Ho Lm

The impact of community psychological responses on outbreak control for severe acute respiratory syndrome in Hong Kong

Objective: To examine the public’s knowledge and perception of SARS and the extent to which various precautionary measures have been adopted. Design: Cross sectional survey. Setting: General population of Hong Kong at the height of the SARS outbreak (29 March to 6 April 2003). Participants: 1115 ethnic Chinese adults. Main results: Forty per cent did not recognise fomites as a possible mode of transmission whereas 55.1% believed that the infection could be transmitted airborne. A large proportion (30.1%) believed they were very or somewhat likely to contract SARS while only one quarter believed they were very likely to survive if they contracted the disease, benchmarked against an actual case fatality ratio of 2.8% at the time of the survey and 15%–20% according to current best estimates. Precautionary measures directed against person to person droplet spread were generally adopted by most while the prevention of transmission through fomites was not practised as frequently. Respondents with higher risk perceptions and a moderate level of anxiety were most likely to take comprehensive precautionary measures against the infection, as were older, female, more educated people as well as those with a positive contact history and SARS-like symptoms. Conclusions: The findings demonstrate that the promotion of protective personal health practices to interrupt the self sustaining transmission of the SARS virus in the community must take into account background perceptions of risk and anxiety levels of the public at large. Continuing public education about preventive measures should be targeted at the identified groups with low current uptake of precautions.

Timing of Pubertal Maturation and Heterosexual Behavior Among Hong Kong Chinese Adolescents

This study presents a cross-sectional examination of the independent contribution of pubertal maturation timing to heterosexual activity among Chinese adolescents. A standardized self-administered questionnaire was designed to obtain information on a spectrum of physical heterosexual behaviors from dating to sexual intercourse, age at first nocturnal ejaculation in boys, age at menarche in girls, and several psychosocial variables that might be associated with sexual behavior in adolescents. A total of 4,116 students aged from 14 to 18 years (2,175 boys and 1,941 girls) were recruited in the Youth Sexuality Survey of the Hong Kong Family Planning Association in 1996–97. When groups were defined as “early,” “average,” and “late maturers,” among boys, early maturers were youngest to report dating and to have sexual intercourse, followed by average and late maturers. Among girls, late maturers were slower to date and have sexual intercourse, but early maturers showed no difference from average maturers. Age of maturation was significantly lower for those reporting all heterosexual behaviors for both sexes. Our findings illustrate cultures moderation of the expression of biological differences.

Methods for Estimating the Case Fatality Ratio for a Novel, Emerging Infectious Disease

Abstract During the course of an epidemic of a potentially fatal disease, it is important that the case fatality ratio be well estimated. The authors propose a novel method for doing so based on the Kaplan-Meier survival procedure, jointly considering two outcomes (death and recovery), and evaluate its performance by using data from the 2003 epidemic of severe acute respiratory syndrome in Hong Kong, Peoples Republic of China. They compare this estimate obtained at various points in the epidemic with the case fatality ratio eventually observed; with two commonly quoted, naïve estimates derived from cumulative incidence and mortality statistics at single time points; and with estimates in which a parametric mixture model is used. They demonstrate the importance of patient characteristics regarding outcome by analyzing subgroups defined by age at admission to the hospital.

Cost of tobacco-related diseases, including passive smoking, in Hong Kong

Background: Costs of tobacco-related disease can be useful evidence to support tobacco control. In Hong Kong we now have locally derived data on the risks of smoking, including passive smoking. Aim: To estimate the health-related costs of tobacco from both active and passive smoking. Methods: Using local data, we estimated active and passive smoking-attributable mortality, hospital admissions, outpatient, emergency and general practitioner visits for adults and children, use of nursing homes and domestic help, time lost from work due to illness and premature mortality in the productive years. Morbidity risk data were used where possible but otherwise estimates based on mortality risks were used. Utilisation was valued at unit costs or from survey data. Work time lost was valued at the median wage and an additional costing included a value of US

Secondhand smoke and respiratory ill health in current smokers

1.3 million for a life lost. Results: In the Hong Kong population of 6.5 million in 1998, the annual value of direct medical costs, long term care and productivity loss was US

Suicidality and cultural values among Hong Kong adolescents.

532 million for active smoking and US

Early life second-hand smoke exposure and serious infectious morbidity during the first 8 years : evidence from Hong Kong's Children of 1997 birth cohort

156 million for passive smoking; passive smoking accounted for 23% of the total costs. Adding the value of attributable lives lost brought the annual cost to US

Seroprevalence of IgG antibodies to SARS-coronavirus in asymptomatic or subclinical population groups

9.4 billion. Conclusion: The health costs of tobacco use are high and represent a net loss to society. Passive smoking increases these costs by at least a quarter. This quantification of the costs of tobacco provides strong motivation for legislative action on smoke-free areas in the Asia Pacific Region and elsewhere.

Passive smoking and its impact on employers and employees in Hong Kong

Background: Numerous studies have concluded that secondhand smoke (SHS) is harmful to non-smokers but controversy persists regarding its effects on smokers. The impact of SHS exposure on the acute respiratory health of current active smokers was examined using a cross sectional design. Methods: 9923 uniformed staff in the Hong Kong Police Force completed a standardised questionnaire on current and past smoking, SHS exposure at home and at work, acute respiratory symptoms, and recent physician consultation. 3999 male current smokers were included in the analysis. Results: About 5% of the smokers were exposed to SHS at home only, 53% were exposed at work only, and 30% were exposed both at home and at work. The prevalence ratios for respiratory symptoms (throat and nasal problems, cough, phlegm, and wheeze), physician consultation, and self medication were higher for those who were exposed to SHS at home or at work. The odds ratios of reporting one or more respiratory symptoms, for SHS exposures at home or at work, were 1.33 (95% confidence interval (CI) 1.12 to 1.59) and 1.66 (95% CI 1.36 to 2.02) respectively, after adjusting for age, marital status, education, rank and duties, exposure to self perceived dusty or polluted environment in previous job, and total dose of active smoking. The adjusted odds ratios showed significant positive dose–response gradients with SHS exposure at home, at work, and at both places combined. Conclusions: SHS exposure is strongly associated with increased acute respiratory symptoms and recent outpatient service utilisation in current smokers. If the association is causal, public health action to limit SHS exposure could also benefit smokers.

Smoking and sexual dysfunction in Chinese males: findings from men's health survey

Scholars have proposed that individualistic values resulting from globalization are associated with increasing behavioral and emotional problems among youth in modernizing cultures. This study examined specific individualistic and traditional values in the context of suicidal ideation and behaviors in Hong Kong among community adolescent youths (N=2427) ages 14-18 years. Participants indicated the extent to which self-direction/independence and obedience/respect for elders were important to them. They also reported on four progressive levels of suicidality: whether in the last year they had experienced suicidal ideation, made plans for a suicide attempt, attempted suicide, and (for attemptors) made a serious attempt requiring medical attention. After controlling for quality of family relationships and depressive symptoms, at least one of the values predicted suicidality at all but the highest level. There were sex-specific associations between values and suicidality. In general, endorsement of self-direction was correlated with reduced risk of suicidality for boys and was irrelevant to girls. In contrast, traditional emphases on obedience and respect for elders were more frequently protective against suicidality for girls and were inconsistent predictors for boys. The relationship between values and suicidality was generally independent of the effect of family relationships and depressive symptoms. Thus, values were associated with adolescent suicidality, but not consistently in the direction predicted by some theorists, and the association depended upon the adolescents sex.