RESUMO
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.
RESUMO
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.
RESUMO
Objective To investigate the epidemiological, clinical and pathogenic characteristics and prognosis of the first imported case of Chikungunya fever in China in 2008. Methods Epidemiological and clinical data of this mate adult patient were analyzed retrospectively. Chikungunya virus (CHIKV)-IgM was detected using enzyme linked immunosorbent assay (ELISA) and colloidal gold immunoassay. CHIKV-RNA was detected using real-time fluorescent polymerase chain reaction (RT-PCR). Results This patient had onset of fever on March 2 in 2008 and lasted for 5 days. In addition, he felt joint and muscle pains, headache and found generalized engorged maculopapule. The laboratory tests showed leukopenia and thrombocytopenia. CHIKV-IgM was detected positive at day 9 after the onset and CHIKV-RNA was all positive at day 3, 5, 7, 9 after the onset. A 575 bp fragment of RT-PCR product was sequenced and detected the nucleotide homology was 99% compared with CHIKV sequences in GenBank. The patient recovered with symptomatic supportive treatment.Conclusion This imported case of Chikungunya virus infection is reported for the first time in China.It shows similar clinical manifestations with dengue fever.