Capacity building in schistosomiasis control institutions in China: a cross-sectional study / 中国血吸虫病防治杂志

Objective To understand the current status of capacity building in schistosomiasis control institutes in schistosomiasis-endemic provinces (municipality, autonomous region) of China. Methods The responsibilities and construction requirements of various schistosomiasis control institutions were surveyed by expert discussions, and field interviews and visits during the period between May and June, 2023, and the questionnaire for capacity maintenance and consolidation in schistosomiasis control institutions was designed. An online questionnaire survey was conducted in county-, municipal-, and provincial-level institutions that undertook schistosomiasis control and surveillance activities through the Wenjuanxing program. The distribution of schistosomiasis control institutions, the status of institutions, departments and staff undertaking schistosomiasis control activities and the translation of scientific researches on schistosomiasis control in China were analyzed. The laboratories accredited by China National Accreditation Service for Conformity Assessment (CNAS) were considered to be capable for testing associated with schistosomiasis control, and the testing capability of schistosomiasis control institutions was analyzed. Results A total of 486 valid questionnaires were recovered from 486 schistosomiasis control institutions in 12 endemic provinces (municipality, autonomous region) of China, including 12 provincial-level institutions (2.5%), 77 municipal-level institutions (15.8%) and 397 county-level institutions (81.7%). Of all schistosomiasis control institutions, 376 (77.4%) were centers for disease control and prevention or public health centers, 102 (21.0%) were institutions for schistosomiasis, endemic disease and parasitic disease control, and 8 (1.6%) were hospitals, healthcare centers or others. There were 37 713 active employees in the 486 schistosomiasis control institutions, including 5 675 employees related to schistosomiasis control, and the proportions of employees associated with schistosomiasis control among all active employees were 5.9% (231/3 897), 5.5% (566/10 134), and 20.6% (4 878/23 682) in provincial-, municipal-, and county-level institutions, respectively. There were 3 826 full-time employees working in schistosomiasis control activities, with 30.5% (1 166/3 826), 34.6% (1 324) and 34.9% (1 336/3 826) at ages of 40 years and below, 41 to 50 years and over 50 years, and there were 1 571 (41.0%) full-time schistosomiasis control employees with duration of schistosomiasis control activities for over 25 years, and 1 358 (35.5%) employees with junior professional titles and 1 290 with intermediate professional titles (35.5%), while 712 (18.6%) full-time employees working in schistosomiasis control activities had no professional titles. The three core schistosomiasis control activities included snail control (26.3%, 374/1 420), epidemics surveillance and management (25.4%, 361/1 420) and health education (18.8%, 267/1 420) in schistosomiasis control institutions. The Kato-Katz method, miracidium hatching test with nylon gauzes, and indirect haemagglutination assay (IHA) were the most commonly used techniques for detection of schistosomiasis, and there were less than 50% laboratories that had capabilities or experimental conditions for performing enzyme-linked immunosorbent assay (ELISA), dipstick dye immunoassay (DDIA), dot immunogold filtration assay (DIG-FA), loop-mediated isothermal amplification (LAMP) and polymerase chain reaction (PCR) assays. During the period from 2018 to 2022, schistosomiasis control institutions had undertaken a total of 211 research projects for schistosomiasis control, with a total funding of 18.596 million RMB, published 619 articles, participated in formulation of 13 schistosomiasis control-related criteria, and applied for 113 schistosomiasis control-related patents, including 101 that were granted, and commercialized 4 scientific research outcomes. Conclusions The proportion of independent specialized schistosomiasis control institutions is low in schistosomiasis control institutions in China, which suffers from problems of unsatisfactory laboratory testing capabilities, aging of staff and a high proportion of low-level professional titles. More investment into and intensified schistosomiasis control activities and improved capability building and talent cultivation in schistosomiasis control institutions are recommended to provide a powerful support for high-quality elimination of schistosomiasis in China.

Interpretation of the Action Plan to Accelerate the Elimination of Schistosomiasis in China (2023—2030) / 中国血吸虫病防治杂志

On June 16, 2023, National Disease Control and Prevention Administration of the People’s Republic of China, in collaboration with other ministries, formulated and issued the Action Plan to Accelerate the Elimination of Schistosomiasis in China (2023—2030). The implementation of this plan provides an important basis for achieving the targets set in the “Healthy China 2030” action plan and the implementation of the rural revitalization strategy. This paper describes the background, principles, targets, control strategies, safeguard measures and effectiveness evaluation of the plan, in order to guide the scientific and standardized implementation of actions for schistosomiasis elimination at the grassroots level, and facilitate the progress towards elimination of schistosomiasis in China with a high quality.

