this hypertensive population was noticed. There was significantly positive correlation between the grade of hypertension knowledge and treatment compliance. The major cause of poor treatment compliance was due to lack of hypertension knowledge.There was poor knowledge on hypertension in the investigated participants, which would influence on the management of hypertension. Data suggested that health education on the knowledge of hypertension in the population needs to be improved.

China is the world’s greatest producer and consumer of cigarettes. According to a survey done in 1984, about 38% of Chinese aged 20 years and above are current smokers. The tobacco industry has developed greatly since 1981. The areas for cultivating tobacco increased from 590,000 hectares in 1981 to 1.85 million hectares in 1992. The total production and consumption of cigarettes almost doubled in that same period. Per capita consumption of cigarettes per person (children included) increased from 880 cigarettes in 1981 to 1400 cigarettes in 1992.