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Table of Content

    27 September 2019, Volume 31 Issue 4
    Current status and new challenges of three important imported parasitic diseases
    2019, 31(4):  353. 
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    Following the concerted efforts for nearly 70 years, great achievements have been obtained in parasitic diseases control in China, and some important parasitic diseases have been eliminated or moving towards elimination in the country. With the socioeconomic development, the implementation of the “Road and Belt Initiative” and the increase in the international communication and overseas investment, there is a rise in the number of overseas labors, businessmen, students, travelers, visitors and participants in national and international communication activities, resulting in a gradual increase in the number of cases with parasitic diseases imported from endemic to non?endemic areas of China and from foreign countries to China. The increase in the number of imported cases causes new challenges for the elimination of parasitic diseases in China. The paper describes the current status of malaria, schistosomiasis and leishmaniasis, analyzes the challenges for the current control activities, and proposes the control strategies and interventions.
    Strengthening the research and application of spatial epidemiology to promote precise prevention and control of parasitic diseases in China
    ZHOU Yi-Biao
    2019, 31(4):  356. 
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    Spatial epidemiology is a new branch of epidemiology, and is a subject that mainly analyzes the geographical distribution and changes of population health or diseases and its related impact factors. Recently, spatial epidemiology has been extensively applied in the prevention and control of parasitic diseases in China, and delightful results have been achieved. However, the research and application of theories and methods of spatial epidemiology are still needed to protect the people’s health in China.
    Thinking on the control strategy at schistosomiasis elimination stage in China
    WANG Tian-Ping
    2019, 31(4):  358. 
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    This paper reviews the evolution of the schistosomiasis control strategy in China at various stages after the founding of the People’s Republic of China, and analyzes the roles and main problems of the schistosomiasis control strategy at different stages. At the end stage of schistosomiasis elimination, the integrated strategy with emphasis on infectious source control should be continued to be sustained and the problems regarding the implementation of this integrated strategy are analyzed. In addition, the countermeasures to solve these problems are proposed.
    Study on biological characteristics: reproduction and viability of Biomphalaria glabrata as an intermediate host of Schistosoma mansoni
    WANG Yi-An, LIANG You-Sheng, QU Guo-Li, SHI Feng, XING Yun-Tian, DAI Jian-Rong
    2019, 31(4):  362. 
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    Objective To compare the difference of fertility of Biomphalaria glabrata snails between self?fertilization and cross?fertilization and to observe the circadian rhythm of laying eggs, the effect of light on laying eggs and the tolerance of the snail to water and food deficiency, so as to provide the evidence for control and elimination of B. glabrata snails in the field. Methods Under laboratory conditions, a single B. glabrata egg for self?fertilization was separated and hatched individually, and young snails were raised in different plastic boxes individually. The eggs for cross?fertilization were hatched and the young snails were fed in the same plastic box. The ability of spawn, the development of the eggs, and the number of snails growing from young to adult snails were compared between the self?fertilization and cross?fertilization. The snails were in the water under four environments, all day illumination, all day without illumination, daytime lighting and night without illumination, and daytime without illumination but night lighting. The eggs were collected and counted daily. The circadian rhythm of spawn and the effect of illumination on spawn were observed. The adult snails were divided into 6 groups and exposed to the environments with relative humidity of 0, 65%, 87% and 100%, respectively. The survival rates of the adult snails exposed to the different environments after different time were observed. The adult snails were placed at 25 ℃ in the oven to remove water content from the soft body of snails. When the dehydration rates of the soft bodies achieved 10%, 20%, 30%, 40%, 50%, 52%, 55%, 57%, 60%, and 70% respectively, the survival rates of the adult snails exposed to the oven were observed. Results In the 25 ℃ water, the average laying egg number for 15 days per snail was (8.77 ± 16.92) eggs/snail in the self?fertilization snail. The average laying egg number for 15 days per snail was (149.71 ± 142.28) eggs/snail in the cross?fertilization snails. There was a significant difference between the self?fertilization snail and cross?fertilization snail (t = 0.999 999,P < 0.01). The hatching rate and reproductive maturation rate of the self?fertilization snails and cross?fertilization snails were 50.1% and 78.9%, and 19.3% and 3.8%, respectively, There was a significant difference (the hatching rate: χ2 = 18.18,P < 0.01, the reproductive maturation rate: χ2 = 11.83,P < 0.01). In the natural environment of daytime with illumination and nighttime with darkness, the amount of laying 20 eggs of B. glabrata snail was (944.07 ± 392.53) eggs/day during a whole day, among them the amount of laying eggs during daytime account for 10.1% and the amount of laying eggs during nighttime account for 89.9%, and the laying egg was given priority to with the night. The above results suggested that the dark environment was conducive to B. glabrata snails to lay eggs. The above results suggested that light can promote the increase of spawning of B. glabrata. When B. glabrata was exposed to the environments with the relative humidity of 0, 65%, 87% and 100% at 25 ℃, respectively, and the longest survival times of snails were 7, 70, 150 d and 100 d, respectively. In the 25 ℃ water, the snails could survive for 50 days without food. The adult snails were placed at 25 ℃ in the oven to remove water content from the soft body of snails. When the dehydration rates of the soft bodies achieved 10%, 20%, 30%, 40%, 50%, 52%, 55%, 57%, 60%, and 70% respectively, the survival rates of the adult snails exposed to the oven were 100%, 100%, 100%, 100%, 70%, 30%, 0, 0, 0 and 0, respectively. Conclusions B. glabrata can achieve the reproductive process by cross?fertilization or self?fertilization. There is a significant difference in reproductive ability between the cross?fertilization snail and self?fertilization snail, cross?fertilization is stronger than self?fertilization, but the rate of reproduction in the self?fertilization is higher than that in the cross?fertilization. It is indicated that B. glabrata that survive after the dry season plays an important role in the maintenance of local snail populations and transmission of schistosomiasis mansoni.
