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Objective To analyze the epidemiological characteristics of imported cases with Plasmodium ovale infections in Jiangsu Province from 2012 to 2020, so as to provide insights into the development of the imported malaria control strategy in the province. Methods All data pertaining to cases with definitive diagnosis of P. ovale malaria in Jiangsu Province from 2012 to 2020 were captured from the National Notifiable Disease Report System and the Information Management System for Parasitic Disease Control in China, including the date of going abroad and returning to China, time of malaria infections overseas, date of malaria onset, initial diagnosis and definitive diagnosis. All data pertaining to epidemic status were descriptively analyzed. Results A total of 347 cases of P. ovale malaria were reported in Jiangsu Province from 2012 to 2020, with the highest number seen in 2015 (71 cases). All cases were laboratory-confirmed overseas imported malaria cases, accounting for 14.32% of all reported malaria cases in Jiangsu Province during the period from 2012 to 2020. The 5 cities with the highest number of imported P. ovale malaria cases included Lianyungang City (53 cases, 15.27%), Nantong City (44 cases, 12.68%), Huai’an (44 cases, 12.68%), Taizhou City (44 cases, 12.68%) and Yangzhou City (36 cases, 10.37%). The highest number of imported P. ovale malaria cases was reported in October (39 cases, 11.24%), and the lowest number was seen in December (21 cases, 6.05%). P. ovale infections mainly occurred in were Equatorial Guinea (97 cases, 37.95%), Angola (60 cases, 17.29%) and Nigeria (40 cases, 11.53%). The median duration between returning to China and malaria onset was 64 (144) days, and 7.49% (26/347) of all cases developed malaria one year after returning to China. The initial diagnosis of P. ovale malaria was mainly made at county-level medical institutions (117 cases, 33.72%), and the definitive diagnosis was mainly made at city-level medical institutions (122 cases, 35.16%). The correct rate of initial diagnosis of P. ovale malaria increased from 0 in 2012 to 78.26% in 2020, appearing a tendency towards a rise year by year (χ2 = 50.90, P < 0.01). Conclusions Imported P. ovale malaria cases were reported in Jiangsu Province each year from 2012 to 2020, and P. ovale infections predominantly occurred in Africa. Initial and definitive diagnoses of P. ovale malaria were mainly made at city- and county-level medical institutions. Training on the detection ability of malaria parasites is recommended among grassroots microscopists to improve the diagnostic ability of P. ovale malaria, and consolidate the achievements of malaria elimination in Jiangsu Province.
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Objective:To evaluate the effect and influence of exchange transfusion on neonatal ABO hemolysis by comparing the changes of indirect bilirubin in serum and internal environment before and after exchange transfusion.Methods:A retrospective analysis of 242 cases with neonatal ABO hemolytic disease from January 2017 to October 2018 in the Children's Hospital of Jiangxi Province was carried out.According to whether the parents signed or agreed to exchange transfusion, they were divided into two groups.The exchange group (126 cases) received routine treatment + exchange of blood, and the control group (116 cases) was only given conventional therapy(blue light + probiotics + gamma globulin). In the exchange group, peripheral venous blood was collected half an hour before the exchange of blood(T1) and half an hour after the exchange of blood(T2), while in the control group, the indirect bilirubin, platelet and blood sugar were measured at two time points of parents signing disapproval of exchange of blood(T1) and disapproval of exchange of blood and one day after the treatment(T2).Results:The indirect bilirubin levels in serum of the exchange group and the control group were decreased, and the difference was statistically significant[(194.010±41.065)μmol/L vs.(390.048±39.058)μmol/L, t=1507.604, (292.014±39.998)μmol/L vs.(383.452±42.820)μmol/L, t=306.820, all P<0.05]. The decrease of serum indirect bilirubin in the exchange group was more significant than that in the control group, and the difference was statistically significant.[(194.010±41.065)μmol/L vs.(292.014±39.998)μmol/L, t=368.267, P<0.05]. After exchange transfusion, the levels of platelet and blood sugar were decreased significantly, and the differences were statistically significant[(91.370±24.766)×10 9/L vs.(350.660±32.564)×10 9/L, t=5061.203, (2.965±0.593)mmol/L vs.(5.490±0.876)mmol/L, t=717.817, all P<0.05]. Decreased platelets and blood sugar could return to normal within 3 days. Conclusion:Exchange therapy can significantly reduce the level of bilirubin and the incidence of bilirubin encephalopathy in neonates with ABO hemolysis.Exchange therapy has certain effect on the internal environment of neonatal ABO hemolytic patients, which is easy to cause thrombocytopenia and blood sugar reduction.But the change of internal environment is temporary and reversible.
