Evaluating modified effects of family factors on intervention to protect primary school students from the impact of heatwave

Identifying the factors that may impact intervention effectiveness of primary students is crucial for developing targeted intervention strategies on heatwave adaption.The purpose of the study was to assess how the family factors could affect the intervention effects of primary school students to adapt heatwave,using the data from a previously conducted primary school-based intervention study.The study recruited 648 students(9-13 years old)and their parents from two primary schools in Dongtai of Jiangsu province,China.From May to September 2017,a 5-mon intervention for enhancing knowledge,attitude and practice(KAP)was implemented at the intervention school.The students'KAP scores and the family-related information were measured by designed self-administered questionnaires at intervention school and control school separately before and after intervention.The effects of the intervention were explored through the propensity score matching and difference-in-difference method(PSM-DID),and stratifed analysis were conducted by family factors.The overall KAP score increased by 2.391(95%CI:1.881,2.902)after intervention,which shows that the intervention was effective.The students whose parents with higher school educational attainment,parents with employment,and household number≤3 achieved significantly higher increment of KAP scores than their counterparts.Although students whose parents in marriage achieved higher score increasing than parents not in marriage,the difference was non-significant.Our findings indicated that parental education status,working status and the household size were the influence factors of heatwave adaption interventions for primary school students.Future interventions should take parental education status,working status and household size into account to improve the effectiveness of heatwave adaption intervention for primary school students.

Cost-effectiveness analysis of the prevention of mother-to-child transmission of HIV

Background:The number of HIV-positive pregnant women accounted for about 10% of China’s total over the past few years in Liangshan Prefecture, Sichuan province in China. Although cost-effectiveness of the PMTCT of HIV have been evaluated in other previous studies, no specific study has been conducted in Liangshan prefecture, nor has the expenses paid individually by HIV-positive pregnant women been included. The purpose of this study was to evaluate both the short-term and long-term cost-effectiveness of PMTCT of HIV in Liangshan Prefecture from the social perspective.Methods:From December 2018 to January 2019, individual expenses and the other costs were collected: individual expenses of 133 recruited HIV-positive pregnant women registered in the National Information System of Prevention of Mother-to-Child Transmission of HIV, Syphilis, and HBV, and the other costs from local maternal and child healthcare hospitals, Centers for Disease Control and Prevention, and general hospitals. The costs, the number of pediatric infections averted from being HIV infected were analyzed. And, Life years gained by pediatric infections averted were calculated by using a life table. Besides, Direct benefit was calculated through a Markov mode. Furthermore, One-way sensitivity analysis was conducted for key variables affecting the benefit–cost ratio.Results:The estimated number of pediatric infections averted was 164.The total cost was USD 114.1 million, including direct medical costs, direct non-medical costs, and indirect costs, which were USD 54.2 million, USD 53.4 million, and USD 6.5 million, respectively. 630.6 person-years discounted to 2017 were gained at a 3% annual rate, and cost per life year gained was USD 1809.50. Direct benefits were USD 198.4 million, indirect benefits USD 82.5 million, and the benefit–cost ratio was 1.5. The sensitivity analysis showed that if PMTCT costs hypothetically ranged from USD 85.6 million to USD 142.6 million, benefit–cost ratio would vary from 1.0 to 2.3.Conclusions:PMTCT of HIV in Liangshan Prefecture was very cost-effective. It was a great economic burden of PMTCT on HIV-positive pregnant women and their families to take individual expenses. Therefore, it could be suggested that individual expenses should be covered as much as possible by different types of financing.

Levels of vaccination coverage among HIV-exposed children in China: a retrospective study

Background:Vaccination is crucial for human immunodeficiency virus(HlV)-exposed children because of their increased risk of morbidity and mortality from various vaccine-preventable diseases.However,studies have shown that they are at high risk of incomplete vaccination.Although China has developed prevention of mother-to-child transmission(PMTCT)of HIV programs substantially over the past decades,few studies have investigated the immunization levels of Chinese HIV-exposed children.Therefore,we aimed to evaluate vaccination coverage and its associated factors among HIV-exposed children in China during 2016-2018.