RESUMEN
BACKGROUND: Outbreaks of low and high pathogenic avian influenza (LPAI, HPAI) H5N2 in chickens have occurred in Taiwan since 2003 and 2012, respectively. Fully understanding the different awareness, attitudes and protective behaviors adopted by workers in live-poultry markets (LPMWs) and local community residents (CRs) to face the challenges of LPAI and HPAI is very important to minimize viral adaptations to human populations. METHODS: A structural questionnaire containing information on respondents' occupation, personal risk awareness, attitudes toward different policies, and preventative measures was administered. The two-stage survey (before and after HPAI H5N2 outbreaks) was conducted from 2007 to 2012, including: (1) 430 LPMWs and 418 CRs at LPMs from different geographical areas of Taiwan after the government announced outbreaks of LPAI H5N2 during 2007-2009, and (2) 73 LPMWs and 152 CRs at two LPMs in central Taiwan after the HPAI H5N2 outbreaks in 2012. The chi-squared test and logistic regression were applied for univariate and multivariate analyses, respectively. RESULTS: Before HPAI-H5N2 outbreaks, higher educated respondents demonstrated greater risk awareness and concerns regarding AI. However, LPM-workers protected themselves less from AI viruses (AIVs) and had lower acceptance of human or avian influenza vaccines. Most importantly, the participants who opposed (versus agreed with) the policy on banning live-poultry slaughtering at LPMs reported lower awareness of government prevention and control policies [Odds Ratio (OR): 0.76, 95 % Confidence Interval (CI): 0.56-1.01] or practiced preventive measures (OR: 0.42, 95 % CI: 0.25-0.70). After HPAI-H5N2 outbreaks, the risk awareness about AI in central Taiwan significantly increased [LPAI to HPAI LPMWs: 34.6 to 65.6 %, p < 0.05; CRs: 44.0 to 76.5 %, p < 0.05] and LPMWs' belief in the effectiveness of vaccination to prevent human or avian influenza virus infection strikingly decreased (92.3 to 68.5 %, p < 0.05). CONCLUSIONS: Risk awareness depends on high or low pathogenicity of AIVs, working in LPMs, levels of education, age, and proximity to the sites of severe AI outbreaks. Regardless of novel LPAI or HPAI virus reassortants that pose public health risks, prompt and clear risk communication focusing on both correct information about AIVs and the most appropriate preventive measures are important for effective prevention of human infection.
Asunto(s)
Actitud Frente a la Salud , Concienciación , Gripe Aviar/epidemiología , Adolescente , Adulto , Anciano , Animales , Pollos , Brotes de Enfermedades/veterinaria , Femenino , Regulación Gubernamental , Humanos , Subtipo H5N2 del Virus de la Influenza A/aislamiento & purificación , Vacunas contra la Influenza/inmunología , Gripe Aviar/virología , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Oportunidad Relativa , Riesgo , Encuestas y Cuestionarios , Taiwán/epidemiología , Adulto JovenRESUMEN
OBJECTIVE: We investigated the overall and age-specific risks of developing breast and endometrial cancer among women with diabetes in a population-based cohort study. METHODS: Women with diabetes (nâ=â319310) and age-matched controls (nâ=â319308), selected from ambulatory care claims and beneficiary registry in 2000, respectively were linked to the in-patient claims (2000-2008) to identify admissions due to breast (ICD-9-CM: 174) and endometrial (ICD-9-CM: 182) cancer. The person-year approach with Poisson assumption was used to estimate the incidence density rate. The age-specific hazard ratios (HRs) of above malignancies in relation to diabetes with multivariate Cox proportional hazard regression. RESULTS: The overall incidence density rate of breast and endometrial cancer was estimated at 1.21 and 0.21 per 10,000 patient-years, respectively, for diabetes. The corresponding figures for controls were lower at 1.00 and 0.14 per 10,000 patient-years. Compared with the controls, the covariate adjusted HR for breast and endometrial cancer was 1.42 (95% confidence interval (CI) 1.34-1.50) and 1.71 (95% CI 1.48-1.97), respectively in women with diabetes. Elderly (>â=â65 years) diabetes had the highest HR (1.61) of breast cancer, while the highest HR (1.85) of endometrial cancer was observed in diabetes aged <â=â50 years. CONCLUSIONS: Diabetes may significantly increase the risks of breast and endometrial cancer in all age stratifications. Health education for strict adherence of cancer screening program in women with diabetes is essential.
