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    30 October 2020, Volume 38 Issue 5
    SPECIAL REPORTS OF J ANGXI PROVINCE DEMONSTRATION AREA
    Preliminary achievements of building-up demonstration area based on“cooperation-innovation”mode for integrated control of important parasitic diseases in Jiangxi Province
    GE Jun, CHEN Ying-dan, ZENG Xiao-jun, LI Shi-zhu, LIU Yi-wen
    2020, 38(5):  529-532.  doi:10.12140/j.issn.1000-7423.2020.05.001
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    This paper summarized the experience in establishment of demonstration area for integrated control of important parasitic diseases in Jiangxi Province during 2016-2019, analyzed the achievements and problems of parasitic disease control in the demonstration area based on the mid-term evaluation findings, providing suggestions for the establishment work of demonstration area in 2020. In 2016, a demonstration area for important parasitic diseases control was established in Xinfen County in Jiangxi Province, as a part of the cooperation between Jiangxi Health Commission and National Institute of Parasitic Diseases (NIPD), Chinese Center for Disease Control and Prevention (China CDC) to cooperatively innovate working mechanism in parasitic diseases control and to establish a demonstration area in Xinfen County. The two parties worked closely in the four years adopting the strategy of “led by health education, prioritized with infection source control”, and implementing health education, treatment of the infected population, improving drinking water and toilet, and surrounding environment. as a result, the building-up of demonstration area gained preliminary achievement. The infection rates of C. sinensis and soil-transmitted nematodes decreased from 21.56% and 2.01% in 2016 to 8.85% and 0.17% in 2018, respectively, showing a reduction by 58.95% and 91.54%. The health awareness of residents was raised; the awareness rate on knowledge of clonorchiasis control increased by 37.40%, and the pass rate of not eating raw fish increased to 83.41%. Moreover, applying the mode of “cooperative innovation”, a surveillance network for parasitic diseases control was established at five administrative levels comprising state, province, city and township, a grass-rooted control task team was developed, and apparently, experience has been accumulated in comprehensive control of parasitic diseases. In addition, the building-up of demonstration area evidently promoted collaboratibe scientific research between NIPD and Jiangxi was promoted, and successfully demonstrates the roles in local control and research activities.

    SPECIAL REPORTS OF JANGXI PROVINCE DEMONSTRATION AREA
    Analysis of soil-transmitted helminth infection in populations in national surveillance sites of Jiangxi Province during 2016-2019
    CHEN Zhe, JIANG Wei-sheng, LI Dong, GE Jun, DAI Kun-jiao, ZENG Xiao-jun, ZHU Ting-jun
    2020, 38(5):  534-541.  doi:10.12140/j.issn.1000-7423.2020.05.002
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    Objective To understand the epidemic status of soil-transmitted helminth (STH) infection in the national surveillance sites in Jiangxi Province during 2016-2019, in order to provide scientific basis for formulating control strategy and evaluating the control effect. Methods National surveillance sites were set up in 11 counties (cities) in Jiangxi Province during 2016-2019, and surveillance was carried out according to the national clonorchiasis and soil-borne nematode surveillance program (provisional version). According to geographical location, each county at surveillance was divided into 5 areas, i.e. east, west, south, north and center areas. From a township of each area, an administrative village was selected as the surveillance site for 4 scheduled years, and no less than 200 permanent residents at age of 3 years or above were cluster sampled from each administrative village, while no less than 1 000 residents totaled from each surveillance site. Fecal samples were collected from the enrolled residents and were examined for STH eggs(two slide-reading/one sample) using the modified Kato-katz thick smear method to estimate infection rate and intensity. The samples of hookworm egg positive were further examined by test-tube filter paper incubation for larva to identify the species. The infection rate between groups was compared by the Chi-square test. Five households were randomly selected in each administrative village to collect soil sample in field or vegetable garden. From each household, 350 g soil was used for hookworm larva detection, and 50 g for Ascaris egg detection. The hookworm larvae in soil were identified by microscopy using 5% saline; the hookworm larvae in soil were detected using the saturated sodium nitrate floatation method. Results The production mode of the 11 surveillance sites were mainly the agricultural mode, and the types of drinking water were mainly tap water and well water. From 2016 to 2019, the coverage rates of sanitary toilets were 78.4% (30 443/38 817), 80.7% (32 856/40 723), 85.6% (35 301/41 258), and 91.0% (37 964/41 730), respectively. The differences between years were statistically significant (P < 0.01). The STH infection rate in the population in the 4 years was 1.6% (175/11 126), 1.4% (160/11 203), 0.8% (91/11 183) and 1.3% (151/11 197), respectively. The infection rate showed an overall downward trend, with a decrease of 14.1% in 2019 compared with 2016; the differences between the years were statistically significant (P < 0.01). The infection rate of STH in Nanfeng county was 4.7% (48/1 016), 3.8% (39/1 034), 2.6% (27/1 028) and 7.4% (75/1 010) in the 4 years, respectively, which were significantly higher than other counties (P < 0.01). The hookworm infection rate fluctuated from 1.0% (116/11 126) in 2016 to 0.6% (70/11 183) in 2018, and then increased to 1.0% (112/11 197) in 2019. The difference was statistically significant between the years (P < 0.01). The infection rates of STH and hookworm in females was higher than that in males, except in 2016. Among the hookworm infected, Necator americanus accounted for 92.2% (71/77), 91.0% (61/67), 97.8% (44/45) and 91.8% (89/97) identified by hookworm larva culture in the 4 years, respectively, while the rest of cases were mixed infection, and single Ancylostoma duodenale infection. The infection rate of Ascaris lumbricoides decreased from 0.5% (53/11 126) in 2016 to 0.3% (29/11 197) in 2019, showing an overall trend of decrease; the differences between years were statistically significant (P < 0.01). The infection rate of Trichuris trichiura was 0.1% (6/11 126), 0.1% (14/11 203), 0.1% (9/11 183) and 0.1% (10/11 197), respectively. The positive rate of Ascaris eggs in soil samples in the 4 years was 9.1% (25/275), 1.8% (5/275), 1.8% (5/275) and 1.5% (4/275), respectively; the differences were statistically significant(P < 0.01). The positive rates of Ascaris eggs and hookworm larvae in soil samples both showed a decreasing trend. Conclusion The STH infection rate and the proportions of moderate and severe infection showed a trend of decrease year by year, displaying a low prevalent status. Hookworm remains the key target parasite, and Nanfeng county the key area for STH control in the future.

    Analysis on the results of surveillance of Enterobius vermicularis infection among children in rural areas in Jiangxi Province during 2016-2019
    CHEN Zhe, JIANG Wei-sheng, GE Jun, DAI Kun-jiao, LI Dong, LIU Ke-xing, ZENG Xiao-jun
    2020, 38(5):  542-547.  doi:10.12140/j.issn.1000-7423.2020.05.003
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    Objective To understand the status and the changing trend of Enterobius vermicularis infection in children in Jiangxi Province during 2016-2019, and to provide scientific basis for formulating control strategies in the province. Methods Surveillance sites of soil-transmitted helminth (STH) were set up in 83 counties (cities and districts) in Jiangxi Province during 2016-2019. Children aged 3-9 years were examined for Enterobius vermicularis infection by the modified Kato-Katz thick smearmethod (two slide reading/one fecal sample) and the adhesive cellophane anal swab method. The SPSS 25.0 statistical software was used to perform statistical description, comparison and trend analysis on the data. Results A total of 32 587 children were examined in 2016-2019, revealing a prevalence of E. vermicularis infection of 10.2% (931/9 155), 12.8% (1 045/8 145), 13.1% (964/7 343) and 10.5% (836/7 944), respectively, in each year, showing a trend of first increase and then decrease (P > 0.05). The average infection rate in children remained ≥ 10% in 4 consecutive years in Xinyu, Jiujiang, Ganzhou and Fuzhou Cities, among them the Xinyu City had the highest infection in each year: 17.4% (8/46), 24.0% (6/25), 32.3% (10/31) and 22.2% (12/54), respectively. The infection rate was comparable between males and females [10.1% (506/4 989) and 10.2% (425/4 166) in 2016, 13.0% (568/4 383) and 12.7% (477/3 762) in 2017, 13.3% (530/3 981) and 12.9% (434/3 362) in 2018, 10.3% (440/4 283) and 10.8% (396/3 661) in 2019, respectively; P > 0.05]. The infection rate among nonboarding children was highest (13.7%, 83/606), whereas in all other years, the kindergarten children had the highest infection rate [13.8% (512/3 705), 16.3% (567/3 486) and 12.3% (477/3 885), respectively]. The infection rate was relatively higher in children aged 4-7, which remained≥ 10% in all years. The detection rate using adhesive cellophane anal swab method was 11.4% (3 730/32 587), significantly higher than the 1.2% (392/32 587) using Kato-Katz thick smear method. Conclusion A higher prevalence of E. vermicularis infection was found among children in Jiangxi Province in 2016-2019, with no significant difference between years. It is necessary to strengthen surveillance and appropriate control for kindergarten children.

