Table of Content

28 August 2019, Volume 31 Issue 3

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Intensifying the precision control to facilitate the progress towards schistosomiasis elimination in mountainous and hilly regions of China

ZHOU Xiao-Nong

2019, 31(3):  229. 

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In China, the mountainous and hilly schistosomiasis?endemic regions are mainly distributed in 2 provinces of Sichuan and Yunnan. Following the concerted efforts for more than 60 years, great successes have been achieved in schistosomiasis control in mountainous and hilly regions of China. Recently, Sichuan and Yunnan provinces seized the opportunity created in the rural and agriculture development, implemented the integrated strategy with emphasis on infectious source control, utilized modern information techniques, innovated schistosomiasis control models, built sensitive and highly effective surveillance?response systems, and actively tackled the challenges of schistosomiasis elimination, which greatly facilitated the progress towards elimination of schistosomiasis in mountainous and hilly regions of China.

Main challenges and strategy of schistosomiasis control in mountainous and hilly regions of China

ZHONG Bo, LIU Yang, WU Zi-Song, CHEN Lin, DONG Yi

2019, 31(3):  231. 

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This review describes the epidemic characteristics and endemic situation of schistosomiasis in mountainous and hilly regions of China, analyzes the main challenges of schistosomiasis control in mountainous and hilly regions and proposes targeted suggestions for the future schistosomiasis control, with aims to accelerate the progress towards schistosomiasis elimination in mountainous and hilly regions and facilitate the achievement of the goal set in The Thirteenth Five?Year National Plan for Schistosomiasis Control in China and The Three?year Tough Action Plan for Endemic Diseases Control (2018–2020) in China.

Development and model of health education and health promotion for schistosomiasis control in mountainous and hilly endemic areas

CHEN Lin, ZHONG Bo, LIU Yang, WU Zi-Song, MENG Xian-Hong, LU Ding, XU Jia, LI Rong-Zhi, WANG Nan-Nan

2019, 31(3):  238. 

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Transmission control and interruption of schistosomiasis has been gradually achieved in the mountainous and hilly endemic areas with the implementation of the schistosomiasis control programmes, which are moving towards the progress of schistosomiasis elimination. As an important measure of schistosomiasis control, health education is experiencing new challenges and problems in the new situation, and conventional health education of schistosomiasis control has already failed to meet the needs of socioeconomic and cultural development and the increasing changes of human production and life styles in the endemic areas. Therefore, a precision health education model for schistosomiasis control is of great need to be established to highly effectively promote the implementation of schistosomiasis control measures. This review summarizes the important role of health education in schistosomiasis control in mountainous and hilly endemic areas, and describes the new health education model based on optimization of the policy environment and creation of the community atmosphere according to the changes in the endemic situation of schistosomiasis and requirements of the schistosomiasis control target, so as to promote the precision and sustainable implementation of health education and health promotion in schistosomiasis control.

Application and effect of integrated control model of schistosomiasis interruption in mountainous and hilly endemic regions

LIU Yang, CHEN Lin, MENG Xian-Hong, ZHANG Yi, LU Ding, XU Jia, LI Rong-Zhi, WU Zi-Song, ZHONG Bo

2019, 31(3):  244. 

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Objective　To explore the integrated schistosomiasis control model in mountainous and hilly endemic regions, so as to provide insights into the development of the schistosomiasis elimination strategy. Methods　Five hilly and mountainous areas endemic for schistosomiasis were selected as the integrated control demonstration areas in Sichuan Province from 2011 to 2015. According to the epidemic characteristics, economic levels and overall development planning of the demonstration areas, the goals, strategies and measures were developed, and the effectiveness of schistosomiasis control was evaluated following implementation of the integrated control. Results　The support system of the integrated schistosomiasis control model was built in the integrated control demonstration areas in Sichuan Province from 2011 to 2015, and five ecological, industrialized and sustainable development models of integrated schistosomiasis control were developed, including integration of balancing rural and urban development, systematic ecological improvement, intensified ecological agriculture, scientific management and health education of schistosomiasis control and ecological ethnic circular economy. Since the implementation of the integrated schistosomiasis control model, the snail habitats were completely changed. Until 2015, 92.0% of all historical areas with snails were managed, the coverage of safe drinking water was 100.0%, and more than 95.0% of the livestock were fenced. The coverage of sanitary toilets increased by 93.0%, 96.8%, 78.8%, 87.1% and 82.0% from 2011 to 2015, respectively, and the farmers’ mean yearly income increased by 32.7% in the demonstration areas. From 2011 to 2015, the seroprevalence of human Schistosoma japonicum infections reduced from 3.1% in 2011 to 1.6% in 2015 in the demonstration areas, and no egg?positives were identified. In addition, the number of fenced bovines reduced year by year, and no egg?positives were detected. The areas of snail habitats were 398.7, 108.2 hm2 and 52.9 hm2 in the demonstration areas from 2011 to 2013, with no infected snails found, and no snails were detected since 2014. The awareness of schistosomiasis control knowledge and percentage of correct behavior formation increased year by year among residents in the demonstration areas from 2011 to 2015. Conclusions　The five integrated schistosomiasis control models meet the needs of the current schistosomiasis control activities in mountainous and hilly endemic areas of Sichuan Province, and achieve the goals of controlling the sources of S. japonicum infections, economic development, social progress and improving the ecological environment, which provides new insights into schistosomiasis elimination in the country. 　

Construction and application of the surveillance system for schistosomiasis transmission risk in Sichuan Province

XU Liang, XU Jia, WAN Jia-Jia, CHEN Ling, LI Rong-Zhi, WANG Nan-Nan, ZHANG Yu, WU Zi-Song

2019, 31(3):  251. 

