Table of Content

01 December 2018, Volume 30 Issue 5

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Endemic status of schistosomiasis in People's Republic of China in 2017

ZHANG Li-Juan, XU Zhi-Min, DAI Si-Min, DANG Hui, LV Shan, XU Jing, LI Shi-Zhu, ZHOU Xiao-Nong

2018, 30(5):  481-488. 

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This report presents the endemic status of schistosomiasis in the People’s Republic of China at national level in 2017， and analyzes the data collected from the national schistosomiasis prevention and control system and 457 national schistosomiasis surveillance sites. Among the 12 provinces （municipality and autonomous region） being endemic of schistosomiasis japonica in P. R. China， 5 provinces （municipality and autonomous region）， i.e.， Shanghai， Zhejiang， Fujian， Guangdong and Guangxi， continued to consolidate the status of elimination of schistosomiasis. Sichuan Province achieved the transmission interruption and 6 provinces of Yunnan， Jiangsu， Hubei， Anhui， Jiangxi and Hunan kept the transmission control by the end of 2017. There were 450 endemic counties （cities， districts） covering 259 million people， specifically including 28 544 endemic villages of 70 324.5 thousand people at risk. Among the 450 endemic counties （cities， districts）， 50.89% （229/450）， 30.89% （139/450） and 18.22% （82/450） reached the criteria of elimination， transmission interruption and transmission control， respectively. By the end of 2017， a total of 8 401 113 individuals received schistosomiasis examinations and 14 individuals were parasitologically diagnosed， decreased by 97.67% compared with 600 cases in 2016. It was estimated of 37 601 cases of schistosome infection， decreased by 30.95% compared with 54 454 cases in 2016. One acute schistosomiasis case was reported in 2017. There were 29 407 advanced schistosomiasis cases documented in 2017. Oncomelania hupensis snail surveys were performed in 19 784 endemic villages and O. hupensis snails were found in 7 310 villages， accounting for 36.95% of total villages， with 19 newly detected villages with snails. The snail survey covered an area of 622 454.49 hm2 and snails were found in an area of 172 501.56 hm2， including a newly detected area of 208.54 hm2. No schistosome?infected snails were found in 2017. A total of 737 016 bovines were raised in the schistosomiasis endemic areas. Of them， 454 830 bovines received the examinations for schistosome infection， and 1 bovine was stool examination positive. There were 119 326 schistosomiasis cases receiving chemotherapy in 2017， with 1 973 968 individuals undergoing expanded chemotherapy； one bovine with schistosomiasis receiving chemotherapy， with 418 925 bovines undergoing expanded chemotherapy. A total of 144 605.31 hm2 area with snail was controlled by using molluscicides， with actual molluscicide?treated area of 73 755.37 hm2； and 5 002.92 hm2 area with snail was treated by environmental modification. Based on the data from the 457 national schistosomiasis surveillance sites， the mean Schistosoma japonicum infection rate was 0.001 6% and 0 in humans and bovines， respectively. No schistosome?infected snails were found by microscopic examinations in all the surveillance sites， and 7 snail samples with schistosome nucleic acid positive were detected by loop?mediated isothermal amplification （LAMP） among 6 surveillance sites. The results demonstrate a continuous decline trend on the endemic situation of schistosomiasis in P. R. China. However， the risk of epidemic rebound still exists in some regions and it is still a challenge to achieve the target set by the Thirteenth Five?year National Plan for Schistosomiasis Control in 2020.

Experience and insights of schistosomiasis elimination in Yujiang County of Jiangxi Province—Commemoration of the 60th anniversary of publishing Chairman Mao Zedong’s two poems “Farewell to the God of Plague”

LIN Dan-Dan, LIU Yi-Wen, TONG Xiao-Qing, AI Dong-Yun, JIANG Qing-Wu

2018, 30(5):  489-492,499. 

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Schistosomiasis is one of the major infectious diseases that seriously endanger the health of people， and social and economic development. Before the year of 1949， Yujiang County of Jiangxi Province was one of hyper?endemic regions for schistosomiasis. After the founding of the People’s Republic of China， under the leadership and high attention of the Chinese Communist Party and the government， after the arduous struggle with schistosomiasis， Yujiang County became the first county that reached the standard of eradication of schistosomiasis in 1958. Moreover， Chairman Mao Zedong gladly wrote the famous poem of "Farewell to the God of Plague". Since then， the work of schistosomiasis control has been greatly inspired by the poem. In 2016， Yujiang County became the first county of schistosomiasis elimination in Jiangxi Province. In this paper， the experience and process of eradication and elimination of schistosomiasis in Yujiang County are systematically reviewed and summarized by analyzing the endemic situation of schistosomiasis before and after the eradication and elimination in Yujiang County， to expound the significance and enlightenment of the schistosomiasis control in Yujiang County. This paper commemorates the 60th anniversary of the publication of Mao Zedong’s poem.

Investigation of Oncomelania hupensis snails in Anhui Province in 2016

GAO Feng-Hua, ZHANG Shi-Qing, WANG Tian-Ping, HE Jia-Chang, LI Ting-Ting, XU Xiao-Juan, XUE Jing-Bo

2018, 30(5):  493-499. 