High-quality acceleration of the Chinese national schistosomiasis elimination programme to advance the building of Healthy China / 中国血吸虫病防治杂志

The goal of achieving elimination of schistosomiasis across all endemic counties in China by 2030 was proposed in the Outline of the Healthy China 2030 Plan. On June 16, 2023, the Action Plan to Accelerate the Elimination of Schistosomiasis in China (2023—2030) was jointly issued by National Disease Control and Prevention Administration and other 10 ministries, which deployed the targets and key tasks of the national schistosomiasis elimination programme in China. This article describes the progress of the national schistosomiasis control programme, analyzes the opportunities to eliminate schistosomiasis, and proposes targeted recommendations to tackle the challenges of schistosomiasis elimination, so as to accelerate the process towards schistosomiasis elimination and facilitate the building of a healthy China.

Screening of Non-Communicable Diseases and their Risk Factors among Tuberculosis Patients in Delhi: A Mix Method Study

Background: India has the highest burden of tuberculosis in the world. It is experiencing an increasing burden of noncommunicable diseases, thereby facing a dual disease burden. Recent evidence shows an association between TB and noncommunicable diseases like diabetes, CVD and chronic respiratory infections. Aims and Objectives: To assess the feasibility of screening for NCDs and risk factors for NCDs among patients with TB in DOTS centers of a medical college in Delhi and ascertain challenges for the same among providers and patients. Methodology: It was a mixed-methods study with a quantitative component (cross-sectional study using questionnaires, anthropometric measurements and records review) and a qualitative component (descriptive study using interview data). Results: Among the 139 patients screened, ten new cases of hypertension and six new patients were diagnosed with DM. Outof- pocket expenditure for tests was a concern of the patients. Health care providers found the screening tool easy to use but were apprehensive about increased workload Conclusion: The study provide useful visions for incorporating NCDs into routine TB care through DOTS centers under RNTCP/NTEP.

Perceptions of Private Practitioners Regarding Revised National Tuberculosis Control Program- A Cross-sectional Study in Sonepat, Haryana

Background: A substantial proportion of tuberculosis patients either take treatment from private care providers or first-time visit private hospitals to diagnose tuberculosis. Hence the role of private providers is too essential to ignore to realize the ambition of tuberculosis elimination in India. Aim and Objectives: To understand the perception of private practitioners of Sonepat district of Haryana state regarding. Setting and Design: A cross-sectional study was done among the private practitioners of the Sonepat district of Haryana Methods and Material: 78 randomly selected practitioners from the list provided by the district health authority were interviewed using a pretested semi-structured questionnaire. The ethics committee of the study institute approved the study. Statistical analysis used: Descriptive analysis in terms of proportion and percentages was conducted. Results: One-third of the study participants were in the age group of 30-40 years. Half of the practitioners were reportedly practicing medicine for less than twenty years. A significant proportion agreed that the government could not single-handedly eliminate tuberculosis without collaborating with private providers. Mostly agreed on the effectiveness of Tuberculosis regimens under the program; however, over-relying on the sputum examination was perceived as a negative component of the program. Conclusions: Private providers understand their pivotal role in tuberculosis-related programs. However, their full participation has not been realized in the program.

