Construction of a schistosomiasis transmission risk assessment system in Wuhan City based on analytic hierarchy process / 中国血吸虫病防治杂志

Objective To construct a schistosomiasis transmission risk assessment system in Wuhan City and preliminary evaluate its application effect, so as to promote the rational allocation of schistosomiasis control resources and accelerate the progress towards schistosomiasis elimination. Methods The schistosomiasis risk assessment indicators were collected through referring schistosomiasis surveillance data of Wuhan City from 2014 to 2020, literature review and expert interviews. Indicators within each criterion and sub-criterion were screened using the Delphi method, and a hierarchical structure model was created based on analytic hierarchy process. Quantitative assignment of each indicator was conducted according to relative importance, and the weight and combination weight of each criterion were calculated in each analytic hierarchy framework to create a schistosomiasis transmission risk assessment system, which was used for the schistosomiasis transmission risk assessment in 12 national schistosomiasis surveillance sites in Wuhan City. Results A three-level schistosomiasis transmission risk assessment system was preliminarily constructed, which included a target layer, 5 criterion layers and 21 sub-criterion layers. Of all indicators in the criterion layer, transmission route had the highest weight (0.433), followed by source of Schistosoma japonicum infection (0.294); and among all indicators in the sub-criterion layer, S. japonicum infection in Oncomelania hupensis and sentinel mice had the highest combination weight (0.125), followed by prevalence of S. japonicum infection in humans (0.091) and bovines (0.053), snail control by chemical treatment (0.049), positive rate of inquiry examinations (0.048), allocation of schistosomiasis control professionals (0.045), and areas of submerged snail-infested settings (0.041). Of the 12 national schistosomiasis surveillance sites in Wuhan City, there were 5 sites with weights of > 0.8, 4 sites with weights of 0.6 to 0.8, and 3 sites with weights of < 0.6 in 2020. Conclusion A schistosomiasis transmission risk assessment system has been constructed based on analytic hierarchy process in Wuhan City, which may provide a evidence-based basis for health resource allocation and decision-making for schistosomiasis control.

Cost-effectiveness simulation analysis of medical services for COVID-19 in Wuhan city / 中华医院管理杂志

Objective:To analyze the cost-effectiveness simulation of medical services for COVID-19 epidemic in Wuhan city based on the social perspective, for the sake of providing references and suggestions to deal with possible public health emergencies in the future.Methods:Through policy documents and literature review, interview survey and Delphi method, the cost and cost-effectiveness of medical services for COVID-19 in Wuhan were simulated based on the decision-tree model, from December 27, 2019 to April 26, 2020.Results:The average curing cost of per patient diagnosed with COVID-19 in Wuhan was 175 462.10 yuan, a figure calculated in the baseline that these epidemic prevention and control measures were taken on January 23, 2020. In Hypothesis 1 (with epidemic prevention and control measures taken one week before), the cost was 164 552.43 yuan, and in Hypothesis 2 (with epidemic prevention and control measures taken one week later), the cost was 187 542.37 yuan. Compared with the baseline, the incremental cost-effectiveness ratio of the medical service for COVID-19 in Wuhan under Hypothesis 1 was 183 000 yuan per patient, which was more cost effective.Conclusions:The public health prevention and control measures played an important role during the COVID-19 epidemic in Wuhan. With the cost-effectiveness simulation results taken into account, this study can provide decision-makers with better references in likewise events.

Effects of urban construction on Oncomelania snails control in Wuhan City / 中国血吸虫病防治杂志