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Objective To investigate the status of Oncomelania hupensis snails in Anhui Province in 2016， so as to provide the evidence for formulating the 13th Five?year Plans for Schistosomiasis Control. Methods In 2016， a snail survey was conducted in Anhui Province according to the National Programme of the Oncomelania Snail Survey， covering all snail habitats or historical snail habitats and suspected environments of snail breeding，and the results of the survey were analyzed. Results In 2016， 22 848 environments were surveyed， and no schistosome?infected snails were found. There were 17 927 historical snail habitats in whole province， among which， the environments without changes， changed partly and changed completely accounted for 71.2%， 19.3% and 9.5%， respectively. The area of historical snail habitats was 1.410 billion m2. There were 4 830 environments with snail habitats covering an area of 0.265 billion m2 in 38 counties of 7 cities， including newly emerging area of 1 287.65 hm2 and reemerging area of 1 375.32 hm2. The density of living snails was 0.392 0 snails/0.1 m2， and the rate of frame with living snails was 12.93%. The type of marshland and lake regions， and the type of hilly and mountainous regions accounted for 22.4% and 77.6% of number of snail habitats， and accounted for 86.7% and 13.3% of areas of snail habitats， respectively. Among the different types of vegetation in snail habitats， grass was superior owe to accounting for 82.2% of the number of snail habitats， 57.3% of the area with snail habitats， and the highest density of living snails （0.413 9 snails/0.1 m2）. Among the different types of environments in snail habitats， the ditch was superior owe to accounting for 56.8% of the number of snail habitats， the highest density of living snails （0.570 3 snails/0.1m2） and the highest rate of frame with living snails （18.57%）， and the beach was superior owe to accounting for 87.8% of the area with snail habitats. In Anhui Province， the first year of snails and schistosome?infected snails being found was 1950 and 1952， respectively， and the latest year of schistosome?infected snails being found was 2012. The map showed that the most environments with snail habitats were distributed along the Yangtze River in Anhui Province. Conclusion For the first time， the investigation has built the database and map of snail spatial distribution， which truly reflect the historic and current status of snail distribution in Anhui Province and can provide the evidence for formulating the 13th Five?Year Plans for Schistosomiasis Control and improving the schistosomiasis prevention and control work in the future.

Preliminary study on molecular detection of polysaccharide from Amusium pleuronectes and its intervention to hepatic fibrosis in rats infected with Schistosoma japonicum

LV Ye-Chao, TANG Xiao-Niu, HU Wei, JIANG Yu-Xin, ZHAN Xiao-Dong, GUO Wei, SUN Qi-Shan, WANG Guo-Dong, ZHOU Shu-Lin

2018, 30(5):  500-503,517. 

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Objective To detect the molecular characterization of polysaccharide purified from Amusium pleuronectes， so as to investigate its role of intervention to the formation of hepatic fibrosis caused by Schistosoma japonicum infection. Methods The crude polysaccharide from A. pleuronectes was extracted and further purified， and the molecular weight and monosaccharide composition were determined by the high pressure size exclusion chromatography and PMP pre?column derivatization method， respectively. A total of 50 female BALB/c mice were randomly divided into five groups： A （normal group）， B （experimental group）， C （polysaccharide group）， D （praziquantel）， and E （polysaccharide + praziquantel group）. The mice in B， C， D， or E groups were attacked on the abdominal skin by using the cercariae of S. japonicum （30 ± 2 for each mouse） respectively. After 8 weeks， the mice in C， D， and E groups were administrated by polysaccharide and/or praziquantel， and the mice in B group were instead of saline. All the livers and sera were collected after 16 weeks. HE staining was employed for the livers， and serum IFN?γ and IL?13 were measured by using ELISA kits. Results The molecular weight of purified polysaccharide from A. pleuronectes was 11.7 kDa. Compared with A and B groups， the serum levels of IFN?γ in C， D， and E groups were significantly increased （F = 63.525， P < 0.01）. However， the serum levels of IL?13 in C， D， and E groups were significantly decreased （F = 99.788， P < 0.01） compared with that in B group. HE staining showed that the egg nodules and hepatic fibrosis were observed in B， C， D， and E groups. The number of egg nodules and fibrosis degree in E group were milder than those in B group （c2 = 7.875， P < 0.05）. Conclusions The polysaccharide from A. pleuronectes has an obvious effect in preventing hepatic fibrosis process induced by S. japonicum infection， particularly combining with the administration of praziquantel.

Polymorphism analysis of microsatellite marker loci of Plasmodium falciparum from different geographical origins

YAN He, FENG Jun, YIN Jian-Hai, CHEN Tian-Mu, ZHOU Shui-Sen

2018, 30(5):  504-507. 

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Objective To compare the genetic diversity of imported Plasmodium falciparum by Polyα and TAA87 microsatellite markers in Southeast Asian and African geographical isolates. Methods Ninety?two and 126 filter paper samples from patients infected with P. falciparum from Southeast Asia （Myanmar） and Africa （Ghana） were collected， respectively. Two neutral microsatellite loci， Polyα and TAA87 were amplified by PCR. The length of PCR fragments was detected by capillary electrophoresis. The allele frequency and expected heterozygosity （He） were calculated by Excel 2010 and GenALEx 6.0 software. Results A total of 146 P. falciparum samples were analyzed as single infection samples with a total of 26 alleles in locus Polyα and 12 alleles in locus TAA87. The mean He value of the two loci was 0.86 ± 0.02. Ten alleles in locus Polyα and 8 alleles in locus TAA87 were distributed in Myanmar isolates， with the He values of 0.86 and 0.81 respectively. Fifteen alleles in locus Polyα and 11 in locus TAA87 were detected in Ghana isolates， with the He values of 0.91 and 0.86 respectively. In addition， the haplotype of 174 bp （Polyα） and 113 bp （TAA87） were only detected in Myanmar isolates with more than 17% gene frequency， whereas they were absent in Ghana isolates. Conclusions The two different geographical sources of imported P. falciparum strains have different allele frequencies and haplotypes at the two neutral microsatellite markers， Polyα and TAA87. Therefore， these two microsatellite loci may be considered as the potential molecular marker candidates for identifying P. falciparum strains with different geographical sources.

Epidemiological survey on clonorchiasis and awareness of prevention and control knowledge in Xinfeng County of Jiangxi Province

CHEN Zhe, ZHU Ting-Jun, YE Bin, ZHOU Chang-Hai, LIU Jian-Zhong, LI Dong, CHEN Ying-Dan, DAI Kun-Jiao, LIU Sai-Na, JIANG Wei-Sheng, ZENG Xiao-Jun

2018, 30(5):  508-512. 