Epidemiological characterization of patients with intestinal stomas

Objective: To characterize the sociodemographic and clinical variables of people with intestinal stomas. Materials and Methods: We conducted a cross-sectional study with 47 patients of a Specialized Rehabilitation Center (CER II/APAE) in the municipality of Três Lagoas, state of Mato Grosso do Sul, Midwestern Brazil, from December 2019 to June 2020. Data was analyzed using inferential descriptive statistics (Anderson-Darling, Chi-squared, and Mann-Whitney normality tests). Results: Regarding the patients, 87.23% were from Três Lagoas, 51.06% were female, 40.43% were aged from 60 to 69 years, 59.57% were married, 53.19% were brown, 59.57% were catholic, 36.17% finished elementary school, 46.81% were retired, and 57.45% earned a monthly income below 1 minimum wage. Moreover, 61.70% had undergone terminal colostomy (61.70%), 61.70% had received guidance about its placing, 57.45% had it placed due to situations of urgency, 74.47% had a stoma installed due to a neoplasia, 38.30% were permanent, with 46.81% located in the inferior left quadrant (ILQ), 59.57% presented pasty effluent, 63.83% had a circular diameter, 53.19% had pouches with 2 pieces and 57.45%, with a flexible base, 87.23% had other adjunct equipment, and 95.74% had been trained in self-care. The most common complication was skin/peristomal irritant contact dermatitis (59,57%), and 65,95% of these cases were solved by teaching self-care. The type of stoma was significantly associated with the consistency of the effluent and the size of the protrusion (p> 0.05). Conclusion: The results found can support strategies to implement practices to promote health, develop new public policies, to provide training in self-care, and prevent and treat complications. (AU)

Keloid nomogram prediction model based on weighted gene co-expression network analysis and machine learning / 生物医学工程学杂志

Keloids are benign skin tumors resulting from the excessive proliferation of connective tissue in wound skin. Precise prediction of keloid risk in trauma patients and timely early diagnosis are of paramount importance for in-depth keloid management and control of its progression. This study analyzed four keloid datasets in the high-throughput gene expression omnibus (GEO) database, identified diagnostic markers for keloids, and established a nomogram prediction model. Initially, 37 core protein-encoding genes were selected through weighted gene co-expression network analysis (WGCNA), differential expression analysis, and the centrality algorithm of the protein-protein interaction network. Subsequently, two machine learning algorithms including the least absolute shrinkage and selection operator (LASSO) and the support vector machine-recursive feature elimination (SVM-RFE) were used to further screen out four diagnostic markers with the highest predictive power for keloids, which included hepatocyte growth factor (HGF), syndecan-4 (SDC4), ectonucleotide pyrophosphatase/phosphodiesterase 2 (ENPP2), and Rho family guanosine triphophatase 3 (RND3). Potential biological pathways involved were explored through gene set enrichment analysis (GSEA) of single-gene. Finally, univariate and multivariate logistic regression analyses of diagnostic markers were performed, and a nomogram prediction model was constructed. Internal and external validations revealed that the calibration curve of this model closely approximates the ideal curve, the decision curve is superior to other strategies, and the area under the receiver operating characteristic curve is higher than the control model (with optimal cutoff value of 0.588). This indicates that the model possesses high calibration, clinical benefit rate, and predictive power, and is promising to provide effective early means for clinical diagnosis.

Epidemiological characteristics of imported malaria in Songjiang District of Shanghai from 2013 to 2022 / 上海预防医学

ObjectiveTo characterize the prevalence and epidemic situation of imported malaria cases in Songjiang District of Shanghai from 2013 to 2022， and to provide evidence for malaria prevention and control. MethodsRelated data were collected and analyzed， including malaria cases， blood testing of febrile patients， and mosquito surveillance in Songjiang from 2013 to 2022. ResultsA total of 13 002 febrile patients in Songjiang were tested for plasmodium parasites from 2013 to 2022， among which 18 malaria cases were confirmed， including 17 cases of falciparum malaria and 1 case of ovale malaria. Moreover， a total of 36 malaria cases were notified in Songjiang through the National Notifiable Disease Reporting System from 2013 to 2022， including cases reported from Songjiang District and other districts or provinces with physical addresses in Songjiang. Of them， there were 31 cases of falciparum malaria， 2 cases of vivax malaria， 2 cases of ovale malaria and 1 case of quartan malaria. The gender ratio of male to female cases was 17∶1， and the majority was young and middle aged. In addition， 35 cases were imported from Africa and 1 case from southeast Asia； 34 cases were migrant workers， and 2 cases were travellers abroad； 17 cases were found and reported in Songjiang， 15 cases were reported from other districts of Shanghai， and 4 cases were reported from other provinces； 27 cases were treated in Shanghai， 3 cases were treated in other provinces and 6 cases were treated with self-provided antimalarial drugs. Mosquito surveillance in Songjiang showed that density of Anopheles sinensis was extremely low. ConclusionNo indigenous malaria case has been notified in Songjiang since 2008. Malaria surveillance on migrant workers remains the focus of malaria prevention and control. Furthermore， achievement of malaria elimination in Songjiang should be continually enhanced to avoid potential further transmission of imported malaria.

