The Transmission Dynamics of Tuberculosis in a Recently Developed Chinese City

BACKGROUND: Hong Kong is an affluent subtropical city with a well-developed healthcare infrastructure but an intermediate TB burden. Declines in notification rates through the 1960s and 1970s have slowed since the 1980s to the current level of around 82 cases per 100 000 population. We studied the transmission dynamics of TB in Hong Kong to explore the factors underlying recent trends in incidence. METHODOLOGY/PRINCIPAL FINDINGS: We fitted an age-structured compartmental model to TB notifications in Hong Kong between 1968 and 2008. We used the model to quantify the proportion of annual cases due to recent transmission versus endogenous reactivation of latent infection, and to project trends in incidence rates to 2018. The proportion of annual TB notifications attributed to endogenous reactivation increased from 46% to 70% between 1968 and 2008. Age-standardized notification rates were projected to decline to approximately 56 per 100 000 in 2018. CONCLUSIONS/SIGNIFICANCE: Continued intermediate incidence of TB in Hong Kong is driven primarily by endogenous reactivation of latent infections. Public health interventions which focus on reducing transmission may not lead to substantial reductions in disease burden associated with endogenous reactivation of latent infections in the short- to medium-term. While reductions in transmission with socio-economic development and public health interventions will lead to declines in TB incidence in these regions, a high prevalence of latent infections may hinder substantial declines in burden in the longer term. These findings may therefore have important implications for the burden of TB in developing regions with higher levels of transmission currently.published_or_final_versio

Overview of Contraindicated Chinese Medicines for Pregnancy

Chinese medicines should be classified into drugs, which have both beneficial and harmful effects. For centuries, Chinese medicines have been widely used to relieve many symptoms and to treat complications during pregnancy. It is not clear how safe the Chinese medicines are being used during pregnancy and if there is any adverse effects to embryo-fetal development and prenatal and postnatal growth. Some Chinese medicines are indicated that they cannot be used in pregnancy. In this chapter, we will conduct a systematic review to summarize and characterize in details the Chinese medicines classified as contraindicated, not recommended and cautiously used for pregnancy in most updated version of Pharmacopeia of the People’s Republic of China. Clinical reports including clinical trials, case reports, case series and animal studies including short-term and long-term toxicity, specific organ toxicity and different species of the Chinese medicines will be studied. Unlike those pharmaceutical drugs not recommend for use during pregnancy because of known or suspected adverse or teratogenic effects evident by animal studies and/or clinical trials, most of the Chinese medicines were utilized for long history in culture which, however, has very limited scientific data regarding the adverse pregnant outcomes

Conformist Opinion Shift as an Accommodation-Motivated Cognitive Experience in Strong and Weak Situations

Singapore Management Universit

Perturbation of Retinoid Homeostasis Increases Malformation Risk in Embryos Exposed to Pregestational Diabetes

Funding. This work was supported by funding from Hong Kong Research Grants Council General Research Fund project reference 441606 and 474109 to A.S.W.S., Y.C.L., C.C.W., P.J.M. and A.J.C..Peer reviewedPostprin