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Objective To understand the situation related to health seeking and diagnosis of imported malaria and to provide practical measures for malaria elimination in Jiangsu province.Methods Data on imported malaria cases in Jiangsu province was retrieved in CISDCP from 2014 to 2016.Relevant information on health seeking behavior,diagnosis and treatment of the disease was gathered.Results A total of 1 068 imported cases were reported in Jiangsu province from 2014 to 2016.Except for one malaria case that was caused by blood transfusion,the rest patients were all recognized as'imported'.Majority of the cases were migrant laborers working in African countries.The accurate rates on the diagnosis of ovale,vivax and quartan malaria and mixed infection were relatively low,as 79.3％ (107/135),29.5％ (18/61),52.9％ (18/34) and 0.0％ (0/2) at the primary health care settings,respectively.Rate of seeking health care on the same day of onset was more in 2015 than in 2014 and 2016 (X2=18.6,P=0.001).While only 65.4％ (699/1 068) of the patients were diagnosed correctly at the primary health care settings.There appeared no statistical difference in the 3-year-study period (x2=5.4,P=0.246).Capacity on'correct diagnosis' seemed stronger at the CDC than at the hospital levels (x2=13.2,P=0.000;x2=5.4,P=0.020).Totally,72.7％ (32/44) of the severe falciparum malaria cases did not immediately seek for health care when the symptoms started.Conclusions Migrant workers returning from the high endemic malaria areas seemed to have poor awareness in seeking health care services.Capability on correct diagnosis for malaria at the primary health care settings remained unsatisfactory and staff from these settings needs to receive adequate training.
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Objective To understand the situation related to health seeking and diagnosis of imported malaria and to provide practical measures for malaria elimination in Jiangsu province.Methods Data on imported malaria cases in Jiangsu province was retrieved in CISDCP from 2014 to 2016.Relevant information on health seeking behavior,diagnosis and treatment of the disease was gathered.Results A total of 1 068 imported cases were reported in Jiangsu province from 2014 to 2016.Except for one malaria case that was caused by blood transfusion,the rest patients were all recognized as'imported'.Majority of the cases were migrant laborers working in African countries.The accurate rates on the diagnosis of ovale,vivax and quartan malaria and mixed infection were relatively low,as 79.3％ (107/135),29.5％ (18/61),52.9％ (18/34) and 0.0％ (0/2) at the primary health care settings,respectively.Rate of seeking health care on the same day of onset was more in 2015 than in 2014 and 2016 (X2=18.6,P=0.001).While only 65.4％ (699/1 068) of the patients were diagnosed correctly at the primary health care settings.There appeared no statistical difference in the 3-year-study period (x2=5.4,P=0.246).Capacity on'correct diagnosis' seemed stronger at the CDC than at the hospital levels (x2=13.2,P=0.000;x2=5.4,P=0.020).Totally,72.7％ (32/44) of the severe falciparum malaria cases did not immediately seek for health care when the symptoms started.Conclusions Migrant workers returning from the high endemic malaria areas seemed to have poor awareness in seeking health care services.Capability on correct diagnosis for malaria at the primary health care settings remained unsatisfactory and staff from these settings needs to receive adequate training.
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Objective To understand the malaria epidemic situation and characteristics in Jiangsu Province in 2015,so as to provide the evidence for malaria elimination. Methods The data of malaria cases in Jiangsu Province in 2015 were collected from China's routine diseases surveillance information system. Results Totally 405 imported cases were reported in Jiangsu Province in 2015,and the cases increased by 14.08％compared with those in 2014. All the malaria cases were imported,and 5 cases(1.23％)were from Southeast Asia and 400(98.77％)were from 25 African countries or regions. The imported malaria cases were reported in 13 cities across Jiangsu Province,where Taizhou,Lianyungang,Nantong,Huaian and Yangzhou cities accounted for 68.64％of all the cases in the province. Jiangsu Institute of Parasitic Diseases(JIPD)reference lab checked all the cases and classified 299 falciparum malaria cases,13 vivax malaria cases,18 quartan malaria cases,71 ovale malaria cas-es,and 4 mixed Plasmodium infection cases. Conclusions In Jiangsu Province,there are no local malaria cases for 4 consecu-tive years,but the imported cases are on the rise. Compared to 2014,the imported vivax cases increased significantly in 2015. It should be the key points to strengthen the surveillance of imported malaria cases,improve malaria diagnosis and treatment abili-ties for all levels of medical institutions,and promote the abilities of Plasmodium check,and focus survey and disposal of all Center for Disease Control(CDC)staffs across Jiangsu Province.
