On behalf of Public Health England,I warmly congratulate the Chinese Center for Disease Control and Prevention on its launch of China CDC Weekly.The UK and China face many common challenges and our collaboration betwe...On behalf of Public Health England,I warmly congratulate the Chinese Center for Disease Control and Prevention on its launch of China CDC Weekly.The UK and China face many common challenges and our collaboration between us is very important to me personally.We already share our respective technical expertise and the opportunity is to further strengthen our partnership.展开更多
国际标准CIE S 026:2018为时间生物学领域的照明专业人员和现场研究人员提供了一种方法来表征非视觉光感受与响应方面的光照量。该标准定义了五种光谱灵敏度函数,以描述光辐射刺激五种α响应视网膜光感受器的能力,这些光感受器通过内在...国际标准CIE S 026:2018为时间生物学领域的照明专业人员和现场研究人员提供了一种方法来表征非视觉光感受与响应方面的光照量。该标准定义了五种光谱灵敏度函数,以描述光辐射刺激五种α响应视网膜光感受器的能力,这些光感受器通过内在光敏视网膜神经节细胞(ipRGCs)对人类产生非视觉效应。CIE最近还发布了一个开放获取的α响应工具箱,基于测量(用户自定义)的光谱或工具箱中内置的标准照明体(A、D65、E、FL11、LED-B3),计算光度量、辐射度量和光子系统中α响应计量的数量和比率。基于视黑素蛋白的ipRGCs光感受已被广泛证明可以解释非视觉响应的光谱敏感性,包括改变夜间睡眠的时间、褪黑素分泌和调节稳态瞳孔直径。最近的研究结果表明,感光色素视黑素蛋白也在视觉响应中发挥作用,并且基于视黑素蛋白的光感受可能对亮度感知和空间视觉方面有重要影响。虽然在非视觉效应方面,关于视杆细胞、视锥细胞与ipRGCs如何交互的认识不断发展,最近CIE的一份关于应用“在合适的时间推荐合适的光照”的立场声明中使用了视黑素响应日光(D65)等效照度来指导调节非视觉响应。关于这种方法的详细说明,可以通过第二届昼夜节律和神经生理光度学国际研讨会(曼彻斯特,2019年8月)的同行评审出版物了解*。CIE S 026新的α响应计量方法实现了可追踪测量,并对个人光照量、光干预和照明设计进行了正式的量化规范。通过使用这个工具箱,将这种计量方法应用于日常光源,包括动态变化的日光、LED照明光源以及智能手机屏幕等。这些示例展示了如何利用视黑素含量随时间变化的光照,以更好地支持人类健康与福祉。展开更多
This article explores the role of public health systems before, during, and after disasters, particularly within the scope of the United Nations Post-2015 Framework for Disaster Risk Reduction. It also examines the ro...This article explores the role of public health systems before, during, and after disasters, particularly within the scope of the United Nations Post-2015 Framework for Disaster Risk Reduction. It also examines the role of scientific and technological developments in assisting with improving the resilience of public health professionals and the communities they work in. In addition, it explores how the wide-ranging activities in public health have already contributed to the improved management of disasters and a decrease in associated risks. The article identifies areas of synergy in five key areas of recent policy and practice in public health(the health systems approach, risk assessments, the WHO/UNISDR/HPA Disaster Risk Management fact sheets, chronic disease and disasters, and mental health impacts following disasters) and makes suggestions based on lessons identified from the previous(2005) global disaster risk reduction framework. In particular, we advocate the use of scientific evidence that addresses health and disaster risk simultaneously to increase the effectiveness of policy and practice in disaster risk reduction, health, and public health.展开更多
Belt and Road Initiative(BRI) is a Chinese national strategy which calls for cooperative economic, political and cultural exchange at the global level along the ancient Silk Road. The overwhelming natural hazards loca...Belt and Road Initiative(BRI) is a Chinese national strategy which calls for cooperative economic, political and cultural exchange at the global level along the ancient Silk Road. The overwhelming natural hazards located along the belt and road bring great challenges to the success of BRI. In this framework, a 5-year international program was launched to address issues related to hazards assessment and disaster risk reduction(DRR). The first workshop of this program was held in Beijing with international experts from over 15 countries. Risk conditions on Belt and Road Countries(BRCs) have been shared and science and technology advancements on DRR have been disseminated during the workshop. Under this program, six task forces have been setup to carry out collaborative research works and three prioritized study areas have been established. This workshop announced the launching of this program which involved partners from different countries including Pakistan, Nepal, Russia, Italy, United Kingdom, Sri Lanka and Tajikistan. The program adopted the objectives of Sendai Framework for Disaster Risk Reduction 2015-2030 and United Nation Sustainable Development Goals 2030 and was implemented to assess disaster risk in BRCs and to propose suitable measures for disaster control which can be appropriate both for an individual country and for specific sites. This paper deals with the outcomes of the workshop and points out opportunities for the near future international cooperation on this matter.展开更多
<div style="text-align:justify;"> <b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"></span><b>...<div style="text-align:justify;"> <b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"></span><b> </b><span style="font-family:Verdana;">The interplay between financial deprivation and tuberculosis (TB) is considered one of the vital socio-economic determinants of disease. This is the first study of its kind to be carried in Pakistan, which aims to identify leading factors contributing towards catastrophic costs of TB diagnosis and management in order to help policy makers. <b></b></span><b><b><span style="font-family:Verdana;">Methodology:</span></b><span style="font-family:Verdana;"></span></b><b> </b><span style="font-family:Verdana;">From </span><span style="font-family:Verdana;">f</span><span style="font-family:Verdana;">our tertiary care hospitals (TCH) in Islamabad and Rawalpindi</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> 400 TB patients were interviewed through a cross-sectional survey. The patient’s pre and post</span><span style="font-family:Verdana;">-</span><span "=""><span style="font-family:Verdana;">TB income and direct and indirect costs for treatment were analysed following WHO recommendations. Multivariable logistic regression model was used to identify the determinants of catastrophic total cost. <b></b></span><b><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"><b></b></span><b><b> </b></b></b><span style="font-family:Verdana;"></span><span style="font-family:Verdana;"></span><span style="font-family:Verdana;">For TB management expenditures, the median (interquartile range) of total costs by households was Rs.</span></span><span "=""> </span><span style="font-family:Verdana;">58,175 Rs</span><span "=""> </span><span style="font-family:Verdana;">(32,050</span><span style="font-family:Verdana;"> - </span><span style="font-family:Verdana;">97,500). At 20% threshold, 67% of TB patient’s households were affected by catastrophic costs. The determinants of the catastrophic total cost were as follows: patient/guardian employed (adjusted odds ratio [aOR] = 3.428, 95% confidence interval [CI]: 1.900</span><span style="font-family:Verdana;"> - </span><span style="font-family:Verdana;">6.186), patient/guardian the only breadwinner (aOR = 1.751, 95% CI: 1.011</span><span style="font-family:Verdana;"> - </span><span style="font-family:Verdana;">3.032), follow-up visits at current health facility (aOR = 1.352, 95% CI: 1.223</span><span style="font-family:Verdana;"> - </span><span style="font-family:Verdana;">1.494), job loss (aOR = 3.381, 95% CI: 1.512</span><span style="font-family:Verdana;"> - </span><span style="font-family:Verdana;">7.561), and unpaid sick leaves (aOR = 2.862, 95% CI: 1.249</span><span style="font-family:Verdana;"> - </span><span style="font-family:Verdana;">6.558).</span><b><b><span "=""> </span><span style="font-family:Verdana;"><b></b></span><b><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"></span></b><span style="font-family:Verdana;"> </span></b></b><span style="font-family:Verdana;">The fi</span><span style="font-family:Verdana;">nancial deprivation experienced by patients of low socio-economic status increases as TB treatment proceeds</span><span style="font-family:Verdana;">. This negatively impacts the treatment adherence, resulting in poor treatment outcomes due to income and job loss. Outcomes are exacerbated if the family has single breadwinner and treatment requires follow-up visits.</span> </div>展开更多
