Table of Content

30 December 2019, Volume 37 Issue 6

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ORIGINAL ARTICLES

Evaluation and analysis of schistosomiasis control in model demonstration and expansion areas with infection sources control strategy implemented in Jiangxi Province

Jun GE, Fei HU, Li-juan ZHANG, Chun-qin HANG, Ke-xing LIU, Shi-zhu LI, Dan-dan LIN, Yi-wen LIU

2019, 37(6):  625-631.  doi:10.12140/j.issn.1000-7423.2019.06.001

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Objective To evaluate and analysis the schistosomiasis control in model demonstration and expansion areas with infection sources control strategy implemented in Jiangxi Province. Methods The programs of model demonstration and expansion areas for schistosomiasis control were initiated during 2011-2015, where the measures to control infection source of schistosomiasis were implemented. These measures included eliminating farming cattle, replacing the farming cattle with agricultural machine, forbidding grazing on snail-inhabited marshlands, snail control, examination and treatment for resident people and livestock and performing health education. The epidemiological data were collected from these areas from 2010-2018 and analyzed. The infection of resident, livestock and snail in these areas after the implementation of the control measures was compared with that before implementation. The epidemic and control effects were analyzed and evaluated. Results The program covered total 672 villages within 69 townships in 13 counties. In the model demonstration areas, after the implementation of control measures, the infection rate of snail decreased from 0.22% in 2010 to 0 in 2014, and there is no infectious snails found for 4 consecutive years from 2015 to 2018. The positive rate of fecal examination in residents dropped from 1.12% (175/15 585) in 2010 to 0 in 2015, and cattle positive rate dropped from 2.95% (166/5 629) in 2010 to 0 in 2013. In 4 expansion areas, the snail infection rate dropped to 0 after 1 year with the program implemented, with no infectious snails found for 5 consecutive years. The infection rate of cattle dropped to 0 after 1-3 years of the program implementation. Only 7 cases were found with schistosome egg positive in the expansion areas during 2015-2018. Conclusion At the low infection areas, the infection rate of schistosomiasis in people, cattle and snail could be further decreased by implementing the strategy focusing infection source control in the model demonstration area and extension areas. It is necessary to further strengthen the integrated measures for infection source control including banning livestock husbandry in marshlands, as to consolidate control achievements in these demonstration and expansion areas.

Investigation on the accessibility and need of the health education materials in different schistosomiasis endemic areas of Jiangxi Province

Jing ZHANG, Lan LI, Fei HU, Jun-jiang CHEN, Chun-li CAO, Shu-ying XIE, Yue-min LIU, Dan-dan LIN, Jing XU

2019, 37(6):  632-636.  doi:10.12140/j.issn.1000-7423.2019.06.002

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Objective To evaluate the accessibility to the health education materials for residents who lived in different schistosomiasis epidemic regions in Jiangxi Province, and understand the demand of these materials for local people in these regions. Methods A face-to-face questionnaire was performed on residents who were over 20 years old and lived in two pilot villages with lake and marshland(LM) and hilly and mountainous (HM) type schistosomiasis endemic regions, respectively, in Jiangxi Province. At the meanwhile, a semi-structured interview was carried out on administrative staffs in the survey sites including the administrators of related township, local workers for schistosomiasis control, village doctors and teachers. Results Total 348 questionnaires were issued to residents in HM-type village with 347 responded, 309 questionnaires to HM-type villagers with 304 responded. All answers were qualified. The print materials were the main sources for acquiring the knowledge of schistosomiasis control and health education in both villages. The accessible rate to printed health education materials in HM village was 85.5% (260/304) which significantly higher than that in LM village 60.8% (211/347) (P < 0.01). The accessible rate to video materials was low in both 2 villages, with 20.5% (71/347) in LM village and 18.4% (56/304) in HM village with no significant difference (P > 0.05). The accessible rates to tangible education materials was 57.4% (199/347) in LM village and 28.0% (85/304) in HM village with significantly higher in LM village (P < 0.01). The demand rate for tangible education materials was 75.9% (264/348) in LM village and 67.3% (208/309) in HM village, and for print materials 12.6% (44/348) in LM village and 10.4% (32/309) in HM village, with no significant difference between two villages (P > 0.05). The demand rate for video materials was 22.3% (69/309) in HM village, which is significantly higher than that in LM village 11.5% (40/348) (P < 0.05). Through visiting 93 local administrative staffs, a total of 254 effective suggestions were collected, in which 19.3% (49/254) of them considered that low-educated people were difficult to understand the printed materials and preferred tangible education materials, 13.4% (34/254) of them suggested that doctors should interpret the content of printed materials face to face to local people, and 16.9% (43/254) suggested the designs of education video should be more understandable and related to the life of local people with more case report. Total 27.2% (69/254) of them considered that combination of three types of materials (print, video and tangible materials) would obtain better effect of education than single one, 23.2% (59/254) believed that the government-community-school-family should work together to lead and promote the health education and schistosomiasis control. Conclusion People in the endemic areas are more willing to obtain understandable, intuitive, close to the real life, education material related to the schistosomiasis control. Printed materials are the main sources for acquiring knowledge of schistosomiasis control.

Distribution characteristic and the main influencing factors of Oncomelania hupensis in different years in Poyang Lake area of Jiangxi Province

