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Abstract Background In 2008, the outbreak of kidney stones in children fed by melamine-tainted milk products in Mainland China has caused major public concern of food safety. We identified Hong Kong school children with elevated urine melamine level from a community-based school survey in 2007-08 and reviewed their clinical status in 2009. Methods In 2007-08, 2119 school children participated in a primary and secondary school survey in Hong Kong using a cluster sampling method. Urine aliquots from 502 subjects were assayed for melamine level. High urine melamine level was defined as urine melamine/creatinine ratio >7.1 μg/mmol. Subjects with high urine melamine level were invited for clinical evaluation in 2009 including urinalysis and ultrasound imaging of the urinary system. Results The age range of this subcohort was 6 - 20 years with 67% girls (335 female and 167 male subjects). The spot urine melamine/creatinine ratio of the 502 urine aliquots ranged from undetectable to 1467 μg/mmol (median 0.8 μg/mmol). Of these, 213 subjects had undetectable level (42%). We invited 47 (9%) subjects with high urine melamine level for re-evaluation and one subject declined. The median duration of follow-up was 23.5 months (interquartile range: 19.8 - 30.6 months). None of the 46 subjects (28% boys, mean age 13.9 ± 2.9 years) had any abnormality detected on ultrasound study of the urinary system. All subjects had stable renal function with a median urine albumin-creatinine ratio of 0.70 mg/mmol (interquartile range: 0.00 - 2.55 mg/mmol). Conclusions Hong Kong Chinese school children with high urine melamine levels appeared to have benign clinical course in the short term although a long term follow-up study is advisable in those with persistently high urine melamine level.

Abstract Background Existing surveillance systems for sexually transmitted diseases (STD) and reproductive tract infections (RTI) are important but often ineffective, as they tend to omit cases diagnosed by private-practice doctors Methods During a 15-day study period, 277 private-practice doctors and all public-practice doctors of all the eight local Social Hygiene Clinics (SHC) in Hong Kong filled out daily a standard log-form, recording the number of patients diagnosed with particular types of STD/RTI. Projections for all local private-practice and public-practice doctors were made by the stratification method. Results Data showed that 0.75% of private patients and 40.92% of public patients presented the listed STD/RTI syndromes. It is projected that 12,504 adults were diagnosed with such syndromes by all local private-practice (10,204) or public-practice doctors (2,300); 0.22% (male: 0.26%; female: 0.18%) of the local adult population would fall into this category. The ratio of STD/RTI cases, diagnosed by private-practice versus public-practice doctors, was 4:1. Of the participating private-practice doctors, 96% found the process easy to administer and 75% believed that it was feasible for such a STD/RTI surveillance system to be implemented annually. Conclusions Surveillance of STD/RTI based only on data obtained from the public health system is inadequate. Data obtained from public-practice and private-practice doctors are very different and the majority of the patients presented their STD/RTI syndromes to private-practice doctors. The proposed, improved surveillance system is feasible and has the strengths of involving both private-practice and public-practice medical practitioners and being well accepted by private-practice doctors.

Abstract Background The objective of this study is to estimate the incidence of genital warts in Hong Kong and explore a way to establish a surveillance system for genital warts among the Hong Kong general population. Methods A total of 170 private doctors and all doctors working in the 5 local Social Hygiene Clinics (SHC) participated in this study. During the 14-day data collection period (January 5 through18, 2009), the participating doctors filled out a log-form on a daily basis to record the number of patients with genital warts. The total number of new cases of genital warts presented to private and public doctors in Hong Kong was projected using the stratification sampling method. Results A total of 721 (0.94%) adults presented with genital warts to the participating doctors during the two-week study period, amongst them 73 (10.1%) were new cases. The projected number of new cases of genital warts among Hong Kong adults was 442 (297 male and 144 female) during the study period. The incidence of genital warts in Hong Kong was estimated to be 203.7 per 100,000 person-years (respectively 292.2 and 124.9 per 100,000 person-years for males and females). Conclusions The incidence of genital warts is high among adults in Hong Kong. The study demonstrates the importance of collecting surveillance data from both private and public sectors.

