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    16 May 2020, Volume 32 Issue 3
    Moving towards a new era in elimination of schistosomiasis in Dongting Lake regions
    ZHOU Xiao-Nong
    2020, 32(3):  219. 
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    Hunan Province occupies a particular position in the history of the national schistosomiasis control programme of China. The province is hyperendemic for schistosomiasis, and achieves great successes and many experiences at various stages of the national schistosomiasis control programme of China. Recently, remarkable schistosomiasis control benefits have been achieved in Hunan Province because of the strong political will, increased financial support, intensification of the integrated control strategy and sustainable implementation of the four projects, including management of livestock and humans as sources of Schistosoma japonicum infections, snail control and capability building of schistosomiasis control institutions. In addition, a series of schistosomiasis control models have been created from the schistosomiasis control programme, and the concept of control-research combination and research serving for field control has been achieved, which provides the "Hunan experience" for the natonal schistosomiasis control programme of China. Based on the government?led multisectoralcollaboration principle, further actions are required with scientific control and joint prevention and control, implementation of the integrated strategy with emphases on controlling sources of S. japonicum infections and snails, adequate financial support, improved professional capability building, and innovative medical treatment?prevention combination patterns, so as to achieve the goal of schistosomiasis elimination in Hunan Province as soon as possible.
    Implications, spiritual characteristics and practical significance of Chinese schistosomiasis control culture
    DENG Wei-Cheng, LI Yue-Sheng, CHENG Xiang-Hui, REN Guang-Hui, HE Hong-Bin, ZHOU Yi-Biao, ZHANG Yue-Yun, HU Ben-Jiao, LIU Han-Qiu, LU Shi-Kui, LI Sheng-Ming, ZHOU Xiao-Nong
    2020, 32(3):  222. 
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    The culture of schistosomiasis control is specific in the history of Chinese culture. Broadly speaking, the culture of schistosomiasis control is a summary of specific social mood, social consciousness and material culture created by Chinese populations during the progress of schistosomiasis control since the founding of the People’s Republic of China. Narrowly speaking, the culture of schistosomiasis control is the spiritual culture that is jointly created and nurtured by schistosomiasis control workers since the founding of the People’s Republic of China. The spiritual features of Chinese schistosomiasis control culture are characterized by the patriotism and care about the people, the matter?to?fact attitude, the pioneering and enterprising spirit, and the spirit of sacrifice and dedication. The ultimate goal of the research on the culture of schistosomiasis control is to facilitate the achievement of the strategic goal of Healthy China 2030 as scheduled, accelerate the progress towards elimination of schistosomiasis, and to promote the sustainable development of schistosomiasis control in China.
    Challenges and countermeasures of schistosomiasis control in Hunan Province in the new era
    LI Sheng-Ming, DENG Wei-Cheng, CHENG Xiang-Hui, HE Hong-Bin, ZHOU Yi-Biao, ZHOU Jie, HU Ben-Jiao, LIU Han-Qiu, LU Shi-Kui, LI Yue-Sheng, ZHOU Xiao-Nong, REN Guang-Hui
    2020, 32(3):  225. 
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    This paper describes the current epidemic characteristics and endemic status of schistosomiasis, analyzes the main challenges of schistosomiasis control and proposes the emphasis and interventions for future schistosomiasis control activities in Hunan Province, so as to provide insights into the elimination of schistosomiasis in Hunan Province.
    Effect of integrated schistosomiasis control measures in Hunan Province from 2004 to 2019
    TANG Ling, ZHOU Jie, ZHAO Zheng-Yuan, WANG Hui-Lan, JIANG Qiong, LIAN Hua, WU Xiang, JIANG Li-Ping, HAN Yang-Qing, REN Guang-Hui, DENG Wei-Cheng
    2020, 32(3):  230. 
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    Objective To examine the effect of the integrated schistosomiasis control measures in Hunan Province from 2004 to 2019, so as to provide insights into the development of the schistosomiasis elimination strategy. Methods The integrated schistosomiasis control measures implemented by the health, agriculture, water resources, forestry, land and resources sectors were retrospectively collected in Hunan Province from 2004 to 2019, and the completion of each measure, cost of control measures, Schistosoma japonicum infections in humans and bovines, and snail status were analyzed each year. An index system for assessing the integrated schistosomiasis control effect was constructed using the Delphi method to calculate the integrated schistosomiasis control effect index. In addition, a cost?effect analysis was performed in terms of the decline in the prevalence of S. japonicum infections in humans and bovines, areas with snails in inner embankments, and areas with infected snails. Results  A total of 7 110 926 500 Yuan were invested into the integrated schistosomiasis control program of Hunan Province from 2004 to 2019. During the 16?year period, a total of 277 437.12 hm2 snail habitats received molluscicidal treatments, 6 927 230 person?times given expanded chemotherapy, 2 116 247 bovine?times given expanded chemotherapy, 954 850 harmless toilets built, 290 359 bovines fenced, 136 666 bovines eliminated, 141 905 machines used to replace bovines, 39 048.63 hm2 water lands improved as dry lands, 724.12 km irrigation regions improved, 3 994 300 populations covered with safe water, 191 102.89 hm2 forests planted and 38 535.27 hm2 lands leveled. The prevalence of S. japonicum infections was 4.29% in humans and 4.48% in bovines in Hunan Province in 2004, with 2 449.37 hm2 snail habitats in inner embankments and 3 423.74 hm2 infected snail areas. In 2019, the prevalence of S. japonicum infections reduced to 0 in both humans and bovines, and areas of snail habitats reduced to 540.92 hm2 (77.92% reductions), while the areas with infected snails reduced to 0. The overall integrated schistosomiasis control effect index appeared a tendency towards a rise over years since 2004, and the integrated schistosomiasis control effect index was 97.35 in 2019; the annual mean costs for a 1% reduction in the prevalence of S. japonicum infections in 100 populations and 100 bovines were 70.11 Yuan and 4 204.78 Yuan, and the annual mean costs for a 1% reduction in the snail areas in inner embankments and infected snail areas were 2 010.20 Yuan and 1 298.09 Yuan, respectively. Conclusions The integrated control measures achieve remarkable effectiveness for schistosomiasis control in Hunan Province, with a remarkable decline in the prevalence of S. japonicum infections in humans and bovines and great shrinking of snail areas in inner embankments and infected snail areas. Adequate fund investment is required to improve the integrated schistosomiasis control measures and consolidate the control achievements.
