Disparities and risks of sexually transmissible infections among men who have sex with men in China: a meta-analysis and data synthesis.

BACKGROUND: Sexually transmitted infections (STIs), including Hepatitis B and C virus, are emerging public health risks in China, especially among men who have sex with men (MSM). This study aims to assess the magnitude and risks of STIs among Chinese MSM. METHODS: Chinese and English peer-reviewed articles were searched in five electronic databases from January 2000 to February 2013. Pooled prevalence estimates for each STI infection were calculated using meta-analysis. Infection risks of STIs in MSM, HIV-positive MSM and male sex workers (MSW) were obtained. This review followed the PRISMA guidelines and was registered in PROSPERO. RESULTS: Eighty-eight articles (11 in English and 77 in Chinese) investigating 35,203 MSM in 28 provinces were included in this review. The prevalence levels of STIs among MSM were 6.3% (95% CI: 3.5-11.0%) for chlamydia, 1.5% (0.7-2.9%) for genital wart, 1.9% (1.3-2.7%) for gonorrhoea, 8.9% (7.8-10.2%) for hepatitis B (HBV), 1.2% (1.0-1.6%) for hepatitis C (HCV), 66.3% (57.4-74.1%) for human papillomavirus (HPV), 10.6% (6.2-17.6%) for herpes simplex virus (HSV-2) and 4.3% (3.2-5.8%) for Ureaplasma urealyticum. HIV-positive MSM have consistently higher odds of all these infections than the broader MSM population. As a subgroup of MSM, MSW were 2.5 (1.4-4.7), 5.7 (2.7-12.3), and 2.2 (1.4-3.7) times more likely to be infected with chlamydia, gonorrhoea and HCV than the broader MSM population, respectively. CONCLUSION: Prevalence levels of STIs among MSW were significantly higher than the broader MSM population. Co-infection of HIV and STIs were prevalent among Chinese MSM. Integration of HIV and STIs healthcare and surveillance systems is essential in providing effective HIV/STIs preventive measures and treatments. TRIAL REGISTRATION: PROSPERO NO: CRD42013003721

Design of agile supply chains including analysing the trade-off between number of partners and reliability

The reliability of supply partners is particularly vital in agile supply chains as it is vulnerable to the inability of a supply partner to meet its high responsiveness and flexibility requirements resulting in the disruption of the whole network. Disruption can have expensive and extensive results for the entire agile supply chain. To mitigate the risk of disruption and improve the reliability of the whole agile supply chain, decision-makers need to pay more attention to supply chain design and construction, whilst simultaneously taking into account the sourcing strategy decisions. This paper proposes a series of models for the design of agile supply chains using dynamic programming modelling. These provide decision-makers with a systematic way of analysing one of the key decisions of sourcing strategy, namely the trade-off between the number of supply partners and reliability. The efficacy of the models is demonstrated through their application to a Chinese bus and coach manufacturer by way of an empirical illustration. The results show that this approach is effective for this application and it can be applied in other related decision-making scenarios. The methods offered in this paper provide managers with a practical tool to design their agile supply chains while considering the trade-offs between the number of partners and the reliability of the entire agile supply chain