Emerging infectious diseases (EIDs) are either newly emerging or previously existing infectious diseases that are experiencing a rapid increase in incidence or geographic spread. The risk of EIDs outbreaks and pandemics is escalating due to factors such as climate change, pathogen evolution. Outbreaks of EIDs, like coronavirus disease 2019 (COVID-19), have significantly impacted on global health, the economy, and social stability. Such global pandemics not only directly affect human health but also negatively impact on economic development, poverty reduction, and education. To tackle the challenges of EIDs, organizations at national and international levels have adopted a series of comprehensive prevention and control strategies, including reducing the risk of pathogen spillover, establishing comprehensive detection and early warning systems, and promoting cross-sectoral collaboration and sharing information with other departments, and implementing the One Health concept for cross-sectoral prevention and control. This article summarizes the challenges posed by EIDs pandemics, the prevention and control strategies at the national and international levels, the current progress, and specific cases to provide a reference for future responses to EIDs pandemics.

Objective To understand the epidemic situation of visceral leishmaniasis (VL) in China in 2023 to provide scientific evidence for formulating prevention and control strategies. Methods Data on VL cases reported in 2023 was collected from the web-based National Diseases Reporting Information System (NDRIS) operated by the Chinese Center for Disease Control and Prevention. From the collected information, suspected cases, duplicate cases and cutaneous leishmaniasis cases were excluded to establish a database. Descriptive epidemiological analysis of the three-dimensional distribution of VL was conducted using Microsoft Excel 2016 software. Results A total of 299 VL cases were reported in 125 counties across 15 provinces (autonomous regions and municipalities) in 2023, with an incidence rate of 0.02/100 000, showing a 25.1% increase from the year 2022. Among these, 237 cases were of mountain-type zoonotic VL (MT-VL), 7 cases were of desert-type zoonotic VL (DT-ZVL), 1 case was of anthroponotic VL (AVL), and 54 cases were imported cases from non-endemic regions. The reported cases were mainly distributed in Shanxi (114 cases), Henan (54 cases) and Shaanxi (38 cases) provinces, together accounting for 68.9% (206/299) of the total reported cases in China. Of the 125 counties, 74 were endemic counties, reporting 245 locally acquired cases, while the remaining 51 were non-endemic counties, reporting 54 imported cases. Among the 74 endemic provinces, seven counties including Pingding County, Suburb District of Yangquan, Xiangfen County in Shanxi Province, Jingxing County of Hebei Province, Huazhou District in Shaanxi Province, Linzhou City and Xin’an County of Henan Province were the major endemic counties. These counties reported 24, 16, 10, 13, 12, 12 and 10 VL cases, respectively, accounting for 32.4% (97/299) of the total cases reported nationwide. Eighteen counties, including Hongdong, Licheng, Linxian, Shilou, and Wutai counties in Shanxi Province; Quyang, Fuping, Laiyuan, Pingshan, Shexian, Tangxian, and Yixian counties in Hebei Province; Songxian and Yuzhou in Henan Province; Chengxian and Kangxian counties in Gansu Province; Yanqing District in Beijing; and Chengcheng County in Shaanxi Province, were new reemergence VL endemic counties, reporting 23 locally acquired cases. The peak incidence of VL occurred in March. The ratio of male to female cases was 1:0.4. Farmers accounted for 57.2% (171/299) of the total cases. The age distribution of VL cases was predominantly in the 45-74 years old group (64.5%). Conclusion VL in China exhibits a low prevalence but the incidence showed a rapid increasing trend, and the endemic area was in expanding. Farmers are recognized as the high-risk population for visceral leishmaniasis. It is imperative to strengthen the surveillance and prevention of visceral leishmaniasis.

Objective Molecular identification of four species of trematode larvae isolated from freshwater snails in the Nenjiang River Basin in Qiqihar City. Methods Freshwater snails were collected from the Liuyuan section of the Nenjiang River in Qiqihar City from March to July 2023. After classification and identification, the shell was crushed, the visceral mass was observed under a microscope, and the trematode larvae in the snails were isolated. The total DNA of different trematode larvae was extracted, and the internal transcribed spacer region 2 (ITS2) of trematode larvae was amplified by PCR, and the amplified products were sequenced. After splicing using Contig Express software, the sequence consistency was compared on the NCBI website. The phylogenetic tree was using the neighbor-joining method, and the genetic distance was calculated using MEGA 11.0 software. Results A total of 7 species of freshwater snails (2 771 snails) were collected, of which 3 species were positive, including Koreoleptoxis amurensis (282 snails), Cipangopaludina chinensis (709 snails) and Bellamya limnophila (142 snails). A total of 4 species of trematode larvae were detected, and each freshwater snail only parasitized 1 species of trematode larvae, which were larvae a (positive rate 25.23%, 107/424) parasitized in K. amurensis and B. limnophila, larvae b (positive rate 2.82%, 20/709) parasitized in C. chinensis, larvae c (positive rate 0.70%, 2/282) parasitized in K. amurensis and larvae d (positive rate 0.56%, 4/709) parasitized in C. chinensis. The amplified lengths of ITS2 target sequences of larvae a-d were about 523 bp, 701 bp, 960 bp and 554 bp, respectively. The results of gene sequencing and sequence alignment showed that the larvae a ITS2 sequence had the highest identity with Notocotylus ephemera (GenBank: OP720890.1) sequence, which was 98.49%. It had the closest genetic distance with N. ephemera and Notocotylidae sp., both of which were 0.014. It was speculated that larva a was a trematode of the Notocotylidae. The larvae b ITS2 sequence had the highest consistency with the sequence of Echinostoma revolutum (GenBank: GQ463130.1), which was 94.56%. The genetic distance with E. revolutum is the closest, which is 0.085. It is speculated that larva b is a trematode of the genus Echinostoma in the family Echinostomatidae. The larvae c ITS2 sequence had the highest consistency with Echinochasmus suifunensis (GenBank: MT447049.1) sequence (99.82%). The genetic distance with E. milvi was the closest, less than 0.001, suggesting that larva c was a trematode of the genus Echinochasmus of the family Echinostomatidae. The larvae d ITS2 sequence had the highest consistency with the sequence of Asymphylodora markewitschi (GenBank: OP106430.1), which was 92.36%. The genetic distance with A. parasquamosa is the closest, which is 0.090, suggesting that the larva d was a trematode of the genus Asymphylodora of the family Monorchiidae. Conclusion Freshwater snails in the Nenjiang River Basin of Qiqihar may harbour trematodes of the Notocotylidae, Echinostoma and Echinochasmus of the Echinostomatidae, and Asymphylodora of the Monorchiidae, potentially endangering the health of fish, poultry and mammals.

