[Laboratory diagnosis of an imported case of visceral leishmaniasis in Henan Province].

OBJECTIVE: To analyze the epidemiological and clinical data of an imported case of visceral leishmaniasis in Henan Province, and explore the method of laboratory diagnosis of kala-azar. METHODS: The epidemiological and clinical data of an imported visceral leishmaniasis patient were analyzed. Leishmania donovani bodies in bone marrow smears were observed microscopically. The antibody was detected by using rK39 dipstick test strips. Two pairs of specific primers, K13A-K13B and LITSR-L5.8S, were used to amplify kinetoplast DNA and internal transcribed spacer of rDNA of the parasite, respectively. RESULTS: The patient had been in the epidemic area of visceral leishmaniasis, and had symptoms such as irregular fever, splenomegaly, pancytopenia, and inversed ratio of albumin and globulin. The amastigotes of L. donovani were found in the bone marrow smears, and rK39 test strip was positive, and the PCR products of K13A-K13B and LITSR-L5.8S were 87 bp and 285 bp respectively. The similarities of the two fragment sequences to the corresponding sequences of L. donovani were 94% and 100%, respectively. CONCLUSIONS: The case is diagnosed as visceral leishmaniasis according to the epidemiological data, clinical manifestations and laboratory test results of the patient, and the pathogen is L. donovani.

[Investigation on human intestinal parasitic diseases in ecological regions of Qinba Mountains in Henan Province in 2015].

OBJECTIVE: To understand and analyze the epidemic status of human intestinal parasitic diseases in the ecological region of the Qinba Mountains in Henan Province, so as to provide the evidence for the control of the diseases in this region. METHODS: According to the methods of National Survey Scheme on Major Human Parasitic Diseases, 26 survey spots were selected in 8 counties (cities) in ecological regions of Qinba Mountains in Henan Province in 2015. After collecting the human fecal samples, the eggs of intestinal helminthes were detected with the modified Kato-Katz thick smear method, the species of Ancylostoma of the hookworm egg-positive samples were identified with the tube fecal culture method, the eggs of Enterobius vermicularis were detected by using the adhesive tape method in children aged 3 to 6 years, and the cyst and trophozoite of intestinal protozoa were examined by iodine staining. The infections of intestinal parasites in different populations and the related influencing factors were analyzed. RESULTS: Totally 6 706 residents were recruited in this study, 8 kinds of parasites were found including 3 species of helminthes and 5 species of protozoans. The overall infection rate of intestinal parasites was 3.39%, covering 2.92% for helminthes and 0.49% for protozoans. The infection rate of E. vermicularis in children aged 3 to 6 years was 3.93%. The 3 identified helminthes were Ascaris lumbricoides, E. vermicularis, and Dicrocoelium dendriticum, with the highest infection rate of E. vermicularis (2.68%, χ2 = 306.362, P < 0.05). The 5 identified protozoans were Entamoeba hartmani, E. coli, Endolimax nana, Giardia lamblia, and Blastocystis hominis, and the infection rate of E. nana was the highest (χ2 = 23.842, P < 0.05). Among the 8 counties (cities), the highest infection rate of helminthes, mainly with Enterobius infection, existed in Ruyang County, and the infection rate of protozoans in Xin'an County was the highest, mainly with E. nana infection. There was a significant difference in the infection rates of helminthes and protozoans among the 8 counties (cities) (helminthes: χ2 = 357.525, P < 0.05; protozoans: χ2 = 38.795, P < 0.05). There was no significant difference in the helminth infection rate between males and females ( χ2 = 0.034, P > 0.05), but the protozoan infection rate of the males was higher than that of the females ( χ2 = 12.946, P < 0.05). The helminth infection rate of the 0-9 years old group was the highest ( χ2 = 62.600, P < 0.05), up to 6.60%, mainly with E. vermicularis infection. There was no significant difference in the infection rate of intestinal parasites among nationalities ( χ2 = 0.212, P > 0.05). The helminth infection rate of preschool children was the highest and up to 8.43%, mainly with E. vermicularis infection. The infection of A. lumbricoides was mainly happened among farmers, with the infection rate of 0.31%. There was a significant difference in the helminth infection rate among different occupations (χ2 = 84.333, P < 0.05). The intestinal parasites infection rate of the illiterate population was the highest and up to 7.63%, there was a significant difference among the populations with different educational levels (χ2 = 72.013, P < 0.05). The helminth infection rate of plain areas was higher than that of valley and hill ( χ2 = 11.690, P < 0.05). The helminth infection rate of people with low-income was the highest and up to 10.32% (χ2 = 244.999, P < 0.05). The protozoan infection rate of people with middle-income was the highest, who had the annual per capita net income of 6 000 to 7 999 Yuan ( χ2 = 24.749, P < 0.05). The helminth infection rate of people drinking well water was much higher than that of people drinking tap water (χ2 = 62.255, P < 0.05). The protozoan infection rate of people without insect repellent was higher than that of people with insect repellent (χ2 = 5.235, P < 0.05). CONCLUSIONS: The infection rates of human intestinal parasites in the ecological region of the Qinba Mountains in Henan Province have decreased sharply. E. vermicularis infection in children should be the main point of prevention and treatment of parasitic diseases in the future.