Objective To evaluate the effectiveness of urban construction projects on Oncomelania snails control in Wuhan City, so as to provide insights into the development of an integrated control strategy for urban schistosomiasis. Methods The data pertaining to the endemic situation of schistosomiasis, schistosomiasis control data, the construction of the Yangtze River Bridge, marshland management and park constructions were collected from Wuhan City from 1990 to 2020. The changes of areas of snail habitats and high-risk settings were compared before and after implementation of these urban construction projects to evaluate the effectiveness of urban construction projects on Oncomelania snails control. Results The number of schistosomiasis cases decreased by 97.35%, and the number of cattle with schistosomiasis decreased by 100% in Wuhan City from 1990 to 2020, with a 41.99% reduction in areas of snail habitats, including 94.97% and 34.40% reductions in snail habitats inside and outside the embankment decreased. During the period from 1990 through 2020, a total of 10 Yangtze River bridges were built in Wuhan City, and areas of snail habitats around the bridges reduced from 11 699.05 hm2 before the bridge building to 8 726.14 hm2 after the building (a 25.41% reduction), while the areas of high-risk settings reduced from 411.69 hm2 before the bridge building to 276.78 hm2 after the building (a 32.77% reduction). Following treatment of three marshlands in Hankou, Hanyang and Wuchang, the areas of snail habitats reduced from 225.80 hm2 before the management to 199.47 hm2 after the management (a 11.66% reduction), and the areas of high-risk settings reduced from 23.14 hm2 before the treatment to 17.73 hm2 after the building (a 23.38% reduction). Following the building of 5 parks in snail-infested settings, the areas of snail habitats reduced from 319.61 hm2 before the construction to 280.80 hm2 after the construction (a 12.14% reduction), and the areas of high-risk settings reduced from 35.00 hm2 before the construction to 27.73 hm2 after the construction (a 20.77% reduction). Conclusion Simultaneous implementation of urban construction projects and schistosomiasis control measures is effective to shrink snail-infested setting and high-risk settings and control the endemic situation of schistosomiasis in endemic foci in Wuhan City.

An acute schistosomiasis case in Wuhan City imported from another province of China in 2020 / 中国血吸虫病防治杂志

An imported case of acute schistosomiasis was reported in Wuhan City in 2020. The case was infected with Schistosoma by contact with the infested water due to playing water in the Yangtze River when working out of Hubei Province. The patient visited four medical institutions and the duration from onset to definitive diagnosis was 20 days. The patient’s low awareness of schistosomiasis prevention and control knowledge and lack of diagnosis and treatment awareness for schistosomiasis among medical institutions were considered as main causes of the development of acute schistosomiasis and progression to severe case. Intensifying schistosomiasis health education among mobile populations and improving the awareness and capability of early diagnosis of schistosomiasis among clinicians are recommended.

Practical exploration of the informationization support for prevention and control of the new coronavirus pneumonia with Tongji Hospital as an example / 中华医院管理杂志

December of 2019 witnessed the outbreak of new coronavirus pneumonia in Wuhan city and a few localities. As a designated hospital, Tongji Hospital is designated as a hospital for the diagnosis and treatment of numerous patients of such a disease. Based on the medical cloud platform, the hospital has initiated a regional remote diagnosis center; based on its IT system, the hospital to operate its epidemic prevention and management mechanism, set up the self-service system for patients at the fever clinic, launched its online diagnosis and treatment services, and established a hospital epidemic supervision platform. By strengthening the informational support needed for epidemic prevention and control, the hospital has enhanced its efficiency of epidemic prevention and control, reducing the risk of cross-infection, and ensuring data security. Its experiences offer references for informationization support for other regions and hospitals in China.

International academic exchange at 2019 Annual Conference and 40th Anniversary of China Association of Acupuncture-Moxibustion in Wuhan, China / 全日本鍼灸学会雑誌

The Annual Conference and the 40th Anniversary of China Association of Acupuncture-Moxibustion was held in Hubei Wuhan City, China for three days from August 16th to 18th, 2019. This meeting was held every two years in China, and more than 2,000 participants gathered each time. 　The World Federation of Acupuncture-Moxibustion Societies (WFAS) supported it, and held an acupuncture pre-training seminar, in which the acupuncture and moxibustion situation of several countries was presented and a demonstration of their practical skills were shown on the first day. To achieve such purposes, representatives from six countries (China, United States, Korea, Netherlands, Iran, and Japan) were invited by WFAS. The theme was "Feature of acupuncture in own country style". I gave a presentation about the history of acupuncture and moxibustion in Japan and emphasized that "palpation" is a special characteristic of the Japanese style. Especially, I introduced Japanese style pulse diagnosis and palpation of the abdomen, back, and meridians. Moreover, I demonstrated a cosmetic facial acupuncture technique based on meridian therapy, which is gaining in popularity in Japan. On the next day, I gave a lecture and presented a practical skill of Japanese cosmetic facial beauty acupuncture for the Chinese Evidence Thumbtack Needle Society.