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Objective To analyze the epidemic situation of malaria in Jiangsu Province in 2019, so as to provide the scientific basis for the development of the strategy for the prevention of re-introduction of imported malaria. Methods The malaria case report information, epidemiological case investigation information, epidemic foci investigation and management report in Jiangsu Province in 2019 were collected, and all epidemiological data were descriptively analyzed. Results A total of 244 malaria cases were reported in Jiangsu Province in 2019, and all cases were laboratory-confirmed overseas imported cases, including 4 cases with vivax malaria, 206 cases with falciparum malaria, 12 cases with malariae malaria and 22 cases with ovale malaria. In 2019, there were 12 malaria cases progressing into severe cases in Jiangsu Province, with one death. Nanjing, Nantong, Lianyungang, Taizhou and Changzhou cities contributed the largest number of malaria cases in 2019, with the number of malaria cases accounting for 59.84% of total cases in Jiangsu Province. The infections occurred in Papua New Guinea (2 cases), Pakistan (1 case) and 27 African countries (241 cases), including Angola, the Democratic Republic of the Congo, Nigeria, Equatorial Guinea, Cote d'Ivoire and so on. There were 77 cases (31.55%) with a visit to doctor on the day of onset, and 146 cases (59.84%) within 1 to 3 days after onset. In addition, there were 149 cases (61.06%) with definitive diagnosis at the first visit and 77 cases (31.55%) diagnosed within 1 to 3 days after the visit, and the mean duration from the visit to definitive diagnosis was (0.80 ± 1.59) d, which significantly shortened as compared to that (1.34 d ± 2.59 d) in 2018 (U = 2.53, P < 0.05). Conclusions Intensifying the surveillance and management of imported malaria and improving the diagnostic capability of imported malaria and the treatment of severe malaria cases are required to consolidate the achievements of malaria elimination in Jiangsu Province.
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Objective To analyze the epidemic situation of malaria in Jiangsu Province in 2018, so as to provide scientific evidence for formulating post-elimination malaria surveillance schemes and technical measures in Jiangsu Province. Methods The malaria case report cards, epidemiological individual investigation forms of malaria cases and foci data were collected from Jiangsu Province in 2018, and the epidemic situation of malaria was descriptively analyzed. Results A total of 243 malaria cases were reported in Jiangsu Province in 2018, which increased by 1.67% in relative to in 2017 (239 cases), and these cases included 171 cases with falciparum malaria, 14 cases with vivax malaria, 15 cases with quartan malaria, 42 cases with ovale malaria and a case with mixed infection of P. vivax and P. ovale. All cases were overseas imported, and no local secondary cases were found. The malaria cases were predominantly workers (76.54%). Nantong City (48 cases), Yangzhou City (33 cases) and Taizhou City (22 cases) were the most 3 cities with the largest number of malaria cases across Jiangsu Province. The malaria infections predominantly occurred in African areas (96.30%), and the other 9 cases had infections in Asia (8 cases) and Central America (1 case). There were 125 cases (51.44%) and 91 cases (37.45%) with definitive diagnosis at the day of admission and within 1 to 3 days post-admission, respectively. The percentages of definitive diagnosis at initial diagnosis were 48.27%, 88.76% and 97.30% at township-, county- and city-level medical institutions, respectively, and the percentage of definitive diagnosis at initial diagnosis was significantly lower in township-level medical institutions than in county- (χ2 = 21.47, P < 0.01) and city-level medical institutions (χ2 = 32.86, P < 0.01). Conclusions There are no local malaria cases in Jiangsu Province; however, the number of overseas imported malaria cases remains high in China. In the future, improving the post-elimination malaria surveillance system, enhancing the awareness of malaria prevention and control knowledge among high-risk populations, increasing the diagnostic capability of malaria in medical institutions, and improving the management of imported malaria cases should be performed to consolidate the achievements of malaria elimination.