Shang-biao LV, Min YUAN, Fei HU, Shan LV, Yi-feng LI, Chun-qin HANG, Dan-dan LIN

2019, 37(6):  637-643.  doi:10.12140/j.issn.1000-7423.2019.06.003

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Objective To investigate the spatial and temporal distribution of Oncomelania hupensis in Poyang Lake area and the influencing factors related to the spread of O. hupensi, so as to provide a scientific basis for formulating measures for the control of O. hupensi in the endemic lake area. Methods Total 35 marshland blocks located at the confluences of rivers at the north and south banks of Poyang Lake were chosen as survey sites. The data for three surveys including area with O. hupensi, the area with infected O. hupensi, average density of living O. hupensi and average density of infected living O. hupensi, hydrologic water level, the bank marshland height and O. hupensi control measures were collected. Average density of living O. hupensi and infected living O. hupensi were analyzed by using rank sum test. Results For the 1^st, 2^nd and the 3^rd O. hupensi survey（1982, 20012, 2017）, the area with O. hupensis was 8 574.5, 9 014.3 and 5 099.8 hm², the area with infected O. hupensiwas 172.0, 91.0 and 0 hm², the average density of living O. hupensi was 0.7(48 833/69 750), 1.6 (134 534/83 387) and 0.3/0.1 m² (33 189/97 315), and the average density of infected O. hupensis was 2.5 × 10^-3 (172/69 750), 1.1 × 10^-3 (91/83 387) and 0 hm², respectively. Except 1985, the average annual maximum water level during 1980-2002(including 1^st and 2^nd snail surveys) was higher than the upper elevation of marshland(18 m), and the average annual minimum water level was lower than the lower elevation of marshland (13 m). From 2003 to 2016 (including 2^nd and 3^rd surveys), the mean annual maximum water level was lower than the upper elevation of the marshland for 7 years, and the mean annual minimum water level was lower than that during 1980-2002. After the second survey, the lower lake water level was not able to merge the marshland during the flood season and the basin of lake was exposed for a longer time and the marshland was dried out during the drought season. There was no change for the elevation of marshland among the three surveys. The mean elevation of marshland from high to low was Xinjiang (16.7 m), Ganjiang North Branch(16.5 m), Fu River (16.5 m), Xiuhe and Ganjiang confluence (16.4 m), Ganjiang South Branch (16.3 m), Rao River (15.7 m) and river entry channel (15.0 m). For the first survey, the average density of living O. hupensi in the areas with and without O. hupensis control was 0.5/0.1 m² （18 227/34 531）and 0.9/0.1 m²（36 605/35 219）, the density of infected O. hupensis in the areas with and without O. hupensis control was 1.7 × 10^-3/0.1m²(58/34 531) and 3.2 × 10^-3/0.1 m² (114/35 219), respectively. For the second survey, the density of living O. hupensis was 1.1/0.1 m² （37 494/34 755） in O. hupensis control area and 2/0.1 m² （97 041/48 632） in area without O. hupensis control, the density of infected O. hupensis was 1.7 × 10^-3/0.1 m²(58/34 755) in O. hupensis control area and 0.7 × 10^-3/0.1 m² (33/48 632) in area without O. hupensis control. For the third survey, the density of living O. hupensis in the areas with and without O. hupensis control was 0.3/0.1 m²（15 180/44 417）and 0.3/0.1 m²（18 009/52 898）, the density of infected O. hupensis in the areas with and without O. hupensis control was 0, respectively, without statistical significance (P > 0.05). Conclusion The growth and spread of O. hupensis in Poyang Lake area was affected by lake water level, elevation of marshland and the snail control intervention. O. hupensis in the higher elevations of marshland in the Southern Lake Area show a trend of retreating to the northwest and the low elevations of marshland in the Northern Lake Area. Application of molluscicides can quickly reduce the O. hupensis density on the marshland, but has low effect on the snail control when the snail density is low.

Effect of health education on the control of schistosomiasis in Xinjian District, Nanchang of Jiangxi Province, during 2016-2018

Zhang-ke YU, You-xing LI, Ding-hua AI, Ping ZHANG, Dan-dan LIN, Zhao-jun LI, Chun-li CAO

2019, 37(6):  644-647.  doi:10.12140/j.issn.1000-7423.2019.06.004

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Objective To evaluate the effect of health education on schistosomiasis control among the residents in the major endemic areas in Xinjian District, Nanchang. Methods Total 5 villages including Xiangyang, Chaoyang and Hongwei in Nanji Township, and Changyi, Caohui in Changyi Township, Nanchang, were selected as study sites based on randomly sampling method during 2016-2018. The residents in these sites were given health education including schistosomiasis control knowledge and personal sanitation behaviors through distributing leaflets, brochures, posters, establishing WeChat social groups, issuing education video for schistosomiasis control, providing physical check and clinic service. A questionnaire was issued to every villager before and after the education intervention to investigate the change of knowledge, behavior and attitude towards schistosomiasis control. Results A total of 202 permanent residents were enrolled in the survey. In 2016, 182 questionnaires were collected before intervention, with the correct rates for the knowledge, attitude and behavior of schistosomiasis control as 86.3% (157/182), 98.4% (179/182) and 28.0% (51/182) respectively. In 2018, 199 questionnaires were received after education intervention, with the correct rates of knowledge, attitude and behavior of schistosomiasis control as 100% (199/199), 100% (199/199) and 24.1% (48/199) respectively, with significantly improved knowledge for schistosomiasis （P < 0.05）, but not for the attitude and behavior improvement (P > 0.05) compared with that before education. Specifically, the answer correct rates for the Schistosoma infection season, clinical manifestations and the consequences of not adequate treatment in children increased from 43.4% (79/182), 91.8% (167/182), 86.3% (157/182) to 99.5% (198/199), 100% (199/199), 100% (199/199) after the intervention. The correct rate of knowledge about the cause of schistosomiasis, the intermediate host of schistosomiasis and the treatment drugs reached 100% after intervention. The correct rate of the attitude towards schistosomiasis control was over 99.0% for all investigators. In terms of the behavior of schistosomiasis control, the correct rates for preventing pasturing, living and performing production activities in the areas with high risk of Schistosoma infection were improved from 28.0% (51/182), 1.6% (3/182) and 40.7% (74/182) before intervention to 100% (199/199), 64.8% (129/199) and 46.2% (92/199) after intervention, respectively, with significant difference (P < 0.05). Conclusion After the implementation of health education the awareness about schistosomiasis control for residents in endemic areas has been significantly improved.

Evaluation on molluscicidal effect of wettable powder of pyriclobenzuron sulphate in marshland schistosomiasis endemic areas

Ze-lin ZHU, Xia ZHANG, Zhang-ke YU, Yu-wan HAO, Tian TIAN, Qiang WANG, Li-ping DUAN, Shi-zhu LI