In response to the outbreak of Ebola Virus Disease in West Africa, the Emergency Response Department of Public Health England produced a series of training and exercising materials to help prepare health and partner o...In response to the outbreak of Ebola Virus Disease in West Africa, the Emergency Response Department of Public Health England produced a series of training and exercising materials to help prepare health and partner organisations in England and other jurisdictions in the United Kingdom deal with a possible case of Ebola in the United Kingdom. They were produced with input from health(NHS England, Health Protection Scotland, Public Health Wales) and other partner organisations. The exercising materials have been used by colleagues working in national and local level organisations in the United Kingdom and other countries in the European Union. Presented here is a description of these training and exercising materials and how they were delivered to the end user.展开更多
This paper proposes a more inclusive statistical model for predicting image noise in Computed Tomography (CT), associated with scanning factors, considering the effect of beam hardening and image processing filters. I...This paper proposes a more inclusive statistical model for predicting image noise in Computed Tomography (CT), associated with scanning factors, considering the effect of beam hardening and image processing filters. It is based on power functions where the levels of the parameters will determine the rate of noise variation with respect to a given scanning factor. It includes the influence of tube potential, tube current, slice thickness, Field of View (FOV), reconstruction methods and post-processing filters. To validate the model, tomographic measurements were made by using a PMMA phantom that simulates paediatric head and adult abdomen, a PET bottle was used to simulate the head of the new-born. The influence of ROI (Region Of Interest) size over nonlinear model parameters was analysed, and high variations of powers of attenuation and FOV were found depending on ROI size. A nonlinear robust regression method was used. The validation was performed graphically by weighted residual analysis. A nonlinear noise model was obtained with an adjusted coefficient of determination for ROI sizes between 10% and 70% of the phantom diameter or FOV. The model confirms the significance of the tube current, slice thickness and beam hardening effect on image. The process of estimation of the parameters of the model by Nonlinear Robust Regression turned out to be optimal.展开更多
Mycoplasma hominis is a member of the genus mycoplasma and has only been isolated from humans. It is most frequently isolated from the urogenital tract in the absence of symptoms, but has been isolated from wounds, br...Mycoplasma hominis is a member of the genus mycoplasma and has only been isolated from humans. It is most frequently isolated from the urogenital tract in the absence of symptoms, but has been isolated from wounds, brain abscess, inflamed joints, blood and placenta from pregnancy with adverse outcomes (especially preterm birth and occasionally term stillbirth). Controversy surrounds whether this organism is a commensal or a pathogen;however, Mycoplasma hominis has been shown to induce preterm birth and foetal lung injury in an experimental primate model as a sole pathogen. These bacteria are known to exist as a parasitic infection, due to a number of missing synthetic and metabolism pathway enzymes from their minimal genome;therefore, the ability to adhere to host cells is important. Here we provide a review that clarifies the different nomenclature (variable adherence-associated antigen and P50) that has been used to investigate the major surface adhesin for this organism, as well as reported mechanisms responsible for turning off its expression. Variation in the structure of this protein can be used to separate strains into six categories, a method that we were able to use to distinguish and characterise 12 UK strains isolated from between 1983 and 2012. We propose that the Vaa should be used in further investigations to determine if commensal populations and those that are associated with disease utilise different forms of this adhesin, as this is under-studied and identification of pathogenic determinants is overdue for this organism.展开更多
The Asian population comprises the third largest ethnic minority in the state of California.However,influenza vaccination coverage amongst the overall Asian population,and the first and third-generation Asian’s have ...The Asian population comprises the third largest ethnic minority in the state of California.However,influenza vaccination coverage amongst the overall Asian population,and the first and third-generation Asian’s have not been widely studied.Previous literature exploring generational status as a corelate of influenza immunization amongst Mexican identified Latino adults confirms disparities in influenza vaccination coverage by generation.This study aims to report on the prevalence of influenza vaccination coverage amongst the overall,first and third-generation Asians in California,and examine the correlates of influenza vaccination coverage in the aforementioned population.Methods:Cross-sectional data from the California Health Interview Survey 2016 for Asian adults was analyzed using IBM SPSS 25.0 for Mac.Descriptive statistics were utilized for reporting the frequencies and percentages of the selected variables.Weighted multivariable binary logistic regression was used to obtain adjusted odds ratios(95%confidence interval)and determine independent association between socioeconomic determinants and influenza vaccination coverage amongst the first and third-generation Asians at P<0.05.The analysis was adjusted for“visit to the doctor”and“insurance status”.Results:Thirteen point one percent(n=2,761)of the survey respondents(N=21,055)identified as Asians.The first-generation(n=1,857,67%)comprised the highest proportion of the Asian ethnic group.Influenza vaccination coverage was reported as 61.2%amongst the overall,61.1%amongst the first-generation and 70.9%amongst the third-generation respectively.All predictor variables were significant amongst the first-generation,however amongst the third-generation all variables except for location and living in a household of 3 and more,were significant predictors of influenza vaccination coverage.Conclusion:Compared to the other ethnic groups in California,the Asian respondents reported a higher percentage of influenza vaccination coverage.Influenza vaccination coverage was the highest amongst the third-generation Asians.Increased influenza vaccination coverage amongst the Asian ethnic group can be ascribed to higher educational attainment,a higher proportion choosing to visit a doctor as well as increased insurance coverage.展开更多
1.Overview The 2016 Quadrennial Ozone Symposium(QOS-2016)was held on 4–9 September 2016 in Edinburgh,UK.The Symposium was organized by the International Ozone Commission(IO3C),the NERC Centre for Ecology&Hydrolog...1.Overview The 2016 Quadrennial Ozone Symposium(QOS-2016)was held on 4–9 September 2016 in Edinburgh,UK.The Symposium was organized by the International Ozone Commission(IO3C),the NERC Centre for Ecology&Hydrology and the University of Edinburgh,and was co-sponsored by the International Union of Geodesy and Geophysics,the International Association of Meteorology and展开更多
The Sendai Framework for Disaster Risk Reduction 2015–2030(SFDRR) is the first global policy framework of the United Nations’ post-2015 agenda. It represents a step in the direction of global policy coherence with e...The Sendai Framework for Disaster Risk Reduction 2015–2030(SFDRR) is the first global policy framework of the United Nations’ post-2015 agenda. It represents a step in the direction of global policy coherence with explicit reference to health, development, and climate change. To develop SFDRR, the United Nations Office for Disaster Risk Reduction(UNISDR) organized and facilitated several global, regional, national, and intergovernmental negotiations and technical meetings in the period preceding the World Conference on Disaster Risk Reduction(WCDRR) 2015 where SFDRR was adopted. UNISDR also worked with representatives of governments, UN agencies, and scientists to develop targets and indicators for SFDRR and proposed them to member states for negotiation and adoption as measures of progress and achievement in protecting lives and livelihoods. The multiple efforts of the health community in the policy development process, including campaigning for safe schools and hospitals, helped to put people’s mental and physicalhealth, resilience, and well-being higher up the disaster risk reduction(DRR) agenda compared with the Hyogo Framework for Action 2005–2015. This article reviews the historical and contemporary policy development process that led to the SFDRR with particular reference to the development of the health theme.展开更多
