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    10 June 2016, Volume 14 Issue 2 Previous Issue    Next Issue
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    Epidemiological analysis on the overseas imported malaria in Anhui province from 2013 to 2015     
    Zhang Tao1, Xu Xian1, Jiang Jingjing1, Lu Manman2, Yu Chen1, Li Weidong1*
    2016, 14 (2):  63-66,70.  doi: 10.3969/j.issn.1672-2302.2016.02.001
    Abstract ( 1991 )   PDF (771KB) ( 2015 )  

    【Abstract】 Objective  To analyze the epidemiological characteristics of imported malaria in Anhui province from 2013 through 2015 for scientific evidence to prevent and control the malaria prevalence. Methods   The epidemiological data of all imported malaria cases were collected from January 1, 2013 to December 31, 2015 in Anhui provice, and descriptively analyzed regarding the distribution in time, areas and population, endemic sources, diagnosis and treatment. Results  A total of 475 imported malaria cases were reported in Anhui from 2013 through 2015. Twenty-five were serious disease and 3 were dead out of the 475 cases. The fetal death rate was 0.63%. 462(97.26%) cases were imported from African countries, and the remaining 13(2.74%) from Southeast Asia and South Asia. The disease primarily affected young and adult men working in overseas countries and population aged (40.27±8.80) years. The most frequently reported cases were in spring festival holidays and between May and July. Although the cases were reported in areas across Anhui, yet were mainly distributed in Hefei areas due to relatively larger number of migrant workers. The median time from onset to visiting doctors was one day(0, 3), and the median time from onset to confirmed diagnosis was one day(0, 3). Conclusion  Severe case accounts for a higher percentage in the imported malaria cases in Anhui province (5.26%), and death occasionally occurs, for which early diagnosis and treatment of this disease is important. In addition, tertian malaria infection should be timely managed in order to prevent it from secondary prevalence in our province.

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    Correlation of the genotype and mutation of HBV and X protein with HCC
    Yang Chunxia, Chi Xiaowei, Zhang Yanmei, You jing, Fan jinghua, Yang Weibo*
    2016, 14 (2):  67-70.  doi: 10.3969/j.issn.1672-2302.2016.02.002
    Abstract ( 1720 )   PDF (415KB) ( 1454 )  

    【Abstract】 Objective  To understand the correlation of the genotype of hepatitis B virus(HBV), mutation loci of 1762/1764 and 1896, and HBV transactivator protein X with hepatocellular carcinoma(HCC) for theoretical evidences in early diagnosis and therapy of this entity. Methods  HBV genotypes and their mutation loci were tested by nucleic acid amplification in 159 blood samples obtained from asymptomatic chronic HBV carriers, patients of chronic Hepatitis B, hepatitis B induced cirrhosis and HBV-associated HCC, and sequenced by the auto genotype analyzer and measured with quantitative method. Expression of X protein in the liver tissues from the aforementioned 4 groups were detected by immunohistochemistry staining, and the results were estimated by semi-quantitative integration. Results  1) In the 159 cases infected with chronic HBV, 56 were associated with genotype B(35.2%, 56/159) and 103 with genotype C (64.8%, 103/159). Genotype C in groups of asymptomatic chronic hepatitis B virus carrier(ASC), patients of chronic hepatitis B(CHB), patients with liver cirrhosis(LC) and HCC accounted for. The difference was significant(χ2 =8.462, P =0.037); 2)Mutations of basal core promoter(BCP)were 44.0%(11/25), 63.2%(36/57), 85.7%(36/46) and 64.5%(20/31), respectively for the four groups of HBV patients with genotype C, and cases with precore(PC) mutation were 45.5%(5/11), 66.7%(24/36), 77.8%(28/36) and 70.0%(14/20), respectively. Cases with two mutations were over those with genotype B, and the difference was significant except for ASC group(P <0.05); 3) Protein X expression was the strongest in group LC, with a positive rate of 71.7%, and came next by group HCC(71.0%), CHB(59.6%) and ASC(52.0%). The difference was significant among groups(P<0.05); 4)Positive rate of X protein expression in chronic HBV infectors with genotype C in group ASC, CHB, LC and HCC was 81.8%(9/11), 72.2%(26/36), 86.1%(31/36) and 85.0%(17/20), and was higher than that in genotype B[28.6%(4/14), 38.1%(8/21), 20.0%(2/10) and 45.5%(5/11), respectively],with statistical difference(P <0.05).  The proportion of HBV infectors with positive BCP mutation and positive X protein expression in the four groups was 61.5%, 73.5%, 69.7% and 81.8%, and the proportion was higher than that in HBV infectors with negative BCP mutation. Positive PC mutation was 46.2%, 67.6%, 78.8% and 63.6%, which was higher than the proportion in HBV infectors with negative PC mutation except for group ASC, yet the difference was not significant. Conclusion  HBV genotype C, mutation loci of 1762/1764 and 1896 and X protein are correlated with each other, suggesting that they are involved in the pathogenesis and development of HCC.   