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Objective To understand the epidemic status of clonorchiasis and awareness of prevention and control knowledge in Xinfeng County of Jiangxi Province， so as to provide the evidences for control measures. Methods The baseline survey was carried out with a clue investigation of raw?fish eating behavior in potential endemic areas in 2016. The residents were examined by stool tests. The metacercariae of Clonorchis sinensis in fish， the rediae and cercariae in freshwater mollusk were detected. The feces samples of cats， dogs and pigs were collected and examined by sedimentation technique. Meanwhile， the epidemic factors， health knowledge and behavior were also surveyed. Results The residents in 26 villages had the habit of eating raw freshwater fish， and 19.51% of the respondents had this habit. The average infection rates of the population， Parafossarulus striatulus， freshwater fishes and reservoir hosts were 21.56%， 0， 8.24% and 2.27%， respectively. The infection rate of the population increased with age. There was a significant positive correlation between the behavior and the infection rate of the population （r = 0.88， P < 0.01）. Only 11.46% of the respondents knew that eating raw?fish might cause C. sinensis infection， and 5.28% of them knew that C. sinensis was harmful to health. Conclusions Twenty?six villages in five townships were endemic areas of clonorchiasis in Xinfeng County. The permanent solution of prevention and control of clonorchiasis is to strengthen the health education and change the habit of raw?fish eating gradually.

Analysis of current drug treatment against clonorchiasis in China

QIAN Men-Bao, ZHU Hui-Hui, CHEN Ying-Dan, ZHOU Xiao-Nong

2018, 30(5):  513-517. 

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Objective To analyze the current drug treatment against clonorchiasis in China， in order to promote the standardization of drug treatment and national deworming for clonorchiasis. Methods All the 10 provinces were enrolled， which reported clonorchiasis in the work report for important helminthiasis in 2016. Then， 20 counties were selected from these 10 provinces. The data on drug treatment including both mass chemotherapy and individual treatment against clonorchiasis were collected and compared. Results All the 10 provinces had no guideline for mass chemotherapy， while only 3 had that for individual treatment against clonorchiasis. Out of 20 counties， only 1 implemented mass chemotherapy. Among these 20 counties， 13 applied praziquantel in individual treatment， while other 7 employed albendazole. In the 12 counties with clear protocol for praziquantel， the total dosage for a man of 60 kg ranged from 3.6 to 18.0 g， the days and times for administration ranged from 1 to 6 and from 3 to 18， respectively. In the 4 counties with clear protocol for albendazole， the total dosage for a man of 60 kg ranged from 0.8 to 8.4 g， the days and times for administration ranged from 2 to 7 and from 2 to 14， respectively. Conclusions Nowadays， the guideline on mass chemotherapy for clonorchiasis is inadequate in China. Although individual treatment is applied in many areas， the protocols vary in drugs， dosage， and days and times for treatment. Thus， the national guideline of mass chemotherapy for clonorchiasis should be established， while the protocols for individual treatment should be standardized.

Assessment of ability of professionals in parasitic disease control and prevention techniques in China| 2017

ZHU Ze-Lin, HAO Yu-Wan, TIAN Tian, XUE Chui-Zhao, TU Hong, HAN Shuai, CAO Chun-Li, LI Shi-Zhu

2018, 30(5):  518-522. 

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Objective To understand the professional theory， prevention and control practice， experimental diagnosis and other technical skills of parasitic diseases among technicians of all levels of disease control and prevention institutions， so as to provide the evidence for strengthening the capacity building of Chinese professional personnel. Methods According to the method of recommendation at all levels， the subjects from disease control and prevention institutions at province，prefecture or county levels were chosen to assess the theory of parasitic diseases and test operation skills by using the method of answering the questions together with on?site operations in China. A database was built consisting of subjects’ basic information and assessment scores. By using the method of hierarchical classification， the scores by gender， age， professional title， institutions and places of participants were analyzed. Results A total of 124 professions in prevention and treatment of parasitic diseases in 31 provinces （cities and regions） were evaluated in China. The average total score of all the subjects was 125.0 ± 35.2， with a passing rate of 54.8%. The average scores of male subjects and female subjects were 120.8 ± 34.2 and 126.6 ± 35.4 respectively； the average scores of the subjects aged under 30 years， between 30 and 40 years， and above 40 years were 125.6 ± 33.6， 124.9 ± 35.8， and 119.3 ± 45.9 respectively； the average scores of persons with junior， intermediate and senior professional titles were 119.8 ± 35.8， 136.0 ± 32.5 and 127.1 ± 40.9 respectively. The average theoretical assessment score of all the subjects was 67.4 ± 15.6， with a passing rate of 68.5%. The average practical skill assessment score of all the subjects was 57.6 ± 21.8， with a passing rate of 46.0%. The average detection rates of Plasmodium falciparum， P. vivax， P. ovale and P. malariae in endemic and non?endemic areas were 64.1%， 72.8%， 57.0%， 58.3% and 35.9%， 46.9%， 33.3%， 43.8%， respectively. The detection ability of professionals in endemic areas was significantly higher than that in non?endemic areas （[χ2] = 767.10， 462.12， 134.97 and 360.80， respectively， all P < 0.01）. The total detection rate of schistosome eggs was 48.7%， and the detection rates of schistosome eggs were 67.4% and 36.8% in endemic and non?endemic areas， respectively. The detection ability of professionals in endemic areas was significantly higher than that in non?endemic areas （[χ2] = 817.74， P < 0.01）. The detection rates of Ascaris lumbricoides， Trichuris trichiura， and Enterobius vermicularis were 85.7%， 78.6%， 91.7%， and 61.8%， 23.5% and 74.4% in the technicians in southern region and northern region of China， showing significant differences （[χ2] = 622.58， 301.70 and 588.71， respectively， all P < 0.01）. Conclusions The overall results of the subjects are good， but the technical operation capability of them is relatively low. Therefore， the specific training based on daily work needs should be enhanced. In addition， we should attach importance to talent cultivation and technical reserve， and strengthen the construction of the team， so as to meet the needs of the prevention and control of parasitic diseases.