The Sendai Framework for Disaster Risk Reduction 2015–2030 recognizes the strong connection between health and disasters and promotes the concept of health resilience throughout.Several of the seven global targets st...The Sendai Framework for Disaster Risk Reduction 2015–2030 recognizes the strong connection between health and disasters and promotes the concept of health resilience throughout.Several of the seven global targets stated in the Sendai Framework are directly related to health in terms of reducing disaster mortality,the number of affected people,disaster damage to critical infrastructure,and disruption of basic services such as health facilities.The Sendai Framework also maintains close coordination with other United Nations landmark agreements relevant to health such as the Sustainable Development Goals.However,the measurement of healthrelated indicators is challenging.Issues arise,for example,in linking deaths to disasters because of the complex interplay between exposure,risk,vulnerability,and hazards.The lack of a universal classification of disasters also means that recording of health data in disasters is not standardized.Developing the guidelines to enable data onthe indicators to be collected and reported to support the Sendai targets requires detailed thinking,time,and consultation with a diverse range of stakeholders.Strong collaboration and partnership will be vital to achieving success.展开更多
The intersection of health and disaster risk reduction(DRR) has emerged in recent years as a field of critical inquiry.Health is recognized as an outcome and a goal of DRR,and the integration of both fields is essenti...The intersection of health and disaster risk reduction(DRR) has emerged in recent years as a field of critical inquiry.Health is recognized as an outcome and a goal of DRR,and the integration of both fields is essential to ensure the implementation of the Sendai Framework for Disaster Risk Reduction 2015–2030.Health Emergency and Disaster Risk Management(Health-EDRM) has emerged as an umbrella field that encompasses emergency and disaster medicine,DRR,humanitarian response,community health resilience,and health systems resilience.In September 2016,an international group of experts met in Hong Kong to assess the current status and potential of the Health-EDRM research field,a research area that these scholars characterized as underdeveloped and fragmented.Key challenges identified include research overlap,lack ofstrategic research agenda,absence of consensus regarding terminology,and limited coordination between stakeholders.The Sendai Framework provides a useful paradigm within which to shape the research field's strategic development.The WHO Thematic Platform for Health-EDRM Research Group was established to coordinate activities,promote information-sharing,develop partnerships,and provide technical advice to strengthen the Health-EDRM research field.This group will promote the generation of robust and scientific health research to support the meaningful implementation of the Sendai Framework.展开更多
The Sendai Framework for Disaster Risk Reduction 2015–2030 recognizes health at the heart of disaster risk management(DRM)at the global policy level.Five years on,it has catalyzed the rapid development of the field o...The Sendai Framework for Disaster Risk Reduction 2015–2030 recognizes health at the heart of disaster risk management(DRM)at the global policy level.Five years on,it has catalyzed the rapid development of the field of Health Emergency and Disaster Risk Management(Health EDRM)by providing a mandate for building partnerships as well as enhancing scientific research.Key milestones achieved include publication of the World Health Organization’s Health EDRM Framework,development of the WHO Thematic Platform for Health EDRM and the WHO Health EDRM Research Network,and further application of health information principles to DRM.Furthermore,health actors at all levels have continued to engage in the Sendai Framework processes and have had a key role in its implementation and proposed monitoring.There have been significant gains made through the partnership of health and DRM,but the relationship has not been without its challenges.Many national,regional,and global initiatives continue to operate with a lack of consistency and of linkages to respond to the Sendai Framework’s call for embedding health resilience in DRM,and conversely,embedding DRM in health resilience.Overcoming this hurdle is important,and doing so will be a key marker of success of the next 10 years of partnership under the Sendai Framework.展开更多
Bioaerosol exposure has been linked to adverse respiratory conditions.Intensive farming and composting facilities are important anthropogenic sources of bioaerosols.We aimed to characterise populations living close to...Bioaerosol exposure has been linked to adverse respiratory conditions.Intensive farming and composting facilities are important anthropogenic sources of bioaerosols.We aimed to characterise populations living close to intensive farming and composting facilities.We also infer whether the public are becoming more concerned about anthropogenic bioaerosol emissions,using reports of air pollution related incidents attributed to facilities.We mapped the location of 1,257 intensive farming and 310 composting facilities in England in relation to the resident population and its characteristics(sex and age),area characteristics(deprivation proxy and rural/urban classification)and school locations stratified by pre-defined distance bands from these bioaerosol sources.We also calculated the average number of air pollution related incidents per year per facility.We found that more than 16%of the population and 15%of schools are located within 4,828 m of an intensive farming facility or 4,000 m of a composting facility;few people(0.01%)live very close to these sites and tend to be older people.Close to composting facilities,populations are more likely to be urban and more deprived.The number of incidents were attributed to a small proportion of facilities;population characteristics around these facilities were similar.Results indicate that populations living near composting facilities(particularly>250 to≤4,000 m)are mostly located in ur6an areas(80188%of the population),which supports the need for more community health studies to be conducted.Results could also be used to inform risk management strategies at facilities with higher numbers of incidents.展开更多
The first international conference for the post-2015 United Nations landmark agreements(Sendai Framework for Disaster Risk Reduction 2015–2030, Sustainable Development Goals, and Paris Agreement on Climate Change) wa...The first international conference for the post-2015 United Nations landmark agreements(Sendai Framework for Disaster Risk Reduction 2015–2030, Sustainable Development Goals, and Paris Agreement on Climate Change) was held in January 2016 to discuss the role of science and technology in implementing the Sendai Framework for Disaster Risk Reduction 2015–2030. The UNISDR Science and Technology Conference on the Implementation of the Sendai Framework for Disaster Risk Reduction 2015–2030 aimed to discuss and endorse plans that maximize science's contribution to reducing disaster risks and losses in the coming 15 years and bring together the diversity of stakeholders producing and using disaster risk reduction(DRR) science and technology. This article describes the evolution of the role of science and technology in the policy process building up to the Sendai Framework adoption that resulted in an unprecedented emphasis on science in the text agreed on by 187 United Nations member states in March 2015 and endorsed by the United Nations General Assembly in June 2015. Contributions assembled by the Conference Organizing Committee and teams including the conference concept notes and the conference discussions that involved a broad range of scientists and decision makers are summarized in this article. The conference emphasized how partnerships and networks can advance multidisciplinary research and bring together science, policy, and practice; how disaster risk is understood, and how risks are assessed and early warning systems are designed; what data, standards, and innovative practices would be needed to measure and report on risk reduction; what research and capacity gaps exist and how difficulties in creating and using science for effective DRR can be overcome. The Science and Technology Conference achieved two main outcomes:(1) initiating the UNISDR Science and Technology Partnership for the implementation of the Sendai Framework; and(2) generating discussion and agreement regarding the content and endorsement process of the UNISDR Science and Technology Road Map to 2030.展开更多