    Design of schistosomiasis surveillance sites based on Spatial Kluster Analysis by Tree Edge Removal (SKATER) method: an exploratory study
    HU Jian, HU Yi, GAO Feng-Hua, CAO Zhi-Guo, ZHANG Zhi-Jie
    2019, 31(4):  368. 
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    Objective To develop a method for designing schistosomiasis surveillance sites, so as to improve the efficiency and quality of schitsosomiasis surveillance. Methods By using the minimum spanning tree?based Spatial Kluster Analysis by Tree Edge Removal (SKATER) method, spatially constrained clustering was performed upon 31 historical schistosomiasis?endemic counties (districts) in Anhui Province. A surveillance site was selected from each cluster to evaluate the representativeness and surveillance efficiency of these cluster?based surveillance sites for the endemic situation of schistosomiassi in Anhui Province, and to compare the surveillance efficiency with local national schistosomiasis surveillance sites. Results There was no significant difference in the environmental factors between the cluster?based schistosomiasis surveillance sites and the whole region, showing a high homogeneity. If the same number of schistosomiasis surveillance sites was selected, there was no significant difference between the cluster?based surveillance sites and national schistosomiasis surveillance sites in the efficiency of the mean risk and long?term trend of schistosomiasis surveillance in Anhui Province; however, the cluster?based surveillance sites were superior to the national schistosomiasis surveillance sites for the prediction and estimation of the endemic situation of schistosomiasis in the unmonitored areas. Conclusion The SKATER?based selection of schistosomiasis surveillance sites may better represent the endemic situation of schistosomiasis in Anhui Province, which may serve as an effective supplement for the conventional method of selecting schistosomiasis surveillance sites.
    Administrative village-based spatial distribution specificity of Oncomelania hupensis and its relationship with water systems in Hubei Province
    CHEN Yan-Yan, LIU Jian-Bing, XIAO Ying, WEI Feng-Hua, ZHONG Chen-Hui, YANG Jun-Jing, ZHANG Wei-Hong, LIU Si
    2019, 31(4):  374. 
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    Objective To investigate the spatial distribution of Oncomelania hupensis snail habitats at the administrative village scale in schistosomiasis?endemic areas of Hubei Province, so as to provide scientific bases for precise control of O. hupensis snails in the province. Methods Data regarding snail distribution at the village level in Hubei Province in 2017 were collected to create a spatial analysis database of snail distribution in Hubei Province. The spatial aggregations of O. hupensis distribution were analyzed using Moran’s I index and Local Moran’s I index. In addition, the distances from schistosomiasis?endemic villages to the Yangtze River were captured using the software ArcGIS 13.0, and their correlations with area of snail habitats were examined with the Spearman correlation method. Results O. hupensis snails were mainly distributed in 5 450 endemic villages from 63 counties of 13 cities in Hubei Province in 2017. The global spatial autocorrelation analysis showed spatial aggregations in the areas of historically accumulated snail habitats, current areas of snail habitats, areas of snail habitats outside the embankment and snail habitats inside the embankment (all Z Scores > 0, all P values < 0.05), and no spatial aggregation was seen in the areas of snail habitats in hilly areas (Z Score > 0, P > 0.05). There were four types of spatial distribution of historically accumulated areas of snail habitats, areas of current snail habitats, areas of snail habitats outside the embankment and snail habitats inside the embankment, including the high?high type (H?H type), high?low type (H?L type), low?high type (L?H type) and random distribution type, and a high percentage of the H?H type was found. There were 340, 125 and 100 endemic villages with the H?H type of areas of historically accumulated snail habitats, current areas of snail habitats and areas of snail habitats outside the embankment, and these villages were mainly concentrated in Wuhan and Jingzhou cities, with almost consistent spatial aggregation locations. There were 319 endemic villages with the H?H type of distribution of snail habitats inside the embankment, which were mainly distributed in Jingzhou, Xiaogan and Huangshi cities. In addition, the areas of historically accumulated snail habitats, current areas of snail habitats and areas of snail habitats outside the embankment negatively correlated with the distance from the endemic villages to the Yangtze River (r = –0.094, P < 0.01; r = –0.225, P < 0.01; r = –0.177, P < 0.01). Conclusion The clustering areas of snail habitats along the Yangtze River Basin, notably the villages near the Yangtze River are key regions for snail monitoring and control in Hubei Province.
    Roles of transforming growth factor-β1 and heat shock protein 47 in progression of Schistosoma japonicum-induced hepatic fibrosis
    ZHOU Yong-Hua, XU Chen, YANG Ying-Ying, MEI Cong-Jin, DONG Pan-Pan, SAI Xue, XU Yong-Liang, FAN Xiao-Lin,YANG Jun-Qi, SHEN Li-Juan
    2019, 31(4):  382. 
