A pulmonary source of infection in patients with sepsis-associated acute kidney injury leads to a worse outcome and poor recovery of kidney function / 世界急诊医学杂志（英文）

BACKGROUND@#Hospital mortality rates are higher among patients with sepsis-associated acute kidney injury (SA-AKI) than among patients with sepsis. However, the pathogenesis underlying SA-AKI remains unclear. We hypothesized that the source of infection affects development of SA-AKI. We aim to explore the relationship between the anatomical source of infection and outcome in patients with SA-AKI.@*METHODS@#Between January 2013 and January 2018, 113 patients with SA-AKI admitted to our Emergency Center were identified and divided into two groups: those with pulmonary infections and those with other sources of infection. For each patient, we collected data from admission until either discharge or death. We also recorded the clinical outcome after 90 days for the discharged patients.@*RESULTS@#The most common source of infection was the lung (52/113 cases, 46%), followed by gastrointestinal (GI) (25/113 cases, 22.1%) and urinary (22/113, 19.5%) sources. Our analysis showed that patients with SA-AKI had a significantly worse outcome (30/52 cases, P<0.001) and poorer kidney recovery (P=0.015) with pulmonary sources of infection than those infected by another source. Data also showed that patients not infected by a pulmonary source more likely experienced shock (28/61 cases, P=0.037).@*CONCLUSION@#This study demonstrated that the source of infection influenced the outcome of SA-AKI patients in an independent manner. Lung injury may influence renal function in an as yet undetermined manner as the recovery of kidney function was poorer in SA-AKI patients with a pulmonary source of infection.

Effect of wild feces detection in Oncomelania hupensis environments on sur-veillance of infection source of schistosomiasis / 中国血吸虫病防治杂志

Objective To evaluate the effect of wild feces detection in Oncomelania hupensis environments on the surveil?lance of infection source of schistosomiasis,and find the weakness in schistosomiasis control in Hubei Province,so as to put for?ward the targeted strategies and measures. Methods Four environments with O. hupensis snails in endemic areas of Hubei Provinces,where human and livestock often haunted,were selected according to the river systems,namely the Juzhanghe River beach in Jingzhou City,Changjiang River beach in Jiayu County,Hanbei River beach in Tianmen City,and Changshou River beach in Zhongxiang City,then the snail survey and wild feces detection were implemented in the selected environments. Re?sults There were O. hupensis snails,livestock,wild feces of cattle or sheep as well as positive cattle feces found in all the 4 environments,and the positive rate of schistosome miracidium incubation was 47.62%. Conclusion The schistosome miracidi?um positive rate of wild feces of cattle is high in the environments with snails in endemic areas of Hubei Province ,which has high risk for schistosomiasis transmission.

Effect of comprehensive schistosomiasis control measures based on infection source control in mountainous areas of Yunnan Province / 中国血吸虫病防治杂志

Objective To evaluate the effect of comprehensive schistosomiasis control measures based on infection source control in plateau mountain areas of Yunnan Province. Methods From 2006 to 2004,four administrative villages were selected as test areas from plateau canyon and plateau basin endemic areas in Jindun Town,Heqing County,two villages each type,and the comprehensive control measures were implemented,including the examination and treatment of schistosomiasis,Oncomela?nia hupensis snail survey and control,health education,improving drinking water and lavatories,banning grazing,constructing sanitary pen of livestock,replacing cattle with machine,etc. The schistosome infection state and snail status in 2006 were treat?ed as the baseline information,and the effect of the comprehensive measures were evaluated. Results The infection rate of hu?man in plateau canyon areas decreased from 4.94%in 2006 to 0.06%in 2014,and that of livestock decreased from 1.11%to 0. In plateau basin areas,there was only 1 case of schistosomiasis found in Xiaolian Village in 2007,and no any other cases found in the other years,the infection rates of livestock dropped from 7.38%to 0. Compared with 2006,the snail areas in the two type areas decreased by 74.89%and 75.30%,respectively,meanwhile,the percentage of snail area,the occurrence rate of frames with snails,as well as the average density of living snails also decreased,and no infected snails were found since 2008. Xidian and Xinzhuang villages in plateau canyon area reached the criteria of schistosomiasis transmission controlled in 2009,and Xiao?lian and Kangfu villages in plateau basin reached the criteria of transmission interrupted in 2014. Conclusions The comprehen?sive schistosomiasis control measures based on infection source control can effectively control the endemic situation of schistoso? miasis in plateau areas of Yunnan Province. In the future,we should pay an equal attention to the infection sources control and snail control to consolidate and amplify the achievement of schistosomiasis control.