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Objective To build a schistosomiasis transmission risk surveillance system in Sichuan Province, so as to provide technical support for facilitating the progress towards schistosomiasis elimination in the province. Methods The surveillance sites for schistosomiasis transmission risk were assigned in 63 endemic counties (districts) of 11 cities (prefectures) in Sichuan Province. During the period from 2015 through 2018, wild feces contamination, the sources of Schistosoma japonicum infections (fever patients, livestock and wild animals), water infectivity in key settings, snail distribution in key settings, and snail breeding risk (snail importation and spread, floating debris carrying snails and snail breeding in ecological wetlands) were monitored in the surveillance sites. Results From 2015 to 2018, a total of 1 636 wild faces were detected in Sichuan Province, and 3 faces were positive for S. japonicum, with a 0.18% positive rate; among 3 995 livestock and 59 wild mice monitored, no S. japonicum infection was detected. A total of 49 414 fever patients were monitored in 2018, and 493 were seropositive for S. japonicum infection; then, 445 seropositives were subjected to stool examinations, and no egg?positives were found. From 2010 to 2018, a total of 93 sentinel sites were assigned, and 3 994 sentinel mice were placed for monitoring the water infectivity, with one S. japonicum?infected mouse detected. Between 2015 and 2018, a total of 4 156 key settings were investigated covering an area of 1 998.46 hm2, and 668 settings were detected with snails (16.07%), covering an area of 193.26 hm2; 497 suspected settings with a likelihood of snail importation with plant introduction were monitored from 2017 to 2018, and 65 settings with snails were found with 2 673 snails captured; 593 sites were assigned to collect the floating debris from 2017 to 2018, and 9 191.39 kg floating debris were collected with 186 snails captured; 4 wetlands were monitored for the risk of schistosomiasis transmission from 2013 to 2015, and snail breeding was found in 2 wetlands. No S. japonicum infection was identified in snails captured from all surveillance sites. Conclusions A sensitive and effective schistosomiasis transmission risk surveillance system has been successfully established in Sichuan Province. There is still a risk of schistosomiasis transmission risk in local areas of Sichuan Province. Therefore, the integrated schistosomiasis control measures with emphasis on the control of the source of S. japonicum infections should be further intensified, and snail monitoring and control and monitoring and control of schistosomiasis in wetlands should be also intensified.

Investigation on current distribution of Oncomelania snails in schistosomiasis-endemic areas of Sichuan Province

LU Ding, XU Liang, MENG Xian-Hong, MAO Yong, ZHONG Bo, LIU Yang, WU Zi-Song

2019, 31(3):  258. 

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Objective　To understand the current distribution of Oncomelania snails in Sichuan Province, so as to provide scientific evidence for formulating the schistosomiasis elimination strategy and implementing the precision schistosomiasis control measures in the province. Methods　According to the National Scheme on Oncomelania hupensis Snails in China and the Scheme on Oncomelania hupensis Snails in Sichuan Province, snail surveys were performed in current snail habitats, historical snail habitats and suspected snail habitats using systematic sampling in Sichuan Province from 2016 to 2017, and the survey results were analyzed. Results　From 2016 to 2017, a total of 88 346 settings were surveyed in schistosomiasis?endemic areas of Sichuan Province, and 19 314 settings were detected with snails, covering an area of 4 829.25 hm2, with no Schistosoma japonicum infection identified in snails. A total of 3 017 915 frames were investigated in Sichuan Province, and 1 041 417 frames were found to have living snails, with totally 1 791 115 living snails captured. The mean density of living snails was 0.59 snails/0.1 m2, and the mean percentage of frames with living snails was 34.51% in Sichuan Province. The current snail habitats were mainly distributed in 1 704 villages, 377 townships, 54 counties (districts) of 9 cities (prefectures) across the schistosomiasis?endemic areas of Sichuan Province. Snail habitats were mainly found in ditches (70.22%), and weeds were the predominant vegetation in snail habitats (66.45%). Snails were firstly discovered in Sichuan Province in 1913, and S. japonicum?infected snails were firstly identified in 1956, with the latest identification of S. japonicum?infected snails in 2008. Conclusion　There are many settings suitable for snail breeding in Sichuan Province, and snail monitoring and control should be intensified in the future.

Investigation on current schistosomiasis cases in Sichuan Province

ZHANG Yi, ZHANG Yu, XU Jia, WU Zi-Song, LIU Yang, ZHONG Bo

2019, 31(3):  264. 

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Objective　To understand the status of current schistosomiasis patients after the interruption of schistosomiasis transmission in Sichuan Province, so as to provide the reference for the development of specific rescue and treatment schemes and the implementation of dynamic management of the patients. Methods　The information of registered schistosomiasis patients in disease control and prevention institutions and medical institutions were reviewed in all schistosomiasis?endemic counties (districts) across Sichuan Province in 2018, and the data of all newly discovered schistosomiasis patients were collected and analyzed. Results　A total of 1 558 current schistosomiasis cases were diagnosed in 11 endemic cities (prefectures) across Sichuan Province, and all were advanced cases. Megalosplenia and ascites were the predominant types of advanced schistosomiasis cases, and no age? ([χ2] = 16.723, P > 0.05) or gender?specific difference ([χ2] = 2.493, P > 0.05) was seen in the clinical types of current schistosomiasis cases. There were 9.3% of current schistosomiasis patients from poor households. There was a tendency towards a decline in the number of advanced schistosomiasis cases since 2012, and the number of schistosomiasis cases in 2018 reduced by 17.8% as compared to that in 2012. Conclusions　Currently, all current schistosomiasis patients are advanced cases in Sichuan Province. In the future, multidisciplinary collaboration should be implemented to search for a feasible financial subsidy pattern and establish an effective care system for advanced schistosomiasis patients.

