Epidemiological analysis on leprosy in China, 2009 / 中华流行病学杂志

Objective To study the epidemiological characteristics of leprosy and to provide evidence for specific strategies development on leprosy control. Methods Descriptive analysis of data from the national leprosy surveillance system was carried out in 2009. Results A total number of 1597 new cases were detected in 2009 with a case detection rate of 0.120 per 100 000 population.The proportions of children under 15, multibacillary and disability grade 2 were 2.4%, 84.3% and 22.8% respectively. A total number of 148 relapse cases were reported in 2009, among which 69 cases were those relapsed after multi-drug therapy. The existing cases were 6603 by the end of 2009 with a prevalence rate of 0.049 per 10 000 populations, among which 3332 cases were on multi-drug therapy. Conclusion The overall leprosy situation is considered to be at low endemic in China but the distribution is unequal, with pocket areas in Yunnan, Sichuan and Guizhou. In order to reach the target on leprosy elimination, which was considered as a public health and social problem, the input and efforts are needed for many years to come.

Insoluble beta-glucan from the cell wall of Candida albicans induces immune responses of human THP-1 monocytes through Dectin-1 / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>beta-glucan is the major structure component of Candida albicans (C. albicans) cell wall. It has been demonstrated that Dectin-1 as the principal C-type lectin pattern-recognition receptor (PRR) can recognize fungal beta-glucan and induce immune responses. In this study, we sought to clarify whether insoluble beta-glucan from the cell wall of C. albicans (CaIG) could induce immune responses in human THP-1 monocytes (a human acute monocytic leukemia cell line) and to determine the underlying mechanisms.</p><p><b>METHODS</b>Human THP-1 monocytes were challenged with CaIG in vitro. The mRNA expression of Dectin-1, Toll-like receptors (TLR2), proinflammatory cytokine (TNF-alpha) and chemokine (IL-8) was assayed by real-time reverse transcription polymerase chain reaction (RT-PCR). The secretion of TNF-a and IL-8 were measured by enzyme-linked immunosorbent assay (ELISA). H(2)O(2) release was determined by microplate fluorescent assay. Western blotting was used to analyze IkappaB-a phosphorylation and degradation.</p><p><b>RESULTS</b>Exposure of THP-1 monocytes to CaIG led to increased gene expression and secretion of TNF-alpha and IL-8. CaIG induced H(2)O(2) release in a time-dependent manner. CaIG hydrolyzed with zymolyase failed to induce gene expression and secretion of TNF-alpha, IL-8 and H(2)O(2) release. CaIG up-regulated the mRNA of Dectin-1, whereas the mRNA level of TLR2 was not altered. THP-1 monocytes challenged with CaIG resulted in the activation of NF-kappaB in a time-dependent manner. Dectin-1 inhibitor laminarin blocked the CaIG-induced production of TNF-alpha and H(2)O(2) in THP-1 monocytes, but no such effect was observed in pretreatment with anti-TLR2 neutralizing antibody and the LPS inhibitor (polymyxin B).</p><p><b>CONCLUSION</b>CaIG may play a role in activation of immune responses in human THP-1 cells through Dectin-1, not TLR2.</p>

A long-term evolution on the epidemiological characteristics of leprosy, towards the goal of its elimination in 1949-2007 in China / 中华流行病学杂志

Objective To understand the epidemiologicsl characteristics of leprosy during the evolution of the disease, towards the goal of elimination for the past 50 years and longer, so as to provide experiences for aecelerating eradication of leprosy in China. Methods Data were collected from National Surveillance System of Leprosy which was composed annually of all the data from county-based leprosy unit reporting system. All the data were reviewed retrospectively. Results A total number of 487 900 leprosy patients were reported from 1949 to 2007 in China. The ease detection rate reduced from the highest of 5.561100 000 in 1958 to the lowest of 0.12/100 000 in 2007. Leprosy patients mainly distributed in mountain areas in Yunnan, Guizhou, Sichuan, Guangdong Guangxi, Hunan and Jiangxi provinces with warm and damp climate and underdeveloped economy. After more than 50 years of leprosy control efforts,the case detection rate declined quickly in provinces in the eastern and the southern parts but very slowly in provinces in the western and the southwestern part of China. The ratio of relapsed patients to newly detected ones increased from 1:139 in 1960s' to 1:10 after 1980s', annually. The proportion of child cases among newly detected patients had been 3 %-4 % since 1968. In the recent 20 years, the proportion of new patients with positive skin smear gradually increased and the rate of disability grade two reached 20 % and more. The average age of new patients upon diagnosis was 45 years old in the east coastal provinces but only 38 years old in the southwest provinces. A new finding was that some new patients detected in the east coastal provinces were immigrants from the southwestern provinces. Conclusion With continuous socio-economic development and active efforts on leprosy control, the prevalence of leprosy gradually declined despite the long evolution period. Some negative events seemed to have influenced the trend of case detection.

Trends of case detection and other indicators of leprosy in China during 1985-2002 / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To analyze the trends of case detection and other indicators of leprosy in China during 1985-2002.</p><p><b>METHODS</b>Data reported by each province were collected by China National Leprosy Database in Nanjing P.R. China. All data about registered cases were put into computer for analysis.</p><p><b>RESULTS</b>From 1985 to 2002, a total of 49,477 new leprosy cases had been detected. Among them, 69.5% were multibacillary cases and 25.4% had grade 2 disability. The child cases aged below 15 years accounted for 3.74% of total cases. Totally, 5824 cases and 303 cases relapsed after dapsone (DDS) mono-therapy and multidrug therapy (MDT), respectively. Case detection showed a marked reduction from 0.47/100,000 in 1985 to 0.18/100,000 in 1993 although there were several spurts due to operational factors. From 1994, case detection showed no significant decline. The grade 2 disability among new patients decreased from 31.4% in 1985 to 23.4% in 2002. The child case detection rate among new cases fluctuated between 2.70%-3.56% from 1999 to 2002. The incidence of relapse declined after the introduction of DDS mono-therapy. However, it increased after the introduction of MDT.</p><p><b>CONCLUSION</b>China experiences in leprosy control show that it will take a long time with continuing present leprosy control activities to bring down the case detection and other indicators to a very low level even after reaching the elimination goal of leprosy.</p>