Analysis of endemic situation of schistosomiasis based on geographic information system (GIS) in Wuhan City in 2017 / 中国血吸虫病防治杂志

Objective To analyze the endemic sitaution of schistosomiasis based on geographic information system (GIS) in Wuhan City in 2017, so as to provide the reference for further schistosomiasis control activities. Methods According to the data of the annual report on the prevention and control of schistosomiasis in Wuhan City in 2017, the spatial database regarding the endemic situation of schistosomiasis was established and analyzed by ArcMap 10.2. Results The 593 schistosomiasis-endemic villages in Wuhan City were mainly located in the Yangtze River and its major tributaries. Kernel density analysis showed that the endemic villages of three regions with the highest density was located in the west of Caidian District (Zhuru Street), the east of Hannan District (Shamao Street) and the southwest corner of Xinzhou District (Yangluo Street). The sero-positive population was densely distributed in the West of Caidian District (Zhuru Street), which accounted for 34.23% of all seruo-positives in the city. There were 492 farming cattle fenced in Donggan Village in Hongbei Street of Caidian District. A higher density of the area with Oncomelania hupensis snails was located in the southwest region of Caidian District (Xiaosi Street), accounting for 31.22% of the total area with snails. In 2017, the re-emerging area with snails was 36.60 hm2. The high kernel density region with snails was located in Zhuru Street of Caidian District. The region with high density of living snails was located in the central region of Hannan District (Hongbei Production Brigade), the average density of living snails was 0.36 snails/0.1 m2. Conclusions The endemic situation of schistosomiasis is at a low level in Wuhan City, and the spatial distribution is not uniform. In some local areas, the historical endemic situation of schistosomiasis is serious and the high risk factors are more concentrated. It is necessary to strengthen the surveillance of schistosomiasis.

Analysis of endemic situation of schistosomiasis based on geographic information system (GIS) in Wuhan City in 2017 / 中国血吸虫病防治杂志

Objective To analyze the endemic sitaution of schistosomiasis based on geographic information system (GIS) in Wuhan City in 2017, so as to provide the reference for further schistosomiasis control activities. Methods According to the data of the annual report on the prevention and control of schistosomiasis in Wuhan City in 2017, the spatial database regarding the endemic situation of schistosomiasis was established and analyzed by ArcMap 10.2. Results The 593 schistosomiasis-endemic villages in Wuhan City were mainly located in the Yangtze River and its major tributaries. Kernel density analysis showed that the endemic villages of three regions with the highest density was located in the west of Caidian District (Zhuru Street), the east of Hannan District (Shamao Street) and the southwest corner of Xinzhou District (Yangluo Street). The sero-positive population was densely distributed in the West of Caidian District (Zhuru Street), which accounted for 34.23% of all seruo-positives in the city. There were 492 farming cattle fenced in Donggan Village in Hongbei Street of Caidian District. A higher density of the area with Oncomelania hupensis snails was located in the southwest region of Caidian District (Xiaosi Street), accounting for 31.22% of the total area with snails. In 2017, the re-emerging area with snails was 36.60 hm2. The high kernel density region with snails was located in Zhuru Street of Caidian District. The region with high density of living snails was located in the central region of Hannan District (Hongbei Production Brigade), the average density of living snails was 0.36 snails/0.1 m2. Conclusions The endemic situation of schistosomiasis is at a low level in Wuhan City, and the spatial distribution is not uniform. In some local areas, the historical endemic situation of schistosomiasis is serious and the high risk factors are more concentrated. It is necessary to strengthen the surveillance of schistosomiasis.

Epidemic situation of imported malaria and diagnostic capabilities of medi-cal institutions in Wuhan City from 2008 to 2017 / 中国血吸虫病防治杂志

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.