    Application of the exponential smoothing model and ARIMA model in prediction of the endemic situation of schistosomiasis in Hunan Province
    ZHOU Jie, REN Guang-Hui, HE Hong-Bin, HOU Xun-Ya, DENG Wei-Cheng
    2020, 32(3):  236. 
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    Objective To predict the changes in the prevalence of Schistosoma japonicum infections in humans and livestock in Hunan Province using the exponential smoothing model and the ARIMA model. Methods The data pertaining to S. japonicum infections in humans and livestock in Hunan Province from 1957 to 2015 were collected, and the exponential smoothing model and the ARIMA model were created using the software Eviews and PASW Statistics 18.0. In addition, the effectiveness of these two models for the prediction of S. japonicum infections in humans and livestock in Hunan Province from 2016 to 2018 was evaluated. Results The exponential smoothing model and the ARIMA model had a high goodness of fit for prediction of S. japonicum infections in humans and livestock in Hunan Province from 1957 to 2015. There was a linear trend in the prevalence of S. japonicum infections in humans and livestock in Hunan Province from 1957 to 2015. The prevalence of S. japonicum infections in humans predicted with the Brown’s linear trend and the prevalence of S. japonicum infections in livestock predicted with the Holt’s linear trend in Hunan Province from 2016 to 2018 fitted better the actual data than the ARIMA model; however, prediction of the ARIMA model indicated that the endemic situation of schistosomiasis remained at a low level in Hunan Province. Conclusion At a low epidemic level, development of highly sensitive tools for monitoring schistosomiasis is urgently needed in Hunan Province to fit the current endemic situation, and the schistosomiasis control measures should be intensified to consolidate the control achievements.
    Endemic situation of schistosomiasis in national surveillance sites of Hunan Province from 2015 to 2019
    LI Guang-Ping, YU Xin-Ling, WU Xiang, ZHAO Zheng-Yuan, XIA Meng, DENG Yi, ZHANG Jie, LUO Zhen-Hua, MAO Wei, JIANG Qiong, WANG Jun
    2020, 32(3):  242. 
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    Objective To analyze the changes in the endemic situation of schistosomiasis in national surveillance sites of Hunan Province, so as to provide scientific basis for the development of the schistosomiasis elimination programme in the province. Methods According to the requirements of the National Guidelines for Schistosomiasis Surveillance in China (2014 version), a total of 41 national schistosomiasis surveillance sites were assigned in all disease?endemic counties (districts) across Hunan Province. During the period between 2015 and 2019, Schistosoma japonicum infections were monitored in local residents, mobile populations and livestock, and snail status was monitored. The morbidity due to schistosomiasis and snail status was compared between years. Results The sero?prevalence of S. japonicum infections was 2.57% and 1.56% in local residents and mobile populations in national surveillance sites of Hunan Province from 2015 to 2019, respectively, and the sero?prevalence appeared a tendency towards a decline over years. A higher sero?prevalence rate of S. japonicum infections was seen in men than in women (P < 0.01). During the 5?year study period, the sero?prevalence rate of human S. japonicum infections appeared a tendency towards a decline in the marshland, embankment, inner embankment and hilly types of endemic areas over years. There were 44 and 19?egg?positives detected in local residents?and 5 and 1 egg?positives in mobile populations in 2015 and 2016?respectively.?A total of 9 346 domestic animals were monitored from 2015 to 2019, and 6 egg?positives were detected in 2015 and 2016 (all were bovine). A total of 0.155 billion m2 settings were surveyed from 2015 to 2019, and the mean density of living snails appeared a tendency towards a decline over years, with a 45.79% reduction in 2019 as compared to 2015. However, no S. japonicum infections were identified in snails during the 5?year period. A total of 1 469 mixed snail samples were detected using loop?mediated isothermal amplification (LAMP), and 6 positive snail samples were identified in 2015 (one sample) and 2017 (5 samples). Conclusions The overall endemic situation of schistosomiasis appears a tendency towards a decline in Hunan Province, and the prevalence of S. japonicum infections is at a low level in humans and livestock; however, there is still a risk of schistosomiasis transmission. Improvements of health education, intensification of schistosomiasis examinations in mobile populations and reinforcement of the surveillance?response system is required to consolidate the achievements of schistosomiasis control in Hunan Province.
    Cloning and sequence analysis of leptin receptor overlapping transcript-like 1 gene from Dermatophagoides farinae
    YANG Hua-Ying, ZHU Han-Ting, CUI Yu-Bao
    2020, 32(3):  248. 