Spatial-temporal clustering analysis of schistosomiasis transmission risk in Yunnan Province from 2004 to 2015

HAO Yu-Wan, GAO Feng-Hua, XUE Jing-Bo, XU Jun-Fang, WANG Qiang, ZHANG Yun, WANG Li-Fang, DONG Yi, LI Shi-Zhu

2019, 31(3):  269. 

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Objective　To explore the spatial?temporal clustering distribution of schistosomiasis transmission risk in Yunnan Province from 2004 to 2015, so as to provide scientific evidence for the future schistosomiasis control and consolidation of the control achievements. Methods　All data pertaining to endemic situation of human and bovine schistosomiasis and snail survey at a township level in Yunnan Province from 2004 to 2015 were collected. A descriptive epidemiological method and Joinpoint model were used to describe the changing trends of Schistosoma japonicum infections in humans, bovine and snails, and the hotspots and clusters of schistosomiasis transmission risk were identified using spatial autocorrelation analysis, hotspots analysis and retrospective space?time scan statistic in Yunnan Province from 2004 to 2015. Results　The prevalence of S. japonicum infections appeared a continuous decline in humans, bovine and snails in Yunnan Province from 2004 to 2015, and the estimated number of schistosomiasis cases reduced from 43 056 in 2004 to 756 in 2015, with a decline rate of 98.24%. There were no acute cases since 2008 and no infected snails since 2014 in Yunnan Province. There were significant differences in the changing trends of human and bovine S. japonicum infections in Yunnan Province between 2012 and 2015 and between 2013 and 2015, respectively using the Joinpoint model (P < 0.05). In addition, there was a spatial autocorrelation in human S. japonicum infections in Yunnan Province from 2004 to 2013 (P < 0.01), and the hotspots areas for human S. japonicum infections were mainly distributed in some townships from Dali City, Weishan County and Eryuan County. Retrospective spatial?temporal scanning revealed that S. japonicum human, bovine and snail infections were clustered in 23, 15, 4 townships from Dali City, Weishan County, Eryuan County, Nanjian County and Heqing County, respectively, with relative risks of 6.25 to 28.75 (P < 0.01), which was almost consistent with the cluster areas detected by hotspots analysis. Conclusions　The endemic situation of schistosomiasis significantly reduced in Yunnan Province from 2004 to 2015; however, there is still a risk of schistosomiasis transmission. The monitoring and control of schistosomiasis should be intensified in the future in Yunnan Province.

Effectiveness of infectious source control after transmission control of schistosomiasis in Eryuan County of Yunnan Province

ZHANG Yun, DU Chun-Hong, SHAO Zong-Ti, WU Ming-Shou, FENG Xi-Guang, XIONG Meng-Tao, SHEN Mei-Fen, HUANG Peng, SONG Jing, DONG Yi

2019, 31(3):  275. 

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Objective　To assess the effectiveness of infectious source control at various stages of transmission control of schistosomiasis in Eryuan County of Yunnan Province, so as to provide insights into the further monitoring and management of infectious sources of schistosomiasis. Methods　Wenbi Village, a plateau subtype region and Qiandian Village, a mountain subtype region in Eryuan County were selected as the study areas. The species, schistosome infection and transmission capability of infectious sources were investigated in Wenbi and Qiandian villages in 2011 and 2018 and were compared. Results　Schistosome infections were detected in human, bovine, horse, dog and mouse in Qiandian Village in 2011, with positive rates of 1.19%, 0.91%, 1.25%, 3.13% and 0.95%, respectively, and human, bovine and dog were found to have schistosome infections, with positive rates of 0.76%, 1.66% and 9.30%, respectively. However, no infections were identified in human, bovine, horse, pig, dog, sheep or mouse in these two villages in 2018. A total of 731 wild feces were collected in both villages in 2011. In Qiandian Village, horse, bovine and dog feces accounted for 34.40%, 29.80% and 20.20% of all fecal samples, and dog and horse feces were found to have schistosome infections (11.94% and 6.90% positive rates, respectively). In Wenbi Village, dog, bovine and human feces accounted for 44.59%, 39.83% and 14.29% of all fecal samples, and dog, human and bovine feces were found to have schistosome infections (16.95%, 9.52% and 2.33% positive rates, respectively). In 2018, a total of 204 wild feces were collected in both villages, and no schistosome infections were identified. Sheep, dog and bovine feces accounted for 36.27%, 33.33% and 27.45% of all fecal samples in Qiandian Village, and dog, bovine and human feces accounted for 72.55%, 11.76% and 10.78% of all fecal samples in Wenbi Village. Conclusions　A remarkable achievement has been obtained in the control of infectious sources of schistosomiasis in Eryuan County, and the role of human and bovine as the major infectious sources of schistosomiasis has been effectively controlled. In the future, the integrated strategy with emphasis on the control of infectious sources should be intensified, and the management of reservoir hosts including dog and mouse should be strengthened. 　

Approaches used for assessment of the burden of advanced schistosomiasis japonica: a comparative study

LI Yi-Ting, CAI Xin-Ting, ZHU Jin-Hua, SUN Le-Ping, HUA Hai-Yong, TIAN Li-Guang, FENG Ting, LI Shi-Zhu, REN Guang-Hui, JIA Tie-Wu

2019, 31(3):  280. 