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    Analysis on the etiology monitoring results in 324 cases of hand-foot-mouth disease in Suzhou in 2015 
    Zhang Ling, Ge Mingming
    2016, 14 (2):  71-73.  doi: 10.3969/j.issn.1672-2302.2016.02.003
    Abstract ( 1635 )   PDF (408KB) ( 1232 )  

    【Abstract】 Objective  To investigate the etiological properties and pathogen distribution in hand-foot and mouth disease(HFMD) in Suzhou area in 2015 for evidences to plan strategies in prevention and control of HFMD prevalence. Methods  Real-time PCR was used to detect the enterovirus 71(EV71), specific nucleic acid in Coxasckie virus A16(CoxA16) and in other enteroviruses(Non-EV 71 and Non-CoxA16). Results  In 324 samples clinically diagnosed as HFMD, 137(42.3%) were found with positive nucleic acid. Thirty-five positive samples were associated with EV 71 infection(10.8%, 35/324), and the constituent ratio was 23.5%(35/137). Twenty-six samples were involved in CoxA16 infection, with positive rate of 8.0%(26/324) and positive ratio of 19.0%(26/137). Another 76 samples were associated with other enterovirus infection(Non-EV 71 and Non-CoxA16). The positive rate was 23.5%(76/324), and positive ratio, 55.5%(76/327). The infection ratio of male to female was 1.6:1, and the positive rate was 43.4%(86/198) and 39.7%(50/126) with no significant difference(χ2=0.445, P>0.05). The patients aged from 0 to 3 years were mostly affected, HFMD prevalence was peaked in January and April through July, in which period the positive rate was over 50%. Conclusion  The peak prevalence of HFMD was observed in spring, summer and autumn seasons in Suzhou area in 2015, and children under 3 years are mostly affected. The enteroviruses are primarily associated with other pathogens except for infection with EV 71 and CoxA16.

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    Imported loaiasis in Beijing: epidemiological characteristics in 5 patients
    He Zhanying, Wang Xiaomei, Li Xitai, Li Xu*
    2016, 14 (2):  74-76.  doi: 10.3969/j.issn.1672-2302.2016.02.004
    Abstract ( 1586 )   PDF (419KB) ( 4044 )  

    【Abstract】 Objectives  To analyze the clinical and epidemiological characteristic of imported loaiasis in patients in Beijing. Methods  Field epidemiological study was performed pertaining to the patients’ previous activities, sources of infection and treatment as well as clinical pictures. Results  A total of 5 cases of confirmed loaiasis were reported in Beijing from 2011 to 2015. The disease was generally imported from Nigeria, Gameroon, Republic of Congo and Gabon. Increased ratio of eosinophils was seen in the five patients, in whom 3 had simple Calabar swellings, 1 had eye symptoms and skin itching, and another 1 had Calabar swellings and sense of worm migration at the conjunctiva. Conclusion  Imported disease may be increased with more international communication. Loaiasis is hard to diagnose, yet accurate diagnosis of this disease can rely on its characteristic symptoms and epidemiology.