Surveillance and risk assessment system of schistosomiasis epidemic focus in Hankou marshland of Wuhan City / 中国血吸虫病防治杂志

To construct a monitoring and risk assessment system of schistosomiasis epidemic focus in marshland, so as to grasp the risk of schistosomiasis transmission, and to provide the technical support for targeted prevention and control measures.The crowd and the risk source of schistosomiasis in Hankou marshland in Wuhan City were monitored to grasp the risk factors of schistosomiasis. The risk level was evaluated by the three-dimensional risk matrix and three-dimensional visualization method.The total numbers of people on holidays and working days were 59 582 and 36 382 persontimes a day respectively in Hankou marshland. Fishing and swimming were the most common ways to contact the river water. The most majority of the people exposed to river water were male (73.9%), retirees (36.1%), local residents (69.7%) and people whose income was 1000 – 3000 yuan per month (52.1%), and the awareness of protection of them was low. In spring, the average density of living Oncomelania hupensis snails was 0.993/0.1 m2, the rat density was 7.72%, and the density of wild feces was 0.78/hm2. In autumn, the average density of living snails was 0.596 /0.1 m2, the rat density was 5.22%, and the density of wild feces was 0.32/hm2. The average density of living snails, the rat density and the density of wild feces were reduced by 39.9%, 32.4% and 59.0% respectively in autumn compared with those in spring. The risk assessment results of three-dimensional matrix showed that part 1 and part 2 were medium risk, part 3 was high risk and part 4 was maximum risk. The risk assessment results of the visualization method showed that the risk level increased from part 1 to part 4, which were basically consistent with the results of the risk matrix.There is a relatively large risk of schistosome infection in Hankou marshland in 2013. The surveillance and risk assessment system of epidemic focus is feasible and scientific.

Assessment of schistosomiasis transmission risk after flood damage in Wuhan City / 中国血吸虫病防治杂志

To assess the schistosomiasis transmission risk after flood damage in Wuhan City.Schistosomiasis epidemic villages in Wuhan City were selected by using probability proportional to size sampling (PPS). The field investigations of Oncomelania hupensis snails, the activity of people and cattle on marshland, water infectivity of schistosome, reservoir host infection and wild feces contamination were conducted. I–III levels of risk environments were assessed and treated with appropriate measures.A total of 90 schistosomiasis epidemic villages and 170 environments were monitored. Totally 9 811 snails were dissected but no Schistosoma japonicum infected snails were found. There were significant decreases in the density of snails and the survival rate of living snails after the flood (χ2 = 102.517, t = 4.724, both P < 0.01). Totally 289 pieces of wild feces were captured, and no eggs of S. japonicum were detected. A total of 11 surveillance and forecast sites were detected on water systems, and 221 sentinel mice were placed. After breeding, 219 sentinel mice survived (99.10%), and no schistosome infection was detected. In addition, 1 720 mouse traps were placed in 3 survey sites, and 66 Apodemus agrarius were captured, and no schistosome-infected ones were found. All of the environments were assessed as Grade III. Meanwhile, 5 key schistosomiasis control areas were determined, and no emergency happened after the implementation of comprehensive control interventions.The risk of schistosomiasis transmission remains low in Wuhan City after the flood, but the potential epidemic risk cannot be ignored.

Molecular epidemiology of Cryptosporidium infection in infants with diar-rhea in Wuhan City / 中国血吸虫病防治杂志

