[Spatio-temporal distribution of COVID-19 in Cologne and associated socio-economic factors in the period from February 2020 to October 2021]. / Die zeitlich-räumliche Verteilung von COVID-19 in Köln und beeinflussende soziale Faktoren im Zeitraum Februar 2020 bis Oktober 2021.

BACKGROUND AND GOALS: Even in the early phase of the COVID-19 pandemic, which took a very different course globally, there were indications that socio-economic factors influenced the dynamics of disease spread, which from the second phase (September 2020) onwards particularly affected people with a lower socio-economic status. Such effects can also be seen within a large city. The present study visualizes and examines the spatio-temporal spread of all COVID-19 cases reported in Cologne, Germany (February 2020-October 2021) at district level and their possible association with socio-economic factors. METHODS: Pseudonymized data of all COVID-19 cases reported in Cologne were geo-coded and their distribution was mapped in an age-standardized way at district level over four periods and compared with the distribution of social factors. The possible influence of the selected factors was also examined in a regression analysis in a model with case growth rates. RESULTS: The small-scale local infection process changed during the pandemic. Neighborhoods with weaker socio-economic indices showed higher incidence over a large part of the pandemic course, with a positive correlation between poverty risk factors and age-standardized incidence. The strength of this correlation changed over time. CONCLUSION: The timely observation and analysis of the local spread dynamics reveals the positive correlation of disadvantaging socio-economic factors on the incidence rate of COVID-19 at the level of a large city and can help steer local containment measures in a targeted manner.

Malignant Granular Cell Tumor of the Esophagus: A Case Report.

INTRODUCTION: Malignant granular cell tumor (MGCT) of the esophagus is an extremely rare malignancy with a poor prognosis. Literature describing this condition is not sufficient, especially regarding long-term survival. PRESENTATION OF CASE: A 52-year-old woman presented with dyspnea and slow onset dysphagia. The endoscopy, endoscopic ultrasound (EUS), bronchoscopy, and positron emission tomography (PET)/computed tomography (CT) supported the suspicion of esophageal gastrointestinal stromal tumor (GIST). Open wedge esophagectomy and tracheal resection were performed. The histology proved periodic acid-Schiff (PAS)-positive granules in epithelial cells, hyperchromatic nuclei and the positivity of Protein soluble in 100% ammonium sulfate (S-100), vimentin, neuron-specific enolase, laminin, and myelinic proteins. Local recurrence after 10 months required a two-phase esophagectomy with retrosternal gastroplasty. Bone, liver, and mediastinal metastases occurred 6 months later, with overall survival of 34 months. DISCUSSION: Preoperative histological confirmation is often not reliable. Tracheal invasion increases the perioperative risk and the probability of an unsuccessful resection. Esophagectomy or radical R0 local resection is the only known curative therapy. Repeated resections may increase survival in case of locoregional recurrence. Radiotherapy has a potential for palliative care. CONCLUSION: Esophageal MGCT requires a detailed presentation including long-term survival. Early surgical removal of intramural esophageal neoplasms with potentially malignant features is highly recommended. Radical and/or repeated esophageal resections are the only known therapies with curative potential.

Epidemiology of Malaria in Yulin, South China 1999-2016: Imported Malaria Threatens Zero Local Case Status.

OBJECTIVES: This article describes the epidemiology of malaria in Yulin, 1999-2016. We review also malaria control strategy in Yulin in the posteradication phase. MATERIALS AND METHODS: We examined all malaria case records from Yulin prefecture reported to the Ministry of Health since 1999 and extracted malaria data between 1999 and 2003, the stage of malaria eradication, from the notifiable disease reporting records and case records of Guangxi. Malaria data between 2004 and 2016, the stage of malaria elimination, was obtained from the National Notifiable Disease Reporting System and National Malaria Reporting System. We collected mosquitoes with light traps in the vector-breeding seasons and did the distinguished work with optical microscope. RESULTS: Malaria average incidence decreased to 0.085/100,000, peaking of 0.263/100,000 in 2006, and no cases in years 2001, 2009, and 2010. Peak seasons are in November and June with proportions of 16.48% and 14.29%, respectively. Pathogenic parasites differed in the two stages; Plasmodium vivax was prevalent between 1999 and 2010, and Plasmodium falciparum between 2011 and 2015. Most malaria cases in the last 18 years occurred in males between 20 and 50 years of age. Of the 91 malaria cases acquired outside Yulin between 1999 and 2016, 31.87% were acquired in other provinces of China, and 68.13% were acquired in foreign countries. Sporozoite-positive vectors were zero between 1999 and 2016. CONCLUSION: In Yulin, between 1999 and 2016, autochthonous malaria cases decreased to zero. The personal preventative measures of surveillance-treatment-follow-up have been demonstrated to be effective in the Yulin malaria elimination campaign between 1999 and 2016. The major threat of malaria reintroduction to Yulin lies in imported malaria, especially by returning employees working in epidemic areas such as Africa and Southeast Asia. Data concerning employees who have worked abroad should be gathered to enable the construction of a mathematic model to forecast future trends of malaria in Yulin. The antimalaria campaign has to work closely with local authorities.