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Objective　To compare the approaches used for the assessment of disability adjust life years (DALYs) for advanced schistosomiasis japonica, so as to provide scientific evidence for accurate assessment of the burden of advanced schistosomiasis japonica. Methods　The patients with advanced schistosomiasis japonica receiving treatment and assistance programs in Hunan Province in 2017 were enrolled, and the years lived with disability (YLD) for the patients with advanced schistosomiasis japonica was calculated using the common global burden of disease (GBD) estimation method, the modified GBD method with addition of common syndromes of advanced schistosomiasis japonica, and the quality of life assessment method. Results　The YLDs of patients with advanced schistosomiasis japonica, the mean YLDs per capita, and the percentages of YLD were 673.94, 728.77 person?years and 1 761.99 person?years; 0.181, 0.196 person?years and 0.474 person?years; and 10.61, 11.48 person?years per 100 thousand persons and 27.75 person?years per 100 thousand persons with the common GBD method, modified GBD method and the quality of life method, respectively. The YLDs of the patients with advanced schistosomiasis japonica in Hunan Province estimated with the modified GBD method and the quality of life method were 8.14% and 2.61 times higher than that with the common GBD method. Of the major symptoms included in the calculation, the 5 symptoms with the greatest contribution to the burden of advanced schistosomiasis japonica included ascites, moderate anemia, severe anemia, diarrhea and hematochezia. Conclusion　The quality of life method may more comprehensively assess the YLDs in patients with advanced schistosomiasis japonica than the common and modified GBD methods.

Study on pathogenicity of Pneumocystis and its association with development of chronic obstructive pulmonary disease

XUE Ting, MA Su-Li, HE Li, AN Chun-Li

2019, 31(3):  285. 

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Objective　To investigate the pathogenicity?of Pneumocystis and its association with the development of chronic obstructive pulmonary disease (COPD). Methods　The rat model of Pneumocystis pneumonia (PCP) was induced by intraperitoneal injection with dexamethasone, which was confirmed by pathogenic detection. The pathologic changes of rat lung specimens were examined using conventional HE staining, and the expression of inflammatory cells were detected by flow cytometry in bronchoalveolar lavage fluid (BALF) and splenic tissues of the rat model of PCP. In addition, the serum levels of matrix metalloproteinase 8 (MMP?8) and MMP?9 were measured using enzyme?linked immunosorbent assay (ELISA). Results　Fusion and atrophy of alveolar spaces and hyperplasia of lung tissue were seen in the lung specimens of the rat model of PCP, and foam?like alveolar exudates and infiltration of inflammation cells were observed in the alveolar space, while severe infections exhibited consolidation of lung, which was similar to pathological features of COPD. The counts of CD8+ T lymphocytes (t = -7.920 and -12.514, P < 0.01), macrophages (t = -7.651 and -14.590, P < 0.01) and granulocytes (t = -10.310 and -16.578, P < 0.01) significantly increased and the counts of CD4+ T lymphocytes (t = 6.427 and 18.579, P < 0.01) significantly reduced in the BALF and splenic specimens of the rats with PCP relative to those without PCP. In addition, higher serum MMP?8 (t = -8.689, P < 0.01) and MMP?9 levels (t = -7.041, P < 0.01) were measured in rats with PCP than in those without PCP. Conclusion　Pneumocystis infection may be associated with the development and progression of COPD.

Application of infrared camera technique in investigation of wild animals as infectious source of schistosomiasis

GAO Feng-Hua， HE Jia-Chang， WU Ming-Yao， Li Yi， CHENG Xue-Feng， XU Xiao-Juan， LIU Ting， WANG Tian-Ping， ZHANG Shi-Qing

2019, 31(3):  291. 

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Objective To investigate the species and activities of wild animals infected with schistosome in hilly and mountain areas by using an infrared camera technique， so as to provide the evidence for the surveillance of schistosomiasis in these areas. Methods Six infrared cameras were selected and placed in 6 environments of the risk monitoring points of schistosomiasis in Shitai County in Anhui Province. The species and activities of the wild animals in the 6 environments were observed through the photographs and videos taken by the cameras. Results Through 5 day’s monitoring， 3 wild mammals， such as voles， hares and wild boars， were found in 4 monitoring environments， of which voles were found at 2 environments with snails， and hares， wild boars and voles were found in 2 environments adjacent to environments with snails respectively. The monitoring showed that the vole activity was most frequent in the monitored environment. Conclusion The use of infrared camera technique has a good effect in the investigation of wild animal infectious source of schistosomiasis， and it is also suitable for the monitoring work in other types of environments.

Observation on growth and reproduction of various Leishmania isolates in different culture media

CHENG Fang-Zhou, YANG Yue-Tao, GAO Chun-Hua, WANG Jun-Yun

2019, 31(3):  294. 