At the first gathering of its kind on the role of science in implementing the Sendai Framework for Disaster Risk Reduction 2015–2030,over 750 scientists,policymakers,business people,and practitioners met in Geneva fr...At the first gathering of its kind on the role of science in implementing the Sendai Framework for Disaster Risk Reduction 2015–2030,over 750 scientists,policymakers,business people,and practitioners met in Geneva from January 27–29,2016.The UNISDR Science and Technology Conference on the Implementation of the Sendai Framework for Disaster Risk Reduction 2015–2030 fea-展开更多
Every year,numerous environmental disasters and emergencies occur across the globe with far-reaching impacts on human health and the environment.The ability to rapidly assess an environmental emergency to mitigate pot...Every year,numerous environmental disasters and emergencies occur across the globe with far-reaching impacts on human health and the environment.The ability to rapidly assess an environmental emergency to mitigate potential risks and impacts is paramount.However,collating the necessary evidence in the early stages of an emergency to conduct a robust risk assessment is a major challenge.This article presents a methodology developed to help assess the risks and impacts during the early stages of such incidents,primarily to support the European Union Civil Protection Mechanism but also the wider global community in the response to environmental emergencies.An online rapid risk and impact assessment tool has also been developed to promote enhanced collaboration between experts who are working remotely,considering the impact of a disaster on the environment and public health in the short,medium,and long terms.The methodology developed can support the appropriate selection of experts and assets to be deployed to affected regions to ensure that potential public health and environmental risks and impacts are mitigated whenever possible.This methodology will aid defensible decision making,communication,planning,and risk management,and presents a harmonized understanding of the associated impacts of an environmental emergency.展开更多
Open data strategies are being adopted in disaster-related data particularly because of the need to provide information on global targets and indicators for implementation of the Sendai Framework for Disaster Risk Red...Open data strategies are being adopted in disaster-related data particularly because of the need to provide information on global targets and indicators for implementation of the Sendai Framework for Disaster Risk Reduction 2015–2030.In all phases of disaster risk management including forecasting,emergency response and post-disaster reconstruction,the need for interconnected multidisciplinary open data for collaborative reporting as well as study and analysis are apparent,in order to determine disaster impact data in timely and reportable manner.The extraordinary progress in computing and information technology in the past decade,such as broad local and wide-area network connectivity(e.g.Internet),highperformance computing,service and cloud computing,big data methods and mobile devices,provides the technical foundation for connecting open data to support disaster risk research.A new generation of disaster data infrastructure based on interconnected open data is evolving rapidly.There are two levels in the conceptual model of Linked Open Data for Global Disaster Risk Research(LODGD)Working Group of the Committee on Data for Science and Technology(CODATA),which is the Committee on Data of the International Council for Science(ICSU):data characterization and data connection.In data characterization,the knowledge about disaster taxonomy and data dependency on disaster events requires specific scientific study as it aims to understand and present the correlation between specific disaster events and scientific data through the integration of literature analysis and semantic knowledge discovery.Data connection concepts deal with technical methods to connect distributed data resources identified by data characterization of disaster type.In the science community,interconnected open data for disaster risk impact assessment are beginning to influence how disaster data are shared,and this will need to extend data coverage and provide better ways of utilizing data across domains where innovation and integration are now necessarily needed.展开更多
Background:The seasonal influenza vaccine coverage rate in China is only 1.9%.There is no information available on the economic burden of influenza-associated outpatient visits and hospitalizations at the national lev...Background:The seasonal influenza vaccine coverage rate in China is only 1.9%.There is no information available on the economic burden of influenza-associated outpatient visits and hospitalizations at the national level,even though this kind of information is important for informing national-level immunization policy decision-making.Methods:A retrospective telephone survey was conducted in 2013/14 to estimate the direct and indirect costs of seasonal influenza-associated outpatient visits and hospitalizations from a societal perspective.Study participants were laboratory-confirmed cases registered in the National Influenza-like Illness Surveillance Network and Severe Acute Respiratory Infections Sentinel Surveillance Network in China in 2013.Patient-reported costs from the survey were validated by a review of hospital accounts for a small sample of the inpatients.Results:The study enrolled 529 outpatients(median age:eight years;interquartile range[IQR]:five to 20 years)and 254 inpatients(median age:four years;IQR:two to seven years).Among the outpatients,22.1%(117/529)had underlying diseases and among the inpatients,52.8%(134/254)had underlying diseases.The average total costs related to influenza-associated outpatient visits and inpatient visits were US$155(standard deviation,SD US$122)and US$1,511(SD US$1,465),respectively.Direct medical costs accounted for 45 and 69%of the total costs related to influenza-associated outpatient and inpatient visits,respectively.For influenza outpatients,the mean cost per episode in children aged below five years(US$196)was higher than that in other age groups(US$129–153).For influenza inpatients,the mean cost per episode in adults aged over 60 years(US$2,735)was much higher than that in those aged below 60 years(US$1,417–1,621).Patients with underlying medical conditions had higher costs per episode than patients without underlying medical conditions(outpatients:US$186 vs.US$146;inpatients:US$1,800 vs.US$1,189).In the baseline analysis,inpatients reported costs were 18%higher than those found in the accounts review(n=38).Conclusion:The economic burden of influenza-associated outpatient and inpatient visits in China is substantial,particularly for young children,the elderly,and patients with underlying medical conditions.More widespread influenza vaccination would likely alleviate the economic burden of patients.The actual impact and cost-effectiveness analysis of the influenza immunization program in China merits further investigation.展开更多
文摘On behalf of Public Health England,I warmly congratulate the Chinese Center for Disease Control and Prevention on its launch of China CDC Weekly.The UK and China face many common challenges and our collaboration between us is very important to me personally.We already share our respective technical expertise and the opportunity is to further strengthen our partnership.