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    Objective To obtain the leptin receptor overlapping transcript?like 1 encoding gene (LepROTL1 gene) from Dermatophagoides farina, investigate the molecular characteristics of the gene and construct a prokaryotic expression vector to express this gene. Methods The LepROTL1 gene?encoding sequence fragments were captured based on the transcriptome sequencing results, and the full?length gene fragments were amplified from total RNA of D. farinae using a RT?PCR assay, and used to construct the expression plasmid pET28a(+)?LepROTL1, followed by sequencing. The plasmid was transformed into E. coli BL21 (DE3) T1R for the induction of IPTG expression. The expression product was characterized by SDS?PAGE and Western blotting. Bioinformatics analyses were performed to analyze the sequence and the molecular characteristics of its encoded protein. Results The amplification products of the RT?PCR assay showed a clear band on agarose gel electrophoresis, and sequencing analysis of the pET28a(+)?LepROTL1 plasmid showed 417 bp in length of the coding gene from the start codon ATG to the termination codon TAA. Following the plasmid transformation into E. coli and induction with IPTG, a specific band was seen on SDS?PAGE, indicating successful expression. Bioinformatics analysis showed that the LepROTL1 gene?encoded protein was composed of 134 amino acids, and had a relative molecular weight of 14 378.13 Da, a hydrophilicity index of 1.149, and certain hydrophobicity. The secondary structure was composed of alpha?helix (19 aa, 14.18%), extended strand (48 aa, 35.82%) and random coil (67 aa, 50.00%). The deduced amino acid sequence was used to obtain homologous genes by BLAST, and the phylogenetic tree showed that D. farinae was clustered with D. pteronyssinus. Conclusion The full?length sequences and expression plasmid of the LepROTL1 gene are obtained, and the molecular features of the gene are demonstrated using bioinformatics analyses, which provide insights into further studies on the gene.
    Impact of gender on hepatic pathology and antibody-mediated immunity caused by Schistosoma japonicum infection in C57BL/6 mice
    WANG Chun, ZHANG Li-Na, TANG Rui, QI Xin, YU Yan-Xiong, YU Bei-Bei, CHEN Ying, WANG Jun-Ling, ZHOU Sha,CHEN Xiao-Jun, LI Ya-Lin, ZHU Ji-Feng, SU Chuan
    2020, 32(3):  255. 
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    Objective To investigate the effect of gender on hepatic pathology and antibody?mediated immunity in Schistosoma japonicum?infected C57BL/6 mice. Methods Female and male C57BL/6 mice were infected with S. japonicum, and the hepatic pathological changes were observed using HE and picrosirius red staining in mice 8 weeks post?infection. The serum specific IgG antibody levels against the soluble adult worm antigen (SWA) and soluble egg antigen (SEA) were measured in mice using enzyme?linked immunosorbent assay (ELISA), and the percentages of follicular helper T (Tfh) cells and regulatory T (Treg) cells were detected in mouse spleen and lymph nodes using flow cytometry. Results HE staining showed no significant difference in the mean area of a single hepatic egg granuloma between female and male mice 8 weeks post?infection with S. japonicum [(28.050 ± 3.576) × 104 μm2 vs. (26.740 ± 4.093) × 104 μm2; t = 0.241, P = 0.821], and picrosirius red staining revealed no statistical differences between female and male mice in terms of the mean proportion of picrosirius red stained hepatic tissues [(7.667 ± 1.856)% vs. (7.667 ± 1.764)%; t = 0, P = 1] or the mean optical density [(0.023 ± 0.003) vs. (0.027 ± 0.007); t = 0.447, P = 0.678]. ELISA detected no significant differences in the serum IgG antibody levels against SWA [(2.098 ± 0.037) vs. (1.970 ± 0.071); t = 1.595, P = 0.162] or SEA [(3.738 ± 0.039) vs. (3.708 ± 0.043); t = 0.512, P = 0.623] between female and male mice 8 weeks post?infection with S. japonicum. Flow cytometry detected significantly greater percentages of Tfh cells in the spleen [female mice, (8.645 ± 1.356)% vs. (1.730 ± 0.181)%, t = 5.055, P = 0.002; male mice, (8.470 ± 1.161)% vs. (1.583 ± 0.218)%, t = 5.829, P = 0.001] and lymph nodes [female mice, (3.218 ± 0.153)% vs. (1.095 ± 0.116)%, t = 11.040, P < 0.001; male mice, (3.673 ± 0.347)% vs. (0.935 ± 0.075)%, t = 8.994, P = 0.001) of both female and male mice 8 weeks post?infection with S. japonicum than in uninfected mice; however, no significant differences were seen between female and male mice 8 weeks post?infection with S. japonicum in terms of the percentages of Tfh cells in the spleen [(8.645 ± 1.356)% vs. (8.470 ± 1.161)%; t = 0.098, P = 0.925] or lymph nodes [(3.218 ± 0.153)% vs. (3.673 ± 0.347)%; t = 1.332, P = 0.241]. There was no significant difference in the proportion of Treg cells in the spleen of male mice between infected and uninfected mice [(10.060 ± 0.361)% vs. (10.130 ± 0.142)%; t = 0.174, P = 0.867], while a higher proportion of Treg cells was seen in the spleen of female mice 8 weeks post?infection with S. japonicum than in uninfected mice [(10.530 ± 0.242)% vs. (9.450 ± 0.263)%; t = 3.021, P = 0.023]. There was no significant difference in the proportion of Treg cells in the spleen between female and male mice infected with S. japonicum [(10.530 ± 0.242)% vs. (10.060 ± 0.361)%; t =1.077, P = 0.323]. In addition, the proportions of Treg cells were significantly greater in the lymph node of S. japonicum?infected female [(17.150 ± 0.805)% vs. (13.100 ± 0.265)%; t = 4.781, P = 0.003] and male mice [(18.550 ± 0.732)% vs. (12.630 ± 0.566)%; t = 6.402, P = 0.001] than in uninfected mice; however, no significant difference was seen between female and male mice 8 weeks post?infection [(17.150 ± 0.805)% vs. (18.550 ± 0.732)%; t = 1.287, P = 0.246]. Conclusion There are no gender?specific hepatic pathological changes or antibody?mediated immunity in C57BL/6 mice post?infection with S. japonicum.