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Objective To understand the integrated ability of parasitic disease prevention and control of professional person-nel of Jiangsu Province through the contest. Methods Totally 56 players from the whole province were selected,and all the players participated in the contest. The theory knowledge and skill scores were collected and the statistical analyses were con-ducted. Results The average theoretical score of the participants was 88.86±15.56 and the passing rate was 91.1％. The aver-age skill operating score was 69.16 ± 16.01 and the passing rate was 67.9％. The average Plasmodium microscopy score was 16.54±8.09 and the passing rate was 50％. The average helminth egg microscopy score was 34.27±10.66 and the passing rate was 67.9％. There were statistical differences among the age groups and different levels of schistosomiasis endemic situation (F =5.10,6.39,both P<0.01). The theoretical knowledge including schistosomiasis,malaria,hydatid disease and others and the score rates were 91.07％,90.94％,85.83％and 90.93％,respectively. The hydatid disease score rate was lower(χ2=19.17, P<0.01). The radar chart displayed that the score rates of tabletting and microscopy test in Kato-Katz film production ,malaria blood film production and microscopy test were all low. Conclusion In Jiangsu Province,the participants have higher score in the theory test. However,they have lower skill test score,especially in the parasite species identification. The operational skills still need to be strengthened for center for disease control(CDC)participants.
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Objective To explore the ginkgo biloba extract curative effect of treatment of elderly unstable angina.MethodsFrom January 2012 to December 2015 encounters during the period of 100 cases of elderly patients with unstable angina as the research object, they were dinided into two groups according to the different methods of treatment.Observation group and control group adopts western medicine aspirin enteric-coated metformin hydrochloride, isosorbide mononitrate zyban and combination treatment with atorvastatin calcium tablet.Observation group plus treated with ginkgo biloba extract tablets.ResultsObservation group the treatment of patients with total effective rate (94.0%) is significantly higher than control group (78.0%), the difference is statistically significant (P<0.05);Before the treatment, two groups product of systolic blood pressure, heart rate and heart rate in patients with systolic blood pressure, CRP index close, there was no statistically significant difference;But after treatment, the observation group of patients with indicators better, statistically significant difference (P<0.05);Blood lipid and blood rheology after treatment, the observation group improved significantly (P<0.05), but the control group to improve the situation is not obvious, the difference between groups with statistical significance (P<0.05);Two groups of adverse reactions in patients with no statistically significant difference.ConclusionGinkgo biloba extract in the treatment of the elderly unstable angina has significant clinical effect, can significantly improve the patient′s blood lipid and blood rheology indexes, and the safety of the drug is good.
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Objective To understand the malaria epidemic situation and characteristics in Jiangsu Province in 2013,so as to provide the evidence for formulating and adjusting effective malaria elimination strategies and measures. Methods The re-ported malaria cases from the Internet Reporting System and the epidemiological data of malaria in Jiangsu Province were collect-ed and analyzed. Results A total of 341 malaria cases were reported in Jiangsu Province in 2013 with the incidence of 0.050/10 000,which increased by 72.22% compared with that in 2012(198 cases). All the cases were imported from other countries including one infected by blood transfusion resulted from imported infection. The cases were mainly distributed in Li-anyungang City(15.84%,54 cases),Nantong City(14.08%,48 cases),Yangzhou City(14.08%,48 cases),Huaian City (11.44%,39 cases)and Yancheng City(8.50%,29 cases). All the cases were confirmed in Jiangsu Provincial Reference Labo-ratory and there were 286 cases of Plasmodium falciparum,8 cases of P. vivax,9 cases of P. malariae,30 cases of P. ovale and 8 cases of mixed infections. Conclusions There were no local malaria cases reported from Jiangsu Province in the last two years which reflected effective achievements of malaria elimination. However,the situation of imported malaria is more serious and the species of infected plasmodium are more diverse. Imported malaria from other countries remains the key of malaria con-trol in Jiangsu Province.
