Endemic situation of schistosomiasis in national surveillance sites of Hubei Province from 2015 to 2019 / 中国血吸虫病防治杂志

ObjectiveTo analyze the changing tendency in the endemic situation of schistosomiasis in the national surveillance sites of Hubei Province, so as to provide the scientific evidence for facilitating the progress towards the elimination of schistosomiasis in the province. Methods According to the National Schistosomiasis Surveillance Scheme (2014 version), a total of 65 national schistosomiasis surveillance sites were assigned in Hubei Province, and the Schistosoma japonicum infections in humans, domestic animals, snails and wild feces were monitored in these national surveillance sites from 2015 to 2019. All data pertaining to the surveillance results were descriptively analyzed. Results There were 151 159 person-time local residents and 70 928 person-time mobile populations screened for S. japonicum infections in the 65 national surveillance sites of Hubei Province from 2015 to 2019, and the seroprevalance of S. japonicum infections reduced from 3.45% (1 077/31 197) in 2015 to 1.57% (431/27 371) in 2019 among local residents and from 1.06% (98/9 249) in 2015 to 0.81% (116/14 318) in 2019 among mobile populations. During the period from 2015 through 2019, there were 22 egg-positive local residents and 2 egg-positive mobile populations identified in 2015, with 0.07% and 0.02% prevalence rates of S. japonicum infections, respectively. During the 5-year period, a total of 7 025 herd-time domestic animals examined for S. japonicum infections, with no infections detected, and a total of 2 035 wild feces were tested, with no egg-positives identified in the 65 national surveillance sites of Hubei Province. Snail survey was conducted covering 28 767.35 hm2 during the 5-year period, and the area of snail habitats ranged from 1 609.82 to 2 119.81 hm2. The mean density of living snails and occurrence of frames with snails reduced from 0.360 5 snails/0.1 m2 and 11.26% in 2015 to 0.175 9 snails/0.1 m2 and 8.43% in 2019, respectively, and no S. japonicum infection was found in snails during the 5-year period. In addition, no snails were found in the potential schistosomiasis transmission foci in the two national surveillance sites in the Three Gorges Dam. Conclusions The overall endemic situation of schistosomiasis appears a tendency towards a decline in Hubei Province during the period from 2015 through 2019; however, the schistosomiasis transmission risk remains. Improving the surveillance system of schistosomiasis and increasing the sensitivity and performance of the surveillance system are required to provide insights into the implementation of precision control strategy and interventions in Hubei Province.

Survey of snail distribution in Four-lake Basin of Hubei Province / 中国血吸虫病防治杂志

Objective To investigate the distribution of Oncomelania snails in Four-Lake Basin of Hubei Province, so as to provide scientific evidence for the development of snail control interventions. Methods The snail distribution was surveyed by means of the retrospective study and cross-sectional survey in the Four-Lake Basin in Spring of 2016. The data pertaining to the endemic situation of schistosomiasis were collected and analyzed in the Four-Lake Basin from 2008 to 2018, and the associations of snail habitat areas with the prevalence of Schistosoma japonicum in humans and bovines were examined. Results There were 16 003 snail habitats in the 9 schistosomiasis-endemic counties (districts) in the Four-Lake Basin in 2016, covering an area of 246 million m2. The mean density of living snails was 0.622 5 snails/0.1 m2, which was relatively high in weed-type settings (0.688 0 snails/0.1 m2) and ditches (0.706 4 snails/0.1 m2). Type I (current snail habitats, 53.03%) and Ⅱ- Ⅳ (historical snail habitats, 46.97%) settings were predominant snail habitats. A big change was seen in snail habitats in dry farmland, marshland and paddy farmland, and environmental modification resulted in satisfactory snail control effectiveness. In addition, the area of snail habitats positively correlated with the changes in the prevalence of S. japonicum infections in humans (r = 0.842, P < 0.01) and livestock (r = 0.695, P < 0.01). Conclusions The integrate strategy with an emphasis on the control of the source of S. japonicum infections results in remarkable snail control effectiveness in the Four-Lake Basin; however, there is a risk of re-emerging snail habitats.

