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Qian Long

Associate Professor of Global Health at Duke Kunshan University
DKU Faculty

Selected Publications


The co-management of tuberculosis-diabetes co-morbidities in Indonesia under the National Tuberculosis Control Program: results from a cross-sectional study from 2017 to 2019.

Journal Article BMC Public Health · April 8, 2022 BACKGROUND: Indonesia suffers from a high burden of tuberculosis (TB) and diabetes (DM). The government initiated national TB-DM co-management activities under the National TB Control Program in 2017. This study investigates the detection and treatment out ... Full text Link to item Cite

Changes in caesarean section rates in China during the period of transition from the one-child to two-child policy era: cross-sectional National Household Health Services Surveys.

Journal Article BMJ open · April 2022 ObjectivesSince 2009, China has introduced policies, principally targeting health professionals, to reduce caesarean section (CS) overuse. In 2016, China endorsed a universal two-child policy. Advanced maternal age and previous CS may indicate cha ... Full text Cite

Antenatal depression in Sri Lanka: a qualitative study of public health midwives' views and practices.

Journal Article Reprod Health · January 28, 2022 BACKGROUND: Almost all pregnant people in Sri Lanka receive antenatal care by public health midwives. While there is strong infrastructure in Sri Lanka for postpartum mental health care, the current practices within antenatal mental health care have not be ... Full text Link to item Cite

Ending tuberculosis in China: health system challenges.

Journal Article Lancet Public Health · December 2021 China has made remarkable progress in reducing tuberculosis cases and deaths during the past three decades; however, it is still far from achieving the targets set out in the WHO End TB Strategy. Since the 2000s, China has tried to transform its vertical t ... Full text Link to item Cite

Predictors and occurrence of antenatal depressive symptoms in Galle, Sri Lanka: a mixed-methods cross-sectional study.

Journal Article BMC Pregnancy Childbirth · November 10, 2021 BACKGROUND: There is a high prevalence of antenatal depression in low-or-middle-income countries, but information about risk factors in these settings is still lacking. The purpose of this study is to measure the prevalence of and explore risk factors asso ... Full text Link to item Cite

Socioeconomic, geographic and health system factors associated with rising C-section rate in Indonesia: a cross-sectional study using the Indonesian demographic and health surveys from 1998 to 2017.

Journal Article BMJ open · May 2021 IntroductionCaesarean section (C-section) has been a public health concern globally. This study investigated the change in C-section rate in 1998-2017 in Indonesia and explored the socioeconomic, geographic and health system factors associated wit ... Full text Cite

A research agenda for ageing in China in the 21st century (2nd edition): Focusing on basic and translational research, long-term care, policy and social networks.

Journal Article Ageing research reviews · December 2020 One of the key issues facing public healthcare is the global trend of an increasingly ageing society which continues to present policy makers and caregivers with formidable healthcare and socio-economic challenges. Ageing is the primary contributor to a br ... Full text Cite

Prevalence and risk factors for postpartum depression in Sri Lanka: A population-based study.

Journal Article Asian J Psychiatr · January 2020 BACKGROUND: Previous studies in Sri Lanka have shown a high prevalence of postpartum depression (PPD). Postpartum depression screening using the Edinburgh Postnatal Depression Scale (EPDS) has been validated and included in routine postnatal care in 2012. ... Full text Link to item Cite

The Effect of an Innovative Financing and Payment Model for Tuberculosis Patients on Health Service Utilization in China: Evidence from Hubei Province of China.

Journal Article Int J Environ Res Public Health · July 12, 2019 Background: Tuberculosis (TB) remains a major social and public health problem in China. The "China-Gates TB Project" started in 2012, and one of its objectives was to reduce the financial burden on TB patients and to improve access to quality TB care. The ... Full text Link to item Cite

Health-Related Quality of Life of Hypertension Patients: A Population-Based Cross-Sectional Study in Chongqing, China.