Geographical features of malaria in Yunnan Province / 中国血吸虫病防治杂志

Objective To understand the geographical features of malaria in Yunnan Province,so as to provide the refer?ence for malaria elimination. Methods The data of malaria in Yunnan Province from 2012 to 2015 were collected and ana?lyzed. Results Totally 2 586 malaria cases were reported in Yunnan Province from 2012 to 2015,in which 274(10.60%) were local cases and 2 311(89.37%)were abroad imported,and one(0.03%)was domestic imported. The imported malaria cases and local cases were analyzed according to the sources and locations respectively,and the arithmetic means of the num?bers of imported and local cases were 96.29 and 10.96 respectively,the standard deviations of the numbers of imported and local cases were 421.18 and 19.12 respectively,and the difference of the means was not significant(Z=-0.326,P>0.10). Both the imported and local malaria cases could be clustered into five sections by the number of 5. The Herfendal?Hirshman indexes of the imported and local malaria cases were 8 121 and 1 598 respectively. Conclusions There is no significant difference of the distribution between the imported and local malaria cases,and they should be attaching equal importance. The non?uniform de?gree of imported cases is higher than that of the local cases,while both of them could be divided into five major clusters in the prevention and control work.

[Geographical features of malaria in Yunnan Province].

OBJECTIVE: To understand the geographical features of malaria in Yunnan Province, so as to provide the reference for malaria elimination. METHODS: The data of malaria in Yunnan Province from 2012 to 2015 were collected and analyzed. RESULTS: Totally 2 586 malaria cases were reported in Yunnan Province from 2012 to 2015, in which 274 (10.60%) were local cases and 2 311 (89.37%) were abroad imported, and one (0.03%) was domestic imported. The imported malaria cases and local cases were analyzed according to the sources and locations respectively, and the arithmetic means of the numbers of imported and local cases were 96.29 and 10.96 respectively, the standard deviations of the numbers of imported and local cases were 421.18 and 19.12 respectively, and the difference of the means was not significant (Z = - 0.326, P > 0.10). Both the imported and local malaria cases could be clustered into five sections by the number of 5. The Herfendal-Hirshman indexes of the imported and local malaria cases were 8 121 and 1 598 respectively. CONCLUSIONS: There is no significant difference of the distribution between the imported and local malaria cases, and they should be attaching equal importance. The non-uniform degree of imported cases is higher than that of the local cases, while both of them could be divided into five major clusters in the prevention and control work.

Analysis of malaria endemic situation in Jingmen City from 2005 to 2014 / 中国血吸虫病防治杂志

Objective To analyze the malaria endemic situation in Jingmen City from 2005 to 2014,so as to provide the evi?dence for revising the measures of malaria elimination. Methods The malaria endemic data of Jingmen City from 2005 to 2014 were collected and analyzed. Results Totally 516 malaria cases were reported during the 10 years in Jingmen City,and the av?erage annual malaria incidence was 0.17/10 000,which was declining year by year. The local infection of malaria cases were 484(accounted for 93.80%)with obvious aggregation in June,July and August,which were also relatively aggregated in farm?ers(accounted for 60.08%). The ratio of male to female was 1.93∶1. No local cases of malaria infection were reported from 2012 to 2014. The imported malaria cases were 32(accounting for 6.20%),showing a rising trend in recent years. Conclusion The incidence of malaria is low and has a downward trend year by year from 2004 to 2015 in Jingmen City. However,the imported malaria cases are increasing in recent years,and the surveillance and management of them should be paid more attention to.

Analysis of epidemic situation of malaria in Yunnan Province from 2011 to 2013 / 中国血吸虫病防治杂志

Objective To understand the epidemic situation and characteristics of malaria in Yunnan Province,so as to pro?vide the reference for malaria elimination. Methods The data of malaria reported in the information system were collected and analyzed in Yunnan Province from 2011 to 2013. Results From 2011 to 2013,totally 2 256 malaria cases were found in Yun?nan Province,with a morbidity of 0.162 8 per million and three of them were death cases. The local cases mainly distributed along the boundary and accounted for 29.48%,while the imported cases mainly came from Myanmar and accounted for 70.52%. The number of endemic counties with local malaria cases decreased from 37 to 10 during the three years. The number of import?ed cases reached the peak in May and the local cases in June. The patients were mainly aged from 20 to 49 years old(accounted for 70.58%),and 85.24% of the cases were peasants and laborers. Totally 86.66% of cases were laboratory confirmed cases, and 13.14% were clinically diagnosed. The proportions of cases reported by hospitals,health service centers and CDCs were 33.02%,37.06% and 29.92%,respectively. Conclusions The prevalence of malaria in Yunnan Province decreased from 2011 to 2013. The work of malaria cases double?checked by province?level CDCs is effective. However,the awareness and accurately diagnostic capability of clinical doctors still should be strengthened.