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    Objective To investigate the dynamic expression of transforming growth factor?β1 (TGF?β1) and heat shock protein 47 (HSP47) and explore their roles?in the progression of hepatic?fibrosis induced by??Schistosoma japonicum infection. Methods Fifty female mice of the ICR strain were randomly divided into the infection group and the normal control group, of 25 mice in each group. Each mouse in the infection group was infected with 20 ± 1 cercariae of S. japonicum via the abdominal skin, while uninfected animals served as normal control. Five mice were sacrificed 4, 6, 8, 10 and 12 weeks post?infection and liver tissues were sampled. Serum HSP47 and TGF?β1 was determined using enzyme?linked immunosorbent assay (ELISA), and the pathological changes of liver specimens were observed with hematoxylin & eosin (HE) staining. In addition, the synthesis of alpha 1 chain of type I collagen (COL1A1) was measured using Masson staining, and the mRNA expression of?TGF?β1, HSP47 and COL1A1 was determined using real?time fluorescent quantitative PCR (qPCR) assay. ?Results During the period of S. japonicum?induced?hepatic?fibrosis, the serum HSP47 and TGF?β1 levels and the mRNA expression of TGF?β1, HSP47 and COL1A1 gradually increased with the progression of hepatic fibrosis. The serum levels of HSP47 and TGF?β1 were (179.26 ± 29.87) pg/mL and (22.37 ± 5.21) ng/mL 6 weeks post?infection, respectively, which were significantly greater than those [(150.29 ± 34.91) pg/mL and (18.54 ± 7.78) ng/mL, respectively] in the normal control group (both P values < 0.05). In addition, the mRNA expression of HSP47, COL1A1 and TGF?β1 was 0.86 ± 0.04, 1.17 ± 0.06 and 0.64 ± 0.13 in mouse liver specimens, which was significantly higher than that (0.23 ± 0.03, 0.20 ± 0.02 and 0.38 ± 0.02) in the normal control group (all P values < 0.01). Conclusions The expression of TGF?β1 and HSP47 during the period of S. japonicum?induced hepatic fibrosis is consistent with the progression of the hepatic fibrosis, and exhibits the same tendency with type I collagen expression. HSP47 is a novel promising diagnosis marker and therapeutic target for?S. japonicum?induced?hepatic?fibrosis.
    Establishment and evaluation of the detection method of Cryptosporidium specific DNA fragment by recombinase aided isothermal amplification
    NI Bi-Xian, WU Xiao-Min, LIU Yan-Hong, XU Xiang-Zhen, YING Qing-Jie, CAO Jun, DAI Yang
    2019, 31(4):  388. 
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    Objective  To establish a recombinase?aided isothermal amplification (RAA) assay for detection of Cryptosporidium. Methods Based on Cryptosporidium?specific 18S rRNA selected as the target gene to be detected, and the primer sequences and fluorescent probes designed using the software Amplfix, and a fluorescent RAA assay was established and optimized. The fluorescent RAA assay was performed to detect 18S RNA target sequence?contained recombinant plasmids at various copies, genomic DNA of Cryptosporidium oocysts at various concentrations, and genomic DNA extracted from various numbers of Cryptosporidium oocysts to assess the sensitivity of the assay, and to detect genomic DNA extracted from Cryptosporidium oocysts, Giardia lamblia cysts, Schistosoma japonicum eggs, Ascaris lumbricoides eggs, Clonorchis sinensis eggs, Salmonella and Shigella to determine the specificity of the assay. Results A fluorescent RAA assay was successfully established, which was effective to amplify the specific 18S RNA gene fragments of Cryptosporidium within 20 min at 39 ℃. The lowest limits of the fluorescent RAA assay were 102 copies/μL for detection of 18S RNA target sequence?contained recombinant plasmids at various copies, 1 pg/μL for detection of genomic DNA of Cryptosporidium oocysts at various concentrations, and one Cryptosporidium oocyst/μL for detection of genomic DNA extracted from various numbers of Cryptosporidium oocysts, and the fluorescent RAA assay was all negative for detection of genomic DNA from G. lamblia cysts, S. japonicum eggs, A. lumbricoides eggs, C. sinensis eggs, Salmonella and Shigella. Conclusion A novel fluorescent RAA assay is successfully established, which is simple, rapid, sensitive and specific to detect genomic DNA of Cryptosporidium oocysts.
    Spatial and temporal distribution of newly diagnosed echinococcosis patients in Sichuan Province from 2007 to 2017
    HE Wei, LIAO Sha, WANG Qian, HUANG Yan, YU Wen-Jie, ZHANG Guang-Jia, WANG Qi, YANG Liu, CHEN Fan, LI Rui-Rui, ZHONG Bo
    2019, 31(4):  393. 
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    Objective To explore the spatial and temporal distribution characteristics of cases with newly diagnosed echinococcosis in Sichuan Province from 2007 to 2017, so as to provide reference for the formulation of echinococcosis prevention and control strategies and for the identification of key areas. Methods The spatial distribution maps of detection of cases with newly diagnosed echinococcosis were plotted in Sichuan Province from 2007 to 2017, and the spatial distribution characteristics and epidemic trends were analyzed. Results From 2007 to 2017, the detection rate of cases with newly diagnosed echinococcosis appeared a decline in Sichuan Province year by year, and the areas with a high detection rate of cases with newly diagnosed echinococcosis were mainly located in western, northwestern and northern parts of Sichuan Province, while the areas with a low detection rate were predominantly found in the southern and eastern parts of the province. The global Moran’s I values were 0.19, 0.22, 0.17, 0.44, 0.48, 0.31 and 0.16 for the detection rate of cases with newly diagnosed echinococcosis in Sichuan Province from 2010 to 2016 (all Z scores > 1.96, all P values < 0.05), suggesting spatial aggregation distribution during this period. Local spatial autocorrelation analysis revealed that the “high?high” areas and “low?low” areas for the detection rate of cases with newly diagnosed echinococcosis all showed an aggregation tendency. Conclusions The detection rate of cases with newly diagnosed echinococcosis decreases in Sichuan Province from 2007 to 2017 year by year, and shows a spatial aggregation. The echinococcosis control activities should be intensified in Shiqu, Seda, Dege, Ganzi and Baiyu counties.
