Epidemiological features and diagnosis of malaria cases in Nantong City from 2015 to 2020 / 中国血吸虫病防治杂志

Objective To investigate the epidemiological characteristics and diagnosis of malaria cases in Nantong City from 2015 to 2020, so as to provide insights into the prevention of re-establishment of imported malaria and consolidation of malaria elimination achievements in the city. Methods The epidemic data of malaria in Nantong City from 2015 to 2020 were captured from the National Notifiable Disease Report System, the Information Management System for Parasitic Disease Control and individual epidemiological survey reports of malaria cases. The malaria parasite species, source of infections, population distribution, temporal distribution, spatial distribution and diagnosis of imported malaria cases were descriptively and statistically analyzed. Results A total of 241 malaria cases were reported in Nantong City from 2015 to 2020, and all were overseas imported cases, including 191 cases with Plasmodium falciparum malaria (79.25%), 8 cases with P. vivax malaria (3.32%), 33 cases with P. ovale malaria (13.69%) and 9 cases with P. malaria malaria (3.73%). Overseas imported malaria cases acquired infections from 34 countries in Asia, Africa and Latin America, and 97.93% of the cases were infected in Africa, and 90.04% (217/241) were reported in Chongchuan District, Hai’an City and Haimen District. Imported malaria cases were aged from 20 to 68 years, and a median age of 45 (13) years, and 97.10% were male. The median duration between returning to China and malaria onset was 7 (9) days among all imported malaria cases, and the median duration from initial diagnosis to definitive diagnosis was 2 (2) days. There were 167 cases that were initially diagnosed as malaria, with a correct rate of 69.29%, and 53.53 (129/241) of malaria cases were diagnosed at city-level medical institutions and 41.49% (100/241) at county-level medical institutions. In addition, the proportion of malaria cases reported by city-level medical institutions increased from 39.62% in 2015 to 81.25% in 2020 (χ2 = 6.94, P < 0.01). Conclusions The accuracy of initial malaria diagnosis requires to be improved in Nantong City. Malaria control knowledge should be specially given to migrant workers to shorten the duration of seeking medical care, and malaria training requires to be intensified among healthcare professionals to improve the diagnostic capability of imported malaria cases and the cure of severe P. falciparum malaria cases.

[Evaluation of implementation effect of schistosomiasis control program in Jiangsu Province from 2010 to 2015].

OBJECTIVE: To evaluate the actual effect of the schistosomiasis control program in Jiangsu Province from 2010 to 2015. METHODS: A total of 67 schistosomiasis-endemic counties in 10 cities were selected, and a combination of retrospective investigation and on-site investigation was adopted to collect and record the epidemic data of the counties from 2010 to 2015, and a retrospective survey database of epidemic situation was established. The effects of integrated control strategies with both Oncomelania hupensis snail control and infection source control were evaluated. RESULTS: From 2010 to 2015, 2 465 911 persons who lived in endemic areas were detected for schistosomiasis, with 16 974 positive cases of blood examinations, and 8 positive cases of fecal examinations. Totally 5 145 people with advanced schistosomiasis were treated and 40 460 people with the history of schistosome cercarial-infested water contact received the expanded chemotherapy. A total of 127 636 cattle raised in the endemic areas were detected, and 51 619 cattle (head-times) with the history of cercarial-infested water contact also received the expanded chemotherapy. The area with snails control by molluscicides was 18 604.84 hm2. By the end of 2015, schistosomeinfected snails had not been found and there was no zoological schistosome infection for 5 consecutive years, and in addition, there had been no acute schistosome-infected persons for 6 consecutive years in the whole province. The area with snails dropped to 1 977.18 hm2, with a decreasing rate of 55.24% compared with that in 2010. CONCLUSIONS: After the implementation of the plan for the prevention and control of schistosomiasis in Jiangsu Province (2010-2015), the prevention and control of schistosomiasis has achieved remarkable effects and realized the goal of the plan.

Evaluation of implementation effect of schistosomiasis control program in Jiangsu Province from 2010 to 2015 / 中国血吸虫病防治杂志