Journal Article International journal of environmental research and public health · July 2019 Purpose: Hypertension is a major risk factor for cardiovascular diseases and stroke, and it requires lifelong medication. This study aimed to investigate the factors impacting on Health-Related Quality of Life (HRQoL) among hypertensive patients in ... Full text Cite

Population Pharmacokinetic Modeling to Evaluate Standard Magnesium Sulfate Treatments and Alternative Dosing Regimens for Women With Preeclampsia.

Journal Article Journal of clinical pharmacology · March 2019 Magnesium sulfate is the standard therapy for prevention and treatment of eclampsia. Two¬†standard dosing regimens require either continuous intravenous infusion or frequent, large-volume intramuscular injections, which may preclude patients from receiving ... Full text Cite

Prevalence of and reasons for women's, family members', and health professionals' preferences for cesarean section in China: A mixed-methods systematic review.

Journal Article PLoS medicine · October 2018 BackgroundChina has witnessed a rapid increase of cesarean section (CS) rates in recent years. Several non-clinical factors have been cited as contributing to this trend including maternal request and perceived convenience. We aimed to assess pref ... Full text Cite

Clinical practice patterns on the use of magnesium sulphate for treatment of pre-eclampsia and eclampsia: a multi-country survey.

Journal Article BJOG : an international journal of obstetrics and gynaecology · November 2017 ObjectiveTo characterise the current clinical practice patterns regarding the use of magnesium sulphate (MgSO4 ) for eclampsia prevention and treatment in a multi-country network of health facilities and compare with international recom ... Full text Cite

Influencing factors of health seeking intention among patients with type 2 diabetes in Chongqing Chronic Disease Management System

Journal Article Fudan University Journal of Medical Sciences · March 25, 2017 Objective: To investigate the health seeking intention and its influencing factors among patients with type 2 diabetes in Chongqing Chronic Disease Management System. Methods: Multi-stage cluster random sampling was used to investigate basic information, d ... Full text Cite

Case management of patients with Type 2 diabetes mellitus: a cross-sectional survey in Chongqing, China.

Journal Article BMC Health Serv Res · February 11, 2017 BACKGROUND: Type 2 diabetes mellitus has been identified as one of the priority diseases and included in the essential public health service package in China. This study investigated the frequency of follow-up visits and contents of care for case managemen ... Full text Open Access Link to item Cite

Treatment of Type 2 diabetes mellitus in Chongqing of China: unaffordable care for the poor.

Journal Article Diabetic medicine : a journal of the British Diabetic Association · January 2017 AimThis study aims to investigate the medical expenditure of people with Type 2 diabetes mellitus in Chongqing, China; to explore factors that contribute to the expenditure; and to examine the financial burden placed on households, particularly po ... Full text Cite

Maternity care system in Maputo, Mozambique: Plans and practice?

Journal Article Cogent Medicine · January 1, 2017 Full text Cite

Implementation of effective practices in health facilities: A systematic review of cluster randomised trials

Journal Article BMJ Global Health · January 1, 2017 Background The capacity for health systems to support the translation of research in to clinical practice may be limited. The cluster randomised controlled trial (cluster RCT) design is often employed in evaluating the effectiveness of implementation of ev ... Full text Cite

The effect of NCMS on catastrophic health expenditure and impoverishment from tuberculosis care in China.

Journal Article Int J Equity Health · October 18, 2016 BACKGROUND: Health expenditure for tuberculosis (TB) care often pushes households into catastrophe and poverty. New Cooperative Medical Scheme (NCMS) aims to protect households from catastrophic health expenditure (CHE) and impoverishment in rural China. T ... Full text Open Access Link to item Cite

The co-management of tuberculosis-diabetes co-morbidities in Indonesia under the National Tuberculosis Control Program: results from a cross-sectional study from 2017 to 2019.

Journal Article BMC Public Health · April 8, 2022 BACKGROUND: Indonesia suffers from a high burden of tuberculosis (TB) and diabetes (DM). The government initiated national TB-DM co-management activities under the National TB Control Program in 2017. This study investigates the detection and treatment out ... Full text Link to item Cite

Changes in caesarean section rates in China during the period of transition from the one-child to two-child policy era: cross-sectional National Household Health Services Surveys.