Objective To understand the infection, morphological and molecular identification of Clonorchis sinensis metacercariae in Pseudorasbora parva in multiple regions of China. Methods From August 2022 to January 2024, P. parva samples were collected from 12 sampling sites of water bodies in East, South, Central, Northwest, and Southwest China. After digesting the fish, metacercariae were isolated for morphological identification. From each sampling site, individual metacercariae in infected fishes were isolated individually to extract DNA， of which 16S rDNA was amplified with PCR and sequenced. Sequence alignment was conducted using BLAST, and a phylogenetic tree was constructed using MEGA7 and Fasttree2 with the maximum likelihood method. SD rats (n = 12) and Kunming mice (n = 10) were fed with metacercariae-positive P. parva (approximately 200 metacercariae per rat and 100 metacercariae per mouse). Eggs and adult worms from fecal samples and the bile ducts were collected, respectively, for morphological and identification at 25, 90 and 300 days post-infection. Data was analyzed by Microsoft Excel 2021 software. Fisher’s exact test was used for comparison between groups. Results Out of the 665 P. parva samples examined, 277 were positive for metacercariae, resulting in an average infection rate of 41.6%. Higher infection rates of P. parva were found in Hengzhou of Guangxi (6/6), Puyang of Henan (100%, 22/22), Yantai of Shandong (98.4%, 122/124), Fuyang of Anhui (75.0%, 24/32), Hanzhong of Shaanxi (49.2%, 95/193), and Ningde of Fujian (5/19). The isolated trematode metacercariae samples were morphologically identified as of C. sinensis. PCR amplification and sequencing results showed that the amplified about 400 bp fragment matched to the sequence of 16S rDNA of C. sinensis, revealing 100% identity (GenBank accession no.: MT607652.1). Phylogenetic analysis indicated that the isolated metacercariae clustered with C. sinensis in the same branch. At 25 and 90 days post-infection, no eggs or adults were found in mouse feces or bile ducts, while eggs were found in rat feces. At 300 days post-infection, eggs were found in the feces of two rats, and adults were isolated from the bile ducts of three rats. The eggs and adults exhibited typical morphological characteristics of C. sinensis. Conclusion The present study domonstrated that C. sinensis infection at varying degrees was found in P. parva from Hengzhou, Guangxi, Puyang, Henan, Yantai, Shandong, Fuyang, Anhui, Hanzhong, Shaanxi, and Ningde, Fujian. The 16S rDNA gene combined with the morphological characteristics can effectively identify C. sinensis metacercariae in P. parva.

Objective To explore the composition and transcriptional profile characteristics of T cell subtypes in liver tissue microenvironment cells of mice infected with Echinococcus granulosus at different time points at the single-cell level. Methods Data were extracted from the single-cell RNA sequencing dataset (genome sequence archive: CRA008416) of BALB/c mouse liver tissue at 1 month (1 mouse), 3 months (1 mouse) and 6 months (2 mice) after E. granulosus infection and healthy mouse (1 mouse, control group) in the previous study of the research group and quality control was conducted. The uniform manifold approximation and projection (UMAP) method was used to visualize the single cell clusters, and the clustering algorithm adopted shared nearest neighbour (SNN) to obtain the optimal cell clusters. SingleR software package was used for cell type annotation of cell subsets based on the immgen reference dataset. FindMarkers function from Seurat software package was used to analyze differentially expressed genes (DEGs) of regulatory T cells (Tregs) and CD8⁺ T cells in mice infected at different time points and control group mice. Functional enrichment and pathway enrichment of DEGs were analyzed using gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG), respectively. Results After quality control, 37 760 cells were obtained, which were divided into 8 types after manual optimization. After re-clustering the T cells, 12 cell groups were obtained. Seven T cell subtypes were annotated and identified, including CD4⁺ naive T cells, CD4⁺ effector T cells, Tregs, CD8⁺ naive T cells, CD8⁺ T cells, proliferative T cells, γδ T cells. The proportion of each T cell subtype did not change significantly at 1 month after E. granulosus infection. The proportion of proliferative T cells (11.91%, 56/470） and Tregs (13.40%, 63/470） were significantly higher than those in control group (3.51%, 38/1 082; 4.34%, 47/1 082） at 3 months after infection. The proportion of CD8⁺ T cells (30.20%, 1 145/3 791） was significantly higher than that of the control group (15.43%, 167/1 082） at 6 months after infection. Tregs showed high expression of tumor necrosis factor-α-induced protein 8 (Tnfaip8), Maf, IKAROS family zinc finger 3 (Ikzf3) and other Treg-maintaining genes at 3 months after infection, while CD8⁺ T cells showed high expression of depletion genes such as CD40 ligand (Cd40lg), chitinase-like 3 (Chil3), secreted phosphoprotein 1 (Spp1) at 6 months after infection. GO analysis showed that DEGs of Tregs were mainly concentrated in transforming growth factor beta receptor complex assembly, positive regulation of T cell activation, cyclic adenosine monophosphate (cAMP) mediated signalling pathway at 3 months after infection; while the DEGs of CD8⁺ T cells were mainly concentrated in the regulation of vascular endothelial growth factor receptor, tryptophan catabolic process, extracellular matrix-cell signalling pathways at 6 months after infection. KEGG analysis showed that DEGs of Tregs were mainly involved in primary immune deficiency and Ras signalling pathway at 3 months after infection; while the DEGs of CD8⁺ T cells were mainly involved in fatty acid metabolism, glutathione metabolism, folate metabolism and other pathways at 6 months after infection. Conclusion There are differences in T cell subtypes in liver of mice at 3 months and 6 months after E. granulosus infection; the proportion of Tregs increased at 3 months, and CD8⁺ T cells increased at 6 months after infection. There were differences in DEGs and their main enrichment pathways of Tregs and CD8⁺ T cells.

