[Epidemiological Analysis of Imported Malaria in Xinjiang from 2004 to 2015].

Objective: To analyze the epidemiological characteristics of imported malaria in Xinjiang. Methods: The information of reported malaria cases and epidemiological records from various sources in Xinjiang Uygur Autonomous Region from 2004 to 2015 was collected. The epidemiological characteristics of malaria cases were analyzed. Results: Seventy-seven malaria cases were reported in Xinjiang from 2004 to 2015, and all were imported cases. In detail, 42 cases （54.5%） were reported during the time period of 2004-2009, with 24 laboratory diagnosed and 18 clinically diagnosed; 35 cases （45.5%） were reported from 2010 to 2015, with 27 laboratory diagnosed and 8 clinically diagnosed. Among the 51 cases with laboratory diagnosis, 18 were falciparum malaria, 31 were vivax malaria, and 2 unidentified. The male-to-female ratio was 6.7 ∶ 1（P<0.05）. The age range of the patients was 14-75 years （39.7 ± 13.3 years）, comprising 26.0% （20/77） for the range of 31-40 years and 24.7% （19/77） for the range of 41-50（P>0.05 among the age groups）. From the perspective of case sources, 28 cases （36.4%） were imported from Africa and 49 cases（63.6%） from Asia (including other provinces of China). The interval from onset to final diagnosis ranged 1-320 days. Only 3 patients（3.9%） were diagnosed within 24 h, and 59 patients（76.6%） were not diagnosed until or over one week. In addition, 28 cases（36.4%） were reported by medical institutions at the provincial level, 15 cases（19.5%） were reported by medical institutions at the prefecture level, 5 cases（6.5%） were reported by the Center for Disease Control and Prevention, and the rest 29 cases（37.7%） were reported at the county level or below. No secondary transmission was found. Conclusion: Most of the imported malaria cases during 2004-2015 were diagnosed with laboratory tests, reported by medical institutions, and were from Africa and Asia.

[Epidemiological Survey of Echinococcosis in Xinjiang Uygur Autonomous Region in 2012].

Objective: To understand the endemic status of echinococcosis in Xinjiang Uygur Autonomous Region, to provide scientific basis for planning and promoting control measures in this region. Methods Eight hundred people of all age ranges were examined in each of the selected agricultural area, pastoral area, pastoral-agricultural area, and township area of 92 counties in 14 prefectures in Xinjiang during March and October of 2012, resulting in a total of 3 200 people surveyed in each county. B ultrasonic abdominal scan was performed, accompanied by serum antibody detection for suspected cases. Methods: Eight hundred people of all age ranges were examined in each of the selected agricultural area, pastoral area, pastoral-agricultural area, and township area of 92 counties in 14 prefectures in Xinjiang during March and October of 2012, resulting in a total of 3 200 people surveyed in each county. B ultrasonic abdominal scan was performed, accompanied by serum antibody detection for suspected cases. Results: A total of 293 140 people were examined. The overall morbidity was 0.14%（407/293 140）. The morbidity in the north region was 0.18%（290/158 985, 71.25%of all the cases）, and that in the south region was 0.09%（117/134 155, 28.75% of all the cases）（P<0.05 between the regions）. The cases were mainly distributed in Urumqi City（19.90%, 81/407）, Tarbagatai Prefecture（13.27%, 54/407）, Yili Kazak Autonomous Prefecture（13.02%, 53/407） and Changji Hui Autonomous Prefecture（9.83%, 40/407）. The prevalence was higher in Mongolian［0.42%（21/5 045）］ and Kirgiz ［0.35%（32/9 045）］ than in other ethnic groups（0.07%-0.22%）（P<0.05）. There was no significant difference in prevalence between males［0.13%（195/144 715）］ and females［0.14%（212/148 425）］ （P>0.05）. The prevalence was lowest in the 0-9 year group［0.07%（7/10 754）］, and higher in the the age groups of 70-79［0.27%（33/12 310）］ and 80-99 years［0.28%（7/2 461）］, showing a trend of elevation with ageing. Further, the cases were mainly in the population of 30-49 years（43%, 175/407）. The prevalence was higher in the uneducated［0.25%, 39/15 470］ than in the educated populations（0.06%-0.14%）（P＜0.05）, and higher in pastoralists［0.29%, 63/22 074］ than in populations with other occupations（0.00%-0.13%）（P<0.05）. The prevalence in pastoral area, agricultural area, pastoral-agricultural area, and township area was 0.16%（70/44 247）, 0.16%（181/113 016）, 0.12%（88/70 610） and 0.10%（68/65 267）, respectively. The township area had the lowest prevalence, which was significantly different from both the pastoral area and the agricultural area (P<0.05). Conclusion: Echincoccosis is widely distributed in Xinjiang, with more cases in the north.