文摘国际标准CIE S 026:2018为时间生物学领域的照明专业人员和现场研究人员提供了一种方法来表征非视觉光感受与响应方面的光照量。该标准定义了五种光谱灵敏度函数,以描述光辐射刺激五种α响应视网膜光感受器的能力,这些光感受器通过内在光敏视网膜神经节细胞(ipRGCs)对人类产生非视觉效应。CIE最近还发布了一个开放获取的α响应工具箱,基于测量(用户自定义)的光谱或工具箱中内置的标准照明体(A、D65、E、FL11、LED-B3),计算光度量、辐射度量和光子系统中α响应计量的数量和比率。基于视黑素蛋白的ipRGCs光感受已被广泛证明可以解释非视觉响应的光谱敏感性,包括改变夜间睡眠的时间、褪黑素分泌和调节稳态瞳孔直径。最近的研究结果表明,感光色素视黑素蛋白也在视觉响应中发挥作用,并且基于视黑素蛋白的光感受可能对亮度感知和空间视觉方面有重要影响。虽然在非视觉效应方面,关于视杆细胞、视锥细胞与ipRGCs如何交互的认识不断发展,最近CIE的一份关于应用“在合适的时间推荐合适的光照”的立场声明中使用了视黑素响应日光(D65)等效照度来指导调节非视觉响应。关于这种方法的详细说明,可以通过第二届昼夜节律和神经生理光度学国际研讨会(曼彻斯特,2019年8月)的同行评审出版物了解*。CIE S 026新的α响应计量方法实现了可追踪测量,并对个人光照量、光干预和照明设计进行了正式的量化规范。通过使用这个工具箱,将这种计量方法应用于日常光源,包括动态变化的日光、LED照明光源以及智能手机屏幕等。这些示例展示了如何利用视黑素含量随时间变化的光照,以更好地支持人类健康与福祉。
基金support of the Third World Conference on Disaster Risk Reduction’s Major Group on Science and Technology, organized by the International Council of Science and its many partners, and its voluntary commitment for the conference
文摘This article explores the role of public health systems before, during, and after disasters, particularly within the scope of the United Nations Post-2015 Framework for Disaster Risk Reduction. It also examines the role of scientific and technological developments in assisting with improving the resilience of public health professionals and the communities they work in. In addition, it explores how the wide-ranging activities in public health have already contributed to the improved management of disasters and a decrease in associated risks. The article identifies areas of synergy in five key areas of recent policy and practice in public health(the health systems approach, risk assessments, the WHO/UNISDR/HPA Disaster Risk Management fact sheets, chronic disease and disasters, and mental health impacts following disasters) and makes suggestions based on lessons identified from the previous(2005) global disaster risk reduction framework. In particular, we advocate the use of scientific evidence that addresses health and disaster risk simultaneously to increase the effectiveness of policy and practice in disaster risk reduction, health, and public health.
基金supported by the International partnership program (Grant No.131551KYSB20160002)National Natural Science Foundation Major International (Regional) Joint Research Project (Grant No.41520104002)Science and Technology Service Network Initiative of Chinese Academy of Science (Grant No.KFJSTS-ZDTP-015)
文摘Belt and Road Initiative(BRI) is a Chinese national strategy which calls for cooperative economic, political and cultural exchange at the global level along the ancient Silk Road. The overwhelming natural hazards located along the belt and road bring great challenges to the success of BRI. In this framework, a 5-year international program was launched to address issues related to hazards assessment and disaster risk reduction(DRR). The first workshop of this program was held in Beijing with international experts from over 15 countries. Risk conditions on Belt and Road Countries(BRCs) have been shared and science and technology advancements on DRR have been disseminated during the workshop. Under this program, six task forces have been setup to carry out collaborative research works and three prioritized study areas have been established. This workshop announced the launching of this program which involved partners from different countries including Pakistan, Nepal, Russia, Italy, United Kingdom, Sri Lanka and Tajikistan. The program adopted the objectives of Sendai Framework for Disaster Risk Reduction 2015-2030 and United Nation Sustainable Development Goals 2030 and was implemented to assess disaster risk in BRCs and to propose suitable measures for disaster control which can be appropriate both for an individual country and for specific sites. This paper deals with the outcomes of the workshop and points out opportunities for the near future international cooperation on this matter.
