Misreporting Rate & Influencing Factors Regarding the Routes of Transmission among Reported HIV Patients in Yili Kazakh Autonomous Prefecture of Xinjiang Uygur Autonomous Region of China

OBJECTIVE:

To understand the misreporting rate regarding the routes of transmission among the reported HIV patients in Yili prefecture of Xinjiang, since 2011.

METHODS:

An investigation focusing on the route of transmission among people living with HIV/AIDS was carried out to clarify the responsible reasons for the situation.

RESULTS:

The overall incorrect reporting rate on the route of transmission was 10.8%.The proportion of heterosexual transmission route was over estimated by 63.8% to 72.0%. However, the proportion of injecting drug was underestimated by 27.5% to 22.2%. The number of cases being confirmed as through heterosexual transmission but incorrectly reported was quite high, contributing 82.6% of all the incorrectly reported cases. Most of the patients that incorrect reported, were moved from injecting drug use to heterosexual transmission, which contributed 79.5% of all the total incorrectly reported cases. Results from multi-factor analysis showed that the risk related to incorrect reporting was 3.64 times in males than in females. People who anticipated to receive HIV testing were 2.23 times more than those who had not. Old-age groups were 3.511, 4.053, 4.415 and 6.524 times higher than those people who were aged below 16 years.

CONCLUSIONS:

The proportion of heterosexual transmission route was over- estimated while the proportion on injecting drug use was underestimated. However, the transmission pattern had changed from injecting drug use at the early epidemic stage, to current sexual transmission mode. We recommended that more attentions should be paid to patients who were males, at older age or those who had no expectation in receiving the HIV testing, during the initial following-up stage.

Purchase full article in Chinese at:   http://goo.gl/DtX3aW

By:  Ni MJ1, Chen XL, Hu XY, Ma YY.

• 1Center for STD/AIDS Control and Prevention, Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi 830011, China. 
• Zhonghua Liu Xing Bing Xue Za Zhi. 2016 Jan 10;37(1):90-3. doi: 10.3760/cma.j.issn.0254-6450.2016.01.019.

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Sex Specific Mortality in HIV/AIDS Patients Receiving Antiretroviral Therapy & Risk Factors in Xinjiang Uygur Autonomous Region

OBJECTIVE:

To analyze the sex specific mortality in HIV/AIDS patients receiving highly active antiretroviral therapy (HAART) and risk factors in Xinjiang Uyghur autonomous region (Xinjiang), and provide evidence for the evaluation of the effect of HAART.

METHODS:

A retrospective analysis was conducted on the mortality and survival of 8 061 male cases and 6 001 female cases of HIV infection, who received HAART during July 2004-June 2013 in Xinjiang. The information of the cases were downloaded from national antiretroviral therapy reporting sub-system in national HIV/AIDS reporting system. Cox proportional hazard model was used to identify the risk factors of deaths.

RESULTS:

The male cases were older and had lower CD4 value at baseline compared with the female cases. The major transmission route was injecting drug use in males, but sexual contact in females. The overall mortality of the male cases was higher than that of the females, which was 10.87/100 person-years during the first three month after receiving HAART, and 7.00/100 person-years two years later in males, but 4.77/100 person-years during the first three month and 3.00/100 person-years two years later in females. The results from Cox analysis showed that the risk factors were the CD4 value at baseline and transmission route. Compared with the cases who had lower CD4 value (CD4<200 cells/µl) at baseline, the HR for the cases who had higher CD4 value (CD4≥350 cells/µl) was 4.08 (95% CI: 2.96-5.62) in males and 5.11 (95% CI: 3.16-8.35) in females. Compared with sexual transmission, the HR for IDUs was 1.99 (95% CI: 1.66-2.40) in males and 1.77 (95% CI: 1.24-2.52) in females. The results of cumulative survival analysis showed that in conventional treatment group (CD4<350 cells/µl) , the five year survival rates were 81% and 87% for the males and females infected through sexual contact and 66% and 75% for the males and females infected through injecting drug use, and in early treatment group (CD4≥350 cells/µl) , the five year survival rates were 97% and 98% for the males and females infected through sexual contact and 86% and 97% for the males and females infected through injecting drug use.