Key points for viral hepatitis management in "Global health sector strategies on, respectively, HIV, viral hepatitis and sexually transmitted infections for the period 2022— 2030":interpretation and clinical practice / 中华检验医学杂志

In June 2022, the World Health Organization released the"Global health sector strategies on, respectively, HIV, viral hepatitis and sexually transmitted infections for the period 2022—2030". It sets more specific and large-scale goals for eliminating the major infectious diseases, which are still threatening human health. In combination with our clinical practice, present document highlights the advances and challenges in the process of implementing the suggested strategies and ways to achieve the stated goal of eliminating the viral hepatitis in China.

Surveillance of Keshan disease at township level in Inner Mongolia Autonomous Region in 2019 / 中华地方病学杂志

Objective:To learn about the condition of Keshan disease at township level in Inner Mongolia Autonomous Region (Inner Mongolia for short).Methods:In accordance with the "Three-Year Tackling Implementation Plan for Keshan Disease in Inner Mongolia", Keshan disease surveillance was carried out from March to December 2019 in the disease affected townships of all 12 diseased banners (counties, cities, disctricts, referred to as banners) in Hulunbuir City, Xing'an League, Chifeng City, and Xilin Gol League in Inner Mongolia, and all permanent residents who lived for more than 6 months were selected as the survey subjects. At the same time, the search for Keshan disease cases was carried out in the relevant medical institutions of the 4 leagues (cities) from 2014 to 2018. The "Diagnosis of Keshan Disease" (WS/T 210-2011) and the "Evaluation Methods for Control and Elimination of Key Endemic Diseases" (2019 edition) were used for diagnosis and elimination evaluation of Keshan disease.Results:There were 75 diseased townships under the jurisdiction of the 12 diseased banners in the 4 leagues (cities) in Inner Mongolia, with a permanent resident population of 1 246 900. A total of 356 150 subjects were examined by electrocardiogram, and 86 507 cases were found to be abnormal, with an abnormal rate of 24.29%. A total of 250 patients with chronic Keshan disease were diagnosed by echocardiography or anteroposterior chest X-ray examination, and the prevalence rate was 2.00/10 000; a total of 287 patients with latent Keshan disease were diagnosed, and the prevalence rate was 2.30/10 000; no patients with acute, subacute or new Keshan disease. After case search, 494 suspected Keshan disease cases were screened out, and 6 cases were finally diagnosed as chronic Keshan disease. From 2014 to 2018, there were no new cases of acute or subacute Keshan disease for five consecutive years, and the prevalence rates of chronic Keshan disease and latent Keshan disease were both lower than 5/10 000 in 2019, meeting the national elimination standard for Keshan disease.Conclusion:In 2019, Inner Mongolia has reached the national elimination standard for Keshan disease, but there are still patients with Keshan disease, so it is necessary to continue to strengthen the monitoring of Keshan disease.

Characteristics and management mechanism of imported malaria from overseas during the malaria elimination phase in Wuhan City / 公共卫生与预防医学

Objective To analyze the characteristics of imported malaria epidemic from overseas in Wuhan, to explore the management mechanism of on-site cases, and to accumulate experience for the treatment of imported malaria in large cities after malaria elimination. Methods The epidemiological data on imported malaria from abroad during the period of malaria elimination (2010-2019) in Wuhan were collected. The gender, age and severe illness-related factors of the cases were analyzed. Based on the characteristics of the epidemic and the current situation of prevention and control, the content and experience of the “Municipal-District 24-7” case mechanism were discussed. Results The medical resources in Wuhan were the best in the central region, resulting in a large number of imported malaria cases, with a total of 474 cases reported from 2010 to 2019 (40.79% of the total number of cases in Hubei Province), including 359 cases of falciparum malaria, 36 severe cases and one death (the death rate was 0.28%). The patients were mainly young and middle-aged men aged 20 to 49 years old (97.26%). There were many referral cases (40.30%), and there was no seasonal clustering of cases reported. The undiagnosed proportion at the first visit was 44.85%, and the time of attack-diagnosis was 4 days or more in 61.00% of cases. The occurrence of severe cases was related to unconfirmed diagnosis at the first visit (χ2=35.46, P<0.001) and attack-diagnosis time (Z=-6.49, P<0.001). Conclusion Imported malaria occurs frequently in Wuhan, mainly falciparum malaria. However, “Municipal-District 24-7” case mechanism has effectively curbed the occurrence of severe and death cases and provided valuable experience for case management in similar cities in China.

