Counties In Shandong Province Research Articles

Financial protection of rural health insurance for patients with hypertension and diabetes: repeated cross-sectional surveys in rural China.

BackgroundThe New Cooperative Medical Scheme (NCMS) in rural China has been expanding in both population coverage and benefit package. China has also established an essential medicine policy in recent years to further reduce patients’ medical expenditures and financial burden. This study aims to evaluate the impact of these policies on reducing medical expenditures and financial burden of patients diagnosed with hypertension and diabetes.MethodsThis study used repeated cross-sectional surveys in 2011 and 2012 in three counties of Shandong Province. Outpatient and inpatient service expenditures and catastrophic health expenditures (CHE) were measured and analyzed.ResultsMedical expenditures for outpatient services significantly increased for hypertensive and diabetic patients within a 1 year period, while inpatient service expenditures remained unchanged. Although NCMS increased its reimbursement rate, hypertensive and diabetic patients still heavily suffered CHE from both outpatient and inpatient services. Outpatient services were more important factors than inpatient services contributing to non-communicable chronic diseases (NCD) patients’ financial burden.ConclusionsThe effects of NCMS expansion have been offset by the rapid escalation of medical expenditures. More attention should be paid to the design of NCMS benefit package to cover NCD outpatient services. There is also an urgent need to reform the current Fee for Service to other provider payment methods in order to control the escalating NCD medical expenditures.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1735-5) contains supplementary material, which is available to authorized users.

Analysis of hemophilia case information of Shandong province

To summarize the general condition, regional distribution, prevalence and clinical characteristics of Shandong province based on hemophilia case registry information. A retrospective study was carried out on 1979 hemophilia patients registered at Shandong Hemophilia Registration Center. The 1979 cases have included 1704 hemophilia A and 275 hemophilia B patients. Hemophilia A was characterized as severe in 1021 patients (59.9%), moderate in 483 patients (28.4%), and mild in 200 patients (11.7%); while hemophilia B was characterized as severe in 125 patients (45.4%), moderate in 116 patients (42.2%), and mild in 34 patients (12.4%). The median age was 23 years (ranging from 1 month to 81 years), and most were young patients. Joint deformity occurred in 963 patients, and 948 patients had a family history of hemophilia. All counties of Shandong province had patients except for Changdao county and Fushan district of Yantai city. The prevalence of Heze city and Dongying city (3.39/100 000 and 3.05/100 000, respectively) were relatively higher. The above data revealed epidemiological and clinical characteristics of Shandong Province. Patient-centered registry system allowed a more detailed and accurate patient information, and promoted the comprehensive care of hemophilia, which also suggested the necessity for the establishment and improvement of the National Hemophilia Registry System.

Prevalence and risk factors of suicide in a rural area of Shandong province in mainland China: a case control study

Objective: Suicide is a major public health problem in China, particularly in rural areas. This study aimed to examine the rate and the risk factors for suicide in a rural area of China. Methods: The mortality data of two counties in Shandong Province from January 1st, 2004 to December 31st 2005 were used. Death information was collected via face-to-face interview with informant(s). Psychological autopsy was conducted on 137 completed suicides and 137 matched controls died from other illnesses. Chi-square/Fisher exact and multiple logistic regression were used for bivariate analyses and predictor analyses, respectively. Results: The suicide rate was 20.90 per 100,000 persons per year with almost equal rates of males and females. Among those with the age over 40 years old, the suicide rate in males was significantly higher than that in females. The peak of suicide fell in the age group of 70-79 years for males and the age group of ≥ 80 years for females. The most commonly used method for suicide was pesticide ingestion (76.7%). Poor interpersonal relationship ( OR =12.79), childhood adversities ( OR =7.26), a history of mental illness ( OR =5.95), adverse life event(s) within 1 year prior to death ( OR =3.19), and unstable extravert personality traits ( OR =6.12) were independent risk factors for suicide. Male gender positively interacted with majority of these risk factors, especially with a history of mental illness ( OR =17.89). Advanced age positively interacted with all independent risk factors, with a history of mental illness having the largest OR of 1.51 as every 10 year of age advancement. In bivariate analyses, a history of previous suicide attempt ( OR =13.06), a family history of suicide ( OR =7.08), and unstable introvert personality trait ( OR =1.83) were also associated with increased risk for suicide; and stable extravert personality trait ( OR =0.21) was associated with decreased risk for suicide. Conclusions: In this rural population of mainland China, the risk for suicide was almost equal in both males and females with the elderly having the highest risk. The positive interactions of advanced age and male gender with independent risk factors suggest that suicide prevention strategies targeting specific groups with different risk factors are essential.