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Objective To understand the malaria epidemic situation and characteristics in Jiangsu Province in 2017, so as to provide the evidence for formulating the targeted strategy of malaria elimination. Methods The data of malaria cases in Jiangsu Province in 2016 were collected from China’s Routine Diseases Surveillance Information System (CRDSIS). Results Totally, 239 imported malaria cases were reported in Jiangsu Province in 2017, and the cases decreased by 22.40% compared to 308 cases in 2015. Except 2 malaria case caused by blood transfusion, the rest patients were all imported. Among them, there were 163 falciparum malaria cases, 21 vivax malaria cases, 11 quartan malaria cases, 43 ovale malaria cases, and 1 mixed infection case (Plasmodium falciparum and P. ovale). The numbers of imported cases of Nantong (39 cases, 16.32%), Suzhou (26 cases, 10.88%), Taizhou (25 cases, 10.46%), Huai’an (24 cases, 10.04%), and Lianyungang (22 cases, 9.21%) ranked in the top 5 cities across Jiangsu Province, the malaria cases in the five cities accounted for 56.90% (136/239). The infection source areas of the imported malaria cases included Africa (225 cases), Asia (8 cases), Oceania (2 cases), and South America (2 cases). Conclusions Jiangsu Province has no local malaria cases for 6 consecutive years. Despite the imported cases in 2017 decreased some-what compared to that in 2016, it is still necessary to strengthen the surveillance of imported malaria cases and improve malaria diagnosis and treatment in the whole province.
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Objective To understand the malaria epidemic situation and characteristics in Jiangsu Province in 2017, so as to provide the evidence for formulating the targeted strategy of malaria elimination. Methods The data of malaria cases in Jiangsu Province in 2016 were collected from China’s Routine Diseases Surveillance Information System (CRDSIS). Results Totally, 239 imported malaria cases were reported in Jiangsu Province in 2017, and the cases decreased by 22.40% compared to 308 cases in 2015. Except 2 malaria case caused by blood transfusion, the rest patients were all imported. Among them, there were 163 falciparum malaria cases, 21 vivax malaria cases, 11 quartan malaria cases, 43 ovale malaria cases, and 1 mixed infection case (Plasmodium falciparum and P. ovale). The numbers of imported cases of Nantong (39 cases, 16.32%), Suzhou (26 cases, 10.88%), Taizhou (25 cases, 10.46%), Huai’an (24 cases, 10.04%), and Lianyungang (22 cases, 9.21%) ranked in the top 5 cities across Jiangsu Province, the malaria cases in the five cities accounted for 56.90% (136/239). The infection source areas of the imported malaria cases included Africa (225 cases), Asia (8 cases), Oceania (2 cases), and South America (2 cases). Conclusions Jiangsu Province has no local malaria cases for 6 consecutive years. Despite the imported cases in 2017 decreased some-what compared to that in 2016, it is still necessary to strengthen the surveillance of imported malaria cases and improve malaria diagnosis and treatment in the whole province.
