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20 August 2025, Volume 23 Issue 4 Previous Issue   

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EXPERT VIEWPOINT

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Evolving trends in the pathogen spectrum of hand, foot and mouth disease in China and strategies for prevention and control ZHANG Zhijie, CHANG Zhaorui 2025, 23 (4):  195-198,215.  doi: 10.20199/j.issn.1672-2302.2025.04.001 Abstract ( 186 )   HTML ( 9 )   PDF (804KB) ( 47 )   Hand, foot and mouth disease (HFMD) is a common infection in children caused by various enteroviruses. It is more prevalent in the Western Pacific Region, and remains significant global public health concerns. In recent years, the prevention and control of HFMD in China is facing new challenges with change of the pathogen spectrum of HFMD. This paper reviewed the evolutionary trends of HFMD pathogen spectrum at home and abroad, and detailed the changing characteristics of HFMD pathogen spectrum in China and its impact on clinical diagnosis, treatment, and disease control. Besides, corresponding countermeasure and proposals were put forward from targeted aspects as strengthening the pathogen monitoring, accelerating the research and development of multivalent vaccines, and implementing non-pharmaceutical intervention measures, with an attempt to provide references for the prevention and control of HFMD in the new situation. References | Related Articles | Metrics

SPECIAL TOPIC ON DENGUE FEVER PREVENTION AND CONTROL

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Epidemiological characteristics and prediction of overseas imported dengue fever in Yunnan Province from 2005 to 2023 FU Jialu, ZHENG Erda, QI Yanbo, WU Linbo, HE Jibo, YANG Rui 2025, 23 (4):  199-204,210.  doi: 10.20199/j.issn.1672-2302.2025.04.002 Abstract ( 158 )   HTML ( 4 )   PDF (3643KB) ( 43 )   Objective To analyze the epidemiological characteristics of overseas imported dengue fever cases in Yunnan Province, and predict the incidence trend for evidence for prevention and control of dengue fever. Methods Case data of overseas imported dengue fever reported in Yunnan Province from 2005 to 2023 were obtained from the Chinese Disease Prevention and Control Information System, and descriptive research methods were used to analyze the epidemiological characteristics of this infection. The SARIMA model was fitted using the case data from 2005 to 2023, and the model was evaluated with the case data of 2024. Results A total of 6 030 overseas imported dengue fever cases were reported in Yunnan Province from 2005 to 2023, which accounted for 19.50% of the total reported cases of dengue fever. The peak period for the imported cases was from August to November (5 094 cases, 84.48%). The top three prefectures/municipalities with the highest case number were Dehong Dai and Jingpo Autonomous Prefecture (2 610 cases, 43.28%), Xishuangbanna Dai Autonomous Prefecture (1 688 cases, 27.99%), and Lincang City (918 cases, 15.22%). The main source country of the cases was Myanmar (4 907 cases, 81.38%). The number of male and female cases was 3 477 (57.66%) and 2 553 (42.34%), respectively. The cases were mainly concentrated in the age group of 20-49 years (4 063 cases, 67.38%), and farmers were dominant in the cases reported (2 575 cases, 42.70%). The SARIMA(1,0,1)(1,0,1)12 model demonstrated excellent fitting effect, with the actual monthly case counts in 2024 all lying within the 95% confidence interval of the model’s forecasts. Conclusion Overseas imported dengue fever cases in Yunnan Province exhibited distinct seasonality, mainly originating from Myanmar and concentrating in Dehong Dai and Jingpo Autonomous Prefecture and Xishuangbanna Dai Autonomous Prefecture. It is recommended to strengthen dengue prevention and control measures for key inbound populations in line with seasonal and regional characteristics. Additionally, the SARIMA(1,0,1)(1,0,1)12 model can well fit the monthly number of overseas imported dengue fever cases in Yunnan Province, making it suitable for short-term prediction of the incidence trend of such cases. Figures and Tables | References | Related Articles | Metrics