Objective To evaluate the actual effect of the schistosomiasis control program in Jiangsu Province from 2010 to 2015. Methods A total of 67 schistosomiasis-endemic counties in 10 cities were selected, and a combination of retrospective investigation and on-site investigation was adopted to collect and record the epidemic data of the counties from 2010 to 2015, and a retrospective survey database of epidemic situation was established. The effects of integrated control strategies with both Oncomelania hupensis snail control and infection source control were evaluated. Results From 2010 to 2015, 2 465 911 persons who lived in endemic areas were detected for schistosomiasis, with 16 974 positive cases of blood examinations, and 8 positive cases of fecal examinations. Totally 5 145 people with advanced schistosomiasis were treated and 40 460 people with the history of schistosome cercarial-infested water contact received the expanded chemotherapy. A total of 127 636 cattle raised in the endemic areas were detected, and 51 619 cattle (head-times) with the history of cercarial-infested water contact also received the expanded chemotherapy. The area with snails control by molluscicides was 18 604.84 hm2. By the end of 2015, schistosomeinfected snails had not been found and there was no zoological schistosome infection for 5 consecutive years, and in addition, there had been no acute schistosome-infected persons for 6 consecutive years in the whole province. The area with snails dropped to 1 977.18 hm2, with a decreasing rate of 55.24% compared with that in 2010. Conclusion After the implementation of the plan for the prevention and control of schistosomiasis in Jiangsu Province (2010–2015), the prevention and control of schistosomiasis has achieved remarkable effects and realized the goal of the plan.

[Epidemic situation and diagnosis and treatment of severe falciparum malaria in Nantong City].

OBJECTIVE: To retrospectively analyze the epidemic situation and diagnosis and treatment of severe falciparum malaria in Nantong City, summarize the causes of severe falciparum malaria, and evaluate the effect of diagnosis and treatment, so as to provide the evidence for formulating the practical treatment measures for this disease. METHODS: All the data of falciparum malaria cases in Nantong City from 2009 to 2016 were collected and analyzed for the onset time, diagnosis process and treatment of the disease. RESULTS: A total of 359 malaria cases, including 289 falciparum malaria cases, were reported in Nantong City from 2009 to 2016, including 26 severe falciparum malaria cases. All the severe falciparum malaria cases were imported from Africa, including 57.70% of cases (15/26) from Angola. All of them were male labor exporting personnel. The incidence of malaria was not obviously seasonal. The average time from onset to definite diagnosis was 5.2 days, and 11 cases were diagnosed 5 days after the onset. All the 26 cases were cured by anti-malaria treatment and symptomatic treatment, and there was no death. CONCLUSIONS: Severe falciparum malaria seriously harm the people's health and its clinical manifestations are complicated. Therefore, the training of medical staff and health education in residents, especially in labor exporting personnel, should be further strengthened.

Evaluation of implementation effect of schistosomiasis control program in Jiangsu Province from 2010 to 2015 / 中国血吸虫病防治杂志

Objective To evaluate the actual effect of the schistosomiasis control program in Jiangsu Province from 2010 to 2015. Methods A total of 67 schistosomiasis-endemic counties in 10 cities were selected, and a combination of retrospective investigation and on-site investigation was adopted to collect and record the epidemic data of the counties from 2010 to 2015, and a retrospective survey database of epidemic situation was established. The effects of integrated control strategies with both Oncomelania hupensis snail control and infection source control were evaluated. Results From 2010 to 2015, 2 465 911 persons who lived in endemic areas were detected for schistosomiasis, with 16 974 positive cases of blood examinations, and 8 positive cases of fecal examinations. Totally 5 145 people with advanced schistosomiasis were treated and 40 460 people with the history of schistosome cercarial-infested water contact received the expanded chemotherapy. A total of 127 636 cattle raised in the endemic areas were detected, and 51 619 cattle (head-times) with the history of cercarial-infested water contact also received the expanded chemotherapy. The area with snails control by molluscicides was 18 604.84 hm2. By the end of 2015, schistosomeinfected snails had not been found and there was no zoological schistosome infection for 5 consecutive years, and in addition, there had been no acute schistosome-infected persons for 6 consecutive years in the whole province. The area with snails dropped to 1 977.18 hm2, with a decreasing rate of 55.24% compared with that in 2010. Conclusion After the implementation of the plan for the prevention and control of schistosomiasis in Jiangsu Province (2010–2015), the prevention and control of schistosomiasis has achieved remarkable effects and realized the goal of the plan.

Epidemic situation and diagnosis and treatment of severe falciparum malaria in Nantong City / 中国血吸虫病防治杂志

Objective To retrospectively analyze the epidemic situation and diagnosis and treatment of severe falciparum malaria in Nantong City, summarize the causes of severe falciparum malaria, and evaluate the effect of diagnosis and treatment, so as to provide the evidence for formulating the practical treatment measures for this disease. Methods All the data of falciparum malaria cases in Nantong City from 2009 to 2016 were collected and analyzed for the onset time, diagnosis process and treatment of the disease. Results A total of 359 malaria cases, including 289 falciparum malaria cases, were reported in Nantong City from 2009 to 2016, including 26 severe falciparum malaria cases. All the severe falciparum malaria cases were imported from Africa, including 57.70% of cases (15/26) from Angola. All of them were male labor exporting personnel. The incidence of malaria was not obviously seasonal. The average time from onset to definite diagnosis was 5.2 days, and 11 cases were diagnosed 5 days after the onset. All the 26 cases were cured by anti-malaria treatment and symptomatic treatment, and there was no death. Conclusions Severe falciparum malaria seriously harm the people’s health and its clinical manifestations are complicated. Therefore, the training of medical staff and health education in residents, especially in labor exporting personnel, should be further strengthened.