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Objective To understand the malaria epidemic situation and characteristics in Jiangsu Province in 2012,so as to provide the evidence for formulating and adjusting effective malaria elimination strategies and measures. Methods The reported malaria cases from the Internet Reporting System and the epidemiological data of malaria in Jiangsu Province were collected and analyzed. Results A total of 198 malaria cases were reported in Jiangsu Province in 2012 with the incidence of 0.026/10 000, which decreased by 47.06%compared with that in 2011(374 cases). A total of 198 malaria cases were reported from 13 prefec-tures of Jiangsu and the cases were mainly distributed in Yangzhou(34 cases),Nantong(31 cases),Nanjing(22 cases),Tai-zhou(21 cases),Xuzhou(17 cases)and Huaian(17 cases),which accounted for 71.72%(142/198)among the total cases of the province. There were no local malaria cases reported from Jiangsu in 2012,and the imported malaria cases from other countries de-creased by 45.15%compared with that in 2011. Conclusions For the first time,there are no local malaria cases reported from Ji-angsu in 2012. However,the imported case distribution is further expanded and the infected plasmodium parasites are more di-verse. Imported malaria from other countries remains the key for malaria control in Jiangsu Province.
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Objective To understand the epidemic situation and influencing factors of malaria in Jiangsu Province and grasp its epidemic regularity and trend. Methods According to the malaria prevalence in Jiangsu Province,6 counties(city,dis-trict)including Yixing,Suining,Wujin,Hai’an,Ganyu and Xuyi were selected as provincial surveillance sites to survey malar-ia epidemic conditions. The basic information,blood test results of fever patients,case investigation information of malaria pa-tients,monitoring data of investigation and disposition of the malaria focus were collected and analyzed. Results In 2013,the blood tests of 66 723 fever patients were performed,the average blood smear checking rate was 1.10%,and the average positive rate was 0.08%(52 plasmodium positive individuals)in the 6 areas. For these 52 plasmodium positive individuals,the blood re-tests and case investigations were completed within 3 days after these cases were reported by the network system,and the investi-gation confirmed that they were foreign imported malaria cases. The malaria focus investigation and disposition were finished within 1 week and the data were reported by the Parasitic Diseases Information System. Four of 52 cases were recrudescence dur-ing the follow-up. Among the 52 cases,20 people went abroad themselves and 4 were labors of private enterprises,21 people came back without the accompanied. Conclusions With the development of the malaria elimination program in Jiangsu Prov-ince,the eliminating malaria“targeted 1-3-7”working pattern has been comprehensively implemented. The personnel monitor-ing for labors who returned from overseas working will be a key in the future.
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Objective To explore the effects of acupuncture and individualized occupational therapy on the rehabilitation of patients with unilateral spatial neglect ( USN ) after stroke.Methods Stroke patients with hemiplegia were evaluated by neuropsychological tests,including line bisection,a cancellation test,clock drawing,and figure and shape copying.Sixty-nine right hemispheric stroke patients identified with USN were randomly assigned to 3 groups:20 patients as a control group received conventional rehabilitation therapy ; another 22 patients as an occupational group received type-specific individualized occupational therapy combined with conventional rehabilitation therapy; the remaining 23 patients as an acupuncture combined with occupational therapy group received acupuncture in addition to both conventional rehabilitation therapy and occupational therapy.These three groups were evaluated with neuropsychological tests and the modified Barthel index (MBI) before and after treatment.Results ①MBI scores in the occupational therapy group and the combined group were significantly higher after treatment,but no significant difference was observed in the control group.②The increased MBI scores in the combined and occupational groups were higher than those in the control group.At the same time the increase in MBI scores in the combined group was significantly greater than in the occupational therapy group.③The assessment results with both line bisection and cancellation tests in all three groups were significantly different after treatment.The line bisection results in the occupational therapy group and the combined group were significantly better than in the control group.The cancellation test results in the combined group were significantly better than in the control group.Conclusion These findings show that acupuncture combined with occupational therapy can have a positive effect on neglect recovery and greatly improve the daily life of USN patients.