Observation on comprehensive control strategy for schistosomiasis with em-phasis on infectious source control in Poyang Lake areas from 2009 to 2014 / 中国血吸虫病防治杂志

Objective To evaluate the long?term effect of the comprehensive control strategy for schistosomiasis with empha?sis on infectious source control in marshland?type endemic areas of Poyang Lake. Methods Three heavy endemic villages with schistosomiasis in the lake areas were selected as pilots for the comprehensive control strategy which included replacing bovine with tractors and forbidding grazing on marshlands. The data of schistosome infections of residents and Oncomelania hupensis snails were collected and analyzed statistically from 2009 to 2014. Results There were no patients with schistosomiasis through feces examinations in the 3 pilot villages. The average density of live snails in Niuzhou marshland showed a decline trend and the density was stable in Liulingwei marshland. There were no infected snails in the 2 marshlands and no schistosome adult worms were found in the sentinel rats Conclusion The implantation of the comprehensive control strategy for schistosomiasis with em?phasis on infectious source control can control the prevalence of schistosomiasis during a long period.

Longitudinal observations on effect of schistosomiasis control in Gongan County,Hubei Province / 中国血吸虫病防治杂志

Objective To evaluate the effect of schistosomiasis control in Gongan County,Hubei Province by longitudinal ob-servations so as to provide the evidence for formulating the schistosomiasis control strategy in lake and marshland regions. Meth-ods The schistosomiasis epidemic data in Gongan County from 2000-2013 were collected by the retrospective research method, and analyzed about the changing tendency of human and cattle infection rates,and Oncomelania hupensis snail situation. Re-sults The tendency of schistosomiasis epidemic situation was descended from 2000 to 2013. The human infection rate declined from 12.62%in 2000 to 0.69%in 2013. The decline scope of human infection rate was 24.1%in the first stage,64.4%in the sec-ond stage,and 73.0%in the third stage. Eight acute schistosomiasis cases were reported in the first stage,15 cases in the second stage,and none in the third stage. The cattle infection rate declined from 6.50%in 2000 to 0.30%in 2013. The rise scope of cattle infection rate was 74.2%in the first stage,but the decline scope was 75.0%in the second stage and 87.6%in the third stage. All the cattle were disposal at the end of 2013. The infection rate of snails,area with infected snails,and average density of living snails in the first stage increased by 18.1%,46.0%and 7.6%,respectively. The 3 indexes above-mentioned in the second stage de-creased by 76.8%,97.8%and 37.9%,respectively. In the third stage,the infection rate of snails and area with infected snails de-creased by both 100%,but the average density of living snails increased by 2.7%. The infected snails were found from 2000 to 2011,but none in 2012 and 2013. The infection rate of snails and area with infected snails dropped yearly,the infection rate of snails declined from 0.0007% in 2000 to 0.0002% in 2011,and the area with infected snails declined from 267.8 hm2 in 2000 to 6.37 hm2 in 2011. Conclusions After the implementation of the integrated schistosomiasis prevention and control strategy with the emphasis on infectious source control,the human and cattle schistosome infection rates decline significantly. Hereafter,it is necessary to prevent the schistosomiasis epidemic outbreak or rebound.