Changes of brain CT imaging of cerebral cysticercosis patients during the period of anti-cysticercus chemotherapy

HU Ying-Xin, GIA Feng-Ju, TAI Hua, YU Zhen-Hua, DAI Jun, YU Tao

2018, 30(5):  523-526,547. 

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Objective To investigate the changes of brain CT imaging in patients with cerebral cysticercosis during the period of anti?cysticercus chemotherapy. Methods A total of 380 inpatients that were conformed to the practical diagnostic criteria of cerebral cysticercosis were enrolled in this study in the Third Affiliated Hospital of Shandong Academy of Medical Sciences from May 2010 to May 2015. All the patients were given anti?cysticercus chemotherapy （albendazole and praziquantel）. All the patients received brain CT scan， and of which 210 received enhanced scan. The data of CT imaging were systematically reviewed. Results Before the treatment， the CT images of the patients showed single or multiple small cystic（s） with low density and small nodule?like cephalomere with high density. The re?examinations of CT showed that there were 81.58% （310/380） of the patients whose low density foci were completely absorbed， there were 16.32% （62/380） of the patients whose foci were mostly absorbed， and there were 2.11% （8/380） of the patients whose foci were calcified. Along with the prolongation of treatment time， the side effects were gradually reduced， and in the third course of treatment， the foci were absorbed or calcified in most of the patients. Conclusion CT examination can diagnose the lesion site， range and classification of cerebral cysticercosis， and can evaluate the effect of the therapy according to the changes of CT imaging during the period of anti?cysticercus chemotherapy.

Epidemiological analysis of malaria in Shandong Province in 2017

KONG Xiang-Li, XU Yan, CHENG Peng, WANG Yong-Bin, BU Xiu-Qin, WANG Long-Jiang, ZHAO Chang-Lei, YAN Ge

2018, 30(5):  527-531. 

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Objective To understand the malaria epidemiological characteristics of Shandong Province in 2017， so as to provide the evidences for formulating targeted prevention and control strategy and measures. Methods The data of malaria cases of Shandong Province in 2017 were collected from the Information Management System for Infectious Diseases Report and Information Management System for Parasitic Diseases Control and Prevention. The epidemiological characteristics of malaria situation and the diagnosis and treatment of malaria cases were analyzed. Results There were 209 malaria cases reported in 2017， all of them were imported cases， and 205 cases （98.09%） were imported from African countries. Among them， 155 cases （74.16%） were falciparum malaria cases. Totally 16 cities had cases reported in 2017， and 154 cases （73.68%） were reported in 6 cities （Yantai， Jining， Weihai， Dezhou， Qingdao， and Tai’an）. The malaria cases distributed in 17 cities， and there were 110 cases distributed in 4 cities， namely Yantai， Tai’an， Weihai， and Qingdao， which accounted for 56.41% of the total cases in Shandong Province. Both the median time from onset to seeing a doctor and the median time from seeing a doctor to being diagnosed were one day. Totally 12.92% of the cases went to visit a doctor 7 days later after they had symptoms and 10.53% of the cases were diagnosed 7 days later after the first visit to a doctor. Conclusions At present， the prevention and control of the imported malaria is the focus of malaria control in Shandong Province. According to the central tendency of the malaria situation， the health education and propaganda among the high risk groups and the training on the diagnosis and treatment among medical workers should be strengthened， so as to prevent the risk of reappearance of local cases in the past malaria endemic regions， and to ensure the goal of malaria elimination been achieved on schedule.

Laboratory detection of imported Plasmodium ovale wallikeri in Sichuan Province

SHANG Jing-Ye, LI Li, YU Tao, LIU Yang, WU Xiao-Hong, HUO Fang, ZOU Yan

2018, 30(5):  532-536. 

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Objective To identify 10 imported cases of Plasmodium ovale wallikeri infection in Sichuan Province from January to April in 2018， and to analyze the P. ovale wallikeri infection status of 1 079 malaria cases reported in this area from 2013 to 2017. Methods The 10 cases collected in 2018 were examined by microscopy， RDT， nested PCR and sequencing. Meanwhile， the retrospective detections of P. ovale wallikeri of the 1 079 blood samples from past 5 years were conducted by nested PCR using wallikeri?specific primers. Results For the 10 cases， the microscopic examinations were all positive for P. ovale， of which 2 were mixed infection with P. falciparum， and the results of RDT were all positive for Plasmodium. Except for 2 cases of P. falciparum infection， the routine nested PCR showed negative results for rest of the samples. The nested PCR for the specific detection of P. ovale wallikeri showed the 10 cases were all positive， and the following sequencing confirmed that the 10 cases were all infected with P. ovale wallikeri. The retrospective tests discovered 2 cases both reported in 2017 and recorded as simple P. falciparum infection tuned out to be mixed infection with P. falciparum and P. ovale wallikeri. Conclusion This is the first time that imported P. ovale wallikeri infection is founded in Sichuan Province.

Establishment of an animal model of Sparganum mansoni infection and study on therapeutic methodsⅠ Establishment of an animal model of Sparganum mansoni infection in mice and changes of serum specific antibody levels post-infection

TONG De-Sheng, HOU Ru, ZHANG Ying, HU Nan-Nan, HUANG Yu-Zheng, LIANG You-Sheng

2018, 30(5):  537-539,558. 