Asunto(s)
Neoplasias de la Mama/etiología , Complicaciones de la Diabetes/etiología , Diabetes Mellitus/fisiopatología , Neoplasias Endometriales/etiología , Adulto , Neoplasias de la Mama/epidemiología , Estudios de Casos y Controles , Complicaciones de la Diabetes/epidemiología , Neoplasias Endometriales/epidemiología , Femenino , Humanos , Incidencia , Persona de Mediana Edad , Estudios Retrospectivos , Medición de Riesgo , Taiwán/epidemiologíaRESUMEN
BACKGROUND: Avian influenza (AI) can be highly pathogenic and fatal. Preventive behavior such as handwashing and wearing face masks has been recommended. However, little is known about what psychosocial factors might influence people's decision to adopt such preventive behavior. This study aims to explore risk perception and other factors associated with handwashing and wearing face masks to prevent AI. METHODOLOGY/PRINCIPAL FINDINGS: An interviewer-administered survey was conducted among 352 traditional market workers and shoppers in Taiwan between December 2009 and January 2010. Factors associated with the recommended AI preventive behavior (i.e., when in a traditional market, wearing a face mask and also washing hands after any contact with poultry) included: having correct knowledge about the fatality rate of AI (adjusted odds ratio [AOR]â=â4.18), knowing of severe cases of AI (AORâ=â2.13), being informed of local AI outbreaks (AORâ=â2.24), living in northeastern Taiwan (AORâ=â6.01), having a senior high-school education (AORâ=â3.33), and having a university or higher education (AORâ=â6.86). Gender interactive effect was also found among participants with a senior high-school education, with males being less likely to engage in the recommended AI preventive behavior than their female counterparts (AORâ=â0.34). CONCLUSIONS/SIGNIFICANCE: Specific information concerning AI risk perception was associated with the recommended AI preventive behavior. In particular, having correct knowledge about the fatality rate of AI and being informed of severe cases and local outbreaks of AI were linked to increased AI preventive behavior. These findings underscore the importance of transparency in dealing with epidemic information. These results also have practical implications for prevention and policy-making to more effectively promote the recommended AI preventive behavior in the public.
Asunto(s)
Recolección de Datos , Conductas Relacionadas con la Salud , Gripe Aviar/prevención & control , Gripe Humana/prevención & control , Percepción , Adulto , Animales , Demografía/estadística & datos numéricos , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Gripe Aviar/transmisión , Gripe Humana/transmisión , Masculino , Análisis Multivariante , Aves de Corral , Riesgo , TaiwánRESUMEN
Human herpesvirus 8 (HHV8) has been consistently linked to Kaposi's sarcoma and many hematological diseases such as pleural effusion lymphoma, multicentric Castleman's disease, some lymphoproliferative diseases and posttransplantation bone marrow failure. However, whether patients with hematological disorders are at a higher risk of HHV8 infection has not been determined. In this study, indirect immunofluorescence was used to detect antibodies against lytic antigens of HHV8 in 265 patients with hematological disorders. Our data showed that 24.5% of patients (65/265) were seropositive for HHV8 IgG antibody, which was significantly higher than in our general population (p < 0.001). A significantly higher seropositive rate can be found in patients with lymphoma, leukemia, autoimmune cytopenias and myeloproliferative disorders, but not in patients with myeloma or aplastic anemia. No difference in the seropositive rate is associated with gender or age. We conclude that some patients with hematological disorders are at a higher risk of HHV8 infection.
Asunto(s)
Anticuerpos Antivirales/sangre , Enfermedades Hematológicas/sangre , Infecciones por Herpesviridae/sangre , Herpesvirus Humano 8 , Inmunoglobulina G/sangre , Adulto , Factores de Edad , Anciano , Femenino , Fibrosis/sangre , Fibrosis/complicaciones , Fibrosis/epidemiología , Enfermedades Hematológicas/complicaciones , Enfermedades Hematológicas/epidemiología , Infecciones por Herpesviridae/epidemiología , Infecciones por Herpesviridae/virología , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Estudios Seroepidemiológicos , Factores SexualesRESUMEN
The major bcr-abl fusion gene is seen as a major marker of chronic myeloid leukemia (CML). However, whether the bcr-abl transcript can be detected in patients with essential thrombocythemia (ET) is still a matter of controversy. We detected the messenger RNA expression of the bcr-abl gene using reverse transcription-polymerase chain reaction in peripheral-blood leukocytes (PBLs) from 63 patients with myeloproliferative disorders (including CML, ET, and polycythemia vera [PV]) and 51 normal, healthy volunteers. The bcr-abl transcript was detected in 4 of the 30 ET patients (13.3%), 17 of the 17 CML patients (100%), none of the 16 PV patients (0%), and 1 of the 51 normal subjects (1.9%). Compared with the normal controls, ET patients have a greater tendency to express the bcr-abl transcript in PBLs (P=.06, Fisher's exact test). Further semiquantitative analysis showed that the intensity of bcr-abl transcript expression in 4 ET patients and a normal individual was 10(3) to 10(4) times less than that in the CML patients. We conclude that the bcr-abl transcript can be detected in the PBLs of Philadelphia chromosome (Ph)-negative ET patients but that the level of expression is markedly less than that in CML patients. The clinical significance of this finding merits further investigation.