2019, 37(6):  648-651.  doi:10.12140/j.issn.1000-7423.2019.06.005

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Objective To evaluate the molluscicidal effect of wettable powder of pyriclobenzuron sulphate (WPPS) and its toxicity to fish in marshland schistosomiasis epidemic areas, so as to provide scientific evidence for the extensive application of this molluscicide in marshland schistosomiasis epidemic areas. Methods Six pilot sites in the marshland around Poyang Lake were selected and all obstacles within these sites were removed. The natural mortality of Oncomelania was calculated. The 25% wettable powder of pyriclobenzuron sulphate(WPPS) was dissolved in water to a final concentration of 1, 2, 4, 8 g/m³. The commonly used molluscicidal drug niclosamide ethanolamine salt(WPNES) was dissolved in water to a final concentration of 1 g/m³. Then these formulated molluscicidal drugs in different concentration were sprayed on the different spots of marshland evenly. The control spot was sprayed with water only. The Oncomelania were collected and examined for their viability by crushing the snails 1, 3 and 7 days after administration of the drugs. To test the toxicity of the molluscicidal drugs to fish, a water area in Hubei Province was selected and separated into 6 chambers. Total 30 carp fishes were put into each chamber and adapt for 1 day before administration with WPPS to the final concentration of 2.5, 5.0 and 7.5 g/m³. The control chamber was administrated with WPNES to 2 g/m³. The blank control chamber was added with clean water only. The survival rate of carp was counted and recorded after administration with the drugs for consecutive three days. Results The adjusted mortality of Oncomelania in each group was more than 85% after administration with molluscicidal drugs for 1 and 3 days. The mortality of Oncomelania 3 days after administration with 1 g/m³, 2 g/m³ WPPS(93.1%, 95.0%)was higher than that with drugs for 1 day(88.2%, 90.9%). The adjusted mortality of Oncomelania after administration with 4 different concentrations of WPPS (1, 2, 4, 8 g/m³) were 90.4%, 90.0%, 90.3% and 89.8%, respectively, all higher than that using 1 g/m² WPNES(76.0%) with significant difference (P < 0.05). The adjusted mortality of Oncomelania was higher than 90% at 1 day, 3 days and 7 days when 2 g/m² WPPS was administrated with highest of 94.7% at 3 days. The fish toxicity test results showed that the mortality of carp at 2.5 g/m³, 5.0 g/m³ of WPPS was similar to that of the blank control (0, 3.3%, 6.9%). The mortality of carp was 50% when WPPS was added to 7.5 g/m³ for 2 and 3 days. Chi-square analysis of mortality of carp at 2.5, 5.0, 7.5 g/m³ WPPS was significantly different(P < 0.05). Conclusion WPPS can effectively kill Oncomelania and has high biological safety for fish, so it can be applied in the environment of marshland, fish pond to effectively control Oncomelania, providing an effective alternative molluscicides in marshland schistosomiasis epidemic areas.

Endemic status of schistosomiasis in national surveillance sites in Jiangxi Province from 2015 to 2018

min YUAN, Yi-feng LI, Shang-biao LV, fei HU, Chun-qin HANG, Zhe CHEN, Dan-dan LIN, Hui DANG, shan LV

2019, 37(6):  652-657.  doi:10.12140/j.issn.1000-7423.2019.06.006

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Objective To understand the endemic status and epidemiological trend of schistosomiasis within national surveillance sites in Jiangxi Province so as to provide a scientific basis for the better prevention and control of schistosomiasis in the whole province. Methods According to the National Schistosomiasis Surveillance Program (2014 edition), total 39 national schistosomiasis surveillance sites were set up in 39 endemic counties (cities, districts) in Jiangxi Province to surveil the transmission and infection of schistosomiasis in local population, livestock and snails, and to investigate the factors related to the transmission during October to November, 2015-2018. Indirect hemagglutination assay (IHA) was used to detect antibody against Schistosoma in local residents and mobile population with age over 6 years old within these surveillance sites. Modified Kato-Katz and egg concentrated/hatch method were used to examine the eggs in the feces of people and livestock in triplicate. Infection of snails was determined by tissue dissection under microscope and LAMP was used to detect parasite DNA. Results Total 45 086 residents and 31 272 mobile population in the selected schistosomiasis surveillance sites in Jiangxi Province were involved in the survey during 2015-2018, with average 4.61% (2 080/45 086) serological positive for residents and 1.78% (556/31 272) positive for mobile population. The range of serological positive for local residents in different year was 4.01%-5.58%, and for mobile population was 1.24%-2.36%, all with highest in 2017, with statistical difference among different years (P < 0.01). The serological positive rate for local resident male 5.41% (1251/23 124) and mobile male 2.15% (394/18 322), which were significantly higher than female residents of 3.77% (829/21 962) and mobile population of 1.25% (162/12 950) (P < 0.01). People > 55-year-old had positive serological rates of 6.22% (902/14 504) for local residents and 2.37% (152/6 421) for mobile population, which were higher than those of other age groups (P < 0.01). The serological positive rate in farmers and fishers was 6.06% (1 932/31 868) for residents and 3.09% (383/12 408) for mobile, which were significantly higher than those of other occupational groups of 1.12% (148/13 218) and 0.92% (173/18 864), respectively (P < 0.01). Only 6 fecal egg positive cases was found in the local residents with 3 male and 3 female, 5 of them with age over 55 years old. All of them were farmers and fishers living around Poyang Lake. No case was found in mobile population. Total 4 128 livestock were monitored during 2015-2018 and no cattle was found egg positive in their fecal samples. A total of 10 510.11 hm² area were examined for snail, 2 907.58 hm² of them contained snails. The density of live snails was 0.16 to 0.66/(0.11 m²). 23 007 live snails were tested by LAMP, and 935 tubes of mixed samples were detected, 4 of them were positive and all from East Turtle Island, Xinhua Village, Lushan City in 2015. Conclusion At present, the risk area of schistosomiasis transmission in Jiangxi province is mainly located around Poyang Lake. Males with age over 55 engaged in agriculture and fishing work are the main risk population for Schistosoma infection. Risk of schistosomiasis transmission still remains in Jiangxi Province. In the future, the schistosomiasis monitoring system should be further strengthened and the high-risk populations in the lake area should be regularly monitored in order to achieve the goal to block the transmission of schstosomiasis in the province in near future.

Analysis on the endemic situation of schistosomiasis in Ruichang, Jiangxi, from 2009 to 2017

Chao LV, Li-yuan ZHOU, Rui CHEN, Xiao-ying XING, Tao CHEN, Han-chen KE, Zhi-yong ZHANG, Hong-qing ZHU, Jing XU

