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Analysis of HIV prevalence among pregnant women in Liangshan Prefecture, China, from 2009 to 2015.

ABSTRACT: Yi people make up about 50% of the population in Liangshan Prefecture, Sichuan Province, China, but accounted for 88.07% of new HIV cases in the prefecture from 2011 to 2013. This study evaluated HIV prevalence in pregnant women of Liangshan Prefecture using HIV sentinel surveillance (HSS) data over the period of 2009 to 2015.Xichang, Zhaojue County, and Butuo County were selected as HSS sites. We investigated the temporal trends in HIV prevalence in these areas, and the association between demographic and behavioral characteristics and risk of HIV infection.Data on a total of 2797 pregnant women in Xichang and 3983 pregnant women in Zhaojue and Butuo was collected for the period 2009 to 2015. There was a fluctuating HIV prevalence among pregnant women of Xichang, with a rate of 0.75% in 2015 (?2trend = 2.27, P = 0.13). HIV prevalence among pregnant women of Zhaojue and Butuo was consistently high, varying between 3.4% (9/267, 2011) and 10.3% (82/796, 2012) over the period of 2010 to 2015 (?2trend = 0.12, P = 0.73). In Xichang, we found that Yi ethnicity (OR = 11.37, 95% CI = 2.92-44.25) and a husband who used drugs (OR = 32.13, 95% CI = 5.33-193.67) were significantly associated with HIV risk in pregnant women. For Zhaojue and Butuo, we observed that pregnant women had a higher risk of HIV infection when they were over 30 years old (OR = 1.72, 95% CI = 1.17-2.52), when they had a higher number of previous births, when their husbands had a history of migrating for work (OR = 1.56, 95% CI = 1.16-2.08), and when they had a history of other sexually transmitted infections (OR = 2.19, 95% CI = 1.16-2.08). Compared to those with a primary school education or below, pregnant women with a secondary or high school education level had a lower risk of HIV infection (OR = 0.28, 95% CI = 0.09-0.89).Our results indicate that there is a serious HIV epidemic among pregnant Yi women, especially for those with less education, more past births, or a husband with a history of out-migrating for work or STD infection.

SUBMITTER: Yang S

PROVIDER: S-EPMC5589085 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Analysis of HIV prevalence among pregnant women in Liangshan Prefecture, China, from 2009 to 2015.

Yang Shujuan S Yang Chao C Liao Qiang Q Zhai Wenwen W Yu Gang G Xiao Lin L Wang Qixing Q Gong Yuhan Y Zhang Suhua S Yao Yongna Y Wang Ke K Wang Ju J Bian Shaochao S Liu Qian Q

PloS one 20170907 9

<h4>Background</h4>Yi people make up about 50% of the population in Liangshan Prefecture, Sichuan Province, China, but accounted for 88.07% of new HIV cases in the prefecture from 2011 to 2013. This study evaluated HIV prevalence in pregnant women of Liangshan Prefecture using HIV sentinel surveillance (HSS) data over the period of 2009 to 2015.<h4>Methods</h4>Xichang, Zhaojue County, and Butuo County were selected as HSS sites. We investigated the temporal trends in HIV prevalence in these area ...[more]

PMID: 28880917

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Project description:BackgroundContinuous surveillance of death can measure health status of the population, reflect social development of a region, thus promote health service development in the region and improve the health level of local residents. Liangshan Yi Autonomous Prefecture was a poverty-stricken region in Sichuan province, China. While at the end of 2020, as the announcement of its last seven former severely impoverished counties had shaken off poverty, Liangshan declared victory against poverty. Since it is well known that the mortality and cause of death structure will undergo some undesirable changes as the economy develops, this study aimed to reveal the distribution of deaths, as well as analyze the latest mortality and death causes distribution characteristics in Liangshan in 2020, so as to provide references for the decision-making on health policies and the distribution of health resources in global poverty-stricken areas.MethodsLiangshan carried out the investigation on underreporting deaths among population in its 11 counties in 2018, and combined with the partially available data from underreporting deaths investigation data in 2020 and the field experience, we have estimated the underreporting rates of death in 2020 using capture-recapture (CRC) method. The crude mortality rate, age-standardized mortality rate, proportion and rank of the death causes, potential years of life lost (PYLL), average years of life lost (AYLL), potential years of life lost rate (PYLLR), standardized potential years of life lost (SPYLL), premature mortality from non-communicable diseases (premature NCD mortality), life expectancy and cause-eliminated life expectancy were estimated and corrected.ResultsIn 2020, Liangshan reported a total of 16,850 deaths, with a crude mortality rate of 608.75/100,000 and an age-standardized mortality rate of 633.50/100,000. Male mortality was higher than female mortality, while 0-year-old mortality of men was lower than women's. The former severely impoverished counties' age-standardized mortality and 0-year-old mortality were higher than those of the non-impoverished counties. The main cause of death spectrum was noncommunicable diseases (NCDs), and the premature NCD mortality of four major NCDs were 14.26% for the overall population, 19.16% for men and 9.27% for women. In the overall population, the top five death causes were heart diseases (112.07/100,000), respiratory diseases (105.85/100,000), cerebrovascular diseases (87.03/100,000), malignant tumors (73.92/100,000) and injury (43.89/100,000). Injury (64,216.78 person years), malignant tumors (41,478.33 person years) and heart diseases (29,647.83 person years) had the greatest burden on residents in Liangshan, and at the same time, the burden of most death causes on men were greater than those on women. The life expectancy was 76.25 years for overall population, 72.92 years for men and 80.17 years for women, respectively, all higher than the global level (73.3, 70.8 and 75.9 years).ConclusionsTaking Liangshan in China as an example, this study analyzed the latest death situation in poverty-stricken areas, and proposed suggestions on the formulation of health policies in other poverty-stricken areas both at home and abroad.