Do different parenting patterns impact the health and physical growth of 'left-behind' preschool-aged children? A cross-sectional study in rural China.

Many migrants from rural China seek work in urban areas and leave their children in their home villages to be raised by relatives. These children are often referred to as 'left-behind children'. Parental migration tends to have a profound impact on a child's growth. This study sought to assess the prevalence of illness and malnutrition among children in rural areas raised with different parenting patterns and to explore factors affecting their health and development. A cross-sectional survey was conducted to examine the physical health of children raised with different parenting patterns and to explore associated risk factors. In total, this study examined 735 children ages 3-6 years in eight rural villages in two counties of Shandong Province. Their primary caregivers were interviewed with a semi-structured questionnaire. Anthropometric measurements of the children were taken and their nutritional status was determined according to WHO Child Growth Standards. This study found a relatively high prevalence of wasting, overweight and obesity among left-behind children. After potential confounders were controlled for, the parenting pattern, annual household income and health literacy of the primary caregiver significantly influenced the health and developmental indicators of children. This study highlighted the impact of the characteristics of the primary caregiver on a child's health and development and the importance of practical interventions for preschool-aged children who are left behind and raised with different parenting patterns.

An Initial Research on Output Well-Being Index Applied to Residents in Wealthy Counties from China

Sampling from three wealthy counties in Shandong province (n = 855), this research examined the characteristics of an output well-being index, and the index shows good internal consistency reliability and ideal construct validity. It could be used as an instrument to evaluate the quality of life of Chinese citizens. The index was applied to an analysis of the quality of life of the residents from three wealthy counties. It shows that the level of the quality of life of the rural residents is higher than that of the urban residents, but the level of some indicators is imbalanced, and the levels of subjective and objective indicators are consistent. These characteristics of the well-being index of the rural residents from the wealthy counties are closely related with the level of the local economy and social development. It is advised that the output well-being index could be used to evaluate the degree of citizen’s need that was met and the degree of human being’s all-over development that was realized. It could also be used as an important policy instrument for the policy makers’ good governance.

An Initial Research on Output Well-Being Index Applied to Residents in Wealthy Counties From China

Abstract Sampling from three wealthy counties in Shandong province (n = 855), this research examined the characteristics of an output well-being index, and the index shows good internal consistency reliability and ideal construct validity. It could be used as an instrument to evaluate the quality of life of Chinese citizens. The index was applied to an analysis of the quality of life of the residents from three wealthy counties. It shows that the level of the quality of life of the rural residents is higher than that of the urban residents, but the level of some indicators is imbalanced, and the levels of subjective and objective indicators are consistent. These characteristics of the well-being index of the rural residents from the wealthy counties are closely related with the level of the local economy and social development. It is advised that the output well-being index could be used to evaluate the degree of citizen’s need that was met and the degree of human being’s all-over development that was realized. It could also be used as an important policy instrument for the policy makers’ good governance.

Integrating tuberculosis screening into annual health examinations for the rural elderly improves case detection.