Abstract Background Childhood and adolescence are critical periods of habit formation with substantial tracking of lifestyle and cardiovascular risk into adulthood. There are various guidelines on recommended levels of physical activity in youth of school-age. Despite the epidemic of obesity and diabetes in China, there is a paucity of data in this regard in Chinese youth. We examined the association of self-reported level of physical activity and cardiovascular risk in Hong Kong Chinese youth of school-age. Methods This was a cross-sectional study conducted in 2007-8 in a school setting with 2119 Hong Kong Chinese youth aged 6-20 years. Physical activity level was assessed using a validated questionnaire, CUHK-PARCY (The Chinese University of Hong Kong: Physical Activity Rating for Children and Youth). A summary risk score comprising of waist circumference, blood pressure, fasting plasma glucose and lipids was constructed to quantify cardiovascular risk. Results In this cohort, 21.5% reported high level of physical activity with boys being more active than girls (32.1% versus 14.1%, p < 0.001). Regression analysis showed physical activity level, sex and pubertal stage were independently associated with cardiovascular risk score. Conclusion Self-reported level of physical activity is associated with cardiovascular risk factors in Chinese youth after adjusting for sex and pubertal stage.

Abstract Background Increasingly more men who have sex with men (MSM) are using the internet to seek sex partners, and many HIV-related studies targeting MSM collect data from gay venues in order to inform the design of prevention programs. However, internet-based MSM may have different HIV risk behaviors and associated factors from those attending venues. This study examined differences in risk behaviors and socio-cultural profiles between MSM recruited from venues (e.g., gay bars/saunas) and from the internet respectively. Methods An anonymous cross-sectional survey was conducted. A total of 566 Chinese MSM (340 recruited from gay-venues and 226 recruited from the internet) who self-reported having had anal or oral sex with another man in the last 12 months completed a structured questionnaire. Results Internet-based MSM were more likely than venue-based MSM to have engaged in unprotected anal intercourse (53.3% vs. 33.8%) or commercial sex (as clients: 12.8% vs. 5.3%; as sex workers: 6.2% vs. 1.5%), to have sought MSM partners from the internet (51.3% vs. 20.9%), and to have contracted sexually transmitted diseases (STD) in the last 12 months (4.4% vs. 0.3%). On the other hand, internet-based MSM were less likely to have multiple sex partners (58.4% vs. 75.6%) and to have used psychoactive substances (7.1% vs. 15.6%) or drunk alcohol before sex (8.8% vs. 16.2%). Moreover, internet-based MSM reported poor acceptance of their own sexual orientation, felt more discriminated against, and received less social support than venue-recruited MSM. Conclusions Significant differences were observed between the two groups of MSM. Segmentation and targeted interventions are recommended when designing preventive interventions.

Abstract Background During the SARS pandemic in Hong Kong, panic and worry were prevalent in the community and the general public avoided staying in public areas. Such avoidance behaviors could greatly impact daily routines of the community and the local economy. This study examined the prevalence of the avoidance behaviors (i.e. avoiding going out, visiting crowded places and visiting hospitals) and negative psychological responses of the general population in Hong Kong at the initial stage of the H1N1 epidemic. Methods A sample of 999 respondents was recruited in a population-based survey. Using random telephone numbers, respondents completed a structured questionnaire by telephone interviews at the 'pre-community spread phase' of the H1N1 epidemic in Hong Kong. Results This study found that 76.5% of the respondents currently avoided going out or visiting crowded places or hospitals, whilst 15% felt much worried about contracting H1N1 and 6% showed signs of emotional distress. Females, older respondents, those having unconfirmed beliefs about modes of transmissions, and those feeling worried and emotionally distressed due to H1N1 outbreak were more likely than others to adopt some avoidance behaviors. Those who perceived high severity and susceptibility of getting H1N1 and doubted the adequacy of governmental preparedness were more likely than others to feel emotionally distressed. Conclusions The prevalence of avoidance behaviors was very high. Cognitions, including unconfirmed beliefs about modes of transmission, perceived severity and susceptibility were associated with some of the avoidance behaviors and emotional distress variables. Public health education should therefore provide clear messages to rectify relevant perceptions.

