Study on the hospitalization cost and its influencing factors of imported malaria patients in Guangxi Zhuang Autonomous Region and Yunnan Province / 中国血吸虫病防治杂志

Objective To analyze the hospitalization cost and its influencing factors of imported malaria patients in Guangxi Zhuang Autonomous Region and Yunnan Province, so as to provide insights into the evaluation of the economic burden due to imported malaria, and the guiding of malaria control and the rational allocation of medical resources. Methods The data pertaining to the hospitalization costs of imported malaria patients admitted to Shanglin County People’s Hospital in Guangxi Zhuang Autonomous Region during the period from January 1 through December 31, 2019, and Tengchong Municipal People’s Hospital in Yunnan Province from January 1, 2015 to December 31, 2019, were collected, and the epidemiological data of these imported malaria patients were extracted from the Information Management System for Parasitic Diseases Control and Prevention, China. The composition of the hospitalization expenses was analyzed using a descriptive method. In addition, the factors affecting the hospitalization expenses of imported malaria patients were identified using a univariate analysis and a recursive system model. Results A total of 206 imported malaria patients were included in this study, including 194 men (94.17%) and 12 women (5.83%). The mean length of hospital stay was 5.00 days per patient and the median hospitalization expenses were 2 813.07 Yuan per time, in which the expenses for laboratory examinations were the highest (45.31%, 1 274.62/2 813.07). Univariate analysis showed that hospital (z = 5.43, P < 0.01), type of malaria (χ2 = 34.86, P < 0.01) and type of payment (χ2 = 7.72, P < 0.05) were factors affecting the hospitalization expenses of imported malaria patients. Recursion system modeling revealed that the total effects on hospitalization expenses of imported malaria patients included length of hospital stay (0.78), selection of hospital (0.34), basic medical insurance for urban and rural residents (0.19), new rural cooperative medical care (0.17), Plasmodium falciparum malaria (0.15), gender (0.11) and P. vivax malaria (0.09). Conclusions The hospitalization expenses of imported malaria patients are affected by multiple factors in Guangxi Zhuang Autonomous Region and Yunnan Province, in which the length of hospital stay is the most predominant influencing factor. A reduction in the length of hospital stay is effective to decrease the hospitalization expenses of imported malaria patients.

Tackling air pollution and extreme climate changes in China: Implementing the Paris climate change agreement.

China still depends on coal for more than 60% of its power despite big investments in the process of shifting to nuclear, solar and wind power renewable energy resources alignment with Paris climate change agreement (Paris CCA). Chinese government through the Communist Party Central Committee (CPCC) ascribes great importance and commitment to Paris CCA legacy and history landmark implementation at all levels. As the world's biggest carbon dioxide emitter, China has embarked on "SMART" pollution and climate changes programs and measures to reduce coal-fired power plants to less than 50% in the next five years include: new China model of energy policies commitment on CO2 and greenhouse gas emissions reductions to less than 20% non-fossil energy use by 2030 without undermining their economic growth, newly introduced electric vehicles transportation benefits, interactive and sustained air quality index (AQI) monitoring systems, decreasing reliance on fossil fuel economic activities, revision of energy price reforms and renewable energy to less energy efficient technologies development. Furthermore, ongoing CPCC improved environmental initiatives, implemented strict regulations and penalties on local companies and firms' pollution production management, massive infrastructures such as highways to reduce CO2 expansion of seven regional emissions trading markets and programs for CO2 emissions and other pollutants are being documented. Maximizing on the centralized nature of the China's government, implemented Chinese pollution, climate changes mitigation and adaptation initiatives, "SMART" strategies and credible measures are promising. A good and practical example is the interactive and dynamic website and database covering 367 Chinese cities and providing real time information on environmental and pollution emissions AQI. Also, water quality index (WQI), radiation and nuclear safety monitoring and management systems over time and space. These are ongoing Chinese valuable and exemplary leadership in Paris CCA implementation to the global community. Especially to pragmatic and responsible efforts to support pollution and climate changes capacity development, technology transfer and empowerment in emissions surveillance and monitoring systems and "SMART" integrated climate changes mitigation packages in global Sustainable Development Goals (SDGs) context, citizenry health and wellbeing.

Application of Auto-regressive Linear Model in Understanding the Effect of Climate on Malaria Vectors Dynamics in the Three Gorges Reservoir / 生物医学与环境科学（英文）

It is important to understand the dynamics of malaria vectors in implementing malaria control strategies. Six villages were selected from different sections in the Three Gorges Reservoir for exploring the relationship between the climatic factors and its malaria vector density from 1997 to 2007 using the auto-regressive linear model regression method. The result indicated that both temperature and precipitation were better modeled as quadratic rather than linearly related to the density of Anopheles sinensis.

Application of structural equation models for elucidating the ecological drivers of Anopheles sinensis in the three gorges reservoir.