CONCLUSION:

In Xinjiang, the higher mortality in male HIV infection cases receiving HAART was related with lower CD4 value at baseline and higher infection rate through injecting drug use. Besides the weak intention for treatment and poor compliancy would be the deeper risk factors.

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By:  Ni M1, Chen X2, Ma Y2, Hu X2.

• 1Center for AIDS and STD Control and Prevention, Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi 830011, China; Email: xjnmj@126.com.
• 2Center for AIDS and STD Control and Prevention, Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi 830011, China. 
• Zhonghua Liu Xing Bing Xue Za Zhi. 2015 Sep;36(9):971-5.

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Socio-Demographic Predictors and Distribution of Pulmonary Tuberculosis (TB) in Xinjiang, China: A Spatial Analysis

Objectives

Xinjiang is one of the high TB burden provinces of China. A spatial analysis was conducted using geographical information system (GIS) technology to improve the understanding of geographic variation of the pulmonary TB occurrence in Xinjiang, its predictors, and to search for targeted interventions.

Methods

Numbers of reported pulmonary TB cases were collected at county/district level from TB surveillance system database. Population data were extracted from Xinjiang Statistical Yearbook (2006~2014). Spatial autocorrelation (or dependency) was assessed using global Moran’s I statistic. Anselin’s local Moran’s I and local Getis-Ord statistics were used to detect local spatial clusters. Ordinary least squares (OLS) regression, spatial lag model (SLM) and geographically-weighted regression (GWR) models were used to explore the socio-demographic predictors of pulmonary TB incidence from global and local perspectives. SPSS17.0, ArcGIS10.2.2, and GeoDA software were used for data analysis.

Results

Incidence of sputum smear positive (SS+) TB and new SS+TB showed a declining trend from 2005 to 2013. Pulmonary TB incidence showed a declining trend from 2005 to 2010 and a rising trend since 2011 mainly caused by the rising trend of sputum smear negative (SS-) TB incidence (p<0.0001). Spatial autocorrelation analysis showed the presence of positive spatial autocorrelation for pulmonary TB incidence, SS+TB incidence and SS-TB incidence from 2005 to 2013 (P <0.0001). The Anselin’s Local Moran’s I identified the “hotspots” which were consistently located in the southwest regions composed of 20 to 28 districts, and the “coldspots” which were consistently located in the north central regions consisting of 21 to 27 districts. Analysis with the Getis-Ord Gi* statistic expanded the scope of “hotspots” and “coldspots” with different intensity; 30 county/districts clustered as “hotspots”, while 47 county/districts clustered as “coldspots”. OLS regression model included the “proportion of minorities” and the “per capita GDP” as explanatory variables that explained 64% the variation in pulmonary TB incidence (adjR² = 0.64). The SLM model improved the fit of the OLS model with a decrease in AIC value from 883 to 864, suggesting “proportion of minorities” to be the only statistically significant predictor. GWR model also improved the fitness of regression (adj R² = 0.68, AIC = 871), which revealed that “proportion of minorities” was a strong predictor in the south central regions while “per capita GDP” was a strong predictor for the southwest regions.

Conclusion

The SS+TB incidence of Xinjiang had a decreasing trend during 2005–2013, but it still remained higher than the national average in China. Spatial analysis showed significant spatial autocorrelation in pulmonary TB incidence. Cluster analysis detected two clusters—the “hotspots”, which were consistently located in the southwest regions, and the “coldspots”, which were consistently located in the north central regions. The exploration of socio-demographic predictors identified the “proportion of minorities” and the “per capita GDP” as predictors and may help to guide TB control programs and targeting intervention.

Below:  The trend of pulmonary TB incidence from 2005 to 2013

Below:  The incidence of pulmonary TB cases in Xinjiang, from 2005–2009

Below:  The incidence of pulmonary TB cases in Xinjiang, from 2010–2013

Below:  The incidence of SS+TB cases in Xinjiang, from 2005–2009

Full article at:  http://goo.gl/AABWrh

By:  

Atikaimu Wubuli, Xuemei Yao

Department of Epidemiology and Biostatistics, School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, China

Feng Xue

Center for Tuberculosis Control and Prevention, Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi, Xinjiang, China

Daobin Jiang, Qimanguli Wushouer

Department of Respiratory Medicine, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China

Halmurat Upur

Department of Traditional Uygur Medicine, Xinjiang Medical University, Urumqi, Xinjiang, China

Atikaimu Wubuli

Research Institution of Health Affairs Development and Reform, Xinjiang Medical University, Urumqi, Xinjiang, China

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The Variations of IL-23R Are Associated with Susceptibility & Severe Clinical Forms of Pulmonary Tuberculosis in Chinese Uygurs

Background

The incidence of tuberculosis (TB) remains high among Chinese Uygurs (a long-dwelling ethnic minority in Xinjiang) in China and the variants in IL-23R likely contribute to individual’s diversity in host response during infection.