Objective To understand the prevalence of Cryptosporidium infection in diarrhea infants under 2 years old in Wuhan City,so as to provide the epidemiological evidence for the prevention and treatment of cryptosporidiosis. Methods The fecal samples from infants under 2 years old with diarrhea were collected in Hubei General Hospital and Central South Hospital in Wuhan City,Hubei Province from August 2014 to July 2015. The fecal samples were stored in 2.5%potassium dichromate at 4℃after filtered. The DNA was extracted from the fecal pellets with the phenol-chloroform method. The Cryptosporidium species were detected by a nested PCR assay targeting the SSU rRNA gene of the parasite. All the positive PCR products were sequenced on ABI 3100 automated sequencer,and the amplified sequences were compared to homologous sequences in the NCBI database by using the Basic Local Alignment Search Tool(BLAST). Phylogenetic analyses were performed by using the software MEGA (version 4.0)based on the Neighbour-Joining method. Results The human stool specimens(n=298)were screened for the presence of Cryptosporidium by nested PCR. The infection rate of Cryptosporidium was 3.02%(9/298). The infection rate of Cryp-tosporidium was 5.93%(7/118)in the infants between 1-2 years old,and the infection rate was 1.11%(2/180)in the infants un-der 1 year old,and there was a significant difference between the two groups(χ2 =4.13,P<0.05). The nine samples which were positive by nested PCR were successfully sequenced and compared with the reference sequences in GenBank. The results revealed the nine positive specimens were all infected with C. parvum,and two of them were co-infected with C. hominis. Neigh-bor-joining trees were constructed from the aligned partial SSU rRNA sequences of these nine isolates,and in the SSU rRNA lo-cus,the nine isolates were grouped with C. parvum. Conclusion There exists Cryptosporidium infection in the infants under 2 years old with diarrhea in Wuhan City,and the main species of Cryptosporidium is C. parvum.

Practice of engineering management and its effect on schistosomiasis control in Hankou marshland,Wuhan City / 中国血吸虫病防治杂志

Objective To investigate the Oncomelania hupensis snail control effect of schistosomiasis control engineering in marshland within Wuhan City. Methods The engineering measures including surface barrier removal,molluscicide,flatting surface,topsoil stripping,topsoil covering and ditch renovation were applied to transform Hankou marshland. Then the corre-sponding technical parameters of engineering measures were put forward. The situation of snails was analyzed before and after the transform project. Results The total length and area of the project were 6015 m and 87.21 hm2,respectively,including 17.44 hm2 of topsoil landfill,52.08 hm2 of topsoil covering and 23 new ditches. After the transformation,the average length of the new groove,the groove top width,groove depth,height difference,and the average values of slopes and ditch bottom slope were all increased,while the average values of the width and height of the ditch were decreased. At the same time,the marsh-land beach surface had a new slope that the embankment was higher than the river and no living O. hupensis snails were found then. Conclusions The snail breeding environment in Hankou marshland has been effectively changed by the project. Howev-er,the constant monitoring and engineering management are still needed to consolidate the effect.

Survey of Current Work Situation of Clinical Pharmacy in Medical Institutions Above Class II in Wuhan City / 中国药师

Objective:To understand the current work situation of clinical pharmacy in medical institutions in Wuhan city .Meth-ods:A questionnaire survey was employed to investigate the stuffing situation of clinical pharmacists , quality of clinical pharmacists and clinical pharmacy development in medical institutions above class II in Wuhan city .The results were analyzed statistically .Re-sults:There was notable difference in the situation of clinical pharmacist among medical institutions above class Ⅱin Wuhan city , and so was in the development of clinical pharmacy .Conclusion:Clinical pharmacy work in medical institutions still demands much atten-tion and support from the relevant departments , and clinical pharmacists own need make great efforts constantly .

Investigation of Capillaria hepatica infection in rodents from Wuhan section of Yangtze River marshland / 中国血吸虫病防治杂志

Objective To understand the prevalence of Capillaria hepatica in rodents from Wuhan section of the Yangtze River marshland. Methods Rodents were trapped in Jiang an section of Wuhan marshland of the Yangtze River. The livers of the rodents were examined for pathological changes by unaided eyes and the liver tissues were examined for the eggs of C. hepati-ca by a microscope. Results According to the natural conditions the investigation was carried out in 6 survey areas. Each sur-vey area was placed with 60 mousetraps and all 360 mousetraps were recovered. A total of 31 rodents rodent density 8.61%were captured and examined including 24 Apodemus agrarius 3 Rattus norvegicus 4 Sorex caecutiens and C. hepatica eggs were found in 1 R. norvegicus 1/3 and not found in A. agrarius and S. caecutiens. Conclusion This study has documented a prevalence of C. hepatica in rodents from Wuhan section of the Yangtze River marshland where is a natural epidemic focus of ca-pillariasis hepatica.