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Objective　To compare the growth and reproduction of the promastigotes of Leishmania isolates from various endemic areas of visceral leishmaniasis in China in various culture media, so as to provide experimental evidence for selecting an appropriate medium for the culture of Leishmania. Methods　A total of 3 × 105 promastigotes of KS?2, Cy and JIASHI?5 Leishmania isolates were inoculated into 1 mL NNN medium, 1 mL M199 medium supplemented with 20% fetal bovine serum medium, 1 mL M199 medium supplemented with 20% horse serum medium, and 1 mL brain heart infusion medium containing heme, respectively. All media were placed at 22 ℃ under a sterile condition, and the number of promastigotes was counted continuously for 8 days under a microscope. The growth curve was plotted for the three Leishmania isolates. Results　The promastigotes of KS?2, Cy and JIASHI?5 Leishmania isolates all grew and reproduced in the NNN medium, the M199 medium supplemented with 20% fetal bovine serum medium, and the M199 medium supplemented with 20% horse serum medium. The number of promastigotes of KS?2, Cy and JIASHI?5 Leishmania isolates was all significantly higher in the NNN medium than in the M199 medium supplemented with 20% fetal bovine serum medium, and the M199 medium supplemented with 20% horse serum medium at various time points of culture (all P values < 0.05), and the number of promastigotes of the KS?2 isolate was all significantly greater than that of the Cy and JIASHI?5 isolates in the NNN medium, the M199 medium supplemented with 20% fetal bovine serum medium, and the M199 medium supplemented with 20% horse serum medium at various time points of culture (all P values < 0.05). In addition, the promastigotes of KS?2, Cy and JIASHI?5 Leishmania isolates failed to grow and reproduce in the brain heart infusion medium. Conclusions　The growth and reproduction of the promastigotes of various Leishmania isolates from various endemic areas of visceral leishmaniasis in China vary in the same culture medium, and the growth and reproduction of a Leishmania isolate vary in different culture media. The NNN medium best fits for the culture of Leishmania isolates in the endemic areas of visceral leishmaniasis in China.

Investigation on Clonorchis sinensis infections in marketed cats in Nanning City

OU Fang-Qi, WANG Zi-Yue, WEI Hai-Yan, WEI Yao-Bao, YANG Yi-Chao, SHI Yun-Liang

2019, 31(3):  299. 

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Objective　To understand Clonorchis sinensis infections in cats in Nanning City, so as to provide evidence for the control of the reservoir host of C. sinensis. Methods　The cat livers were purchased from cat slaughterhouses in Nanning City. The cat gallbladder and liver were dissected, and liver flukes were collected and counted. Then, the worms were subjected to morphological observation, amplification of the ITS2 gene and sequencing. The species of the worms were identified using BLAST. Results　A total of 105 cat livers were collected from two cat slaughterhouses, and 68 were detected with C. sinensis infections, with an infection rate of 64.76%. The highest burden was 980 worms in a single liver, and the mean burden was 72 worms in a liver. There were 3 types of liver flukes with various size and morphology, and all were identified as C. sinensis by means of morphological observation, ITS2 gene amplification, sequencing and sequence alignment. Conclusion　There is a high infection rate of C. sinensi in marketed cats in Nanning City, and it is therefore suggested that targeted interventions should be intensified for the management of C. sinensis infections in cats.

Effects of five Chinese herbs on human demodicid mites in vitro

PAN Yi-ning， ZHAO Ying， ZHAO Ru-juan，YANG Xue-rong，LI Tian-ci，HU Ting-ting，YANG Yan，ZHAO Jin-hong

2019, 31(3):  301. 

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Objective To research the effects of five Chinese herbs of Artemisia argyi， Chimonanthus praecox， Agastache rugosa， pine needles and Osmamthus fragrans on human demodicid mites in vitro. Methods The human demodicid mites were acquired with the cellophane tape method. The ethanol heat reflux extractions were carried out on the 5 kinds of Chinese herbs to be studied and Stemona sessilifolia as the positive control， so as to get the herbal extracts. Next， the drug administration was carried out to the demodicid mites， and the inhibitory or killing effects of the 6 kinds of Chinese herbs above mentioned on the vermiform mites were observed under a microscope. It was considered to be dead when the bodies of the demodicid mites stopped moving. Besides， the duration from drug administration to death of the vermiform mites was recorded， and the data was analyzed by SPSS 17.0. Results Artemisia argyi， Chimonanthus praecox and Agastache rugosa could effectively inhibit and kill human demodicid mites. The effect of Artemisia argyi and Agastache rugosa was similar to the effect of Stemona sessilifolia， and the effect of Chimonanthus praecox was weaker than Stemona sessilifolia’s effect. Among them， Agastache rugosa took a relatively short time （[4.60±1.66]） min and Osmamthus fragrans took the longest time （[114.65±80.14]） min to Demodex folliculorum； Whereas， Artemisia argyi took the shortest time （[3.56±1.92]） min and Osmamthus fragrans took the longest time （[194.24±134.96]） min to Demodex brevis. Conclusions The effects of Artemisia argyi and Agastache rugosa on human demodicid mites are similar to that of Stemona sessilifolia. The effects of Chimonanthus praecox and pine needles are weaker than that of Stemona sessilifolia. Osmamthus fragrans has no acaricidal effect.

Scanning electron microscopical observation on external morphology of Aleuroglyphus ovatus at different developmental stages

CHAI Qiang， HONG Yong， TAO Ning， LI Chao-pin

2019, 31(3):  305. 

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Objective To observe the morphological changes of the live Aleuroglyphus ovatus and the ultrastructure under scanning electron microscope （SEM） at different developmental stages. Methods The mites were cleaned with distilled water， then fixed with 2.5% glutaraldehyde solution and washed again by alcohol. At last the mites were dried by critical?point drying. The disposed mites were settled on the conductive double sided tape and scaned under SEM. Results The larvae had three pairs of legs and the genital area was under?developed. The male was similar with the female. There was a Grandjean’s organ in the front of basipodite of foot Ⅰ. Foot Ⅳ existed a tarsus sucker. Penis was like straight tube and the end of it was fork. There is a pair of suckers on both sides of anus. Three pairs of postanal seta almost aligned in the same line. The female adult mite slightly larger and had two pairs of postanal setae. Conclusion The description of the morphology and ultrastructure of A. ovatus mites provide important information for the taxonomy and further study of its life history.

Surveillance of epidemic factors of schistosomiasis in wetlands in Sichuan Province

MAO Yong, XU Jia, XU Liang, CHEN Ling, WAN Jia-Jia, LI Rong-Zhi, TANG Meng, ZHONG Chao-Kun, YANG Fang, XU Hui-Rong, YE Yu-Ling, WU Zi-Song

2019, 31(3):  307. 