文摘<div style="text-align:justify;"> <b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"></span><b> </b><span style="font-family:Verdana;">The interplay between financial deprivation and tuberculosis (TB) is considered one of the vital socio-economic determinants of disease. This is the first study of its kind to be carried in Pakistan, which aims to identify leading factors contributing towards catastrophic costs of TB diagnosis and management in order to help policy makers. <b></b></span><b><b><span style="font-family:Verdana;">Methodology:</span></b><span style="font-family:Verdana;"></span></b><b> </b><span style="font-family:Verdana;">From </span><span style="font-family:Verdana;">f</span><span style="font-family:Verdana;">our tertiary care hospitals (TCH) in Islamabad and Rawalpindi</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> 400 TB patients were interviewed through a cross-sectional survey. The patient’s pre and post</span><span style="font-family:Verdana;">-</span><span "=""><span style="font-family:Verdana;">TB income and direct and indirect costs for treatment were analysed following WHO recommendations. Multivariable logistic regression model was used to identify the determinants of catastrophic total cost. <b></b></span><b><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"><b></b></span><b><b> </b></b></b><span style="font-family:Verdana;"></span><span style="font-family:Verdana;"></span><span style="font-family:Verdana;">For TB management expenditures, the median (interquartile range) of total costs by households was Rs.</span></span><span "=""> </span><span style="font-family:Verdana;">58,175 Rs</span><span "=""> </span><span style="font-family:Verdana;">(32,050</span><span style="font-family:Verdana;"> - </span><span style="font-family:Verdana;">97,500). At 20% threshold, 67% of TB patient’s households were affected by catastrophic costs. The determinants of the catastrophic total cost were as follows: patient/guardian employed (adjusted odds ratio [aOR] = 3.428, 95% confidence interval [CI]: 1.900</span><span style="font-family:Verdana;"> - </span><span style="font-family:Verdana;">6.186), patient/guardian the only breadwinner (aOR = 1.751, 95% CI: 1.011</span><span style="font-family:Verdana;"> - </span><span style="font-family:Verdana;">3.032), follow-up visits at current health facility (aOR = 1.352, 95% CI: 1.223</span><span style="font-family:Verdana;"> - </span><span style="font-family:Verdana;">1.494), job loss (aOR = 3.381, 95% CI: 1.512</span><span style="font-family:Verdana;"> - </span><span style="font-family:Verdana;">7.561), and unpaid sick leaves (aOR = 2.862, 95% CI: 1.249</span><span style="font-family:Verdana;"> - </span><span style="font-family:Verdana;">6.558).</span><b><b><span "=""> </span><span style="font-family:Verdana;"><b></b></span><b><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"></span></b><span style="font-family:Verdana;"> </span></b></b><span style="font-family:Verdana;">The fi</span><span style="font-family:Verdana;">nancial deprivation experienced by patients of low socio-economic status increases as TB treatment proceeds</span><span style="font-family:Verdana;">. This negatively impacts the treatment adherence, resulting in poor treatment outcomes due to income and job loss. Outcomes are exacerbated if the family has single breadwinner and treatment requires follow-up visits.</span> </div>
文摘In response to the outbreak of Ebola Virus Disease in West Africa, the Emergency Response Department of Public Health England produced a series of training and exercising materials to help prepare health and partner organisations in England and other jurisdictions in the United Kingdom deal with a possible case of Ebola in the United Kingdom. They were produced with input from health(NHS England, Health Protection Scotland, Public Health Wales) and other partner organisations. The exercising materials have been used by colleagues working in national and local level organisations in the United Kingdom and other countries in the European Union. Presented here is a description of these training and exercising materials and how they were delivered to the end user.
文摘This paper proposes a more inclusive statistical model for predicting image noise in Computed Tomography (CT), associated with scanning factors, considering the effect of beam hardening and image processing filters. It is based on power functions where the levels of the parameters will determine the rate of noise variation with respect to a given scanning factor. It includes the influence of tube potential, tube current, slice thickness, Field of View (FOV), reconstruction methods and post-processing filters. To validate the model, tomographic measurements were made by using a PMMA phantom that simulates paediatric head and adult abdomen, a PET bottle was used to simulate the head of the new-born. The influence of ROI (Region Of Interest) size over nonlinear model parameters was analysed, and high variations of powers of attenuation and FOV were found depending on ROI size. A nonlinear robust regression method was used. The validation was performed graphically by weighted residual analysis. A nonlinear noise model was obtained with an adjusted coefficient of determination for ROI sizes between 10% and 70% of the phantom diameter or FOV. The model confirms the significance of the tube current, slice thickness and beam hardening effect on image. The process of estimation of the parameters of the model by Nonlinear Robust Regression turned out to be optimal.
文摘Mycoplasma hominis is a member of the genus mycoplasma and has only been isolated from humans. It is most frequently isolated from the urogenital tract in the absence of symptoms, but has been isolated from wounds, brain abscess, inflamed joints, blood and placenta from pregnancy with adverse outcomes (especially preterm birth and occasionally term stillbirth). Controversy surrounds whether this organism is a commensal or a pathogen;however, Mycoplasma hominis has been shown to induce preterm birth and foetal lung injury in an experimental primate model as a sole pathogen. These bacteria are known to exist as a parasitic infection, due to a number of missing synthetic and metabolism pathway enzymes from their minimal genome;therefore, the ability to adhere to host cells is important. Here we provide a review that clarifies the different nomenclature (variable adherence-associated antigen and P50) that has been used to investigate the major surface adhesin for this organism, as well as reported mechanisms responsible for turning off its expression. Variation in the structure of this protein can be used to separate strains into six categories, a method that we were able to use to distinguish and characterise 12 UK strains isolated from between 1983 and 2012. We propose that the Vaa should be used in further investigations to determine if commensal populations and those that are associated with disease utilise different forms of this adhesin, as this is under-studied and identification of pathogenic determinants is overdue for this organism.
文摘The Asian population comprises the third largest ethnic minority in the state of California.However,influenza vaccination coverage amongst the overall Asian population,and the first and third-generation Asian’s have not been widely studied.Previous literature exploring generational status as a corelate of influenza immunization amongst Mexican identified Latino adults confirms disparities in influenza vaccination coverage by generation.This study aims to report on the prevalence of influenza vaccination coverage amongst the overall,first and third-generation Asians in California,and examine the correlates of influenza vaccination coverage in the aforementioned population.Methods:Cross-sectional data from the California Health Interview Survey 2016 for Asian adults was analyzed using IBM SPSS 25.0 for Mac.Descriptive statistics were utilized for reporting the frequencies and percentages of the selected variables.Weighted multivariable binary logistic regression was used to obtain adjusted odds ratios(95%confidence interval)and determine independent association between socioeconomic determinants and influenza vaccination coverage amongst the first and third-generation Asians at P<0.05.The analysis was adjusted for“visit to the doctor”and“insurance status”.Results:Thirteen point one percent(n=2,761)of the survey respondents(N=21,055)identified as Asians.The first-generation(n=1,857,67%)comprised the highest proportion of the Asian ethnic group.Influenza vaccination coverage was reported as 61.2%amongst the overall,61.1%amongst the first-generation and 70.9%amongst the third-generation respectively.All predictor variables were significant amongst the first-generation,however amongst the third-generation all variables except for location and living in a household of 3 and more,were significant predictors of influenza vaccination coverage.Conclusion:Compared to the other ethnic groups in California,the Asian respondents reported a higher percentage of influenza vaccination coverage.Influenza vaccination coverage was the highest amongst the third-generation Asians.Increased influenza vaccination coverage amongst the Asian ethnic group can be ascribed to higher educational attainment,a higher proportion choosing to visit a doctor as well as increased insurance coverage.