[Monitoring results of soil-transmitted nematodiasis in national surveillance site of Huaiyang County in Henan Province, 2006-2015].

OBJECTIVE: To understand the epidemic situation of soil-transmitted nematodiasis in the national surveillance site in Henan Province. METHODS: Over 1 000 fecal samples from inhabitants in Huaiyang County of Henan Province, which was a national surveillance site, were collected each year from 2006 to 2015, the eggs of soil-transmitted nematodes and other intestinal helminths were examined by Kato-Kats technique. The cellophane swab method was used to detect Enterobius vermicularis eggs in children aged 3 to 12 years. In addition, the soil samples were collected from vegetable fields, lavatories, courtyards and kitchens of 10 families randomly selected in each year to examine Ascaris eggs by a modified saturated sodium nitrate floatation method. RESULTS: From 2006 to 2015, 10 419 persons were investigated, and the eggs of five species of intestinal helminths, Ascaris lumbricoides, Trichuris trichiura, hookworm, E. vermicularis, and Trichostrongylus orientalis, were detected, The average infection rate of soil-transmitted nematodes in residents in Huaiyang County was 3.69%. The intensity of infection was mild and a family clustering was obvious. Both the infection rates of E. vermicularis in children and soil-transmitted nematodes in villagers had no significant differences between different genders (both P＞0.05). The infection rates of soil-transmitted nematodes, A. lumbricoides and E. vermicularis all reached the highest in the age group of 1-10 years. For different education back-ground, the people with primary school education had the highest infection rate, and the infection rate showed a decreasing trend with the increase of the educational level. The infection rate of soil-transmitted nematodes in the national surveillance site in Henan Province showed a decreasing trend from 2006 to 2015. Unfertilized and fertilized A. lumbricoides eggs were detected in the soil samples, but the positive rate was very low. CONCLUSIONS: In the recent 10 years, the infection rate of soil-transmitted nematodes in the national surveillance site in Henan Province shows a decreasing trend and maintains at a low level. The infection shows a family clustering. The children, especially those aged 3-9 years are the main infected population, and E. vermicularis infection is the key point of prevention and control.

[Survey and analysis of epidemic status of principal human parasitosis in ecological region of Huaiyang hills of Henan Province in 2015].

OBJECTIVE: To understand the epidemic status of principal human parasitosis in the ecological region of Huaiyang hills of Henan Province. METHODS: According to the scheme of The 3rd National Survey of Principal Human Parasites made by National Institute of Parasitic Diseases, the survey was performed based on the ecological regions. The stratified cluster sampling was made combined with the economic and geographical conditions. The infections of intestinal helminths and protozoans in permanent residents were respectively detected by Kato-Kats technique and iodine solution. Trichuris trichiura infection was detected by the cellophane swab method in children aged 3 to 6 years. RESULTS: Totally 6 710 residents in 26 survey spots from 9 counties were detected, in which 528 children aged 3 to 6 years were detected for T. trichiura infection. Eleven kinds of parasites were found in this survey, including 5 species of helminthes and 6 species of protozoans. The infection rates of overall parasites, helminthes and protozoans were respectively 1.65%, 1.07% and 0.61%. The infection rate of T. trichiura in the children aged 3 to 6 years was 3.79%. Only 0.10 percent of the infections were co-infection, and all were infected by 2 kinds of parasites. The principal parasites in this district were Ascaris lumbricoides (0.31%), Blastocystis hominis (0.28%) and hookworm (0.27%). The T. trichiura infection rate among children was 3.79% by the cellophane swab method. The infections of protozoans were found in all age groups. In the group aged 9 years and below, the maximum kinds of parasites were found. CONCLUSIONS: The infection rates of principal human parasites in Huaiyang hilly ecological region of Henan have decreased sharply, but more efforts still should be paid on the prevention and control of parasitosis in children.

