Correspondence
2
3
4
5
Silbermann M. Middle East Cancer Consortium. In: International Innovation. Bristol: Research Media Ltd, 2013: 66–67. Cleary J, Silbermann M, Scholten W, Cherny N. Formulary availability and regulatory barriers to accessibility of opioids for cancer pain in the Middle East. A report from the Global Opioid Policy Initiative (GOPI). Ann Oncol 2013; 24: 51–59. Ben Ari E. Global Collaboration. Considering culture when providing cancer care. NCI Cancer Bull 2010; 7: 23. International Narcotics Control Board. Population: World Health Organization. WHO Collaborating Center for Drug Statistics Methodology, Pain & Policy Group, University of Wisconsin Carbone Cancer Center, Madison, Wisconsin. http://www.painpolicy.wisc.edu (accessed April 7, 2015). Silbermann M, Epner DE, Charalambous H, et al. Promoting new approaches for cancer care in the Middle East. Ann Oncol 2013, 24: 5–10.
I declare no competing interests.
Hong Zhang [email protected]
Cigarette smoking among Chinese medical staff Tobacco smoking among medical staff in China is an important issue. According to a survey 1 done in 7169 male medical students from 16 universities in 12 provinces the proportion of smokers was 910 (12·8%) of 7135. Another survey2 in 992 female medical students from a medical college in the city of Chongqing (Sichuan Province), showed that the proportion of smokers in these women was 34 (3·5%) of 970. Tobacco consumption is the leading cause of preventable diseases and death that physicians face in their professional careers. However, doctors’ smoking behaviour might affect their attitudes towards tobacco control. According to a survey3 in Changzhou (Jiangsu Province), 171 (27·6%) of 620 of doctors were smokers; the proportion of male smokers 168 (27·1%) of 620 was substantially higher than female smokers 3 (0·5%) of 620. Of the surgeons surveyed, almost half were smokers. Additionally, www.thelancet.com Vol 385 April 25, 2015
Department of Neurology, Teaching and Research Department of Neuropsychiatry, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei, China 1
2
3
4
Liu J, Zhang J, Liao J. Analysis of smoking behavior among Chinese male medical students in 16 universities. Chin J Sch Health 2013; 34: 303–06 (in Chinese). Lei C, Xiong H. Survey on smoking and attempting smoking behavior and their influencing factors among female students of a medical college in Chongqing. Chongqing Med 2014; 43: 208–10 (in Chinese). Feng L, Xu C. A survey on cigarette smoking related behavior among medical doctors in Changzhou. Chin Prev Med 2013; 14: 852–56 (in Chinese). Chinese Ministry of Health. China smoking is hazardous to health reports. Chin J Health Educ 2012; 28: 603 (in Chinese).
Dengue fever in China The Lancet Seminar1 by Maria Guzman and Eva Harris on dengue regarded the burden of dengue in China as unknown. However, dengue fever is a notifiable disease in China, and all cases of dengue fever were diagnosed according to the unified diagnostic criteria issued by the National Health and Family Planning Commission, which includes definitions of clinically diagnosed and laboratory-confirmed cases. From 1978 to 2008, a total of 655 324 cases
50 000 45 000
4·0
Cases Incidence rate
3·5
40 000
3·0
35 000
2·5
30 000 Cases
1
141 (22·7%) of 620 doctors never or rarely asked about the smoking habits of their patients and only 355 (57·3%) of 620 doctors encouraged their patients to quit smoking.3 The Chinese Ministry of Health issued a report in 2012 about the dangers that smoking can have on health.4 However, some doctors and medical students are still smoking despite these risks. Therefore, specific health education and training, targeting doctors and medical students, about how to quit smoking is key to reduce this burden. Importantly, medical staff should encourage their patients and the general population to quit smoking too.
25 000
2·0
20 000
1·5
15 000
1·0
10 000
0·5
5000 0
Incidence (per 100 000 people)
(RF-A); Department of Oncology, Tawam Hospital, Al-Ain, Abu Dhabi, United Arab Emirates (MAJ); and Weill Cornell Faculty of Medicine, National Center for Cancer Care and Research, Doha, Qatar (AAH)
2009
2010
2011
2012
2013
2014
0
Year
Figure: Incidence and cases notified of dengue fever (2009–14)
were reported in mainland China, resulting in 610 deaths.2 According to China National Notifiable Disease Surveillance System, from 2009 to 2014, the range of incidence was 0·0091–3·4581 per 100 000 people, and a total of 52 749 cases of dengue fever and six deaths were notified (figure). Because dengue is an emerging disease in China, possible cases are traced by active field investigation when outbreaks occur in the community. Thus, dengue surveillance involves both passive and active case detection. Further study should focus on analysis of prevalence and assessment of relations between seroprevalence and incidence. In 2014, a series of dengue fever outbreaks occurred in Guangdong, Yunnan, Fujian, and Guangxi. These outbreaks pose a substantial socioeconomic burden. Additionally, these outbreaks showed new epidemic trends for dengue fever in Guangdong. Hui and colleagues 3 showed that DENV-2 strains circulating in Guangdong have been stable since their introduction in the 2000s—which challenged the view that dengue fever is an imported epidemic disease.4 We declare no competing interests. We thank the National Basic Research Programme of China and the National Natural Science Foundation of China for support.