2019, 37(6):  658-664.  doi:10.12140/j.issn.1000-7423.2019.06.007

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Objective To analyze the endemic situation of schistosomiasis in Ruichang, Jiangxi Province from 2009 to 2017, so as to provide reference for formulating the corresponding prevention and control measures and strategies. Methods The annually reported data related to the prevention and control of schistosomiasis in Ruichang were collected from 2009 to 2017. These data mainly include the annual examination of schistosomiasis in the population, the treatment for the advanced schistosomiasis patients, status for livestock infection and snail control. Then a database related to the Schistosoma infections of humans, livestock and snail was established accordingly by using township as calculated units. The serological positive rate in humans, the fecal egg positive rate in livestock, the area with snail, the occurrence rate and the density of living snails were analyzed based on the database. Results A total of 736 216 individuals received examination for schistomiasis including 703 121 received serological test. Total 6 404 were serologically positive with positive rate of 0.40%~1.48%, which was statistical difference between the years (P < 0.01). The serological positive rate increased after flood in 2016 and reached to 1.45% (701/48 458) in 2017, with a significant difference compared with 2015 (0.40%, 357/90 271). Total 107 318 individuals received fecal examination with 292 egg positive, with positive rate ranging from 0 to 1.24%, with statistical difference between different years (P < 0.01). The egg positive patients were mainly distributed in 7 townships including Xiafan (25.68%, 75/292), Fanzhen (21.23%, 62/292), Matou (15.75%, 46/292), Guilin (12.33%, 36/292), Gaofeng (11.99%, 35/292), Henggang (8.90%, 26/292) and Nanyang (3.42%, 10/292). There was no acute schistosomiasis patient found in consecutive 9 years. There was no fecal positive patient since 2015. However, there were still 209 cases of advanced schistosomiasis in Ruichang region mainly distributed in the town of Xiafan (73, 34.93%), Gaofen (51, 24.40%), Fanzhen (24, 11.48%), Huangjin (22, 10.53%) and Matou (15, 7.18%). The total number of 36 460 cattle were examined from 2009 to 2017, in which 258 confirmed with infection of Schistosoma, most of them distributed in Xiafan (87, 33.72%), Gaofeng (48, 18.60%), Huangjin (62, 24.42%) and Wujiao (29, 11.24%). Total 262 infected cattle received anthelmintic treatment and the mass administration of anthelmintic expanded to 29 750 cattle. The area with snails decreased year by year since 2009 (615.99 hm²), and reached to the lowest level of 584.11 hm² in 2015, however, the difference in area with snail between 2015 and 2009 was no significant. The incidence of frames with snails decreased from 20.56% in 2009 to 10.78% in 2015, with statistical differences between the years (P < 0.01). Similarly, the density of snail decreased from 0.34/frame in 2009 to 0.16 /frame in 2015, with statistical difference between the two years (P < 0.05). Affected by the flood in 2016, the area with snail increased 43.60% (838.76 hm²) compared to that in 2015 with significant difference (P < 0.01), however, there was no significant change for the occurrence rate with snail in frames and the density of snail. In 2017, the incidence of frames with snails reached to 27.94%, and the density of snails reached to 0.56/frame, which were significantly higher than that in 2015 (10.78%, 0.16/frame)(P < 0.01). This increase happened in main nine towns of Ruichang. The correlation coefficient between serological positive rate in people, fecal egg positive rates in human and cattle and the area with snail, snail density, percentage of frames with snail was low (r = -0.199-0.202), without significance. Conclusion The endemic situation of schistosomiasis in Ruichang region was decreasing year by year since 2009. However, Matou, Gaofeng, Fanzhen, Xiafan, Henggang and Guilin are still the main areas with high risk of schistosomiasis transmission and the major areas for the disease control. Snail control is difficult to be consolidated and greatly affected by flood and other natural factors. Therefore, it is critical to establish emergent plan and the monitoring system after flood to prevent rebound of schistosomiasis in the flooded area.

Case management for those with positive anti-Schistosoma antibody in Poyang Lake of Jiangxi Province area after transmission control

Yin-long LI, Zhang-ke YU, You-xing LI, Ding-hua AI, Ping ZHANG, Zhao-jun LI, Dan-dan LIN, Jing XU

2019, 37(6):  665-669.  doi:10.12140/j.issn.1000-7423.2019.06.008

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Objective To determine the anti-Schistosoma antibody level in residents around endemic Poyang Lake after transmission of schistomosiasis has been controlled and the scientific management model for people with antibody-positive, so as to provide reference for precise prevention and control of schistosomiasis in areas with transmission controlled. Methods Two major schistosomiasis endemic townships: Nanji Township(including Xiangyang, Chaoyang and Hongwei Villages) and Changyi Township (including Changbei and Caohui Villages), were selected as the research sites. The sera were collected from residents in these villages with age over 6 years old and the indirect hemagglutination assay (IHA) was used to detect the anti-Schistosoma antibody in the sera. The identified 302 residents with antibody positive were randomly divided into three groups, praziquantel chemotherapy plus health education (joint intervention group), praziquantel chemotherapy only (chemotherapy group), health education only (education group). The antibody titers were examined annually for consecutive three years among these people from 2016 to 2018. Their knowledge, awareness and attitude towards schistosomiasis control was investigated by a questionnaire annually. Results The survey subjects were male, mainly over 40 years old, with primary and junior high school education, mostly farmers or fishermen. In 2017, there were 38.1% (37/97), 33.7% (32/95) and 40.0% (38/95) people with antibody converted to negative for joint intervention group, chemotherapy group and education group, respectively, without significant difference between groups (P > 0.05). The average titers of antibody in joint intervention group, chemotherapy group and education group in 2017 were 1 : 22.5, 1 : 26.6 and 1 : 29.9, respectively, with significant difference between the groups (P < 0.05). In 2018, the average titers of antibody in joint intervention group, chemotherapy group and education group were 1 : 24.0, 1 : 18.7 and 1 : 25.6, respectively, with significant difference between groups (P < 0.05), with 47.9% (45/94), 45.3% (43/95) and 51.7% (43/95) people with antibody converted to negative, respectively, without significant difference between groups (P > 0.05). The correct rate for the knowledge about schistosomiasis control in joint intervention group, chemotherapy group and education group increased year by year, from 84.0% (79/94), 87.5% (84/96), 88.6% (78/88) in 2016 to 85.9% (85/99), 90.7% (88/96), 90.2% (83/92) in 2017, and then all groups reached to 100%, respectively, without significant difference between groups in the same year (P > 0.05). The correct rate for schistosomiasis control behavior in joint intervention group, chemotherapy group and education group have increased from 31.9% (30/94), 22.9% (22/96), 22.7% (20/88) in 2016, to 42.4% (42/99), 44.8% (43/96), 45.7% (42/92) in 2017, and to 63.4% (64/101), 65.7% (65/99), 66.3% (65/98) in 2018, respectively, without significant between groups though (P > 0.05). Conclusion To better manage the antibody positive people in the endemic areas, the health education is important to improve the knowledge and behavior in people living in endemic areas to prevent the infection of S. japanicum, as a supplement for chemotherapy with praziquantel.

Prevalence of human soil-transmitted helminth infections in rural areas of Guizhou Province in 2015

Ai-ya ZHU, Dan-cheng YAO, An-mei LI, Jia-rui DAI, Yang LI, Yu-ting HUANG, Wei-fang SHI, Dan-ya SHE