[Epidemiological Studies on Echinococcosis in Kizilsu Kirgiz Autonomous Prefecture of Xinjiang].

Objective: To understand the prevalence and characteristics of echinococcosis in Kizilsu Kirgiz Autonomous Prefecture (abbreviated as Kizilsu) of Xinjiang, in the aim of providing evidence for prevention and treatment of echinococcosis. Methods: Sixty-two villages were selected as investigation spots from 19 towns in agricultural and pasturing areas of Ulugqat County, Artux City, Akto County, and Akqi County during 2011-2012. Ultrasound abdominal scan was performed in all residents in these spots to examine the occurance of echinococcosis. ELISA was performed to detect the echinococcosis-specific antibody in sera from children of 6-12 years and the antigen of Echinococcus granulosus in freshly-collected dog feces. Hydatid cysts in viscera of at slaughterhouses in the four spots were examined by touching and visual observation. Results: Ultrasound was conducted in 12 000 residents, among whom 60 were found to be positive for echinococcosis (echinococcosis granulosa), with a morbidity of 0.5%（60/12 000）. The morbidity in Ulugqat County was 1.1%（35/3 200）, significantly higher than that in Artux City（0.5%, 13/2 400）, Akto County（0.2%, 8/3 200）, and Akqi County（0.1%, 4/3 200）（χ2=4.92-24.79, P<0.05）. The morbidity was highest in residents ≥71 years（1.2%, 4/323）, followed by the age group of 0-10 years（0.9%, 3/350）, but with no significant difference among age groups（χ2=0.39-3.31, P＞0.05）. The serum antibody positive rate in children was 3.1%（230/7 338）, highest in Artux City（4.9%, 89/1 828） with significant difference in comparison to Akto County（2.9%, 56/1 927）, and Akqi County（0.7%, 11/1 639）（χ2=9.71, 54.34, P<0.05）. The hydatid cyst rate in livestock was 7.7%（291/3 769）, of which 97.3%（283/291） were in sheep. The antigen positive rate in dog feces was 3.3%（74/2 219）. Conclusion: The morbidity（1.1%） was highest in Ulugqat County and the antibody positive rate（4.9%） in children was highest in Artux City. Infection was found in livestock and dogs.

[Epidemiological Survey on Human Intestinal Protozoa in Xinjiang Uygur Autonomous Region in 2015].

Objective: An epidemiological survey was made on human intestinal protozoa in Xinjiang Uygur Autonomous Region (Xinjiang) to evaluate recent control achievements and provide basis for making specific control strategies. Methods: Regions in Xinjiang were categorized by types of ecological system and geographical characteristics into five ecological areas（types I-V） according to the National Ecological Function Stratification issued by the Ministry of Environment Protection and Chinese Academy of Science and Technology. Stratification sampling was made in each ecological area. Feces from human of all ages were collected for morphological identification of protozoan species using the Iodine Liquid Direct Smear Method. Results: In the five ecological areas, 26 886 people from 132 survey sites in 39 counties (cities) were examined, with an examination rate of 81.47% （26 886/33 000）. The infection rate was 0.32%（85/26 886）. Four species of intestinal protozoa were detected, i.e., Entamoeba histolytica, Giardia lamblia, Blastocystis hominis, and Entamoeba coli, with an infection rate of 0.22% （60/26 886）, 0.03% （9/26 886）, 0.01% （2/26 886） and 0.61% （17/26 886）, respectively. Of the five areas, the type IV area had the highest infection rate of 0.75%（28/3 758）（P<0.05）. Besides, the infection rate was higher in males （0.24%, 33/13 623） than that in females （0.39%, 52/13 263） （P<0.05）, higher in age ranges of 21-30（1.40%, 16/3 959） and 31-40 years（0.46%, 22/4 799） than other age groups （P>0.05）, higher in housewives （0.48%, 2/418） than those with other occupations, higher in the Hui group （0.61%, 15/2 445） than that in other ethnic groups, as well as highest in populations with a primary education level （0.37%, 35/9 375） and lowest in those with a college level or above（0.20%, 8/3 945）. Conclusion: The human intestinal protozoa infection was at a low level in Xinjiang in 2015.