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Objective To analyze the results of samples testing of Jiangsu Provincial Malaria Diagnostic Reference Laboratory in 2017, so as to provide the evidence for improving the malaria diagnostic performance in this province. Methods The samples of reported malaria cases in Jiangsu were collected by the provincial reference laboratory (PRL) in 2017. The microscopy and nucleic acid test were performed to confirm the infection of Plasmodium species of each case, while Plasmodium antigen tests (rapid diagnostic test, RDT) were performed as well. The detection results were analyzed among different areas and different species. Results Totally 242 malaria cases were reported and the samples were collected by PRL in 2017. A total of 239 cases were confirmed Plasmodium infections, including 163 cases of Plasmodium falciparum infection, 21 cases of P. vivax infection, 11 cases of P. malariae infection, 43 cases of P. ovale infection, and 1 case of P. falciparum and P. ovale mixed-infection. The diagnostic coincidence rates of reported malaria case in 13 prefectures with districts were all > 80%, and the total coincidence rate was 88.8%. The species diagnostic coincidence rates of P. falciparum, P. vivax, P. malariae, and P. ovale were 98.8%, 57.1%, 63.6%, and 81.4% respectively, and the detection rates by RDT to those four species infections were 95.7%, 85.0%, 63.6% and 79.1% respectively. Conclusions In 2017, the malaria diagnostic quality of medical technicians is generally high in Jiangsu Province. However, the diagnostic capacity is slightly different among different regions, and the ability to identify non- P. falciparum parasites remains to be improved. RDT is not ideal for the detection of non-P. falciparum infection. In the current stage of malaria elimination, the malaria diagnostic capacity of technicians in all the sectors should be strengthened and maintained.
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Objective To analyze the epidemic situation of malaria in Jiangsu Province in 2018, so as to provide scientific evidence for formulating post-elimination malaria surveillance schemes and technical measures in Jiangsu Province. Methods The malaria case report cards, epidemiological individual investigation forms of malaria cases and foci data were collected from Jiangsu Province in 2018, and the epidemic situation of malaria was descriptively analyzed. Results A total of 243 malaria cases were reported in Jiangsu Province in 2018, which increased by 1.67% in relative to in 2017 (239 cases), and these cases included 171 cases with falciparum malaria, 14 cases with vivax malaria, 15 cases with quartan malaria, 42 cases with ovale malaria and a case with mixed infection of P. vivax and P. ovale. All cases were overseas imported, and no local secondary cases were found. The malaria cases were predominantly workers (76.54%). Nantong City (48 cases), Yangzhou City (33 cases) and Taizhou City (22 cases) were the most 3 cities with the largest number of malaria cases across Jiangsu Province. The malaria infections predominantly occurred in African areas (96.30%), and the other 9 cases had infections in Asia (8 cases) and Central America (1 case). There were 125 cases (51.44%) and 91 cases (37.45%) with definitive diagnosis at the day of admission and within 1 to 3 days post-admission, respectively. The percentages of definitive diagnosis at initial diagnosis were 48.27%, 88.76% and 97.30% at township-, county- and city-level medical institutions, respectively, and the percentage of definitive diagnosis at initial diagnosis was significantly lower in township-level medical institutions than in county- (χ2 = 21.47, P < 0.01) and city-level medical institutions (χ2 = 32.86, P < 0.01). Conclusions There are no local malaria cases in Jiangsu Province; however, the number of overseas imported malaria cases remains high in China. In the future, improving the post-elimination malaria surveillance system, enhancing the awareness of malaria prevention and control knowledge among high-risk populations, increasing the diagnostic capability of malaria in medical institutions, and improving the management of imported malaria cases should be performed to consolidate the achievements of malaria elimination.
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Objective To analyze the results of samples testing of Jiangsu Provincial Malaria Diagnostic Reference Laboratory in 2017, so as to provide the evidence for improving the malaria diagnostic performance in this province. Methods The samples of reported malaria cases in Jiangsu were collected by the provincial reference laboratory (PRL) in 2017. The microscopy and nucleic acid test were performed to confirm the infection of Plasmodium species of each case, while Plasmodium antigen tests (rapid diagnostic test, RDT) were performed as well. The detection results were analyzed among different areas and different species. Results Totally 242 malaria cases were reported and the samples were collected by PRL in 2017. A total of 239 cases were confirmed Plasmodium infections, including 163 cases of Plasmodium falciparum infection, 21 cases of P. vivax infection, 11 cases of P. malariae infection, 43 cases of P. ovale infection, and 1 case of P. falciparum and P. ovale mixed-infection. The diagnostic coincidence rates of reported malaria case in 13 prefectures with districts were all > 80%, and the total coincidence rate was 88.8%. The species diagnostic coincidence rates of P. falciparum, P. vivax, P. malariae, and P. ovale were 98.8%, 57.1%, 63.6%, and 81.4% respectively, and the detection rates by RDT to those four species infections were 95.7%, 85.0%, 63.6% and 79.1% respectively. Conclusions In 2017, the malaria diagnostic quality of medical technicians is generally high in Jiangsu Province. However, the diagnostic capacity is slightly different among different regions, and the ability to identify non- P. falciparum parasites remains to be improved. RDT is not ideal for the detection of non-P. falciparum infection. In the current stage of malaria elimination, the malaria diagnostic capacity of technicians in all the sectors should be strengthened and maintained.