    Study on immunological functions of heat shock protein 40 kDa of Schistosoma japonicum
    YU Yan-Xiong, LI Sha-Sha, ZHU Ji-Feng, CHEN Xiao-Jun, XU Zhi-Peng, LI Ya-Lin, ZHOU Sha, SU Chuan
    2020, 32(3):  262. 
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    Objective To investigate the immunological functions of heat shock protein 40 kDa of Schistosoma japonicum (SjHSP40). Methods The homology of the SjHSP40 protein sequence was analyzed and the B and T cell epitopes of SjHSP40 were predicted using bioinformatics tools. The full?length SjHSP40 gene was amplified using a PCR assay, and cloned into the prokaryotic expression vector pGEX?6P?1, which was transformed into Escherichia coli BL?21. The protein expression was induced with isopropyl β?D?thiogalactoside (IPDG), and then, the recombinant protein was purified with glutathione?sepharose 4B resin to yield the fusion protein GST?SjHSP40, which was checked with SDS?PAGE and Western blotting. Following immunization with GST?SjHSP40, the serum levels of anti?SjHSP40 IgG antibody and IgG1 and IgG2a subtypes were detected in BALB/c mice using ELISA. In addition, the effect of SjHSP40 on CD4+ T?cell subset differentiation was examined using flow cytometry. Results SjHSP40 contained 7 potential B cell epitopes and multiple T cell epitopes (CTL epitopes and Th epitopes). The prokaryotic expression plasmid pGEX?6p?1?SjSHP40 was successfully constructed, and the fusion protein GST?SjHSP40 was obtained following IPDG induction and protein purification. Significantly higher serum levels of anti?SjHSP40 IgG, IgG1 and IgG2a antibodies were detected in mice immunized with GST?SjHSP40 than in other groups; however, SjHSP40 showed no remarkable effects on CD4+ T?cell subset differentiation. Conclusions SjHSP40 may induce specific humoral immune responses in mice; however, it does not affect the balance of Th immune responses. It is suggested that SjHSP40 may be a potential vaccine candidate.
    Spatial distribution characteristics of reported echinococcosis patients in Inner Mongolia Autonomous Region from 2013 to 2018
    JIANG Xiao-Feng, FENG Ke-Min, HAO Hui-Xia, SONG Jian, GUO Wei-Dong
    2020, 32(3):  268. 
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    Objective To investigate the spatial distribution patterns and changing tendency of reported echinococcosis patients in Inner Mongolia Autonomous Region from 2013 to 2018, so as to provide the evidence for the management of echinococcosis in high?risk areas. Methods All data pertaining to echinococcosis patients in Inner Mongolia Autonomous Region were captured from the National Notifiable Communicable Disease Reporting System from 2013 to 2018 and analyzed using a spatial epidemiological method. Results The incidence of reported echinococcosis was 0.22 to 0.41 per 100 000 in Inner Mongolia Autonomous Region from 2013 to 2018, and the number of banner reporting echinococcosis patients increased from 24 in 2013 to 39 in 2018. The highly prevalent areas of echinococcosis were mainly concentrated in West Ujimqin Banner (the highest incidence, 19.23 per 100 000), East Ujimqin Banner (the highest incidence, 12.93 per 100 000) and New Barag Right Banner (the highest incidence, 11.66 per 100 000). Three?dimensional trend analysis showed that the areas with high incidence of reported echinococcosis were mainly located in central by eastern parts of Inner Mongolia Autonomous Region. There was a positive spatial autocorrelation in the number of echinococcosis patients, and the cases appeared a clustering distribution (Moran’s I > 0, P < 0.05), with “high?high” and “low?high” regions. Conclusion The reported echinococcosis patients show a spatial aggregation in Inner Mongolia Autonomous Region, and the hotspot areas are mainly concentrated in Xilingol League and Chifeng City, in which targeted control interventions for Inner Mongolia Autonomous Region are recommended to be intensified.
    Knowledge, attitude and practice of echinococcosis prevention and control, and their influencing factors among residents living in Seda County, Sichuan Province
    LEI Ya-Lin, XIAO Cheng-Han, MA Xiao
    2020, 32(3):  273. 
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    Objective To understand the status of knowledge, attitude and practice on echinococcosis prevention and control and investigate their influencing factors among residents living in Seda County of Sichuan Province, so as to provide a scientific basis for the further implementation of health education interventions in the county. Methods A multi?stage stratified random sampling method was employed on September 2018. Ten townships were randomly sampled, and 2 to 3 administrative villages were randomly sampled from each township. Then, 20 to 40 households were randomly sampled from each village, and 1 to 2 villagers were investigated in each household. The knowledge, attitude and practice on echinococcosis prevention and control were investigated using a household questionnaire survey, and the factors affecting the qualification of echinococcosis prevention and control knowledge were identified using chi?square test and logistic regression analysis. Results A total of 760 questionnaires were assigned, and 748 effective questionnaires were recovered, with a recovery rate of 98.42%. The overall qualification rate of echinococcosis prevention and control knowledge was 56.42% (422/748) in residents living in Seda County, and the awareness of the question “How to get echinococcosis?” was only 48.40%. The proportion of subjects with a positive attitude towards echinococcosis prevention and control was 64.71% to 94.79%, and the rate of corrected echinococcosis prevention and control behaviors was 10.40% to 82.45%. Univariate analysis showed that factors affecting the qualification rate of echinococcosis prevention and control knowledge included gender, occupation, education level, frequency of echinococcosis screening and frequency of health education (all P < 0.05), and binary logistic regression analysis showed that women, herdsmen as the primary occupation, an education level of primary school and below, absence of echinococcosis screening and absence of health education were factors responsible for the unqualified awareness of echinococcosis prevention and control knowledge (all P < 0.05). Conclusions There is a low awareness rate of echinococcosis prevention and control knowledge and a low proportion of corrected echinococcosis prevention and control behaviors in residents living in Seda County, Sichuan Province. Multiple forms of health education activities pertaining to echinococcosis prevention and control are needed with adaptation to local circumstance, and implementation of appropriate behavioral interventions is recommended.