    Inhibition of Toxoplasma gondii excretory-secretory antigens on growth of murine Lewis lung carcinoma
    JIAO Yu-Meng, TAO Zhi-Yong, CUI Yu-Jian, LIU Chun-Xiang, XIA Hui, WANG Xue-Mei, FANG Qiang
    2019, 31(4):  400. 
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    Objective To investigate the effect of Toxoplasma gondii excretory?secretory antigens (ESA) on CD4+CD25+ Foxp3+ T (Treg) cells in mice carrying Lewis lung carcinoma, and examine the inhibitory effect of T. gondii ESA on tumor growth. Methods C57BL/6 mice were randomly assigned into the PBS group (n = 14) and the Lewis group (n = 34). Mice in the Lewis group were subcutaneously injected with 2 × 105 Lewis lung carcinoma cells in the right axilla, while animals in the PBS group were injected with the same volume of sterile PBS. On day 7 post?injection (D7), mice in the PBS group were further divided into the PBS2 group and the PBS2 + ESA group, of 7 mice in each group, and mice in the Lewis group were further divided into the Lewis2 group and the Lewis2 + ESA group, of 17 mice in each group. Then, mice in the PBS2 + ESA group and the Lewis2 + ESA group were intraperitoneally injected with 100 μL of ESA. The mouse spleen coefficient was calculated in each group 7 days post?injection with ESA, and the changes of Treg cell counts and the long?term tumor growth were measured in tumor?bearing mice. Results The spleen coefficient was significantly greater in the PBS2 + ESA group and the Lewis2 + ESA group than in the PBS2 (0.66% ± 0.09% vs. 0.30% ± 0.02%, P < 0.05) and Lewis2 groups (0.69% ± 0.07% vs. 0.33% ± 0.03%, P < 0.05) 7 days post?treatment with ESA, respectively, and the percentage of splenic Treg cells in splenocytes was significantly lower in the PBS2 + ESA group and the Lewis2 + ESA group than in the PBS2 (1.28% ± 0.14% vs. 2.06% ± 0.07%, P < 0.05) and Lewis2 groups (1.58% ± 0.14% vs. 2.44% ± 0.23%, P < 0.05), respectively. T. gondii ESA treatment caused a delay in tumor growth, and the tumor size was significantly smaller in the Lewis2 + ESA group than in the Lewis2 group (P < 0.05). Conclusion T. gondii ESA may reduce the proportion of splenic Treg cells in splenocytes and inhibit tumor growth in mice carrying Lewis lung carcinoma.
    Quantitative analysis of gene expression in Pomacea canaliculata infected with Angiostrongylus cantonensis and α-tubulin gene expression in various tissues
    YUE Zhi-Yuan, ZHANG Yi, GUO Yun-Hai, QIN Zhi-Qiang, HUANG Yun, ZHANG Wei
    2019, 31(4):  404. 
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    [Abstract] Objective To investigate the expression of some genes in Pomacea canaliculata infected with Angiostrongylus cantonensis, so as to provide insight into the preliminary understanding of the interactions between Angiostrongylus cantonensis and its intermediate host Pomacea canaliculata. Methods P. canaliculata was fed with rat faces containing the first?stage larvae of A. cantonensis. Three to five P. canaliculata was sampled 1, 10 days and 20 days after feeding, and the hemolymph, hepatopancreas, kidney, intestinal tract, head?foot and gill tissues were collected, while uninfected P. canaliculata served as controls. Total RNA was extracted from various tissues of P. canaliculata at different time points post?infection, and transcribed reversely into cDNA. Based on previous transcriptome sequencing results, 10 genes associated with immune defense, signal transduction, cell growth and metabolism, stress response were selected, and the gene expression was determined in the hemolymph tissues of P. canaliculata 1, 10 days and 20 days post?infection with A. cantonensis using real?time fluorescent quantitative PCR assay, and the α?tubulin gene expression was quantified in the hepatopancreas, kidney, head?foot, intestinal tract and gill tissues of P. canaliculata infected with A. cantonensis. Results Higher CELA1 gene expression was detected in the infection group than in the control group 1 (t = 12.32, P < 0.05), 10 days (t = 23.51, P < 0.05) and 20 days post?infection (t = 34.92, P < 0.05), and the CELA1 expression increased with the time of infection. The GST gene expression was (7.26 ± 1.80) times higher in the infection group than in the control group 1 day post?infection, and was significantly lower in the infection group than in the control group 10 days (t = 23.89, P < 0.05) and 20 days post?infection (t = 19.83, P < 0.05). Higher ferritin gene expression was found in the infection group than in the control group 10 days post?infection (t = 32.76, P < 0.05), and higher CRT gene expression was seen in the infection group than in the control group 1 (t = 7.23, P < 0.05), 10 days (t = 5.78, P < 0.05) and 20 days post?infection (t = 6.32, P < 0.05). In addition, the greatest α?tubulin gene expression was observed in the the hepatopancreatic tissues of P. canaliculata (F = 17.58, P < 0.05), and the α?tubulin gene expression altered in various tissues of P. canaliculata post?infection with A. cantonensis, with the most remarkable reduction of α?tubulin gene expression seen in the hepatopancreatic tissues (P < 0.05). Conclusions  Following A. cantonensis infection in P. canaliculata, the expression of multiple genes is altered, and the expression of α?tubulin gene is inhibited in multiple tissues. The findings provide a basis for the further elucidation of the interactions between P. canaliculata and A. cantonensis.