Bin Chen, *Qiyong Liu [email protected]
1621
2
3
4
5
Silbermann M. Middle East Cancer Consortium. In: International Innovation. Bristol: Research Media Ltd, 2013: 66–67. Cleary J, Silbermann M, Scholten W, Cherny N. Formulary availability and regulatory barriers to accessibility of opioids for cancer pain in the Middle East. A report from the Global Opioid Policy Initiative (GOPI). Ann Oncol 2013; 24: 51–59. Ben Ari E. Global Collaboration. Considering culture when providing cancer care. NCI Cancer Bull 2010; 7: 23. International Narcotics Control Board. Population: World Health Organization. WHO Collaborating Center for Drug Statistics Methodology, Pain & Policy Group, University of Wisconsin Carbone Cancer Center, Madison, Wisconsin. http://www.painpolicy.wisc.edu (accessed April 7, 2015). Silbermann M, Epner DE, Charalambous H, et al. Promoting new approaches for cancer care in the Middle East. Ann Oncol 2013, 24: 5–10.
I declare no competing interests.
Hong Zhang [email protected]
Cigarette smoking among Chinese medical staff Tobacco smoking among medical staff in China is an important issue. According to a survey 1 done in 7169 male medical students from 16 universities in 12 provinces the proportion of smokers was 910 (12·8%) of 7135. Another survey2 in 992 female medical students from a medical college in the city of Chongqing (Sichuan Province), showed that the proportion of smokers in these women was 34 (3·5%) of 970. Tobacco consumption is the leading cause of preventable diseases and death that physicians face in their professional careers. However, doctors’ smoking behaviour might affect their attitudes towards tobacco control. According to a survey3 in Changzhou (Jiangsu Province), 171 (27·6%) of 620 of doctors were smokers; the proportion of male smokers 168 (27·1%) of 620 was substantially higher than female smokers 3 (0·5%) of 620. Of the surgeons surveyed, almost half were smokers. Additionally, www.thelancet.com Vol 385 April 25, 2015
Department of Neurology, Teaching and Research Department of Neuropsychiatry, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei, China 1
2
3
4
Liu J, Zhang J, Liao J. Analysis of smoking behavior among Chinese male medical students in 16 universities. Chin J Sch Health 2013; 34: 303–06 (in Chinese). Lei C, Xiong H. Survey on smoking and attempting smoking behavior and their influencing factors among female students of a medical college in Chongqing. Chongqing Med 2014; 43: 208–10 (in Chinese). Feng L, Xu C. A survey on cigarette smoking related behavior among medical doctors in Changzhou. Chin Prev Med 2013; 14: 852–56 (in Chinese). Chinese Ministry of Health. China smoking is hazardous to health reports. Chin J Health Educ 2012; 28: 603 (in Chinese).
Dengue fever in China The Lancet Seminar1 by Maria Guzman and Eva Harris on dengue regarded the burden of dengue in China as unknown. However, dengue fever is a notifiable disease in China, and all cases of dengue fever were diagnosed according to the unified diagnostic criteria issued by the National Health and Family Planning Commission, which includes definitions of clinically diagnosed and laboratory-confirmed cases. From 1978 to 2008, a total of 655 324 cases
50 000 45 000
4·0
Cases Incidence rate
3·5
40 000
3·0
35 000
2·5
30 000 Cases
1
141 (22·7%) of 620 doctors never or rarely asked about the smoking habits of their patients and only 355 (57·3%) of 620 doctors encouraged their patients to quit smoking.3 The Chinese Ministry of Health issued a report in 2012 about the dangers that smoking can have on health.4 However, some doctors and medical students are still smoking despite these risks. Therefore, specific health education and training, targeting doctors and medical students, about how to quit smoking is key to reduce this burden. Importantly, medical staff should encourage their patients and the general population to quit smoking too.
25 000
2·0
20 000
1·5
15 000
1·0
10 000
0·5
5000 0
Incidence (per 100 000 people)
(RF-A); Department of Oncology, Tawam Hospital, Al-Ain, Abu Dhabi, United Arab Emirates (MAJ); and Weill Cornell Faculty of Medicine, National Center for Cancer Care and Research, Doha, Qatar (AAH)
2009
2010
2011
2012
2013
2014
0
Year
Figure: Incidence and cases notified of dengue fever (2009–14)
were reported in mainland China, resulting in 610 deaths.2 According to China National Notifiable Disease Surveillance System, from 2009 to 2014, the range of incidence was 0·0091–3·4581 per 100 000 people, and a total of 52 749 cases of dengue fever and six deaths were notified (figure). Because dengue is an emerging disease in China, possible cases are traced by active field investigation when outbreaks occur in the community. Thus, dengue surveillance involves both passive and active case detection. Further study should focus on analysis of prevalence and assessment of relations between seroprevalence and incidence. In 2014, a series of dengue fever outbreaks occurred in Guangdong, Yunnan, Fujian, and Guangxi. These outbreaks pose a substantial socioeconomic burden. Additionally, these outbreaks showed new epidemic trends for dengue fever in Guangdong. Hui and colleagues 3 showed that DENV-2 strains circulating in Guangdong have been stable since their introduction in the 2000s—which challenged the view that dengue fever is an imported epidemic disease.4 We declare no competing interests. We thank the National Basic Research Programme of China and the National Natural Science Foundation of China for support.
Bin Chen, *Qiyong Liu [email protected]
1621