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Objective To establish an animal model of Sparganum mansoni （plerocercoid larva of S. mansoni） infection in mice and observe the changes of blood routine examinations and serum anti?sparganum antibody levels after the infection. Methods The spargana tapeworms were collected from frogs， and 25 Kunming mice were orally infected with the Sparganum tapeworms （3 tapeworms/mouse）. Two days before the infection and 2， 7， 14， 21， 28， 35， 42 days and 49 days after the infection， the peripheral blood samples of mice were collected for the blood routine examinations and the detections of anti?S. mansoni IgG antibody with ELISA. Forty?nine days after the infection， all the mice were sacrificed to find out the Sparganum tapeworms in the bodies of mice. Results The count of the total white blood cells was significantly elevated on the second day of the mice infected with Sparganum. The serum anti?Sparganum antibody was detected on the 14th day of the infection in some mice， and on the 21st day of the infection， the serum anti?Sparganum antibody was detected in all the mice. After the mice were sacrificed， the Sparganum tapeworms were found out in many tissues and organs， and especially in the subcutaneous tissues and muscle. Conclusion The establishment of animal model of Sparganum infection is successful in mice with the oral method， and white blood cells and serum specific IgG antibody detection can be used as auxiliary diagnosis methods of S. mansoni infection.

Molluscicidal effects of different formulations of niclosamide ethanolamine salt in marshlands

LI Wei, YOU Ben-Rong, SHI Liang, HU Heng-Guang, CHEN Xiao-Jian, MEI Qiao-Fang, YANG Kun

2018, 30(5):  540-543. 

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Objective To evaluate the molluscicidal effects of different formulations of niclosamide ethanolamine salt in marshlands. Methods The molluscicidal effects of spraying with 25% suspension concentrate of niclosamide ethanolamine salt （25% SCN） and 50% wettable powder formulation of niclosamide ethanolamine salt （50% WPN）， and dusting with 4% niclosamide ethanolamine salt dustable powder （4% DP） for controlling Oncomelania hupensis snails were investigated and compared in the fields， and the cost?effectiveness was analyzed. Results The corrected mortalities and the reduced rates of density of snails were 54.37%， 91.70%， 92.76%， 79.50%， and 59.55%， 95.93%， 97.63%， 94.15%， respectively， on 3， 7， 15， 30 d after spaying with 25% SCN， those on 3， 7， 15， 30 d after dusting with 4% DP were 59.10%， 91.83%， 95.56%， 93.34% and 65.03%， 94.93%， 97.61%， 97.28%， respectively； and those on 3， 7， 15， 30 d after spraying with 50% WPN were 76.29%， 91.68%， 93.12%， 81.59% and 81.24%， 97.02%， 97.84%， 95.27%， respectively. The cost of spraying with 25% SCN was 0.21 Yuan/m2， that of dusting with 4% DP was 0.39 Yuan/m2， and that of spraying with 50% WPN was 0.23 Yuan/m2 for snail control in the marshland. The cost of reduced one percentage of the corrected mortalities and the density of snails in controlling snails by 25% SCN， 4% DP and 50% WPN on 15 d were 22.68， 40.63， 25.17 Yuan and 21.54， 39.78， 23.95 Yuan， respectively. Conclusions The three different formulations of niclosamide are reliable and effective for snail control in marshlands. There are some differences among the different molluscicides in start time， pharmacodynamic characteristics， spraying methods in the field， cost of snail control， and influencing factors. Therefore， we need reasonably select the suitable molluscicides according to the environmental characteristics and working condition.

Assessment of schistosomiasis elimination in Changzhou City, Jiangsu Province

HE MIng-Zhen, XIE Yi-Qing, ZHU Shi-Ying, CHEN Hong, ZOU Yong-Gen, GUO Yan-Li

2018, 30(5):  544-547. 

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Objective To assess the state of schistosomiasis elimination in 6 districts of Changzhou City， Jiangsu Province， so as to provide the evidence for the formulation of consolidation measures. Methods Three towns （streets） were selected according to the schistosomiasis epidemic degree in each district， and one village was sampled from each town. The on?site assessment was carried out between 2016 and 2017， including Oncomelania hupensis snail survey， population investigation and domestic animal investigation. In addition， the related data and materials were evaluated and the monitoring ability was assessed. Results In the history， there were 54 endemic towns， 368 endemic villages in Changzhou City， with a total area of 3 934.79 hm2 of historic snail spots， and 114 990 schistosomiasis cases so far. In the field assessment in 6 districts， a total of 26 environments were surveyed， with the surveyed area of 36.23 hm2， and there were no living snails captured in each village. A total of 18 199 people were examined for schistosome infection， 255 were blood test positive， and the sero?positive rate was 1.40%. The stool examination was done in 255 sero?positive cases， and no cases were stool?positive. A total of 779 domestic animals were investigated， including 200 cattle， 179 sheep and 400 pigs， and no infections were detected. The files regarding the snail status and schistosomiasis epidemic situation， and the monitoring data were complete and accurate in 6 districts. The annual investment funds for schistosomiasis prevention were 3 120 000 Yuan in Changzhou City， and the number of staff working for schistosomiasis prevention was 86 totally， which could meet the requirements of high quality monitoring. Conclusions All 6 districts of Changzhou City have met the requirements of schistosomiasis elimination.

Oncomelania hupensis status in national schistosomiasis surveillance sites of Yunnan Province from 2015 to 2017

SHEN Mei-Fen, DONG Yi, WU Ming-Shou, ZHANG Yun, FENG Xi-Guang, SONG Jing, WANG Li-Fang

2018, 30(5):  548-551. 

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Objective To master the Oncomelania hupensis distribution and infection status in the national schistosomiasis surveillance sites of Yunnan Province， so as to provide the evidence for making the control and prevention measures. Methods The data of O. hupensis surveillance in the 18 national surveillance sites of Yunnan Province from 2015 to 2017 were collected and analyzed with the descriptive analysis method according to the national schistosomiasis surveillance programme. Results The total surveillance area was 5 710.94 hm2， the area with O. hupensis snails was 205.69 hm2. The number of surveillance frames was 2 094 553， the occurrence rate of frames with snails was 0.62%， and the density of living snails was 0.025 4 snails/0.1 m2. In the schistosomiasis epidemic controlled areas， the area with snails， the occurrence rate of frames with snails and the density of living snails were all the highest. The snail concentrated distribution areas were the small reservoir， bottomland， paddy field， ditch， and dry land， and the snails mainly distributed in the rice， dry crop， weed and wood vegetation. The number of frames with snails， occurrence rate of frames with snails， total number of snails， number of living snails， and repetition areas with snails presented increasing trends， and however， no schistosome?infected snails were found during the three years. Conclusions The O. hupensis snail status is obviously serious in the national schistosomiasis surveillance sites of Yunnan Province. The comprehensive snail control measures should continue to be strengthened， so as to effectively control the spread of the snails and reduce the risk of schistosomiasis outbreaks.

