City Surveillance Research Articles

Effect of sexual behavior change on long-term human immunodeficiency virus prevalence among homosexual men.

Substantial changes in human immunodeficiency virus (HIV)-related sexual behavior have been reported by virtually every survey of homosexual/bisexual men in the last decade. This paper uses a behavior-based simulation to examine how such changes are likely to affect the long-term future of the acquired immunodeficiency syndrome (AIDS) epidemic among homosexual men. Data from the Longitudinal AIDS Impact Project in New York City are used to estimate age-specific patterns of unprotected anogenital contact and behavioral change from 1980 to 1991. Model projections are validated using New York City surveillance data on AIDS incidence from 1981 to 1991. The current levels of unsafe sex reported in the Longitudinal AIDS Impact Project are shown to be almost exactly on the epidemic threshold. If this behavior were maintained, HIV prevalence would slowly decline in the population, but with just one additional unsafe sexual partner per year HIV would instead become endemic, with seroprevalence of about 65% in the oldest group and about 25% in the youngest. Transmission dynamics in the youngest group are analyzed in detail. For this group, the assortative age-matching bias in partner selection patterns raises the unsafe behavior threshold slightly in the long run.

A neonatal hepatitis B surveillance and vaccination program: New York City, 1987 to 1988.

From July 1987 to June 1988, 1030 pregnant women with hepatitis B were reported to a New York City surveillance program. Among 832 infants under follow-up, the coverage rates for combined hepatitis B immune globulin and vaccine doses 1, 2, and 3 were 84%, 77%, and 59%, respectively. Infants covered by Medicaid and uninsured Black and Hispanic infants were significantly less likely to be completely vaccinated. An estimated 160 cases of chronic hepatitis B infection were prevented among infants enrolled in the program. Strategies are needed to improve vaccine coverage among hard-to-reach groups.

How Chinese clinicians contribute to the improvement of maternity care

Clinicians in China are deeply involved in efforts to improve maternity care throughout the country. A Women's Health section has been established in the Chinese Society of Obstetrics and Gynecology. Staff of tertiary hospitals participate in perinatal surveillance of cities, including regular maternal and perinatal mortality meetings and comparative inter-hospital evaluations of service and clinical statistics. Clinicians from larger urban centers visit rural hospitals to provide guidance in management of high risk patients.

The impact of city surveillance teams in Bangladesh during the smallpox eradication campaign.

Some of the methods of distribution and collection of information in the city of Dacca, Bangladesh during the Smallpox Eradication Campaign are described. The use of surveillance teams and exchange of information between the city and surrounding countryside are emphasized.