    Comparison of status of soil-transmitted helminth infection between poverty and non-poverty areas in Jiangxi Province
    ZENG Xiao-jun, JIANG Wei-sheng, GE Jun, XIE Shu-ying, LI Zhao-jun, HANG Chun-qin, LI Dong
    2020, 38(5):  548-553.  doi:10.12140/j.issn.1000-7423.2020.05.004
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    Objective To compare and analyze the status of soil-transmitted helminth (STH) infection between poverty and non-poverty areas in Jiangxi Province, in order to provide scientific basis for precise parasitic diseases control. Methods According to the protocol of the 3rd National Human Parasitic Diseases Survey in 2014, the survey sites for current study were sampled using the stratified cluster sampling method based on the economic and geographical characteristics of Jiangxi Province. From each sampled natural village, 250 villagers were randomly selected for fecal examination by modified Kato-Katz thick smear method to estimate the prevalence of STH infection. Meanwhile, 60 villagers who participated in fecal examinationin each survey site were randomly selected for the questionnaire survey. According to the list of poverty counties in Jiangxi Province issued by the government, the survey data and information of major parasitic diseases in Jiangxi Province in 2014 were sorted and analyzed. The comparison of infection rate between the poverty areas and the non-poverty areas was made by the Chi-square test. Results A total of 92 survey sites of 32 counties in Jiangxi Province were surveyed. The average infection rates of STH, Ascaris lumbricoides and Trichuris trichiura in the poverty areas were 6.97% (466/6 690), 2.20% (147/6 6690) and 2.42% (162/6 690), respectively, which were significantly higher than those of the non-poverty areas [6.04% (1 022/16 916), 0.35% (59/16 916) and 0.37% (63/16 916), respectively] (P < 0.01). The average infection rate of hookworm in non-poverty areas was 5.44% (920/16 916), which was significantly higher than the 2.71% (181/16 916) in poverty areas (P < 0.01). The infection rates of STH and hookworm in both poverty and non-poverty areas showed a trend of increase with age, which peaked in the age group of ≥70 (9.54%, 44/461; 13.13%, 184/1 401; respectively). The infection rates of A. lumbricoides peaked in the age group of <10 in the poverty areas (3.07%, 29/946) and in the age group of 20-29 years in the non-poverty areas (0.55%, 6/1 088). The infection rates of T. trichiura peaked in the age group of ≥70 in the poverty areas (3.69%, 17/461) and in the age group of 10-19 years in the non-poverty areas (0.60%, 9/1 491). The infection rates of STH in the age group of <10 and in the age group of 30-39 years in the poverty areas [4.97% (47/946), 5.64% (44/780)] were higher than those in the non-poverty areas [1.10% (28/2 534), 2.73% (46/1 685)], respectively (P < 0.01). The infection rates of hookworm in the age groups of 40-49 years and above in the non-poverty areas [4.67% (140/2 999), 7.40% (237/3 203), 10.66% (268/2 515), 13.13% (184/1 401)] were higher than those in the poverty areas [2.70% (30/1 111), 3.34% (40/1 999), 4.72% (43/911), 9.54% (44/461)], respectively (P < 0.01). The infection rates of A. lumbricoides in all age groups except the age group of 20-29 years in the poverty areas were higher than those in the non-poverty areas, and the infection rates of T. trichiura in all age groups except the group aged 10-19 years in the poverty areas were higher than those in the non-poverty areas. In both the poverty and non-poverty areas, the infection rates of STH [8.66% (290/3 348), 6.66% (581/8 720)], hookworm [3.58% (120/3 348), 6.06% (528/8 720)] and T. trichiura [2.63% (88/3 348), 0.42% (37/8 720)] in females, were higher than those in males [5.27% (176/3 342), 5.38% (441/8 196); 1.83% (61/3 342), 4.78(392/8 196) and 2.21% (74/3 342), 0.32%(26/8 196), respetively] (P < 0.01). In the poverty areas, the infection rate of A. lumbricoides in females (2.75%, (93/3 348) was higher than that in males (1.65%, 55/3 342) (P < 0.01). In females, the infection rate of STH in the poverty areas was higher than that in the non-poverty areas (P < 0.01). The infection rates of A. lumbricoides and T. trichiura both in female and males in the poverty areas were higher than those in the non-poverty areas (P < 0.01); and the infection rates of hookworm both in female and males were higher in the non-poverty areas than in the poverty areas (P < 0.01). The proportion of safe toilets in the non-poverty areas was 52.06%, significantly lower than that in the poverty areas(61.23%, P < 0.01). The rate of fertilization with fresh feces was 36.31% in the non-poverty areas, which did not differ significantly from the 33.72% in the poverty areas (P > 0.05); in addition, 55.20% and 63.62% of residents in the non-poverty and poverty areas respectively had the habit of working barefoot in field. Conclusion The survey data indicates that the key target parasites for control are hookworm in non-poverty areas, while A. lumbricoides, hookworm and T. trichiura in poverty areas, and the population at the age of 40-49 years and above is the main target for hookworm control and populations at the age of 40-49 years and below is the main target for control of A. lumbricoides and T. trichiura.