Measures of infection source control of schistosomiasis and their effects in Four-lake regions of Hubei Province / 中国血吸虫病防治杂志

Objective To evaluate the effect of a new schistosomiasis control strategy based on the infection source control in four-lake regions of Hubei Province. Methods The new strategy based on the infection source control included the safe water sup-ply,feces harmless treatment,replacing cattle with machine,captive livestock,chemotherapy,Oncomelania hupensis snail con-trol in susceptible areas,hardening ditches,etc,and the new control strategy was implemented for 7 years in 9 counties(cities or districts)of the four-lake regions. The schistosomiasis situations were investigated before and after the intervention of the new strat-egy. Results The coverage rates of feces harmless toilets(three format toilets),biogas digesters,and safe water supply were 42.00%,23.16% and 93.76%,respectively. The number of ditch hardening was 1 960;the area of eliminating snails was 1 378.42 hm2;the number of persons who received the health education was 3 524 818 accounting for 92.17%of the total popula-tion;the number of person-time of taking active protection measures was 516 636 963. The average annual decline rates of schisto-some infection were 24.42%and 38.38%in residents and cattle,respectively. The endemic villages decreased by 4.77%,the vil-lages with snails decreased by 7.05%,and the villages with snails accounted between 63.19%and 66.21%of the total endemic vil-lages. The area with snails decreased by 90.35%,and the advance schistosomiasis patients decreased by 5.55%,and the fatality rate of advanced schistosomiasis patients decreased by 1.24%. No acute schistosomiasis patients occurred. Type One and Two en-demic(heavy endemic)villages decreased to zero;Type Three endemic(moderate endemic)villages decreased by 10.22%;but Type Four endemic(mild endemic)villages increased by 66.38%;and Type Five endemic(no endemic for 5 years)villages de-creased by 0.22%. The standards of schistosomiasis transmission controlled have achieved on schedule. Conclusion The imple-mentation of the new schistosomiasis control strategy based on the infection source control in four-lake regions of Hubei Province can effectively control schistosomiasis.

Effect of comprehensive schistosomiasis control strategy based on infection source control in Hanchuan City / 中国血吸虫病防治杂志

Objective To evaluate the effect of comprehensive schistosomiasis control measures based on infection source control in Hanchuan City marshland and lake endemic regions . Methods The data of comprehensive schistosomiasis control in Hanchuan City from 2004 to 2013 were collected and the change trends of the Oncomelania hupensis snail status and the in?fection situation of human and livestock were analyzed to evaluate the control effect. Results After the implementation of the comprehensive measures the infection rates of residents and cattle decreased from 6.38%and 8.11%in 2004 to 0.16%and 0 in 2013 respectively. There were no acute schistosomiasis patients since 2007 no new infection cases since 2011 and no infected snails since 2012. Compared with 2004 the occurrence rate of frames with living snails and the average density of living snails decreased by 56.78%and 68.35% respectively but the snail area and susceptible area increased by 0.62%and 7.10% respec?tively. In 2013 all the 367 endemic villages in 26 townships reached the criteria of transmission controlled. Conclusions The comprehensive schistosomiasis control measures based on infection source control can control the schistosomiasis transmission effectively in marshland and lake endemic regions. When consolidating the achievement the snail area in inner embankment should be compressed to prevent the schistosome re?infection in human and livestock.

Leptospirosis en humanos en el municipio Playa La Habana 2000-2010 / Leptospirosis in humans at Playa municipality Havana 2000-2010

Introducción: La Leptospirosis, considerada históricamente la Zoonosis de mayor repercusión internacional y que mayores daños ha provocado desde el punto de vista económico y social. Objetivo: Describir las características socio-demográficas y clínicas de personas infectadas con Leptospirosis en el municipio Playa La Habana. Método: Se realizó un estudio descriptivo, de carácter retrospectivo; se notificaron 153 casos sospechosos de Leptospirosis humana por tarjeta de Enfermedad Declaración Obligatoria (EDO) reportados al Departamento municipal de Zoonosis, se les realizó encuesta epidemiológica a 25 casos confirmados. Se revisaron 23 encuestas que constituyeron nuestro universo de estudio. No se pudieron localizar dos de ellas que corresponden al año 2002. Las variables estudiadas fueron: edad, sexo, ocupación, fuente de infección, animales reservorios, signos y síntomas, frecuencia de casos según meses, tiempo transcurrido entre el inicio de los síntomas y la obtención de asistencia médica. Resultados: La enfermedad fue más frecuente en hombres trabajadores expuestos de 35-44 años de edad, las fuentes de infección fueron la alta infestación de roedores, seguida por el contacto directo con animales reservorio. Los casos predominaron en el segundo semestre cuyos síntomas y signos fueron fiebre, cefalea, mialgias y artralgias en la forma anictérica o leve de la enfermedad. La mitad de los pacientes recibió asistencia médica a las 72 horas o más de iniciados los síntomas de la enfermedad. Conclusiones: La Leptospirosis es una enfermedad de causa ocupacional donde el conocimiento del reservorio, vía de transmisión y fuente de infección son fundamentales para adoptar las medidas de prevención.