Journal Article BMJ open · April 2022 ObjectivesSince 2009, China has introduced policies, principally targeting health professionals, to reduce caesarean section (CS) overuse. In 2016, China endorsed a universal two-child policy. Advanced maternal age and previous CS may indicate cha ... Full text Cite

Antenatal depression in Sri Lanka: a qualitative study of public health midwives' views and practices.

Journal Article Reprod Health · January 28, 2022 BACKGROUND: Almost all pregnant people in Sri Lanka receive antenatal care by public health midwives. While there is strong infrastructure in Sri Lanka for postpartum mental health care, the current practices within antenatal mental health care have not be ... Full text Link to item Cite

Ending tuberculosis in China: health system challenges.

Journal Article Lancet Public Health · December 2021 China has made remarkable progress in reducing tuberculosis cases and deaths during the past three decades; however, it is still far from achieving the targets set out in the WHO End TB Strategy. Since the 2000s, China has tried to transform its vertical t ... Full text Link to item Cite

Predictors and occurrence of antenatal depressive symptoms in Galle, Sri Lanka: a mixed-methods cross-sectional study.

Journal Article BMC Pregnancy Childbirth · November 10, 2021 BACKGROUND: There is a high prevalence of antenatal depression in low-or-middle-income countries, but information about risk factors in these settings is still lacking. The purpose of this study is to measure the prevalence of and explore risk factors asso ... Full text Link to item Cite

Socioeconomic, geographic and health system factors associated with rising C-section rate in Indonesia: a cross-sectional study using the Indonesian demographic and health surveys from 1998 to 2017.

Journal Article BMJ open · May 2021 IntroductionCaesarean section (C-section) has been a public health concern globally. This study investigated the change in C-section rate in 1998-2017 in Indonesia and explored the socioeconomic, geographic and health system factors associated wit ... Full text Cite

A research agenda for ageing in China in the 21st century (2nd edition): Focusing on basic and translational research, long-term care, policy and social networks.

Journal Article Ageing research reviews · December 2020 One of the key issues facing public healthcare is the global trend of an increasingly ageing society which continues to present policy makers and caregivers with formidable healthcare and socio-economic challenges. Ageing is the primary contributor to a br ... Full text Cite

Prevalence and risk factors for postpartum depression in Sri Lanka: A population-based study.

Journal Article Asian J Psychiatr · January 2020 BACKGROUND: Previous studies in Sri Lanka have shown a high prevalence of postpartum depression (PPD). Postpartum depression screening using the Edinburgh Postnatal Depression Scale (EPDS) has been validated and included in routine postnatal care in 2012. ... Full text Link to item Cite

The Effect of an Innovative Financing and Payment Model for Tuberculosis Patients on Health Service Utilization in China: Evidence from Hubei Province of China.

Journal Article Int J Environ Res Public Health · July 12, 2019 Background: Tuberculosis (TB) remains a major social and public health problem in China. The "China-Gates TB Project" started in 2012, and one of its objectives was to reduce the financial burden on TB patients and to improve access to quality TB care. The ... Full text Link to item Cite

Health-Related Quality of Life of Hypertension Patients: A Population-Based Cross-Sectional Study in Chongqing, China.

Journal Article International journal of environmental research and public health · July 2019 Purpose: Hypertension is a major risk factor for cardiovascular diseases and stroke, and it requires lifelong medication. This study aimed to investigate the factors impacting on Health-Related Quality of Life (HRQoL) among hypertensive patients in ... Full text Cite

Population Pharmacokinetic Modeling to Evaluate Standard Magnesium Sulfate Treatments and Alternative Dosing Regimens for Women With Preeclampsia.