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@#ObjectiveTo investigate the effect of the recreational therapy on the ability of social communication in stroke patients. Methods58 cases of stroke patients were divided into recreational group (28 cases) and control group (30 cases). All of them received routine rehabilitation therapy, while the recreational group received the recreational therapy in addition. All patients were evaluated with Functional Independence Measure (FIM) before and after treatment. ResultsThe scores of FIM significantly improved after treatment (P<0.05) in both groups, and the scores in social communication improved more (P<0.01) in recreational group than in control group. ConclusionRecreational therapy may improve the ability of social communication more effectively for stroke patients.
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Objective To explore the sample reIated factors affecting the short-term culture of erythrocytic Plasmodium dvax in vitro.Methods The vivax malaria blood samples were collected from the patients with malaria in endemic areas,and then incubated with McCoy's 5A medium in an incubator containing 5%CO_2 at 37℃.The factors affecting the short-term culture of Plasmodium vivax were analyzed.Results Plasmodium vivax could finish one asexual cycle in the selected medium.By analyzing the culture results of 74 samples.it was found that the factors affecting the short-term culture included long time delaying al room temperature(>4 h),single stage(only parasites in ring stage were found),patients taking antimalarials,antibiotics or sulfonamides.and low parasitemia.Conclusion The sample related factors are important to the short-term culture of erythrocytic Plasmodium vivax in vitro.
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Objective To establish a simple,convenient,quick and high sensitive method of loop-mediated isothermal amplification (LAMP) for detection of Plasmodium vivax-carrying mosquitoes.Methods The species conservative regions of P.v CSP gene were selected to design 2 pairs of primers which recognized 6 distinct regions.To evaluate the specificity of detection by LAMP,infected Anopheles,An.sinensis (An.s),Plasmodium falciparum (P.f),and healthy human blood DNA were selected as templates.To assess the sensitivity of detection,1.3×10~6,1.3×10~5,1.3×10~4,1.3×10~3,1.3×10~2,1.3×10~1 and 1.3×10~0 copies of P.v CSP plasmid DNA mixed with 1.0 μl An.s DNA were used as the templates of LAMP.The infected An.s DNAs were diluted with negative An.s DNA by 1:2,1:4,1:8,1:16,1:32,1:64,1:128 and 1:256 and then detected by LAMP to show the sensitivity of batch quantity detection.The applied value of this method was evaluated by detecting the same batch of 67 artificial infected An.s mosquitoes,and compared with the detection of microscopic examination and nested PCR in parallel.Results By using LAMP,the detection of infected An.s was positive,while the control samples were all negative.The limits of detection of different proportion dilutions of the mixture of P.v CSP plasmid DNA with An.s DNA were 1.3×10~2 copies.The limits of detection of different proportion dilutions of the mixture of infected An.s DNA with An.s DNA were 1:128.The positive rate of detecting the same batch of 67 artificial infected mosquitoes was 47.76% by LAMP,25.37% by the microscopic examination (X~2 = 7.24,P0.05).Compared with the test of the microscopic examination and then with a statistical analysis,the sensitivity of LAMP was 100%,which agreed well with the sensitivity of nested PCR (100%).Conclusion The method of LAMP is simple,convenient and high sensitive,and it is a potential method for detecting Plasmodium vivax-carrying mosquitoes in the field.