To assess the feasibility and effects of identifying tuberculosis (TB) cases by integrating TB screening into routine health examinations for the elderly in rural China. Three counties in Shandong Province were randomly selected for TB screening among three groups of elderly individuals (aged ⩾60 years) at high risk for TB: 1) those with symptoms of TB, 2) patients with type 2 diabetes mellitus (DM), and 3) close contacts of TB cases. Individuals with X-rays suggestive of TB were referred to the county TB dispensary for further investigation. Among the 93 094 elderly residents who underwent health examinations, 9044 (9.7%) were identified as high risk for TB. TB detection rates were 0.87 per 1000 among those who showed TB symptoms only and 3.36/1000 among those with DM only; however, the rate was significantly higher (115/1000) among those who had both DM and TB symptoms. No TB cases were identified from the close contacts group. Integrating TB screening into annual health examinations for the elderly in rural areas was effective in identifying new cases, especially among elderly DM patients with TB symptoms.

Sleep disturbance and attempted suicide in rural China: a case-control study.

This study aimed to examine the association between sleep disturbance and attempted suicide in rural China. The study group included 409 suicide attempters from six rural counties in Shandong Province, China and an equal number of controls matched on age, sex, and residency. Sleep disturbance was assessed by the item "sleep restless" in the Center for Epidemiologic Studies Depression Scale. Sleep disturbance was reported more frequently in suicide attempters than in controls (1-2 days/week, 9.0% vs. 4.4%; 3-4 days/week, 11.5% vs. 2.4%; ≥5 days/week, 30.3% vs. 7.5%, χ 2= 128.72, p < 0.001). Suicide risk was significantly associated with increased frequency of sleep disturbance (OR = 3.98, 95% CI = 1.62-9.74 for 1-2 days/week; OR = 3.28, 95% CI = 1.21-8.84 for 3-4 days/week; OR = 2.41, 95% CI = 1.26-4.60 for ≥5 days/week) even after adjusting for potential psychosocial confounding factors and mental disorders. This finding may have important implications for early intervention and prevention of suicide.

A study of spatiotemporal delay in hand, foot and mouth disease in response to weather variations based on SVD: a case study in Shandong Province, China.

BackgroundA large number of hand, foot and mouth disease (HFMD) outbreaks was reported during 2008 in China. However, little is known about the effects of meteorological conditions on different temporal and spatial scales on HFMD incidence in children. The aim of this study was to explore the relationship between meteorological data on various temporal and spatial scales and HFMD incidence among children in Shandong Province, China.MethodsThe association between weekly HFMD cases and meteorological data on different temporal and spatial scales in Shandong Province from May 2008 to July 2008 and September 2008 to October 2008 was analyzed, using buffer analysis and the singular value decomposition method.ResultsWind speed within a 50-km buffer circle of counties in Shandong Province with two-week lag and RH within a 10-km buffer circle of counties with eight-week lag were significantly associated with HFMD incidence. We found a positive correlation between wind speed within the 50-km buffer circle in the prior two weeks and wind speed within the province in the prior one week.ConclusionsThis study revealed strong associations between HFMD incidence in children and wind speed and RH. Thus, meteorological anomalies in the prior two or eight weeks could be used as a valid tool for detecting anomalies during the peak periods of infectious disease.

Smoking, smoking cessation and tobacco control in rural China: a qualitative study in Shandong Province.

BackgroundSmoking prevalence is high in China and even higher among rural residents. The aims of this study were: 1) to gain insights into the motivations of tobacco use and barriers to smoking cessation among rural village residents; 2) to understand the current tobacco control measures in the rural villages and barriers encountered or perceived for implementation.MethodsQualitative semi-structured face-to-face interviews and focus group discussions were conducted of 59 rural villagers including 37 village residents, 10 village leaders and 12 village doctors in three counties in Shandong Province, China.ResultsSmoking initiation was most often out of curiosity when seeing others smoke, but pressure from cigarette sharing and gifting custom was the major barrier to smoking cessation. The most important reason for quitting successfully was a detrimental health problem. Although many attempted to quit at the advice of other family members, relapses were common and few were able to quit completely and for long-term unless accompanied by significant health issues. Although doctor’s advice to quit is effective, many doctors do not offer advice to all patients. There is a lack of true understanding of the harm of smoking and second-hand smoking among the villagers and a lack of access to and knowledge of effective smoking cessation tools among both smokers and village doctors. Tobacco control activities at villages were rare and infrequent.ConclusionsThis study highlighted the need to develop tobacco control measures that reflect the unique culture in rural China. Smoking cessation measures are not likely to achieve large scale effect unless the prevailing cigarette sharing and gifting custom is drastically changed. More educations of the hazards of smoking and second-hand smoking to village residents and educations of effective smoking cessation treatment to both village residents and healthcare providers are needed.