OBJECTIVE: To identify the major ecological drivers for malaria vector density using the structural equation model (SEM) in the Three Gorges Reservoir. METHOD: An 11-year longitudinal surveillance of malaria vector as well as its related ecological factors was carried out in the Three Gorges Reservoir. The Delphi method was used to identify associated ecological factors. The structural equation model was repeatedly corrected and improved by the corrected index, combined with the actual situation. The final model was defined by relative simplicity, best fitting as well as the practicality. RESULT: The final model indicated that the direct effects of temperature, livestock, humidity, and breeding on the vector were 0.015, -0.228, 0.450, 0.516 respectively, their total effects on the vector were 0.359, -0.112, 0.850, and 0.043 through different pathways. CONCLUSION: SEM was effective and convenient in elucidating the mechanism by which malaria vector dynamics operated in this study. It identified that the breeding had the highest direct effect on vector and played a key role for mediating effect of temperature and humidity.

Malaria transmission potential in the Three Gorges Reservoir of the Yangtze River, China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To define and evaluate the malaria transmission potential in the Yangtze River, following construction of the Three Gorges Reservoir.</p><p><b>METHODS</b>Six villages, namely, Kaixian, Fengjie, Wanzhou, Fuling, Yubei, and Zigui were selected for investigating the malaria transmission potential in the reservoir. Transmission potential was estimated by mathematical modeling and evaluation of the local malaria situation. Factors that influenced the transmission potential were analyzed using Poisson regression analysis in combination with Grey Systematic Theory (based on evaluation by the Delphi method).</p><p><b>RESULTS</b>Indirect fluorescent antibody data and the incidence of malaria in the local population were consistent with the malaria transmission potential calculated for the area. Multivariate Poisson regression analysis showed a statistically significant association between the riparian zone and the man-biting rate.</p><p><b>CONCLUSION</b>The risk of a malaria epidemic can be forecasted using the malaria transmission potential parameters investigated here which was closely correlated with the riparian zone.</p>

Comparative evaluation of light-trap catches, electric motor mosquito catches and human biting catches of Anopheles in the Three Gorges Reservoir.

The mosquito sampling efficiency of light-trap catches and electric motor mosquito catches were compared with that of human biting catches in the Three Gorges Reservoir. There was consistency in the sampling efficiency between light-trap catches and human biting catches for Anopheles sinensis (r = 0.82, P<0.01) and light-trap catches were 1.52 (1.35-1.71) times that of human biting catches regardless of mosquito density (r = 0.33, P>0.01), while the correlation between electric motor mosquito catches and human biting catches was found to be not statistically significant (r = 0.43, P>0.01) and its sampling efficiency was below that of human biting catches. It is concluded that light-traps can be used as an alternative to human biting catches of Anopheles sinensis in the study area and is a promising tool for sampling malaria vector populations.

Application of the indirect fluorescent antibody assay in the study of malaria infection in the Yangtze River Three Gorges Reservoir, China.

BACKGROUND: China Yangtze Three Gorges Project (TGP) is one of the biggest construction projects in the world. The areas around the Three Gorge Dam has a history of tertian malaria and subtertian malaria epidemic, but there are no overall data about malaria epidemics before the completion of the project. The objective of this study was to get a reliable baseline on malaria infection in the Yangtze River Three Gorges reservoir area and to provide reference data for future studies about the impact of the project on malaria epidemics. METHODS: Two surveys of malaria infection were carried out in area, at six-month intervals in May and October 2008. About 3,600 dual specimens blood film samples for parasite diagnosis and filter paper blood spots for serology (using the immunofluorescence antibody test) were collected from the general population, including school populations, whenever possible. RESULTS: The overall percentage of positive response of the same population during post-transmission periods was about twice (1.40/0.72) of that in pre-transmission. Positive individuals under 15 years of age were detected in all the localities. CONCLUSION: A certain extent of malaria infection existed in this area. Additional studies are needed to determine the length of malaria experience, and chemotherapeutic intervention as well as the distribution of main vectors for transmission in this area.

Evaluation on current malaria prevalence using capture-recapture method in national sentinel surveillance points malaria / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the feasibility of using the capture-recapture method (CRM) for national malaria sentinel surveillance program and to evaluate the malaria prevalence at those points.</p><p><b>METHODS</b>By CRM to compare data on malaria cases reported from national sentinel surveillance program and those from the registration of case report system (CRS). Analysis was made to express the difference regarding the number of cases in order to get the estimates and the incidence rate.</p><p><b>RESULTS</b>The incidence in the relative higher epidemic area, unstable epidemic area and relative lower epidemic area were 1247.30/100000, 171.50/100000 and 46.10/100000, respectively. The rate of miss-reporting malaria cases in these areas were 65.20% ,45.32% and 66.67%, respectively.</p><p><b>CONCLUSION</b>The situation of the malaria cases in the national sentinel surveillance points could be estimated,using the CRM.</p>