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To establish a systemized malaria biobank with well-rounded epidemiologic data and a computer-aid management system, thus to provide qualified sources for malaria elimination and human malaria research.The malaria biobank was based on the platform of Jiangsu Institute of Parasitic Diseases. The blood smear samples, dried blood samples, whole blood samples and parasite strains isolated from patients (from both local and imported cases) were collected since 2011 according to a standardized operational procedure. The biobank management software was applied to input of the epidemiological data and samples, and the quality of samples was monitored regularly.A standard malaria biobank was established. The Information Management System was applied to input, storage and output of samples. Totally 99.42% (2 223/2 236) of the blood smear samples, 92.58% (2 070/2 236) of the dried blood samples, 94.50% (2 113/2 236) of whole blood, and 2.06% (46/2 236) of the isolated stains in 2 236 reported cases were included in the malaria biobank in Jiangsu Province from 2011 to 2017. Based on the malaria biobank, 99.42% (2 223/2 236) of the blood smears and 82.74% (1 850/2 236) of DNA (from dried blood and whole blood samples) from malaria patients in Jiangsu Province were re-checked. Moreover, the samples in the malaria biobank were used in the studies of the mechanism of parasite drug resistance, malaria molecular epidemiology, and diagnosis technology development and evaluation.The establishment of malaria biobank provides a guarantee for malaria elimination in Jiangsu Province and also provides a qualified resource for malaria research.
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To analyze the working conditions and evaluate the effectiveness of blood smear examinations in fever patients after the start of national malaria elimination program (NMEP), and explore the suitable strategy for malaria diagnosis and surveillance in NMEP, so as to provide the evidence for the development and adaptation of malaria elimination strategies and measures in Jiangsu Province.The data of malaria epidemic situation reported by network, fever patients’ blood test tables, and epidemiological surveys of malaria cases were collected and statistically analyzed by SPSS 16.0 in Jiangsu Province from 2010 to 2016.A total of 2 367 cases of malaria cases were reported from 2010 to 2016. Among the 3 691 188 person-times of fever patients tested, there were 2 252 positives (0.06%). The number of blood tests of fever patients decreased from 742 900 in 2010 to 277 000 in 2016. At the same time, the positive rate increased from 0.04% in 2010 to 0.16% in 2016. The positive rate of blood tests of fever patients in 2016 was significantly higher than that in 2010 (χ2 = 161.61, P < 0.01). From 2010 to 2016 in Jiangsu province, the centers for disease control and prevention of cities and counties, that completed the blood review within 3 days, deleted 273 negative cases. In 2010, the centers for disease control and prevention of cities and counties deleted 61 negative cases, but in 2016, the centers deleted only 14 negative cases, and the negative rate of blood review in 2010 was significantly higher than that in 2016 (χ2 = 22.99, P < 0.01).A large number of blood smear examinations have been tested in fever patients in Jiangsu Province. It not only conforms to the strong monitoring system requirements issued by World Health Organization (WHO) in malaria elimination, but also provides the evidence for no local malaria case in Jiangsu since 2012.