Physical illness and suicide risk in rural residents of contemporary China: a psychological autopsy case-control study.

Physical illness is linked with an increased risk of suicide; however, evidence from China is limited. To assess the influence of physical illness on risk of suicide among rural residents of China, and to examine the differences in the characteristics of people completing suicide with physical illness from those without physical illness. In all, 200 suicide cases and 200 control subjects, 1:1 pair-matched on sex and age, were included from 25 townships of three randomly selected counties in Shandong Province, China. One informant for each suicide or control subject was interviewed to collect data on the physical health condition and psychological and sociodemographic status. The prevalence of physical illness in suicide cases (63.0%) was significantly higher than that in paired controls (41.0%; χ² = 19.39, p < .001). Compared with suicide cases without physical illness, people who were physically ill and completed suicide were generally older, less educated, had lower family income, and reported a mental disorder less often. Physical illness denoted a significant risk factor for suicide with an associated odds ratio of 3.23 (95% CI: 1.85-5.62) after adjusted for important covariates. The elevated risk of suicide increased progressively with the number of comorbid illnesses. Cancer, stroke, and a group of illnesses comprising dementia, hemiplegia, and encephalatrophy had a particularly strong effect among the commonly reported diagnoses in this study population. Physical illness is an important risk factor for suicide in rural residents of China. Efforts for suicide prevention are needed and should be integrated with national strategies of health care in rural China.

A cross sectional survey on the prevalence of active pulmonary tuberculosis in three ‘key’ elderly population

To conduct a survey on the prevalence of active pulmonary tuberculosis among 65 year olds or above. Study subjects would include those with characteristics of TB suspicious symptoms, diabetes and close contacts. Purpose-sampling method was applied to choose 3 counties in Shandong province as the study sites, relying on the local basic public health service, for those elderly under 65 years old or above. The study team would introduce the process and contents of this study to the subjects followed by chest X-ray and sputum smears on those registered tuberculosis suspects, patients with diabetes, TB close contacts in the past 2 years, from January to September, 2013. 82 active pulmonary TB cases were identified among 9 041 cases who received the examination, with a crude prevalence rate as 9.1‰. From patients having both suspicious TB and diabetic symptoms, patients with diabetes or having suspicious symptoms of TB, the prevalence rates of active TB were 115‰, 3.4‰, 0.9‰ respectively. No active pulmonary TB case was found in the TB close contacts, patients with diabetes, or those people with suspicious TB symptoms. TB prevalence rates among all the above mentioned groups were significantly different (χ(2) = 697.478, P = 0.000). Prevalence rate of active pulmonary TB with diabetes was 18 times (RR = 17.951) higher than those non-diabetic patients, and 2 times higher than those with suspicious symptoms (RR = 3.860). Results from single factor analysis showed that diabetes were closely related to the prevalence of pulmonary tuberculosis(χ(2) = 46.637, P = 0.000), the longer duration of diabetes and the higher risk of tuberculosis(RR > 1). Our data showed that active pulmonary TB prevalence was high in elderly diabetes patients which suggesting that 'Key crowd screening program' should be introduced into case-finding strategy on TB, with special focus on TB patients with diabetes or those people having suspicious symptoms of TB.

An Analysis of the Relationship between the Finance and the Economic Growth of Counties in China's Shandong Province

Based on the theory of financial development and economic growth, an investigation has been conducted to reveal the contradictions and correlations between the finance and economic growth in the counties of China's Shandong Province. This paper has proposed some countermeasures through the investigation of counties of Shandong Province.