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Epidemiological characteristics of dengue fever in Guangzhou City from 2014 to 2023 CHEN Qin, WU Li’nan, LAI Shifeng, JIANG Mingming, LIU Wenhui 2025, 23 (4):  205-210.  doi: 10.20199/j.issn.1672-2302.2025.04.003 Abstract ( 232 )   HTML ( 12 )   PDF (1444KB) ( 59 )   Objective To analyze the epidemiological characteristics of dengue fever in Guangzhou area for scientific basis in prevention and control of this infection. Methods Data on dengue fever cases residing in Guangzhou from 2014 to 2023 were obtained through the Chinese Disease Prevention and Control Information System. Descriptive epidemiology was used to analyze the temporal, regional and population distribution as well as the case origins, interval between onset and diagnosis, and viral serotypes. Results From 2014 to 2023, a total of 42 828 dengue fever cases were reported in Guangzhou City. Among these, 42 023 were local cases, 726 were imported cases from overseas, and 79 were imported cases from other domestic regions. The annual incidence rate ranged from 0.05/100 000 to 281.70/100 000 population. Reports of local cases and cases imported from other domestic regions were mainly concentrated in the period from August to November (41 494 cases and 77 cases, respectively). Cases imported from overseas were reported throughout the year, with the majority concentrated in the period from May to November (613 cases). These cases are mainly distributed in the central urban areas (36 744 cases, 85.79%). By the case origins, domestic imported cases (51 cases) were mainly from provinces such as Yunnan and Guangxi. Overseas imported cases were primarily associated with Southeast Asian countries such as Cambodia and Thailand (591 cases). Among different demographic groups, 21 309 were male cases and 21 519 female cases. The male-to-female ratio was relatively higher among the overseas imported cases (2.47∶1). Locally acquired cases were concentrated in the 20-59 age group (29 544 cases, 70.30%), while imported cases were mainly aged 20-49 years (656 cases, 81.49%). By occupation distribution, local cases were predominated by people engaged in housework & unemployed individuals, retirees, and commercial service workers (21 408 cases, 50.94%), whereas imported cases were mainly commercial service workers, people engaged in housework & unemployed individuals, and laborers (454 cases, 56.40%). The dominant serotypes were DENV-1 (66.18%, 2 464/3 723) and DENV-2 (31.78%, 1 183/3 723). The median interval from onset to diagnosis was 5 (3, 7) days. The detection rate during the viremia period was 59.35%, which showed an increasing annual trend (χ2trend=5.823, P<0.05). Conclusion In recent years, local dengue fever outbreaks in Guangzhou have primarily been caused by imported cases, with the incidence rate remaining at a relatively high level. These outbreaks exhibit distinct seasonal characteristics. Relevant authorities should focus on key areas and populations, continuously optimize and implement comprehensive prevention and control measures centered on case management and Aedes mosquito control, and rigorously prevent the spread of the epidemic. Figures and Tables | References | Related Articles | Metrics

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Epidemiological characteristics and temporal trend of dengue fever in Chengdu City, 2011-2023 YAN Ke, FENG Jing, ZHOU Rong, DU Xunbo, LIU Hui, WANG Yao 2025, 23 (4):  211-215.  doi: 10.20199/j.issn.1672-2302.2025.04.004 Abstract ( 186 )   HTML ( 4 )   PDF (1332KB) ( 38 )   Objective To analyze the epidemiological characteristics and temporal trend of dengue fever in Chengdu area for scientific evidences to effectively control epidemic import and local transmission. Methods The case data of dengue fever reported in Chengdu area from 2011 to 2023 were collected from the Chinese Disease Prevention and Control Information System as well as epidemiological investigation. Descriptive epidemiology was used to analyze the epidemiological characteristics, and Joinpoint regression model was used to analyze time trends. Results In total, 269 cases of dengue were reported in Chengdu area from 2011 to 2023, including 1 indigenous case, 197 imported cases from overseas, and 71 imported cases from other provinces within China. The top three districts/counties with the higher number of imported cases were Xindu District (28 cases), Jinniu District (27 cases), and Qingyang District (24 cases). Of the imported cases, the onset age was dominant in 21-50 years (225 cases, 83.96%). One hundred and fifty were males, and 118 females, with a sex ration of 1.27∶1. The occupational distribution was led by commerce/services (60 cases, 22.39%), homemakers/unemployed (59 cases, 22.01%), and workers (47 cases, 17.54%). Overseas imported cases originated primarily from Southeast Asia (169 cases, 85.79%), and domestic imported cases came from Yunnan Province (69 cases, 97.18%) and Guangdong Province (2 cases, 2.82%). Overseas imported cases occurred year-round, and the incidence peaked from June to October (69.54%, 137/197). Domestic imported cases were reported exclusively between August and November. The locally acquired case occurred in October. Overall, the incidence of dengue fever in Chengdu area exhibited a “slow rise-rise-decline-rise” trend from 2011 to 2023 (AAPC=39.26%, P<0.05). The case number was slowly increased from 2011 to 2018 (APC=28.53%, P<0.05), shot rapidly from 2018 to 2019 (APC=322.90%, P<0.05), sharply decreased from 2019 to 2021 (APC=-99.58%, P<0.05), and greatly went up from 2021 to 2023 (APC=2 746.79%, P<0.05). Conclusion The dengue fever epidemic in Chengdu area is primarily influenced by imported cases from Southeast Asian regions and neighboring domestic provinces. Summer and autumn seasons represent critical periods for prevention and control dengue fever in Chengdu area. Effective measures should be implemented to address the risk of epidemic spread caused by imported cases and potential local outbreaks. Figures and Tables | References | Related Articles | Metrics