    Investigation on the risk of of Anisakis infection among high-risk populations along the coastal areas of Jiangsu Province
    MAO Fan-Zhen, SUN Bo-Chao, NI Bi-Xian, ZHANG Xue-Yan, WU Xiao-Min, DING Xin, ZHANG Qiang, XU Xiang-Zhen, JIN Xiao-Lin, DAI Yang, CAO Jun
    2020, 32(3):  282. 
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    Objective To investigate the risk of Anisakis infections among high?risk populations along the coastal areas of Jiangsu Province, so as to develop the strategy for the prevention and control of anisakiasis in the province. Methods Three counties along the coastal areas of Jiangsu Province were selected as the study sites in 2018, including Rudong County in Nantong City, Haizhou District in Lianyungang City and Dongtai City in Yancheng City. The knowledge, attitude and practice (KAP) of anisakiasis prevention and control, and the prevalence of serum specific IgG antibody against Anisakis were investigated among high?risk populations among these three study sites, including fishermen, fish seller and people who liked eating fresh and live marine fish. Factors affecting the prevalence of the specific IgG antibody against Anisakis were identified using a multiple logistic regression model. In addition, Anisakis larvae infections were detected in fresh and live marine fish samples collected from local markets, and the prevalence and intensity of Anisakis infections were estimated. Results A total of 625 high?risk populations were investigated, including 349 men (55.8%). Only 13.0% of the subjects heard about anisakiasis, and a low awareness rate of anisakiasis prevention and control knowledge was seen among these three types of high?risk populations. There were 21.6% of the subjects eating raw or half?cooked marine fish, 5.8% eating undercooked marine fish, 3.2% presenting vomiting, nausea and diarrhea after eating marine fish, 5.1% developing systemic allergic symptoms, and 65.6% using the same chopping board for raw and cooked food. The sero?prevalence of the anti?Anisakis IgG antibody was 7.0% among the study subjects. Multiple logistic regression analysis identified education level [OR = 0.687,95% CI (0.478,0.987)] and development of systemic allergic symptoms [OR = 4.641,95% CI(1.411,15.268)]as factors affecting the positive anti?Anisakis IgG antibody among the study subjects. Among 494 fresh and live marine fish detected, the prevalence and intensity of Anisakis larvae infection was 64.0% and 8.1 larvae per fish, with high prevalence seen in Trichiurus haumela and Pneumatophorus japonicas. Conclusions The awareness of anisakiasis prevention and control knowledge is low among the high?risk populations living along the coastal areas of Jiangsu Province, and there are high?risk behaviors, such as eating raw or half?cooked food, using the same chopping board for raw and cooked food. In addition, the prevalence of Anisakis infections is high in the marine fish in these areas. Therefore, the health education and health promotion for anisakiasis prevention and control should be intensified.
    Effects of copper and cadmium ions on protective enzyme activity in Oncomelania hupensis
    GAO Meng-Yang, ZHANG Qin, TANG Xiao-Niu, ZHOU Shu-Lin
    2020, 32(3):  290. 
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    Objective To evaluate the effects of Cu2+ and Cd2+ at different concentrations on superoxide dismutase (SOD), catalase (CAT) and peroxidase (POD) activity in Oncomelania hupensis. Methods Cu2+? and Cd2+?containing solutions were prepared at 7 concentrations, and O. hupensis snails were exposed to the solutions for 24 h, of 15 snails in each concentration. Then, the snail body was collected following removal of the snail shell and homogenated, and the SOD, CAT and POS activities were detected in the supernatants. Results With the increase of the Cu2+ concentration, the SOD activity appeared a rise followed by a reduction in O. hupensis snails, and the CTA activity appeared a decline?rise?decline tendency, while the POD activity showed a tendency towards rise followed by decline. With the increase of the Cd2+ concentration, the SOD activity appeared a rise followed by a reduction in O. hupensis snails, and the CTA activity appeared a decline?rise?decline tendency, while the POD activity showed a decline?rise?decline tendency. Conclusion Exposure to Cu2+ and Cd2+ at high concentrations results in a decline in the activity of SOD, CAT and POD in O. hupensis at the same time.
    Effect of several human metabolic compounds for trapping Culex pipiens quinquefasciatus
    WU Hua, DAI Jian-Qing, CHEN Da-Song, HUANG Hong
    2020, 32(3):  294. 