2019, 37(6):  670-675.  doi:10.12140/j.issn.1000-7423.2019.06.009

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Objective To investigate the infection status of human soil-transmitted helminths (STH) in rural areas of Guizhou Province so as to provide scientific basis for formulating the prevention and control measures for these diseases in the province. Methods The study was performed according to the National Survey Program and Implementation Rules for the Status of Human Key Parasites in 2015. Total 30 survey sites were selected from 12 counties (cities or districts) based on the stratified cluster random sampling method. No less than 250 permanent villagers in each site were enrolled in the survey. The fecal samples were collected from each participant and the eggs of STHs (Ascaris lumbricoides, hookworm, whipworm and Enterobius vermicularis) were examined under microscope using Kato-Katz technique. The eggs of E. vermicularis were examined using transparent adhesive tape around anuses of children with age of 3-6 years old. Results A total of 7 572 residents were investigated with STH infection rate of 14.9% (1 127/7 572). The infection rates of A. lumbricoides, whipworm, hookworm, and E. vermicularis were 8.1% (614/7 572), 2.2% (163/7 572), 6.3% (477/7 572) and 0.3% (21/7 572), respectively. Among the 12 counties surveyed, the infection rate of STH in Zhenfeng County was the highest (30.8%, 160/519), while that in Sinan County was the lowest (5.2%, 13/250), with statistical significance in different counties (P < 0.01). The infection rate of STH in males was 12.6% (472/3 756), which is lower than that in females (17.2%, 655/3 816) with statistical difference (P < 0.01). The STH infections were found in all age groups with the highest infection rate in the age group over 70 years old (21.0%, 111/528). Farmers as well as herdsmen and fishermen, possessed the highest infection rate of 15.8% (780/4 946) compared with people with other occupations. People in Gelao ethnic group owned higher STH infection rate of 22.9% (63/275) than people with other ethnic groups. In terms of education, the STH infection rate was highest among illiterate residents (18.9%, 214/1 133). There was statistical difference in infection rates among the residents with different age groups, occupations, nationalities and education levels (P < 0.01). Conclusion A. lumbricoides and hookworm are the main soil-transmitted helminths that infect people in rural areas of Guizhou Province. There are obvious regional distribution. Female with age over 70, farmers including hersman and fisherman, Gelao minority ethnic group and illiterate people are the main population with high infection and therefore the major control targets.

Establishment of a mouse model of Capillaria hepatica infection

Ya-lan ZHANG, Yan-kun ZHU, Li-jun GAO, Lei WANG, Yan DENG, Wei-qi CHEN, Bian-li XU, Xi-meng LIN, Hong-wei ZHANG

2019, 37(6):  676-680.  doi:10.12140/j.issn.1000-7423.2019.06.010

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Objective To establish a mouse infection model of Capillaria hepatica to facilitate the research on hepatic capillariasis. Methods The C. hepatica infected rats were collected from endemic area in Luoyang, Henan. The C. hepatica eggs were collected from the liver of an infected rat by 1% pepsin digestion. The collected eggs were divided into 3 groups with 1 000, 5 000 and 10 000 per well in duplicate, then cultured in vitro at 28 ℃ in an incubator. The eggs were observed under microscope for their embryonated rate at Day 18, 21, 23, 25, 29. The fully embryonated eggs were divided into two groups and incubated in distilled water and artificial gastric juice respectively under 37 ℃. The hatched larvae were observed. Three male Kunming mice with 4 weeks old in each group were inoculated orally with 5, 10, 20, 60, 100, 200, 500 and 800 C. hepatica embryonated eggs. The survival rate of each group was observed as evidence of successful infection. Another sixteen mice were infected orally with 60 C. hepatica embryonated eggs to systemically observe the infection and development of C. hepatica worms and eggs in livers at Day 14, 18, 21, 29, 35, 55, 90, 365 post infection by necropsying 2 mice at each time point. Results Seventeen rats were captured from endemic area Luoyang, Henan, and five identified to be infected with C. hepatica with infection ratio of 5/17. Rattus norvegicus rat was the only species infected with C. hepatica with infection rate of 5/8. Most of C. hepatica eggs observed in the livers of infected rats were at Ⅲ to Ⅳ cell divided stage. After being cultured in vitro, the cell in collected C. hepatica eggs started to develop and divide to multiple cells. The embryonated eggs could be seen on Day 16 of culture. The rates of embryonated eggs in the culture groups of 1 000, 5 000 and 10 000 eggs per well were 39.6% (67/169), 35.2% (45/128) and 21.4% (98/458) on Day 18; 74.0% (148/200), 75.1% (411/547) and 60.9% (340/558) on Day 23; 88.0% (125/142), 89.2% (140/157) and 79.3% (168/212) on Day 25; and 94.9% (131/138), 97.0% (254/262) and 88.6% (140/158) on Day 29; respectively, with statistical significance between each culture time points (P < 0.05). No larva was hatched from embryonated eggs either in distilled water or in artificial gastric juice. The Kunming mice were successfully infected with 200 or less embryonated eggs of C. hepatica and all survived during the infection. The mice could not survive with infection of more than 500 eggs. In the groups of mice infected with 60 C. hepatica embryonated eggs, the larvae of C. hepatica could be observed in the liver tissue on Day 14. The matured and pregnant female adult worms were observed on Day 18. The adult worms started to die and the unembryonated eggs were laid into liver tissue on Day 35. All worms degenerated and only eggs were observed in liver tissue on Day 90 and 365 post infection. Conclusion The embryonated eggs of C. hepatica can be acquired by in vitro culture of eggs collected from infected rat and C. hepatic infection model was successfully established in Kunming mice with less than 200 embryonated infective eggs.

Epidemiological investigation of hepatic echinococcosis in human population in Jiuzhi, Qinghai Province in 2018

Wei GAO, Hao WANG, You-liang MA, Shun-yun ZHAO, Ajide, Jin-yu YANG

2019, 37(6):  681-684.  doi:10.12140/j.issn.1000-7423.2019.06.011

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Objective To investigate the endemic status and distribution of hepatic hydatidosis in Jigzhi County, Qinghai Province. Methods Six natural villages (or towns), including Zhiqingsongduo, Mentang, Baiyu, Suohurima, Wa’eryi and Wasai, were selected as survey sites from July to December, 2018. Abdominal ultrasound examination was performed in full-time residents with age over 6 years old. Anti-Echinococcus IgG was detected in the sera from the villagers who were willing to donate blood by ELISA. The endemic status of hepatic hydatidosis in Jiuzhi population was analyzed. Results A total of 23 505 subjects underwent the abdominal ultrasound examination, 345 of them were diagnosed as hepatic hydatidosis with the detection rate of 1.47%, of which 126 as hepatic cystic echinococcosis (0.54%) and 219 as hepatic alveolar echinococcosis (0.93%), with higher prevalence of hepatic alveolar echinococcosis than that of cystic echinococcosis(P < 0.05). The prevalence of hepatic hydatidosis in male (0.86%, 99/11 560) was lower than that in female (2.06%, 246/11 945) with significant difference (P < 0.01). Wa’eryi and Baiyu villages in Jiuzhi County owned the higher prevalence of 3.89% (147/3 782) and 3.01% (149/4 949), respectively, than the rest villages (χ²= 277.926, P < 0.01). Regarding the occupation, self-employed businessmen/the unemployed and those doing housework showed the higher prevalence of 20.40% (20/98) and 17.39% (60/345) compared with other occupational groups (P < 0.05). Those with age within 20-29 and 30-39 years old had the higher prevalence of 2.01% (112/5 563) and 2.16% (189/8 756), respectively, with significant differences compared to other age groups (P < 0.01). Among all subjects, 7 845 were involved in the ELISA assay for testing serological anti-Echinococcus IgG and 2 305 of them were antibody positive with the positive rate of 29.38%. The positive rate of anti-Echinococcus IgG was 100% in 107 cases confirmed by the abdominal ultrasound examination. Among 126 cases with hepatic cystic echinococcosis, 49 of them had cyst over 10 cm in diameter (38.9%). Among 219 cases with hepatic alveolar echinococcosis, 116 presented the infiltrating type, 34 calcified and 69 with liquid/cavitary type. Conclusion The prevalence of hepatic echinococcosis is still high in the population in Jiuzhi, Qinghai, with mixed cystic and alveolar echinococcosis. Alveolar echinococcosis was dominant in this endemic county. People with middle age, female, working at home or other business, living in Wa’eryi and Baiyu villagers had the highest prevalence of hepatic hydatidosis and should be the main target for treatment and prevention.