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    Epidemiological analysis of malaria from 2003 to 2014 in Youjiang District of Baise City, Guangxi Province
    Deng Jiguang, Yu Shuilan, Jiang Chaosui, Nong Zhi, Liang Shaoyi
    2016, 14 (2):  77-79.  doi: 10.3969/j.issn.1672-2302.2016.02.005
    Abstract ( 1711 )   PDF (369KB) ( 1257 )  

    【Abstract】 Objective  To understand the epidemic features and trend of malaria from 2003 through 2014 in Youjiang District of Baise city, Guangxi province. Methods  The data on blood smear examination of febrile patients, including local residents, returned migrant workers and floating population in Youjiang District were collected from 2003 to 2014 and analyzed with descriptive statistics. Results  Between 2003 and 2014, febrile examination was performed in a total of 119 216 persons/times, in whom 522 were returned migrant workers and 22 260, floating population. Of the three groups of population, the average positive rate of blood examination was 0.0017%, 0.575% and 0.119%, respectively. In the 30 confirmed malaria cases, 3 were indigenous infection and 27, oversea imported infection. Twenty cases were associated with falciparum malaria, 9 with tertian malarial fever, and another 1 case was undifferentiated in clinical diagnosis. Conclusion  The imported malaria is dominated in Youjiang District of Baise city, and half of the cases are associated with falciparum malaria. 

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    Spatial-temporal variation pattern of infected snails in Hunan Province from 2004 to 2011
    Li Guangping1, Fang Xiaoping2, Xia Meng1, Zhao Zhengyuan1, Tang Ling1, Ren Guanghui1, Hu Benjiao1 *
    2016, 14 (2):  80-82.  doi: 10.3969/j.issn.1672-2302.2016.02.006
    Abstract ( 1702 )   PDF (453KB) ( 1479 )  

    【Abstract】 Objective To investigate the spatial-temporal variation pattern of infected snails in Hunan province in order to evaluate the effects of the integrated control strategies on prevention and control of schistosomiasis for scientific evidence in following plan decision. Methods  Data on the areas with infected snails were collected on town basis from 2004 to 2011. The electric map was prepared on town polygon, and spatial database was developed to match the polygon. The total index ,the spatial autocorrelation and spatial scan statistics at town level were included to quantify the spatial-temporal characteristics in the endemic areas. Results  The areas with infected snails tended to decline in general between 2004 and 2011. The decrease was from 2 627.9hm2 in 2004 to 664.6hm2 in 2011, and the corresponding P50, P75 and P90 was decreased sharply. However, the P90 was still at high level in 2011(5.9 h㎡), and the high level areas were associated with towns near the rivers with infected snails. Simulation analysis of the spatial weight matrix by Moran’s I between 20014 and 2011 indicated the index was greater than the expected one, which fell in 0.13-0.28, and the difference was statistically significant(Z>3.77, P<0.05). The number of towns, clustered primarily along the banks of Dongting Lake, with H-H types of auto-correlation was between 23-41. Conclusion  The areas with infected snails were significantly reduced in Hunan Province from 2004 through 2011, suggesting that the integrated measures with emphasis on infectious sources control appear effective for schistosomiasis control. However, distribution of the areas with infected snails tends to be positive auto-correlation, and the snail burden is still heavy in some towns in 2011. This needs further consolidated comprehensive prevention and control, particularly in areas with H-H types of distribution. 

     

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    Analysis on the measures and effects of snail control inside the embankment in Hanshou County, Hunan Province from 2004 to 2015
    Liu Mengli1, Wang Huilan2#, Xia Meng2, Tang Ling2, Jiang Qiong2, Dong Rulan2, Ren Guanghui2, Li Shengming 2*
    2016, 14 (2):  83-86.  doi: 10.3969/j.issn.1672-2302.2016.02.007
    Abstract ( 1781 )   PDF (602KB) ( 1411 )  