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    Objective To evaluate the indoor effect of six human metabolic compounds for trapping adult Culex pipiens quinquefasciatus. Methods The effects of six human metabolic compounds alone (acetic acid, propionic acid, octanoic acid, lactic acid, 1?octene?3?alcohol and urea alone), liquid lactic acid, acetic acid, propionic acid, octanoic acid, lactic acid or 1?octene?3?alcohol in combination with urea at an equal mass ratio, and lactic acid?urea combinations at various mass ratios, for trapping Cx. p. quinquefasciatus were examined using the trapping method, while the dechlorinated water served as a control. Results The indoor mosquito?trapping efficacy of the six human metabolic compounds was all superior to the dechlorinated water. Acetic acid, propionic acid, octanoic acid, or 1?octene?3?alcohol combined with urea at a mass ratio of 1∶1 had a comparable mosquito?trapping efficacy with acetic acid, propionic acid, octanoic acid, or 1?octene?3?alcohol alone (all P values > 0.05). The lactic acid?urea combination at a mass ratio of 1∶1 had a significantly higher mean cumulative trapping capacity [(35.60 ± 8.11) mosquitoes]than lactic acid [(20.80 ± 8.53) mosquitoes], urea [(17.00 ± 7.18) mosquitoes] or dechlorinated water alone (7.20 ± 2.68) (all P values < 0.05). In addition, the lactic acid?urea combinations at mass ratios of 1∶1, 1∶2, 1∶3, 1∶4 or 1∶5 all had significantly greater mosquito?trapping efficacies than lactic acid, urea or dechlorinated water alone (all P values < 0.05), and the optimal combination (lactic acid?urea at a 1∶4 mass ratio) had a mean cumulative trapping capacity of (56.20 ± 9.88) mosquitoes, which was significantly superior to lactic acid [(17.00 ± 3.94) mosquitoes], urea [(16.40 ± 3.78) mosquitoes] or dechlorinated water alone [(7.40 ± 3.44) mosquitoes] (all P values < 0.05). Conclusions The lactic acid?urea combination remarkably increases the indoor trapping capability of Cx. p. quinquefasciatus, and this combination has a weak smell, which is suitable to be used at home and office environments.
    Epidemic status of malaria and progress of malaria elimination in Henan Province, 18
    YANG Cheng-Yun, QIAN Dan, LU De-Ling, LIU Ying, ZHOU Rui-Min, LI Su-Hua, ZHANG Hong-Wei, ZHAO Yu-Ling
    2020, 32(3):  298. 
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    Objective To understand the epidemic status of malaria and progress of malaria elimination in Henan Province in 2018, so as to provide the scientific evidence for formulating the control strategy of malaria. Methods All data pertaining to the epidemic status of malaria and malaria case were captured from Henan Province in 2018, and the epidemic status of malaria and the diagnosis and treatment of malaria cases were analyzed using a descriptive epidemiological method. Results A total of 174 malaria cases were reported in Henan Province in 2018, with a male?to?female ratio of 33.8∶1. The cases were predominantly found at 30- and 40- years, and farmer was the highest?risk population. All cases were imported for overseas countries and 96.55% (168/174) were from Africa. The cases were reported across 17 cities of the province, and 63.22% (110 cases) were detected in 4 cities of Zhengzhou, Luoyang, Xuchang and Puyang. Both the median duration from onset to initial admission and the median time from the initial admission to definitive diagnosis were 1 d. There were 6 cases (3.45%) with more than 7 days to visit a doctor, and there were 13 cases (7.47%) with definitive diagnosis of over 7 days (delay in definitive diagnosis). All malaria cases were reported within 24 h, and 98.28% (171/174) completed case investigations within 3 d. All 18 cities had achieved malaria elimination by December 2018. Conclusions All malaria cases reported in Henan Province in 2018 are imported from overseas countries. Intensifying malaria surveillance among returnees from Africa and Southeast Asia and timely identification and treatment of imported malaria cases are required to prevent the development of secondary malaria cases, so as to ensure the achievement of malaria elimination in Henan Province on schedule.
    Endemic situation of schistosomiasis in national surveillance sites of Anhui Province from 2015 to 2018
    LI Ting-Ting, DING Song-Jun, HE Jia-Chang, ZHANG Shi-Qing, WANG Tian-Ping, WANG Hao, GAO Feng-Hua
    2020, 32(3):  301. 
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    Objective To analyze the endemic situation of schistosomiasis in national surveillance sites of Anhui Province from 2015 to 2018, so as to provide scientific evidence for schistosomiasis control and prevention in Anhui Province. Methods  According to the National Schistosomiasis Surveillance Programme (2014 version), a total of 51 national schistosomiasis surveillance sites were assigned in Anhui Province in 2015, and Schistosoma japonicum infections in humans and livestock and snail distribution were monitored from 2015 to 2018. Results A total of 89 638 local residents and 42 609 mobile populations received serological screening of schistosomiasis in 51 national surveillance sites of Anhui Province from 2015 to 2018, and the sero?prevalence of S. japonicum infections was 1.41% to 3.69% in local residents and 0.84% to 2.13% in mobile populations, respectively. There were 5 egg?positive local residents and 1 egg?positive mobile populations detected in 2015, with occupations of farmers and fishermen. There were 6 405 livestock detected for S. japonicum infections, and no egg?positives were identified. Among an area of 12 661 hm2 surveyed in the national schistosomiasis surveillance sites of Anhui Province from 2015 to 2018, the areas of snail habitats were 2 461.27 to 2 628.96 hm2, and the mean density of living snails was 0.375 7 to 0.433 0 snails/0.1 m2, with no S. japonicum infections identified in snails. Conclusions The endemic situation of schistosomiasis is at a low level in Anhui Province; however, the risk of schistosomiasis transmission remains in local regions of the province. The construction of the surveillance?response system should be reinforced to consolidate the achievements of schistosomiasis control in Anhui Province.
    Serum vitamin D expression in advanced schistosomiasis patients with hepatic fibrosis and its association with disease progression
    ZHOU Li-Yun, WU Yi-Ming, ZHANG Li-Fang
    2020, 32(3):  304. 