    The achievements of 3-year efforts of clonorchiasis control in the demonstration area of Xinfeng County in Jiangxi Province
    GE Jun, JIANG Wei-sheng, YUAN Chang-hong, ZHU Ting-jun, CHEN Zhe, YANG Yu-hua, LAN Ming-xing, DAI Kun-jiao, LI Dong, ZENG Xiao-jun, CHENG Ying-dan
    2020, 38(5):  554-560.  doi:10.12140/j.issn.1000-7423.2020.05.005
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    Objective To evaluate the effect of comprehensive control of clonorchiasis in the demonstration area in Xinfeng County of Jiangxi Province during 2016-2018, and discuss the role of the integrated control strategy “led by health education and prioritizing infection source control” in clonorchiasis control. Methods All 26 administrative villages in Xinfeng County with the habit of eating raw fish were included in this study. Investigations on the baseline information before intervention and the intervention effect after intervention were carried out in the demonstration area in October-November of 2016 and 2018, respectively. From each village, 150 residents at the age over 3 years were cluster sampled for examination by modified Kato-Katz thick smear method (two slide reading/one sample) to detect Clonorchis sinensis infection. Meanwhile, questionnaire surveys to the residents was conducted to investigate the knowledge awareness, behavior and attitude on clonorchiasis as well as administration history of anthelmintics. Freshwater snails and fish (no less than 100 in each village) were collected from natural water bodies such as fish ponds and streams, and C. sinensis metacercaria infection in intermediate hosts was detected by crushing microscopy. Five fecal samples from cats, dogs or pigs were collected from each village, and C. sinensis eggs in the feces of reservoir hosts were examined by the method of washing sedimentation for egg concentration. Results The demonstration area in Xinfeng County covered 26 villages in 5 towns, with a total population of 79 764. The infection rate dropped from 21.56% (878/4 072) in 2016 to 8.85% (365/4 125) in 2018, a decrease of 58.95%. In 2016, the infection rates of C. sinensis in males and females in the demonstration area were 29.53% (577/1 954) and 14.21% (301/2 118), respectively, with statistically significant differences (P < 0.05). In 2018, the infection rates in males and females decreased to 13.09% (266/2 032) and 4.73% (99/2 093), respectively, showing statistically significant differences (P < 0.05). Both surveys showed that the infection rate of C. sinensis increased with age, with adults over 20 years old being the main population infected. Compared with 2016, the infection rates in all age groups decreased significantly in 2018 (P < 0.01). The decrease rates in the populations at age of 3-19 years and 20-39 years reached 72.99% and 74.85%, respectively. Compared with 2016, the infection rate decreased significantly in all occupation groups except in businessmen and public officials. The deworming coverage among the infected residents in the demonstration area increased from 54.21% (476/878) in 2016 to 84.01% (310/369) in 2018, with statistically significant difference (P < 0.05). In 2016 and 2018, 400 and 1 000 snails were collected for examining C. sinensis infection, respectively, but neither redia nor cercaria were found. The average infection rate in freshwater fish dropped from 8.24% (144/1 747) in 2016 to 0.80% (1/125) in 2018, decreased by 90.29%. The average infection rate in reservoir host was 2.27% (8/353) in 2016, and declined to 0 in 2018. The awareness rate of prevention and control and the rate of correct behavior of not eating raw fish increased from 13.02% (525/4 033) and 80.49% (3 246/4 033) in 2016 to 20.80% (850/4 087) and 83.41% (3 409/4 087) in 2018, respectively, with statistically significant differences (P < 0.05). Over the 3 years, 890 people were treated with anthelmintic, with an average coverage rate of 65.78%, and 3 465 new non-hazardous toilets were built, with the average coverage of non-hazardous toilets increasing from 93.48% (16 326/17 464) in 2016 to 97.21% (1 9791/20 360) in 2018, increased by 3.99%. Conclusion The 3-year control efforts in Xinfeng County suggest that the integrated control strategy “led by health education and prioritizing infection source control” plays a positive role in clonorchiasis control in the demonstration area, indicative of significant achievement in clonorchiasis control in the area gained as expected.

    Analysis on the status of human infection in national surveillance sites for clonorchiasis in Xinfeng County during 2016-2019
    YUAN Chang-hong, LAN Ming-xing, ZHU Ting-jun, WANG Mei, CHEN Zhe, HU Li-feng, HUANG Qi, JIANG Wei-sheng
    2020, 38(5):  561-564.  doi:10.12140/j.issn.1000-7423.2020.05.006
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    Objective To understand the prevalence of Clonorchis sinensis infection in Xinfeng County, so as provide scientific basis for formulating control strategies. Methods The Xinfeng County was divided into 5 areas according to the geographical location, and in each area one village was selected from a township to serve as the surveillance site, including Yu Village of Gubei Town, Zhangtang Village of Datangbu Township, Zhengao Village of Zhengping Township, Huangni Village of Xiniu Township, and Jiaokeng Village of Jiading Township. During 2016 to 2019, no less than 200 permanent residents aged 3 years or above were cluster sampled from each administrative village each year for fecal examination using the modified Kato-Katz thick smrar method (two slide reading/one sample) to estimate the status of Clonorchis infection. In addition, no less than 150 examinees were randomly selected for questionnaire survey on the knowledge, attitude and behavior towards clonorchiasis. Comparison of infection rate between groups was analyzed by chi-square test. Results From 2016 to 2019, the infection rate of C. sinensis was 9.3% (96/1 027), 8.9% (89/1 005), 5.2% (52/1 000) and 6.4% (64/1 002), respectively in each year, and the youngest infected people was at the age of 3, 11, 26 and 27 years, respectively. The infection rate in males was higher than that in females (P < 0.01). No infection was found in preschool children except in 2016, while the infection occurred in all other groups of different education levels in all years. The questionnaire survey indicates that from 2016 to 2019, the proportions of residents eating raw fish was 14.4% (22/153), 16.6% (25/151), 9.3% (14/150) and 18.8% (29/154), respectively. The proportion of residents having heard of clonorchiasis increased from 13.7% (2/153) in 2016 to 55.8% (86/154) in 2019. Conclusion The infection rate of C. sinensis remains high in the national surveillance site in Xinfeng County, and the proportion of residents eating raw fish keeps persistent in the four years.

    Survey on the knowledge, attitude and practice towards clonorchiasis and analysis of the influencing factors in Xinfeng County of Jiangxi Province in 2016
    CHEN Zhe, YE Bin, JIANG Wei-sheng, YANG Yu-hua, LAI Bo-wen, ZENG Xiao-jun, ZHOU Chang-hai
    2020, 38(5):  567-573.  doi:10.12140/j.issn.1000-7423.2020.05.007
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    Objective To understand the knowledge, attitude and practice towards clonorchiasis and the influencing factors in Xinfeng Country of Jiangxi Province, in order to provide scientific evidence for formulating pertinent control measures for clonorchiasis. Methods In 2016, at least 150 local residents over 3 years old were cluster sampled from each of 26 villages in 5 towns (Datangbu, Xiaohe, Jiading, Gubei and Zhengping) of Xinfeng County, where the residents have the habit of eating raw or undercooked freshwater fishes. Among them, a questionnaire survey was conducted to obtain basic information concerning C. sinensis infection. The awareness rate of clonorchiasis and the proportion having the habit of eating raw fish were calculated, and analyzed by chi-square test to comparethe rate or proportion between groups. The influencing factors for the awareness rate and the proportion of eating raw fish were analyzed by logistic regression. Results A total of 4 033 residents were participated in the survey. The awareness rate of C. sinensis was 13.0% (525/4 033). Among them, 19.5% (787/4 033) had a history of eating raw fish. The awareness rate and the proportion of eating raw fish in males were 7.4% (142/1 933) and 32.8% (633/1 933), respectively, which were significantly higher than those in females at 2.2% (47/2 100) and 7.3% (154/2 100), respectively (P < 0.01). The awareness rate showed a trend of increasing first then decreasing with ages, which peaked in the age group of 30-39 years (9.8%, 30/305), and displayed significant difference between all age groups (P < 0.01). The proportion of eating raw fish among the residents increased with age, and reached a peak of 30.6% (241/787) in the age group 50-59 years (P < 0.01). The awareness rates and the proportion of eating raw fish among businessmen and public servants were 35.6% (42/118) and 45.8% (54/118), respectively, significantly higher than those of other occupations (P < 0.01). The awareness rate and the proportion of eating raw fish showed a trend of increasing with higher education level, which were highest in the groups with senior middle school and higher education level [25.8%(56/217) and 32.7%(71/217), respectively] (P < 0.01). The results of logistic regression analysis showed that the awareness rate in males was 2.726 times that in females (P < 0.01), the awareness rate among businessmen and public servants was 3.707 times that in farmers (P < 0.01), while the awareness rate of students was only 0.068 times of farmers (P < 0.01). The awareness rate increased with higher educational levels, with the rate in the group with senior middle school or higher education level group being 11.609 times that of illiterate and preschool children(P < 0.01). The occurrence probability of eating raw fish behavior in males was 6.976 times that in females (P < 0.01). The occurrence probability of eating raw fish behavior in businessmen and public servants was 1.989 times that in farmers (P < 0.01). The occurrence probability of eating raw fish behavior increased with higher educational level, with rate in the group of junior middle school, senior middle school and technical school education was 2.076-fold (P < 0.01) and 1.966-fold (P < 0.05) of that in the illiterate and preschool children, respectively. Conclusion The awareness rate is generally low in Xinfeng County. Males, businessmen, public servants and those with higher educational levels have higher counts including awareness rate and proportion of eating raw fish behavior, thus they are the main target populations for clonorchiasis control.