Objective To analyze the epidemic characteristics and influencing factors of Taenia infection and cysticercus antibody in the residents of Dali, Yunnan, to provide a scientific basis for prevention and control of taeniasis and cysticercosis. Methods From October to November 2023, a survey was conducted in Dabaguan Village, Huoshan Village, Jingang Village and Qingshuigou Village in the historical endemic area of taeniasis and cysticercosis in Dali Prefecture. Permanent residents aged over 3 years were enrolled in the survey using the method of cluster random sampling. A questionnaire survey was conducted to collect information including whether there was a history of proglottid excreted, subcutaneous nodules, symptoms of epilepsy and severe headache, as well as the dietary habits, hygiene behaviors and living environment. Fecal samples were collected, and examined by the modified Kato-Katz method (two slide-reading for each sample). For residents with positive fecal test results or with a history of excreting proglottids in the past year, pharmacological diagnostic deworming was conducted using the areca-pumpkin seed method. Those positives in fecal examination and found expelled worms were considered as the infected persons and used to calculate the infection rate. Serum cysticercus specific antibodies were detected using cysticercus (Taenia solium) IgG antibody detection kit. The chi-square test, Fisher’s exact probability method and logistic regression analysis were used to analyze the influencing factors of Taenia infection and serum cysticercus antibody positivity in the population. Results A total of 1 842 people from the 4 villages participated in the questionnaire survey, and 39 people (2.1%) had excreted proglottids in the past year. Fecal examination was performed on 1 533 people, and 25 people (1.6%) were found positive. A total of 39 people received diagnostic deworming, and 33 people expelled complete worms (1 person positive in fecal examination did not expel the parasite), and the infection rate was 1.8% (34/1 842). The infection rates in the Jingang, Huoshan, Dabaguan and Qingshuigou villages were 2.1% (10/475), 1.3% (6/450), 2.7% (12/450) and 1.3% (6/467), respectively, with no significant difference (χ² = 3.31, P > 0.05). The infection rate was 2.6% (22/848) in males and 1.2% (12/994) in females (χ² = 4.90, P < 0.05). The infection rates of the 30-59 age group (2.8%, 24/862), Miao (1/2), and farmers and herdsmen (3.0%, 28/944) were the highest in each group (χ² = 10.10, P < 0.01; Fisher = 26.04, P < 0.01; χ² = 13.47, P < 0.01). The positive rate of serum cysticercus antibody was 9.2% (82/887). Positive rates of serum antibodies in Qingshuigou, Dabaguan, Huoshan and Jingang villages were 12.7% (20/157), 4.7% (11/236), 10.4% (26/251) and 10.3% (25/243), respectively, with significant differences (χ² = 8.88, P < 0.05). The positive rates in males were 9.2% (36/393) and 9.3% (46/494) in females (χ² = 0.01, P > 0.05). The serum antibody positive rates in the groups aged 60 years and above (2.8%, 24/862), farmers and herdsmen (11.2%, 61/546) and illiterate people (15.0%, 35/234) were the highest in each group (χ² = 8.66, 12.37, 6.47, P < 0.05 or 0.01). The results of univariate analysis showed that gender, age, nationality, occupation and consuming raw pork products (raw pig skin, pork and liver) were the influencing factors of Taenia infection (χ² = 4.86, 10.10, 26.04, 13.48, 5.72, all P < 0.05). There was a positive correlation between the frequency of consuming raw pork products per month and Taenia infection rate[OR = 1.135, 95% CI: (1.023, 1.259)]. The age, education level, occupation, use of tap water and consuming raw pork products were influencing factors for the positive rate of serum cysticercus antibody (χ² = 8.66, 12.37, 6.47, 3.58, 2.20, all P < 0.05). The results of multivariate analysis showed that males [OR = 2.047, 95% CI: (1.001, 4.189) ] and eating raw pork products [OR = 4.986, 95% CI: (1.166, 21.321) ] were the risk factors for Taenia infection. The low education level [OR = 2.051, 95% CI: (1.183, 3.557)] was a risk factor for positive serum cysticercus antibody, while using tap water [OR = 0.320, 95% CI: (0.124, 0.824) ] was a protective factor for positive serum cysticercus antibody. Conclusion Considerably high Taenia infection rate and positive rate of serum cysticercus antibody are observed in the residents of Dali, Yunnan. Eating raw pork products and male gender are the risk factors for Taenia infection; using tap water and high education level are the protective factors for positive serum cysticercus antibody.

Echinococcosis is a kind of parasitic zoonosis that seriously endangers human health and economic development, which is mainly caused by the parasitization and development of the Echinococcus larvae in the intermediate host. According to current research advances, the globally identified Echinococcus includes 9 valid natural species, which can cause 4 types of echinococcosis. This consensus has evolved alongside the development of research methods and scientific technology over the past two thousand years. Therefore, this article introduced the whole process of human exploration, recognition and cognition of Echinococcus and echinococcosis by summarizing and combing references. The landmark historical event is that in 1801, Rudolphi established an independent genus of Echinococcus for this flatworm. After that, several species of Echinococcus have been found in the world successively. In 1953, Rausch re-classified Echinococcus based on biological characteristics and gradually developed the concept and classification method of subspecies for Echinococcus; in 1967, Rausch further proposed the concept of Echinococcus strains, which was confirmed in the 1990s by Bowles through molecular biological methods. In 2013, Nakao introduced the phylogenetic species concept, revising Echinococcus into nine valid natural species that are still in use today. In addition, this paper summarized the discovery history of Echinococcus and echinococcosis in China. Since 1908, five species of Echinococcus have been reported in China, including E. shiquicus, which was unique to the Qingzang Gaoyuan region. This article provides a systematic review of the historical understanding of Echinococcus and echinococcosis, summarizing extensive historical data to further comprehend the taxonomic research advancements of Echinococcus.

Objective To analyze the genetic differentiation characteristics of Echinococcus multilocularis and E. shiquicus in Qinghai region to provide theoretical support for the prevention and control of echinococcosis in Qinghai Province. Methods Small mammals were captured in the main natural endemic areas of Echinococcus spp. in Yushu, Guoluo, and Huangnan Tibetan Autonomous Prefecture and were dissected to collect cysts. The genomic DNA from cysts tissue was extracted and the cytochrome oxidase 1 (cox1) gene was amplified using PCR and sequenced. DnaSP v6, Iqtree, BEAST v2.7.4 and other software were used for haplotype analysis, nucleotide polymorphism analysis, construction of a phylogenetic tree, and estimation of the divergence time of the Echinococcus genus. Results A total of 55 hydatid cysts were obtained from 2 864 small mammals. All 55 cyst samples were amplified for cox1 bands with a length of approximately 800 bp, of which 37 were E. multilocularis, and 18 were E. shiquicus, the prevalence of E. multilocularis in Neodon fuscus was 1.96% (37/1884). The prevalence of E. shiquicus in Ochotona curzoniae was 1.84% (18/980). In the 37 cox1 sequences of E. multilocularis, there were 5 haplotypes in the 37 cox1 sequences of E. multilocularis with EmH3 being the predominant one (33/37), the haplotype diversity index was 0.207, the nucleotide diversity index was 0.033 55, and there were 156 variable sites. In the 18 cox1 sequences of E. shiquicus, There were 8 haplotypes, with the EsH2 haplotype being the predominant one (8/18), the haplotype diversity index was 0.778, the nucleotide diversity index was 0.060 52, and there were 14 variable sites. Thirteen haplotypes of E. multilocularis and E. shiquensis were uploaded to GenBank. The accession numbers of haplotypes EmH1-EmH5 are OR821706, OR821707, OR830343, OR830344, OR826123, respectively. The accession numbers of haplotypes ESH1-ESH8 are OR835156, OR835157, OR830376, OR830378, OR831110, OR875250, OR835161, OR841080. The phylogenetic tree shows that the 5 haplotypes of E. multilocularis were clustered together with the Asian strain of E. multilocularis, and the 8 haplotypes of E. shiquicus were clustered with E. shiquicus in the GenBank. The divergence time based on the cox1 gene showed that the common ancestor of E. granulosus, E. multilocularis, E. shiquicus, E. oligarthrus and E. vogeli existed approximately 5.67 million years ago (Mya) (95% CI: 4.72-6.66 Mya), and the average divergence time for E. granulosus, E. shiquicus and E. multilocularis was approximately 2.02 Mya (95% CI: 1.51-2.49 Mya). Conclusion E. multilocularis and E. shiquicus in Qinghai region have high genetic diversity, with EmH3 haplotype dominating E. multilocularis and EsH2 haplotype dominating E. shiquicus.