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Epidemiological investigation and response of two dengue fever outbreaks at construction sites in Shenzhen City WAN Jia, NIU Cong, WANG Ying, WANG Meng, LÜ Ziquan, ZHANG Zhen, LU Jianhua, FENG Tiejian, KONG Dongfeng 2025, 23 (4):  216-221,234.  doi: 10.20199/j.issn.1672-2302.2025.04.005 Abstract ( 169 )   HTML ( 4 )   PDF (1199KB) ( 28 )   Objective To analyze the epidemiological characteristics and measures to manage dengue fever outbreaks in two construction sites in Shenzhen area, and summarize the experience in prevention and control of the two outbreaks. Methods Case finding was carried out in the surrounding areas and medical institutions of A construction site in Nanshan District and B construction site in Bao’an District where the epidemic occurred, and case exposure and epidemiological history, and clinical manifestations were investigated. Colloidal gold immunochromatography assay was used to detect the antibodies and antigens, and RT-PCR was used for nucleic acid detection and typing. Viral tracing was performed through next-generation sequencing. Mosquito vector density was measured using Breteau index (BI) and mosquito ovitrap index (MOI). Results The two outbreaks, occurring between September and November, involved 94 and 86 cases and lasted for 84 and 45 days, respectively. The cases were predominated by males (n=144; 80.00%) and population aged 30-59 years (n=143; 79.44%). Occupational distribution was primarily associated with workers (n=130; 72.22%). All cases were clinically classified as mild dengue fever. A total of 31 cases (32.98%) and 23 cases (26.74%) were respectively detected more than 5 days after symptom onset. Epidemiological investigations revealed that neither of the index cases in the two outbreaks had a travel history outside Shenzhen within 14 days prior to symptom onset. A presymptomatic case from Site A had resided in the worker’s dormitory at Site B 13 days prior to the onset of the outbreak at Site B. In the early stage of the two waves of the epidemic, the viruses infecting 24 cases were all dengue virus serotype Ⅰ, genotype Ⅰ, showing a homology of 99.90%. Finally, 180 cases were identified in 1 509 individuals screened. Targeted mosquito elimination and breeding site cleanup were conducted every 3 days at core epidemic foci in both worksites. The average daily BI and MOI both dropped to safe levels (BI ≤ 5 and MOI ≤ 5) on October 20th. The epidemic was declared over 25 days after the last case was reported, when no new cases emerged and the BI and MOI at both construction sites dropped below 5. Conclusion Both outbreaks were endemics spread across construction sites through asymptomatic infected migrant workers. The findings suggest that prevention and control of dengue fever at the construction site is involved in such problems as high mobility of personnel, weak awareness of seeking medical treatment, high density of mosquito vectors and difficulty in epidemic control, for which we recommend that it is necessary to implement various prevention and control measures, including case detection, mosquito vector control and worker management. Figures and Tables | References | Related Articles | Metrics