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    Objective To compare the expression of serum vitamin D in advanced schistosomiasis patients with grade I and II hepatic fibrosis, and to preliminarily examine its associations with the internal diameter of the main portal vein and progression of hepatic fibrosis. Methods The medical records of 126 advanced schistosomiasis patients with grade I and II hepatic fibrosis referred to Jiaxing First Hospital from March 2012 to September 2015 were retrospectively analyzed. The internal diameter of the main portal vein and serum 25?hydroxyvitamin D3 [25(OH)D3] level were measured. The progression of hepatic fibrosis was followed up, and the serum vitamin D level was compared between patient with disease progression and stable disease. Results The 126 advanced schistosomiasis patients included 72 men and 54 women, and had ages of 62 to 80 years. There were 58 cases with grade I hepatic fibrosis and 68 cases with grade II hepatic fibrosis. There were significant differences between patients with grade I and II hepatic fibrosis in terms of hemoglobin, white blood cell count, prothrombin time, international normalized ratio, activated partial thromboplastin time, fibrinogen or 25(OH)D3 level (all P > 0.05), and significant differences were seen in alanine aminotransferase, aspartate aminotransferase, blood calcium, blood phosphorus levels and the internal diameter of the main portal vein (all P values < 0.05). In addition, a lower serum 25(OH)D3 level was detected in patients with broadened internal diameter of the main portal vein than in those with normal internal diameter of the main portal vein [(19.08 ± 1.36) nmol/L vs. (25.61 ± 6.69) nmol/L, P < 0.05]. Following 3?year follow?up, there were 73 cases with progression of hepatic fibrosis, and a significantly lower serum vitamin D level was found in patients with disease progression than in those with stable disease [(20.00 ± 0.81) nmol/L vs. (25.47 ± 5.91) nmol/L, P < 0.05]. Conclusions Vitamin D deficiency is common in advanced schistosomiasis patients with hepatic fibrosis, and it may be associated with the internal diameter of the main portal vein and the progression of hepatic fibrosis disease.
    Effect of rational emotive therapy on negative emotion in advanced schistosomiasis patients with repeated hospitalization
    ZHOU Rui-Hong, YU Hui-Qiong, LIU Jia-Xin, XIAO Cui-Lan, PAN Jie, LAI Ru-Yi, LI Li-Le
    2020, 32(3):  308. 
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    Objective To examine the effect of rational emotive therapy on negative emotions among advanced schistosomiasis patients with repeated hospitalizations. Methods A total of 97 advanced schistosomiasis patients with anxiety and depressive emotions that were hospitalized in Xiangyue Hospital of Hunan Institute of Schistosomiasis Control for three times or more were enrolled, and given rational emotive therapy for 4 weeks in addition to routine nursing care. The scores for anxiety, depression and quality of life were estimated in patients before and after the rational emotive therapy using the Self?Rating Anxiety Scale (SRS), the Self?Rating Depression Scale (SDS) and WHOQOL?BREF Form. Results The SAS and SDS scores were significantly lower 4 weeks following rational emotive therapy than before the intervention (SAS score, 45.40 ± 7.77 vs. 59.25 ± 9.29, t = 14.021, P < 0.01; 51.48 ± 8.01 vs. 63.93 ± 9.59, t = 12.991, P < 0.01). The percentages of patients with moderate and severe anxiety and depression were significantly lower 4 weeks following rational emotive therapy than before the intervention (P < 0.01), and the scores for each item in the quality of life were all significantly greater 4 weeks following rational emotive therapy than before the intervention (P < 0.01). Conclusion Rational emotive therapy may improve the negative emotions and the quality of life of advanced schistosomiasis patients with repeated hospitalizations.
    Survey of the capacity building of the county-level schistosomiasis diagnosis network laboratory in Hunan Province
    XIA Meng, YU Xin-Ling, HE Hong-Bin, LI Guang-Ping, WU Xiang, DENG Yi, LUO Zhen-Hua, ZHANG Jie
    2020, 32(3):  311. 
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    Objective To examine the construction and operation of the schistosomiasis diagnostic network platform in Hunan Province, so as to provide insights into the improvements of the schistosomiasis diagnostic network laboratory system in the province. Methods According to the criteria and requirements for the construction of the county?level schistosomiasis diagnostic network laboratory in China, the establishment and operation of the laboratory were assessed using self?assessment and field review in national schistosomiasis surveillance sites of Hunan Province. Results A total of 41 county?level schistosomiasis diagnostic network laboratories were built in national schistosomiasis surveillance sites of Hunan Province, and 36 met the requirements for the construction of the national schistosomiasis diagnostic network laboratory in China, which were approved for inclusion in the province?level schistosomiasis diagnostic network laboratory. During the six inter?laboratory comparisons performed by the national schistosomiasis diagnostic reference center of China, full consistency was achieved by 3 county?level schistosomiasis diagnostic network laboratories in Hunan Province, and the coincidence rates for re?review of serological and pathogenic detection samples were 98.40% and 100%, respectively. Conclusion The county?level schistosomiasis diagnostic network laboratory system has been preliminarily built and under effective operation in Hunan Province; however, the building capability remains to be improved.
    Investigation of epidemic status of clonorchiasis sinensis in western regions of Jilin Province
    XU Chang-Xi, WANG Xin, WANG Shu-Ya, WANG Ben-He
    2020, 32(3):  314. 