Project description:BACKGROUND:Due to historical perceptions of Liangshan Yi Autonomous Prefecture (Sichuan Province, China) as being a violent place, and due to its rugged terrain, cultural differences, and relative inaccessibility, few researchers have conducted in-depth ethnobotanical investigations in Liangshan. But wild edible plants (WEPs) are widely consumed by the Yi people of Liangshan, and their associated ethnobotanical knowledge remains relatively unknown, especially outside of China. This study aimed to (1) investigate the WEPs used by the Liangshan Yi, (2) document the traditional knowledge held about these plants, (3) analyze their special preparation methods and consumption habits, and (4) identify species with important cultural significance to the Liangshan Yi. METHODS:During 2016-2017, 396 Yi individuals were interviewed in 1 county-level city and 6 counties across Liangshan. Prior informed consent was obtained, and multiple ethnographic methods were utilized, including direct observation, semi-structured interviews, key informant interviews, informal discussions, and field visits. Market surveys were conducted in April, July, and August 2017 by interviewing 38 Yi merchants selling WEPs in 6 Liangshan traditional markets. We collected information about the parts consumed, preparation methods, consumption habits, growth pattern of species, collection months, market prices, and other uses of WEPs. Use values (UVs) were calculated to analyze the relative cultural importance of each WEP. RESULTS:In total, 105 plant species belonging to 97 genera and 62 families were recorded. Rosaceae was the family with the largest number of species (14), and herbs (58 species) were the dominant growth form reported. Fruits (34 species), roots (21 species), and tender shoots (20 species) were the primary plant parts used for snacking and cooking. There were 6 main preparation and consumption methods of WEPs reported, ranging from primary food, famine food, snack, spice, culinary coagulant, and medicine, among a few other uses. The Liangshan Yi mainly collect WEPs from March to October, seldom collecting from November to February. There were 35 species of WEPs sold in the markets we visited in Liangshan. The price of medicinal plants was much higher than the price of food and fruits. In total, we documented 49 species of edible medicinal plants in Liangshan, accounting for 44.7% of all WEPs. They can be used for treating 27 medical conditions, including cough, diarrhea, injury, and headaches. The plants with the highest UVs were Berberis jamesiana (1.92), Pyracantha fortuneana (1.87), and Artemisia capillaris (1.44) indicating that these species are the most commonly used and important to the Liangshan Yi's traditional life and culture. CONCLUSIONS:The traditional knowledge of WEPs from the accumulated experience of the Yi people's long period residing in Liangshan reflects the cultural richness of the Yi and the plant diversity of the region. Future research on the nutrition, chemical composition, and bioactivity of the WEPs are needed. Some species with high medicinal value but with sharp wild population decline should be surveyed for resource assessment, conservation, and domestication potential.

Project description:BackgroundMalaria in human immunodeficiency virus (HIV)-positive patients is an ever-increasing global burden for human health. The present meta-analysis summarizes published literature on the prevalence of malaria infection in HIV-positive children, pregnant women and adults.MethodsThis study followed the PRISMA guideline. The PubMed, Science Direct, Google Scholar, Scopus and Cochrane databases were searched for relevant entries published between 1 January 1983 and 1 March 2020. All peer-reviewed original papers evaluating the prevalence of malaria among HIV-positive patients were included. Incoherence and heterogeneity between studies were quantified by the I2 index and Cochran's Q test. Publication and population biases were assessed with funnel plots, and Egger's regression asymmetry test.ResultsA total of 106 studies were included in this systematic review. The average prevalence of malaria among HIV-positive children, HIV-positive pregnant women and HIV-positive adults was 39.4% (95% confidence interval [CI]: 26.6-52.9), 32.3% (95% CI = 26.3-38.6) and 27.3% (95% CI = 20.1-35.1), respectively. In adult patients with HIV, CD4+ (cluster of differentiation 4) < 200 cells/µl and age < 40 years were associated with a significant increase in the odds of malaria infection (odds ratio [OR] = 1.5, 95% CI = 1.2-1.7 and OR = 1.1, 95% CI = 1-1.3, respectively). Antiretroviral therapy (ART) and being male were associated with a significant decrease in the chance of malaria infection in HIV-positive adults (OR = 0.8, 95% CI = 0.7-0.9 and OR = 0.2, 95% CI = 0.2-0.3, respectively). In pregnant women with HIV, CD4+ count < 200 cells/µl was related to a higher risk for malaria infection (OR = 1.5, 95% CI = 1.1-1.9).ConclusionsThis systematic review demonstrates that malaria infection is concerningly common among HIV-positive children, pregnant women and adults. Among HIV-positive adults, ART medication and being male were associated with a substantial decrease in infection with malaria. For pregnant women, CD4+ count of < 200 cells/µl was a considerable risk factor for malaria infection.

Dataset Information

Analysis of HIV prevalence among pregnant women in Liangshan Prefecture, China, from 2009 to 2015.

Publications

Analysis of HIV prevalence among pregnant women in Liangshan Prefecture, China, from 2009 to 2015.

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