Abstract Background Large population growth surveys of children and adolescents aged 6 to 18 y were undertaken in Hong Kong in 1963 and 1993. The global epidemic of obesity is a major public health concern. To monitor the impact of this epidemic in Hong Kong children and to identify secular changes in growth, a further growth survey was undertaken in 2005/6. Methods Cross-sectional height and weight measurements of 14,842 children and adolescents aged 6 to 18 y from Hong Kong's 18 districts were obtained during the 2005/6 school year. Percentile curves were constructed using LMS method and sex-specific percentile values of weight-for-age, height-for-age, and BMI-for-age were compared with those data from 1963 and 1993. Results Secular changes in height, weight and BMI were noted between 1963 and 1993 and between 1993 and 2005/6. In the latter period, greater changes were observed at younger ages, and particularly in boys. On an annual basis, the 1993–2005/6 changes were less than those during 1963–1993. Using the International Obesity Task Force cut-offs, 16.7% of children were overweight or obese in 2005/6, which was a 5.1% increase since 1993. Conclusion These data provide policy-makers with further evidence of the secular changes in child growth and the increasing obesity epidemic among Hong Kong children.

Abstract Background The prevalence of self-reported preventive behaviors in response to an anticipated local human-to-human H5N1 transmission outbreak and factors associated with such behaviors have not been examined. Methods A random, anonymous, cross-sectional telephone survey of 503 Hong Kong Chinese adults. Results The public in Hong Kong is likely to adopt self-protective behaviors (e.g., wearing face mask in public venues (73.8%), increasing the frequency of handwashing (86.7%)) and behaviors that protect others (e.g., wearing face masks when experiencing influenza-like illness (ILI, 92.4%), immediately seeking medical consultation (94.2%), making declarations when crossing the border with ILI (87.1%), complying to quarantine policies (88.3%)). Multivariate analyses indicated that factors related to age, full-time employment, perceived susceptibility, perceived efficacy of preventive measures, perceived higher fatality as compared to SARS, perceived chance of a major local outbreak, and being worried about self/family members contracting the virus were significantly associated with the inclination to adopt self-protective measures. Similar analyses showed that education level, variables related to perceived efficacy, perceived major local outbreak and such were significantly associated with various behaviors directed towards protecting others. Conclusion In the event of a human-to-human H5N1 outbreak, the public in Hong Kong is likely to adopt preventive measures that may help contain the spread of the virus in the community.

Background: Socio-political circumstances, including security, poverty, national wealth, income inequality, social integration and political conflicts, determine population health. Anticipated socio-political developments refer to the perceived improvement/deterioration in these circumstances in the future year. Aims: This study tested relationships between this anticipation and population mental health (probable depression/depressive symptoms and life satisfaction) and the mediation roles of negative personal responses toward socio-political situations (frustration, emotional disturbance, self-efficacy in political involvement, perceived sense of security, and satisfaction about societal ability in fulfilling individuals' needs) in explaining these relationships. Method: The telephone survey randomly interviewed 420 (59.5% female) adults in Hong Kong. Questionnaire included scales assessing the aforementioned variables. Results: Most participants (71.7%) had pessimistic anticipations over socio-political developments; 11.3% of the participants were classified as having probable depression. Anticipated deterioration in socio-political developments was significantly associated with depressive symptoms and life satisfaction; emotional disturbance, sense of security and need satisfaction were partial mediators of these relationships. Need satisfaction and sense of security showed the strongest mediation effects both for mediations that involved depressive symptoms and life satisfaction. Conclusion: Both politicians' awareness and mental health promotion are required to alleviate the negative impact of negative socio-political perception on mental health. [ABSTRACT FROM AUTHOR]