    Analysis of endemic situation of schistosomiasis based on geographic information system (GIS) in Wuhan City in 2017
    LI Yang, WANG Hao, ZHANG Jia-Jing, ZUO Yu-Ting, XIONG Yue-Lin, LUO Hua-Tang, ZHOU Ye-Hua, XU Ming-Xing
    2019, 31(4):  410. 
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    Objective To analyze the endemic sitaution of schistosomiasis based on geographic information system (GIS) in Wuhan City in 2017, so as to provide the reference for further schistosomiasis control activities. Methods According to the data of the annual report on the prevention and control of schistosomiasis in Wuhan City in 2017, the spatial database regarding the endemic situation of schistosomiasis was established and analyzed by ArcMap 10.2. Results The 593 schistosomiasis?endemic villages in Wuhan City were mainly located in the Yangtze River and its major tributaries. Kernel density analysis showed that the endemic villages of three regions with the highest density was located in the west of Caidian District (Zhuru Street), the east of Hannan District (Shamao Street) and the southwest corner of Xinzhou District (Yangluo Street). The sero?positive population was densely distributed in the West of Caidian District (Zhuru Street), which accounted for 34.23% of all seruo?positives in the city. There were 492 farming cattle fenced in Donggan Village in Hongbei Street of Caidian District. A higher density of the area with Oncomelania hupensis snails was located in the southwest region of Caidian District (Xiaosi Street), accounting for 31.22% of the total area with snails. In 2017, the re?emerging area with snails was 36.60 hm2. The high kernel density region with snails was located in Zhuru Street of Caidian District. The region with high density of living snails was located in the central region of Hannan District (Hongbei Production Brigade), the average density of living snails was 0.36 snails/0.1 m2. Conclusions The endemic situation of schistosomiasis is at a low level in Wuhan City, and the spatial distribution is not uniform. In some local areas, the historical endemic situation of schistosomiasis is serious and the high risk factors are more concentrated. It is necessary to strengthen the surveillance of schistosomiasis.
    Spatial-temporal distribution of malaria in Jiangxi Province from 1950 to 2017
    GONG Yan-Feng, LEI Lei, LI Zhi-Hong, SHANG-GUAN Jun, ZHENG Jian-Gang
    2019, 31(4):  414. 
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    Objective To explore the spatial?temporal distribution of malaria in Jiangxi Province from 1950 to 2017, so as to provide scientific evidence for developing the malaria elimination strategy. Methods The epidemic situation of malaria, demographic data, historical species of malaria parasites and transmission vectors were collected from each county of Jiangxi Province from 1950 to 2017 to create a geographic information system database of malaria in Jiangxi Province. The software ArcGIS 10.3 was used to analyze the incidence of malaria and display the spatial?temporal distribution of malaria in Jiangxi Province, so as to explore the spatial?temporal patterns of malaria in the province. Results From 1950 to 2017, the prevalence of malaria was classified into 3 stages in Jiangxi Province, including the peak period (from 1950 to 1975), the continuous decline period (from 1976 to 1997), and the low?level fluctuation period (from 1998 to 2017). During the period from 1950 through 2017, the incidence of malaria declined, the epidemic area of malaria shrank, and the intensity of malaria transmission gradually reduced to no local infections in Jiangxi Province. The spatial distribution of epidemic areas of malaria shifted from southern mountainous areas to northern plain areas, and finally aggregated, retained and disappeared in plain areas. The species of malaria parasites shifted from a co?endemic area for Plasmodium vivax, P. falciparum and P. malariae to a single endemic area for P. vivax, and finally a co?endemic area for imported P. vivax, P. falciparum, P. malariae and P. ovale. The transmission vectors shifted from multiple vectors of Anopheles sinensis, An. minimus, An. anthropophagus and others to a single vector of An. sinensis. Conclusions There are no local malaria cases for successive 6 years since 2012, and the transmission of malaria has been interrupted in Jiangxi Province, in which the criteria for malaria elimination have been achieved. However, the risk of malaria transmission secondary to imported malaria will emerge in Jiangxi Province for a long period of time.
    Epidemiological screening of an epidemic of imported cutaneous leishmaniasis in Luoyang City
    ZHANG Yan-Ling, ZHU Xin, YANG Zhi-Guo
    2019, 31(4):  418. 