CONTROL STUDY

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Epidemiological characteristics and prediction of epidemic trend of norovirus infections in Yunnan Province ZHENG Erda, JIA Yuchen, LIU Sixian, SHEN Xiulian, HUANG Tian, HE Jibo, LIU Huihui 2025, 23 (4):  222-228.  doi: 10.20199/j.issn.1672-2302.2025.04.006 Abstract ( 163 )   HTML ( 3 )   PDF (2081KB) ( 49 )   Objective To analyze the epidemiological characteristics of norovirus infection in Yunnan Province from 2017 to 2023，and assess the application of autoregressive integrated moving average (ARIMA) model and prospective spatialtemporal scan statistics in the incidence trend and early warning of norovirus infection. Methods The case data of norovirus infections in Yunnan Province reported from 2017 to 2024 were collected from the Chinese Disease Prevention and Control Information System, and analyzed regarding the characteristics of temporal, regional, and population distribution using descriptive epidemiology. ARIMA model was established to predict the number of cases, and prospective spatio-temporal scan was used for spatiotemporal aggregation analysis of monthly reported cases. Results Between 2017 and 2024, a total of 15 600 cases of norovirus infections were reported in Yunnan Province, with the highest incidence reported in 2024 (17.473 /100 000). The incidence generally peaked from February to May, during which 53.99% (8 422/15 600) of the cases were reported. The top three prefectures (cities) with higher annual reported incidence were Qujing City (14.167 /100 000), Pu’er City (11.062 /100 000) and Lijiang City (10.706 /100 000). By population distribution, 8 709 cases were males, and 6 891 females. The 0-4 age group had the highest proportion of reported cases, who accounted for 68.93% (10 753/15 600). Children living at home were dominated by occupation distribution, who accounted for 63.23% (9 864/15 600). Ljung Box test of ARIMA (2,0,0)(0,1,0)12 model indicated Q=7.449 (P=0.964), and that the residual sequence was white noise. The model fitting effect appeared sound. The relative error between predicted value and the actual value from January to December 2024 was 14.76%. In the prospective spatiotemporal scanning statistics, 50% of the high-risk population was used as the maximum spatial scanning window, and 14 days were used as the maximum time scanning window for spatiotemporal scanning clustering analysis. The results showed that the spatiotemporal clustering areas in January 2024 were consistent with the actual areas where clustering epidemics occurred, and the warning time was 5 days earlier than the outbreak occurred. Conclusion In recent years, the number of reported cases of norovirus infection in Yunnan Province has risen rapidly, and the areas with reported infections expanded. Children under 5 years old living at home are the main affected population. ARIMA model and prospective spatiotemporal scan statistics can be more accurate for early warning of this infection, which has important application value in practical work. Figures and Tables | References | Related Articles | Metrics

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Epidemiological characteristics and transmission dynamics of varicella in Changsha City from 2014 to 2023 ZHAO Jin, ZHOU Yinzhu, QIU Jinsong, CHEN Shuilian 2025, 23 (4):  229-234.  doi: 10.20199/j.issn.1672-2302.2025.04.007 Abstract ( 116 )   HTML ( 2 )   PDF (4388KB) ( 57 )   Objective To analyze the epidemiological characteristics and transmission dynamics of varicella in Changsha area for evidences in following prevention and control of this infection. Methods The case data on varicella registered in Changsha area from 2014 to 2023 were obtained through the Chinese Disease Prevention and Control Information System, and descriptively analyzed regarding the temporal, regional, and population distribution. Joinpoint regression model was used to analyze incidence trends, and the SEIR model was applied for analysis of the transmission dynamics. Results A total of 74 146 varicella cases were reported in Changsha are from 2014 to 2023. The average annual incidence rate was 87.57 per 100 000 population. From 2014 to 2018, the incidence showed an upward trend, with an annual percentage change (APC) of 24.07% (t=2.71, P=0.042), followed by a downward trend from 2018 to 2023 (APC=-23.79%, t=-4.98, P=0.004). The main peak for the infection occurred from October to January (38 268 cases, 51.61%) and the secondary peak emerged between April and July (23 551 cases, 31.76%). The average annual reported incidence rate was lower in central urban area (85.34/100 000) than that in surrounding counties (cities) (90.31/100 000). The cases were dominated by population in the 0-14 age group (55 894 cases, 75.38%), and the average annual reported incidence rate was higher in males than in females (91.18/100 000 vs. 83.77/100 000). Occupational distribution indicated that school students (36 555 cases, 49.30%), children in kindergartens (16 811 cases, 22.67%) and those living at home (10 317 cases, 13.91%) were the most affected groups. Primary schools were the major outbreak settings (75 events, 76.53%). The mean daily reproduction number (Rt) during epidemic peaks was 1.548 (ascending phase) and 0.672 (descending phase), with the highest annual mean daily Rt observed in 2023 (1.124) and the lowest in 2022 (0.990). Conclusion Varicella incidence in Changsha area still remains at risk of high endemicity. In order to mitigate transmission, we recommend that comprehensive health education in schools and increased varicella vaccination coverage are urgently needed. Figures and Tables | References | Related Articles | Metrics

