Epidemiological investigation of blood transfusion - induced malaria caused by an imported case with Plasmodium falciparum infection / 中国血吸虫病防治杂志

Objective To analyze a case infected with Plasmodium falciparum due to blood transfusion in Taizhou City, so as to provide scientific evidence for malaria control. Methods The epidemiological investigation of a case with P. falciparum malaria was conducted, and the blood donors’blood samples were collected and detected in laboratory to identify the origin of the infection. Results Microscopy detected Plasmodium in the blood samples from a 64-year-old male inpatient with nephropathy, and P. falciparum malaria was diagnosed. The case had no history of travel to Africa or Southeast Asia except blood transfusion, and he had received blood transfusion 14 times during his hospital stay. Detection of blood donors’blood samples showed P. falciparum in the archived blood samples from an Indonesian student studying in China, as revealed by PCR assay, and the student was found to have a history of malaria. Conclusions The patient was confirmed to be a case with P. falciparum malaria due to blood transfusion. Screening of malaria should be intensified in blood donors to prevent the development of malaria transmitted by blood transfusion.

Epidemiological investigation of blood transfusion - induced malaria caused by an imported case with Plasmodium falciparum infection / 中国血吸虫病防治杂志

Objective To analyze a case infected with Plasmodium falciparum due to blood transfusion in Taizhou City, so as to provide scientific evidence for malaria control. Methods The epidemiological investigation of a case with P. falciparum malaria was conducted, and the blood donors’blood samples were collected and detected in laboratory to identify the origin of the infection. Results Microscopy detected Plasmodium in the blood samples from a 64-year-old male inpatient with nephropathy, and P. falciparum malaria was diagnosed. The case had no history of travel to Africa or Southeast Asia except blood transfusion, and he had received blood transfusion 14 times during his hospital stay. Detection of blood donors’blood samples showed P. falciparum in the archived blood samples from an Indonesian student studying in China, as revealed by PCR assay, and the student was found to have a history of malaria. Conclusions The patient was confirmed to be a case with P. falciparum malaria due to blood transfusion. Screening of malaria should be intensified in blood donors to prevent the development of malaria transmitted by blood transfusion.

Liver histological changes in chronic hepatitis B patients with elevated ALT less than 2 x ULN / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the relevant factors of liver histological changes in chronic hepatitis B (CHB) patients with mildly elevated ALT and to explore the clinical values of these factors on anti-viral treatment.</p><p><b>METHODS</b>A total of 152 CHB patients with mildly elevated ALT (less than 2 x ULN) who underwent liver biopsy were included in the study. Correlations between routine laboratory markers, liver histological inflammation grade and fibrosis stage were statistically assessed by Spearman correlation analysis, one-way ANOVA, area under the curve (AUC) of the receiver operating characteristic curves (ROC) and Logistic regression statistical analysis.</p><p><b>RESULTS</b>All patients in the study showed various hepatic histological damages. Among the 152 patients 50 (32.9%) were found with inflammation grade 1 (G1), 42 (27.6%) with G2, 46 (30.3%) with G3 and 14 (9.2%) with G4. 16 patients (10.5%) were found with fibrosis stage 2 (S2), 25 (16.5%) with S3 and 41 (27.0%) with S4. Routine laboratory markers Alb, BPC and WBC were significantly correlated with hepatic histological inflammation grade and fibrosis stage. Marked liver fibrosis and moderate to severe liver damage were significantly higher in patients aged more than 40 years as compared to those less than 40 years of age (P = 0.002, P = 0.010). The regression equation P = 1/[1+e-(9.36250-1625Alb-0.0234BPC)] was established with sensitivity and specificity of 83.3% and 65.0%, respectively.</p><p><b>CONCLUSION</b>67.8% of CHB patients with mildly elevated ALT have significant injury to the liver tissue. CHB patients aged more than 40 years have a significant increase of marked liver fibrosis and moderate to severe liver damage. The regression equation is valuable to predict whether CHB patients need antiviral therapy or not.</p>