[Investigation on the Outbreak of Visceral Leishmaniasis in 2014 in Jiashi County of Xinjiang].

OBJECTIVE: To understand the epidemiological characteristics of visceral leishmaniasis (VL) outbreak in Jiashi County of Xinjiang Uygur Autonomous Region in 2014, and provide basis for VL prevention and control strategies. METHODS: Data on VL epidemic situation in Xinjiang from July 1, 2009 to June 30, 2015 were collected from Chinese CDC Infectious Disease Reporting Information Management System (reporting system). On-site epidemiological investigation was conducted in October, 2014, among children under 3 years in 23 villages in Gholtoghrak Township and Koxawat Township in Jiashi County, regions that had dramatically increased reports of VL cases from July 1. For suspected cases who showed symptoms such as fever and hepato-splenomegaly, blood (20 µl) was collected through fingerstick (with parental guardian consent) for rk39 immunochromatographic strip testing. Chil- dren with positive results were given sodium stibogluconate treatment (6x200 mg/kg, intravenously). RESULTS: A total of 637 VL cases were reported in Xinjiang from July 1, 2009 to June 30, 2015. Among the 192 cases reported from July 1, 2014 to June 30, 2015 in Xinjiang, cases from Jiashi County occupied 86.46% (166/192) of the cases. The number of VL cases in Jiashi County showed a trend of increase since the first report in August, with a total number of 114 in October, November and December. The 166 cases in Jiashi County had an age range of 23 days-8 years, with those under one year accounting for 95.18%(158/166). The 113 cases in Gholtoghrak Township of the County had an age range of 23 days-3 years, with those under one year accounting for 96.46% (109/113). The age--distribution of VL casess in the County accorded with the characteristic of the desert type. On-site investigation of 833 children in the 23 villiages revealed 11 children with positive results of rk39 immunochromatographic strip testing out of 14 suspected cases, all recovered after one course of sodium stibogluconate treatment. CONCLUSION: In 2014, VL outbreak occurs in Jiashi County with 95% of the cases being children under one year old. This outbreak was identified to be the desert type.

[Retrospective analysis of echinococcosis surgerical cases in Xinjiang from 2005 to 2013].

UNLABELLED: [Abstract] OBJECTIVE: To analyze the situation of echinococcosis surgerical cases in Xinjiang Uygur Autonomous Region from 2005 to 2013. METHODS: The surgery cases of echinococcosis in Xinjiang from 2005 to 2013 were collected, and analyzed with SPSS 17.0 and Epi Info 3.5.3 software. RESULTS: A total of 8 639 hydatid disease cases were reported during 2005-2013 from 94 counties (cities and districts) of 14 prefectures (municipalities) in the Region. The average number of annual operation cases were 960 cases (8,639/9 years), and the annual incidence was 4.40/100,000 (960/21.81 million). 82.8% (7,152/8,639) of report cases came from northern Xinjiang area with an incidence of 7.59/100,000, and 17.2% (1,487/8,639) distributed in southern Xinjiang area with an incidence of 1.58/100,000. There were 373 cases (4.4%, 373/8,639) reported in 2005, and increased to 1434 cases (16.5% 1,434/8,639) in 2013 (P<0.05). The cases mainly distributed in Yili Kazak Autonomous Prefecture (2,028 cases), Tarbagatai Prefecture (1,218 cases), Changji Hui Autonomous Prefecture (1,179 cases), and Urumqi City (1,128 cases) of the northern Xinjiang area. There were 4,557 male (52.8%, 4,557/8,639) and 4 082 famale patients (47.3%, 4,082/8,639)(P<0.05). The age distribution showed a single-peak curve, and more patients concentrated in the age group of 31-40 years, accounting for 26.2% (2,265/8,639). Among 8,639 cases, farmers accounted for 47.9% (4 134/8 639). CONCLUSION: The nunber of surgical cases of echinococcosis increases every year in Xinjiang since 2005, and the distribution of the disease shows a trend from the agricultural and pastoral areas to the towns.