INFORMATION EXCHANGES

Effect of ecological environment change around Poyang Lake of Jiangxi Province on schistosomiasis control

Zhao-jun LI, Yi-wen LIU, Fei HU, Yue-min LIU, jing XU, Dan-dan LIN, Shi-zhu LI

2019, 37(6):  685-689.  doi:10.12140/j.issn.1000-7423.2019.06.012

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The article explores the effect of ecological environment change, including construction projects, on the transmission and control of schistosomiasis at Poyang Lake area. The ecological environment of Poyang Lake has been kept changing since 1950s, which includes making farmland from the lake, strengthening the lake bank, planting on the lake bank and hydraulic and irrigating project, which can reduce the transmission of schistosomiasis. However, some other projects like flood reservoir, recovery of lake from farmland and the tourism development facilitate the transmission of schistosomiasis. In the process of ecological construction, the assessment and evaluation of schistosomiasis transmission should be strengthened, and the strategies and measures for controlling the transmission of schistosomiasis should be adopted appropriately.

Construction of diagnostic network for schistosomiasis in Jiangxi Province

Wei-ming LAN, Shu-ying XIE, Zhi-qiang QIN, Yin XU, Xiao-jun ZENG, Dan-dan LIN, Jing XU

2019, 37(6):  690-693.  doi:10.12140/j.issn.1000-7423.2019.06.013

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This paper summarized the construction of network platform for schistosomiasis diagnosis in Jiangxi Province, analyzed the existing problems for currently established network laboratories for schistosomiasis diagnosis, and provided suggestions for the further development of diagnostic laboratories. Jiangxi Province has established a network platform for the diagnosis of schistosomiasis in the endemic counties (cities) around the Poyang Lake region since 2015. Sixteen network laboratories have been established as standardized and applicable infrastructure for schistosomiasis diagnosis in schistosomiasis prevention institutions. The construction of schistosomiasis diagnosis network laboratories facilitates and strengthens the prevention and control of schistosomiasis in Jiangxi Province. However, it is still needed to further improve the operation, management, personnel skills, proficiency and other aspects of the diagnostic network.

SWOT analysis of blocking schistosomiasis transmission in cooperative innovative demonstration areas in Jiangxi Province

Yi-feng LI, Li-yuan ZHOU, Zhang-ke YU, Jing XU, Rui CHEN, Ping ZHANG, Yi-wen LIU, Dan-dan LIN, Shi-zhu LI

2019, 37(6):  694-698.  doi:10.12140/j.issn.1000-7423.2019.06.014

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The cooperative and innovative demonstration areas for integrated interruption of schistosomiasis transmission in Poyang Lake region and hilly region were established in Xinjian County and Ruichang City, respectively. These demonstration areas have targeted to achieve the goal of transmission interruption by the end of 2020. However, there are both internal and external difficulties to achieve the goal at current situation. By using SWOT analysis method, this paper objectively summarizes and analyzes the internal advantages and disadvantages, external opportunities and threats faced by the demonstration areas to achieve the goal of transmission interruption, and moves forward the corresponding strategies and suggestions in order to achieve the goal as scheduled.

Evaluating the implementation of Diagnostic Criteria for Schistosomiasis(WS 261-2006)

Shu-ying XIE, Jing ZHANG, Bin ZHENG, Fei HU, Jing XU, Wei-ming LAN, Min YUAN, Chun-qin HANG, Dan-dan LIN

2019, 37(6):  699-702.  doi:10.12140/j.issn.1000-7423.2019.06.015

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A questionnaire was issued to staffs of schistosomiasis control institutions, health and family planning administrative agencies and hospitals in the schistosomiasis endemic areas of total 8 cities and 39 counties including Nanchang, Jiujiang, Shangrao, Jingdezheng, Yichun, Ganzhou, Yintan and Jian etc, to determine the implementation situation of Diagnostic Criteria for Schistosomiasis (WS 261-2006), from April to September in 2017. Database was constructed using software EPI data 3.0, and analyzed by software SPSS Statistics 20.0. The Chi square test was used to compare the accuracy rates of the answers, and the Pearson correlation coefficient was used to analyze the correlation between the accuracy and education. A total of 624 questionnaires were received and 450 were valid. The valid respondents consisted of 251 males and 199 females with age from 19 to 61 years old, in which 66.0% (297/450) person from staffs at schistosomiasis control institutions, 4.7%(21/450) person from staffs at health and family planning administrative agencies and 29.3%(132/450) from hospitals. The highest rate of people who used the diagnostic criteria all the time or frequently was at schistosomiasis control institutions (69.7%, 202/290), followed by administrative agency(66.7%, 14/21) and hospitals(25.6%, 32/125). In hospital, less medical workers used the diagnostic criteria with 29.6% (37/125) of them occasionally used and 44.8%(56/125) of them seldomly used. Since the diagnostic criteria had been implemented, there were 1.8%(8/450) people never used or promoted it, 69.3% (312/450) of them had advocated or promoted it with mean times of 1.96 ± 5.13. A total of 55.3% (249/450) institutions had dispatched people to other institutions to train them on average of 5.59 ± 18.98 times. There were 15.1%(68/450) staffs did not know the implementation of the criteria. The correct accuracy rates of knowledge of the criteria in staff groups with different educations, jobs, in different work unit, types were significant different, and there was a positive correlation between education level and accuracy rate (r = 0.97, P < 0.05). Total 82.3% (52/61) interviewers believed that the current diagnostic criteria was practical. The progessional level and the compliance of staffs are the most important favtors that effects the application of the criteria. However, it still exists some problems with the criteria, such as some criteria has not been set up clearly or strictly. The implementation of the Diagnostic Criteria for Schistosomiasis (WS 261-2006) was not good enough in the different levels of schistosomiasis control institutions in Jiangxi province. The advocate and education on the criteria should be strengthened.