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Objective To observe the residual effect of Demand CS - impregnated bednets to Anopheles sinensis.Methods The numbers of adult mosquitoes which were knocked down at every minute after treatment were observed by using the enforced contact method recommended by WHO,and the mortality of mosquitoes tested after 24 h was calculated.Results The Kt_(50) of Demand CS - impregnated bednets with impregnations concentrations of 10,15,20 mg/m~2 to Anopheles sineasis were 21.40,16.20,15.70 min,respectively,and the 24 h mortality was 100%.The Kt_(50) of Responsar SC (12.5 % Beta - cyfluthrin) impregnated bednets with a impregnation concentration of 15 mg/m~2 to Anopheles sinensis was 16.06 min,and the 24 h mortality was 100%,too.Conclusions Both the Demand CS - impregnated bednets and the Responsar SC impregnated bednets can kill Anopheles sinensis.
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Objective To analyse the epidemic characteristics and control measures of malaria in Jiangsu Province during the past fifty years, evaluate the control effect and explore the current appropriate control strategy and measures. Methods The historical data about malaria cases and control measures from 1951 to 2008 in Jiangsu Province were collected, and the effects of malaria control in different stages were assessed. Results The integrated control measures with emphasis on the control of infectious source were adopted during the stage of two outbreaks of malaria. In the stage of basical elimination of malaria, the comprehensive measures with emphasis on the vector control in the areas of Anopheles anthropophagus were adopted, and the measures with emphasis on the surveillance of infectious source surveillance and early treatment of malaria in other areas were adopted. In the stage of consolidation, the measures including the surveillance of infectious source and management, surveillance of vector and epidemic situation, management of floating population, etc, were adopted. The malaria incidence dropped from 2 495/10 000 in 1960 to 0.09/10 000 in 2008, and was under 1/10 000 in all the counties of Jiangsu Province during the past 2 years, which demonstrated the various measures were feasible and effective in different stages of malaria. Conclusions Malaria has been controlled effectively in Jiangsu Province, however, the improvement of early diagnosis and norm treatment of malaria cases, the enhancement of health education and promotion, as well as the malaria surveillance and management among floating population, are still necessary for achieving the goal of malaria elimination.
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Objective To establish a fast and sensitive method to detect Plasmodium sporozoites in mosquitoes. Methods Anopheles anthropophagus (An.a) artificially infected with Plasmodium vivax (P.v), Anopheles dirus (An.d) infected with Plasmodium falciparum (P.f) and both of P.v and P.f, field mosquitoes of Anopheles sinensis (An.s) captured in epidemic seasons were detected by nested-PCR. Results The results of 28 batches of An.a infected with P.v, 2 batches of An.d with P.f and 1 batch of An.d mixed with P.v and P.f by nested-PCR were accorded with the microscopical examination absolutely. Two positives of 589 An.s field mosquitoes were discovered with a positive rate of 0.34%. Conclusion The nested-PCR is fast and sensitive for detecting different species of Plasmodium in mosquitoes.
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Objective To discuss the malaria control strategy and its effects in different stages during past 30 years, and search anti-malaria measures fit for the current situation. Methods The historical anti-malaria and epidemical data in Jiangsu Province during the past 30 years were collected and analyzed. Results 6216128 malaria cases were reported in the province in 1973, and the incidence was 1136.34/10000. Through the five anti-malaria stages in past 30 years, the epidemic has been effectively controlled gradually. Six hundred and thirty-eight malaria cases were reported in the province in 2003, and no individual locally infected with P.falciparum was found for 16 successive years. Conclusion The anti-malaria strategy of the five stages is basically suitable for the actual situation of malaria control in Jiangsu Province.
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Objective To understand the resistance of Anopheles vectors to pyrethroid after several years mosquito control with the impregnated bed net method. Methods The resistant level was measured by the tentative diagnostic dose and degree method of China combined with the standard methods of WHO. Results In the area after more than 5 years mosquito control with the impregnated bed net method, An.sinensis had initial resistance to deltamethrin and permethrin. However, An.anthropophagus did not be captured. In the area after less than 5 years mosquito control with the impregnated bed net method, both An. sinensis and An.anthropophagus were susceptive to deltamethrin and permethrin. Conclusion In this research, no resistance of An.anthropophagus to deltamethrin and permethrin has been found. An.sinensis has initial resistance to them. So we must pay more attention to monitor the resistance in future malaria control programs.