[Investigation on transmitting vectors of visceral leishmaniasis in Jiashi County, Xinjiang].

OBJECTIVE: To investigate sandfly vectors transmitting visceral leishmaniasis, including species and seasonal distribution in Jiashi county of Xinjiang Uygur Autonomous Region. METHODS: Sandflies were collected in the field, counted and identified. The specimens were dissected to analyze the gonotrophic cycle and to find infection of promastigotes. The resting places were observed by using oil-paper and sandfly-capturing trap. RESULTS: 4540 sandflies were collected with 99.9% of Phlebotomus wui and only 0.1% Sergentomyia minutus sinkiangensis. On the seasonal distribution, the first peak appeared by the end of May and the first ten-day of June, and the second peak was in the middle of August. Observation showed that the activity of sandflies occurred mainly from 22:00 to 4:00, reaching to the maximum in the midnight. Analysis on the gonotrophic cycle revealed that Ph. wui was an exophilic species and appeared nocturnally for feeding with preference to human blood. Natural infection with promastigotes was found in 4 sandflies, more in the field than the residential area. Resting places included the aperture on the wall of livestock sheds and in the caves. CONCLUSION: Ph. wui is the predominant species in Jiashi, with higher infection rate of natural promastigotes in the field and with two life generations annually.

[Visceral leishmaniasis in Artux City of Xinjiang Uygur Autonomous Region during 1996-2007].

Visceral leishmaniasis cases in Artux City of Xinjiang Uygur Autonomous Region in 1996-2007 were collected and statistically analyzed. Altogether, 102 leishmaniasis cases were found in the ten years. Among 7 townships and an urban district, more cases were reported in the townships of Ahu (occupying 37.3%), Azake (27.5%), Sumutake (19.6%) and Shangatushi (8.8%), while sporadical cases occurred in other townships/district. Male and female ratio was 1.04:1. More cases were from 0-5 year age group (30.4%) and 6-10 year age group (29.4%). In the ten years, the highest number of cases (21.6%) occurred in 1998 and the lowest in 2000 (1.0%). Visceral leishmaniasis has been endemic in Artux City.

[An epidemiological survey of visceral leishmaniasis in Hamangou coal mine area of Korla City, Xinjiang].

OBJECTIVE: To investigate the epidemiological status of visceral leishmaniasis in Hamangou coal mine area of Korla City of Xinjiang Uygur Autonomous Region. METHODS: Based on a hint of possible existence of patients, a retrospective survey was carried out house by house to find cases with suspected signs/symptoms of the disease. Meanwhile, a survey on current status was conducted, including physical examination (liver and spleen palpation) to those less than 15 years-old, leishmanin skin test and rk39 immunochromatographic strip test for part of the residents. Bone marrow smears were examined for the cases with clinical signs/symptoms and positive rk39 strip test. Sandflies were collected using routine methods in and around the area, identified, and dissected to find infection of promastigotes. RESULTS: Leishmanin skin test was performed in 185 people with a positive rate of 21.1% (39/185), 39 out of 140 local residents who have lived there for more than 6 years showed positive (27.9%), while all residents who have lived less than 6 years and children under 5 years old were negative. Of the 81 children under 15 years old with a negative skin test, one showed positive for rk39 strip test, and leishmania body was found in the bone marrow smear of this case, so confirmed as visceral leishmaniasis. 12 sandflies were identified as Phlebotomus alexandri, and natural infection with promastigotes was found in one sandly. CONCLUSION: The investigation confirms that visceral leishmaniasis is endemic in the Hamangou coal mine area.

[A newly identified endemic area of visceral leishmaniasis in Minfeng county of South Xinjiang I. epidemiological survey].