    Evaluation of the effect of health education on clonorchiasis in primary schools in Xinfeng County of Jiangxi Province
    ZHU Ting-jun, QIAN Men-bao, CHEN Ying-dan, CHEN Zhe, GE Jun, ZENG Xiao-jun, YUAN Chang-hong, LAN Ming-xing, LI Shi-zhu
    2020, 38(5):  574-579.  doi:10.12140/j.issn.1000-7423.2020.05.008
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    Objective To evaluate the effect of health education on clonorchiasis among primary school students in endemic areas. Methods This study was implemented in Xinfeng County, Jiangxi Province from 2017 to 2019. Three townships were selected in Xinfeng County, the demonstration area for integrated control for clonorchiasis, from each township two villages were selected to serve as the control and the intervention group, respectively. The baseline survey was conducted to understand the awareness of the transmission route and harmfulness of Clonorchis sinensis among the primary school students and villagers in the control group and the intervention group, as well as their attitude towards eating raw fish and the behavior of eating raw freshwater fish. In villages of the intervention group, comprehensive health education measures were carried out in primary schools, including watching a cartoon about the prevention and control of clonorchiasis once a semester, preparing a blackboard bulletin, writing a composition about clonorchiasis, and carrying out a propaganda activity for parents. No intervention measures were taken in the control group. In 2019, the effect of health education in students and villagers was evaluated in the intervention group and the control group using the same method as the baseline survey. Results In the control group and intervention group, 298 and 254 students, as well as 147 and 168 villagers participated in the baseline survey and evaluation survey. The students’ awareness rate of the transmission route and harmfulness of clonorchiasis in the intervention group increased from 44.49% (113/254) and 0 before intervention to 79.13% (201/254) (P < 0.01) and 23.22% (59/254) (P < 0.01) after intervention; the willingness of not eating raw fish increased from 75.2% (191/254) to 94.09% (239/254) (P < 0.01), and the behavioral rate of eating raw fish was 2.36% (6/254) and 0.39% (1/254) (P > 0.05), respectively. In the control group, the awareness rate of transmission route and harmfulness of clonorchiasis among the students increased from 11.41% (34/298) and 0.33% (1/298) to 53.02% (158/298) (P < 0.01) and 22.48% (67/298) (P < 0.01), respectively; the rate of willingness of not eating raw fish decreased from 95.64% (285/298) to 91.28% (272/298) (P < 0.05); the rate of eating raw fish was 1.34% (4/298) and 1.01% (3/298) (P > 0.05), respectively. In the intervention group, the villagers’ awareness rate of transmission route was 18.45% (31/168) and 26.19% (44/168) (P > 0.05), and the awareness rate of harmfulness of clonorchiasis increased from 4.17% (7/168) to 16.07% (27/168) (P < 0.05); the rate of willingness of not eating raw fish was 95.83% (161/168) and 94.05% (158/168) (P > 0.05), and the behavior of eating raw fish decreased from 35.12% (59/168) to 15.48% (26/168) (P < 0.05). In the control group, the villagers’ awareness rate of clonorchiasis transmission route decreased from 56.46% (83/147) to 39.46% (58/147) (P < 0.05), the awareness rate of harmfulness increased from 3.4% (5/147) to 9.52% (14/147) (P < 0.05); the rate of willingness of not eating raw fish increased from 82.31% (121/147) to 94.56% (139/147) (P < 0.05); the behaviorial rate of eating raw fish decreased from 23.13% (34/147) to 6.8% (10/147) (P < 0.05). Conclusion The health education on clonorchiasis in primary schools can improve the students’ knowledge on the prevention and control of clonorchiasis, strengthen the perception of not eating raw fish in the future, and meantime also reduce the occurrence of eating raw fish among adults, playing evident role in improving the awareness rate among adults.

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    Objective To investigate correlation between the susceptibility to antimalarials and the polymorphisms of drug resistance genes of Plasmodium falciparum isolates from China-Myanmar border region, to provide basis for formulating rational strategy for using antimalarial drugs in the local areas. Methods In 2009, an investigation site was set up at the Nongriban Clinic in Lazan City, Myanmar, and the participant patients were selected based on the inclusion criteria: single infection of P. falciparum diagnosed by microscopy; and no chemotherapy history with antimalarials, sulfonamides, or tetracyclines within the past 2 weeks. For in vitro drug sensitivity test and genetic analysis, whole blood or filter paper blood samples were collected from the patients prior to drug treatment. The Rieckmann in vitro microassay method was used to assess the susceptibility of P. falciparum parasites to artemisinin, chloroquine, piperquine and pyronidine. Blood DNA was prepared to test examine the polymorphisms of chloroquine resistant transporter gene (Pfcrt), multiple-drug resistance (Pfmdr) and Kelch gene (PfK13). The associations between the susceptibility to antimalarial drugs and gene polymorphisms were analyzed with Spearman rank correlation coefficient test by SPSS 23.0 software. Results A total of 63 patients with single infection of P. falciparum examined by microscopy were included in this study, of them 51 samples underwent in vitro drug susceptibility test, with 42 samples were completed successfully, accounting for 82.4% (42/51). In the in vitro assay, P. falciparum showed higher mean inhibitory concentration, higher 50% inhibitory dose (ID50) and higher resistance rate to chloroquine, which were 880 nmol/L, 320.5 nmol/L and 95.2%, respectively; and showed lower mean inhibitory concentration to pyronaridine (410 nmol/L), lower ID50 to artemisinin (84.8 nmol/L) and lower resistant rate to piperaquine (7.1%). Of the 40 blood samples resistant to chloroquine, the cross resistance rate to pyronaridine was 52.5% (21/40), to artemisinin 37.5% (15/40) and to piperaquine 7.5% (3/40). Of the 3 blood samples resistant to piperaquine, all were cross-resistant to chloroquine (3/3), artemisinin (3/3) and pyronaridine (3/3). Among the samples displaying cross-resistance, 21 cases showed cross-resistance of chloroquine-pyronaridine, 15 of chloroquine-artemisinin, while 13 were artemisinin-pyronaridine cross-resistant, and respective 3 cases of piperaquine-resistance being cross-reactive with chloroquine, artemisinin and pyronaridine. Spearman rank correlation coefficient test revealed a significant correlation between artemisinin resistance and piperaquine or pyronaridine resistance (r = 0.354, 0.446; P < 0.05). The Pfcrt gene of 37 cases was sequenced and examined, indicative of triple-mutant genotype C72V73I74E75T76 (mutation rate 100%, 37/37) at the loci 74-76. The mutation prevalence of Pfmdr gene at position N86Y and D1246Y were 2.1% (1/47) and 100% (49/49), respectively. The PfK13 gene was successfully sequenced from 20 isolates, and found to harbor 3 different mutations, including 10 cases with mutation at F446I, showing higher prevalence(50.0%, 10/20), one case with mutation at L492L/S and one case at C580Y showing low prevalence (5.0%, 1/20; 5.0%, 1/20; respectively). Among the drug resistant cases determined by in vitro drug test, the mutant prevalence of Pfcrt C72V73I74E75T76, Pfmdr N86Y1246, PfK13 I446S492C580 and Pfcrt/Pfmdr I74E75T76/Y1246 was 100% (37/37), 93.9% (46/49), 50% (10/20) and 69.0% (29/42) respectively. Spearman’s rank correlation coefficient analysis showed that there was no correlation of Pfcrt, Pfmdr and PfK13 gene mutation with the drug sensitivity in vitro. Conclusion The P. falciparum isolates from Laza City of China-Myanmar border region have developed resistance to chloroquine widely, and resistance to pyronaridine and artemisinin to certain extent, but remain usceptible to piperaquine.