Disease burden of patients with advanced schistosomiasis in Jiangsu Province

GAO Yue-Xia, ZHONG Ya-Qin, LI Yi-Ting, YANG Kun, YOU Lu, HUANG Yi, HUA Hai-Yong

2018, 30(5):  552-554,577. 

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Objective To understand the disease burden of patients with advanced schistosomiasis in Jiangsu Province. Methods Totally 450 patients with advanced schistosomiasis from southern， northern and central Jiangsu were chosen by the stratified sampling method， and surveyed by the self?designed economic burden questionnaire in 2015. The economic burden of the patients was analyzed by the descriptive analysis method， and its determinants were explored by the multiple linear regression analysis. Results A total of 450 subjects were surveyed and 434 valid questionnaires were recovered with the recovery rate of 96.44%. The per capita economic burden of advanced schistosomiasis patients was 10 217 Yuan in Jiangsu Province in 2015， including 7 221 Yuan in direct economic burden and 2 996 Yuan in indirect economic burden. The average lost labor force time was 140 days for the patients， and was 23 days for the family. The multiple linear regression analysis showed that the marital status， hospitalization health service utilization， and self?reported health score impacted on the disease economic burden. Conclusion The disease burden of patients with advanced schistosomiasis in Jiangsu Province is heavy.

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

CAO Cai-Qun, DING Gui-Sheng, WANG Wei-Ming

2018, 30(5):  555-558. 

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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 malaria elimination surveillance in Liyang City from 2010 to 2016

HUANG Xiao-Mei, LV Lai-Fu, WANG Wei-Ming, ZHU Shi-Ying, HUANG Li-Zhong, JIANG Liang

2018, 30(5):  559-562. 

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Objective To evaluate the effect of malaria elimination monitoring in Liyang City， so as to provide the evidence for formulating control strategies and measures of malaria elimination. Methods The monitoring data about the epidemic situation， blood tests of feverish patients and epidemiology investigation of individual malaria patients in Liyang City from 2010 to 2016 were collected and analyzed by the descriptive epidemiology method. Results From 2010 to 2016， there were 67 malaria cases in total. Totally 39 196 feverish patients had blood tests for Plasmodium， and 65 of them showed positive and the positive rate was 0.17%. The other 2 cases of microscopy negative were treated with anti?malarial drugs by themselves after the onset of fever， and no Plasmodium was detected in the microscopy， but the tests with malaria rapid diagnostic kit （RDTs） were positive. Among all the 67 cases， there were 49 falciparum malaria cases， 13 ovale malaria cases and 5 vivax malaria cases. All the 67 malaria cases were imported， and the number of cases from Africa was 63 （94.03%）. Totally 97.01% （65/67） of the malaria patients were male and most of them were young adults. The patients aged 30 to 49 years accounted for 73.13% （49/67） and 80.60% （54/67） of them were farmers. There were malaria cases in all the 10 towns of the city， and the time of onset had no obvious seasonal characteristics. The timely rate of case report， timely rate of blood film review， standardized treatment rate， epidemiological case investigation rate， and epidemic focus investigation and disposal rate were all 100%. There were 18 076 people with the active case investigation， but no malaria parasite positive carriers were found. The mosquito vector monitoring was performed with the methods of mosquito trap lamp and human bait half night trap， and 187 and 78 Anopheles mosquitoes were captured respectively， and all the parasites were Anopheles sinensis. A total of 88 person?times were performed for the Plasmodium examinations with microscopy and RDTs （one blood sample， two detections） in Liyang City Center for Disease Prevention and Control from 2012 to 2016， and 35 person?times were positive， including 28 person?times of Plasmodium falciparum and 7 person?times of P. ovale， and there was no statistically significant difference between the detection rates of P. falciparum， and P. ovale （adjusted [χ2] = 0.05， P > 0.05）. There were 34 RDTs positive cases， including 14 cases of malignant malaria， and 17 cases of malignant malaria or mixed infections of P. falciparum with other three kinds of Plasmodium parasites， and 3 cases of single infection or mixed infections of other three kinds of Plasmodium parasites， and there was a statistically significant difference among them in the positive RDTs detection rates （adjusted [χ2] = 13.75， P < 0.05）. Conclusions There are still imported malaria cases and there is the risk of malaria retransmission in Liyang City. Therefore， it is necessary to strengthen the malaria surveillance work and the management of infectious sources， so as to consolidate the achievements of malaria elimination in the future.

Current status of chronic filariasis in Jiangsu Province

MAO Fan-Zhen, XU Xiang-Zhen, JIN Xiao-Lin, NI Bi-Xian, DAI Yang

2018, 30(5):  563-566. 

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Objective To understand the current status of chronic filariasis patients in Jiangsu Province so as to provide basic data for following?up care for them. Methods The patients were followed up one by one according to history archives between June and July， 2018， and the clue investigation was also conducted. The base data of the patients was collected through a face?to?face questionnaire survey and analyzed. Results There were still 3 160 chronic filariasis patients in Jiangsu Province. Among them， the male accounted for 40.0%， and 91.8% of the patients were older adults aged 60 years or above. From the aspect of regional distribution， Suqian （24.2%）， Huai’an （19.5%）， Suzhou （17.3%）， Xuzhou （11.2%）， and Yancheng （9.8%） were the five top high prefectures. The patients with simple lymphatic inflammation or lymphadenitis， simple lymphedema or elephantiasis， simple chyluria， simple hydrocele of tunica vaginalis， and two symptoms or more accounted for 2.7%， 37.1%， 11.2%， 0.9%， and 48.1%， respectively. For the patients with lymphedema or elephantiasis， 97.8% of edema was seen in the lower limbs， and more than 90% of the edema stages were I-III. The number of current caring sites was 220， covering 2 091 patients. The average number of times of caring activities in this year was 3.2. The average cumulative time of caring activities among all the sites was 11.3 years. Conclusions The number of chronic filariasis patients has been dramatically decreased，most of the patients are old and have long disease durations. The caring sites have not covered all the patients. In order to release the symptoms and improve the life quality of the patients， all the patients should be taken care of in Jiangsu Province.