Endemic situation of schistosomiasis in surveillance sites of Tianmen City from 2015 to 2018 / 中国血吸虫病防治杂志

Objective To monitor the change patterns of the endemic situation of schistosomiasis in Tianmen City from 2015 to 2018, so as to provide the evidence for formulating the schistosomiasis control strategy in the city. Methods A total of 8 schistosomiasis surveillance sites were assigned in Tianmen City from 2015 to 2018, and the endemic situation of schistosomiasis and the related epidemiological factors were monitored. Results During the period from 2015 to 2018, a total of 15 983 local person-times and 3 629 mobile populations were detected for schistosomiasis using an indirect hemagglutination test (IHA) in Tianmen City, and the sero-prevalence was 0.88% to 1.44% and 0.96% to 2.39%, respectively; however, no egg-positives were identified. A total of 1 245 herd-times were detected, and no egg-positives were found in bovines. In addition, the areas of snail habitats were 116.69 to 117.23 hm2 and the mean densities of living snails were 0.07 to 0.17 snails/0.1 m2 during the study period; however, no infections were identified in snails. Conclusions The endemic situation of schistosomiasis appears low in Tianmen City; however, the factors related to schistosomiasis transmission remain in the city. The integrated strategy with emphasis on the control of infectious sources should be still intensified to consolidate the schistosomiasis control achievements.

[Study on effect of clinical pathway implementation in advanced schistosomiasis with ascites].

OBJECTIVE: To evaluate the effect of clinical pathway (CP) on the implementation of advanced schistosomiasis patients with ascites. METHODS: Totally 1 129 cases of advanced schistosomiasis patients with ascites but without other complications were selected randomly from the Performance Evaluation and Management System for Medical Treatment of Advanced Schistosomiasis Patients in Hubei Province from year 2011 to 2013. Among the patients, 754 cases were treated by CP (CP group), and 375 cases were treated with traditional methods (NCP group), and the hospitalization days, hospitalization expenses, medicine proportions, treatment outcomes and degrees of satisfaction and health knowledge rates of the two groups were compared. Meanwhile, the variation of CP was calculated. RESULTS: The average length of hospital days of the CP group and NCP group were (13.85 ± 5.60) d and (17.92 ± 5.80) d, respectively, and the average hospitalization costs of the two groups were (4 699.14 ± 1 520.59) Yuan and (5 692.01 ± 1 616.66) Yuan, respectively, both the differences were statistically significant (both P ＜ 0.05). Also the hospitalization cost structures of the two groups were remarkably different, the composition ratios of the inspection fee and accommodation fee in the CP group were lower than those in the NCP group, but the constituent ratios of the examination fee, diagnosis and treatment fee, drug charges and other expenses were higher than those in the NCP group (all P < 0.05). The awareness rate of health knowledge in the CP group was higher than that in the NCP group (P < 0.05), but there were no statistically significant differences in the treatment outcome and the degree of satisfaction between the two groups (both P > 0.05). The variation rate of CP was 9.02% (68/754). CONCLUSIONS: The implementation of CP can decrease the days of hospital stay and medical expenses, improve the awareness rate on health knowledge of the patients. The CP treatment with low variation rate is applicable to advanced schistosomiasis patients with ascites but without complications.

Study on effect of clinical pathway implementation in advanced schistosomi-asis with ascites / 中国血吸虫病防治杂志

Objective To evaluate the effect of clinical pathway(CP)on the implementation of advanced schistosomiasis pa-tients with ascites.Methods Totally 1 129 cases of advanced schistosomiasis patients with ascites but without other complica-tions were selected randomly from the Performance Evaluation and Management System for Medical Treatment of Advanced Schistosomiasis Patients in Hubei Province from year 2011 to 2013.Among the patients,754 cases were treated by CP(CP group),and 375 cases were treated with traditional methods(NCP group),and the hospitalization days,hospitalization expens-es,medicine proportions,treatment outcomes and degrees of satisfaction and health knowledge rates of the two groups were com-pared.Meanwhile,the variation of CP was calculated.Results The average length of hospital days of the CP group and NCP group were(13.85 ± 5.60)d and(17.92 ± 5.80)d,respectively,and the average hospitalization costs of the two groups were(4 699.14 ± 1 520.59)Yuan and(5 692.01 ± 1 616.66)Yuan,respectively,both the differences were statistically significant(both P＜0.05).Also the hospitalization cost structures of the two groups were remarkably different,the composition ratios of the inspection fee and accommodation fee in the CP group were lower than those in the NCP group,but the constituent ratios of the examination fee,diagnosis and treatment fee,drug charges and other expenses were higher than those in the NCP group(all P<0.05).The awareness rate of health knowledge in the CP group was higher than that in the NCP group(P<0.05),but there were no statistically significant differences in the treatment outcome and the degree of satisfaction between the two groups(both P>0.05).The variation rate of CP was 9.02％(68/754).Conclusions The implementation of CP can decrease the days of hos-pital stay and medical expenses,improve the awareness rate on health knowledge of the patients.The CP treatment with low vari-ation rate is applicable to advanced schistosomiasis patients with ascites but without complications.