OBJECTIVE: To investigate the epidemiological status of visceral leishmaniasis in Minfeng county, a newly identified endemic area in south Xinjiang, China. METHODS: Based on a hint of possible existence of patients, a retrospective survey was carried out house by house in Andier Township of the county to find cases with suspected signs/symptoms of the disease in the past 20 years including those died. Meanwhile, a survey on current status was conducted, including physical examination(liver and spleen palpation) to those under 15 years-old, leishmanin skin test and rk39 immunochromatographic strip test for part of the residents. RESULTS: The investigation covered 313 local residents and revealed no case with present illness but 60 cases with a history of suspected signs/symptoms including 13 deaths, traced back as visceral leishmaniasis. Leishmanin skin test was performed in 171 people with a positive rate of 99.4% and 28 out of 29 suspected cases showed positive (96.6%). rk39 immunochromatographic strip test was conducted in 197 people with a positive rate of 10.2% (20/197) and 19.4% (6/31) in those with a history of suspected signs/symptoms. CONCLUSION: The epidemiological investigation indicates that the Andier Township of Minfeng County is an endemic area of visceral leishmaniasis.

[A newly identified endemic area of visceral leishmaniasis in Minfeng county of south Xinjiang II. Investigation on phlebotomine vectors].

OBJECTIVE: To investigate the transmitting phlebotomine sandfly in Minfeng County, a newly-identified endemic area of visceral leishmaniasis in the south of Talim Pendi of Xinjiang. METHODS: Sandflies were collected using routine methods in and around the Yatonggusi village of Andier Township. The sandflies were identified to get their composition. Sandfly density was calculated following an observation at a given spot and time-period, and their appearance was recorded at night-time and day-time. Sandflies were dissected to analyze the gonotrophic cycle and to find infection of promastigotes. RESULTS: Phlebotomus wui was identified as the transmitting vector of visceral leishmaniasis in Andier Township, which occupied 99.2% of the sandflies collected. The first and second ten-day period of June was the first peak of its seasonal distribution. Analysis of the gonotrophic cycle revealed that Ph. wui was an exophilic species and appeared nocturnally for feeding with preference to human blood. Natural infection with promastigotes was found in 2 sandflies. CONCLUSION: Phlebotomus wui is the transmitting vector for visceral leishmaniasis in the newly found endemic area of south Xinjiang.

[Change of knowledge rate after health education on visceral leishmaniasis among residents in a township of Kashgar City].

Health education activities including distribution of brochures, posters, and lectures were conducted in selected villages of a kala-azar endemic-township, Kashi city of Xinjiang in 2004-2006. Questionnaire was carried out before and after health education in residents and students. The percentage of correctly answering all 5 questions on leishmaniasis in residents and primary/secondary school students increased from 0.7% and 0 to 54.2% and 70.7% respectively, indicating that health education can raise public awareness for the disease prevention and control.

An Epidemiological Survey of Visceral Leishmaniasis in Hamangou Coal Mine Area of Korla City, Xinjiang / 中国寄生虫学与寄生虫病杂志

Objective To investigate the epidemiological status of visceral leishmaniasis in Hamangou coal mine area of Korla City of Xinjiang Uygur Autonomous Region.Methods Based on a hint of possible existence of patients, a retrospective survey was carried out house by house to find cases with suspected signs/symptoms of the disease.Meanwhile, a survey on current status was conducted, including physical examination(liver and spleen palpation) to those less than 15 years-old, leishmanin skin test and rk39 immunochromatographic strip test for part of the residents.Bone marrow smears were examined for the cases with clinical signs/symptoms and positive rk39 strip test.Sandflies were collected using routine methods in and around the area, identified, and dissected to find infection of promastigotes.Results Leishmanin skin test was performed in 185 people with a positive rate of 21.1%(39/185), 39 out of 140 local residents who have lived there for more than 6 years showed positive(27.9%) , while all residents who have lived less than 6 years and children under 5 years old were negative.Of the 81 children under 15 years old with a negative skin test, one showed positive for rk39 strip test, and leishmania body was found in the bone marrow smear of this case, so confirmed as visceral leishmaniasis.12 sandfies were identified as Phlebotomus alexandri, and natural infection with promastigotes was found in one sandly.Conclusion The investigation confirms that visceral leishmaniasis is endemic in the Hamangou coal mine area.