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Objective　To investigate the epidemic factors of schistosomiasis in wetlands in Sichuan Province, so as to provide scientific evidence for the prevention and control of schistosomiasis in wetlands. Methods　The artificial and natural wetlands were selected from Sichuan Province, and the relevant data regarding wetlands were collected. Routine snail survey, investigation on human morbidity due to schistosomiasis, snail diffusion experiments, questionnaire survey, determination of water infectivity and retrospective survey were conducted. Results　In Sichuan Province, the mean densities of living snails were 0.003 snails/0.1 m2 and 2.033 snails/0.1 m2 in the upper and lower reaches of the Meiwan Reservoir wetlands, 0.08 snails/0.1 m2 in the Jinyan Lake of Guanghan City, 0.21 snails/0.1 m2 in Muhe River of Guanghan City, and 0.02 snails/0.1 m2 prior to the construction of Qionghai wetland park in Xichang City in 2015. Artificial simulation experiments showed that the largest distance of snail diffusion in water was 2 000 m. There were 8.80% (41/466) of subjects that lived neighboring wetlands, worked in wetlands and visited wetlands having infested water contact behaviors. A total of 690 sentinel mice were assigned, and no Schistosoma japonicum infection was detected in the 677 mice dissected. Retrospective survey showed that the construction of the Meiwan Reservoir caused the spread of schistosomiasis in Dailing County, and snails were found in the ditches entering the Jinyan Lake and in Jinyan Lake areas 5 years following the construction of the Jinyan Lake in Guanghan City, with S. japonicum?infected snails detected in the ditches entering the Jinyan Lake. Conclusions　O. hupensis snails are found in some wetlands in Sichuan Province. Protection of wetlands and snail control with environmental improvements are recommended for the prevention of snail importation in natural wetlands, while in artificial wetlands, thorough snail control is recommended during the construction of the wetlands because of the likelihood of snail importation via water systems. In addition, both natural and artificial wetlands require long?term systematic surveillance of schistosomiasis.

Epidemiological features and changing patterns of intestinal parasitic diseases in Jiangxi Province

HUANG Bei-Nan, JIANG Wei-Sheng, XIE Shu-Ying, CHEN Hong-Gen, HANG Chun-Qin, GE jun, LI Zhao-Jun, Lan Wei-Ming, ZENG Xiao-Jun

2019, 31(3):  311. 

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Objective　To understand the epidemiological features and changing patterns of intestinal parasitic diseases in Jiangxi Province from 1989 to 2014, so as to provide scientific evidence for formulating the preventive and control strategy for intestinal parasitic diseases. Methods　The data regarding the status of intestinal parasitic diseases in Jiangxi Province were captured from the 1989 national survey on the distribution of human parasites in China and the 2014 national survey on major human parasitic diseases in China, and the status of human intestinal parasite infections was compared between the two surveys in Jiangxi Province. Results　The prevalence rate of human intestinal parasite infections was 79.59% and 9.64% in Jiangxi Province in 1989 and 2014, with a decline rate of 87.89% during the 25?year period (χ2 = 30 870.5, P < 0.01). There were 24 and 20 species of human intestinal parasites detected in Jiangxi Province in 1989 and 2014, respectively, with totally 26 species detected during the two surveys. In Jiangxi Province, the 3 most highly prevalent human intestinal parasites included Ascaris lumbricoides (71.06%), hookworm (17.61%) and Enterobius vermicularis (17.59%) in 1989, and E. vermicularis (13.73%), hookworm (4.66%), whipworm (0.95%) in 2014. A higher rate of human intestinal parasite infections was found in females than in males in both surveys in Jiangxi Province (P < 0.01), and the prevalence of human intestinal parasite infections reduced by 82.50% to 95.31% in different age groups in Jiangsu Province during the 25?year period. Conclusions　The prevalence of human intestinal parasite infections shows a remarkable decline tendency in Jiangxi Province, and soil?transmitted nematodes remain the main species of human intestinal parasites in Jiangxi Province.

Epidemic situation and control strategy of malaria in Guangxi Zhuang Autonomous region from 2011 to 2018

LIN Kang-Ming, LI Jun, WEI Shu-Jiao, ZHANG Wei-Wei, FENG Xiang-Yang, YAN Hui, WEI Hai-Yan, YANG Yi-Chao

2019, 31(3):  315. 

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Objective　To analyze the epidemic situation of malaria and explore the targeted control strategy in Guangxi from 2011 to 2018. Methods　The malaria surveillance data were collected in Guangxi Zhuang Autonomous Region from 2011 to 2018, and a descriptive method was employed to analyze the epidemiological features of the malaria cases. Results　A total of 2 944 malaria cases were reported in Guangxi Zhuang Autonomous Region from 2011 to 2018, including a case with local infection (0.03%) and 2 943 imported cases (99.97%). There were 2 933 cases (99.63%) positive for Plasmodium confirmed by laboratory testing, including 2 166 cases (73.86%) with P. falciparum malaria, 388 cases (13.23%) with P. ovale malaria, 276 cases (9.41%) with P. vivax malaria, 40 cases (1.36%) with P. malariae malaria and 62 cases (2.11%) with mixed infections, and 11 clinically diagnosed cases (0.37%). The malaria cases were distributed in 91 counties (districts) of 14 cities in Guangxi, with the largest number of cases found in Nanning City (2 515 cases, 85.43%). The malaria cases were originated from 29 countries in Africa (94.67%), 7 countries in Southeast Asia (5.10%), one country in South America (0.07%), 2 countries in South Asia and China (0.10%). In African countries, most malaria cases were from Ghana (1 947 cases, 66.13%), and in Southeast Asian countries, most cases were from Myanmar (75 cases, 2.55%). Most malaria cases were young men, and 2 899 cases (98.13%) were male, while 2 583 cases (87.74%) were at ages of 20 to 49 years. Gold washing and mining was the predominant occupation (2 561 cases, 86.99%), and the malaria cases were reported in each month across the year, with the largest number of cases detected in June (665 cases, 22.59%), while no season?specific distribution was found. There were 1 431 cases (48.61%) reported by disease control and prevention institutions, 1 511 cases (51.30%) reported by medical institutions, and 2 cases (0.07%) reported by inspection and quarantine institutions. During the period from 2011 to 2018, there were 6 deaths of imported malaria cases in Guangxi, and no secondary cases were reported. Conclusions　The epidemic situation of local malaria has been effectively controlled in Guangxi; however, there is a great challenge for the management of overseas imported malaria. Strengthening the monitoring and management of migrant labors is the key to consolidate the achievements of malaria elimination.