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Registration status and influencing factors of healthcare-seeking delay among elderly tuberculosis patients in Hefei City from 2017 to 2023 CAO Hong, LI Zhen, CHEN Shuangshuang, XU Rui, WU Jinju, LU LunShan 2025, 23 (4):  235-238,253.  doi: 10.20199/j.issn.1672-2302.2025.04.008 Abstract ( 132 )   HTML ( 4 )   PDF (803KB) ( 28 )   Objective To analyze the registration status and influencing factors of healthcare-seeking delay among pulmonary tuberculosis (TB) patients aged 65 years and above (elderly TB patients) in Hefei City, so as to provide evidence for TB prevention and control in the elderly population. Methods The data of elderly TB patients registered in seven designated TB hospitals in Hefei City from 2017 to 2023 were extracted from the Chinese Disease Prevention and Control Information System. Descriptive epidemiological methods were used to analyze registration status, and logistic regression analysis was performed to identify the factors associated with healthcare-seeking delay. Results A total of 8 135 elderly TB cases were registered, which accounted for 32.81% of all TB cases in Hefei area. There were 4 695 pathogen-positive cases (57.71%). Both the composition ratio of elderly TB cases and the pathogen-positive rate showed an upward trend (χ2 trend = 50.23 and 168.96, respectively, both P < 0.01). Healthcare-seeking delay occurred in 5 118 cases (62.91%), which exhibited a declining trend (χ2 trend = 84.58, P<0.01). The medium duration for healthcare-seeking was 20 (10-40) days. Multivariate logistic regression analysis revealed that the risks of healthcare-seeking delay were relatively lower in population whose current residential address was in the suburban areas/counties (OR=0.643, 95% CI: 0.575-0.719), floating populations (OR=0.502, 95% CI: 0.314-0.803), and patients identified through referral (OR=0.702, 95% CI: 0.598-0.824) or active follow-up (OR=0.466, 95% CI: 0.389-0.559). Conclusion The proportion of elderly TB patients and bacteriological confirmation rate in Hefei increased from 2017 to 2023, yet healthcare seeking delay remains higher, for which strengthening active TB screening and health education for the elderly is recommended to improve the situation healthcare-seeking delay. Figures and Tables | References | Related Articles | Metrics