Journal Article Journal of clinical pharmacology · March 2019 Magnesium sulfate is the standard therapy for prevention and treatment of eclampsia. Two¬†standard dosing regimens require either continuous intravenous infusion or frequent, large-volume intramuscular injections, which may preclude patients from receiving ... Full text Cite

Prevalence of and reasons for women's, family members', and health professionals' preferences for cesarean section in China: A mixed-methods systematic review.

Journal Article PLoS medicine · October 2018 BackgroundChina has witnessed a rapid increase of cesarean section (CS) rates in recent years. Several non-clinical factors have been cited as contributing to this trend including maternal request and perceived convenience. We aimed to assess pref ... Full text Cite

Clinical practice patterns on the use of magnesium sulphate for treatment of pre-eclampsia and eclampsia: a multi-country survey.

Journal Article BJOG : an international journal of obstetrics and gynaecology · November 2017 ObjectiveTo characterise the current clinical practice patterns regarding the use of magnesium sulphate (MgSO4 ) for eclampsia prevention and treatment in a multi-country network of health facilities and compare with international recom ... Full text Cite

Influencing factors of health seeking intention among patients with type 2 diabetes in Chongqing Chronic Disease Management System

Journal Article Fudan University Journal of Medical Sciences · March 25, 2017 Objective: To investigate the health seeking intention and its influencing factors among patients with type 2 diabetes in Chongqing Chronic Disease Management System. Methods: Multi-stage cluster random sampling was used to investigate basic information, d ... Full text Cite

Case management of patients with Type 2 diabetes mellitus: a cross-sectional survey in Chongqing, China.

Journal Article BMC Health Serv Res · February 11, 2017 BACKGROUND: Type 2 diabetes mellitus has been identified as one of the priority diseases and included in the essential public health service package in China. This study investigated the frequency of follow-up visits and contents of care for case managemen ... Full text Open Access Link to item Cite

Treatment of Type 2 diabetes mellitus in Chongqing of China: unaffordable care for the poor.

Journal Article Diabetic medicine : a journal of the British Diabetic Association · January 2017 AimThis study aims to investigate the medical expenditure of people with Type 2 diabetes mellitus in Chongqing, China; to explore factors that contribute to the expenditure; and to examine the financial burden placed on households, particularly po ... Full text Cite

Maternity care system in Maputo, Mozambique: Plans and practice?

Journal Article Cogent Medicine · January 1, 2017 Full text Cite

Implementation of effective practices in health facilities: A systematic review of cluster randomised trials

Journal Article BMJ Global Health · January 1, 2017 Background The capacity for health systems to support the translation of research in to clinical practice may be limited. The cluster randomised controlled trial (cluster RCT) design is often employed in evaluating the effectiveness of implementation of ev ... Full text Cite

The effect of NCMS on catastrophic health expenditure and impoverishment from tuberculosis care in China.

Journal Article Int J Equity Health · October 18, 2016 BACKGROUND: Health expenditure for tuberculosis (TB) care often pushes households into catastrophe and poverty. New Cooperative Medical Scheme (NCMS) aims to protect households from catastrophic health expenditure (CHE) and impoverishment in rural China. T ... Full text Open Access Link to item Cite

Social networks and health-related quality of life among Chinese old adults in urban areas: results from 4th National Household Health Survey.

Journal Article Public health · February 2016 ObjectiveTo examine the associations between components of social networks and health-related quality of life (HRQoL) in community-dwelling old adults in urban areas in China.Study designData from the 4th National Household Health Survey ... Full text Cite

Factors that determine catastrophic expenditure for tuberculosis care: a patient survey in China.

Journal Article Infect Dis Poverty · January 25, 2016 BACKGROUND: Tuberculosis (TB) often causes catastrophic economic effects on both the individual suffering the disease and their households. A number of studies have analyzed patient and household expenditure on TB care, but there does not appear to be any ... Full text Link to item Cite

Implementing a "free" tuberculosis (TB) care policy under the integrated model in Jiangsu, China: practices and costs in the real world.