文摘1.Overview The 2016 Quadrennial Ozone Symposium(QOS-2016)was held on 4–9 September 2016 in Edinburgh,UK.The Symposium was organized by the International Ozone Commission(IO3C),the NERC Centre for Ecology&Hydrology and the University of Edinburgh,and was co-sponsored by the International Union of Geodesy and Geophysics,the International Association of Meteorology and
文摘The Sendai Framework for Disaster Risk Reduction 2015–2030(SFDRR) is the first global policy framework of the United Nations’ post-2015 agenda. It represents a step in the direction of global policy coherence with explicit reference to health, development, and climate change. To develop SFDRR, the United Nations Office for Disaster Risk Reduction(UNISDR) organized and facilitated several global, regional, national, and intergovernmental negotiations and technical meetings in the period preceding the World Conference on Disaster Risk Reduction(WCDRR) 2015 where SFDRR was adopted. UNISDR also worked with representatives of governments, UN agencies, and scientists to develop targets and indicators for SFDRR and proposed them to member states for negotiation and adoption as measures of progress and achievement in protecting lives and livelihoods. The multiple efforts of the health community in the policy development process, including campaigning for safe schools and hospitals, helped to put people’s mental and physicalhealth, resilience, and well-being higher up the disaster risk reduction(DRR) agenda compared with the Hyogo Framework for Action 2005–2015. This article reviews the historical and contemporary policy development process that led to the SFDRR with particular reference to the development of the health theme.
文摘The Sendai Framework for Disaster Risk Reduction 2015–2030 recognizes the strong connection between health and disasters and promotes the concept of health resilience throughout.Several of the seven global targets stated in the Sendai Framework are directly related to health in terms of reducing disaster mortality,the number of affected people,disaster damage to critical infrastructure,and disruption of basic services such as health facilities.The Sendai Framework also maintains close coordination with other United Nations landmark agreements relevant to health such as the Sustainable Development Goals.However,the measurement of healthrelated indicators is challenging.Issues arise,for example,in linking deaths to disasters because of the complex interplay between exposure,risk,vulnerability,and hazards.The lack of a universal classification of disasters also means that recording of health data in disasters is not standardized.Developing the guidelines to enable data onthe indicators to be collected and reported to support the Sendai targets requires detailed thinking,time,and consultation with a diverse range of stakeholders.Strong collaboration and partnership will be vital to achieving success.
文摘The intersection of health and disaster risk reduction(DRR) has emerged in recent years as a field of critical inquiry.Health is recognized as an outcome and a goal of DRR,and the integration of both fields is essential to ensure the implementation of the Sendai Framework for Disaster Risk Reduction 2015–2030.Health Emergency and Disaster Risk Management(Health-EDRM) has emerged as an umbrella field that encompasses emergency and disaster medicine,DRR,humanitarian response,community health resilience,and health systems resilience.In September 2016,an international group of experts met in Hong Kong to assess the current status and potential of the Health-EDRM research field,a research area that these scholars characterized as underdeveloped and fragmented.Key challenges identified include research overlap,lack ofstrategic research agenda,absence of consensus regarding terminology,and limited coordination between stakeholders.The Sendai Framework provides a useful paradigm within which to shape the research field's strategic development.The WHO Thematic Platform for Health-EDRM Research Group was established to coordinate activities,promote information-sharing,develop partnerships,and provide technical advice to strengthen the Health-EDRM research field.This group will promote the generation of robust and scientific health research to support the meaningful implementation of the Sendai Framework.
文摘The Sendai Framework for Disaster Risk Reduction 2015–2030 recognizes health at the heart of disaster risk management(DRM)at the global policy level.Five years on,it has catalyzed the rapid development of the field of Health Emergency and Disaster Risk Management(Health EDRM)by providing a mandate for building partnerships as well as enhancing scientific research.Key milestones achieved include publication of the World Health Organization’s Health EDRM Framework,development of the WHO Thematic Platform for Health EDRM and the WHO Health EDRM Research Network,and further application of health information principles to DRM.Furthermore,health actors at all levels have continued to engage in the Sendai Framework processes and have had a key role in its implementation and proposed monitoring.There have been significant gains made through the partnership of health and DRM,but the relationship has not been without its challenges.Many national,regional,and global initiatives continue to operate with a lack of consistency and of linkages to respond to the Sendai Framework’s call for embedding health resilience in DRM,and conversely,embedding DRM in health resilience.Overcoming this hurdle is important,and doing so will be a key marker of success of the next 10 years of partnership under the Sendai Framework.
文摘Bioaerosol exposure has been linked to adverse respiratory conditions.Intensive farming and composting facilities are important anthropogenic sources of bioaerosols.We aimed to characterise populations living close to intensive farming and composting facilities.We also infer whether the public are becoming more concerned about anthropogenic bioaerosol emissions,using reports of air pollution related incidents attributed to facilities.We mapped the location of 1,257 intensive farming and 310 composting facilities in England in relation to the resident population and its characteristics(sex and age),area characteristics(deprivation proxy and rural/urban classification)and school locations stratified by pre-defined distance bands from these bioaerosol sources.We also calculated the average number of air pollution related incidents per year per facility.We found that more than 16%of the population and 15%of schools are located within 4,828 m of an intensive farming facility or 4,000 m of a composting facility;few people(0.01%)live very close to these sites and tend to be older people.Close to composting facilities,populations are more likely to be urban and more deprived.The number of incidents were attributed to a small proportion of facilities;population characteristics around these facilities were similar.Results indicate that populations living near composting facilities(particularly>250 to≤4,000 m)are mostly located in ur6an areas(80188%of the population),which supports the need for more community health studies to be conducted.Results could also be used to inform risk management strategies at facilities with higher numbers of incidents.