A method for detecting Leishmania based on loop-mediated isothermal amplification (LAMP) was established to support for the prevention and treatment of visceral leishmaniasis. According to the sequence of the kinetoplast 5.8S ribosomal RNA of Leishmania (GenBank: OP829811), specific primers for LAMP were designed and synthesized, and the LAMP method was established. The DNA of blood samples from patients infected with Plasmodium falciparum, P. vivax, P. malariae, P. ovale and healthy individuals, as well as the promastigote DNA of Schistosoma japonicum, Toxoplasma gondii, and L. donovani, were detected by the LAMP method to evaluate the specificity. The promastigote DNA of L. donovani was diluted to 1 ng/μl, 100 pg/μl, 10 pg/μl, 1 pg/μl, 100 fg/μl, 10 fg/μl, and 1 fg/μl to determine the minimum detection limit of the LAMP method and the effect of the presence or absence of calcein on the detection limit. LAMP method and real-time fluorescence quantitative PCR (qPCR) were used to detect blood samples from patients with unexplained fever and healthy people. Bone marrow smears of positive patients were stained by Giemsa to find Leishmania amastigotes. The established LAMP method could detect L. donovani DNA, and the reaction results were green; the results of detecting blood samples of patients infected with 4 species of Plasmodium and healthy people, as well as S. japonicum and T. gondii DNA were all negative, and orange. A total of 46 healthy blood samples were tested by the LAMP method, all of which were negative, without cross-reaction, and with high specificity. After reaction at 65 ℃ for 60 min, the detection limits without and with calcein were 1 pg/μl and 1 ng/μl, respectively. The average peak values of turbidity rates without and with calcein were 0.194 and 0.120, and the time of turbidity after adding calcein was delayed by an average of 23.6 min compared with that without calcein. The LAMP method and qPCR method were used to detect 67 blood samples from patients with fever, of which the same 2 samples were positive. The bone marrow smears corresponding to the same two positive blood samples were examined under a microscope and Leishmania amastigotes were found. The LAMP method for detecting Leishmania is easy to operate, has high sensitivity and specificity, and the test results are visible, which has good promotion and application value.

As one of the invasive alien species in China and the main intermediate host for spreading angiostrongyliasis cantonensis, Pomacea sp. are now widely spreading in China and posing a serious threat to agricultural, forestry, animal husbandry, fishery production, ecological environment and human health in the affected areas. Accurate and rapid identification of Pomacea sp. is the foundation for research on the invasion mechanism, dispersal patterns and population genetics. It is also of great significance to the development and implementation of prevention and control strategies. At present, the identification methods of Pomacea sp. are mainly based on traditional morphology and molecular biology, among which the molecular identification of Pomacea sp. is mainly based on specific primer PCR rapid identification technology and DNA barcode technology. This article reviews the species identification methods of Pomacea sp..

Objective To investigate the protective effects and mechanisms of Echinococcus granulosus antigen B (AgB) and calcium-binding protein 1 (CBP1) in immune thrombocytopenia (ITP) mouse models through TLR4/NF-κB/NLRP3 signaling pathway. Methods Forty-two healthy female BALB/c mice were randomly divided into six groups: control, ITP, AgB, AgB + ITP, CBP1 and CBP1 + ITP, with seven mice in each group. Mice in the AgB and AgB + ITP groups received daily intraperitoneal injection of 100 μg (200 μl) of AgB, while those in the CBP1 and CBP1 + ITP groups received 100 μg (200 μl) of CBP1, mice in the control and ITP groups received 200 μl of PBS, all for five consecutive days. Subsequently, mice in the ITP, AgB + ITP and CBP1 + ITP groups received daily intraperitoneal injection of 3 μg (200 μl) of anti-CD41 monoclonal antibody (Ab) to establish ITP model, while those in the control, AgB, and CBP1 groups received 200 μl of PBS daily, all for five consecutive days. Platelet counts in peripheral blood were measured one day before modeling (D0), during modeling (D1-D5), and one day after modeling (D6). On the day after modeling, the mice were euthanized to collect spleens and livers, which were weighed for calculation of organ index. The mRNA relative transcription levels of Toll-like receptor 4 (TLR4), NOD-like receptor pyrin domain-containing protein 3 (NLRP3), apoptosis-associated speck-like protein containing a CARD (ASC) and IL-1β in spleen tissues were detected by qRT-PCR. The relative expression levels of TLR4, inducible nitric oxide synthase (iNOS), nuclear factor κB (NF-κB), and caspase-1 in spleen tissues were detected by Western blotting. One-way ANOVA was used for comparisons between groups, and the LSD-t test was used for pairwise comparison between multiple groups. Results From the D1 to D6, the platelet counts in the ITP group mice were (102.1 ± 6.8) × 10⁹/L, (234.7 ± 18.1) × 10⁹/L, (229.7 ± 45.8) × 10⁹/L, (316.7 ± 26.8) × 10⁹/L, (320.6 ± 60.5) × 10⁹/L, (179.1 ± 22.2) × 10⁹/L, which were lower than those of (526.6 ± 90.4) × 10⁹/L, (679.3 ± 58.5) × 10⁹/L, (828.0 ± 61.0) × 10⁹/L, (855.3 ± 101.9) × 10⁹/L, (784.1 ± 177.7) × 10⁹/L, (877.4 ± 107.5) × 10⁹/L in the control group (LSD-t = -4.2, -5.5, -6.9, -6.3, -3.9, -4.8; all P < 0.05). Platelet counts in the mice of AgB + ITP group and CBP1 + ITP group on D6 were (512.6 ± 100.5) × 10⁹/L and (511.1 ± 114.8) × 10⁹/L, which were higher than those in the ITP group (LSD-t = 2.3, 2.3; both P < 0.05). The spleen index of the ITP group was 12.1 ± 1.2, higher than that of the control group (6.3 ± 0.4) (LSD-t = 6.8, P < 0.01). The spleen index in the AgB + ITP group was 9.0 ± 0.3, which was lower than that in the ITP group (LSD-t = -3.6, P < 0.01). The results of qRT-PCR showed that the relative transcription levels of TLR4, NLRP3, ASC, IL-1β in spleen tissue of the ITP group were 7.5 ± 2.1, 5.3 ± 1.5, 3.6 ± 0.7, 4.0 ± 0.9, respectively, which were higher than those of 1.3 ± 0.3, 1.2 ± 0.2, 1.2 ± 0.3, 1.0 ± 0.1 in the control group (LSD-t = 4.8, 4.5, 4.2, 5.2; P < 0.01). The mRNA relative transcription levels of the AgB + ITP group were 1.7 ± 0.3, 0.6 ± 0.1, 1.0 ± 0.3 and 0.7 ± 0.1, while those of CBP1 + ITP group were 1.7 ± 0.1, 1.0 ± 0.3, 1.1 ± 0.4 and 0.4 ± 0.1, all were lower than those of ITP group (LSD-t = -4.6, -5.1, -4.5, -5.9, -4.5, -4.7, -4.4, -6.3; all P < 0.01). Western blotting results showed that the relative expression levels of TLR4, iNOS, NF-κB p65, caspase-1 in spleen tissue of the ITP group were 0.7 ± 0.1, 0.5 ± 0.0, 1.4 ± 0.2, 1.5 ± 0.2, all were higher than those of 0.2 ± 0.0, 0.3 ± 0.0, 0.9 ± 0.2, 0.8 ± 0.2 in the control group (LSD-t = 8.6, 6.5, 3.1, 3.5; all P < 0.01). The relative expression levels of AgB + ITP group were 0.4 ± 0.0, 0.4 ± 0.0, 0.9 ± 0.1, 1.0 ± 0.1, while those of CBP1 + ITP group were 0.2 ± 0.1, 0.2 ± 0.0, 0.6 ± 0.1, 0.7 ± 0.1, all were lower than those of ITP group (LSD-t = -6.1, -2.8, -3.1, -2.3, -8.9, -7.1, -4.9, -4.2; all P < 0.05). Conclusion Both AgB and CBP1 showed protective effect in mouse ITP, and their mechanisms are associated with the regulation of the TLR4/NF-κB/NLRP3 pathway.