Journal Article Infect Dis Poverty · January 22, 2016 BACKGROUND: In the 1990s, China introduced a "free" tuberculosis (TB) care policy under the national TB control program. Recently, as a part of a new TB diagnosis and treatment model, it has been recommended that the integrated model scale up. This paper e ... Full text Link to item Cite

Non-medical financial burden in tuberculosis care: a cross-sectional survey in rural China.

Journal Article Infectious diseases of poverty · January 2016 BackgroundTreatment of tuberculosis (TB) in China is partially covered by national programs and health insurance schemes, though TB patients often face considerable medical expenditures. For some, especially those from poorer households, non-medic ... Full text Cite

Disparity in reimbursement for tuberculosis care among different health insurance schemes: evidence from three counties in central China.

Journal Article Infectious diseases of poverty · January 2016 BackgroundHealth inequity is an important issue all around the world. The Chinese basic medical security system comprises three major insurance schemes, namely the Urban Employee Basic Medical Insurance (UEBMI), the Urban Resident Basic Medical In ... Full text Cite

Drug-resistant tuberculosis control in China: progress and challenges.

Journal Article Infectious diseases of poverty · January 2016 BackgroundChina has the second highest caseload of multidrug-resistant tuberculosis (MDR-TB) in the world. In 2009, the Chinese government agreed to draw up a plan for MDR-TB prevention and control in the context of a comprehensive health system r ... Full text Cite

Onsite midwife-led birth units (OMBUs) for care around the time of childbirth: A systematic review

Journal Article BMJ Global Health · January 1, 2016 Introduction: To ensure timely access to comprehensive emergency obstetric care in low- and middle-income countries, a number of interventions have been employed. This systematic review assesses the effects of onsite midwife-led birth units (OMBUs) embedde ... Full text Cite

Are free anti-tuberculosis drugs enough? An empirical study from three cities in China.

Journal Article Infectious diseases of poverty · October 2015 BackgroundTuberculosis (TB) patients in China still face a number of barriers in seeking diagnosis and treatment. There is evidence that the economic burden on TB patients and their households discourages treatment compliance.MethodsA cro ... Full text Cite

Caesarean section rates in Mozambique.

Journal Article BMC pregnancy and childbirth · October 2015 BackgroundThe Caesarean section (C-section) rate is used as an indicator for availability and utilization of life-saving obstetric services. The purpose of the present study was to explore changes in C-section rates between 1995 and 2011 by area, ... Full text Cite

Cesarean section in Shanghai: women's or healthcare provider's preferences?

Journal Article BMC pregnancy and childbirth · August 2014 BackgroundCesarean section (CS) rate has increased rapidly over the past two decades in China mainly driven by non-medical factors. This study was to compare recalled preferences for CS among first-time mothers in early and late pregnancy with act ... Full text Cite

A community-based approach to non-communicable chronic disease management within a context of advancing universal health coverage in China: progress and challenges.

Journal Article BMC Public Health · 2014 Paralleled with the rapid socio-economic development and demographic transition, an epidemic of non-communicable chronic diseases (NCDs) has emerged in China over the past three decades, resulting in increased disease and economic burdens. Over the past de ... Full text Link to item Cite

Changes in health expenditures in China in 2000s: has the health system reform improved affordability.

Journal Article Int J Equity Health · June 13, 2013 BACKGROUND: China's health system reform launched in early 2000s has achieved better coverage of health insurance and significantly increased the use of healthcare for vast majority of Chinese population. This study was to examine changes in the structure ... Full text Link to item Cite

China's biggest, most neglected health challenge: Non-communicable diseases.

Journal Article Infect Dis Poverty · April 5, 2013 BACKGROUND: Over the past two decades, international health policies focusing on the fight against the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), tuberculosis (TB), malaria, and those diseases that address maternal and chil ... Full text Link to item Cite

Impact of financial and educational interventions on maternity care: results of cluster randomized trials in rural China, CHIMACA.