Schistosomiasis control in China from 2012 to 2021: progress and challenges / 中国血吸虫病防治杂志

Schistosomiasis has been endemic in China for more than 2 000 years, which causes huge morbidity, social and economic burdens. Guided by the national specific strategic programs and criteria for schistosomiasis, tremendous achievements have been gained for schistosomiasis elimination in China. This paper reviews the progress of schistosomiasis control and endemic status of schistosomiasis in China during the period from 2012 to 2021, analyzes the challenges to achieve the goal of schistosomiasis elimination in China by 2030, and proposes suggestions for future schistosomiasis control programs.

Pharmacokinetics and blood-brain barrier penetration of a novel salidroside derivative pOBz in rats / 中国药理学通报

Aim To develop a ultra-high performance liquid chromatography electrospray-ionization tandem mass spectrometry ( UPLC-MS/MS ) method for the simultaneous determination of salidroside derivative pOBz in rat plasma and brain tissue, and to study the pharmacokinetic profile and penetration of the blood-brain barrier in rats after a single dose intravenous administration of pOBz. Methods SD rats were administered pOBz at a dose of 50 mg • kg

Current prevalence and control strategies of visceral leishmaniasis in Sichuan Province: A review / 中国血吸虫病防治杂志

Visceral leishmaniasis is a parasitic disease transmitted by Phlebotomus chinensis that poses a great threat to human health. Historically, visceral leishmaniasis was predominantly prevalent in northwestern regions of Sichuan Province. Following the founding of the People’s Republic of China, large-scale integrated interventions had been implemented in visceral leishmaniasis-endemic areas of Sichuan Province, including identification and treatment of visceral leishmaniasis patients, elimination of infected dogs, Ph. chinensis control and health education. This review summarizes the prevalence of visceral leishmaniasis, discusses the control strategy of visceral leishmaniasis and analyzes the challenges of elimination of visceral leishmaniasis based on the One Health concept in Sichuan Province, so as to provide insights into elimination of visceral leishmaniasis in the province.

Schistosomiasis control in Sichuan Province since the 12th Five - Year Plan period: progress and prospects / 中国血吸虫病防治杂志

An ambitious goal has been set for elimination of schistosomiasis in all endemic counties (districts) in Sichuan Province by 2023. To achieve this goal, and to continue to consolidate the control achievements, it is necessary to understand the current endemic status of schistosomiasis, identify the challenges and analyze the experiences and lessons from the schistosomiasis control program, and develop targeted control strategies and interventions in the province. This paper reviews the progress of schistosomiasis control in Sichuan Province since the 12th Five-Year Plan period, analyzes the challenges in the schistosomiasis elimination program, and proposes recommendations for future directions and priorities.

Cross-talk elimination in determination of gross α and gross β activities using a low-background α/β gas-flow proportional counter / 中国辐射卫生

Objective To explore cross-talk elimination method in the determination of gross α and gross β activities using a low-background α/β gas-flow proportional counter. Methods A CLB-104 low-background α/β gas-flow proportional counter was used in this study. First, the α threshold was increased to eliminate the cross-talk counting caused by β particles in the α channel. Then, the α-β anticoincidence threshold was reduced to eliminate the cross-talk counting induced by low-energy α particles in the β channel, and β counts were corrected to eliminate the counts induced by internal convention electrons in the β channel. Finally, gross α and gross β activities of non-saline water samples with different activity levels were determined and compared with gross α and gross β activities of the same samples determined on a BH1227 low-background α/β solid scintillation counter, in order to verify effectiveness of the cross-talk elimination method. Results By eliminating the cross-talk counts of β particles in the α channel and the cross-talk counts of α particles in the β channel, and deducting the counts of internal convention electrons in the β channel, the gross α and gross β activities of the same samples determined by CLB-104 were consistent with the values determined by BH1227. Conclusion Cross-talk counts induced by low-energy α particles or β particles can be eliminated by threshold adjustment, and the counts caused by internal convention electrons in the β channel can be eliminated by correction.