Epidemic situation and diagnosis and treatment of severe falciparum malaria in Nantong City / 中国血吸虫病防治杂志

Objective To retrospectively analyze the epidemic situation and diagnosis and treatment of severe falciparum malaria in Nantong City, summarize the causes of severe falciparum malaria, and evaluate the effect of diagnosis and treatment, so as to provide the evidence for formulating the practical treatment measures for this disease. Methods All the data of falciparum malaria cases in Nantong City from 2009 to 2016 were collected and analyzed for the onset time, diagnosis process and treatment of the disease. Results A total of 359 malaria cases, including 289 falciparum malaria cases, were reported in Nantong City from 2009 to 2016, including 26 severe falciparum malaria cases. All the severe falciparum malaria cases were imported from Africa, including 57.70% of cases (15/26) from Angola. All of them were male labor exporting personnel. The incidence of malaria was not obviously seasonal. The average time from onset to definite diagnosis was 5.2 days, and 11 cases were diagnosed 5 days after the onset. All the 26 cases were cured by anti-malaria treatment and symptomatic treatment, and there was no death. Conclusions Severe falciparum malaria seriously harm the people’s health and its clinical manifestations are complicated. Therefore, the training of medical staff and health education in residents, especially in labor exporting personnel, should be further strengthened.

[Study on Oncomelania hupensis snails infected with Schistosoma japonicum miracidia under different conditions in snail-existent non-endemic areas of schistosomiasis in Nantong City].

OBJECTIVE: To understand the forming cause of the Oncomelania hupensis snail-existent non-endemic areas of schistosomiasis (SENEAS), and to verify the conclusion of previous studies, so as to provide the evidence for schistosomiasis monitoring in such areas in Nantong City, Jiangsu Province. METHODS: The controlled field tests were carried out to observe the O. hupensis snails artificially infected by schistosome miracidia in SENEAS. The influence of the soil from SENEAS and the endemic areas on O. hupensis snails artificially infected by miracidia were observed. RESULTS: All the experimental snails could be infected by schistosome miracidia except the smooth-shell snails from Tangyuan Village in the controlled field test environment of SENEAS or the endemic areas. The infection rates of the smooth-shell snails were lower than those of the ribbed-shell snails, but there were no statistically significant differences. The mortality rates of the smooth-shell snails were higher than those of the ribbed - shell snails, which were statistically significant (χ2Xindian = 135.118, χ2Shuangdian = 122.836, χ2Baipu =154.436, χ2Dingyan = 138.288, χ2Control = 151.923, all P < 0.01). There were no significant differences in the infection rates of snails between each test group of the soil from SENEAS and the endemic areas (χ2Rugao = 0.071, χ2Rudong = 0.216, both P > 0.05). Also there was no significant difference between each test group and the control group without soil (χ2 = 7.148, P > 0.05). CONCLUSIONS: It is likely to form the spread of schistosomiasis in SENEAS in Nantong City with sufficient amount of infection source of schistosomiasis imported. It is still necessary to implement the surveillance of schistosomiasis and O. hupensis snails in Nantong City.

[Investigation on current situation of malaria blood examinations in township-level hospitals of Nantong City].

OBJECTIVE: To understand the quality of malaria blood examinations in township-level hospitals, so as to provide the evidence for continuing the malaria blood examinations in the stage of post-malaria elimination. METHODS: A total of 64 township hospitals were investigated and 640 negative malaria blood slides were scored individually according to 10 indicators in "Malaria Elimination Technical Scheme" in 2013 and 2014. The single and multiple indicators were calculated, and the work of blood examinations and situation of technicians were investigated. The data of malaria blood examinations and patient discovery in township hospitals of Nantong City were collected and analyzed during the period of 2011-2014. RESULTS: For the single indicator, 29.5% of the thick blood films did not reach the standard, and 35.8% of thin blood films did not reach the standard. For the multiple indicators, blood slides with more than 4 indicators below the standard (poor quality) accounted for 32.5%. From malaria blood examinations and malaria situation, the number of slides was 194 635 during the period of 2011-2014, and there were no local vivax malaria casesin 4 consecutive years from 2011 to 2014, and local malaria has been effectively controlled in Nantong City. For health facilities where malaria patients initially presented, the township and village level accounted for 16.3%, and county and higher level accounted for 83.7%. CONCLUSIONS: The quality of malaria blood examinations in township level hospitals of Nantong City is not high and the microscopic examination has a relatively low efficiency in the discovery of malaria cases. A new model for malaria blood examinations needs to be further explored.