Objective To ascertain the endemic status of Clonorchis sinensis in Zhejiang Province. Methods From 2013 to 2017, one county (city, district) which had clonorchiasis cases reported before in Zhejiang Province was selected as the regular surveillance site and 3 townships in each site were selected for monitoring each year. No less than 100 permanent residents over age 3 in each township were selected as monitored objects. Venous blood samples were collected, and serum C. sinensis antibody was detected by enzyme-linked immunosorbent assay (ELISA). The positive rate of antibodies in the monitored objects was calculated. And questionnaire surveys were conducted on the factors affecting the infection of C. sinensis from 2013 to 2015. From 2018 to 2022, Ningbo City was selected as the fixed surveillance site and 7-9 counties (cities, districts) were selected as the mobile surveillance sites. Each surveillance site was divided into 5 areas as geographically at east, west, south, north and centre. In each area, one administrative village was randomly selected from one township for cluster sampling of no less than 200 permanent residents over age 3. Fecal samples (over 30 g) were collected for examining C. sinensis eggs using the modified Kato-Katz thick smear method. The infection rate of the monitored object was calculated. Freshwater fish from natural water were collected in regular surveillance sites from 2013 to 2017 and in the fixed surveillance site and a mobile surveillance site from 2018 to 2022. The infection of encysted metacercaria was detected by pressing method after identified the species. From 2018 to 2022, the fecal samples of cats, dogs and pigs were collected in surveillance sites which monitoring the intermediate hosts, and examined C. sinensis eggs using the modified Kato-Katz thick smear method. SPSS 19.0 was used for data statistical analysis. Infection rates were compared between groups using the chi-squared test. Results From 2013 to 2017, a total of 1 516 people were examined in Zhejiang Province and antibody positive rate was 2.51% (38/1 516). A total of 52 626 people were examined from 2018 to 2022. No C. sinensis eggs were found in fecal samples and the infection rate was 0 (0/52 626). The highest antibody positive rate of 6.00% (18/300) was seen in Panan County. The antibody positive rate in different surveillance sites was statistically significant (χ² = 21.212, P < 0.01). The highest antibody positive rate of 8.82% (6/68) was seen in the age 3-17 group. The antibody positive rate in different age groups was statistically significant (χ² = 13.105, P < 0.05). The infection rate of C. sinensis in freshwater fish from 2013 to 2022 were 12.56% (476/3 791). The highest infection rate of 33.47% (84/251) was seen in Ninghai County in 2018. The infection rate in different surveillance sites was statistically significant (χ² = 242.727, P < 0.01). The highest infection rate of 75.00% (21/28) was seen in Acanthobrama simoni. The infection rate in different fish species was statistically significant (χ² = 174.750, P < 0.01). The infection rate of reservoir host was 1.17% (3/257). Conclusion The infection rate of C. sinensis in human population was considerably low in surveillance sites in Zhejiang Province, but the infected intermediate hosts and reservoir hosts still remained, which poses a potential epidemic risk and requires strengthened surveillance, prevention and health education.

Objective To evaluate the intervention effect of comprehensive prevention and control measures on enterobiasis among children so as to provide a informative basis for formulating and adjusting the prevention and control strategies. Methods Using random cluster sampling method, one kindergarten was selected from each of the 12 districts in Nanjing to conduct a survey on the infection of Enterobius vermicularis among all children in September to October 2022. Based on the survey results, four kindergartens with higher infection rates and similar environment and scale were selected from both urban and suburban areas, respectively. All children from 8 kindergartens, one guardian living with each child and the class teacher of each class were enrolled in the survey. Among them, two kindergartens in the urban area and two in the suburbs were assigned as the experimental group implemnting comprehensive control measures, while the remaining four kindergartens as the control group carring out traditional control measures; both groups conducted one-year intervention from November 2022 to November 2023. For the experimental group, the intervention measres comprised of symptom surveillance (on children’s suspected symptoms of Enterbobius infection), companion surveillance (sampling test for positive children’s family members living together with, classmates and playmates), and environmental surveillance (using transparent adhesive tape pasting method to collect environmental samples from positive children’s families and classes), as well as health education with three-dimension of “knowledge, attitude, and practice” as entering point to perform educational intervention jointly with multiple sectors including families, schools, and communities. The intervention measures for the control group were deworming for positive children only and health education delivered to the children and their family members. The After completion of the intervention study, anal swab method with transparent adhesive tape was used to examine the E. vermicularis infection rate in the children of two groups, respectively. Before and after the inervention, questionnaire survey on E. vermicularis control related knowledge was delivered to one class teacher of each class and one guardian living with each child, respectively. Results Before the intervention, the E. vermicularis infection rates in the experimental group and the control group were 1.5% (13/885) and 1.4% (12/886), respectively, showing no significant difference between the two groups (χ² = 0.042, P > 0.05). A total of 234 children with suspected symptoms were found during symptom monitoring in the experimental group, among them, anal itching proportion was found the highes (34.62%, 81/234), followed by sleeping teeth grinding symptom (20.5%, 48/234). A total of 8 positive cases were detected, of which symptoms of anal itching accounted for the highest (5/8), followed by symptoms of sleeping teeth grinding (2/8). In companion surveillance, four positives were detected from positive children’s family members and two positives from their classmates, repectively. In environmental surveillance, four positives were found from plush toys samples, and two positive samples of blankets, sheets, and sofas were detected in the positive children’s family environment, respectively, and one positive sample was found from the desk and chair of their classroom, respectively. After one-year intervention, the infection rate in the experimental group decreased from 1.5% (13/885) before intervention to 0.1% (1/885) (χ² = 10.368, P < 0.05), which was significantly lower than that in the control group after intervention (0.9%，8/886) (χ² = 4.014, P < 0.05). The questionnaire showed that prior to the intervention, there was no significant difference in positive response rate towards children’s hygiene behaviour habits, and parents’ and teachers’ awareness points regarding to enterobiasis “knowledge, attitude, and practice” between the two the groups (all P > 0.05). The correct response rates to the questions “whether washing hands before and after meals, habits of trimming nails, biting fingers and biting toys”(89.9%, 796/885; 88.9%, 787/885; 85.8%, 759/885; 86.8%, 768/885) and correct hygiene habits rates of “whether have a separate towel, frequency of weekly showers, and frequency of monthly bedding drying” (89.2%, 789/885; 85.7%, 758/885; 78.9%, 698/885) in the experimental group were significantly higher than those in the control group (61.7%, 547/886; 71.2%, 631/886; 56.2%, 498/886; 59.8%, 530/886; 78.8%, 698/886; 78.8%, 698/886; 68.6%, 608/886) after intervention (χ² = 192.194, 86.989, 187.741, 164.402, 35.371, 14.285, 24.010; all P < 0.05). After intervention, the positive response rates to all questions towards enterobiasis “knowledge, attitude, and practice” the experimental group were significantly higher those in the control group (all P < 0.05). In post-intervention, the positive response to all questions towards awareness of enteroviasis in teachers were all significantly higher than those in the control group (all P < 0.05). Conclusion Implementation of comprehensive prevention and control measures effectively reduced E. vermicularis infection rate in children, achieved timely interruption and precise control, meanwhile, raised parents’ and teachers’ health awareness and cognitive level on enterobiasis, and promoted changes of their attitudes and behaviours, driving children to develop good hygiene habits, and leading to effectively prevent and interrupt the transmission and spread of enterobiasis.

