Epidemic characteristics of malaria cases before and after malaria elimination in Hubei Province / 中国热带医学

@#Abstract: Objective　To collect and organize malaria case data in Hubei Province from 2017 to 2021, compare and analyze the malaria epidemic characteristics on the before and after malaria elimination, and provide scientific support for Hubei Province to further optimize the comprehensive strategies to prevent re-transmission after the elimination of malaria. Methods The study was conducted by collecting the data of reported malaria cases of Hubei during 2017-2021 from the Infectious Disease Surveillance Reporting and Management System, and conducting the epidemiological characteristics of malaria on pre-elimination (2017-2019) and post-elimination (2020-2021). Results A total of 429 cases of imported malaria were reported in Hubei Province from 2017 to 2021, and the malaria epidemic showed an obvious trend of rising first and then falling. On the pre-malaria elimination, 374 malaria cases were reported, including 262 cases of P.falciparum (70.05%); on the post-malaria elimination, 55 malaria cases were reported, including 25 cases of P.falciparum (45.45%). There was a statistically significant difference in the proportion of infections caused by the four types of malaria parasites before and after the elimination of malaria (χ2=14.248, P<0.05). On the pre-malaria elimination, the peak of disease onset mainly occurred in January, July, and November; on the post-malaria elimination, the peak of disease onset mainly occurred in January to February, and December. Both before and after malaria elimination, the reported cases were mainly concentrated in Wuhan, Yichang, Huangshi, Xiangyang, Shiyan and Huanggang, but the range of cases showed a clear trend of narrowing. Before and after malaria elimination, malaria cases in Hubei Province were mainly among young and middle-aged males aged 30-49. The proportions of workers and migrant workers increased from 37.70% and 9.09% before the elimination to 50.91% and 18.18% after the elimination, respectively, with a statistically significant difference (χ2=17.839, P<0.05). The percentage of interval from onset of illness to initial diagnosis ≥ 5d decreased from 21.66% before the elimination to 10.91% after the elimination (χ2=6.448, P<0.05). The percentage of definitive diagnosis of malaria at initial diagnosis in town clinic increased from 18.18% before the elimination to 50.00% after the elimination. The proportion of malaria cases diagnosed by county-level medical institutions increased from 22.73% before the elimination to 34.55% after elimination. There was no statistically significant difference in the proportion of malaria cases diagnosed by medical institutions at all levels before and after the elimination of malaria (χ2=5.630, P>0.05). The proportion of cases with the interval between initial diagnosis and diagnosis within 24h increased from 43.85% before the elimination to 70.91% after the elimination. There was a statistically significant difference in the proportion of cases with the interval between initial diagnosis and diagnosis before and after the elimination of malaria (χ2=14.006, P<0.05). Before and after malaria elimination, all reported cases were mainly imported from African countries. Conclusions There are imported malaria cases reported every year in Hubei Province before and after the elimination of malaria, which poses a great challenge to the prevention of re-transmission. Therefore, it is necessary to strengthen the surveillance system, detect and standardize the treatment of imported malaria cases in a timely manner, conduct targeted retransmission risk surveys and assessments, and consolidate the achievements of malaria elimination.

Final evaluation of the prevention and control plan of key parasitic diseases in Hubei Province, 2016-2019 / 中国热带医学

@#Abstract: Objective　To evaluate the completion and final effect of key parasitic disease prevention and control planning tasks in Hubei Province from 2016 to 2019, summarize the experience, find out the problems, and provide the basis for the next stage of prevention and control. Methods　According to the requirements of the Final Evaluation Plan of the National Plan for the Prevention and Control of Hydatid Disease and Other Major Parasitic Diseases (2016-2020), a retrospective survey method was adopted to collect relevant data on the implementation and safeguard measures of the prevention and control of major parasitic diseases, and population infection status in Hubei Province in 2016-2019. Results From 2016 to 2019, We carried out 2 920 992 person times of publicity and education, 209 times of prevention and control technology training, 7 680 person times of business training, with an average of 52 sessions and 1 920 person times per year. We have allocated 3.445 2 million yuan for the prevention and control of parasitic diseases, including 1.722 2 million Yuan froom provincial government, to achieved full coverage of safe drinking water in rural areas under the current national standards, and 7.687 9 million harmless toilets have been built in rural areas. From 2016 to 2019, we carried out 39 658 person times of monitoring and disease investigation, the infection rate of human liver fluke was 0, and the infection rate of soil transmitted nematode was 0.42%. While the annual infection rates varied, there was no statistically significant difference in infection rate between years (χ2＝2.276, P>0.05), but there were statistically significant differences in the infection rates between various soil nematodes (χ2=112.807, P<0.01). From 2016 to 2019, a total of 5 393 people were detected at 17 monitoring points, with the serum positive rate of 3.93% for paragonimiasis, there was a statistically significant difference in serological positive rate between years (χ2=146.011, P<0.01); a total of 738 stream crabs were collected, and the infection rate of intermediate host was 16.26%, wtih a statistically significant difference in the infection rate of stream crabs between years (χ2=49.731, P<0.01). Conclusions　From 2016 to 2019, we adhered to the prevention and control strategy of "prevention first, prevention and control combined", implemented comprehensively various prevention and control measures, and achieved remarkable results in Hubei Province. The key parasitic diseases have been in a low epidemic situation, meeting the requirements of the prevention and control objectives. But the transmission risk still exists, the next step is to continue to strengthen security and monitoring and consolidate the achievements of prevention and control.