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Epidemiological characteristics and spatiotemporal clustering analysis of hemorrhagic fever with renal syndrome in Chuxiong Yi Autonomous Prefecture, 2012-2023 LI Qin, QIAN Fabao, JIANG Suhong, WANG Anwei, WU Xuelin, HU Haimei, ZHOU Silei, GAO Lifen 2025, 23 (4):  239-244.  doi: 10.20199/j.issn.1672-2302.2025.04.009 Abstract ( 128 )   HTML ( 3 )   PDF (4457KB) ( 32 )   Objective To analyze the spatiotemporal distribution characteristics of hemorrhagic fever with renal syndrome (HFRS) in Chuxiong Yi Autonomous Prefecture, Yunnan Province, so as to provide a basis for scientific prevention and control of infection. Methods HFRS case data reported from 2012 to 2023 in Chuxiong Prefecture were retrieved from the Infectious Disease Surveillance System of Chinese Disease Prevention and Control Information System. Host animal surveillance data for 2021 were obtained from Chuxiong Prefecture Center for Disease Control and Prevention. Descriptive analysis was conducted on the characteristics of time, region and population for HFRS, as well as on the surveillance results of its host animals. Joinpoint regression model was used to analyze the incidence trend. Spatial information visualization techniques and kernel density estimation were used to evaluate the spatiotemporal clustering characteristics of cases. Results A total of 1 131 HFRS cases and 2 deaths were reported in Chuxiong Prefecture during 2012-2023. The annual incidence rate fluctuated between 0.41/100 000 and 8.18/100 000, showing an overall upward trend (AAPC=34.37%, t=3.74, P<0.01). More cases were reported from March to July (n=583; 51.55%). The cases were mainly distributed in Yao’an County, Chuxiong City, and Lufeng City, accounting for 77.54% (877/1 131) of total cases. The incidence rate in Yao’an County showed a continuous increase from 2012 to 2023 (APC=AAPC=62.45%, t=13.26, P<0.01), while Chuxiong City demonstrated a declining trend after 2018 (APC=-25.30%, t=-2.42, P<0.05). Spatiotemporal hotspots evolved from Lucheng Town and Donggua Town in Chuxiong City to Dongchuan Town and surrounding townships in Yao’an County. The average annual incidence rate was higher in males (4.88/100 000) than in females (2.16/100 000). The majority of cases were farmers (n=837; 74.00%). The median age of cases was 50.0 (38.0, 61.0) years, with the age at onset increasing from 40.0 (32.0, 56.0) years in 2012 to 57.0 (48.0, 68.0) years in 2023. In 2021, the average rodent density was 3.01%, with Rattus norvegicus (64.00%) and Rattus flavipectus (21.09%) being the dominant species. The hantavirus infection rate in rodents was 14.74% (158/1 072). Conclusion The incidence of HFRS in Chuxiong Prefecture showed obvious spatiotemporal clustering. Males, farmers, and population over 50 years old were most affected, and the age at disease onset showed a yearly increasing trend. The findings suggest that host animal control and prevention measures for key populations should be strengthened during high-incidence seasons. Figures and Tables | References | Related Articles | Metrics

EXPERIMENTAL STUDY

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Polymorphism analysis of nad2 gene of Echinococcus multilocularis larvae isolates from human in Altay Prefecture of Xinjiang ZHAO Jiangshan, GUO Baoping, SHI Guangzhong, YALIKUN Maimaitiyiming, ADILI Simayi, WANG Shuo 2025, 23 (4):  245-248.  doi: 10.20199/j.issn.1672-2302.2025.04.010 Abstract ( 135 )   HTML ( 3 )   PDF (1158KB) ( 26 )   Objective To understand the genotype and genetic diversity of Echinococcus multilocularis larvae isolates from human in Altay Prefecture of Xinjiang, and to provide a theoretical basis for the prevention and control of alveolar echinococcosis (AE). Methods The liver lesion tissues were obtained from patients with AE in Altay Prefecture of Xinjiang who were treated in the First Affiliated Hospital of Xinjiang Medical University between 2021 and 2024, and from which the tissue DNA was extracted. The nad2 gene was amplified and sequenced by PCR. The successfully sequenced gene sequence was uploaded to the NCBI website for Blast comparison, the nad2 gene polymorphism was analyzed using DnaSP 5 software, the haplotype network diagram was drawn by NetWork 10, and the nad2 gene phylogenetic tree was established by using the neighbor-joining method in MEGA 11 software. Results A total of 36 liver lesion tissues were obtained. After PCR amplification, specific bands at 882 bp were observed in all 36 samples, which was in line with the expected size. The results of gene polymorphism showed that there were three haplotypes in nad2 gene belong to the Asian clade, with a haplotype diversity of 0.341 and nucleotide diversity of 0.000 76. The Hap1 was the main haplotype (29/36, 80.56%). The systematic evolution tree showed that the isolates have a close kinship with the reference sequences of Echinococcus multilocularis from Xinyuan County of Xinjiang (KT965464), Kazakhstan (AB461406), Poland (KY20700), Canada (MT429276), Hokkaido of Japan (AB461407) and Sichuan (AB461408). Conclusion Human Echinococcus multilocularis isolated from subjects in Altay Prefecture of Xinjiang belongs to Asian clade, and is genetically relatively conserved. The dominant haplotype of it is Hap1. Figures and Tables | References | Related Articles | Metrics