Objective To develop a rapid visualization method for specific nucleic acid fragments of Schistosoma japonicum using the recombinase polymerase amplification (RPA) technology combined with clustered regularly interspaced short palindromic repeats-associated 12a protein (CRISPR/Cas12a), and to preliminarily evaluate its application value. Methods RPA primers, single-stranded DNA (ssDNA) reporter and CRISPR RNA (crRNA) were designed to target the SjCHGCS20 sequence (GenBank: FN356222.1). The concentrations of T4 recombinase Y, T4 recombinase X, T4 single-stranded binding protein and creatine kinase were optimized in the RPA reaction system, along with the RPA reaction temperature and time. A one-tube RPA-CRISPR/Cas12a method was established by adding the optimized RPA amplification assays, mineral oil and Cas12a reaction system to a reaction tube. After RPA amplification under optimized conditions, the Cas12a reaction was initiated by mixing with the RPA amplification products. The bright green fluorescence signal, indicative of a positive result, was visualized following the CRISPR/Cas12a-mediated cleavage reaction. The sensitivity of the RPA-CRISPR/Cas12a method was evaluated by detecting various amounts of S. japonicum genomic DNA (10⁰, 10^-1, 10^-2, 10^-3, 10^-4, 10^-5 and 10^-6 ng). The assay specificity was assessed by detecting genomic DNA (1 ng total) from S. japonicum, S. mansoni, Paragonimus westermani and Clonorchis sinensis. The effectiveness of the method was further evaluated using mice dummy positive sera containing S. japonicum genomic DNA at final concentrations of 0.2, 2, 20 and 200 ng/ml, as well as sera from mice infected with S. japonicum on day 3, 7, 21, 28, 35 and 42 post-infection. Results The optimized RPA reaction system utilized final concentrations of 50 ng/μl for T4 recombinase Y, 440 ng/μl for T4 recombinase X, 200 ng/μl for T4 single-stranded binding protein and 120 ng/μl for creatine kinase, and the optimized reaction condition was 40 ℃ for 30 min. Sensitivity evaluation of established RPA-CRISPR/Cas12a method indicated the reaction products were positive when the S. japonicum genomic DNA content exceeded 10^-5 ng. Specificity evaluation indicated the reaction product of S. japonicum genomic DNA was positive, and the reaction products of S. mansoni, P. westermani and C. sinensis genomic DNA were negative. The results of mice dummy positive sera showed that the reaction products of S. japonicum genomic DNA concentrations of 2, 20 and 200 ng/μl were positive, and the reaction product of 0.2 ng/ml was weakly positive. The reaction products of sera from mice infected with S. japonicum on day 28 and 42 post-infection were positive, and the reaction product of sera on day 35 was weakly positive. Conclusion The study successfully established a one-tube RPA-CRISPR/Cas12a method for detecting the SjCHGCS20 sequence. The method has a lowest detectable limit of 10^-5 ng for S. japonicum genomic DNA, with no cross-reaction with genomic DNA from S. mansoni, P. westermani or C. sinensis. It is rapid, sensitive, specific and simple to operate, allowing for visual observation of results under blue light, and holds potential for field diagnosis of schistosomiasis japonica.

Objective To investigate the prevalence and epidemiological characteristics of soil-transmitted helminth (STH) infections in China in 2021, so as to provide data support for improving soil-transmitted helminthiasis control strategies in high-prevalence areas and implementing transmission control and interruption of soil-transmitted helminthiasis in low-prevalence areas. Methods National surveillance on soil-transmitted helminthiasis was performed in 412 surveillance counties across 31 provinces (municipalities and autonomous regions) in China in 2021. Each surveillance county was divided into eastern, western, southern, northern, and central parts according to geographical locations, and one administrative village was sampled from one township in each part. Then, 200 permanent residents over 3 years old were sampled from each administrative village, and at least 1 000 residents of different age groups were recruited in each surveillance county. Subjects’ stool samples were collected for detection of STH eggs using a modified Kato-Katz thick smear method (two smears from one stool). In addition, 5 households were randomly sampled from each administrative village, and soil samples were collected from their farmlands or vegetable gardens to detect hookworm larvae and Ascaris lumbricoides eggs. Comparisons of proportions were done with the Chi-square test. Results A total of 424 306 residents were investigated in 412 soil-transmitted helminthiasis surveillance counties across China in 2021, and the overall prevalence of STH infections was 0.88% (3 730/424 306), with 0.67% (2 845/424 306) of hookworm infection, 0.11% (461/424 306) of A. lumbricoides infection and 0.12% (526/424 306) of Trichuris trichura infection, respectively. The highest prevalence of STH infections was demonstrated in Yunnan Province (5.74%, 917/15 967), the highest prevalence of hookworm infection was also in Yunnan Province (4.93%, 787/15 967), the highest prevalence of A. lumbricoides infection was in Qinghai Province (0.52%, 32/6 106), and the highest prevalence of T. trichura infection was in Hainan Province (1.10%, 46/4 184). The prevalence of STH infections was higher in females (0.94%, 2 052/217 245) than in males (0.81%, 1 678/207 061) (χ² = 21.90, P < 0.01), and the highest prevalence of STH infections was shown among residents aged over 60 years (1.62%, 1 921/118 413) (χ² = 1 175.93, P < 0.01). The proportions of light-intensity infections in hookworm, A. lumbricoides and T. trichura were 92.16% (2 622/2 845), 90.46% (417/461) and 93.54% (492/526), and the proportions of moderate infections were 4.04% (115/2 845), 9.54% (44/461) and 6.08% (32/526). There were 108 residents detected with heavy-intensity hookworm infections (3.80%, 108/2 845), and 2 participants with heavy-intensity T. trichura infections (0.38%, 2/526); however, no heavy-intensity A. lumbricoides infection was found. A. lumbricoides eggs were detected in 73 out of 2 475 households of soil samples (2.95%, 73/2 475), and hookworm larvae were identified in 58 households of soil samples (2.34%, 58/2 475). Both A. lumbricoides eggs and hookworm larvae were detected in soil samples from farmlands and vegetable gardens. In addition, the detection rates of Necator americanus and Ancylostoma duodenale larvae were 1.86% (46/2 475) and 0.40% (10/2 475), respectively. Conclusion The prevalence of STH infections was reduced to less than 1% in national surveillance counties of China in 2021; however, it varied greatly in regions. More attention is required to be paid to residents at ages of over 60 years and females. Precise control strategies tailored to local circumstances are recommended, and initiation of transmission control and interruption of soil-transmitted helminthiasis is encouraged in low-prevalence areas.