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    Objective To understand Leishmania infections among employees of China Petroleum First Construction Corporation returning from Uzbekistan, and take timely actions to prevent the spread of the epidemic. Methods Questionnaire survey was conducted to collect screening subjects’ information. Palpation of the liver, spleen and superficial lymph nodes was performed by a physician, and the lesions on the frequently exposed skin were detected by a dermatologist. In addition, the liver and spleen sizes were measured using B?mode ultrasonography, and serum samples were collected to be subjected to an rK39?based rapid diagnostic test for detection of visceral leishmaniasis. Leishmania was detected using microscopy in the specimens sampled from the lesioned skin, and the parasites species was identified using molecular assays in parasitologically positive specimens. Results Among the 181 employees screened, enlarged cervical lymph nodes were palpable in 6 subjects, and skin lesions were found in 12 cases. B?mode ultrasonography displayed hepatosplenomegaly in 5 cases, and rK39 test were positive in 3 serum samples. Two classical lesioned skin specimens were sampled, and Leishmania was detected in one specimen. The promastigote DNA was extracted and two fragments of 120 bp and 350 bp in sizes were amplified using PCR assay with K13A/K13B and L5.8S/LITSR primers specific to Leishmania. The two amplification products were 90% and 98% homologous to the corresponding sequences of L. major (GenBank accession numbers: EU370906.1 and FN677342.1). Conclusions Six patients with cutaneous leishmaniasis were screened, including 2 uncured cases. One uncured case was diagnosed as imported cutaneous leishmaniasis caused by L. major infection.
    Effect of transfusing blood components containing Babesia microti on B. microti infection in BALB/c mice
    SHEN Hui-Min, CAI Yu-Chun, CHEN Jia-Xu, ZHENG Kui-Yang
    2019, 31(4):  423. 
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    Objective To evaluate the effects of intravenous injection of different blood components containing Babesia microti on B. microti infection in mice. Methods Healthy mice were infected with B. microti, and then blood samples were collected from the mouse orbit to prepare whole blood, serum?free blood components and pure red blood cells containing B. microti. Twenty seven BALB/c mice were divided into three groups, including the whole blood group, the serum?free blood component group and the pure red blood cell group, of 9 mice in each group, and then, each group was divided into three subgroups, of 3 mice in each subgroup, which were injected with 100 μL of blood components containing B. microti at concentrations of 9.00, 0.90, 0.09 B. microti parasites/μL (900, 90, 9 B. microti parasites) via the tail vein, respectively. Blood samples were collected from the mouse tail tip every other day since one day post?injection to prepare thin blood smears. Following Giemsa staining of blood smears, B. microti infection was identified in red blood cells using microscopy. Results Following injection of 900 B. microti parasites, B. microti was identified in the peripheral blood in the whole blood group and the serum?free blood component group 3 days post?injection, and the density of B. microti parasites started to increase 15 days post?injection and peaked 21 days post?injection, with 2.21% and 1.76% rates of B. microti infection in red blood cells, respectively. Subsequently, the density of B. microti parasites declined, and the percentage of B. microti infection in red blood cells tended to be 0 31 days post?injection. During the study period, no B. microti was found in the peripheral blood in the pure red blood cell group. Following injection of 90 B. microti parasites, B. microti was identified in the peripheral blood in the whole blood group 3 days post?injection, and the density of B. microti parasites increased 15 days post?injection and peaked 21 days post?injection, with a 1.35% rate of B. microti infection in red blood cells, while the percentage of B. microti infection in red blood cells tended to be 0 31 days post?injection. During the study period, no B. microti was detected in the peripheral blood in the serum?free blood component group or the pure red blood cell group. Following injection of 9 B. microti parasites, no B. microti was detected in the peripheral blood in the whole blood group, the serum?free blood component group or the pure red blood cell group. Conclusion Blood components and dose of B. microti parasites may affect intravenous injection of B. microti injection in mice, and transfusion of blood components may case a risk of Babesia infection.
    Investigation on Toxoplasma gondii infections among patients with malignant tumors of the digestive tract in Hainan Province
    Li Chun-Yun
    2019, 31(4):  427. 
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    Objective To investigate the prevalence of the serum anti?Toxoplasma gondii antibody among patients with malignant tumors of the digestive tract in Hainan Province. Methods A total of 1 932 patients with malignant tumors of the digestive tract were enrolled in Hainan Province from 2016 to 2019, including 376 esophageal cancer patients, 475 gastric cancer patients, 401 colorectal cancer patients, 427 hepatic cancer patients and 253 pancreatic cancer patients, and 400 healthy people served as controls. The serum IgG and IgM antibodies specific to T. gondii were detected using enzyme?linked immunosorbent assay, and the seroprevalence was compared. Results The overall seroprevalence of anti?T. gondii IgG antibody was significantly greater in patients with malignant tumors of the digestive tract than in healthy controls (19.82% vs. 3.75%; χ2 = 60.49, P < 0.01), and no significant difference was seen in the overall seroprevalence of anti?T. gondii IgM antibody between patients with malignant tumors of the digestive tract and healthy controls (1.09% vs. 0.50%; χ2 = 1.17, P > 0.05). The seroprevalence of anti?T. gondii IgG antibody was 15.16%, 19.58%, 21.70%, 23.65% and 17.79% in patients with esophageal cancer, gastric cancer, colorectal cancer, hepatic cancer and pancreatic cancer, which was all significantly greater than in healthy controls ( χ2 = 29.97, 50.29, 58.03, 67.85 and 36.59; all P < 0.01); however, the seroprevalence of anti?T. gondii IgG antibody in patients with esophageal cancer (1.06%), gastric cancer (1.47%), colorectal cancer (0.75%), hepatic cancer (1.17%) and pancreatic cancer (0.79%) did not differ from that in healthy controls ( χ2 = 0.80, 2.02, 0.20, 1.11 and 0.21; all P > 0.05). There was a significant difference in the seroprevalence of anti?T. gondii IgG antibody among various types of malignant tumors of the digestive tract ( χ2 = 10.65, P < 0.05); however, no significant difference was detected in the seroprevalence of anti?T. gondii IgM antibody ( χ2 = 1.33, P > 0.05). Conclusions There is a high seroprevalence of anti?T. gondii IgG antibody among patients with malignant tumors of the digestive tract in Hainan Province, and there is a significant difference in the seroprevalence in terms of the cancer type. It is suggested that the screening for T. gondii infections should be intensified in patients with malignant tumors of the digestive tract to effective prevent and control the damages to patients with malignant tumors of the digestive tract caused by T. gondii infections.