    Analysis of malaria epidemiological characteristics in Guangxi Province in 2010-2019
    LI Jun, WEI Shu-jiao, ZHANG Wei-wei, LIN Kang-ming, YAN Hui, FENG Xiang-yang
    2020, 38(5):  589-594.  doi:10.12140/j.issn.1000-7423.2020.05.010
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    Objective To analyze the epidemiological characteristics of malaria and response capabilities of medical institutions in the malaria elimination phase in Guangxi Province, in order to provide scientific basis for consolidating the achievements of malaria elimination. Methods Malaria epidemic data during 2012-2019 in Guangxi were collected through the Information Management System for Parasitic Diseases and the data in 2010 and 2011 were obtained from the “individual questionnaire survey”. SPSS19.0 software was used to analyze the Plasmodium species, imported source country, case reporting situation, distribution of cases and the diagnosis. Results A total of 3 195 malaria cases were reported in Guangxi from 2010 to 2019, among them, one indigenous case was reported in 2012, and one case infected through blood-transfusion was reported in 2015, and the rest 3 193 were imported cases, including 7 cases of foreign nationalities, and 7 deaths. Of the imported cases, 72.3% were infected with Plasmodium falciparum (2 310/3 193), 9.8% with P. vivax (314/3 193), 13.9% with P. ovale (444/3 193), 1.4% with P. malariae (45/3 193), 2.1% with mixed infection (66/3 3 193) and 0.4% were clinically diagnosed cases (14/3 193), respectively. The malaria cases were distributed in 14 cities in Guangxi, with the top 5 being Nanning city (84.6%, 2 700/3 193), Guilin city (3.8%, 120/3 193), Hechi city (3.5%, 111/3 193), Liuzhou city (1.5%, 49/3 193) and Baise city (1.4%, 45/3 193). The cases were mainly at the age of 30-49 years (66.5%, 2 123/3 193), and the male-to-female ratio was 49.7 ∶ 1. The place of inporting source involves 33 African countries (93.8%, 2 994/3 193), 9 Southeast Asia countries (5.9%, 187/3 193), and Guyana of America (0.1%, 3/3 193). The cases at first visit in county-based centers for disease control (CDC) and medical institutions accounted for 80.4% (2 539/3 159) of all visited cases. The rate of confirmed diagnosis of malaria at first visit was 90.6% (2 862/3 159), which was significantly different among the medical institutions at different levels and between CDCs and medical institutions. The correctness rate of identification for parasite species was highest for P. falciparum (92.2%, 2 114/2 292), followed by P. oval (90.5%, 402/444), P. vivax (77.5%, 231/298), and P. malariae (75.6%, 34/45). The average time lag from primary to confirmed diagnosis was (3.15 ± 9.80) d for P. vivax, (1.73 ± 4.45) d for P. malariae, (1.16 ± 3.9) d for P. oval and (0.89 ± 4.81) d for P. falciparum. There was a statistically significant difference in the average time lag for confirmed diagnosis for P. vivax, P. falciparum, and P. oval (P < 0.01). Conclusion There has been no indigenous case of malaria reported in Guangxi Province since 2012. The imported cases were largely falciparum malaria cases, and mainly came from Africa. The county-level medical institutions and CDCs are the main body to respond to the epidemic.

    Polyclonal antibody preparation, tissue localization and activity of serine protease inhibitor serpin of Cysticercus pisiformis
    WANG Li-jie, WANG Li-qun, LIU Ting-li, ZHANG Shao-hua, LIU Guang-xue, LI Yan-ping, LIANG Pan-hong, LUO Xue-nong
    2020, 38(5):  595-601.  doi:10.12140/j.issn.1000-7423.2020.05.011
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    Objective To study the tissue distribution of serine protease inhibitor of Cysticercus pisiformis (Cpserpin) and its inhibitory effect on serine proteases. Methods Prokaryotically expressed recombinant Cpserpin (rCpserpin) was used to immunize rabbits, and the titers of rabbit serum after immunization were determined by indirect ELISA. The polyclonal antibodies were purified and analyzed for the specificity by Western blotting. The tissue distributions of rCpserpin in C. pisiformis adult and larva were assayed by immunohistochemistry. The recombinant plasmid pPIC9K-Cpserpin was constructed, transformed into Pichia pastoris KM71 competent cells after linearization, induced for expression in high-copy strains obtained by G418 screening, and then the products were purified. The purified recombinant protein was tested using chromogenic substrate method for its inhibitory effects on the activity of three serine proteases including α-chymotrypsin, trypsin and elastase, at the concentrations of 6, 9, 18 and 21 μg/ml, respectively. Results The results of indirect ELISA showed that the titer of serum polyclonal antibody IgG reached 1 ∶ 51 200. Western blotting showed that the purified polyclonal antibody could specifically react with rCpserpin and the C. pisiformis worm soluble antigen. Immunohistochemistry showed that Cpserpin was expressed at a low level during the cysticercus stage, but was highly expressed in mature proglottid and gravid proglottid, with wide distribution in the worm body wall and eggs. The rCpserpin expressed by P. pastoris showed enhanced inhibitiory effect on the three n of serine proteases with increased concentration, having highest inhibition rate at 21 μg/ml for α-chymotrypsin (50.5 ± 2.5)%, trypsin (71.5 ± 1.5)% and elastase (77.4 ± 1.5)% (P < 0.05). Conclusion The polyclonal antibody produced displays specificity against rCpserpin, the Cpserpin is highly expressed in mature proglottid and gravid proglottid of C. pisiformis, and the recombinant Cpserpin exhibits strong inhibitory effect on α-chymotrypsin, trypsin, and elastase.

    Prevalence of visceral leishmaniasis in China in 2019
    ZHOU Zheng-bin, LI Yuan-yuan, ZHANG Yi, LI Shi-zhu
    2020, 38(5):  602-606.  doi:10.12140/j.issn.1000-7423.2020.05.012
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    Objective To understand the epidemic situation of visceral leishmaniasis in China in 2019. Methods Data of visceral leishmaniasis in 2019 were collected from the web-based National Diseases Reporting Information System operated by the Chinese Center for Disease Control and Prevention. After excluding suspected cases, duplicates and cutaneous leishmaniasis cases, a database was established. Descriptive epidemic statistics of visceral leishmaniasis was performed using a Microsoft Excel 2016. Results A total of 166 cases of visceral leishmaniasis were reported in 72 counties of 15 provinces (autonomous regions and municipalities) in 2019, including 163 cases of mountainous zoonotic type, 3 cases of desert zoonotic type and no anthroponotic type. The cases mainly distributed in Shanxi (52 cases), Gansu (43 cases) and Shaanxi Provinces (34 cases), accounting for 77.7% (129/166) of the total reported. A total of 124 local transmitted cases were reported from 31 endemic counties, and 42 imported cases reported 41 non-endemic counties. Zhouqu County of Gansu Province, Hancheng City of Shaanxi Province, Yangquan City suburb and Pingding County of Shanxi Province were the major endemic areas, with 16, 16, 13 and 10 cases reported respectively, accounting for 33.1% (55/166) of the total cases. Zhenyuan County in Gansu Province, Hejin City in Shanxi Province, Long’an District in Henan Province, and Xingtai County in Hebei Province were reemerging endemic counties of visceral leishmaniasis, reporting 6 indigenous cases. The occurrence of visceral leishmaniasis peaked in April, with a male-to-female ratio of 1 ∶ 0.5. Farmers as well as preschoolers are the high-risk populations for visceral leishmaniasis, accounting for 47.6% (79/166) and 27.1% (45/166) of the total cases, respectively. The visceral leishmaniasis cases were mainly distributed in the group aged ≥15 years. However, the age distribution varied significantly due to different types of visceral leishmaniasis, with the desert-type zoonotic cases mainly distributed in age group of 0-2 years of preschoolers and the mountain-type zoonotic cases mainly in farmers aged of ≥15 years. Conclusion Visceral leishmaniasis has a low prevalence in China, whereas the endemic area shows a trend of spreading, thus, it is imperative to strengthen the surveillance for visceral leishmaniasis.