Methods

A hospital based one to one matched case–control study was performed to assess the role of single nucleotide polymorphisms (SNPs) and copy number variation (CNV) of IL-23R in susceptibility and clinical features of pulmonary TB in Chinese Uygurs. Thirteen SNPs in IL-23Rwere genotyped by multiplex SNaPshot and a CNV was analyzed using Taqman real-time PCR in 250 pairs of pulmonary TB patients and controls.

Results

The SNP rs7518660 (OR = 4.78, 95 % CI 3.14–8.52) and the CNV in IL23R (OR = 2.75, 95 % CI 1.51–4.98) were significantly associated with susceptibility to pulmonary TB. The SNP rs11465802 (OR = 3.23, 95 % CI 1.85–5.62) was significantly associated with drug-resistance and the SNP rs1884444 (OR = 3.61, 95 % CI 1.90–6.85) was significantly related to cavitary lesion in Chinese Uygurs.

Conclusions

Our study shows for the first time that SNP and CNV in IL23R were associated with susceptibility, drug resistance and cavity formation of pulmonary TB. Our findings indicate that these IL-23R polymorphisms may be considered as risk factors for active pulmonary TB and its severe clinical forms.

Below:  Linkage Disequilibrium Plot of SNPs of IL-23R in the control group. Linkage disequilibrium (LD) blocks in the IL23R polymorphisms black squares indicate significant allelic association between groups of SNPs from the control subjects measured by the D' (left panels) and r 2 (right panels) statistics. A D' or r 2 cutoff of 0.8 is used for LD. High D' values are dark, low D' values are light

Below:  Copy number frequencies distribution of IL-23R between controls and pulmonary TB patients

Full article at:  http://goo.gl/OMqbqd

By:  Daobin Jiang¹²³, Atikaimu Wubuli¹, Xin Hu¹, Syed Ikramullah¹, Abudoujilili Maimaiti¹,Wenbao Zhang^4* and Qimanguli Wushouer^1*

¹Department of Pulmonology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China

²Department of Pulmonology, Xinjiang Uygur Autonomous Region Hospital of Traditional Chinese Medicine, Urumqi 830054, Xinjiang, China

³Xinjiang Uygur Autonomous Region Respiratory Physiology Pathology Key Laboratory, Urumqi 830054, Xinjiang, China

⁴Clinical Medical Research Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang, China

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Acceptability of Male Circumcision among College Students in Medical Universities in Western China: A Cross-Sectional Study

Male circumcision (MC) has been shown to reduce the risk of female to male transmission of HIV. The goal of this survey was to explore MC’s acceptability and the factors associated with MC among college students in medical universities in western China.

A cross-sectional study was carried out in three provinces in western China (Guangxi, Chongqing and Xinjiang) to assess the acceptability of MC as well as to discover factors associated with the acceptability among college students in medical universities. A total of 1,790 uncircumcised male students from three medical universities were enrolled in this study. In addition, 150 students who had undergone MC were also enrolled in the survey, and they participated in in-depth interviews.

Of all the uncircumcised participants (n = 1,790), 55.2% (n = 988) were willing to accept MC. Among those who accepted MC, 67.3% thought that MC could improve their sexual partners’ hygiene, 46.3% believed that HIV and sexually transmitted diseases (STDs) could be partially prevented by MC. The multivariable logistic regression indicates that MC’s acceptability was associated with three factors: the redundant foreskin (OR = 10.171, 95% CI = 7.629–13.559), knowing the hazard of having a redundant foreskin (OR = 1.597, 95% CI = 1.097–2.323), and enhancing sexual pleasure (OR = 1.628, 95% CI = 1.312–2.021). The in-depth interviews for subjects who had undergone MC showed that the major reason for having MC was the redundant foreskin (87.3%), followed by the benefits and the fewer complications of having MC done. In addition, most of these participants (65.3%) said that the MC could enhance sexual satisfaction.