[Competition Results of Parasitic Disease Control Techniques among Technician in Hubei Province in 2015].

Objective: Objective To understand the qualification of technicians in parasitic disease control in Hubei Province by analyzing the rusults of technique competition in 2015. Methods: Provincial competitions on basic knowledge and on skills were conducted among 68 technicians in 17 cities （prefectures） in May 2015. The results were collected and analyzed with SPSS18.0 software. Scores were descriptively analyzed, and group comparisons were made by t-test and ANOVA. Results: The average score of the 68 competitors was 77.6, with a passing rate of 76.5%. In detail, the average scores of blood slide-making, Plasmodium detection, Kato-Katz slide-making and helminth egg detection were 9.3（passing rate, 98.5%）, 14.2 （32.4%）, 8.6 （98.53%） and 22.6 （27.9%） respectively. The average scores on theoretical knowledge and blood slide-making of female competitors were （84.5±17.3） and （9.4±0.4）, respectively, significantly higher than those of the males （70.7±21.1, 9.1±0.9 respectively） （P<0.05）. The scores of Plasmodium microscopy and egg microscopy were higher in competitors from counties［（16.3±8.0）, （25.8±12.0）］ than in those from cities/prefectures ［（12.5±6.5）, （20.0±10.8）］ （P<0.05）. In addition, the average scores on theoretical knowledge and egg dection were higher in competitors from districts with schistosomiasis control task ［（84.4±18.4）, （25.4±11.0）］ than in those from areas without schistosomiasis control task［（61.1±14.7）, （16.0±10.8）］（P<0.05）. There were no statistically significant differences in scores of various items among competitors of different ages and with professional ranks (P>0.05). Conclusion: There is a good overall performance among the professionals but an imbalance in detecting capability in different areas. The microscopic examination skill also needs to be improved.

[Epidemiological analysis of malaria prevalence in Hubei Province in 2013].

OBJECTIVE: To explore the endemic situation of malaria in Hubei Province in 2013, so as to put forward effective elimination strategies and measures. METHODS: The data of malaria cases were searched from the Disease Reporting Information System of Chinese Center for Disease Control and Prevention and analyzed with the descriptive epidemiological method for the epidemiological characteristics of malaria in Hubei Province in 2013. RESULTS: A total of 129 malaria cases were reported in Hubei Province in 2013 with the incidence of 0.02/10,000, and all of them were imported cases, in which 86 cases with Plasmodium falciparum infection, 32 cases with P. vivax infection, 7 cases with P. ovale infection and 4 cases with P. malariae infection. The distribution of malaria cases was concentrated in Wuhan City (76 cases), Yichang City (10 cases), Xiangyang City (7 cases) and Huangshi City (6 cases), accounting for 76.74% of the total cases. There was no significant seasonal variation in the reporting time of the cases. Totally 99.22% of the cases were male, the age distribution concentrated mainly on 20-49 years. The occupation distribution concentrated mainly on the worker, farmer, cadre staff and migrant worker. The main original areas of the imported cases were Africa (111 cases, 86.05%) and Asia (17 cases, 13.18%). CONCLUSIONS: There is no local malaria cases reported in Hubei Province in 2013, however, the imported malaria cases are increased. Therefore, it is necessary to further strengthen the multi-sector collaboration of vector control, while the health education should be intensified especially in the key population.

[Epidemic situation and control strategy of imported malaria in Hubei Province from 2006 to 2011].

OBJECTIVE: To understand the characteristics of imported malaria in Hubei Province so as to provide the evidence for formulating the prevention and control strategy. METHODS: The data of all imported malaria cases from 2006-01 to 2011-07 were retrospectively analyzed, and at the same time, the imported malaria cases since 2010 were interviewed through telephone and the cases since 2011-05 were interviewed face to face. All data were analyzed with EpiInfo. RESULTS: There were 195 imported malaria cases from 2006-01-01 to 2011-07-07, and there was a rising trend but there was no obvious difference among seasons. The interval between the disease onset and diagnosis was shorter in high educated people than low educated people (chi2 = 10.93, P < 0.01) and in the severe cases than the slight cases (chi2 = 4.58, P < 0.05). The severe rates of malaria cases were 70.4% and 82.9% in the low educated group and the high educated group, respectively (chi2 = 7.02, P < 0.01). Non-condition regression analysis showed that there were three influence factors which affected severe malaria, including whether or not self-treatment instead of seeing doctor when being fever; whether or not having health education before going abroad; whether or not considering malaria of the initial diagnosis doctor. CONCLUSION: It is very important to strengthen the personnel abroad malaria health education, the malaria blood smear microscopic inspection in medical institutions, and the initial diagnosis doctor's awareness on malaria.

[Lymphatic filariasis in Hubei Province: from prevailing to elimination].

Lymphatic filariasis used to highly prevalent in 69 counties (cities) with 29 million people at the risk of infection in Hubei Province. There were 2 million people infected either by B. malayi or W. bancrofti that 1.6 million microfilaremia cases and 0.4 million chronic patients. The average rate of microfilaremia among population was 5.94%. Anopheles sinensis and Culex quinquefasciatus were the principal transmitting vectors. Since 1970s, with the strategy of taking elimination of infection source as a major focus, the average rate of the microfilaremia reduced to 0.048% with a village as the unit in 1988, and reached the standard of transmission interruption. With continuous surveillance for over a decade, the province reached the goal of filariasis elimination in 2001. This paper reviews the prevalence, control and elimination process of filariasis in Hubei Province since 1950s.