Investigation on intestinal nematode infections and their risk factors in Shanpo Sub-district, Jiangxia District, Wuhan City

XIONG Shou-Jia, LIU Rong, ZHONG Qin-Ping, ZONG Hong-Ying, YAO Wan-Hong, DONG Hui-Fen

2018, 30(5):  567-570,580. 

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Objective To investigate the infection status of intestinal nematodes and their risk factors in rural residents of Jiangxia District， Wuhan City， so as to provide the reference for the establishment of targeted prevention and control measures. Methods According to the requirements of cross?sectional study of the national human key parasitic diseases， the residents in Shanpo Sub?district， Jiangxia District were randomly selected as the objects for the investigation of the infection status of Ascaris lumbricoides， hookworm and Trichuris trichiura. A questionnaire survey was performed simultaneously. Results Totally 236 residents received the stool tests， and only the hookworm eggs were found， with an infection rate of 7.63% （18 cases）. The survey of intestinal parasitic infection status and their risk factors in 600 residents found 397 cases of suspected roundworm infection， 355 cases of suspected hookworm larvae dermatitis， 295 cases of suspected hookworm infection， and 145 cases of suspected whipworm infection， respectively. The Logistic regression analysis found that the risk factors of suspected roundworm infection included not always washing hands after toilet， using manure and fertilizer， and not often wearing shoes when doing farm work； the protective factors included knowing how roundworm infection was gained， and not using fresh dung for fertilization. The risk factors of suspected hookworm infection included using well water and pond water as the source of drinking water， eating food off the ground， using manure and fertilizers， and not washing when there was only one cutting board， and its protective factors included using tap water and well water as drinking water source， knowing how the roundworm infection was gained， and sometimes or not suing fresh feces for fertilization. The risk factors for suspected whipworm infection included eating food off the ground. Conclusions The intestinal parasite prevalence in the residents of the Shanpo Sub?district， Jiangxia District in Wuhan City is relatively high， and some risk factors associated with their infection indeed exist. Therefore， the regional government and health department should strengthen the health education to improve the residents’ knowledge about parasitic diseases and self?protection awareness. At the same time， the residents should take physical examination regularly and take necessary deworming treatment to effectively control the prevalence and spread of intestinal parasitic diseases.

Analysis of research status and hotspots of snail intestinal flora based on bibliometrics

BI Ding-Qi, CHEN Hui-Bo, LI Xin-Yang, ZHANG Yi, LI Lan-Hua, GUO Yun-Hai

2018, 30(5):  571-574. 

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Objective To understand the current research focus and trends in the field of snail intestinal flora. Methods The literature focusing on snail intestinal flora and published from 1998 to 2017 were retrieved from the core database of Web of Science. The quantitative analysis of literature was then conducted by using CiteSpace software based on the bibliometricsmethod.The research trends were then summarized systematically， and the potential research fronts and focuses were explored. Results Totally 139 articles were identified in the field of snail intestinal flora. The top three countries with highest publications included the United States of American， Brazil， and South Korea； while the top three institutions were Kyung Hee University， Osvaldo Cruz Foundation， and Oxford University. Five terms were identified as the key words in this field， including diversity， cellulose， Achatina fulica， lignocelluloses， and species nova. Meanwhile， 5 critical papers with the citation frequency over 15 were recognized， and 5 study clusters were formed including the application， diversity，and function of intestinal flora， difference of snail source and flora， and newly discovered bacteria in the snail intestine. Conclusion The current research focuses on intestinal flora of snails include the diversity， function and application of intestinal flora.

Interpretation of Detection of Intestinal Helminthes—The Kato-Katz Method (WS/T 570-2017)

ZHU Ting-Jun, ZHOU Chang-Hai, XU Long-Qi, ZHENG Bin, XIONG Yan-Hong, CHEN Ying-Dan

2018, 30(5):  575-577. 

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The criteria for the Kato?Katz thick smear are compiled following the Management Measures for Health Criteria and GBT 1.1-2009 Standardization Working Guidelines. The criteria are composed of five chapters， including the range of application， terms and definitions， equipments， reagent materials， and testing procedures. Three informative appendices （identification of helminth eggs in human faeces， counting method of eggs in Kato?Katz thick smear， and other considerations） are appended. The criteria have been issued by the National Health and Family Planning Commission of the People’s Republic of China， it provides a technical reference for the detection of helminth eggs in human faeces in medical institutions and disease prevention and control institutions.

SWOT analysis of informatization of parasitic disease prevention and control

WANG Qiang, ZHANG Xue-Qiang, LU Yao, XUE Jing-Bo, YANG Wei, WANG Pei, LI Shi-Zhu

2018, 30(5):  578-580. 

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The study analyzes the strengths， weaknesses， opportunities and threats （SWOT） of the informatization of parasitic disease prevention and control in China， and puts forward the development strategies， in order to provide the reference for accelerating the informatization of parasitic disease prevention and control.

Design of an interactive management system between doctors and echinococcosis patients in Sichuan Province

ZHANG Guang-Jia, LIAO Sha, WANG Yi-Fei, HUANG Yan, YU Wen-Jie, HE Wei, WANG Qi, LI Rui-Rui, CHEN Fan, YANG Liu, ZHONG Bo, WANG Qian

2018, 30(5):  581-582,585. 