    【Abstract】 Objective  To investigate the measures for snail control in subtype epidemic areas within the embankment in Hanshou county, Hunan Province. Methods  Archival data on schistosomiasis epidemiology and control were collected in Hanshou county from 2004 through 2015, and analyzed with the snail change to evaluate the effects and measures implemented in snail control within the embankment. Results  The areas with snails were reduced from 99.64 hm2 in 2004 to 0.87 hm2 in 2015 inside embankment of Hanshou county(a drop of 99.1%). The average density of living snail was declined to 0.01/0.11 m2 in 2015 from 0.15/0.11m2 in 2004, and the number of and areas with infected snail were sharply decreased. No infected snails were found between 2006 and 2015. Conclusion  The measures, implemented on molluscicide use basis plus transforming rice fields into dry land, raising killing snails, land leveling, hardening of the local canals and ditches, reconstruction of the culverts and sluices and modification of the micro-environment, have led to effective control and elimination of the snail prevalence within the embankment of Hanshou county. Nevertheless, governments at different levels are suggested to continue to increase investment in comprehensive management programs for final eradication of local schistosomiasis.

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    Outcome of schistosomiasis control by hardening the water diversion channels located in Zhongzhou Town in Yueyang County
    Ren Xiaobing1, Fang Xiaoping1, Hu Benjiao2, Zhao Zhengyuan2, Li Yiyi2, Li shanfeng1, Ren Guanghui2*
    2016, 14 (2):  87-89,92.  doi: 10.3969/j.issn.1672-2302.2016.02.008
    Abstract ( 1840 )   PDF (452KB) ( 1203 )  

    【Abstract】 Objective  To investigate the outcomes of schistosomiasis control by hardening water diversion channels originated from snail ridden areas in Dongting Lake. Methods  East-West main channels and their branches, which were hardened with cement and concrete and run through Zhongzhou Town in Yueyang County, were selected as study sites. The information on endemic situation and measures for schistosomiasis control as well as the snail density changes in the marshland near the water inlet and within the channels were collected from 2006 to 2015 for evaluation of the outcomes after hardening the water diversion channels. Results  Average snail density in between 2006 and 2016 in the marshland around water sources was fluctuated in 0.40 heads/0.11m2. The average snail density inside the water diversion channel was 0.1999heads/0.11m2, and average infected snail density was 0.0018 heads/0.11m2 before channel hardening. However, no snails were found inside the diversion works from 2007 to 2015, when the rate of schisosome infection was dropped to 0.19% from 6.12% in population living along the diversion channels, and to zero from 14.86% in domestic animals over the same period. Conclusion  Hardening the water diversion channels originated from snail ridden areas in Dongting Lake can effectively prevent snails from spreading and breeding inside the works, and local transmission of schistosomiasis can be totally controlled by additional conventional measures.

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    Report and analysis of Fanconi syndrome caused by low dose of adefovir dipivoxil in 5 cases
    Kong Lingyi, Tong Hui
    2016, 14 (2):  90-92.  doi: 10.3969/j.issn.1672-2302.2016.02.009
    Abstract ( 1664 )   PDF (404KB) ( 1754 )  