The patient was a 67-year-old male American Chinese. On the evening of August 28th, 2023 (US local time), the patient developed fever symptoms, with a maximum body temperature of 39.7 ℃. On August 29th (US local time), he visited the Massachusetts General Hospital of Harvard Medical School. Chest X-ray showed bilateral ground glass shadows, diagnosed with “pneumonia”, and was treated orally with “azithromycin, benzoate, amoxicillin, and guaiacol”. The patient arrived in Zhuhai on August 31st (Beijing time). On September 1st, he sought medical attention at the Fifth Affiliated Hospital of Sun Yat-sen University due to persistent fever symptoms. Admission examination: hemoglobin 93.00 g/L↓, eosinophils 0.00 × 10⁹/L↓, urinary occult blood 4 +↑, urinary protein 2 +↑. Microscopic examination of blood smear revealed the presence of Babesia microti in red blood cells. Metagenomic next-generation sequencing (mNGS) detection of 1 338 308 sequences of Babesia microti. The patient has been residing in New Hampshire, USA (Babesia epidemic area) for a long time, and had a history of insect bites. The next-generation sequencing results showed positive results for Babesia microti. The patient was treated with minocycline (0.1 g each time, once every 12 hours) + clindamycin (0.6 g each time, once every 6 hours) for anti-infection. After treatment, the condition improved, and the patient was discharged on September 11th. The blood count prior to discharge showed: hemoglobin 76.00 g/L, platelet count 208.00 × 10⁹/L, alanine aminotransferase 39.60 U/L, and aspartate aminotransferase 37.20 U/L. After 2 months of follow-up after discharge, the patient recovered well.

Objective To analyze the epidemiological characteristics and spatio-temporal distribution of visceral leishmaniasis (VL) in Kashi Prefecture, Xinjiang, from 2005 to 2022, to provide a scientific basis for formulating prevention and control strategies for VL in Kashi area. Methods Data on VL cases reported in Kashi Prefecture, Xinjiang, from 2005 to 2022 were collected from the National Diseases Reporting Information System. Descriptive epidemiological methods were used to analyze the three-dimensional distribution characteristics of VL. Spatial auto-correlation analysis was performed using Geoda 1.22 software, and spatio-temporal scanning statistical analysis was performed using SaTScan 10.1.2 software. Results From 2005 to 2022, a total of 1 965 VL cases were reported in Kashi Prefecture, Xinjiang, with an average annual incidence rate of 0.13 per 100 000 people. The peak incidence years were 2008 and 2015, with incidence rates of 6.10 per 100 000 (363 cases) and 8.29 per 100 000 (396 cases), respectively. Among the population distribution characteristics, 1 125 cases were male and 840 were female, with a male-to-female ratio of 1.34 ∶ 1. Cases were reported across all age groups, with the composition rate of 75.47% (1 483/1 965) in the 0-4 years age group. The high-risk population was scattered children (75.32%, 1 480/1 965). VL cases were reported monthly from 2005 to 2022, with noticeable seasonal distribution between 2008-2010 and 2014-2016, peaking from September to December. VL mainly occurred in the northern counties of Kashi, with the highest incidence rate in Jiashi County (15.84/100 000), Kashi City (4.10/100 000), Shufu County (1.30/100 000), and Bachu County (1.21/100 000). The results of spatial auto-correlation analysis revealed a significant positive spatial correlation in the incidence of VL in Kashi Prefecture, Xinjiang in 2012 (Moran’s I = 0.126 5, Z = 2.193 2, P < 0.05). Local autocorrelation analysis exhibited that high-high clustering areas were mainly distributed in Shufu County, Kashgar City, Jiashi County and Shule County. Spatiotemporal scanning analysis showed that the main clustering area was Jiashi County, and a high incidence period was from 2008 to 2016. Conclusion From 2005 to 2022, the overall incidence of VL exhibited a downward trend in Kashi Prefecture, Xinjiang. The high-risk population consisted mainly of young scattered children, and the northern counties of Kashi were the high endemic areas of VL.

Objective To evaluate the potential risk of disease transmission by Hyalomma asiaticum in the distribution area of Przewalski’s horses, investigate the metagenomic characteristics and conduct pathogen analysis of male and female ticks. Methods In April 2022, tick samples were collected using the “waiting for ticks” method in the Kalamaili Mountain Ungulate Nature Reserve in Xinjiang. The ticks were morphologically identified under a stereomicroscope, and DNA of 48 ticks (24 males and 24 females) was extracted for molecular identification by PCR amplification of the mitochondrial cytochrome C oxidase subunit 1 (COⅠ) sequence. Metagenomic sequencing of H. asiaicum was conducted by grouping the ticks according to sex. The non-redundant sequences were compared to the non-redundant protein (NR) database to analyze the composition of the microbial communities carried by the ticks. Additionally, comparisons were made with the Kyoto encyclopedia of genes and genomes (KEGG) and the antibiotic resistance genes database (ARDB) to obtain the annotations for gene function and the antibiotic resistance functions in ticks and tick-borne pathogens. The data were analyzed using t-test. Results A total of 124 ticks were collected and morphological identification revealed that 119 were H. asiaicum adult. The PCR amplification result showed that the positive production with a length of 700 bp were amplified from tick DNA and the sequences were 99%-100% identical to H. asiaicum (Genbank: MH459386.1). After quality control filtering, a total of 469 327 812 sequence reads were obtained from metagenomic sequencing, and open reading frame prediction yielded 836 843 to 1 094 994 sequences. The NR database comparison revealed that the bacterial community abundance carried by H. asiaicum accounted for 99.13% of the total community abundance, with bacteria from 32 phyla and 2 040 species identified. The predominant phyla are Proteobacteria and Actinobacteria, accounting for 51.52% and 44.35% of the bacterial community abundance, respectively. The dominant species is Anaplasma phagocytophilum, accounting for 16.35% of the bacterial community abundance. The viral community abundance accounts for 0.004% of the total community abundance, with viruses from 5 phyla and 21 species identified. There were no significant differences in the richness and diversity of bacterial and viral communities between female and male ticks (t = -1.180、-1.729, both P > 0.05). KEGG gene function analysis revealed that the highest proportion of genes in H. asiaticum were involved in metabolism (54.38%), with the primary functional categories include amino acid metabolism, carbohydrate metabolism, and membrane transport. A total of 11 352 pathways were identified, 154 of which exhibited statistically significant differences between female and male ticks (t = -2.348, P < 0.05). ARDB analysis revealed that H. asiaticum carried 154 antibiotic resistance genes, comprising 49 different types. The major type of resistance gene was Baca (62.53%), and the main class of antibiotics was glycopeptides. The majority of resistance genes were associated with multi-drug resistance, including Mexf, Mexb, Emrd, Mexw and others. The resistance of Emrd gene in female ticks were higher than male (t = -7.558, P < 0.05). Conclusion This study revealed the major bacterial and viral communities carried by the H. asiaticum at the metagenomic level, along with multidrug resistance-related antibiotic resistance genes. Female ticks and their associated pathogens exhibited higher species richness and gene abundance.

