ABSTRACT
Objective To understand the epidemiological characteristics of imported malaria and the control and diagnostic capacities of the medical institutions in Wuhan City,so as to offer the evidence for formulating the surveillance and control strat-egies.Methods From 2008 to 2017,the epidemiological data of imported malaria were collected.The information including gender,age,distribution,vocational background,positive rate of fever patients,and time of final diagnosis was analyzed with the descriptive statistic method.The Plasmodium species composition and infection source were analyzed by chi square test.The initial and confirmed diagnosis abilities of medical institutions were analyzed by rank sum test.Results Totally,424 imported malaria cases were reported,including 301 falciparum malaria cases(70.99％).The male population aged 20 to 49 years was the main morbidity group,and the incidence was not related to seasons.For the parasite species,there was a significant differ-ence between African countries and Southeast Asian countries(Χ 2=205.83,P<0.01).Plasmodium ovale and P.malariae were all imported from sub-Saharan Africa.For diagnostic capacities of the medical institutions at different levels,the initial diag-nosis(Z=-3.89,P<0.01)and confirmed diagnosis(Χ2=53.88,P<0.01)were significantly different,respectively.The abili-ty of malaria diagnosis was improved rapidly in the clinical laboratory after 2008 and achieved to 100％in 2010.The detection rate within 24 hours increased to at least 90％and the detection rate within 6 days decreased to 0 in 2016.Conclusions Al-though the medical institutions in Wuhan City have strong ability to treat imported malaria,they are still faced with a serious sit-uation for malaria control and elimination.The capacity building should be strengthened constantly.
ABSTRACT
PURPOSE: To compare the diagnostic capability of Bruch membrane opening-minimum rim width (BMO-MRW) and peripapillary retinal nerve fiber layer (RNFL) thickness for the detection of primary open angle glaucoma. METHODS: Spectral-domain optical coherence tomography (SD-OCT) with 24 radial and 1 peripapillary B-scans centered on the Bruch membrane opening (BMO) was performed. Two SD-OCT parameters were computed globally and sectorally: (1) BMO-MRW, the minimum distance between BMO and internal limiting membrane; and (2) peripapillary retinal nerve fiber layer (RNFL) thickness. The diagnostic performance of BMO-MRW and RNFL thickness were compared with receiver operating characteristic (ROC) analysis globally and sectorally. Areas under the ROC (AUC) were calculated and compared. RESULTS: One hundred fourteen eyes (52 healthy, 62 glaucomatous) of 114 participants were included. In global analyses, the performance of BMO-MRW was similar to that of RNFL thickness (AUC 0.95 [95% confidence interval {CI}, 0.91-0.99], and 0.95 [95% CI, 0.91-0.99], respectively, p=0.93). In sectoral analyses, the pair-wise comparison among the ROC curves showed no statistical difference for all sectors except for the superotemporal, superonasal, and nasal sectors, which had significantly larger AUCs in BMO-MRW compared to RNFL thickness (p=0.03, p<0.001, and p=0.03, respectively). The parameter with the largest AUC was the inferotemporal sector for both BMO-MRW and RNFL thickness (AUC 0.98 [95% CI, 0.96-1.00], and 0.98 [95% CI, 0.96-1.00], respectively, p=0.99). CONCLUSIONS: Global BMO-MRW performed as well as global RNFL thickness for detection of glaucoma. In superotemporal, superonasal and nasal sectors, regional BMO-MRW performed better than regional RNFL thickness.
Subject(s)
Area Under Curve , Bruch Membrane , Glaucoma , Glaucoma, Open-Angle , Membranes , Nerve Fibers , Retinaldehyde , ROC Curve , Tomography, Optical CoherenceABSTRACT
PURPOSE: To investigate the retinal nerve fiber layer (RNFL) thickness concordance when measured by spectral domain (SD) and swept source (SS) optical coherence tomography (OCT), and to compare glaucoma-discriminating capability. METHODS: RNFL thicknesses were measured with the scan circle, centered on the optic nerve head, in 55 healthy, 41 glaucoma suspected, and 87 glaucomatous eyes. The RNFL thickness measured by the SD-OCT (sdRNFL thickness) and SS-OCT (ssRNFL thickness) were compared using the t-test. Bland-Altman analysis was performed to examine their agreement. We compared areas under the receiver operating characteristics curve and examined sdRNFL and ssRNFL thickness for discriminating glaucomatous eyes from healthy eyes, and from glaucoma suspect eyes. RESULTS: The average ssRNFL thickness was significantly greater than sdRNFL thickness in healthy (110.0 ± 7.9 vs. 100.1 ± 6.8 µm, p < 0.001), glaucoma suspect (96.8 ± 9.3 vs. 89.6 ± 7.9 µm, p < 0.001), and glaucomatous eyes (74.3 ± 14.2 vs. 69.1 ± 12.4 µm, p = 0.011). Bland-Altman analysis showed that there was a tendency for the difference between ssRNFL and sdRNFL to increase in eyes with thicker RNFL. The area under the curves of the average sdRNFL and ssRNFL thickness for discriminating glaucomatous eyes from healthy eyes (0.984 vs. 0.986, p = 0.491) and glaucoma suspect eyes (0.936 vs. 0.918, p = 0.132) were comparable. CONCLUSIONS: There was a tendency for ssRNFL thickness to increase, compared with sdRNFL thickness, in eyes with thicker RNFL. The ssRNFL thickness had comparable diagnostic capability compared with sdRNFL thickness for discriminating glaucomatous eyes from healthy eyes and glaucoma suspect eyes.
Subject(s)
Glaucoma , Nerve Fibers , Optic Disk , Retinaldehyde , ROC Curve , Tomography, Optical CoherenceABSTRACT
OBJECTIVE: To assess diagnostic accuracy of the transvaginal ultrasonography and confirm the clinical safety as a final diagnosis in the asymptomatic ectopic pregnancy. METHODS: Total 58 women which were suspected with ectopic pregnancy were recruited during 1 year period. Women without sonographic evidence of the intrauterine gestational sac with serum beta-hCG level beyond 1,500 mIU/ml or gestational periods beyond 37 days were included (n=44), and women with acute symptom were excluded (n=14). We performed the laparoscopy and compared them with the ultrasonographic findings. We regarded the cases with accordance between two findings as an accurate diagnosis, and calculated diagnostic accuracy. All surgical specimens were confirmed by the pathological examination. RESULTS: Of 44 subjects, we suspected ectopic pregnancy by ultrasonography in 42 patients and classified as right fallopian tube (20 cases), left fallopian tube (15 cases), right interstitial (3 cases), left interstitial (4 cases), normal finding (2 cases). Of 42 cases, 41 cases were confirmed as an ectopic pregnancy by laparoscopical and pathological examination. There were two cases of inaccurate diagnosis, in one case, suspected site was not concordant, in another case, ectopic pregnancy focus was not identified in laparoscopy. In 2 cases with normal ultrasonographic findings, any other findings suspicious of ectopic pregnancy were not identified in laparoscopy. By 2X2 contingency table analysis, sensitivity, specificity, positive predictive value, negative predictive value of the transvaginal ultrasonography for diagnosis of the ectopic pregnancy were 100%, 50%, 98%, 100%, respectively. CONCLUSION: Diagnostic capability of the transvaginal ultrasonography in the ectopic pregnancy was very powerful and reliable, and sonographical diagnosis may replace the diagnostic laparoscopy if medical treatment is intended.