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Objective To design and construct a patient?doctor interaction system for echinococcosis treatment. Methods The in?depth interview and brainstorming method were used to determine the main functional modules of the system based on the server/client model. Results An echinococcosis patient?doctor interaction system was successfully constructed in Sichuan Province and got through preliminary debugging. The system contained four functions， namely quick consultation， treatment supervision， health education， and other auxiliary functions. Conclusion The patient?doctor interaction system of echinococcosis treatment is hopeful to enhance the management effectiveness on echinococcosis patients， and to provide more convenient and quick medical consultation and health information for patients.

Epidemic situation of imported malaria in Beijing City, 2017

HE Zhan-Ying, WANG Xiao-Mei, DU Dan, LEN Hai-Lin, LI Ji, LI Xu

2018, 30(5):  583-585. 

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Objective To explore the epidemic situation and epidemiological characteristics of imported malaria in Beijing City in 2017， so as to provide the evidence for developing malaria control interventions. Methods The data of registered malaria cases were collected and analyzed by using descriptive epidemiological methods. Results A total of 90 malaria cases were reported in Beijing in 2017， and all the cases were imported. The 90 cases included 74 cases of falciparum malaria （82.22%）， 10 cases of vivax malaria （11.11%）， 4 cases of ovale malaria （4.45%） and 2 cases of malariae malaria （2.22%）， and 97.78% of the malaria patients were at ages of 19 to 61 years. Eighty?one cases （90.00%） came back from Africa and 44 cases （48.89%） suffered two or more courses of malaria. Among the 66 patients with disease onset after returning from abroad， 53 cases （80.30%） of falciparum malaria had an onset within two weeks. The patients went to the malaria?endemic areas were mainly because of working （46.34%） or business （41.46%）. Eighty?nine cases used mosquito nets while living in malaria?endemic areas and 59 cases used mosquito repellents in addition. Conclusions The prevention and control for imported malaria is still the major target for the surveillance in Beijing City. The highly efficient surveillance system for malaria should be sustained， and the awareness of the disease among migrant workers should be enhanced.

Investigation of infestation of Carpoglyphus lactis in stored jujube from Anhui Province

ZHAO Ya-Nan, ZHAN Xiao-Dong, LI Chao-Pin

2018, 30(5):  586-587. 

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Objective To investigate the breeding of Carpoglyphus lactis in stored jujube from Anhui Province， so as to provide the evidence for preventing the harm of C. lactis to stored jujube. Methods The jujube samples stored for more than 6 months were collected from dried fruit shops and/or Chinese herbal medicine warehouses， which were chosen as survey sites in Anhui Province. The mites were isolated and identified under a microscope. Results Totally 19 samples infested with C. lactis were obtained from 300 samples in 17 cities of Anhui Province， the breeding rate and breeding density of C. lactis were 6.33% and 6.52 per gram respectively. The constituent ratios of different developmental stages were adult 85.72%， larva 12.27%， dormancy body 0.56%， and egg 1.45%， respectively. Conclusion The breeding density of C. lactis in the stored jujube is high and the species diversity is rich， so the control of C. lactis and the prevention of human acariasis should be strengthened.

Treg/Th17 balance and immunology of schistosome infection: a review

GAO Yan-Ru, CHEN Wei-Wen, LI Jia-Wang, ZOU Hui-Lan

2018, 30(5):  588-591. 

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Many factors are reported to be involved in regulating the immunopathogenesis of schistosome infection. CD4+ T cell is one of the key players in the regulation of the liver granuloma formation by differentiation into different effector subsets including T helper （Th） 1， Th2， Th17， and T regulatory cells （Treg cells）. Treg cells play an important suppressive role in immunopathology control and favor the pathogen to escape from the host immune assault. The functional activity of Tregs has been related to some autoimmune diseases including asthma and inflammatory bowel disease， which suggests that the manipulation of Tregs to restore their numbers and function may be therapeutic. However， interleukin?17 （IL?17） is a pro?inflammatory cytokine involved in the pathogenesis of many inflammatory and infectious conditions， including schistosomiasis. Therefore， a deeper understanding of the mechanisms of these immune regulations is necessary for the better control of pathology in schistosomiasis. In this paper， we review the Treg/Th17 balance and the immunology of schistosome infection.

Measures and achievements of schistosomiasis control in the Yangtze River Basin

HU Ben-Jiao, XIE Hong-Ling, LI Sheng-Ming, ZHAO Zheng-Yuan, ZHOU Yi-Biao, LUO Zhi-Hong, JIANG Qing-Wu, LEN Guang-Hui

2018, 30(5):  592-595. 

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This paper reviewed the prevention and control of schistosomiasis in the Yangtze River Basin in three stages， centered on the measures and achievements. It pointed out the key work of prevention and control which are infectious source control and effective surveillance at present stage. It will be beneficial to schistosomiasis control in China.

Advances in the regulatory roles of exosomes on pathological process of schistosomiasis hepatic fibrosis

ZHOU Yong-Hua, TANG Xian-Shi, SHEN Li-Juan, DONG Xuan, WANG Ke, YANG Jun-Qi, XU Yong-Liang

2018, 30(5):  596-600. 

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Exosomes are a group of membraneous vesicles generated and released by multi?vesicular bodies or cell membranes in a variety of cell types. Acting as important messages between cells， they participate in almost every physiological and pathological process of living organisms. Exosomes contain specific proteins， mRNA， miRNAs， etc. and mediate intercellular communications， signal transductions and gene expressions effectively. Exosomes are involved in the formation of hepatic fibrosis， which is the typical liver pathological change in the progression of schistosomiasis and is caused by the liver repair and （or） regeneration involving inflammation stimulated by exosomes， activated hepatic stellate cells and other related pathways in reaction to the parasite infection. Exosomes could serve as new markers for schistosomiasis hepatic fibrosis diagnosis and potential targets for its treatment. This paper briefly reviews the latest development of studies on the regulatory roles of exosomes in schistosomiasis hepatic fibrosis， so as to provide ideas for searching new treatment targets of the disease.