Low awareness of influenza vaccination among pregnant women and their obstetricians: a population-based survey in Beijing, China

We assessed how an awareness of influenza vaccination might influence both the willingness of pregnant women to be vaccinated and the readiness of obstetricians to recommend antenatal influenza vaccination in Beijing, China. From March to April 2016, we surveyed pregnant women who were attending antenatal clinics at eight hospitals in Beijing, along with obstetricians at the same clinics. Demographic, attitudinal, and behavioral information regarding influenza vaccination were collected using structured questionnaires. Consent and completed questionnaires were obtained from 988 of 1009 pregnant women and 165 of 173 obstetricians. Only 113 (11.4%) pregnant women reported being willing to receive an influenza vaccine during their pregnancies. Willingness to receive an influenza vaccination was positively associated with ever having a history of vaccination or influenza (aOR=6.74, 95%CI: 1.72-26.4, P=0.006), perceiving benefits of vaccination (aOR=1.67, 95%CI: 1.00-2.79, P=0.050), and having a higher level of influenza knowledge (aOR=82.2, 95%CI: 21.7-311.1, P<0.001). Among obstetricians, only 19.4% reported being willing to recommend influenza vaccination to their pregnant patients and 15.2% reported knowledge that influenza vaccination during pregnancy was recommended by China’s National Health Commission. Neither pregnant women nor their obstetricians were aware of Chinese government recommendations that antenatal influenza vaccination should be encouraged and provided. Pregnant women and their obstetricians were ill-informed of the relevant evidence. It is in emergent need to train and disseminate the updated evidence on influenza vaccination to obstetricians. It also warranted more high-quality trials regarding influenza vaccination during pregnancy to address public concern

Sociodemographic disparities in gastric cancer and the gastric precancerous cascade: A population-based study

Background: Gastric carcinogenesis is a multistep process initiating with chronic gastritis and progressing through atrophy, intestinal metaplasia, and dysplasia to carcinoma. This study aims to comprehensively investigate sociodemographic disparities in each stage of gastric carcinogenesis and estimate to what extent the inequalities could be ascribed to risk factors of gastric cancer (GC). Methods: We used the baseline data from a community-based study in China's high-risk areas, totalling 27094 participants. Gastric mucosa status was ascertained by endoscopy and biopsies. An overall socioeconomic status (SES) variable was generated by latent class analysis. We calculated relative risks (RRs) and 95% confidence intervals (CIs) using modified Poisson regression to assess associations of sociodemographic factors with each cascade stage. We estimated the percentage of the excess risk for neoplastic lesions among vulnerable populations that can be explained by established risk factors. Results: Age and sex showed associations with all gastric lesions, whose RRs increased with lesion progressing. Compared with individuals without schooling, the RRs of neoplastic lesions for people with primary, secondary, and post-secondary education were 0·86 (95% CI 0·76–0·97), 1·00 (95% CI 0·88–1·13), and 0·70 (95% CI 0·47–1·03), respectively. Participants with medium SES had a lower risk of neoplastic lesions than people in the low SES group (RR 0·83, 95% CI 0·74–0·93). GC risk factors could explain 33·6% of the excess risk of neoplastic lesions among men and a small proportion of the disparities among SES groups. Interpretation: Age and sex were essential sociodemographic factors for GC and precursor diseases. Individuals with low educational levels or SES were more likely to have neoplastic lesions. About one-third of the sex difference and a slight fraction of the socioeconomic inequalities could be attributed to included risk factors. Funding: Sanming Project of Medicine in Shenzhen, National Natural Science Foundation, and Special Project of Bejing-Tianjin-Hebei Basic Research Cooperation