[Establishment of surveillance and forecast platform of schistosomiasis in key water regions in Hubei Province].

OBJECTIVE: To establish an expression platform of surveillance and forecast for schistosomiasis in key water regions of Hubei Province. METHODS: The platform of surveillance and forecast for schistosomiasis was established based on Google Earth, GIS Office software, network albums and network video stations. The results of the field surveillance and laboratory testing, and figures and videos were inputted into the established platform, and an information management file was set up to express the information of forecasting. RESULTS: The operation and expression platform based on Google Earth in key water regions of Hubei Province was successfully established. It was able to provide the forecasting data timely, to achieve off-site and real-time query and sharing. CONCLUSIONS: The platform based on Google Earth has preferable prospective on field application in Hubei Province.

[Application of CroelDRAW software in drawing sketch map of schistosomiasis control].

OBJECTIVE: To improve the information level of schistosomiasis control by using the related functions of CorelDRAW software. METHODS: Combining with the requirement of schistosomiasis control, the sketch map was drawn according to the linear element drawing, the geometric drawing, the color rendering and the text adding. RESULTS: The schistosomiasis epidemic sketch map and the Oncomelania hupensis snail distribution sketch map at all levels were produced in CorelDRAW software. CONCLUSIONS: The sketch map drawing in CorelDRAW software is beautiful and standardizing, and it can improve the level of information management.

[Analysis of Oncomelania hupensis snail situation in schistosomiasis surveillance sites in Hubei Province from 2009 to 2014].

OBJECTIVE: To analyze the Oncomelania hupensis snail situation in schistosomiasis surveillance sites in Hubei Province from 2009 to 2014. METHODS: From 2009 to 2014, 207 schistosomiasis endemic villages from 13 cities were selected as the surveillance sites in Hubei Province, where the surveillance of snail situation was performed, and the data about the indexes of snail situation during the 6 years were collected and analyzed statistically. RESULTS: From 2009 to 2014, totally 80 963.47 hm2 of snail areas were investigated, and 45 309.77 hm2 of area with snails as well as 364.93 hm2 of area with infected snails were found out, and 1 646 125 snails were captured. In the 207 surveillance sites, the density of living snails was reduced from 0.493 3 snail/0.1 m2 in 2009 to 0.339 3 snail/0.1 m2 in 2014, with a decline rate of 31.22%; the density of infected snails was reduced from 0.000 7 snail/0.1 m2 in 2009 to 0 in 2014; the infection rate of snails was reduced from 0.14% in 2009 to 0 in 2014. The infection rates of snails in the third-rank villages, endemic areas in inner embankment, ditch environment and weed environment were relatively higher. CONCLUSIONS: The snail situation of Hubei Province has been declined steadily. However, the environment of snail breeding has not been changed completely. In order to consolidate the control achievements further, the measures including mollusciciding and snail control projects should be strengthened.

[Effect of wild feces detection in Oncomelania hupensis environments on surveillance of infection source of schistosomiasis].

OBJECTIVE: To evaluate the effect of wild feces detection in Oncomelania hupensis environments on the surveillance of infection source of schistosomiasis, and find the weakness in schistosomiasis control in Hubei Province, so as to put forward the targeted strategies and measures. METHODS: Four environments with O. hupensis snails in endemic areas of Hubei Provinces, where human and livestock often haunted, were selected according to the river systems, namely the Juzhanghe River beach in Jingzhou City, Changjiang River beach in Jiayu County, Hanbei River beach in Tianmen City, and Changshou River beach in Zhongxiang City, then the snail survey and wild feces detection were implemented in the selected environments. RESULTS: There were O. hupensis snails, livestock, wild feces of cattle or sheep as well as positive cattle feces found in all the 4 environments, and the positive rate of schistosome miracidium incubation was 47.62%. CONCLUSIONS: The schistosome miracidium positive rate of wild feces of cattle is high in the environments with snails in endemic areas of Hubei Province, which has high risk for schistosomiasis transmission.

[Epidemiological investigation on confirmed cases of schistosomiasis in Hubei Province].