    Changes in subsets and functional exhaustion of CD4+ T cells in spleens of mice infected with Echinococcus multilocularis
    HOU Xin-ling, LI Ling-hui, LI Liang, LI Jing, WANG Hui, SHAO Ying-mei, ZHANG Chuan-shan
    2020, 38(5):  611-618.  doi:10.12140/j.issn.1000-7423.2020.05.013
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    Objective To investigate the effects of different doses of Echinococcus multilocularis infection on splenic CD4+ T cell subsets and immune functions in mice. Methods Sixty female C57BL/6 mice were randomly divided into 4 groups, 15 in each group, including sham operation group (saline), low-dose infection group (50 protoscoleces/mouse), medium-dose infection group (500 protoscoleces/mouse), and high-dose infection group (2 000 protoscoleces/mouse). Mice were inoculated via the hepatic portal vein under anaesthetia with different doses of protoscoleces in saline, whereas the control mice were injected with the same volume of saline. Spleens were taken from 5 mice of each group at 2, 12, and 24 weeks after infection, and ground to isolate lymphocytes. Flow cytometry was performed to detect the memory phenotype, the proportions of different subsets, and LAG3 expression in splenic CD4+ T cells in different experimental groups. Statistical analysis was performed using Graphad Prism 6.0 software. Results At 2 weeks after infection, the proportions of splenic CD4+IFN-γ+ T cells in the low- and medium-dose groups were (7.54 ± 1.44)% and (7.58 ± 3.17)%, respectively, which were higher than that in the sham operation group [(3.52 ± 1.03)%, P < 0.05]; and the proportions of splenic CD4+TNF-α+ T cells were (39.34 ± 4.19)% and (39.53 ± 10.7) %, respectively, which were higher than that of the sham operation group [(22.62 ± 1.50)%, P < 0.01]. At 12 weeks after infection, the proportions of splenic CD4+IFN-γ+ T cells in the low- and medium-dose groups were (16.52 ± 0.77)% and (22.98± 4.32)%, respectively, which were higher than that in the sham operation group [(16.88 ± 2.49)%, P < 0.05]; the proportions of splenic CD4+TNF-α+ T cells were (27.26 ± 2.12)% and (28.36 ± 5.24)%, respectively, which were higher than that of the sham operation group [(19.72 ± 3.87)%, P < 0.05]; and the proportions of splenic CD4+IL-17A+ T cells were (10.70 ± 1.81)% and (11.52 ± 2.68)%, respectively, which were higher than that of the sham operation group [(5.40 ± 1.32)%, P < 0.01]. In addition, the proportions of splenic CD4+IL-4+ T cells in the low- and medium-dose groups were (2.87 ± 0.84)% and (3.50 ± 0.77)%, respectively, which were higher than that of the sham operation group (1.75 ± 0.83)% (P < 0.01); and the proportions of splenic CD4+IL-10+ T cells were (4.63 ± 0.78)% and(7.09 ± 2.42)%, respectively, which were higher than that of the sham operation group [(3.03 ± 0.79)%, P < 0.01]. At 24 weeks after infection, the proportions of splenic CD4+IFN-γ+ T cells, CD4+TNF-α+ T cells, CD4+IL-4+ T cells, CD4+IL-10+ T cells and CD4+IL-17A+ T cells in the medium- and high-dose groups were all higher than those in the sham operation group (P < 0.05), and the proportion of splenic Treg cells in the high-dose group was higher than that in the sham operation group (P < 0.01). Moreover, at 24 weeks, the proportions of splenic CD4+ Treg cells in the three infection groups were all higher than that in the sham operation group; and the proportions of splenic CD4+LAG3+ T cells in the three infection groups were (16.45 ± 4.89)%, (14.54 ± 4.96)%, and (14.62 ± 2.43)%, respectively, which were higher than that of the sham operation group (8.43 ± 3.46)% (P < 0.05). At 24 weeks after infection, the proportions of LAG3-positive CD4+ T cells sereting IFN-γ and TNF-α in the high dose group were (1.67 ± 0.66)% and (0.69 ± 0.27)%, which were significantly lower than those LAG3-negative CD4+ T cells[(5.11 ± 1.81)% and(31.7 ± 12.1)%, P < 0.01]. Conclusion After infected with low and medium doses of E. multilocularis, the mice may make advantages of T1 and T17 immune responses to kill and clear the worms, while infection with a high dose of E. multilocularis may lead to imbalance of T1/T2 and T17/Treg type immune responses, and the occurance of CD4+ T cells up-regulating the expression of LAG3, resulting in the exhaustion of CD4+ T cells and causing chronic alveolar echinococcosis.

    A survey on the prevalence and knowledge awareness of human echinococcosis in residents in Maqin County of Qinghai Province in 2017-2018
    MA Xiao, ZHANG Xue-fei, LEI Wen, MA Jun-ying, LIU Jia, CAI Hui-xia, WANG Wei, ZHAN Pei-zhen, FANG Hai-ning, ZHANG Jing-xiao, LIU Yu-fang, LIU Na, WANG Yong-shun, ZHANG Qing, ZHAO Cun-zhe, ZHANG Xiong-ying, SHI Ke-mei, LIU Pei-yun, DAN Cuo, CHANG Mei
    2020, 38(5):  619-624.  doi:10.12140/j.issn.1000-7423.2020.05.014
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    Objective To understand the status of infection and knowledge of human echinococcosis prevention in Maqin County of Qinghai Province. Methods A cluster random sampling method was used to select permanent residents at age over 2 years from 6 townships and 2 towns in Maqin County for B-ultrasound examination during 2017-2018 to calculate the prevalence rate of echinococcosis in the population. A questionnaire survey was performed randomly among local residents and schoolchildren of fourth grade and higher to estimate the awareness rate of knowledge on echinococcosis control. The estimated rates were compared using Chi-square test. Results A total of 36 705 residents were examined by B ultrasound scanning, and 433 were found of echinococcosis, with a prevalence rate of 1.18% (433/36 705). In 2017 and 2018, 485 and 436 questionnaires were distributed, respectively, which revealed awareness rate of echinococcosis knowledge of 89.69% and 91.74%, respectively. The prevalence of echinococcosis in females (1.58%, 280/17 746) was higher than that in males (0.81%, 153/18 959) (P < 0.01). The prevalence showed a trend of increase with age, with the age group of ≥70 years being the highest (2.63%, 38/1 446). Among all occupation groups, the prevalence rate was highest (2.56%) in herdsmen, and lowest (0.06%) in officials. Among educational levels, the echinococcosis prevalence was highest (3.15%, 235/7 466) in the illiterates, followed by the primary school level (1.30%, 183/14 033), and the lowest in group with the university education (0.03%, 2/5 995). As to the residing patterns, the nomads had the highest prevalence of echinococcosis (4.67%, 107/2 290). The prevalence was found highest in Youyun Township (7.67%, 95/1 238). It was noted that the prevalence difference between males and females, age groups, occupations, educational levels, residing patterns and geographical locations was statistically significant (P < 0.05). In 2017 and 2018, the knowledge awareness rate of echinococcosis prevention and control was lowest in herdsmen (66.33%, 65/98; 79.34%, 96/121), and highest in officials (98.89%, 89/90; 98.77%, 80/81) among the occupations; and lowest in the education group of primary school (78.77%, 141/179; 86.08%, 167/194), and highest in the undergraduates (98.80%, 90/91; 98.77%, 80/81). There were significant differences in the awareness rate of knowledge of echinococcosis prevention and control among different occupations and education levels (P < 0.05). Conclusion The situation of echinococcosis control in Maqin County is still challenging, showing a prevalence rate of 1.18%. Although the knowledge awareness rate on echinococcosis has been improved, it is essential to strengthen health education, particularly for the key target population of herdsmen.