Quality of blood smear examinations for malaria parasites in Chenzhou City after malaria elimination / 中国血吸虫病防治杂志

Objective To analyze the quality of blood smear examinations for malaria parasites in Chenzhou City, so as to provide insights into sustainable consolidation of malaria elimination achievements. Methods All positive blood smears from fever patients were irregularly sampled from each county (district) of Chenzhou City from 2018 to 2022 and reexamined, and no less than 3% negative blood smears were reexamined. The preparation, dyeing, cleanliness and microscopic examination results of blood smear were reexamined, and the quality of blood smear reexaminations was assessed using a descriptive statistical method. Results A total of 13 625 fever patients received blood smear examinations for malaria parasites in Chenzhou City from 2018 to 2022, of which 21 were positive and 13 604 were negative; 687 blood samples were reviewed, and the percentage of negative blood smear reexaminations was 4.90% (666/13 604), with a 63.51% rate of qualified negative blood smears preparation, a 67.87% rate of qualified dyeing and a 76.13% rate of qualified cleanliness, and no missing diagnosis found. There were 21 positive blood smears reexamined, and the proportions of qualified blood smears preparation, dyeing and cleanliness were all 85.71%, with 2 smears mistaking Plasmodium species (9.52%). The percentage of qualified negative blood smears preparation was 51.41% in 2022, which reduced by 31.61% in relative to that (75.17%) in 2019 (χ2 = 9.033, P < 0.05), and the percentage of qualified negative blood smears dyeing was 60.19% in 2022, which reduced by 28.82% in relative to that (84.56%) in 2019 (χ2 = 19.498, P < 0.05), while the percentage of qualified negative blood smears cleanliness was 62.96% in 2022, which reduced by 28.93% in relative to that (88.59%) in 2019 (χ2 = 23.826, P < 0.001). In addition, there were no significant differences in the proportion of qualified negative blood smears preparation (χ2 = 0.260, P > 0.05) or dyeing (χ2 = 1.094, P > 0.05) among the three years, while a significant difference was detected in the percentage of qualified negative blood smears cleanliness (χ2 = 12.175, P < 0.05). Conclusions No missing diagnosis was seen in blood smear examinations for malaria parasites among fever patients in Chenzhou City after malaria elimination; however, there were reductions in proportions of qualified blood smears preparation, dyeing and cleanliness. Quality control of blood smear examinations is recommended to be reinforced in key regions of Chenzhou City.

Optimized pathway to schistosomiasis elimination in China: a scrutiny using a marginal benefit approach / 中国血吸虫病防治杂志

Following concerted efforts for over 7 decades, great achievements have been gained in the national schistosomiasis control program of China. Currently, China is moving towards the stage of schistosomiasis elimination, when the major task is to make full use of available resources to improve schistosomiasis surveillance and response to sustainably consolidate gained schistosomiasis control achievements and prevent re-emerging schistosomiasis. There is therefore an urgent need for optimization of interventions for schistosomiasis elimination. Based on analysis of socioeconomic features at different stages of the national schistosomiasis control program in China, this review discusses the relationship between the needs of assessment of schistosomiasis elimination interventions and the optimized strategy of schistosomiasis elimination at different stages of the national schistosomiasis control program using a marginal benefit approach and proposes the optimized schistosomiasis elimination strategy that allows the highest marginal benefit with currently available schistosomiasis elimination costs, so as to provide the optimal strategic pathway to schistosomiasis elimination and facilitate the achievement of the targets set in Healthy China 2030.