Analysis on detection of enterovirus nucleotides in feces samples of hand-foot-mouth disease patients after recovery / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the duration of enterovirus (EV) nucleotides positive in feces samples of hand-foot-mouth disease (HFMD) patients after recovery.</p><p><b>METHODS</b>A consecutive 6-week follow up were carried out towards 49 cases of laboratory-diagnosed HFMD patients. A total of 5 - 8 g feces sample was collected from each patient once a week. The common EV nucleotides of HFMD were detected by RT-PCR method and analyzed by Kaplan-Meier Survival Analysis Method.</p><p><b>RESULTS</b>The subtypes of the 49 HFMD patients included 16 enterovirus 71 (EV71), 15 coxsackievirus A16 (CoxA16) and 18 EV; a six-week follow up was carried out among all of them. In the first week, one EV71 patient and two EV patients were lost; in the fourth week, one CoxA16 were lost; and in the fifth week, one EV71 patient was lost. During the consecutive 6-week follow-up, the positive rates of EV nucleotides among EV71 patients were 81.3%, 60.9%, 47.4%, 33.9%, 27.1% and 18.1% separately; and the positive rates in CoxA16 group were 93.3%, 73.3%, 53.3%, 33.3%, 16.7% and 8.3% respectively. In EV group, the positive rates of EV nucleotides were 44.4% and 7.4% in the first two weeks and then turned to negative in the next 4 weeks. There was significant statistical difference in positive rates of EV nucleotides among different patients (χ(2) = 11.78, P = 0.001); however, each group of HFMD patients showed a declined trend with the extension of time.</p><p><b>CONCLUSION</b>The duration of EV nucleotides positive in feces samples of HFMD patients lasted for a long period since their recovery; and the positive results in EV71 and CoxA16 patients might last for 6 weeks.</p>

Study on the quality of life and social support among people living with HIV/AIDS and their family members / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the quality of life and related social support among people living with HIV/AIDS with related factors.</p><p><b>METHODS</b>331 people living with HIV/AIDS and 148 of their family members were selected using a typical sampling method. Questionnaires on general conditions, tables on history of infection, generic quality of life inventory-74 (GQOLI-74) and social support scale (SSS) were used.</p><p><b>RESULTS</b>Data from one-way analysis suggested that people living with HIV/AIDS and their family members with the different sexs, different villages and different cultural backgrounds had differences in GQOLI-74 scores (P < 0.05) while people living with HIV/AIDS with the different villages had differences in SSS scores (P < 0.05). Results from Multiple linear regression analysis revealed that being elderly and negative life events were negatively associated with social support (P < 0.05), while factors as more advanced educational background, harmonious neighborhood relationship and having bother pouring nature were the predictive factors (P < 0.05).</p><p><b>CONCLUSION</b>Many factors might affect dimensions of quality of life among people living with HIV/AIDS and their family members in rural areas of northern Anhui. Community care and social support of HIV/AIDS should still be greatly enhanced in the countryside of China. A community care mode based on family and neighborhood was expected to be developed.</p>

Study on the equity of rural health service in the experimental region of new rural cooperative medical scheme, Yuexi county, Anhui province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the situation of equity in health service delivery in the experimental region of new rural cooperative medical scheme (NRCMS).</p><p><b>METHODS</b>A household questionnaire survey was conducted to 2112 residents in the experimental county of NRCMS in Yuexi county with a stratified-cluster sampling on the situation of health service delivery, from July 1-15,2005. Data was analyzed with Epi Info 6.04 and SPSS 11.0 software and indices as rate, ratio, Gini coefficient, concentration index (CI) and chi-square test etc.</p><p><b>RESULTS</b>There was no significante difference of the treatment-seeking rate during two weeks among five groups economic condition residents (chi2 = 5.52, P > 0.05) and the rates were 48.14 per thousand, 82.90 per thousand, 65.88 per thousand, 48.72 per thousand and 50.66 per thousand respectively with CI = -0.026. Similarly, the hospitalization rates were 59.08 per thousand, 67.36 per thousand, 51.76 per thousand, 58.97 per thousand and 52.86 per thousand respectively in the last year and the CI = - 0.017. But there was a significante difference of rates on chronic disease among the five groups of residents with different economic conditions in the last six months (chi2 = 18.42, P < 0.01) and the rates were 295.40 per thousand, 243.52 per thousand, 230.59 per thousand, 225.64 per thousand and 176.21 per thousand and the CI = -0.055. When income reduced, the prevalence had been increasing among residents. Meanwhile, the collection funds showed unfair in residents with various income and the compensating fund of new rural cooperative medical scheme had not reduced the gap between rich and poor.</p><p><b>CONCLUSION</b>There was an unequity of medicine expenditure and compensating fund in residents with various income in the experimental region. The low income residents had a high health service need and the government should improve NRCMS greatly to change the situation.</p>