Analysis on prevalence states and associated factors of hypertension and prehypertension among adults in Shandong province

To analyze the prevalence states of hypertension and prehypertension and to explore relevant influencing factors among adult residents in Shandong province. 15 600 residents aged between 18 and 69 from 20 counties in Shandong province were selected by multiple stratified and clustered sampling method from July to September, in 2011, to acquire related information by questionnaire survey and physical measurement. The prevalence of hypertension and prehypertension was estimated by special statistic method used to deal with complex sampling data, and the relevant influencing factors were also analyzed. A total of 15 350 subjects were actually completed the survey, with age at (41.4 ± 14.1) years old. The average systolic blood pressure and diastolic blood pressure were 121.1(95%CI: 119.7-122.4) and 78.8(95%CI: 77.8-79.9) mmHg (1 mmHg = 0.133 kPa) respectively. And also 3776 hypertension patients and 5721 subjects with prehypertension were detected, and the weighting prevalence of hypertension and prehypertension were 23.4% (95%CI: 20.9%-26.0%) and 37.1% (95%CI: 34.7%-39.5%) with adjustive prevalence at 20.7% and 36.5% respectively. The multiple SURVEYLOGISTIC analysis showed that age above 40 years old (OR = 3.24, 95%CI: 2.56-4.10), overweight(OR = 2.22, 95%CI: 1.70-2.89) and obesity(OR = 5.84, 95%CI: 3.54-9.66), smoking history(OR = 1.82, 95%CI: 1.03-3.23), constantly drinking (OR = 1.71, 95%CI: 1.08-2.70), diabetes (OR = 1.99, 95%CI: 1.29-3.07), abnormal TC(OR = 1.64, 95%CI: 1.24-2.17), abnormal TG(OR = 1.75, 95%CI: 1.24-2.48) and high 24 h urine Na/K ratio (OR = 1.05, 95%CI: 1.02-1.08) were risk factors of hypertension, while education equal to or above junior middle school (OR = 0.68, 95%CI: 0.52-0.89) was protective factor of hypertension; age above 40 years old (OR = 1.49, 95%CI: 1.15-1.91), overweight(OR = 1.76, 95%CI: 1.25-2.48) and obesity (OR = 3.50, 95%CI: 2.05-5.97), abnormal TC (OR = 1.54, 95%CI: 1.10-2.14), abnormal TG (OR = 1.79, 95%CI:1.25-2.56) and high 24 h urine Na/K ratio (OR = 1.02, 95%CI: 1.01-1.04) were risk factors of prehypertension, while female (OR = 0.41, 95%CI: 0.31-0.56) and education level equal to or above junior middle school (OR = 0.67, 95%CI: 0.52-0.87) were protective factors. The hypertension, especially prehypertension tends to be at high prevalence states currently, which may be affected by many factors.

Molecular epidemiology of Orientia tsutsugamushi in chiggers and ticks from domestic rodents in Shandong, northern China