CLINICAL STUDY

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Clinical characteristic in patients with severe or non-severe imported malaria YU Feidan, ZHANG Tao, CHEN Lin, ZHU Shengtao, YIN Huafa, XIE Qinxiu 2025, 23 (4):  249-253.  doi: 10.20199/j.issn.1672-2302.2025.04.011 Abstract ( 123 )   HTML ( 1 )   PDF (975KB) ( 37 )   Objective To understand the clinical characteristics and predictive indicators of severe imported malaria for a basis in early identification of this infection. Methods Clinical data were collected from the confirmed imported malaria cases treated on hospitalization basis in the Department of Infectious Diseases at the First Affiliated Hospital of Anhui Medical University between December 2013 and September 2024, and the general information, clinical features and laboratory findings of severe and non-severe malaria patients were comparatively analyzed. Logistic regression model and receiver operating characteristic (ROC) curve analysis were used to evaluate the predictive value of relevant laboratory indicators for severe malaria. Results A total of 76 confirmed cases of imported malaria were enrolled, including 23 severe cases and 53 non-severe cases. The infections were primarily imported from African countries (97.37%, 74/76). Fifty-eight cases of Plasmodium falciparum (P. falciparum) infection (76.32%), with a higher proportion of P. falciparum infection in the severe group than in the non-severe group (95.65% vs. 67.92%, χ2 =6.82, P<0.05). The incidences of chills/rigors and Coca-Cola colored urine were higher in the severe group. Compared to the non-severe group, patients in the severe group had significantly higher levels of total bilirubin (TBIL), alanine amino-transferase (ALT), aspartate amino-transferase (AST), creatinine (Cr), blood urea nitrogen (BUN), and procalcitonin (PCT), yet markedly lower hemoglobin (Hb) level and platelet (PLT) counts (all P<0.05). The ROC curve of predictive factors of severe malaria showed that the area under the curve (AUC) of TBIL was 0.896 (95% CI: 0.810-0.982) (P<0.05). The optimal cut-off value for TBIL, determined at the maximum Youden index, was 48.6 μmol/L, yielding a sensitivity of 73.9% and specificity of 96.2% for predicting severe malaria. Conclusion Patients with severe malaria are prone to significant liver and kidney damage, characterized by decreased PLT counts and Hb, and elevated TBIL levels. TBIL has value in predicting severe malaria. Figures and Tables | References | Related Articles | Metrics

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Clinical value of MALDI-TOF MS for detection of Mycobacterium tuberculosis and drug resistance XIONG Yanjun, XIAO Yu, FANG Xuehui, HUANG Pengfei, WANG Hua 2025, 23 (4):  254-258.  doi: 10.20199/j.issn.1672-2302.2025.04.012 Abstract ( 134 )   HTML ( 2 )   PDF (858KB) ( 37 )   Objective To evaluate the clinical utility of the matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) technology for identification of Mycobacterium tuberculosis and detection of associated drug-resistance genes, so as to provide technical suport for precision diagnosis of tuberculosis (TB). Methods Clinical data were collected from tuberculosis patients treated in Anhui Provincial Chest Hospital between November 2020 and May 2023. All patients underwent smear microscopy, mycobacterial growth indicator tube (MGIT) 960 culture and drug susceptibility testing (DST), Xpert MTB/RIF assay, and MALDI-TOF MS. MGIT 960 culture and DST results were used as the reference standard to evaluate the performance of MALDI-TOF MS for Mycobacterium tuberculosis identification and drug-resistance detection. Results The detection rate of Mycobacterium tuberculosis was 94.70% (125/132) by MALDI-TOF MS, 84.09% (111/132) by Xpert MTB/RIF, 67.42% (89/132) by MGIT 960, and 29.55% (39/132) by smear microscopy. The difference was significant (Q=172.87, P<0.001). The positive detection rate for rifampicin resistance was 53.03% (70/132) by MALDI-TOF MS, 45.45% (60/132) by Xpert MTB/RIF, and 44.70% (59/132) by MGIT 960 (Q=9.920, P=0.004). MALDI-TOF MS demonstrated the highest consistency for rifampicin resistance, which showed almost perfect agreement (Kappa=0.879, P<0.001), followed by high agreement with the results for fluoroquinolones and isoniazid (Kappa=0.698 and 0.667, both P<0.001). The consistency in clofazimine detection was relatively poor, showing moderate agreement (Kappa=0.476, P<0.001). Conclusion MALDI-TOF MS is worthy of recommendation in specialized hospitals, because this technique is highly sensitive and reliable for molecular diagnosis and drug-resistance screening of TB. Figures and Tables | References | Related Articles | Metrics