文摘The first international conference for the post-2015 United Nations landmark agreements(Sendai Framework for Disaster Risk Reduction 2015–2030, Sustainable Development Goals, and Paris Agreement on Climate Change) was held in January 2016 to discuss the role of science and technology in implementing the Sendai Framework for Disaster Risk Reduction 2015–2030. The UNISDR Science and Technology Conference on the Implementation of the Sendai Framework for Disaster Risk Reduction 2015–2030 aimed to discuss and endorse plans that maximize science's contribution to reducing disaster risks and losses in the coming 15 years and bring together the diversity of stakeholders producing and using disaster risk reduction(DRR) science and technology. This article describes the evolution of the role of science and technology in the policy process building up to the Sendai Framework adoption that resulted in an unprecedented emphasis on science in the text agreed on by 187 United Nations member states in March 2015 and endorsed by the United Nations General Assembly in June 2015. Contributions assembled by the Conference Organizing Committee and teams including the conference concept notes and the conference discussions that involved a broad range of scientists and decision makers are summarized in this article. The conference emphasized how partnerships and networks can advance multidisciplinary research and bring together science, policy, and practice; how disaster risk is understood, and how risks are assessed and early warning systems are designed; what data, standards, and innovative practices would be needed to measure and report on risk reduction; what research and capacity gaps exist and how difficulties in creating and using science for effective DRR can be overcome. The Science and Technology Conference achieved two main outcomes:(1) initiating the UNISDR Science and Technology Partnership for the implementation of the Sendai Framework; and(2) generating discussion and agreement regarding the content and endorsement process of the UNISDR Science and Technology Road Map to 2030.
文摘At the first gathering of its kind on the role of science in implementing the Sendai Framework for Disaster Risk Reduction 2015–2030,over 750 scientists,policymakers,business people,and practitioners met in Geneva from January 27–29,2016.The UNISDR Science and Technology Conference on the Implementation of the Sendai Framework for Disaster Risk Reduction 2015–2030 fea-
基金The European Multiple Environmental Threats emergency NETwork(EMETNET)project was co-funded by the European Union.
文摘Every year,numerous environmental disasters and emergencies occur across the globe with far-reaching impacts on human health and the environment.The ability to rapidly assess an environmental emergency to mitigate potential risks and impacts is paramount.However,collating the necessary evidence in the early stages of an emergency to conduct a robust risk assessment is a major challenge.This article presents a methodology developed to help assess the risks and impacts during the early stages of such incidents,primarily to support the European Union Civil Protection Mechanism but also the wider global community in the response to environmental emergencies.An online rapid risk and impact assessment tool has also been developed to promote enhanced collaboration between experts who are working remotely,considering the impact of a disaster on the environment and public health in the short,medium,and long terms.The methodology developed can support the appropriate selection of experts and assets to be deployed to affected regions to ensure that potential public health and environmental risks and impacts are mitigated whenever possible.This methodology will aid defensible decision making,communication,planning,and risk management,and presents a harmonized understanding of the associated impacts of an environmental emergency.
基金This work was supported by the Strategic Priority Research Program of Chinese Academy of Sciences[grant number XDA19020201].
文摘Open data strategies are being adopted in disaster-related data particularly because of the need to provide information on global targets and indicators for implementation of the Sendai Framework for Disaster Risk Reduction 2015–2030.In all phases of disaster risk management including forecasting,emergency response and post-disaster reconstruction,the need for interconnected multidisciplinary open data for collaborative reporting as well as study and analysis are apparent,in order to determine disaster impact data in timely and reportable manner.The extraordinary progress in computing and information technology in the past decade,such as broad local and wide-area network connectivity(e.g.Internet),highperformance computing,service and cloud computing,big data methods and mobile devices,provides the technical foundation for connecting open data to support disaster risk research.A new generation of disaster data infrastructure based on interconnected open data is evolving rapidly.There are two levels in the conceptual model of Linked Open Data for Global Disaster Risk Research(LODGD)Working Group of the Committee on Data for Science and Technology(CODATA),which is the Committee on Data of the International Council for Science(ICSU):data characterization and data connection.In data characterization,the knowledge about disaster taxonomy and data dependency on disaster events requires specific scientific study as it aims to understand and present the correlation between specific disaster events and scientific data through the integration of literature analysis and semantic knowledge discovery.Data connection concepts deal with technical methods to connect distributed data resources identified by data characterization of disaster type.In the science community,interconnected open data for disaster risk impact assessment are beginning to influence how disaster data are shared,and this will need to extend data coverage and provide better ways of utilizing data across domains where innovation and integration are now necessarily needed.
基金This study was supported by grants from the Ministry of Health-WHO five-year Cooperative Project on Influenza Surveillance in China,the Harvard Center for Communicable Disease Dynamics from the National Institute of General Medical Sciences(grant no.U54 GM088558)a commissioned grant from the Health and Medical Research Fund,Food and Health Bureau,Government of the Hong Kong Special Administrative Region(grant no.HKS-15-E05).
文摘Background:The seasonal influenza vaccine coverage rate in China is only 1.9%.There is no information available on the economic burden of influenza-associated outpatient visits and hospitalizations at the national level,even though this kind of information is important for informing national-level immunization policy decision-making.Methods:A retrospective telephone survey was conducted in 2013/14 to estimate the direct and indirect costs of seasonal influenza-associated outpatient visits and hospitalizations from a societal perspective.Study participants were laboratory-confirmed cases registered in the National Influenza-like Illness Surveillance Network and Severe Acute Respiratory Infections Sentinel Surveillance Network in China in 2013.Patient-reported costs from the survey were validated by a review of hospital accounts for a small sample of the inpatients.Results:The study enrolled 529 outpatients(median age:eight years;interquartile range[IQR]:five to 20 years)and 254 inpatients(median age:four years;IQR:two to seven years).Among the outpatients,22.1%(117/529)had underlying diseases and among the inpatients,52.8%(134/254)had underlying diseases.The average total costs related to influenza-associated outpatient visits and inpatient visits were US$155(standard deviation,SD US$122)and US$1,511(SD US$1,465),respectively.Direct medical costs accounted for 45 and 69%of the total costs related to influenza-associated outpatient and inpatient visits,respectively.For influenza outpatients,the mean cost per episode in children aged below five years(US$196)was higher than that in other age groups(US$129–153).For influenza inpatients,the mean cost per episode in adults aged over 60 years(US$2,735)was much higher than that in those aged below 60 years(US$1,417–1,621).Patients with underlying medical conditions had higher costs per episode than patients without underlying medical conditions(outpatients:US$186 vs.US$146;inpatients:US$1,800 vs.US$1,189).In the baseline analysis,inpatients reported costs were 18%higher than those found in the accounts review(n=38).Conclusion:The economic burden of influenza-associated outpatient and inpatient visits in China is substantial,particularly for young children,the elderly,and patients with underlying medical conditions.More widespread influenza vaccination would likely alleviate the economic burden of patients.The actual impact and cost-effectiveness analysis of the influenza immunization program in China merits further investigation.