MC’s acceptance among college students in medical universities is higher than it is among other populations in western China. An implementation of an MC programme among this population is feasible in the future.

Read more at:  http://goo.gl/MWktKo

By:

Junjun Jiang, Jinming Su, Xiaobo Yang, Wei Deng, Jiegang Huang, Bingyu Liang, Li Ye, Hao Liang

Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, 530021, China

Hao Liang

Guangxi Medical Research Center, Guangxi Medical University, Nanning, Guangxi, 530021, China

Mingbo Huang, Qian Wang

Department of Microbiology, Biochemistry, and Immunology, Morehouse School of Medicine, Atlanta, Georgia, 30310, United States of America

Bo Qin

The First Affiliated Hospital, Chongqing Medical University, Chongqing, 400016, China

Halmurat Upur

School of Public Health, Xinjiang Medical University, Xinjiang, 830011, China

Chaohui Zhong

School of Public Health, Chongqing Medical University, Chongqing, 400016, China

Qianqiu Wang

National Center for STD Control, Chinese Center for Disease Control and Prevention, Nanjing, 210042, China

Yuhua Ruan

State Key Laboratory for Infectious Disease Prevention and Control (SKLID), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, 102206, China


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Study on Gay Identity Status & Its Association with Sexual Behaviors among Men Who Has Sex with Men in Xinjiang Uygur Autonomous Region

From May to August in 2013, an anonymous questionnaire survey with convenience sampling was conducted among MSM in Urumqi, Kashgar, Aksu and Yining cities of Xinjiang. Those who were ≥ 16 years of age and claimed to have male-to-male sex behaviors were eligible for the survey. A total of 1 467 participants were recruited...

The MSM with positive ego-identity accounted for 44.7%, and positive social-identity accounted for 29.1%. For ego-identity, Uyghur MSM were less positive than Han MSM was 0.43 (0.32-0.58) ) ; those who were over 20 years of age when accepting their sexual orientation were less positive than those who were younger than 20 years of age when accepting their sexual orientation (OR (95%CI) was 0.61 (0.47-0.80) );and homosexuals were more positive than bisexuals was 1.98 (1.50-2.61) ). For social-identity, Hui MSM were less positive than Han MSM was 0.61 (0.42-0.88) ); those whose education level was higher than college were less positive than those with junior high education; famers/herdsmen were more positive than students was 4.17 (2.13-8.17) ); the divorced/widowed were more positive than the singles was 2.40 (1.34-4.29) ); those who were over 20 years of age when accepting their sexual orientation were less positive than those who were younger than 20 years of age when accepting their sexual orientation. Among the MSM with negative ego-identity and negative social-identity, the proportion of planning to get married with women was 66.8% (267/400) and 76.5% (306/400), respectively, which were higher than those with positive ego-identity (33.2% (133/400)) and positive social-identity (23.5% (94/400)) ; their proportion of intending to have offspring was 62.0% (287/463) and 73.4% (340/463), respectively, which were higher than those with positive ego-identity and social-identity (38.0% (176/463), 26.6% (123/463)) (χ(2) = 39.61 and 7.90, respectively, both P values were <0.05). Among the MSM with negative social-identity, the proportion of looking for male sexual partners in toilets or parks was 18.1% (188/1 040), in bathhouse or sauna was 17.3% (180/1 040), and through internet was 82.0% (853/1 040), which were higher than those with positive social-identity (8.9% (38/427), 9.8% (42/427) and 61.6% (263/427)) (χ(2) = 66.78, P < 0.01).

In 2013, the gay identity of MSM in Xinjiang was relatively poor, and the factors associated with it included ethnicity, occupation, marital status and education level. The MSM with negative identity tended to involve in risk sexual behaviors, and had increased risk of HIV infection.

Via:  http://ht.ly/S8dGm

By: Ni M1, Hu X, Li Z, Ma Y, Chen X, Hu X.
1Xinjiang Center for Disease Control and Prevention, Urumqi 830011, China.