Clinical value of transient elastography (Fibroscan) in detection of clonorchiasis

ZHONG Bin, WU Jian-Lin, WAN Xiao-Lin, Lü Guo-Li, TANG Wen-Qian, JIANG Zhi-Hua

2019, 31(3):  319. 

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Objective　To assess the clinical significance of transient elastography (Fibroscan) in detection of clonorchiasis, so as to provide new insights into the assessment of therapeutic efficacy of deworming. Methods　The liver stiffness measurement (LSM) values were measured in parasitologically diagnosed clonorchiasis patients using Fibroscan before and after deworming, and the patients’ age, gender, body mass index (BMI), duration of raw fish consumption and total amount of raw fish consumption were collected for correlation analyses. Results　The clonorchiasis patients’ age, gender, BMI, duration of raw fish consumption and total amount of raw fish consumption had no associations with pre?treatment LSM values (r/rs = 0.189, 0.073, 0.180; 0.071, –0.098, 0.033; 0.166, 0.309, 0.172; 0.235, 0.247, 0.209; 0.164, 0.277, 0.088; all P values > 0.05). There was a significant difference in the LSM values from the seventh, eighth and ninth intercostal space prior to deworming (F = 3.259, P < 0.05), and no significant difference was detected after deworming (F = 0.851, P > 0.05). The LSM values from the seventh, eighth and ninth intercostal space were significantly lower pre?deworming than post?deworming (t = 6.724, 5.603, 2.884; all P values < 0.05). Conclusions　Fibroscan is feasible to assess the therapuetic efficacy of deworming in patients with clonorchiasis; however, measurement at various sites affects the LSM value.

Emergency treatment of schistosomiasis outbreaks in transmission?interrupted mountainous and hilly areas

DONG Yi, ZHANG Yun, DU Chun-Hong, FENG Xi-Guang, SONG Jing, CAO Chun-Li, LI Shi-Zhu

2019, 31(3):  323. 

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In China, the mountainous and hilly schistosomiasis?endemic areas are mainly distributed in 2 provinces of Sichuan and Yunnan. Although great success has been achieved in schistosomiasis control in mountainous and hilly areas, there is a risk of re?emerging schistosomiasis in local areas. Hereby, we described the emergency treatment of two schistosomiasis outbreaks that occurred in transmission?interrupted areas of Yunnan Province in 2011 and 2013, pointed out the risk of schistosomiasis rebounding in mountainous and hilly areas and proposed some suggestions.

Capability building and professional staff of schistosomiasis control institutions in Yunnan Province: a cross-sectional survey

SONG Jing, ZHANG Yun, WANG Li-Fang, DONG Yi

2019, 31(3):  326. 

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To understand the current status of professional staff and capacity building among schistosomiasis control institutions in Yunnan Province, the data pertaining to the current status of professional staff and capacity building were captured from the schistosomiasis control institutions at all levels in Yunnan Province. There were 20 schistosomiasis control institutions at a level of above county in Yunnan Province, with 411 employees, and there were 11 institutions with an independent legal personality, with a mean building area of 69.83 m2 per capita. Among all institutions, the number of posts was 382, and the actual number of employees was 360, with 22 job vacancies. The mean age of professional staff was 41.6 years at a province level, 44.1 years at a city level and 42.4 years at a county level, and there were no professionals at ages of < 30 years in city?level institutions. Of all professionals, there were 45.76% with a college degree or below, and 54.26% with a bachelor degree or higher, and 16.55%, 24.57% and 39.90% had senior, moderate and primary professional titles, with mean ages of 49.10, 44.37 years and 38.36 years, respectively. The results of the cross?sectional study demonstrate that there are problems of job vacancy, population aging and low education levels in schistosomiasis control institutions in Yunnan Province. Therefore, the capability building and professional quality should be further improved in schistosomiasis control institutions to meet the requirements of schistosomiasis control activities in Yunnan Province.

Construction and operation of schistosomiasis diagnosis reference (network) laboratory in Yunnan Province

DU Chun-Hong, ZHANG Yun, WU Ming-Shou, FENG Xi-Guang, SHEN Mei-Fen, CHEN Chun-Qiong, SONG Jing, WANG Li-Fang, SUN Jia-Yu, YAN Jia-Qi, XIONG Meng-Tao, JIANG Hua, DONG Yi

2019, 31(3):  329. 