Treatment of soft tissue defects in the heels of children in an emergency setting.

Reverse flow sural flap (RFSF) and vacuum sealing drainage (VSD) have been used to cover soft tissue defects in the heels of children in medical emergency settings. We report a retrospective case series, including a total of 19 children with soft tissue defects in heels resulting from spokes injury. In six patients, soft tissue defects in the heel were covered with RFSF. Further, in 13 patients, the defects were covered with VSD, in seven patients defects were repaired using free skin, and in six patients defects were repaired using RFSF after VSD. All wounds in the donor and recipient areas healed by first intention, and all free skins or island flaps completely survived; the color and luster on reconstructed areas were perfect. Patients were followed up for about 3-30 months, without osteomyelitis and infection in the heel, and the functions of the heel were satisfactory. RFSF and VSD were both advantageous, and were ideal for covering heel defects in children in emergency settings.

[Investigation and analysis of overseas imported malaria prevalence in Henan Province from 2012 to 2014].

OBJECTIVE: To understand the epidemic characteristics of imported malaria in Henan Province from 2012 to 2014, so as to provide the evidence for proposing the reasonable suggestions for imported malaria prevention and control. METHODS: The data of imported malaria were collected and the epidemic characteristics were analyzed in Henan Province from 2012 to 2014. RESULTS: A total of 569 imported malaria cases were reported in Henan Province from 2012 to 2014, including 445 cases of falciparum malaria, 48 cases of vivax malaria, 61 cases of ovale malaria, 14 cases of quartan malaria, and 1 case of mixed infection. All the malaria cases were confirmed in laboratory. During the three years, the time of higher incidence was in Spring Festival, and May and June, and the cases mainly distributed in Luoyang, Zhengzhou, Puyang, Xinxiang, Anyang, Xuchang and Nanyang cities, accounting for 68.54%. Totally 82.43% of the patients were male youth and middle-aged. Of the 569 patients, 534 (93.85%) returned from Africa and 35 (6.15%) returned from Southeast Asian countries. The average time was 6.22 d and the median was 4 d from the onset to diagnosis. Among 569 cases, 290 (50.97%) were confirmed by different levels of centers for disease prevention and control, and 279 (49.03%) were diagnosed by different levels of medical institutions. CONCLUSIONS: The imported malaria cases have been increased obviously in recent 3 years in Henan Province. Therefore, the health education for the knowledge about malaria prevention and control, and the technician training should be strengthened.

[Analysis of malaria death cases in Henan Province from 2010 to 2015].

OBJECTIVE: To retrospectively overview the malaria death cases reported in Henan Province and analyze the cause of death. METHODS: The data including basic information, epidemiological survey and medical records of malaria death cases in Henan Province from 2010 to 2015 were collected and analyzed. RESULTS: In the six years, a total of 14 malaria patients were dead. All the death patients were adult males and imported from Africa. They had definite histories of living in malaria-epidemic areas and the symptoms of fever. Twelve patients were diagnosed as malaria after at least twice diagnoses. The average time from symptom appearing to correct diagnosis was 6.5 d. The causes of deaths were misdiagnosis and delayed treatment. CONCLUSIONS: The major reasons of malaria death cases in Henan Province are the failure of correct diagnosis and prompt treatment. Health education of malaria prevention and diagnosis and treatment training of malaria should be strengthened in order to improve the public awareness and the diagnosis ability of clinical doctors for malaria, which can prevent the death of imported malaria cases.