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    Objective To understand the epidemic status of clonorchiasis sinensis in western region of Jilin Province, so as to provide the evidence for formulating the planning and strategy of prevention and control of the disease. Methods In 2017, the areas where the residents had the customs of eating Sashimi were selected as the research areas in the western region of Jilin Province, and according to the cluster sampling, 25 villages in 25 towns (each village per town) of 5 counties in the region were selected as the investigation points. The basic information of crowd was collected by a questionnaire investigation. The Kato?Katz method was used for etiological examinations. The results were analyzed statistically. Results A total of 4 980 people in the 25 villages were investigated, and 1 220 people were infected with Clonorchis sinensis. The average infection rate was 24.50%. There was a significant difference among different counties (cities, districts) in the infection rate of C. sinensis (P < 0.01), and the infection rate in Daan City was the highest (53.82%). In addition, there were significant differences between/among the gender, nation, age, educational level, and occupation in the infection rate (all P values < 0.01). The infection rate of the male was higher than that of the female, the rate of Han was higher than that of other ethnic groups, the rate of the high age group was higher than that of the low age group, the rate of the college degree group was higher than that of the other educational level groups, the rate of the cadre was higher than that of the other occupation groups, and the rate of the group who had vermifuge before the investigation was lower than that of the group who did not have vermifuge. Conclusions The western region of Jilin Province is still the high?incidence area of clonorchiasis sinensis. Therefore, the comprehensive control and prevention measures, such as giving vermifuge and health education, should be strengthened in key population and areas in the future.
    Endemic situation of schistosomiasis in Hunan Province in 2019
    WANG Hui-Lan, ZHOU Jie, JIANG Qiong, WU Xiang, JIANG Li-Ping, TANG Ling, LI Chang-Lian, HE Hong-Bin, REN Guang-Hui
    2020, 32(3):  317. 
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    Objective To analyze the endemic situation of schistosomiasis in Hunan Province in 2019, so as to provide insights into the achievement of transmission interruption of schistosomiasis in the province in 2020. Methods The data pertaining to Schistosoma japonicum infections in humans and livestock and snail status were captured from Hunan Province in 2019 and analyzed. Results Schistosomiasis was endemic in 281 townships (towns) from 41 counties (districts) of 6 cities in Hunan Province by the end of 2019. A total of 991 900 persons received blood testing in Hunan Province in 2019, and 22 773 were positive for the blood testing, with sero?prevalence of 2.30%. All stool examinations were negative in 22 933 individuals detected. The high sero?prevalence was seen in Nanxian County, Anxiang County and Ziyang District. Currently, there were 5 034 cases with advanced schistosomiasis detected in Hunan Province, and they were predominantly identified in Yuanjiang City, Heshan District and Yueyang County. There were 44 963 bovines fenced in schistosomiasis?endemic villages in Hunan Province in 2019, which were predominantly distributed in Yuanjiang City, Hanshou County and Ziyang District, and no positives were detected in 1 996 bovines receiving blood testing or 20 684 bovines receiving stool examinations. In 2019, there were snail habitats of 1.73 billion m2 found in Hunan Province, which were mainly found in Yuanjiang City, Hanshou County and Yueyang County. Conclusion The endemic situation of schistosomiasis further decreases in Hunan Province in 2019; however, there is still a risk of schistosomiasis transmission in local areas of the province.
    Progress of schistosomiasis control in Dongting Lake regions
    HU Ben-Jiao, LI Sheng-Ming, ZHOU Jie, HOU Xun-Ya, ZHOU Yi-Biao, JIANG Qing-Wu, REN Guang-Hui
    2020, 32(3):  320. 
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    As an ancient parasitic disease, schistosomiasis has been endemic in Dongting Lake areas for more than 2 100 years. In the early 20th century, the first human case of schistosomiasis in China was reported in Dongting Lake areas, which was paid extensive attention. After the founding of the People’s Republic of China, large?scale schistosomiasis control activities were launched promptly in Dongting Lake areas, and great successes have been achieved following the three stages of control efforts, including the snail control?based stage, synchronous chemotherapy for humans and livestock?based control stage and infectious source control?based control stage. In 2015, transmission control of schistosomiasis was achieved in Hunan Province. This paper comprehensively describes the discovery and control of schistosomiasis, analyzes the challenges for the current schistosomiasis control programs and proposes the emphasis for future control activities in Dongting Lake areas, so as to provide insights into the schistosomiasis control program in this area.
    Difficulties and countermeasures for the perioperative management of megasplenectomy in patients with advanced schistosomiasis
    PAN Ge, DENG Wei-Cheng, LIU Jia-Xin, LI Jie-Ling
    2020, 32(3):  323. 
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    The etiology, pathology, clinical features and prognosis of megalosplenic advanced schistosomiasis have their specific features, and therefore, the perioperative management of this disorder has special countermeasures. The review analyzes the difficult problems in the perioperative management of megalosplenic advanced schistosomiasis, including ultra?low platelet counts, extensive and severe adhesive splenomegaly, massive hemorrhage during surgery and portal vein thrombosis, and proposes countermeasures to tackle these problems, with aims to guide the clinical treatment and cure of schistosomiasis, thereby improving the prognosis, reducing complications and improving the quality of life.
    Breast schistosomiasis japonica: a case report
    WANG Hong-Bo, HUANG Dan
    2020, 32(3):  326. 
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    A case with breast schistosomiasis japonica was reported.
    Imported falciparum malaria in Suzhou City: a report of two cases in 2019
    WU Xiu-Zhen, JIANG Ling, GU Na-Li, ZHOU Jing, SU Jing
    2020, 32(3):  328. 
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    The demographic features, epidemiology, diagnosis and treatment of two cases with falciparum malaria imported into Suzhou City in 2019 were reported. These findings indicate a risk of imported malaria in visitors besides high prevalence in migrant labors, and much attention should be paid to children that are at a high risk of infections.