OBJECTIVE: To grasp the distribution and epidemiology of confirmed cases of schistosomiasis in Hubei Province, so as to provide the evidence for promoting the prevention and control work. METHODS: The confirmed cases of schistosomiasis in Hubei Province from 2010 to 2014 were epidemiologically investigated, and the prevalence characteristics and main influencing factors were analyzed. RESULTS: A total of 10 102 confirmed cases from 2010 to 2014 were surveyed. There were 1 062 local infected patients, accounting for 10.51% and including 354 repeated infections and 17 newly infected. There were 290 foreigninfected patients, accounting for 2.87%, with 206 repeated infection cases and 84 newly infected. There were 8 750 historical patients, including 2 229 patients who leaked the former schistosomiasis investigations, accounting for 22.06%; 570 patients missed treatment, accounting for 5.64%; 3 640 patients were treated with non-standard therapy, accounting for 36.03%; 2 311 patients were treated with poor medication efficacy, accounting for 22.88%. The multivariate non-conditional Logistic regression, targeting at confirmed cases in 2014, showed that, for the leaking investigations, the potential risk factors included the age, educational level, and latrine renovation (b＞0, OR＞1), the protective factors were the times of previous treatment, cattle feeding in villager team, and Oncomelania hupensis snails in surroundings (b＜0, OR＜1); for the treatment-missing, the age, educational level, snails in the surroundings of residence were risk factors (b＜0, OR＜1); for the substandard treatment, the risk factors included the occupation and snails in the surroundings of residence (b＞0, OR＞1), and the educational level and snails in the own field were protective factors (b＜0, OR＜1). CONCLUSIONS: The epidemiological investigation on the confirmed cases of schistosomiasis could grasp the epidemic factors so as to improve the management and carry out the scientific control.

[Surveillance of schistosomiasis in Hubei Province in 2014].

OBJECTIVE: To analyze the surveillance results of schistosomiasis and understand the transmission situation in Hubei Province in 2014. METHODS: According to the Scheme of Schistosomiasis Surveillance in Hubei Province (the 2009 edition), 207 endemic sites were selected, where the schistosome infections of residents and livestock, and the distribution of Oncomelania hupensis snails were investigated. RESULTS: In the 207 sites, there were 27 sites without positive results of the blood tests and 129 sites without positive results of the stool tests. The infection rates of residents and cattle were 0.17% and 0, respectively. The density of living snails was 0.339 3 snails/0.1m2, the rate of living snails was 10.12%, and the infection rate of snails was 0. The infection rate of residents in the inner embankment type was 0.22%, higher than the rates in the other types. In different age groups, the infection rate in the 50-59 years age group was higher than the rates in other age groups. The infection rates of residents in farmer and fisherman were higher than those in the other occupation groups. The infection rate of floating people was 0, and no acute schistosomiasis patients were found. CONCLUSIONS: The endemic situation of schistosomiasis has decreased obviously in Hubei Province, and the whole province has achieved the criteria for transmission control of schistosomiasis.

Effect of nucleus pulposus autograft to the cavum epidurale on the structure and function of nerve roots in rats / 第二军医大学学报

Objective: To find out the pathomechanism of low back and leg pain related to intervertebral disc. Methods: The nucleus pulposus of coccygeal vertebral was transplanted to the cavum epidurale of rats to establish the non-compressive model with transplanted nucleus pulposus. The evoke potentials and morphology of nerve roots were observed. Results: Even without mechanical compression, rats transplanted with nucleus pulposus resulted in significant harm to evoked potential and morphology of cauda equina. Conclusion: The biomechanical and/or immunologic inflammatory effect of nucleus pulposus can result in nerve roots injury and is an important factor in the pathogenesis of low back and leg pain.

Effect of nucleus pulposus autograft to the cavum epidurale on the structure and function of nerve roots in rats / 第二军医大学学报

Objective: To find out the pathomechanism of low back and leg pain related to intervertebral disc. Methods: The nucleus pulposus of coccygeal vertebral was transplanted to the cavum epidurale of rats to establish the non-compressive model with transplanted nucleus pulposus. The evoke potentials and morphology of nerve roots were observed. Results: Even without mechanical compression, rats transplanted with nucleus pulposus resulted in significant harm to evoked potential and morphology of cauda equina. Conclusion: The biomechanical and/or immunologic inflammatory effect of nucleus pulposus can result in nerve roots injury and is an important factor in the pathogenesis of low back and leg pain.