BackgroundScrub typhus is endemic to a 13,000,000-km2 area of the Asia-Pacific region, and causes an annual incidence of 1 million people. The mortality rate of scrub typhus ranges from 6.1% to 25% in Southeast Asia. Natural infection of Orientia tsutsugamushi has been identified in domestic rodents in Shandong Province. However, infestation of chiggers and ticks on the domestic rodents and prevalence and genotypes of O. tsutsugamushi in these Acarina remain unclear.MethodsDuring September 2010 to March 2012, 3134 chiggers and 89 ticks were collected from domestic rodents captured in three counties of Shandong Province. We amplified and sequenced the 56-kDa type-specific antigen gene of O. tsutsugamushi from DNA samples of these Acarina and designated to genotype according to sequence analysis.ResultsOverall, the infestation rate of chiggers on domestic rodents was 17.0%, and the chigger index was 5.38. The infestation rate of ticks on rodents was 3.1%. Natural infection of O. tsutsugamushi was found in Leptotrombidium taishanicum, L. linhuaikongense, L. intermedium, L. scutellare, L. palpale, and Ixodes spp., the minimum positive rates of which were 5.9%, 3.2%, 1.2%, 0.8%, 0.8%, and 2.2%, respectively. Kawasaki-like genotypes were predominant in chiggers and ticks on domestic rodents, which were detected from L. taishanicum, L. intermedium, L. scutellare, L. palpale, and Ixodes spp. Shimokoshi-like genotype was detected from L. palpale.ConclusionsIn the present study we investigated the infestation of chiggers and ticks on domestic rodents in Shandong Province, and identified the prevalence and genotypes of O. tsutsugamushi in the Acarina. Infestation of vector chiggers in domestic rodents, prevalence of O. tsutsugamushi in infested chiggers, and high nucleotide homologies among the O. tsutsugamushi sequences from the Acarina, their animal hosts and scrub typhus patients, implied that domestic rodents may play an important role in the transmission of scrub typhus in Shandong, China. Further studies are needed to verify the vector significance of chiggers and ticks that tested positive for O. tsutsugamushi, and to assess the risk of human exposure to chiggers and ticks on domestic rodents.

Fishpond Reconstruction Based on Water Quality Security for the East Route Project of Diverting Water from the South to the North of China—With an Example of Weishan County Shandong Province

Weishan County gets its name for Weishan Lake, also known as Nansi Lakes because it consists of the four major lakes (Small Weishan, Zhaoyang, Dushan and Nanyang). Weishan Lake is an important water source in Shandong Province and one of the main impounded lakes in the East Route Project of Water Diversion from the South to the North. In order to ensure the water quality, the relevant cities and counties of Shandong Province attach great importance to water pollution control around the Weishan Lake. According to field investigation and analysis of present situation of the project area, common problems existed in pond culture along Weishan Lake were found out, meanwhile the targeted solutions for them were given aiming at the transformation of snakehead farming pond by ecological engineering, that focus on an establishment of the demonstration base so as to demonstrate a mode of aquiculture that is environmentally friendly, to enhance ecological health of aquiculture for sankeheaded, and to provide a strong guarantee for the East Route Project of Water Diversion from the South to the North to have a good water quality.

Determinants of health care-seeking delay among tuberculosis patients in Shandong Province, China

It is beneficial for tuberculosis patients to seek health care in time. The aim of this study was to understand the situation of initial health care-seeking delay among tuberculosis patients in eastern China, and explore its influencing factors, to provide a basis for formulating related polices and reducing its transmission. A cross-sectional survey was conducted in six counties of Shandong Province, China, and we selected study sites by multi-stage random sampling. Subjects were pulmonary tuberculosis patients registered with the county tuberculosis dispensaries at study sites that completed treatment during the period October 2006 to September 30, 2007. For the 819 cases of pulmonary tuberculosis, the median initial health care-seeking delay time was 6 days, and 49.8% of them were initial health care-seeking delayed. The logistic regression analysis showed that marriage (odds ratio = 0.354, 95% confidence interval: 0.193-0.650) and knowledge of the national tuberculosis subsidy policy (odds ratio = 1.753, 95% confidence interval: 1.258-2.441) were associated with initial health care-seeking delay. Changing the perception of patients and popularizing the national tuberculosis subsidy policy will do well towards reducing initial health care-seeking delay.