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To understand the quality of production of blood slides and laboratory personnel’s ability to microscopically examine Plasmodium at Jiangsu Province clinic inspection stations at all levels, so as to provide the evidence for the construction of malaria diagnostic laboratories and the evaluation of malaria elimination effect.After the reexamination of the negative blood slides of the examination stations of the malaria center in each county (district), the negative blood slides of the outpatient inspection station in the district and all the positive blood slides of the direct report of the network from 2011 to 2017, the staining and cleanliness of the blood smears, microscopic examination results and the coincidence rate of positive blood species were comprehensively analyzed.A total of 19 109 checked blood samples were examined. The qualified rates of blood preparation, dyeing and cleanliness were 87.5%, 89.3% and 87.6%, respectively. The quality of reexamined blood slides in different years showed statistically significant difference (all P < 0.05), by using chi-square trend test, and there was a trend of increasing year by year. There was a significant difference in the quality of the reexamined blood slides among the different cities with districts (P < 0.05). In addition, there were 1 860 blood samples from 2012 to 2017, and the total coincidence rate was 87.4% and the coincidence rate of positive blood smear examinations was 98.9%. The species coincidence rates of Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae, Plasmodium ovale and mixed infection were 95.4%, 33.3%, 56.0%, 76.5% and 9.1%, respectively (P < 0.05). The total coincidence rates of blood smear reexaminations in different years were 85.0%, 90.1%, 86.0%, 85.3%, 90.0% and 87.6% from 2012 to 2017, respectively, and the difference was not statistically significant (P > 0.05).The quality of blood slides at the primary clinic inspection stations in Jiangsu Province conforms to the standard established by the provincial malaria reference laboratory; however, the ability of Plasmodium species identification is insufficient and needs to be improved.
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There were vivax malaria, falciparum malaria, and malariae malaria epidemic in Jiangsu Province, and vivax malaria was the dominant disease. Anopheles sinensis and An. anthropophagus were malaria-transmitted vectors. Since the founding of People’s Republic of China, there have been two major malaria outbreaks in Jiangsu Province, when the highest annual malaria incidence reached up to 24.95%. According to prevention and control principles of “adjusting measures to local conditions, giving different guidance to different categories and highlighting key points”, during the epidemic outbreak stage, the largescale malaria prevention and control measures were implemented for all the residents who were target population in Jiangsu malaria-endemic areas. During the basic eradication stage, the targeted prevention and control measures had been carried out according to the different epidemic features to gradually consolidate the achievement of prevention and control in Jiangsu Province. In the malaria elimination stage, Jiangsu Province focused on controlling of the source of infection and malaria surveillance. According to the “1-3-7 targeted elimination” work model, the management of infectious sources and investigation and disposal of foci were carried out for each epidemic focus to block the malaria transmission. By the end of 2017, there had been no indigenous malaria cases for the six consecutive years in Jiangsu Province. All the 13 cities have passed the assessment of malaria elimination of Jiangsu Province. Although Jiangsu Province has achieved the goal of malaria elimination, it is urgent and necessary to maintain and improve malaria surveillance capabilities to prevent malaria reintroduction.
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Objective To explore the expression characteristics of cytochrome P450(CYP)candidate genes(CYP6M3, CYP6Y1,CYP6P5,CYP4H14,CYP4G17,CYP12F16)in Anopheles sinensis.Methods The samples were collected from dif-ferent developmental stages(eggs,larvae,pupae and adult mosquitoes(females and males)),and different tissues(salivary glands,malpighian tubes,midguts,ovaries,and fat bodies)of An.sinensis and the female adult mosquitoes exposed by differ-ent insecticide doses(0,1.25,3.75,6.25,12.5μg/bottle)and time points(0,5,15,30,60 minutes),then the total RNA was extracted. Quantitative reverse transcription PCR(qPCR)assay was used to analyze the relative expressions of six CYP genes in An.sinensis at different developmental stages,tissues and different insecticide exposure doses and time.Results The expressions of CYP6M3 and CYP6Y1 in the male adult mosquitoes were the highest,the expression of CYP6M3 gene in the males was 35.1 times higher than that in the females,the expression of CYP6Y1 in the males was 61.4 times higher than that in the females;the expression level of CYP4H14 in the larvae was the lowest,the expression of CYP4H14 in the females was 22.5 times higher than that in the fourth instar larvae.The expressions of candidate CYP genes in different tissues of An.sinensis were significantly different,the expression of CYP6M3 in the malpighian tubule was 38.9 times higher than that in the ovary,the ex-pression of CYP6Y1 in the fatbody was 9.1 times higher than that in the ovary,the expression of CYP4G17 was 4.6 times higher than that in the ovary,and the expression of CYP12F16 was 4.4 times higher thanthat in the ovary.The exposure to different in-secticide doses and time showed some induction effects in the expressions of candidate CYP genes,which affected the expres-sions of candidate CYP genes in An.sinensis.Conclusion The expression of candidate CYP genes varies significantly in differ-ent developmental stages and various tissues of An.sinensis,and exposure to deltamethrin at various doses and time points af-fects CYP genes expression in An.sinensis.