    INFORMATION EXCHANGE
    Analysis on the funding sources of articles published in Chinese Journal of Parasitology and Parasitic Diseases from 2013 to 2018
    YI Feng-yun, ZHANG Zheng-yang, SHENG Hui-feng, YANG Fan, CHEN Qin
    2020, 38(5):  625-628.  doi:10.12140/j.issn.1000-7423.2020.05.015
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    The funding information for the original articles (including original articles, experimental studies, field studies, clinical studies, etc.) published in the Chinese Journal of Parasitology and Parasitic Diseases (CJPPD) from 2013 to 2018, were collected and analyzed using method of bibliometrics. The statistic results showed that total 428 original articles were published in CJPPD during the past six years, 324 of them was funded by different foundations with the funding rate of 75.7%. The total number of funding projects was 638, and the average number of funded projects for each published article was 1.5. The number of articles funded by 1, 2, 3, 4, 5 and 6 foundation projects was 141 (43.5%), 95 (29.3%), 58 (17.9%), 19 (5.9%), 8 (2.5%) and 3 (0.9%), respectively. According to the first foundation project, the number of articles funded by national level funds was 191 (58.9%), followed by provincial, ministerial, and international funds of 107 (33.0%), 14 (4.3%), and 12 (3.7%), respectively. In terms of research content, the top five of funded articles were the research related to echinococcosis (49 articles, 15.1%), schistosomiasis (48 articles, 14.8%), malaria (48 articles, 14.8%), toxoplasmosis (42 articles, 13.0%), and mosquito vectors (14 articles, 4.3%). In terms of research discipline, the number of funded articles related to molecular biology, epidemiology, immunology and diagnostics, pharmacology, etiology and clinical direction were 144 (44.4%), 63 (19.4%), 56 (17.3%), 26 (8.0%), 19 (5.9%) and 16 (4.5%), respectively. In general, the rate of funded research papers published in CJPPD during 2013-2018 remains at a high level.

    REVIEWS
    An overview on the resistance of Plasmodium falciparum to primary anti-malarial drugs in China
    YE Sheng-yu, CHENG Yi-yi, LI Man, ZHOU Hong-ning
    2020, 38(5):  631-636.  doi:10.12140/j.issn.1000-7423.2020.05.016
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    Malaria is prevalent in tropical and subtropical regions, and is one of the public health problems in Africa and Southeast Asia. Although since 2017 there has been no indigenous malaria cases reported in China, it is still of particular importance to treat and care imported falciparum malaria cases, monitor anti-malarial drugs, and prevent the occurrence or outbreak of local cases caused by imported cases. The anti-malarial drugs have long been one of the main approaches for malaria control and have effectively controlled the global transmission of malaria. However, with the long-term use of anti-malarial drugs, the problem of drug resistance of P. falciparum, particularly the resistance to artemisinin drugs, has become one of the major challenges for malaria prevention and control at present. In this review, we summarize the researches on the resistance of P. falciparum to some main anti-malarial drugs in China.

    Advances in researches on the genetic diversity of Echinococcus multilocularis
    SHANG Jing-ye, ZHANG Guang-jia, YU Wen-jie, HE Wei, LIAO Sha, LI Rui-rui, HUANG Yan, LIU Yang, ZHONG Bo
    2020, 38(5):  637-641.  doi:10.12140/j.issn.1000-7423.2020.05.017
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    Alveolar echinococcosis is an extremely severe chronic parasitic disease caused by infection with the larval-stage Echinococcus multilocularis. In this review we summarize research progress on the genetic diversity of E. multilocularis based on DNA sequences and microsatellite DNA data, in order to provide reference for the prevention and control of alveolar echinococcosis.

    Applications of high-throughput omics technology in research on dust mite
    LIU Na-na, CUI Yu-bao, YE Lin-hua, HUANG Lu-sheng
    2020, 38(5):  642-646.  doi:10.12140/j.issn.1000-7423.2020.05.018
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    House dust mites are one of the most common inhaled allergens worldwide. Since the last 20 years, the prevalence of dust mite allergy has shown a trend of increase. With the advent of the post-genome age, research in life sciences has entered a new stage of systematic, comprehensive and dynamic exploration. High-throughput omics technology has been applied to comprehensively analyze samples at the gene and/or protein levels by sequencing for data mining, and interpreting intrinsic mechanisms of biological processes. This paper reviews the advance in application of high-throughput omics in the genomics, transcriptomics, proteomics and microbiology of dust mites, providing ideas forfurther research on dust mite allergens and allergic diseases and for the development of new control strategies.

    Advances in research on olfactory receptors of mosquitoes
    WANG Yang, LI Ting-ting, GONG Mao-qing
    2020, 38(5):  647-652.  doi:10.12140/j.issn.1000-7423.2020.05.019
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    Many behaviors of mosquitoes rely on the olfactory system, such as feeding, mating, seeking host and blood-sucking through odors released by the host or natural environment. Therefore, the olfactory system is crucial for mosquitoes in adaptation of to the external environment and population reproduction. Mosquito olfactory receptors(ORs), which serve as a hub for transmitting odor information, play a key role in odor-evoked behaviors. Therefore, based on understanding of mosquito odor-evoked behaviors, to elucidate the characteristics of OR gene expression, and the mechanisms of OR-mediated olfactory signal transductionin association with the design of repellents, can further advance the knowledge of mosquito olfaction, thereby providing scientific basis for development of new measures for mosquito control.

    Advances in research on exosomes of Toxoplasma spp.
    LI Peng-ju, ZUO Su-qiong, DUAN Yu-juan, LI Hao-ran, ZHANG Zhen-chao, LI Xiang-rui, WANG Shuai
    2020, 38(5):  653-657.  doi:10.12140/j.issn.1000-7423.2020.05.020
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    Exosomes are a type of extracellular vesicles secreted by a variety of cells, and contain many active components such as proteins, lipids, and nucleic acids. Studies have shown that a majority of parasites can secrete exosomes, which play important roles in mediating communications between parasites and host cells, regulating host immune responses, as well as transmitting pathogenic factors, drug resistance-associated genes and differentiation factors. In addition, exosome-based therapies and vaccine development are still under the way. In this paper, we summarize the biological characteristics and functions of exosomes secreted by Toxoplasma spp., and discuss their application potentials.

    SHORT COMMUNICATIONS
    The third survey on Enterobius vermicularis infection in children in Fujian Province
    XIE Xian-liang, XIE Han-guo, JIANG Dian-wei, CHEN Yun-hong, CHEN Bao-jian
    2020, 38(5):  607-610.  doi:10.12140/j.issn.1000-7423.2020.05.021
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    According to the scheme of the 3rd National Survey of Principal Human Parasitic Diseases, a survey on Enterobius vermicularis infection among children was performed in Fujian Province in 2015-2017. Based on the ecological category, economic condition and geographical location of the region, all counties (cities) were listed into the east, south, west, north and middle regions of the province respectively, for stratified cluster random-sampling. One to two kindergartens were selected from each region, and E. vermicularis infection was examined in children aged 3-6 years by using the adhesive cellophane anal swab. A total of 3 472 children in 15 counties (cities) were examined, and 205 children were found having E. vermicularis infection, with an infection rate of 5.90%, which was decreased by 87.38% and 73.21% as compared to the first and second surveys, respectively. The prevalence of E. vermicularis was 7.24% (128/1 769) in boys, higher than that in girls (4.52%, 77/1 703) (P < 0.05), and the prevalence showed a trend of increasing with age. The infection rate was highest in the age group of 6 years (7.39%, 95/1 285), and the difference between all age groups was statistically significant (P < 0.05). The infection rate in the economically advanced regions was 4.27% (86/2 016), significantly lower than those in the medium- (7.22%, 52/720) and less-developed regions (9.10%, 67/736). The infection rate in the Zhejiang-Fujian mountainous and hilly ecological regions was 4.48% (58/1 294), significantly lower than that in the Yunnan-Guangxi-central Guangdong-southern Fujian mountainous and hilly ecological regions (6.75%, 147/2 178). The infection rate was significantly lower in public (4.40%, 59/1 340) than in private kindergartens (6.85%, 146/2 132) (P < 0.05). The infection rate of E. vermicularis was highest in Zhangzhou City (15.59%, 63/404) and lowest in Xiamen City (2.51%, 10/398). The results suggest that the infection rate of E. vermicularis was significantly decreased compared to the second survey, but there still need to strengthen the surveillance and control of E. vermicularis infection.

