Differences in perception of dysentery and enteric fever and willingness to receive vaccines among rural residents in China.

BACKGROUND: Enteric diseases including dysentery and enteric fever remain significant public health problems in China. While vaccines offer great potential in controlling these diseases, greater understanding of factors influencing acceptance of vaccines is needed to create effective enteric disease control programs in rural China. DESIGN: Cross-sectional quantitative study with randomly sampled households from two sites in China, one experiencing high rates of shigellosis (Zengding) and the other of typhoid/paratyphoid (Lingchuan). METHODS: Sociobehavioral survey data were collected through face-to-face interviews from 501 respondents (56% female) in Zhengding regarding dysentery and 624 in Lingchuan (51% female) regarding enteric fever. Vaccine acceptability was measured by expressed need for vaccination and willingness to pay. Comparative and associative analyses were conducted to assess disease perception, vaccination service satisfaction, likelihood of improvements in water and sanitation, and vaccine acceptability. RESULTS: Nearly all respondents in Lingchuan considered enteric fever to be prevalent in the community, while only one half of the respondents in Zhengding considered dysentery to be problematic (p < 0.01). Nevertheless, more respondents in Zhengding were fearful that a household member would acquire dysentery than were Lingchuan respondents worried that a household member would acquire enteric fever (p < 0.01). Perceived vulnerability of specific subgroups (odds ratios ranging from 1.6 to 8.1), knowing someone who died of the disease (odds ratio reached infinity) and satisfaction with past vaccination services (odds ratios reached infinity) were consistently associated with perceived need for vaccines of target populations of all age groups while the association between perception of sanitary improvement and vaccine need was limited. Perceived need for a vaccine was associated with willingness to pay for the vaccine. CONCLUSIONS: Perceptions of enhanced vulnerability of specific subgroups to a disease and satisfactory experiences with vaccination services may increase the perceived need for a vaccine, leading to increased willingness to pay for vaccine. Vaccines are not perceived as important for the elderly

Health care preferences for children with typhoid fever in two slum communities in Karachi, Pakistan.

This study examined health care preferences and influences in response to initial and persistent symptoms of typhoid fever among children in two slum communities in Karachi, Pakistan. Typhoid fever in this area is endemic and has a high rate of multi-drug resistantce. The study involved a household survey of 502 respondents. Private practitioners, including qualified medical specialists, were the preferred providers for initial symptoms, with government and private hospitals preferred for continuing symptoms. A number of cases continued to select initial health care choices regardless of the severity of symptoms. The findings point to factors of cost, access to care, previous use of a provider and perceived quality of care as key influences regarding health care choices. These findings suggest that cases of typhoid fever in these communities are at risk for not receiving appropriate diagnoses and treatment for children who are at risk for severe cases of multi-drug resistant disease. Suggestions are made for improving the care of children with typhoid in this context

Experimental and theoretical investigation of the electronic structure of Cu2O and CuO thin films on Cu(110) using x-ray photoelectron and absorption spectroscopy

The electronic structure of Cu2O and CuO thin films grown on Cu(110) was characterized by X-ray photoelectron spectroscopy (XPS) and X-ray absorption spectroscopy (XAS). The various oxidation states, Cu0, Cu+, and Cu2+, were unambiguously identified and characterized from their XPS and XAS spectra. We show that a clean and stoichiometric surface of CuO requires special environmental conditions to prevent loss of oxygen and contamination by background water. First-principles density functional theory XAS simulations of the oxygen K edge provide understanding of the core to valence transitions in Cu+ and Cu 2+. A novel method to reference x-ray absorption energies based on the energies of isolated atoms is presented.Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicada

Experimental and theoretical investigation of the electronic structure of Cu2O and CuO thin films on Cu(110) using x-ray photoelectron and absorption spectroscopy

The electronic structure of Cu2O and CuO thin films grown on Cu(110) was characterized by X-ray photoelectron spectroscopy (XPS) and X-ray absorption spectroscopy (XAS). The various oxidation states, Cu0, Cu+, and Cu2+, were unambiguously identified and characterized from their XPS and XAS spectra. We show that a clean and stoichiometric surface of CuO requires special environmental conditions to prevent loss of oxygen and contamination by background water. First-principles density functional theory XAS simulations of the oxygen K edge provide understanding of the core to valence transitions in Cu+ and Cu 2+. A novel method to reference x-ray absorption energies based on the energies of isolated atoms is presented.Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicada

Adults\u27 perceived prevalence of enteric fever predicts laboratory-validated incidence of typhoid fever in children

This study was undertaken to develop a model to predict the incidence of typhoid in children based on adults’ perception of prevalence of enteric fever in the wider community. Typhoid cases among children, aged 5-15 years, from epidemic regions in five Asian countries were confirmed with a positive Salmonella Typhi culture of the blood sample. Estimates of the prevalence of enteric fever were obtained from random samples of adults in the same study sites. Regression models were used for establishing the prediction equation. The percentages of enteric fever reported by adults and cases of typhoid incidence per 100,000, detected through blood culture were 4.7 and 24.18 for Viet Nam, 3.8 and 29.20 for China, 26.3 and 180.33 for Indonesia, 66.0 and 454.15 for India, and 52.7 and 407.18 for Pakistan respectively. An established prediction equation was: incidence of typhoid (1/100,000= −2.6946 + 7.2296 × reported prevalence of enteric fever (%) (F=31.7, p2=0.992). Using adults’ perception of prevalence of disease as the basis for estimating its incidence in children provides a cost-effective behavioural epidemiologic method to facilitate prevention and control of the disease

Adults' Perceived Prevalence of Enteric Fever Predicts Laboratory-validated Incidence of Typhoid Fever in Children

This study was undertaken to develop a model to predict the incidence of typhoid in children based on adults' perception of prevalence of enteric fever in the wider community. Typhoid cases among children, aged 5-15 years, from epidemic regions in five Asian countries were confirmed with a positive Salmonella Typhi culture of the blood sample. Estimates of the prevalence of enteric fever were obtained from random samples of adults in the same study sites. Regression models were used for establishing the prediction equation. The percentages of enteric fever reported by adults and cases of typhoid incidence per 100,000, detected through blood culture were 4.7 and 24.18 for Viet Nam, 3.8 and 29.20 for China, 26.3 and 180.33 for Indonesia, 66.0 and 454.15 for India, and 52.7 and 407.18 for Pakistan respectively. An established prediction equation was: incidence of typhoid (1/100,000= -2.6946 + 7.2296 7 reported prevalence of enteric fever (%) (F=31.7, p&lt;0.01; R2=0.992). Using adults' perception of prevalence of disease as the basis for estimating its incidence in children provides a cost-effective behavioural epidemiologic method to facilitate prevention and control of the disease