    Thinking on integration of ideological and political education into Human Parasitology teaching
    CHEN Lin, XU Zhi-Peng, JI Min-Jun, WU Guan-Ling
    2019, 31(4):  431. 
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    To achieve the combination of ideological and political education curriculum and curriculum ideological and political education, the ideological and political education was integrated into the teaching of medical basic course Human Parasitology. Based on improving the cultivation of the teaching team, insisting on morality education and education?directed professional curriculum teaching, the pathway of integrating curriculum ideological and political education into medical science education was explored. Through putting the ideological and political elements contained throughout the professional curriculum teaching process, establishing new teaching patterns of integrating ideological and political education into the curriculum, and strengthening the collaboration between professional institutions and universities, we aimed to build Human Parasitology as a gold ideological and political education curriculum.
    Surveillance of schistosomiasis 34 years after transmission?interruption in Songjiang District, Shanghai City
    SUN Cai-Ying, LU Xue-Hui, JIN Yan-Jun, LYU Xi-Hong, GUO Xiao-Qin, FEI Sheng-Jun, TANG Yi-Ming
    2019, 31(4):  434. 
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    Objective To analyze the surveillance data after schistosomiasis transmission interruption from 1985 to 2018, so as to provide scientific basis for the future prevention and control of schistosomiasis. Methods The data pertaining to snail survey, surveillance of schistosomiasis in humans and livestock, and health education were collected and analyzed in Songjiang District after schistosomiasis transmission interruption from 1985 to 2018. Results From 1985 to 2018, there were 8 townships, 68 villages and 1 462 settings with snails in Songjiang District, covering an area of 96.399 hm2. There were 4 townships and 59 villages with snails newly identified in previously schistosomiasis non?endemic areas, with emerging snail habitats of 60.161 hm2. A total of 26 148 snails were captured, and no infections were detected. The snail habitats were mainly distributed in the river course, ditches and farmlands, which accounted for 45.28%, 33.17% and 21.55% of total snail habitats, respectively. A total of 245 955 humans were subjected to the serological test, with a positive rate of 0.03%, and 37 humans were subjected to the parasitological test, with 3 positives detected. These three egg?positives were all imported chronic cases with schistosomiasis. A total of 9 109 livestock were detected using the serological test, and no infection was found. Most of the awareness rate of schistosomiasis control knowledge and the rate of correct behavior formation were over 80% in residents and students. Conclusions The achievements of schistosomiasis control are consolidated in Songjiang District; however, there are still risk factors of schistosomiasis transmission, including residual snails, snail diffusion and importation of external source of infection. The future surveillance of schistosomiasis should focus on snails and sources of infection.
    Analysis of imported malaria cases in Leshan City from 2012 to 2018
    XIE Ying-Guo, LIU Xin-Liang
    2019, 31(4):  436. 
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    Objective To analyze the epidemiological characteristics of reported malaria cases in Leshan City, so as to provide insights into malaria control. Methods The data pertaining to malaria cases and epidemiological individual information in Leshan City from 2012 to 2018 were captured from the National Notifiable Communicable Disease Reporting System and the Information System for Parasitic Diseases Control and Prevention, and a descriptive epidemiological analysis was performed. Results A total of 34 malaria cases were reported in Leshan City from 2012 to 2018, and all cases were confirmed as imported malaria cases by Sichuan provincial malaria diagnosis reference laboratory. Of all 34 cases, there were 14 vivax malaria cases, 18 falciparum malaria cases, a malariae malaria case and an ovale malaria case. The sites where malaria parasite infections occurred mainly included African areas (accounting for 58.82%) and Southeastern Asian areas (accounting for 29.41%), and the malaria cases were mainly reported in January, February, June and July, which accounted for 65.63% of all cases. The cases included 33 men and a woman, and had ages of 21 to 59 years. The cases’ occupations mainly involved overseas peasants, technical workers and businessmen. The duration from onset of malaria to diagnosis ranged from 0 to 31 days, and the percentage of definitive diagnosis was 85.29% at initial diagnosis. Conclusions There are no local malaria cases in Leshan City; however, imported malaria cases are reported. The monitoring, management and health education of overseas returners should be further strengthened and malaria training should be improved to enhance the diagnostic and treatment capability in professionals, so as to consolidate malaria control achievements.
    Epidemiological investigation of blood transfusion?-nduced malaria caused by an imported case with Plasmodium falciparum infection
    HUANG Wen-Ming, CHEN Jian-Feng, ZHANG Xiang, HE Yi-Lin
    2019, 31(4):  439. 