Journal Article Matern Child Health J · February 2013 To report on the design and basic outcomes of three interventions aimed at improving the use and quality of maternity care in rural China: financial interventions, training in clinical skills, and training in health education. Community-based cluster rando ... Full text Link to item Cite

High Caesarean section rate in rural China: is it related to health insurance (New Co-operative Medical Scheme)?

Journal Article Social science & medicine (1982) · August 2012 The epidemic of Caesarean section (CS) is worldwide, and it has been argued that it is mainly due to non-medical factors, including healthcare financing patterns. We investigated the use of CS in rural China and the related factors, particularly health ins ... Full text Cite

Impact of Chinese one-child policy on sibling structure: Experience from rural areas in three provinces

Journal Article BMJ Open · July 16, 2012 Objectives: To study the influence of population policy and boy preference on the sibling structure, that is, in which order and combinations boys and girls are born into families. Design: A population-based survey with a representative sample of new mothe ... Full text Cite

Patient medical costs for tuberculosis treatment and impact on adherence in China: a systematic review.

Journal Article BMC Public Health · May 26, 2011 BACKGROUND: Charging for tuberculosis (TB) treatment could reduce completion rates, particularly in the poor. We identified and synthesised studies that measure costs of TB treatment, estimates of adherence and the potential impact of charging on treatment ... Full text Link to item Cite

Giving birth at a health-care facility in rural China: is it affordable for the poor?

Journal Article Bull World Health Organ · February 1, 2011 OBJECTIVE: To investigate changes in the expenditure of giving birth in health-care facilities in rural China during 1998-2007, to examine the financial burden on households, particularly poor ones, and to identify factors associated with out-of-pocket exp ... Full text Link to item Cite

Utilization of delivery care among rural women in China: does the health insurance make a difference? a cross-sectional study.

Journal Article BMC public health · November 2010 BackgroundSince 2003, the New Cooperative Medical Scheme (NCMS) has been implemented throughout rural China, usually covering delivery services in its benefit package. The objective of this study was to compare the difference of utilization of del ... Full text Cite

Utilisation, contents and costs of prenatal care under a rural health insurance (New Co-operative Medical System) in rural China: lessons from implementation.

Journal Article BMC health services research · November 2010 BackgroundIn China, the New Co-operative Medical System (NCMS), a rural health insurance system, has expanded nationwide since 2003. This study aims to describe prenatal care use, content and costs of care in one county where prenatal care is incl ... Full text Cite

Utilisation of maternal health care in western rural China under a new rural health insurance system (New Co-operative Medical System).

Journal Article Trop Med Int Health · October 2010 SUMMARY OBJECTIVE: To investigate factors influencing maternal health care utilisation in western rural China and its relation to income before (2002) and after (2007) introducing a new rural health insurance system (NCMS). METHODS: Data from cross-section ... Full text Link to item Cite

Dramatic increase of Cesarean deliveries in the midst of health reforms in rural China.

Journal Article Social science & medicine (1982) · May 2010 Cesarean delivery (CD) rates were until recently low in rural China where the population lacked health insurance. In July 2003 the New Cooperative Medical Scheme (NCMS) was introduced. We report findings from a health systems study carried out in the EC-fu ... Full text Cite

Barriers to accessing TB diagnosis for rural-to-urban migrants with chronic cough in Chongqing, China: a mixed methods study.

Journal Article BMC Health Serv Res · October 2, 2008 BACKGROUND: China is facing a significant tuberculosis epidemic among rural-to-urban migrants, which poses a threat to TB control. This study aimed to understand the health seeking behaviour of and health systems responses to migrants and permanent urban r ... Full text Link to item Cite

Treatment seeking for symptoms suggestive of TB: comparison between migrants and permanent urban residents in Chongqing, China.

Journal Article Trop Med Int Health · July 2008 OBJECTIVES: To understand the health-seeking behaviour of rural-to-urban migrants with chronic cough in Chongqing city, and compare this with the permanent urban population taking into account the socioeconomic factors influencing delays in access to healt ... Full text Link to item Cite