Evaluation of fall campaign on snail control in Ruichang, Jiangxi Province during 2012-2018

Li-yuan ZHOU, Chao LV, Hong-qing ZHU, Jing XU, Xiao-ying XING, Rui CHEN, Zhi-yong ZHANG, Qing-sheng ZHOU, Guo-rong KE, Shang-biao LV, Dan-dan LIN

2019, 37(6):  703-708.  doi:10.12140/j.issn.1000-7423.2019.06.016

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To analyze the effectiveness and feasibility of Fall Campaign on Snail Control in Ruichang, Jiangxi Province, from 2012 to 2018, so as to provide reference and suggestions for the better control of oncomelania snail that transmits schistosomiasis. Data related to the villages, participants, invested fund involved in the Fall Campaign on Snail Control in Ruichang, Jiangxi, during 2012 to 2018 were collected. The effect of the campaign on the snail control was evaluated by the reduction of snail occurrence area, occurrence rate of frame with snail and snail density. Total 333 institutions (units) and 187 persons led by mayor had participated in the campaign from 2012 to 2018, with total investment of 2.9138 million yuan. Total 58.46 t of mullosicidal suspension drugs and 12.96 t of mullosicidal powder were used during the 7 years campaign and 4 986.67 hm² snail areas were fulfilled. During 2012-2015, the eliminated snail areas exceeded the area with snails found in that year. During 2016-2018, it did not exceed the area with snails found in that year, with the largest gap in 2016. From 2012 to 2018, the area with snail decreased year by year after the campaign was launched with the lowest in 2017. During the 7 years, the total checked area for snail was 21 218 hm², and 4 611.41 hm² was found with snails. The area with snails decreased from 2012 to 2015, reaching a minimum of 561.62 hm² in 2015, with little difference from 2012 (P > 0.05). The area of snails increased significantly after flood in 2016, which was significantly different from that in 2012 (P < 0.05) and 2015 (P < 0.05), reaching a peak of 789.31 hm² in 2017. From 2012 to 2015, the occurrence rate of frames with snail decreased from 16.66% to 11.59% with significant difference in changes among these years (P < 0.01). After the flood in 2016, the occurrence rate of frame with snails rebounded and increased to a maximum of 30.30% in 2017, which is significantly higher than that in 2015 and 2016（P < 0.01）. In 2018, the occurrence rate of snail frame decreased to 28.96%. From 2012 to 2015, the density of living snails decreased from 0.26/0.1 m² per frame to 0.17/0.1 m². After the flood, the density of living snails slightly increased to 0.190/.1 m² in 2016 and big jumped to 0.61/0.1 m² in 2017. In 2018, it slightly decreased to 0.53/0.1 m² with no significant decrease compared to 2017. After launch of The Fall Campaign on Snail Control, government paid great attention to it and several departments were actively involved. The areas with snail and snail density was decreased. However, the initiative enthusiasm has turned sour at the end and effective control of snail cannot achieve based only on the campaign. Natural disasters such as flood could rebound the snail spread that offset the efforts of the campaign.

REVIEWS

Research progress in the role of profilin in parasitic infection and immunity

Fei-yu QIN, Hai-tong SONG, Xin ZHANG, Yu-di LI, Fei YUAN, Cheng HE, Zhuan-zhuan LIU

2019, 37(6):  709-712.  doi:10.12140/j.issn.1000-7423.2019.06.017

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Profilin is an actin-binding protein highly conserved in all eukaryotes. It regulates the polymerization and depolymerization of actin, therefore affecting parasite movement and invasion in the host and inducing specific immune responses during parasite infection. Here we reviewed the structure and function of profilin, its role during parasite infection and immune responses in the host and its potential as a vaccine candidate and adjuvant, in order to provide reference for the better prevention and treatment of parasitic diseases.

Research progress on the immunopathological mechanism of Schistosoma japonicum egg-induced granuloma

Yu-jun SUN, Zhao-qi LI, Fang-li LV

2019, 37(6):  713-717.  doi:10.12140/j.issn.1000-7423.2019.06.018

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After infection with Schistosoma japonicum, mature female adult worms lay eggs which deposit in the liver, intestinal wall, and other tissues of the infected mammalian host, which induces predominant Th2 immune responses and causes egg granuloma and fibrosis. It has been reported that neutrophils, macrophages, eosinophils, natural killer cells, B cells (including regulatory B cells), T cells (including Th1, Th2, and Th17 cells), Treg cells, hepatic stellate cells, and hepatocytes are involved in this process. In this paper, we reviewed the cell types involved in the egg granulomatous response of S. japonicum and their possible mechanisms in order to provide a helpful reference for related researchers in this field.

SHORT COMMUNICATIONS

Survey of key human parasitic infections in the Eastern Tibet and Western Sichuan Eco-region, Yunnan Province, China

Ben-fu LI, Fang-wei WU, Xin-liu YAN, Jin-rong ZI, Jia PENG, Xue-ying BAO, Xuan CAI, Zheng-qing WANG, Ya-ming YANG

2019, 37(6):  718-722.  doi:10.12140/j.issn.1000-7423.2019.06.019

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To determine the endemic status of important human parasite infections in the Eastern Tibet and Western Sichuan Eco-region of Yunnan Province, Shangri-La and Gongshan counties were selected for the survey in 2015 based on The Third National Survey Plan and Implementation of Key Human Parasitic Diseases. The modified Kato-Katz thick Smear Method was used to examine the helminth eggs in the collected fecal samples in duplicate. The species of hookworm was identified by culturing the larvae using filter paper/tubing method from the egg positive fecal samples (one sample one examination) The saline direct smear method and iodine solution smear method were applied to examine protozoa trophozoites and cysts, respectively. The anal transparent tape method was used to detect Enterobius vermicularis and tapeworm infections in children with age of 3-6 years old. Total 1 271 people from 5 villages in Shangri-La and Gongshan counties were enrolled in the survey, 36.0% (458/1 271) of them were infected with one or more of 12 species of helminths and protozoa. Among them the infection rate was 31.9%（406/1 271） for 5 species of helminth and 5.9% for 7 species of protozoa. The prevalence of soil-transmitted helminths (STH) was 31.9% with Trichuris trichiura as the most common STH (23.1%). The prevalence of STH in Gongshan (50.0%, 383/764) was significant higher than that in Shangri-La (4.5%, 23/507) （P < 0.05). Among the STH infections, most of them were light infection (78.7%, 509/647), with less medium infection (19.3%, 125/647) and heavy infection (2.0%, 13/647). The overall prevalence of protozoan infections was 5.9% in investigated people with Blastocystis hominis as the most common protozoan infection (2.2%). The prevalence of protozoan infections in Shangri-La (10.1%, 51/507） was significantly higher than that in Gongshan (3.1%, 24/764）(P < 0.05）. There was no significant difference in the prevalence of intestinal parasite infections between male (36.3%, 206/567） and female (35.8%, 252/704） participants (P > 0.05). Children with age of 0-9 years old had the highest prevalence of intestinal parasite infections (50.0%, 95/190）. Regarding education level, people with high school or professional school had the highest prevalence of intestinal helminth and protozoa infections (41.2%, 14/34）. In terms of ethical nationality, Dulong people had the highest prevalence of intestinal parasite infections (84.0%, 225/268）. There was significant differences in the prevalence of intestinal parasite infections among people with different age, occupations, education levels and ethical nationalities（P < 0.05）.The survey results showed that the prevalence of key human intestinal parasite infections is still high in the Shangri-La and Gongshan Counties within Eastern Tibet and Western Sichuan Eco-region of Yunnan Province. It is necessary to strengthen the prevention, control and surveillance measures for intestinal parasitic diseases in farmers, students and children who have the highest infections.