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    Objective To analyze a case infected with Plasmodium falciparum due to blood transfusion in Taizhou City, so as to provide scientific evidence for malaria control. Methods The epidemiological investigation of a case with P. falciparum malaria was conducted, and the blood donors’ blood samples were collected and detected in laboratory to identify the origin of the infection. Results Microscopy detected Plasmodium in the blood samples from a 64?year?old male inpatient with nephropathy, and P. falciparum malaria was diagnosed. The case had no history of travel to Africa or Southeast Asia except blood transfusion, and he had received blood transfusion 14 times during his hospital stay. Detection of blood donors’ blood samples showed P. falciparum in the archived blood samples from an Indonesian student studying in China, as revealed by PCR assay, and the student was found to have a history of malaria. Conclusions The patient was confirmed to be a case with P. falciparum malaria due to blood transfusion. Screening of malaria should be intensified in blood donors to prevent the development of malaria transmitted by blood transfusion.
    Progress of research on biologically invasive medical molluscs in China
    ZHANG Chao-Qun, DAI Jian-Rong
    2019, 31(4):  441. 
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    Invasion of alien species has increasingly become a major environmental problem that damages human health, economic development and ecological security in China, which has been paid much attention. Until now, there have been 753 invasive species reported in China, and invasive medical molluscs include Pomacea canaliculata, Achatina fulica, and Biomphalaria straminea. This review summarizes the status of biologically invasive species in China, describes the species and distribution of invasive medical molluscs, analyzes the damages of the invasive medical molluscs?transmitted diseases, and proposes the preventive and control measures.
    Advances in researches on mechanism of macrophage migration inhibitory factor regulating parasite?host immune interaction
    HUANG Lin, MA Yuan-Fen, WANG Ling-Jun, ZHENG Ming-Hui, LIU Hui
    2019, 31(4):  446. 
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    Macrophage migration inhibitory factor (MIF), a type of pleiotropic immunoregulatory cytokine with a specific structure, participates in the regulation of host cell growth and migration and immune responses. Following parasitic infections, hosts may produce MIF and then participate in the parasite?host interactions. In addition, parasites may secrete parasite?derived MIF, and they jointly participate in parasite?host interactions. This paper reviews the regulation of MIF gene expression following parasitic infections, the role of MIF in parasite?host immune system interactions, and important signaling pathways of MIF?mediated immune responses.
    Plasmodium falciparum infection by blood transfusion: a case report
    ZHANG Yang, LIN Yong-Ju, TEN Qing, LUO Wei-Feng, CHEN Jin-Yan, FU Yong-Shui
    2019, 31(4):  450. 
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    This paper reported one acute?lymphoblastic?leukemia patient who infected with Plasmodium falciparum after blood transfusion. Through the epidemiological investigation on this patient and the related blood donors as well as laboratory detections, the source of infection was ascertained. This blood donor was an overseas student from Africa, whose blood sample was positive in the rapid diagnostic test, and the results of microscopic examination of?peripheral blood smear and PCR both suggested P. falciparum positive.
    Imported schistosomiasis haematobia in Suzhou City: a case report
    SHI Qian-Wen, GU Jun, SHEN Ling-E, ZHOU Jing, GUO Feng, WANG Hai-Tao
    2019, 31(4):  453. 
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    Objective To report the diagnosis and treatment of an imported case of schistosomiasis haematobia. Methods  The patient’s medical records were collected, and the clinical features, laboratory diagnosis, epidemiological survey, diagnosis and treatment were analyzed. Results The patient had arrived to Sudan and Egypt for many times and had a history of contact with the infested water. After returning to China, the patient reported a gross hematuria with unknown causes. Cystoscopy showed neoplasms in the bladder, and pathologic examinations showed chronic granulomatous inflammation with infiltration of plenty of plasma cells, and parasite eggs. Serological test showed positive for the dipstick dye immunoassay, and the microscopic examination of urine sediment revealed Schistosoma haematobium eggs. Following praziquantel treatment for a month, S. haematobium eggs were still detected in the urine. The case was treated with praziquantel again and cured without adverse reactions. Conclusions Health education should be strengthened among China?aid?African workers to improve the awareness of self?protection. In addition, the diagnosis and treatment should be improved in medical professionals to achieve a timely definitive diagnosis.
    Laboratory diagnosis of an imported case of visceral leishmaniasis in Henan Province
    LI Su-Hua, GAO Li-Jun, ZHANG Ya-Lan, ZHOU Rui-Min, YANG Cheng-Yun, QIAN Dan, LIU Ying, LU De-Ling, ZHAO Yu-Ling, ZHANG Hong-Wei, XU Bian-Li
    2019, 31(4):  456. 
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    Objective To analyze the epidemiological and clinical data of an imported case of visceral leishmaniasis in Henan Province, and explore the method of laboratory diagnosis of kala?azar. Methods The epidemiological and clinical data of an imported visceral leishmaniasis patient were analyzed. Leishmania donovani bodies in bone marrow smears were observed microscopically. The antibody was detected by using rK39 dipstick test strips. Two pairs of specific primers, K13A?K13B and LITSR?L5.8S, were used to amplify kinetoplast DNA and internal transcribed spacer of rDNA of the parasite, respectively. Results The patient had been in the epidemic area of visceral leishmaniasis, and had symptoms such as irregular fever, splenomegaly, pancytopenia, and inversed ratio of albumin and globulin. The amastigotes of L. donovani were found in the bone marrow smears, and rK39 test strip was positive, and the PCR products of K13A?K13B and LITSR?L5.8S were 87 bp and 285 bp respectively. The similarities of the two fragment sequences to the corresponding sequences of L. donovani were 94% and 100%, respectively. Conclusion The case is diagnosed as visceral leishmaniasis according to the epidemiological data, clinical manifestations and laboratory test results of the patient, and the pathogen is L. donovani.