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A three?level (provincial, municipal and county levels) schistosomiasis diagnosis network platform had been created in Yunnan Province, and assessment of laboratory quality?control samples and field evaluation of nucleic acid diagnostic techniques and immunodiagnostic reagents had been performed. This paper described the review process of the schistosomiasis diagnosis network laboratory and the operation of schistosomiasis diagnosis network laboratory and analyzed the problems of the schistosomiasis diagnosis network laboratory in Yunnan Province. The establishment of the schistosomiasis diagnosis reference (network) laboratory will provide a strong support for schistosomiasis control in Yunnan Province in the new era.

Impact of earthquake disaster on schistosomiasis transmission and emergency prevention and control in Sichuan Province

XU Jia, ZHONG Bo, LIU Yang, WU Zi-Song, ZHANG Yi, CHEN Lin

2019, 31(3):  333. 

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Earthquake is a serious natural disaster. The earthquake that occurs in schistosomiasis?endemic areas not only causes direct human and economic losses, but also induces secondary disasters that greatly threaten public health safety in affected areas. This paper analyzed the impact of the 2008 Wenchuan Earthquake and 2013 Lushan Earthquake on schistosomiasis transmission in Sichuan Province, and proposed emergency measures and assessment activitiesresponding to schistosomiasis following earthquake disasters. The experiences from schistosomiasis control after two earthquake disasters in Sichuan Province may provide insights into the emergency control in other regions or after other natural disasters.

Risk assessment of schistosomiasis transmission in Chuxiong City of Yunnan Province

WANG Jian-Xiang, SHEN Mei-Fen, LI Hui-Cai, DU Chun-Hong, XIONG Meng-Tao, WANG Li-Fang, WANG Yu, YANG Jia-Heng

2019, 31(3):  337. 

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Objective　To evaluate the potential risk of schistosomiasis transmission so as to provide the evidence for formulating the control strategy. Methods　Two villages were selected as the investigated sites in Chuxiong City and the risk of schistosomiasis transmission was evaluated by reviewing the data of schistosomiasis epidemic situation and prevention and control work, and carrying out the field survey for Oncomelania hupensis snail status, wild faeces, and schistosome infection of the population from 2015 to 2017. Results　There was 1.49 hm2 area of snail habitats, with an average density of 0.54 snails/0.1 m2. The occurrence rate of frames with snails was 5.41%. No schistosome?infected snails were found. The positive rate of schistosomiasis serological tests of the residents was 3.36%, but the stool examination positive cases were not found. A total of 58 wild faeces samples were collected but no schistosome infested cases were found. The risk levels of schistosomiasis transmission in both villages were Grade III. Conclusions　Although Chuxiong City has been in a low risk state of schistosomiasis transmission, the density of snails is still high, and there is a risk of infection source importation. In the future, the infection source control and snail control should be strengthened.

Effect of integrated schistosomiasis control in Honghu City from 2008 to 2018

Li Rong-Jie, Guo Jun, Li Jun-Yang, Ma Hong-Wei, Yuan Mei-Zhi, He Liang-Cai

2019, 31(3):  339. 

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Objective　To evaluate the effect of integrated schistosomiasis control measures in Honghu City during the period from 2008 through 2018. Methods　The data pertaining to schistosomiasis control measures and the endemic situation of schistosomiasis in Honghu City were collected from 2008 to 2018, and the effect of integrated schistosomiasis control measures implemented was evaluated. Results　The resources from agriculture, water resources, forestry, land, education and communication sectors were integrated to implement the integrated schistosomiasis control strategy with the focus on the control of source of Schistosoma japonicum infection in Honghu City from 2008 to 2018. The prevalence of S. japonicum infection reduced from 3.03% in 2008 to 0 in 2018 in humans in the city, and no acute infection was detected since 2009. In addition, the prevalence of S. japonicum infection in cattle reduced from 2.85% in 2008 to 0 in 2018, and no snail infection was found since 2012. Transmission control of schistosomiasis was achieved in the city in 2013, and transmission interruption was achieved in 2018. Conclusions　The integrated schistosomiasis control measures achieve remarkable effects in Honghu City; however, there is still a risk of schistosomiasis transmission.

Preliminary investigation of Blomia tropicalis breeding status in ground dust rice in Haikou City

HONG Yong， ZHAO Ya-nan， PENG Jiang-long， LI Chao-pin

2019, 31(3):  343. 

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Objective To investigate the Blomia tropicalis breeding status in the ground dust rice collected in Haikou City. Methods Totally 17 samples of ground dust rice were collected from 10 sampling sites in Haikou City. Then 10 g of dust rice was taken from each individual sample for isolation of the mites that were made of slide specimen， and the mites were identified and classified under a microscope. Results B. tropicalis mites were found in all the 17 samples with the detection rate of 100%. A total of 1 176 heads of B. tropicalis were isolated， with an average breeding density of 6.91 heads/g. Conclusion B. tropicalis breeding status is severe in Haikou City. The effective measures should be taken to prevent and control the harm associated with B. tropicalis contamination.

Progress of researches on genes associated with sulfadoxine?pyrimethamine resistance in Plasmodium vivax

ZOU Qi-Cheng, LU Feng

2019, 31(3):  346. 

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Malaria is a parasitic disease which threatens human life and health seriously. Sulfadoxine?pyrimethamine (SP) has been recommended for intermittent preventive treatment of malaria in children and pregnant women, and also used as a compound component of artemisinin based therapy. The mechanisms of SP resistance in P. falciparum involve point mutations in the genes encoding dihydrofolate reductase (DHFR) and dihydropteroate synthase (DHPS), and the drug pressure can also lead to the mutations in the two genes of P. vivax. To provide the information for the formulation of anti?malarial strategies, this article reviews the discovery, application, effect of SP, and the resistance mechanism and research progress of the related genes in P. vivax.