Infections of Clostridium difficile, Blastocystis hominis and Cryptosporidium spp. in patients with chronic diarrhea

Ya-ling ZHOU, Liang WU, Qing YIN, Yao WU, Lei HE, Zhi-qing ZOU, Xiao-yue DAI, Wen XIA

2019, 37(6):  723-726.  doi:10.12140/j.issn.1000-7423.2019.06.020

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Ninety-six stool samples were collected from patients with chronic diarrhea at affiliated hospital of Jiangsu University (inpatients and outpatients) in 2018. Each stool sample was smeared for microscopic examination. At the same time fecal DNA was extracted. The genes for 16S rDNA, toxin A (tcdA), toxin B (tcdB), binary toxin (cdtA and cdtB) of Clostridium difficile were detected by multiplex PCR. The SSU rRNA gene of Blastocystis hominis was detected by conventional PCR and the SSU rRNA gene of Cryptosporidium spp. was detected by nest-PCR. C. difficile 16S rDNA was detected in 64 out of 96 patients with chronic diarrhea with a positive rate of 66.7%. C. difficile TcdA gene was detected in 24 cases and tcdB gene in 18 cases of all C. difficile positive samples. There was no sample with only tcdB. No cdtA and cdtB genes were detected in any C. difficile positive sample. The rate of toxigenic strain was 37.5%. Microscopic examination detected 16 B. hominis infected samples with detection rate of 16.7%. PCR results showed that 21 samples B. hominis SSU rRNA gene was amplified in 96 stool samples with a detection rate of 21.9%. All microscopic positive samples were positive in PCR detection. No mixed infection of C. difficile and B. hominis was detected. The Cryptosporidium spp. SSU rRNA gene was not detected in all stool samples. The results showed that C. difficile and B. hominis were the main organisms detected in patients with chronic diarrhea in Nanjing area.

Application of metagenomic Next-Generation Sequencing in the diagnosis of imported malaria

Ren-qing LI, Xiao-mei WANG, Yu-lan SUN, Yan-ning LV, Xiang-feng DOU, Quan-yi WANG

2019, 37(6):  727-729.  doi:10.12140/j.issn.1000-7423.2019.06.021

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The feasibility and application of metagenomic Next-Generation Sequencing (mNGS) in the detection of Plasmodium spp. was investigated by testing a blood sample of a malaria case imported from Africa. The peripheral blood was collected from a malaria patient from Africa. The thick and thin blood smears were prepared and examined under a microscope. Nucleic acid of patient’s whole blood was extracted and detected by real-time PCR. A cDNA library was constructed and used for mNGS by using an Illumina Miseq sequencer. The BLASTn alignment results of the reads and contig sequences were analyzed using Megan6 software, and the assignment mode was aligned by base mode. Microscopic examination showed that the patient was a co-infection of P. falciparum and P. malariae, with lower proportion of P. malariae. The results of real-time PCR showed that the detection of P. falciparum nucleic acid was positive with all negative for P. vivax, P. malariae and P. ovarian. A total of 271 526 reads were obtained, of which 254 674 reads qualified. After filtered by mapping to the Human reference genome, 1 833 reads were finally obtained, and the non-human reads accounted for only 0.7% of the total qualified reads. After de novo, 408 contigs with a length of more than 100 nucleotides were obtained. The results of Megan6 analysis showed that the reads of P. falciparum accounted for 44.7% (29 667/66 374) of the total reads, and 34.5% (22 885/66 376) of the total contig. The results suggest that P. falciparum is the most dominant pathogen. Based on the reads and contig, the pathogen can be traced to the P. falciparum 3D7.

Detection and analysis of fecal egg and serum IgG antibody in 146 suspected cases of Clonorchis sinensis infection in Guangxi

Xue-mei ZENG, Zhi-hua JIANG, Ji-qing SHEN, Qing-li YANG

2019, 37(6):  730-732.  doi:10.12140/j.issn.1000-7423.2019.06.022

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In order to determine the endemic status and develop a diagnostic method for Clonorchis sinensis infection, the fecal eggs of C. sinensis and Haplorchis taichui and the specific IgG antibody in the sera of patients with suspected C. sinensis infections in Guangxi was examined. The fecal samples of suspected C. sinensis infected cases were collected from the Department of Preventive Health Examination, Guangxi Center for Disease Prevention and Control from March to September, 2017. Kato-Katz thick smears were prepared from each stool sample in triplicate. The eggs of C. sinensis or H. taichui were examined and counted (EPG, egg per gram stool). Blood samples from fecal positive patients were collected and the serum IgG antibodies against C. sinensis were detected by indirect ELISA. The correlation between EPG and A₄₅₀ value of IgG antibody was analyzed. The maximum EPG is 21 502 and the minimum EPG is 8 among 146 eggs-positive fecal samples. The total positive rate of C. sinensis IgG antibody was 84.9% (124/146). The antibody positive rates in male and female patients were 86.0% (111/129) and 76.5% (13/17), respectively, without significant difference (P > 0.05). There was a positive correlation between fecal egg EPG and serum C. sinensis IgG A₄₅₀ value (r_s = 0.436, P < 0.01). The positive rates of IgG antibody in patients with mild, moderate, and severe infection were 78.4% (69/88), 96.0% (48/50) and 87.5% (7/8), respectively, and showed significant difference among them (P < 0.05). The geometric mean of fecal EPG in individuals with C. sinensis IgG positive and negative were 736 and 204, respectively, with significant difference (P < 0.01). There is a positive correlation between fecal egg count and C. sinensis IgG antibody titer in Guangxi, where C. sinensis and H. taichui are co-infected. However, there was false negative in the detection of C. sinensis infection by fecal examination alone, serological antibody detection could increase the diagnostic of C. sinensis infection.