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Objective To understand the malaria epidemic situation and characteristics in Jiangsu Province in 2016,so as to provide the evidence for formulating and adjusting the strategy and measures for malaria elimination. Methods The data of malaria cases in Jiangsu Province in 2016 were collected from China's Routine Diseases Surveillance Information System(CRD-SIS)and analyzed statistically.Results Totally,308 malaria cases were reported in Jiangsu Province in 2016,and the cases decreased by 23.95% compared to 405 malaria cases in 2015.Except for 1 malaria case that was caused by blood transfusion, the rest patients were all imported.Among the 308 cases,237 were infected with Plasmodium falciparum,11 were infected with P.vivax,8 were infected with P.malariae,51 were infected with P.ovale,and 1 was mixed infection.Among all the cities in Ji-angsu Province,the numbers of imported cases of Nantong(53 cases),Huai'an(41 cases),Taizhou(40 cases),Lianyungang (36 cases)and Yangzhou(29 cases)ranked in the top 5,and the total malaria cases in the five cities accounted for 64.61%. Conclusions There were no local malaria cases in Jiangsu Province for 5 consecutive years up to 2016.Although the imported cases decreased slightly compared to those in 2015,we still should strengthen the surveillance of imported malaria cases as well as improve malaria diagnosis and treatment abilities for related personnel at all levels of medical institutions.Also we should fo-cus on the Plasmodium check,focus survey and disposal to realize the aim of malaria elimination in Jiangsu Province in time.
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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 design and develop an online training and evaluation system for parasitic pathogen recognition. Methods The system was based on a Parasitic Diseases Specimen Image Digitization Construction Database by using MYSQL 5.0 as the system of database development software,and PHP 5 as the interface development language. It was mainly used for on-line training and evaluation of parasitic pathology diagnostic techniques. Results The system interface was designed simple, flexible,and easy to operate for medical staff. It enabled full day and 24 hours accessible to online training study and evaluation. Thus,the system broke the time and space constraints of the traditional training models. Conclusion The system provides a shared platform for the professional training of parasitic diseases,and a reference for other training tasks.
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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 establish a method based on repetitive protein sequences and linear B cell epitope to predict and screen specific peptides of Plasmodium vivax. Methods A P. vivax protein sequence database was reconstructed based on Plas-moDB data,and a customized software for searching of repetitive sequences was used to count the repetition times of each 16 aa peptide in the whole database,and the highly repetitive peptides were chosen to predict the potential linear B cell epitopes. The re-petitive peptides with P. vivax specificity were selected as candidate antigen peptides to synthesize and to couple with KLH carrier protein for immunizing BALB/c mice. After the immunization,the antibody titers of the immunized mice were detected. Results The repetitive information of 16 aa peptides was analyzed by screening of the total 5 432 peptide sequences in the P. vivax data-base. A total of 22 peptides were identified as candidate peptides from the top 1 000 repetitive peptides by linear B cell epitope pre-diction on the BcePred website. Through clustering analysis and similarity comparison,five potential P. vivax specific peptides were selected,synthesized and then coupled with KLH to immunize the mice. The antibody titers of the immunized mice induced by the 5 peptides were all above 1:9 000. Conclusion The method for predicting and screening of specific peptides of P. vivax based on repetitive protein sequences and linear B cell epitope has been established successfully,and all the 5 peptides obtained by the method can induce the high titer antibody in mice.