Introduction: Leptospirosis is historically considered the zoonosis of bigger international repercussion since it has provoked the bigger number of damages from the social and economical point of view. Objective: To describe the social - demographic and clinical characteristics of the persons infected with leptospirosis at Playa municipality in Havana. Method: 153 cases under suspicious of human leptospirosis by the card of obligatory declaration of illness were notified to the municipal zoonosis department. An epidemiological survey was made to 25 confirmed cases being checked 23 cases thatconstitute the universe of this study. The different variables were: age, gender, job, source of infection, reservoir animals, signs and symptoms, frequency of cases by months and elapsed time between the initial symptoms and medical attention. Results: The highest frequency was found in male workers among 35 and 44 years old, The source of infection was the high infestation of rodents followed by the direct contact with reservoir animals. There was a prevalence in the second semester of the year and the main symptoms were: fever, migraines, myalgias and athralgias in the slight form of the illness. Half of the patients received medical assistance after 72 hours or more of the initial symptoms. Conclusions: Leptospirosis is an illness of occupational cause where reservoirs, the transmission ways and the infection sources are fundamental aspects to be known in order to take the correct measures of prevention.

Investigation on the source of the first human of avian influenza A (H5N1) case in Beijing / 中华流行病学杂志

Objective To investigate the source of the first human case of avian influenza A (H5N1) infection in Beijing. Methods Interviewing the relatives of the case and other key persons, collecting and detecting samples of related biological, epidemiological and environmental data of the case were conducted. Later, the infection source was thoroughly investigated. Results The case ever contacted a slaughtered duck 5 days prior to the onset of illness, and the duck was bought from a stall of a wet market in Yanjiao area of Hebei province. Ten environmental samples were collected in this stall and the neighboring stall of the market. Another 6 samples were tested positive for H5N1 virus by PCR method, with 5 virus strains isolated. The whole-genome sequencing indicated that the amino acid homology between the H5N1 virus strains from the environment and the virus isolated from the case reached 99.8%-100%. Conclusion From both epidemiological and virological evidence, it was proved that the first human case of avian influenza A (H5N1) infection in Beijing was infected by a duck that carrying H5N1 virus the case contacted 5 days proceeding the onset of illness.

THE CLASSIFICATIONS AND ENDEMIC CHARACTERISTICS OF INFECTION SOURCE AREAS OF SCHISTOSOMIASIS JAPONICA IN LAKE BEACH AND EMBANKMENT REGIONS / 中国血吸虫病防治杂志

This paper presents the classifications of the infection source areas for schistosomiasis japonica in the lake beach and embankment regions, systematically demonstrates the geo-graphical and endemic characteristics of different types of infection source areas. The results provide the basis for making control strategies of the disease.

Effect of schistosomiasis control by synthetic measures with emphasis on infection source control / 中国血吸虫病防治杂志

Objective To evaluate the effect on schistosomiasis control by implementing the synthetic measures with emphasis on infection source control.Methods Ten higher endemic villages in 10 counties were chosen to implement the measures of " replacing cattle with machines", "rearing domestic animals in pens", "safely treating night-soil or building methane-generating pits".In these villages, all cattle should be eliminated, other livestock be reared in pens, and all households be supplied with sanitary lavatories that could safely treat night-soil, or with methane-generating pits, and safe water. Results After 1 year of implementing the project, the number of cattle, sheep, pigs and dogs in 10 villages reduced by 92.7%,70.8%,14.3% and 20.2%, respectively, 76.0% of households had sanitary lavatories or methane-generating pits, 75.9% of households had safe water supply, all the remaining pigs were reared in pens, and the schistosome infection rate of residents reduced by 75.8%, the infection rate of cattle reduced by 79.8%, the density of infected snails reduced by 75.0% and the infection rate of snails reduced by 60.0%, respectively. Conclusion The synthetic measures with emphasis on infection source control are effective in schistosomiasis control.