Objective To analyze the schistosomiasis epidemic situation post-reassessment in five provinces (Municipality, Autonomous Region) that have achieved schistosomiasis elimination as of the end of 2023, including Shanghai, Zhejiang, Fujian, Guangdong, and Guangxi, and to provide scientific evidence for further control and elimination of schistosomiasis. Methods The data relevant to schistosomiasis control and including examinations in residents and livestock, snail survey and molluscaciding in endemic counties, cities, and districts of Shanghai, Zhejiang, Fujian, Guangdong, and Guangxi in 2015 to 2023 were collected from National Schistosomiasis Control and Prevention Information Management System, as well as schistosomiasis case report information from China CDC management System of Systematic Surveillance Reports of Disease Prevention and Control Information. The data collected were analyzed. Results From 2015 to 2023, 64 cases of schistosomiasis were reported in five provinces, including 50 cases of schistosomiasis japonica imported from other provinces in China and 14 cases of African schistosomiasis imported from other countries. Schistosomiasis eleimination achieved in 112 historically endemic counties in the five provinces, where the number of schistosomiasis cases decreased from 1 038 in 2015 to 780 in 2023, showing a 24.86% reduction, and no local infection cases were reported. The existing schistosomiasis cases were comprised of local advanced schistosomiasis (1 028 cases) and imported schistosomiasis cases (10 cases), all of which were distributed in Zhejiang Province. The overall serological tests positive rate was 0.59% in 2015 (827/141 204) to 0.17% in 2023 (228/136 002). Among them, the average sero-positive rate in Changshan County of Zhejiang Province was the highest (1.87%, 1 469/78 484). The number of bovines decreased by 51.93% from 125 362 in 2015 to 60 267 in 2023, 29 298 received serological examinations, with 8 positive detected in 2015 only. A total of 4 284 bovines received stool examinations, with no positives identified. From 2015 to 2023, snail distribution was reported in 38 counties. The actual snail habitats increased from 75.26 hm² (1 hm² = 10 000 m²) in 2015 to 86.35 hm² in 2023. Hill and water network types were the main snail habitat types. From 2015 to 2018, the area of emerging snail habitats increased annually, peaking at 12.57 hm² in 2018, while from 2019 to 2023, the area was fluctuated and decreased to 0.56 hm² by 2023. From 2015 to 2023, molluscicide treatment was annually performed in 2 076.95 hm² to 2 307.35 hm² snail habitats, 19 735.08 hm² snail habitats received molluscicide treatment in total throughout the 9 years. Environmental improvements were performed in snail habitats covering an area of 110.63 hm², among which Guangdong Province had the largest improved area (58.53 hm², 52.91%). Conclusion The five provinces have been continueing to consolidate the achievements of schistosomiasis elimination. It is recommended that the five provinces persist the control concept of surveying and eliminating remaining snails and preventing exogenous sources of infection, underline the issue of emerging and reemerging snail habitats, and continuously strengthen risk surveillance and epidemic information management to consolidate the achievements in schistosomiasis elimination.

Objective To develop machine learning models utilizing radiomic and clinical features to precisely identify the biological activity of haptic cystic echinococcosis (HCE). Methods The CT images and clinical data of 521 HCE patients treated at the Hepatobiliary and Pancreatic Surgery Department of Qinghai University Affiliated Hospital, along with 236 HCE patients treated at the General Surgery Departments of Guoluo Prefectural People’s Hospital and Yushu Prefectural People’s Hospital in 2018-2022, were collected. Radiomics features were extracted and screened accordingly. Univariate and multivariate logistic regression analyses were performed on the clinical data to select features for model construction. To construct radiomics and clinical models, seven machine learning algorithms were employed including Logistic Regression (LR), Support Vector Machine (SVM), K-Nearest Neighbors (KNN), Random Forest (RandomForest), Extreme Gradient Boosting (XGBoost), Light Gradient Boosting Machine (LightGBM), and Extra Trees. A clinical-image combined model was constructed based on the prediction from radiomics model combining clinical model, using soft voting method. DeLong’s test was used to compare the performances of the radiomics model, clinical model, and combined clinical-imaging model. In addition, external validation was utilized to assess the model’s performance. Results A total of 430 patients were included for model development and training, while 171 patients were designated for external validation. Fifty-one radiomics features and five clinical features were selected for model construction. Among the seven machine learning models, the XGBoost algorithm demonstrated the best performance, achieving area under the curve (AUC) values of 0.977 [95% confidence interval (CI): 0.964-0.990] and 0.839 (95% CI: 0.776-0.901) on the training and external validation sets, respectively. The radiomics model achieved AUC values of 0.998 (95% CI: 0.997-1.000) and 0.874 (95% CI: 0.822-0.927), while the combined model obtained AUC values of 1.000 (95% CI: 0.999-1.000) and 0.931 (95% CI: 0.894-0.968). The DeLong test results indicated that the performance of the combined model was superior to that of the clinical model in the training set (Z = 2.154, P < 0.05) and showed no statistically significant difference when compared to the radiomics model (Z = 0.562, P > 0.05); however, its performance on the external validation set was better than both the clinical and radiomics models (Z = 3.338, 3.331; P < 0.05). Calibration plots and decision curve analysis (DCA) indicated that the combined model exhibited the best calibration performance in both the training and external validation sets, yielding the highest net benefit, demonstrating consistent performance across different datasets, and displaying good generalizability and reliability in external validation. Conclusion The machine learning model, developed based on radiomic and clinical data, can precisely identify the biological activity of HCE lesions. The combined model exhibits higher diagnostic accuracy and clinical application potential, providing reference for making treatment plan for HCE patients.