    Epidemic characteristics of imported malaria during 2013-2019 in Baoshan City, Yunnan Province
    YANG He-xian, LI Jia-quan
    2020, 38(5):  660-663.  doi:10.12140/j.issn.1000-7423.2020.05.022
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    The malaria epidemic data in Baoshan City during 2013-2019 were collected through the Information Management System for the Prevention and Treatment of Parasitic Disease, the Infectious Disease Surveillance Reporting and Management System of the Chinese Center for Disease Control and Prevention. Database was established using Microsoft Excel 2007 for statistical analysis. A total of 880 cases of malaria were reported during 2013-2019 in Baoshan City, and 846 (96.1%) cases were imported from abroad. No indigenous malaria cases were reported after September, 2013. The numbers of imported malaria cases in Baoshan during 2013-2019 were 181, 198, 248, 104, 55, 28 and 32, respectively. Among the imported malaria cases, 765 (90.4%) were vivax malaria, 78 (9.2%) falciparum malaria, and 3 (0.4%) quartan malaria. The number of cases was highest in Tengchong City (549 cases, 64.9%), and lowest in Changning County (12 cases, 1.42%). The peak of case number occurred from April to July (540 cases, 63.8%), with the highest in May (183 cases, 21.6%). Of all imported cases, 759 were male (89.7%) and 802 were farmers (94.8%), and 704 cases were young adults aged 20-49 years (83.2%). The main source of infection was from Southeast Asia (841 cases, 99.4%), with Myanmar accounting for the largest number of imported cases (810 cases, 95.7%). All of the 846 imported cases were laboratory-confirmed, the longest time span from onset to diagnosis was 58 days, and 754 (89.1%) cases were confirmed within 7 days. The centers for disease control and prevention reported 279 cases (33.0%), township hospitals reported 265 cases (31.3%), general hospitals reported 204 cases (24.1%), and private hospitals and others reported 98 cases (11.6%).

    Epidemiological investigation of paragonimiasis epidemic focus in Luoyang City of Henan Province
    LI Yun-xia, AI Lin, DENG Yan, CHEN Wei-qi, ZHU Xin, YANG Zhi-guo, LI Ke-wei, SUN Yi-ying
    2020, 38(5):  664-666.  doi:10.12140/j.issn.1000-7423.2020.05.023
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    To investigate the status of Paragonimus spp. infection in freshwater crabs in Luoyang City of Henan Province, and identify the epidemic focus of paragonimiasis. Freshwater crabs as the second intermediate host were collected from surveillance sites in 9 counties(cities) of Luoyang City during the time from August 2013 to October 2019. Paragonimus spp. infection in the crabs was detected in laboratory settings. Paragonimus spp. metacercariae were identified by PCR amplification of the sequence of internal transcribed spacer 2 (ITS2) and mitochondrial cytochrome oxidase subunit 1(CO1). A total of 560 freshwater crabs were captured, and Paragonimus metacercariae were found in the crabs from Yiyang County, Luoning County, Xin’an County, Song County, and Luanchuan County, and identified as the species P. skrjabini by morphological observation and PCR amplification. The infection rate and infectivity were found highest in the crabs collected from Yiyang County (58.33%, 11.54 metacercariae/crab), followed by Xin’an County (25.93%, 0.33 metacercariae/crab), Song County (19.64%, 0.23 metacercariae/crab), Luoning County (11.96%, 0.12 metacercariae/crab), and Luanchuan County (6.17%, 0.06 metacercariae/crab). Results of PCR showed that the ITS2 amplification product has a sequence length of 500 bp from the metacercariae isolated from the crabs of Yiyang County, Xin’an County, Songxian County, Luoning County and Luanchuan County, with 98%-100% homology to P. skrjabini (GenBank accession No. KX129924.1). It was recognized that five counties including Yiyang County, Luoning County, Xin’an County, Luanchuan County, and Song County were identified to be the epidemic foci of paragonimiasis among them, Yiyang County was a moderate endemic area, while the others being mild endemic regions.

    Laboratory test and epidemiological investigation of the first imported case of schistosomiasis haematobia in Wenzhou City
    NI Qing-xiang, RUAN Wei, YAO Li-nong, NI Dan-dan, XIANG Fang-lv
    2020, 38(5):  667-669.  doi:10.12140/j.issn.1000-7423.2020.05.024
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    A case of schistosomiasis haematobia imported from abroad was reported from Wenzhou Municipality Center for Disease Control and Prevention On November 27, 2019. The clinical data of the patient were collected; urine and fecal samples as well as the pathological sections of bladder tissue were subject to laboratory examination; and epidemiological investigation was conducted. Schistosoma haematobium eggs were found in the urine sediment smear, and identified in the pathological tissue sections, which were considered as S. haematobium egg granuloma. These findings, combined with the clinical symptoms and epidemiological history of the patient, confirmed the diagnosis of imported schistosomiasis haematobia from Nigeria. After treatment with an oral dose of 60 mg/kg praziquantel × 2 days, the patient's symptom was improved. Follow-up urine testing at 1 week and 1 month after treatment revealed no presence of eggs. This case was the first imported case of schistosomiasis haematobia in Wenzhou city.

    Investigation on the status of Clonorchis sinensis infection in Xinfeng County, Jiangxi Province, China
    HUANG Qi, JIANG Wei-sheng, YAN Yue-kang, CHEN Zhe, XIONG Yan-feng, YANG Yu-hua, WANG Shou-shan
    2020, 38(5):  670-673.  doi:10.12140/j.issn.1000-7423.2020.05.025
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    According to the geographical location and eating habits of residents, Xinfeng County was divided into areas of eating and non-eating raw fish. From each area, two townships were randomly selected, and then one administrative village was selected from each township for conducting the survey. Fecal samples of examinees were examined using the modified Kato thick smear method (two slide-reading/one sample), and questionnaire survey was performed for the residents to collect information on the awareness of clonorchiasis knowledge and the behavior of eating raw freshwater fish. During 2014-2015, a total of 1 376 villagers were investigated, and the total infection rate of C. sinesis was 11.70% (161/1 376). The infection rate in the area of eating raw fish (21.18%, 122/576) was significantly higher than in the area of non-eating raw fish (4.88%, 39/800) (P < 0.01); in males (19.07%, 131/687) than in females (4.35%, 30/689) (P < 0.01). The infection rate was highest at age 70 years and above among all age groups (22.50%, 18/80), and showed a trend of increasing with age (P < 0.01). Among groups of different education levels, the infection rate was highest among people with the education of junior college and higher (39.53%, 17/43), and showed a trend of higher with increased education (P < 0.01). Among different occupations, the public servants had the highest infection rate(51.02%, 25/49), and there was a significant difference among the different occupation groups (P < 0.01). A total of 283 people were surveyed with questionnaire, of them 69.61% (197/283) knew that eating raw fish would cause clonorchiasis, and 30.74% (87/283) of the respondents had the behavior of eating raw freshwater fish and shrimps. The area of eating raw fish had a significantly lower awareness rate (66.00%, 72/120) and a significantly higher behavioral rate (40.00%, 48/120) compared with the area of non-eating raw fish (76.69%, 125/163; 23.93%, 39/1 63). The results suggest that the Xinfeng County of Ganzhou City, Jiangxi Province is an area with frequent occurrence of clonorchiasis. Health education and comprehensive prevention and control measures of population-based deworming should be actively carried out to change the habits of eating raw fish and reduce the infection rate of C. sinensis among the villagers.