An integrated individual, community, and structural intervention to reduce HIV/STI risks among female sex workers in China

BackgroundWe assessed the effectiveness of an integrated individual, community, and structural intervention to reduce risks of HIV and sexually transmitted infections (STIs) among female sex workers (FSWs).MethodsThe integration individual, community, and structural intervention was implemented from 2004 to 2009 in six counties of Shandong Province. Post-intervention cross-sectional surveys were conducted in six intervention counties and 10 control counties.ResultsOf 3326 female sex workers were recruited and analyzed in the post-intervention survey with 1157 from intervention sites and 2169 from control sites. No HIV positive was found in both intervention and control counties. The rate of syphilis was 0.17% for intervention sites and 1.89% for control sites (OR = 11.1, 95% CI: 2.7, 46.1). After adjusted for age, marital status, education, economic condition, recruitment venues, the rates of condom use in the last sex with clients(AOR = 2.7; 95% CI: 1.9, 3.8), with regular sex partners(AOR = 1.5; 95% CI: 1.1, 1.9) and consistent condom use in the last month with clients (AOR = 3.3; 95% CI: 2.6, 4.1) and regular sex partners (AOR = 1.7; 95% CI: 1.3, 2.3) were significantly higher in intervention sites than that in control sites. The proportion of participants correctly answered at least six out of eight HIV-related questions (83.3%) in intervention sites is significant higher than that (21.9%) in control sites (AOR = 24.7; 95% CI: 2.5, 42.7), the five indicators related to HIV-related intervention services ever received in the last year including HIV testing(AOR = 4.9; 95% CI: 2.8, 6.7), STD examination and/or treatment(AOR = 5.1; 95% CI: 4.2, 6.4), free condom(AOR = 20.3; 95% CI: 14.3, 28.9), peer education(AOR = 4.3; 95% CI: 3.5, 5.4), education materials(AOR = 19.8; 95%CI: 13.1, 29.8) were significantly higher in intervention sites than that in control sites, the participants in the intervention sites are more likely to seek medical treatment when they had any disorders (AOR = 3.2; 95% CI: 2.5, 4.2).ConclusionThis study found that the integrated individual, community, and structural intervention showed positive impact in reducing HIV and STI risks among FSWs.

Will China's Cooperative Medical System fail again? Insight from farmer satisfaction survey

This paper studied the sustainability of China's New Rural Cooperative Medical System (NCMS) by evaluating the satisfaction rate of its participants-the farmers. The study related the overall satisfaction of the farmers to their satisfaction with the four different aspects of the program. It also identified which personal and program attributes affect the farmers' satisfaction rate. Survey data of 1278 households from 66 counties in Shandong Province of China were collected in 2011 using a multi-stage stratified cluster-sampling method. To overcome the nepotistic barriers in rural China, field surveys in each township were conducted by university students from the same place. Data were analyzed using multiple regressions and structural equation modeling method. The results showed that 86% of the farmers were either satisfied or very satisfied with the NCMS and 82% indicated their intention to continue participating in the program. Aside from its financial benefits, both the publicity and reimbursement procedure of the program were found to be significant factors in influencing the satisfaction of the farmers. Majority of the participants held positive opinions toward the NCMS, contradicting the negative assessments made by many previous studies. Given the high proportion of farmers willing to continue with the program, it is likely to be sustainable in the near future. Greater publicity and education efforts should be made to make the farmers better informed about the program, and measures should be taken to improve its reimbursement procedure and the setting of the premium level.

Severe Fever with Thrombocytopenia Syndrome Virus among Domesticated Animals, China

To investigate the infections of severe fever with thrombocytopenia syndrome virus (SFTSV) in domesticated animals, we sampled a total of 3,039 animals in 2 counties in Shandong Province, People’s Republic of China, from April to November 2011. SFTSV-specific antibodies were detected in 328 (69.5%) of 472 sheep, 509 (60.5%) of 842 cattle, 136 (37.9%) of 359 dogs, 26 (3.1%) of 839 pigs, and 250 (47.4%) of 527 chickens. SFTSV RNA was detected in all sampled animal species, but the prevalence was low, ranging from 1.7% to 5.3%. A cohort study in 38 sheep was conducted to determine when seroconversion to SFTSV occured. SFTSVs were isolated from sheep, cattle, and dogs and shared >95% sequence homology with human isolates from the same disease-endemic regions. These findings demonstrate that natural infections of SFTSV occur in several domesticated animal hosts in disease-endemic areas and that the virus has a wide host range.