    【Abstract】 Objective  To analyze the causes of acquired Fanconi syndrome(FS) and chronic renal damage due to prolonged use of adefovir dipivoxil(ADV) in low dose for hepatitis B, and suggest early diagnosis of ADV-induced FS and preventive measures for nephrotoxicity. Methods  The data were collected in 5 cases of FS confirmed in our hospital between January 2008 and 2013, and the clinical manifestations and therapy were analyzed. Results  Generally, the five patients received ADV in dose of 10 mg/d and average medication of 42.6 months. The FS symptoms averagely developed at 35.4 months. Clinical pictures were progressive systemic bone and joint pain, and 2 cases showed increased nocturnal urination frequencies. Serum phosphorus level was decreased to a certain extent in the 5 patients, in whom 3 had hypouricemia. Reduced estimated glomerular filtration rate(eGFR) was seen in the 5 cases, and increased alkaline phosphatase(ALP) in 4. Positive urine protein and abnormal glucose in urine were respectively found in 4 and 3 cases. Three patients were misdiagnosed as primary osteoporosis by dual-energy X-ray absorptiometry. After ADV withdrawal and replacement with entecavir in dose of 0.5 mg/d combined with oral neutral phosphate solution, alfacalcidol and calcium, bone pain was released in the 5 patients in 3 to 10 months, and blood phosphorus level restored to normal in 1 to 3 months. Hypouricemia was reversed in 2 of the 3 cases at the first and the eleventh month, and increased ALP was corrected in 2 of the 4 cases at the first and the twelfth month. Urine protein disappeared in 2 cases at the fifth and the twelfth month after ADV withdrawal, and another 2 cases with abnormal urine glucose were recovered in 4 and 8 months. Conclusion  Low-dose ADV can induce Fanconi syndrome. Patients, particularly those of the aged, with drinking habit or chronic diseases, needing prolonged use of ADV should be regularly monitored for the levels of serum phosphorus and ALP as well as renal function and routine urine test findings. Once renal damage occurs, ADV should be withdrawn in timely fashion and therapy regime may be replaced by other antiviral drugs with oral neutral phosphate solution, or prolonged ADV medication interval is decided by eGFR level.

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    Analysis of TORCH infection in early pregnant women in Huainan area of Anhui Province
    Kang Li
    2016, 14 (2):  93-94,99.  doi: 10.3969/j.issn.1672-2302.2016.02.010
    Abstract ( 1553 )   PDF (399KB) ( 1724 )  

    【Abstract】 Objective  To analyze the screening results of infection with Toxoplasma gondii(TOX), rubella virus(RuV), cytomegalovirus(CMV) or herpes simplex virus(HSV)(TORCH) among women in early pregnancy in Huainan area, and to explore the clinical implications by TORCH test. Methods  Enzyme linked immunosorbent assay (ELISA) was performed to detect TORCH-IgM and TORCH-IgG antibodies in 4 832 pregnant women living in Huainan area. Results  Highest positive rate of HSV-IgM and IgG was found in the pregnant women received TORCH tests(P<0.05), and 48.84% (21/43) adverse pregnancy outcomes were associated with CMV. The difference was significant compared to adverse pregnancies caused by other virus(P<0.05). Abortion(65.12%, 28/43) appeared dominant in the incidence of adverse pregnancy, which was statistically different from other causative factors. Conclusion  Positive TORCH was detected in some women in early pregnancy in Huainan area, and TORCH infection is one of the important risk factors for adverse pregnancy outcomes. Therefore, TORCH test in the early stage of pregnancy or before pregnancy may have implications to improve local population quality of newborns.

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    Endemic status of schistosomiasis in Hubei Province in 2014
    Xiao Ying, Zhong Chenhui, Zhang juan, Shan xiaowei, Cai Shunxiang, Liu Jianbing*
    2016, 14 (2):  95-99.  doi: 10.3969/j.issn.1672-2302.2016.02.011
    Abstract ( 2138 )   PDF (481KB) ( 1267 )  

    【Abstract】 This report presents the endemic status of schistosomiasis in Hubei province in 2014. Among the 63 administrative areas with endemic schistosomiasis, including cities, districts and counties, 24 areas achieved transmission interruption, and 39 reached the criteria of transmission control by the end of 2014. There were 9 962 600 residents living in 5 450 villages with endemic schistosomiasis japonica, the estimated infected number was 34 455, which was decreased by 34.58% compared to 2013. Positive stool was detected in 4 509 individuals, which was reduced by 54.99% compared to 2013. No local acute infection was reported in 2014. Estimated 73 392 cattle being raised within the endemic areas across our province were free of positive results by stool examination. The areas with oncomelania snail presence were reduced by 320.58hm2 from 76 165.12hm2 in 2014. No areas were reported with newly infected snails or with new snail habitats. The data indicate that the endemic status tends to decline in Hubei province, yet challenges still exist to reach the goal of Comprehensive Management Plan of Schistosomiasis in Hubei Province (2014~2018), and surveillance should be strengthened to ensure effective prevention and control of schistosomiasis. .

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