Risks of and response to cluster outbreak of imported malaria during malaria post-elimination era in China / 中国热带医学

@#Abstract: Objective　To analyze the recent cluster outbreaks of imported malaria and explore the risks, challenges and countermeasures for dealing with such events during malaria post-elimination era of malaria, and to provide reference for effectively addressing the risks and consolidating the achievements of malaria elimination. Methods　The individual malaria case data from "The Information System for Infectious Disease Surveillance" and "The Information System For Parasitic Diseases Prevention And Control" were collected，and the diagnosis classification, infection source, time and space distribution of cases were analyzed. Results　From January 1 to August 11, 2022, a total of 429 malaria cases were reported nationwide, an 18.9% decrease compared to the same period last year (529 cases), all of which were imported cases. The overall weekly trend of the outbreak remained stable, but since Week 31 (July 25-31), there has been a significant increase in the number of cases, with a peak on August 5. From July 25 to August 11, 2022, a total of 162 malaria cases were reported nationwide, up 315.4% from 39 cases in the same period last year, accounting for 37.8% of the total cases up to August 11, 2022. The main source of imported infections was Guinea (95 cases, 58.6%), with most cases reported in Longgang District, Shenzhen City, Guangdong Province (30 cases), Shilin County, Kunming City, Yunnan Province (21 cases), Chaoyang District, Beijing (11 cases), and Xiaoshan District, Hangzhou City, Zhejiang Province (7 cases). Conclusions　Due to the concentration of returnees to China, several entry port cities simultaneously experienced cluster outbreaks of imported malaria, which brought immense pressure and challenges to local medical and health institutions. Health facilities at all levels need to maintain high vigilance and sensitivity, be well prepared, and avoid death and secondary transmission caused by imported cases.

Epidemic characteristics of malaria cases before and after malaria elimination in Hubei Province / 中国热带医学

@#Abstract: Objective　To collect and organize malaria case data in Hubei Province from 2017 to 2021, compare and analyze the malaria epidemic characteristics on the before and after malaria elimination, and provide scientific support for Hubei Province to further optimize the comprehensive strategies to prevent re-transmission after the elimination of malaria. Methods The study was conducted by collecting the data of reported malaria cases of Hubei during 2017-2021 from the Infectious Disease Surveillance Reporting and Management System, and conducting the epidemiological characteristics of malaria on pre-elimination (2017-2019) and post-elimination (2020-2021). Results A total of 429 cases of imported malaria were reported in Hubei Province from 2017 to 2021, and the malaria epidemic showed an obvious trend of rising first and then falling. On the pre-malaria elimination, 374 malaria cases were reported, including 262 cases of P.falciparum (70.05%); on the post-malaria elimination, 55 malaria cases were reported, including 25 cases of P.falciparum (45.45%). There was a statistically significant difference in the proportion of infections caused by the four types of malaria parasites before and after the elimination of malaria (χ2=14.248, P<0.05). On the pre-malaria elimination, the peak of disease onset mainly occurred in January, July, and November; on the post-malaria elimination, the peak of disease onset mainly occurred in January to February, and December. Both before and after malaria elimination, the reported cases were mainly concentrated in Wuhan, Yichang, Huangshi, Xiangyang, Shiyan and Huanggang, but the range of cases showed a clear trend of narrowing. Before and after malaria elimination, malaria cases in Hubei Province were mainly among young and middle-aged males aged 30-49. The proportions of workers and migrant workers increased from 37.70% and 9.09% before the elimination to 50.91% and 18.18% after the elimination, respectively, with a statistically significant difference (χ2=17.839, P<0.05). The percentage of interval from onset of illness to initial diagnosis ≥ 5d decreased from 21.66% before the elimination to 10.91% after the elimination (χ2=6.448, P<0.05). The percentage of definitive diagnosis of malaria at initial diagnosis in town clinic increased from 18.18% before the elimination to 50.00% after the elimination. The proportion of malaria cases diagnosed by county-level medical institutions increased from 22.73% before the elimination to 34.55% after elimination. There was no statistically significant difference in the proportion of malaria cases diagnosed by medical institutions at all levels before and after the elimination of malaria (χ2=5.630, P>0.05). The proportion of cases with the interval between initial diagnosis and diagnosis within 24h increased from 43.85% before the elimination to 70.91% after the elimination. There was a statistically significant difference in the proportion of cases with the interval between initial diagnosis and diagnosis before and after the elimination of malaria (χ2=14.006, P<0.05). Before and after malaria elimination, all reported cases were mainly imported from African countries. Conclusions There are imported malaria cases reported every year in Hubei Province before and after the elimination of malaria, which poses a great challenge to the prevention of re-transmission. Therefore, it is necessary to strengthen the surveillance system, detect and standardize the treatment of imported malaria cases in a timely manner, conduct targeted retransmission risk surveys and assessments, and consolidate the achievements of malaria elimination.